Conceptualizing mind, body, spirit interconnections through, and beyond, spiritual healing practices.

PubMed

Mark, Glenis; Lyons, Antonia

2014-01-01

Although research is increasingly exploring the concept of the mind, body, spirit (MBS) and its relevance to health and well-being, it remains difficult to precisely define it. This research aims to explore indigenous and non-indigenous spiritual healers' conceptualizations of MBS and consider implications for theory and practice. A total of 12 spiritual healers from Aotearoa/New Zealand participated in a semi-structured interview about their healing practices. The research interview asked participants to discuss how they conceptualized the mind, body, spirit in their work. The data were analyzed using interpretative data analysis. Transcripts of the interviews were analyzed using interpretative phenomenological analysis, which led to the identification of three major themes: MBS interconnections of healing, impacts on the mind and the body, and spiritual aspects of healing. These results are discussed in terms of their implications for concepts of healing and conceptualizations of MBS. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors that influence engagement in collaborative practice

PubMed Central

Herbert, Carol P.; Bainbridge, Lesley; Bickford, Julia; Baptiste, Susan; Brajtman, Susan; Dryden, Trish; Hall, Pippa; Risdon, Cathy; Solomon, Patricia

2007-01-01

OBJECTIVE To generate hypotheses regarding factors that might influence engagement in collaborative practice. DESIGN Qualitative study using in-depth interviews. SETTING Participants interviewed each other in dyads. The pairing was based upon geographical location and proximity to each other. PARTICIPANTS Eight professionals from the disciplines of medicine, nursing, occupational therapy, physical therapy, and massage therapy. METHOD Semistructured interviews, lasting 30 to 45 minutes each, were recorded and transcribed verbatim. The transcripts were read by all research team members using independent content analysis for common words, phrases, statements, or units of text for key themes. At a subsequent face-to-face meeting, the team used an iterative process of comparing and contrasting key themes until consensus was reached. The transcripts were then analyzed further for subthemes using NVivo software. MAIN FINDINGS Initial findings suggest that some common characteristics grounded in family history, school experiences, social interactions, and professional training might influence collaborative practice choices. The narrative form of the interview broke down interpersonal and interprofessional barriers, creating a new level of trust and respect that could improve professional collaboration. CONCLUSION This study suggests that life experiences from childhood into later adulthood can and do influence professional choices. PMID:17872847

Is verbatim transcription of interview data always necessary?

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M

2006-02-01

Verbatim transcription of interview data has become a common data management strategy in nursing research and is widely considered to be integral to the analysis and interpretation of verbal data. As the benefits of verbal data are becoming more widely embraced in health care research, interviews are being increasingly used to collect information for a wide range of purposes. In addition to purely qualitative investigations, there has been a significant increase in the conduct of mixed-method inquiries. This article examines the issues surrounding the conduct of interviews in mixed-method research, with particular emphasis on the transcription and data analysis phases of data management. It also debates on the necessity to transcribe all audiorecorded interview data verbatim, particularly in relation to mixed-method investigations. Finally, it provides an alternative method to verbatim transcription of managing audiorecorded interview data.

School Leadership for Dual Language Education: A Social Justice Approach

ERIC Educational Resources Information Center

DeMatthews, David; Izquierdo, Elena

2016-01-01

This article examines how a dual language program can be developed within the framework of social justice leadership. The authors analyzed principal, teacher, and parent interview transcripts as well as field notes and key documents to understand the role of school leadership in creating inclusive dual language programs to close the Latina/o-White…

Influences of Religion and Culture on Continuing Bonds in a Sample of British Muslims of Pakistani Origin

ERIC Educational Resources Information Center

Hussein, Hanan; Oyebode, Jan R.

2009-01-01

This study considered the nature of continuing bonds with deceased relatives in a sample of Pakistani Muslims living in the United Kingdom. Ten participants were interviewed following a cultural psychology approach and transcripts were analyzed using grounded theory methodology. Dreaming, talking with others about the deceased, following the…

Perspectives of Parent-Child Interaction in Filipino Mothers of Very Young Children with and without Disabilities

ERIC Educational Resources Information Center

Santos, Rosa Milagros; McCollum, Jeanette A.

2007-01-01

This study was designed to expand understandings about Filipino mothers' daily interactions with their infants and toddlers with and without disabilities. Qualitative procedures were used to analyze transcripts from structured, open-ended interviews with mothers of 10- to 26-month-old children. Three themes were used to characterize and compare…

The Psychology of Working: A Case Study of Mexican American Women with Low Educational Attainment

ERIC Educational Resources Information Center

Guerrero, Laura; Singh, Satvir

2013-01-01

Using Blustein's (2006) psychology of working and Hackman and Oldham's (1975) job characteristics theory, the authors investigated the job attribute preferences of Mexican American women with low educational attainment. They used content analysis to code and analyze the interview transcripts of 27 women. The most valued job attributes were not…

"Her Energy Kind of Went into a Different Place": A Qualitative Study Examining Supervisors' Experience of Promoting Reflexive Learning in Students

ERIC Educational Resources Information Center

McCandless, Robert; Eatough, Virginia

2012-01-01

For family therapists in training, a key learning outcome is the development of reflexive abilities. This study explores the experience of three experienced training supervisors as they address this learning outcome with students. Transcripts of semi-structured interviews were analyzed using interpretative phenomenological analysis. The…

Influence of abuse on condom negotiation among Mexican-American women involved in abusive relationships.

PubMed

Davila, Yolanda R

2002-01-01

This study explored cultural and gender perspectives of abuse on condom negotiation behaviors for AIDS prevention among Mexican-American women in abusive intimate relationships. A convenience sample of 20 abused women participated in the study. Data were collected through a demographic questionnaire and audiotaped responses to a semistructured interview guide. Content analysis using QSR NUDIST was used to analyze the verbatim transcriptions of all participant interviews. The predominant category, "He always got his way," was developed in response to the content of the verbatim transcriptions. The category was further expanded to include the self-descriptive subcategories of "He beat me," "He made me feel bad," and "He forced me." Through content analysis, a relationship between abuse by male sexual partners and condom negotiation for AIDS prevention was identified. Trustworthiness of the data collection and analysis was established through methods suggested by Lincoln and Guba.

User experience of lower-limb orthosis.

PubMed

Yang, Bing-Shiang; Chen, Yen-Wan; Tong, Ji-Rou

2017-06-09

If an assistive device is not acceptable to the user, it will not achieve efficacy and would be resource-wasting. This study employed in-depth interviews to understand what users' individual activities of daily living, problems of using orthoses, and considerations for selecting orthoses are. We conducted qualitative interviews with 35 lower-limb orthosis users, and semi-structured interviews were applied in this study. We analyzed the interview data from transcripts, through coding and concepts, to theories based on grounded theory. The results showed that problems of using orthoses are mostly related to activities of daily living of the user and user's expectation. Therefore, in order to enhance its efficacy and use intention, the design and prescribing process of orthoses need to address the problems in the light of activities of daily living and user education.

A Transcription and Translation Protocol for Sensitive Cross-Cultural Team Research.

PubMed

Clark, Lauren; Birkhead, Ana Sanchez; Fernandez, Cecilia; Egger, Marlene J

2017-10-01

Assurance of transcript accuracy and quality in interview-based qualitative research is foundational for data accuracy and study validity. Based on our experience in a cross-cultural ethnographic study of women's pelvic organ prolapse, we provide practical guidance to set up step-by-step interview transcription and translation protocols for team-based research on sensitive topics. Beginning with team decisions about level of detail in transcription, completeness, and accuracy, we operationalize the process of securing vendors to deliver the required quality of transcription and translation. We also share rubrics for assessing transcript quality and the team protocol for managing transcripts (assuring consistency of format, insertion of metadata, anonymization, and file labeling conventions) and procuring an acceptable initial translation of Spanish-language interviews. Accurate, complete, and systematically constructed transcripts in both source and target languages respond to the call for more transparency and reproducibility of scientific methods.

Conglomeration or Chameleon? Teachers' Representations of Language in the Assessment of Learners with English as an Additional Language.

ERIC Educational Resources Information Center

Gardner, Sheena; Rea-Dickins, Pauline

2001-01-01

Investigates teacher representations of language in relation to assessment contexts. Analyzes not only what is represented in teachers' use of metalanguage, but also how it is presented--in terms of expression, voice, and source. The analysis is based on interviews with teachers, transcripts of lessons, and classroom-based assessments, formal…

"Big Loud Voice. You Have Important Things to Say": The Nature of Student Initiations during One Teacher's Interactive Read-Alouds

ERIC Educational Resources Information Center

Maloch, Beth; Beutel, Denise Duncan

2010-01-01

This qualitative study explored the nature of student initiations during interactive read alouds of fiction and non-fiction texts in a second grade, urban classroom. Data sources--including expanded field notes, video/audiotape records and transcripts, and teacher interviews--were analyzed inductively, utilizing the constant comparative method and…

An Examination of Information Security Training and Education for IT Professionals in a Community College: A Case Study

ERIC Educational Resources Information Center

Stark, Adam

2017-01-01

This case study research explored the cybersecurity systems and training and education of IT professionals at a member college of the Florida College System. Thematic analysis was utilized to analyze interview transcripts of 6 respondents. A more descriptive analysis was completed using the survey responses from 15 respondents. From this analysis…

Towards program theory validation: Crowdsourcing the qualitative analysis of participant experiences.

PubMed

Harman, Elena; Azzam, Tarek

2018-02-01

This exploratory study examines a novel tool for validating program theory through crowdsourced qualitative analysis. It combines a quantitative pattern matching framework traditionally used in theory-driven evaluation with crowdsourcing to analyze qualitative interview data. A sample of crowdsourced participants are asked to read an interview transcript and identify whether program theory components (Activities and Outcomes) are discussed and to highlight the most relevant passage about that component. The findings indicate that using crowdsourcing to analyze qualitative data can differentiate between program theory components that are supported by a participant's experience and those that are not. This approach expands the range of tools available to validate program theory using qualitative data, thus strengthening the theory-driven approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

Constraints and Opportunities with Interview Transcription: Towards Reflection in Qualitative Research

PubMed Central

Oliver, Daniel G.; Serovich, Julianne M.; Mason, Tina L.

2006-01-01

In this paper we discuss the complexities of interview transcription. While often seen as a behind-the-scenes task, we suggest that transcription is a powerful act of representation. Transcription is practiced in multiple ways, often using naturalism, in which every utterance is captured in as much detail as possible, and/or denaturalism, in which grammar is corrected, interview noise (e.g., stutters, pauses, etc.) is removed and nonstandard accents (i.e., non-majority) are standardized. In this article, we discuss the constraints and opportunities of our transcription decisions and point to an intermediate, reflective step. We suggest that researchers incorporate reflection into their research design by interrogating their transcription decisions and the possible impact these decisions may have on participants and research outcomes. PMID:16534533

Embodied Transcription: A Creative Method for Using Voice-Recognition Software

ERIC Educational Resources Information Center

Brooks, Christine

2010-01-01

Voice-recognition software is designed to be used by one user (voice) at a time, requiring a researcher to speak all of the words of a recorded interview to achieve transcription. Thus, the researcher becomes a conduit through which interview material is inscribed as written word. Embodied Transcription acknowledges performative and interpretative…

Teaching primary care obstetrics: insights and recruitment recommendations from family physicians.

PubMed

Koppula, Sudha; Brown, Judith B; Jordan, John M

2014-03-01

To explore the experiences and recommendations for recruitment of family physicians who practise and teach primary care obstetrics. Qualitative study using in-depth interviews. Six primary care obstetrics groups in Edmonton, Alta, that were involved in teaching family medicine residents in the Department of Family Medicine at the University of Alberta. Twelve family physicians who practised obstetrics in groups. All participants were women, which was reasonably representative of primary care obstetrics providers in Edmonton. Each participant underwent an in-depth interview. The interviews were audiotaped and transcribed verbatim. The investigators independently reviewed the transcripts and then analyzed the transcripts together in an iterative and interpretive manner. Themes identified in this study include lack of confidence in teaching, challenges of having learners, benefits of having learners, and recommendations for recruiting learners to primary care obstetrics. While participants described insecurity and challenges related to teaching, they also identified positive aspects, and offered suggestions for recruiting learners to primary care obstetrics. Despite describing poor confidence as teachers and having challenges with learners, the participants identified positive experiences that sustained their interest in teaching. Supporting these teachers and recruiting more such role models is important to encourage family medicine learners to enter careers such as primary care obstetrics.

Teaching strategies used by internal medicine residents on the wards.

PubMed

Smith, Dustin T; Kohlwes, R Jeffrey

2011-01-01

Residents serve as teachers to interns and students in most internal medicine residency programs. The purpose of our study is to explore what internal medicine residents perceive as effective teaching strategies in the inpatient setting and to formulate a guideline for preparing residents to lead their ward teams. Housestaff identified as excellent teaching residents were recruited from a large internal medicine residency program. Focus groups were formed and interviews were conducted using open-ended questions. Transcripts of the interviews were reviewed, analyzed, and compared for accuracy by two investigators. The transcripts were then coded to categorize data into similar subjects from which recurrent themes in resident teaching were identified. Twenty-two residents participated in four focus group interviews held in 2008. We identified five principal themes for effective teaching by residents: (T)aking advantage of teaching opportunities, (E)mpowering learners, (A)ssuming the role of leader, (C)reating a learning environment, and (H)abituating the practice of teaching. Strategies for effective teaching by residents exist. The TEACH mnemonic is a resident-identified method of instruction. Use of this tool could enable residency programs to create instructional curricula to prepare their residents and interns to take on the roles of team leaders and teachers.

A conceptual framework for patient-centered fertility treatment.

PubMed

Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Schoyer, Katherine D; Sandlow, Jay; Strawn, Estil Y; Flynn, Kathryn E

2017-09-07

Patient-centered care is a pillar of quality health care and is important to patients experiencing infertility. In this study we used empirical, in-depth data on couples' experiences of infertility treatment decision making to inform and revise a conceptual framework for patient-centered fertility treatment that was developed based on health care professionals' conceptualizations of fertility treatment, covering effectiveness, burden, safety, and costs. In this prospective, longitudinal mixed methods study, we collected data from both members (separately) of 37 couples who scheduled an initial consult with a reproductive specialist. Data collection occurred 1 week before the initial consultation, 1 week after the initial consultation, and then roughly 2, 4, 8, and 12 months later. Data collection included semi-structured qualitative interviews, self-reported questionnaires, and medical record review. Interviews were recorded, transcribed, and content analyzed in NVivo. A single coder analyzed all transcripts, with > 25% of transcripts coded by a second coder to ensure quality control and consistency. Content analysis of the interview transcripts revealed 6 treatment dimensions: effectiveness, physical and emotional burden, time, cost, potential risks, and genetic parentage. Thus, the revised framework for patient-centered fertility treatment retains much from the original framework, with modification to one dimension (from safety to potential risks) and the addition of two dimensions (time and genetic parentage). For patients and their partners making fertility treatment decisions, tradeoffs are explicitly considered across dimensions as opposed to each dimension being considered on its own. Patient-centered fertility treatment should account for the dimensions of treatment that patients and their partners weigh when making decisions about how to add a child to their family. Based on the lived experiences of couples seeking specialist medical care for infertility, this revised conceptual framework can be used to inform patient-centered treatment and research on infertility and to develop decision support tools for patients and providers.

Adult attachment interview, thematic analysis, and communicative style in families with substance use disorder.

PubMed

Anolli, Luigi; Balconi, Michela

2002-02-01

The paper examined the Adult Attachment Interview with special reference to thematic and semantic analysis in line with the discourse study (van Dijk, 1997). The hypothesis was that correspondence between the communicative organization of speech and the mental representations of the attachment experiences would be substantial. Eight Adult Attachment Interview transcripts of fathers with a heroin addicted young son were analyzed at two levels, (a) thematic analysis to individuate the topics of their talk applying the structural and semantic study of discourse and (b) enunciative analysis of speech to define their linguistic patterns utilizing a set of linguistic micro- and macro-units. Results showed nine main topics in the Adult Attachment Interview, each of which was characterized by a distinctive linguistic profile. In this perspective this device seems to be effective not only for discriminating attachment styles between subjects but also to identify differences within subjects belonging to the same attachment pattern.

The Influence of Pastors' Ideologies of Homosexuality on HIV Prevention in the Black Church.

PubMed

Quinn, Katherine; Dickson-Gomez, Julia; Young, Staci

2016-10-01

Young, Black men who have sex with men (YBMSM) are disproportionately affected by HIV, and Black Churches may be a source of stigma which can exacerbate HIV risk and contribute to negative health and psychosocial outcomes. Findings from this study are based on 21 semi-structured interviews with pastors and ethnographic observation in six Black Churches. Interview transcripts and field notes were analyzed in MAXQDA using thematic content analysis. Although pastors espoused messages of love and acceptance, they overwhelmingly believed homosexuality was a sin and had difficulty accepting YBMSM into their churches. The tension around homosexuality limited pastors' involvement in HIV prevention efforts, although there still may be opportunities for some churches.

Exploring family environment characteristics and multiple abuse experiences among homeless youth.

PubMed

Ferguson, Kristin M

2009-11-01

This qualitative study used data from the Social Enterprise Intervention (SEI) pilot study, a comprehensive vocational training program with integrated clinical services for homeless youth. In-depth interviews were conducted with 28 homeless youth participating in the SEI study to explore their perceptions of family environment characteristics and abuse experiences. The constant comparative method was used to analyze transcripts from in-depth interviews with the youth participants. Emergent themes related to family characteristics include home instability, abandonment, and caregiver substance abuse. Abuse-related subthemes include intrafamilial abuse, caregiver abuse, rejection, and deprecation by caregivers. Grounded theory is used to interpret findings and develop working hypotheses to guide future studies of multitype maltreatment among homeless youth.

Perceptions of the Nature and 'Goodness' of Argument among College Students, Science Teachers, and Scientists

NASA Astrophysics Data System (ADS)

Abi-El-Mona, Issam; Abd-El-Khalick, Fouad

2011-03-01

This study aimed to elucidate college freshmen science students, secondary science teachers, and scientists' perceptions of 'scientific' argument; to compare participants' perceptions with Stephen Toulmin's analytical framework of argument; and to characterize the criteria that participants deployed when assessing the 'quality' or 'goodness' of arguments. Thirty students, teachers, and scientists-with 10 members in each group-participated in two semi-structured individual interviews. During the first interview, participants generated an argument in response to a socioscientific issue. In the second interview, each participant 'evaluated' three arguments generated by a member from each participant group without being privy to the arguer's group membership. Interview transcripts were qualitatively analyzed. The findings point to both similarities and differences between participants' conceptions of argument and those based on Toulmin's analytical framework. Participants used an array of common and idiosyncratic criteria to judge the quality or goodness of argument. Finally, contrary to expectations, participants independently agreed that the 'best' arguments were those generated by participant science teachers.

The evaluator as technical assistant: A model for systemic reform support

NASA Astrophysics Data System (ADS)

Century, Jeanne Rose

This study explored evaluation of systemic reform. Specifically, it focused on the evaluation of a systemic effort to improve K-8 science, mathematics and technology education. The evaluation was of particular interest because it used both technical assistance and evaluation strategies. Through studying the combination of these roles, this investigation set out to increase understanding of potentially new evaluator roles, distinguish important characteristics of the evaluator/project participant relationship, and identify how these roles and characteristics contribute to effective evaluation of systemic science education reform. This qualitative study used interview, document analysis, and participant observation as methods of data collection. Interviews were conducted with project leaders, project participants, and evaluators and focused on the evaluation strategies and process, the use of the evaluation, and technical assistance. Documents analyzed included transcripts of evaluation team meetings and reports, memoranda and other print materials generated by the project leaders and the evaluators. Data analysis consisted of analytic and interpretive procedures consistent with the qualitative data collected and entailed a combined process of coding transcripts of interviews and meetings, field notes, and other documents; analyzing and organizing findings; writing of reflective and analytic memos; and designing and diagramming conceptual relationships. The data analysis resulted in the development of the Multi-Function Model for Systemic Reform Support. This model organizes systemic reform support into three functions: evaluation, technical assistance, and a third, named here as "systemic perspective." These functions work together to support the project's educational goals as well as a larger goal--building capacity in project participants. This model can now serve as an informed starting point or "blueprint" for strategically supporting systemic reform.

The Emotional Experience of Motherhood in Planned Lesbian Families in the South African Context: "… Look How Good a Job I'm Doing, Look How Amazing We Are".

PubMed

Van Ewyk, Jacquetta; Kruger, Lou-Marié

2017-01-01

This article focuses on lesbian mothers' emotional experience of motherhood. It forms part of a larger qualitative and exploratory study with 10 lesbian couples in South Africa on their lived experience of planned motherhood. The study is located in a feminist phenomenological framework. Semi-structured interviews were conducted and interview transcripts were analyzed using thematic analysis. Participants described many different emotions associated with new motherhood: hope, joy, love, anxiety, helplessness, exhaustion, and feeling companionship and togetherness as well as feeling compromised and deprived. Mothers described these emotions but also focused on the development of a new identity, that of being a mother.

Childrearing Among Thai First-Time Teenage Mothers

PubMed Central

Sriyasak, Atcharawadee; Åkerlind, Ingemar; Akhavan, Sharareh

2013-01-01

The aim of this study is to explore and describe the experiences of being a teenage mother and taking care of infants less than 6 months of age. Ten teenage mothers were interviewed. Latent content analysis was used to analyze interview transcripts with the teenage mothers. It was found that previous childrearing experiences and social support were important factors in determining how teenage mothers adapted to being a mother and how they practiced infant care. Becoming a mother created feelings of responsibility in the maternal role and led to affection toward their babies. Nevertheless, teenage mothers appreciated the help they received from their families and health-care providers. Instruction and assistance with infant care built self-confidence in the maternal role and in childrearing. PMID:24868133

Contingency interaction analysis in psychotherapy.

PubMed

Canfield, M L; Walker, W R; Brown, L G

1991-02-01

This article introduces (a) a computerized coding procedure that rates words and utterances in terms of emotion, cognition, and contract and (b) a contingency method of analyzing verbal interactions. Using transcripts of sessions conducted by 3 master therapists with 1 client, the rating procedure and contingency correlation analyses supported the study's hypotheses. Therapists' utterances were characterized by significantly different amounts of emotion, cognition, and contracts, indicating that communication styles varied in the relative emphasis placed on these attributes. Differences suggest that the therapists responded differently to emotional, cognitive, and contract utterances and that the client's responses were different across the 3 therapist interviews. Split halves of the interviews within therapists and within client sessions were not different, providing further evidence of reliability of the coding and contingency procedures.

The influence of pastors’ ideologies of homosexuality on HIV prevention in the Black Church

PubMed Central

Quinn, Katherine; Dickson-Gomez, Julia; Young, Staci

2016-01-01

Young, Black men who have sex with men (YBMSM) are disproportionately affected by HIV and Black churches may be a source of stigma which can exacerbate HIV risk and contribute to negative health and psychosocial outcomes. Findings from this study are based on 21 semi-structured interviews with pastors and ethnographic observation in six Black Churches. Interview transcripts and field notes were analyzed in MAXQDA using thematic content analysis. Although pastors espoused messages of love and acceptance, they overwhelmingly believed homosexuality was a sin and had difficulty accepting YBMSM into their churches. The tension around homosexuality limited pastors’ involvement in HIV prevention efforts, although there still may be opportunities for some churches. PMID:27099095

Investigators’ Successful Strategies for Working with Institutional Review Boards

PubMed Central

Cartwright, Juliana C.; Hickman, Susan E.; Nelson, Christine A.; Knafl, Kathleen A.

2014-01-01

This study was designed to identify successful strategies used by investigators for working with their Institutional Review Boards (IRBs) in conducting human subjects research. Telephone interviews were conducted with 46 investigators representing nursing, medicine, and social work. Interview transcripts were analyzed using qualitative descriptive methods. Investigators emphasized the importance of intentionally cultivating positive relationships with IRB staff and members, and managing bureaucracy. A few used evasive measures to avoid conflict with IRBs. Few successful strategies were identified for working with multiple IRBs. Although most investigators developed successful methods for working with IRBs, further research is needed on how differences in IRB culture affect human subjects protection, and on best approaches to IRB approval of multi-site studies. PMID:23813748

Development of a Patient-Reported Outcome Instrument to Evaluate Symptoms of Advanced NSCLC: Qualitative Research and Content Validity of the Non-Small Cell Lung Cancer Symptom Assessment Questionnaire (NSCLC-SAQ)

PubMed Central

Atkinson, Thomas M.; DeBusk, Kendra P.A.; Liepa, Astra M.; Scanlon, Michael; Coons, Stephen Joel

2016-01-01

PURPOSE To describe the process and results of the preliminary qualitative development of a new symptom-based PRO measure intended to assess treatment benefit in advanced non-small cell lung cancer (NSCLC) clinical trials. METHODS Individual qualitative interviews were conducted with adult NSCLC (Stage I–IV) patients in the US. Experienced interviewers conducted concept elicitation (CE) and cognitive interviews using semi-structured interview guides. The CE interview guide was used to elicit spontaneous reports of symptom experiences along with probing to further explore and confirm concepts. Interview transcripts were coded and analyzed by professional qualitative coders using Atlas.ti software, and were summarized by like-content using an iterative coding framework. Data from the CE interviews were considered alongside existing literature and clinical expert opinion during an item-generation process, leading to development of a preliminary version of the NSCLC Symptom Assessment Questionnaire (NSCLC-SAQ). Three waves of cognitive interviews were conducted to evaluate concept relevance, item interpretability, and structure of the draft items to facilitate further instrument refinement. FINDINGS Fifty-one patients (mean age 64.9 [SD=11.2]; 51.0% female) participated in the CE interviews. A total of 1,897 expressions of NSCLC-related symptoms were identified and coded in interview transcripts, representing approximately 42 distinct symptom concepts. A 9-item initial draft instrument was developed for testing in three waves of cognitive interviews with additional NSCLC patients (n=20), during which both paper and electronic versions of the instrument were evaluated and refined. Participant responses and feedback during cognitive interviews led to the removal of 2 items and substantial modifications to others. IMPLICATIONS The NSCLC-SAQ is a 7-item PRO measure intended for use in advanced NSCLC clinical trials to support medical product labelling. The NSCLC-SAQ uses a 7-day recall period and verbal rating scales. It was developed in accordance with the FDA’s PRO Guidance and scientific best practices, and the resulting qualitative interview data provide evidence of content validity. The NSCLC-SAQ has been prepared in both paper and electronic administration formats and a tablet computer-based version is currently undergoing quantitative testing to confirm its measurement properties and support FDA qualification. PMID:27041408

Mainstream Teachers' Experiences of Communicating with Students with Multiple and Severe Disabilities

ERIC Educational Resources Information Center

De Bortoli, Tania; Balandin, Susan; Foreman, Phil; Arthur-Kelly, Michael; Mathisen, Bernice

2012-01-01

The aim of this study was to explore regular teachers' perceptions and experiences of supports and obstacles to communicative interactions for students with multiple and severe disabilities (MSD). Five teachers of students with MSD participated in two in-depth interviews. Interview transcripts were analysed using content analysis. Transcripts were…

More normal than not: a qualitative assessment of the developmental experiences of gay male youth.

PubMed

Eccles, Thomas A; Sayegh, M A; Fortenberry, J D; Zimet, G D

2004-11-01

To examine gay youth experiences within the context of normal adolescent development. Thematic analyses of interviews with 13 self-identified gay male youth, aged 16-22 years, each reporting minimal sexual identity distress, were completed. Interviews focused on: (a) descriptions of developmental changes perceived to occur for all adolescents, (b) descriptions of the participants' developmental experience, and (c) participants' direct comparisons of their perceptions of gay and nongay developmental experience. Data were analyzed by two investigators who, after initial review of the interview transcripts, developed a unified coding template to permit systematic analysis of the transcripts for recurrent themes. (a) Few (2 of 13) participants reported overall developmental experience markedly different from nongay peers. (b) Peer interaction was seen as the domain most different from that of nongay peers. (c) Open gay self-identification altered, generally positively, all peer interaction. (d) Increased peer interaction enhanced maturity in other domains. (e) Family dynamics were not substantively altered by open gay self-identification. (f) Middle and high school were identified as relatively hostile environments in which to openly identify as gay, affecting the timing and the extent of self-disclosure. (g) Developmental progress showed asynchrony across developmental domains. General developmental dysfunction is not inevitable for gay adolescents, nor is identifiable personal or family pathology directly related to sexual identity.

Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

PubMed Central

Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

2013-01-01

Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369

Transcripts of Oral Histories for An Ethnohistory of the Westport-Norwalk Area from 1900 to Today.

ERIC Educational Resources Information Center

Westport-Weston Arts Council, CT.

Transcripts are presented of interviews with 20 individuals of various ethnic backgrounds who live in the Westport-Norwalk, Connecticut, area. The document is part of a project to investigate the ethnically varied cultural, heritage of the Westport-Norwalk area from 1900 to 1979. Persons interviewed are identified by ethnic group, including…

Women Physicians: Choosing a Career in Academic Medicine

PubMed Central

Borges, Nicole J.; Navarro, Anita M.; Grover, Amelia C.

2011-01-01

Purpose Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on a career in academic medicine. Method In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose an academic medicine career. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data. Results Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clincial medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing phyisican, fellow, resident, or medical student. Conclusions Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people—be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering acadmic medicine chose this after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather it was serendipitous or circumstantial. PMID:22104052

Women physicians: choosing a career in academic medicine.

PubMed

Borges, Nicole J; Navarro, Anita M; Grover, Amelia C

2012-01-01

Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on careers in academic medicine. In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose academic medicine careers. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data. Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clinical medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing physician, fellow, resident, or medical student. Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people-be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering academic medicine chose to do so after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather, it was serendipitous or circumstantial.

Transcription Tales or Let Not Love's Labour Be Lost

ERIC Educational Resources Information Center

Downs, Yvonne

2010-01-01

Drawing heavily on my MA dissertation but influenced by subsequent transcription experience, I relate how a technical problem in the recording of an interview necessitated deliberations on the nature and purpose of transcription that continue to have repercussions for my transcription practice and, furthermore, for my understanding of research as…

Parenting styles and parents' perspectives on how their own emotions affect the functioning of children with autism spectrum disorders.

PubMed

Zhou, Ting; Yi, Chunli

2014-03-01

The grounded theory method was used to analyze the parenting styles used by caregivers to rear children with autism spectrum disorders (ASD) and to investigate parents' experiences regarding how to help their child overcome the symptoms. Thirty-two parents from 28 families of children with ASD in mainland China were interviewed. Analysis of interview transcripts revealed four patterns of parenting styles which varied in affiliation to the roles of caretaker and coach. Based on their experience, a sizable group of parents perceived that their own emotions influence the child's emotions and his/her symptoms. The results suggest the value of developing intervention programs on emotion regulation and positive parenting for the parents of children with ASD. © 2014 FPI, Inc.

On Sinking and Swimming: The Dialectic of Hope, Hopelessness, and Acceptance in Terminal Cancer

PubMed Central

Sachs, Emily; Kolva, Elissa; Pessin, Hayley; Rosenfeld, Barry; Breitbart, William

2016-01-01

For terminally ill cancer patients, hope and hopelessness are constructs that significantly impact the quality of life. The aim of this study was to examine the relationship between hope and hopelessness in advanced cancer and to identify factors that maintain hope and increase vulnerability to hopelessness. Semistructured interviews were conducted with 22 terminally ill cancer patients. Interview transcripts were analyzed using thematic content analysis to identify patient definitions of these terms and associated cognitions and emotions. Hope and hopelessness were identified as distinct, often co-occurring, and dialectically interacting constructs. The relationship between hope and hopelessness often balanced on acceptance, perceived as diametrically opposed to hopelessness, and conducive to redirecting hope toward new goals. Positive interpersonal relationships enhanced hope, and uncontrolled physical pain increased vulnerability to hopelessness. PMID:22556280

The experiences of security industry contractors working in Iraq: an interpretative phenomenological analysis.

PubMed

Messenger, Katy; Farquharson, Lorna; Stallworthy, Pippa; Cawkill, Paul; Greenberg, Neil

2012-07-01

To explore the occupational experiences of private security contractors working in a war zone and how it impacts on their mental health. Semistructured interviews were conducted with seven contractors employed by a large UK-based private security company. Interpretative phenomenological analysis was used to analyze the interview transcripts. Participants also completed the 12-item General Health Questionnaire and the Posttraumatic Stress Disorder Checklist. Four overarching themes emerged: the appeal of the job; vulnerability; keep going; and seeking help for stress in the workplace. No clinically significant levels of distress were reported. Contractors are frequently exposed to stressors known to increase risk of psychiatric difficulty in military personnel. A number of potential protective factors were identified. Only a minority of participants were open to seeking help for mental health difficulties.

Communicating with parents of the newborn with intersex: transcript of an interview.

PubMed

Lee, Peter A; Money, John

2004-07-01

The following is the actual transcript of an interview with a father whose child, who had a severe micropenis, was 3 weeks of age. The diagnosis had not yet been made, and a decision concerning sex of rearing had not yet been made. This text illustrates numerous important issues concerning communications with parents of infants with intersex.

A Haiku Suite: The Importance of Music Making in the Lives of Secondary School Students

ERIC Educational Resources Information Center

Prendergast, Monica; Gouzouasis, Peter; Leggo, Carl; Irwin, Rita L.

2009-01-01

This study offers an arts-based a/r/tographic inquiry using poetic transcription and representation of interviews conducted with a co-educational group of 14 students in a West Vancouver, British Columbia secondary school rhythm and blues band class. The decision to translate and analyse the interview transcripts into the Japanese poetry form of…

Using the Child's Testimony in Defending the Alleged Child Molester.

ERIC Educational Resources Information Center

Castro, Carolyn D.

Analysis of the transcript of a social worker's interview with a five-and-a-half-year-old girl allegedly sexually abused by a man focuses on how the interview was conducted and elements that suggest it should not be used as testimony. First, inconsistencies in the transcript that cast doubt on the child's reliability are noted, and the truth of…

Interviews as Historical Evidence: A Discussion of New Standards of Documentation and Access.

ERIC Educational Resources Information Center

Ritchie, Donald A.; And Others

1991-01-01

Presents a discussion of the documentation of and access to interviews for historical research purposes. Examines problems of documentation, transcription, permission, and storage. Presents questions of property, professional ethics, and witnesses. Argues for interview guidelines, training of researchers for interviewing, and taping of interviews.…

Strategic Planning towards a World-Class University

NASA Astrophysics Data System (ADS)

Usoh, E. J.; Ratu, D.; Manongko, A.; Taroreh, J.; Preston, G.

2018-02-01

Strategic planning with a focus on world-class university status is an option that cannot be avoided by universities today to survive and succeed in competition as a provider of higher education. The objective of this research is to obtain exploratory research results on the strategic plans of universities that are prepared to generate world-class university status. This research utilised exploratory qualitative research method and data was collected by in-depth interviews method. Interview transcripts were analyzed by using thematic content analysis through NVivo software analysis and manual systems. The main finding of interview shows that most interviewees agreed that UNIMA has been engaged in strategic planning. Contribution from faculties and schools are acknowledged and inform the planning process. However, a new model of strategic planning should be adopted by UNIMA due to the shift towards a “corporate university”. The finding results from documents, literature review and interview were the addition of world-class university characteristics and features to current strategic planning of UNIMA and how to upgrade by considering to use the characteristics and features towards world-class university.

"I'm Just Forgetting and I Don't Know Why": Exploring How People Living With HIV-Associated Neurocognitive Disorder View, Manage, and Obtain Support for Their Cognitive Difficulties.

PubMed

Terpstra, Alexander R; Worthington, Catherine; Ibáñez-Carrasco, Francisco; O'Brien, Kelly K; Yamamoto, Aiko; Chan Carusone, Soo; Baltzer Turje, Rosalind; McDougall, Patrick; Granger, William; Thompson, Victor; DeSousa, Maureen; Creal, Liz; Rae, Allan; Medina, Claudia; Morley, Elizabeth; Rourke, Sean B

2018-05-01

HIV-associated neurocognitive disorder (HAND) is common, but the lived experience of HAND is not well-understood. In this descriptive qualitative study, we explored how adults with HAND view, manage, and obtain support for cognitive difficulties. We interviewed 25 participants (20% female; median age = 51 years) who were diagnosed with HAND using neuropsychological assessment and a clinical interview. Semistructured interviews, co-developed with community members living with HIV, focused on how cognitive difficulties manifested and progressed, impacted well-being, and were discussed with others. We analyzed interview transcripts using a team-based, thematic approach. Participants described concentration, memory, and multitasking difficulties that fluctuated over time, as well as potential risk factors, management strategies, and psychosocial consequences. They reported they seldom discussed cognitive impairment with health care professionals, and that receiving a HAND diagnosis was validating, informative, yet somewhat disconcerting. Conversations between health care professionals and people living with HIV about HAND may provide opportunities for education, assessment, and support.

Perceptions of Primary Care-Based Breastfeeding Promotion Interventions: Qualitative Analysis of Randomized Controlled Trial Participant Interviews

PubMed Central

Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-01-01

Abstract Objective This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. Subjects and Methods A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Results Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Conclusions Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates. PMID:22621223

Perceptions of primary care-based breastfeeding promotion interventions: qualitative analysis of randomized controlled trial participant interviews.

PubMed

Andaya, Elise; Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-12-01

This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates.

Oral History Interview Transcripts Tombigbee Historic Townsites Project. Volume 1 (Interview Numbers 100-102).

DTIC Science & Technology

1981-01-01

interviews’ content and flavor . In keeping with this policy, all transcripts were edited for clarity of script. For the most part, editing consisted of...There’s nothing better than flavoring your liquor with white oak. The longer you kept it the better it was supposed to be. There used to be beautiful white...It made for a very good flavor , but it had so many bones. The bones were not like a channel cat or a trout or any of the fish like that. The bones

Using Multiple Interviewers in Qualitative Research Studies: The Influence of Ethic of Care Behaviors in Research Interview Settings

ERIC Educational Resources Information Center

Matteson, Shirley M.; Lincoln, Yvonna S.

2009-01-01

This study considered the methodological implications of a qualitative study that involved two research practitioners as interviewers, one male and one female, who conducted semistructured cognitive interviews with middle school students. During the reading and analysis of interview transcriptions, differences were noted between the interviewers'…

Provoked vestibulodynia-women's experience of participating in a multidisciplinary vulvodynia program.

PubMed

Sadownik, Leslie A; Seal, Brooke N; Brotto, Lori A

2012-04-01

Provoked Vestibulodynia (PVD) is the most common cause of pain with intercourse that affects reproductively aged women. The treatment outcome literature suggests that existing treatments, when administered individually, may have only limited benefits for improving pain, and that multidisciplinary approaches may be more effective for reducing pain and pain-associated distress. A program that offers education, group cognitive behavioral therapy, pelvic floor physiotherapy, and medical appointments was developed and implemented at our hospital site. To explore the experiences of women who participated in the Multidisciplinary Vulvodynia Program (MVP) in order to identify the perceived benefits of this program. Qualitative retrospective study. A semi-structured interview format was used to interview graduates of the MVP. Nineteen women, mean age 30.8 (20-54 years), participated in a one-on-one in-depth interview with a trained interviewer. The key question asked was "What has been the impact of the mvp on your life?" interviews were audio-recorded, transcribed, and qualitatively analyzed for major themes. Content analysis of interview transcripts. Five main themes emerged and included: increased knowledge, gained tools/skills, perceived improved mood/psychological well-being, a sense of validation and support, and an enhanced sense of empowerment. Overall, a multidisciplinary vulvodynia program was perceived as being beneficial for women with PVD. © 2012 International Society for Sexual Medicine.

Imagining the Future: Perspectives Among Youth and Caregivers in the Trans Youth Family Study

PubMed Central

Katz-Wise, Sabra L.; Budge, Stephanie L.; Orovecz, Joe J.; Nguyen, Bradford; Nava-Coulter, Brett; Thomson, Katharine

2016-01-01

Future perspectives of transgender youth and their caregivers may be shaped by knowledge of discrimination and adverse mental health among transgender adults. Qualitative data from the Trans Youth Family Study were used to examine how transgender and gender nonconforming (TGN) youth and their caregivers imagine the youth's future. A community-based sample of 16 families (16 TGN youth, ages 7-18 years, and 29 caregivers) was recruited from two regions in the United States. Participants completed in-person qualitative interviews and surveys. Interview transcripts were analyzed using grounded theory methodology for coding procedures. Analyses yielded 104 higher order themes across 45 interviews, with eight prominent themes: comparing experiences with others, gender affirming hormones, gender affirming surgery, gender norms, questioning whether the youth is really transgender, expectations for romantic relationships, uncertainty about the future, and worries about physical and emotional safety. A conceptual model of future perspectives in TGN youth and caregivers is presented and clinical implications are discussed. PMID:28068129

The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers.

PubMed

Polachek, Alicia J; Wallace, Jean E

2018-03-01

Compassionate work appears paradoxical as it may provide great rewards, but may also come at great costs to care providers. This paper explores the paradox of compassionate work by examining what interactions contribute to compassion satisfaction and what interactions contribute to compassion fatigue. This mixed-methods, cross-sectional study uses qualitative interview data from animal health care providers (N = 20) to identify work interactions that they find satisfying or stressful. Quantitative survey data (N = 572) are used to test hypotheses generated from the interviews regarding predictors of compassion satisfaction and compassion fatigue. Interview transcripts were analyzed using a directed content analysis approach. Survey data were analyzed using ordinary least squares regression. The results highlight the complex nature of compassionate work. As hypothesized, making a difference to animals and building relationships with animal patients and human clients relate to greater compassion satisfaction. Human client barriers to animal care and witnessing client grief relate to greater compassion fatigue, as predicted. None of the predictors relate to less compassion fatigue, but forming relationships with animal patients relates to both greater compassion satisfaction and compassion fatigue. This paper enhances our understanding of provider-client-patient interactions and highlights the paradox of compassionate work.

Analysis of chemistry textbook content and national science education standards in terms of air quality-related learning goals

NASA Astrophysics Data System (ADS)

Naughton, Wendy

In this study's Phase One, representatives of nine municipal agencies involved in air quality education were interviewed and interview transcripts were analyzed for themes related to what citizens need to know or be able to do regarding air quality concerns. Based on these themes, eight air quality Learning Goal Sets were generated and validated via peer and member checks. In Phase Two, six college-level, liberal-arts chemistry textbooks and the National Science Education Standards (NSES) were analyzed for congruence with Phase One learning goals. Major categories of desired citizen understandings highlighted in agency interviews concerned air pollution sources, impact, detection, and transport. Identified cognitive skills focused on information-gathering and -evaluating skills, enabling informed decision-making. A content match was found between textbooks and air quality learning goals, but most textbooks fail to address learning goals that remediate citizen misconceptions and inabilities---particularly those with a "personal experience" focus. A partial match between NSES and air quality learning goals was attributed to differing foci: Researcher-derived learning goals deal specifically with air quality, while NSES focus is on "fundamental science concepts," not "many science topics." Analysis of findings within a situated cognition framework suggests implications for instruction and NSES revision.

New York State Public Health System Response to Hurricane Sandy: Lessons From the Field.

PubMed

Shipp Hilts, Asante; Mack, Stephanie; Eidson, Millicent; Nguyen, Trang; Birkhead, Guthrie S

2016-06-01

The aim of this study was to conduct interviews with public health staff who responded to Hurricane Sandy and to analyze their feedback to assess response strengths and challenges and recommend improvements for future disaster preparedness and response. Qualitative analysis was conducted of information from individual confidential interviews with 35 staff from 3 local health departments in New York State (NYS) impacted by Hurricane Sandy and the NYS Department of Health. Staff were asked about their experiences during Hurricane Sandy and their recommendations for improvements. Open coding was used to analyze interview transcripts for reoccurring themes, which were labeled as strengths, challenges, or recommendations and then categorized into public health preparedness capabilities. The most commonly cited strengths, challenges, and recommendations related to the Hurricane Sandy public health response in NYS were within the emergency operations coordination preparedness capability, which includes the abilities of health department staff to partner among government agencies, coordinate with emergency operation centers, conduct routine conference calls with partners, and manage resources. Health departments should ensure that emergency planning includes protocols to coordinate backup staffing, delineation of services that can be halted during disasters, clear guidelines to coordinate resources across agencies, and training for transitioning into unfamiliar disaster response roles. (Disaster Med Public Health Preparedness. 2016;10:443-453).

Critical Care Nurses' Experiences With Spiritual Care: The SPIRIT Study.

PubMed

Bone, Nigel; Swinton, Marilyn; Hoad, Neala; Toledo, Feli; Cook, Deborah

2018-05-01

Little is known about the effect of chaplains on critical care nurses who are caring for critically ill patients and their families. To understand nurses' experiences when they make a referral to the Spiritual Care Department for a patient or the family of a patient who is dying or deceased. Specific aims were to explore spiritual care's effect on nurses and how nurses understand the role of spiritual care in practice. A qualitative descriptive study using in-person, semistructured interviews in a 21-bed medical-surgical intensive care unit in a teaching hospital. Purposeful sampling identified nurses who had at least 5 years of experience and had cared for at least 5 patients who died on their shift and at least 5 patients for whom they initiated a spiritual care referral. Interviews were digitally recorded and anonymized; conventional content analysis was used to analyze transcripts. Three investigators independently coded 5 transcripts and developed the preliminary coding list. As analysis proceeded, investigators organized codes into categories and themes. A total of 25 nurses were interviewed. The central theme that emerged was presence, described through 3 main categories: the value of having chaplains present in the intensive care unit and their role, nurses' experiences working with chaplains, and nurses' experiences providing spiritual care. Nurses considered spiritual care essential to holistic care and valued the support chaplains provide to patients, families, and staff in today's spiritually diverse society. © 2018 American Association of Critical-Care Nurses.

Transcript of Interview: Mark K. Craig

NASA Technical Reports Server (NTRS)

McCurdy, Howard E.

1992-01-01

This document is a transcript of an interview given by Howard E. McCurdy to Mark K. Craig. Craig gives details on his background including information on his family, education, and career path, his reaction to the news that America was planning to put a man on the Moon, why he thinks we should go to Mars, and the political speeches made at the time of early human space exploration planning.

Hotel housekeeping work influences on hypertension management.

PubMed

Sanon, Marie-Anne

2013-12-01

Characteristics of hotel housekeeping work increase the risk for hypertension development. Little is known about the influences of such work on hypertension management. For this qualitative study, 27 Haitian immigrant hotel housekeepers from Miami-Dade County, FL were interviewed. Interview transcripts were analyzed with the assistance of the Atlas.ti software for code and theme identification. Influences of hotel housekeeping work on hypertension management arose both at the individual and system levels. Factors at the individual level included co-worker dynamics and maintenance of transmigrant life. Factors at the system level included supervisory support, workload, work pace, and work hiring practices. No positive influences were reported for workload and hiring practices. Workplace interventions may be beneficial for effective hypertension management among hotel housekeepers. These work influences must be considered when determining effective methods for hypertension management among hotel housekeepers. © 2013 Wiley Periodicals, Inc.

Optimizing the utility of military injury surveillance systems: a qualitative study within the Australian Defence Force.

PubMed

McKinnon, Adam D; Ozanne-Smith, Joan; Pope, Rodney

2009-05-01

Injury prevention guided by robust injury surveillance systems (ISS's) can effectively reduce military injury rates, but ISS's depend on human interaction. This study examined experiences and requirements of key users of the Australian Defence Force (ADF) ISS to determine whether the operation of the ISS was optimal, whether there were any shortcomings, and if so, how these shortcomings might be addressed. Semistructured interviews were conducted with 18 Australian Defence Department participants located throughout Australia. Grounded theory methods were used to analyze data by developing an understanding of processes and social phenomena related to injury surveillance systems within the military context. Interviews were recorded and professionally transcribed and information contained in the transcripts was analyzed using NVivo. Key themes relating to the components of an injury surveillance system were identified from the analysis. A range of processes and sociocultural factors influence the utility of military ISS's. These are discussed in detail and should be considered in the future design and operation of military ISS's to facilitate optimal outcomes for injury prevention.

Analysis of PGY-1 Pharmacy Resident Candidate Letters of Recommendation at an Academically Affiliated Residency Program.

PubMed

McLaughlin, Milena M; Masic, Dalila; Gettig, Jacob P

2018-04-01

Letters of recommendation (LORs) are a critical component for differentiating among similarly qualified pharmacy residency candidates. These letters contain information that is difficult to ascertain from curricula vitae and pharmacy school transcripts. LOR writers may use any words or phrases appropriate for each candidate as there is no set framework for LORs. The objective of this study was to characterize descriptive themes in postgraduate year 1 (PGY-1) pharmacy residency candidates' LORs and to examine which themes of PGY-1 pharmacy residency candidates' LORs are predictive of an interview invitation at an academically affiliated residency program. LORs for candidates from the Pharmacy Online Residency Centralized Application System (PhORCAS) from 2013 and 2014 for the Midwestern University PGY-1 Pharmacy Residency were analyzed. LOR characteristics and descriptive themes were collected. All scores for candidate characteristics and overall PhORCAS recommendation were also recorded. A total of 351 LORs for 111 candidates from 2013 (n = 47 candidates) and 2014 (n = 64 candidates) were analyzed; 36 (32.4%) total candidates were offered an interview. Themes that were identified as predictors of an interview included a higher median (interquartile range) number of standout words (3 words [1.3-4] vs 3.8 words [2.5-5.5], P < .01) and teaching references (3.7 words [2.7-6] vs 5.7 words [3.7-7.8], P = .01). For this residency program, standout words and teaching references were important when offering interviews.

Music and Deaf Culture: Images from the Media and Their Interpretation by Deaf and Hearing Students.

PubMed

Darrow; Loomis

1999-01-01

The purpose of the study was threefold: (a) to examine how the visual media have portrayed the subject of music and the deaf, (b) to verify the validity of these portrayals with members of the deaf community, and (c) to compare and contrast deaf and hearing audiences' impressions of these portrayals. An additional purpose of the research was to examine the results in light of possible misconceptions that may be construed by music therapists and music educators based upon the media's representation of the relationship between music and deaf culture. Since music therapists and music educators are the primary persons responsible for the music instruction of students in school programs for deaf and hard-of-hearing students, it is particularly important that they receive accurate messages about the relationship of music to deaf culture. Fifty deaf (n = 25) and hearing (n = 25) undergraduate college students individually viewed motion picture and television excerpts related to music and the deaf. Subjects were instructed to take notes as needed regarding the content of each excerpt and their impressions. Students were then interviewed in their native language, English or American Sign Language, as to their interpretations and perceptions regarding these excerpts and their accuracy. Interviews of the deaf students were translated into English from American Sign Language by trained interpreters. Written transcriptions were then made of the interpreters' English translations of the interviews with deaf students and of the verbal interviews with hearing students. Interview transcripts from both groups were coded and analyzed for recurring themes and patterns using content analysis. Data analysis revealed cultural patterns for the two groups, impressions specific to individual subjects, and trends in communication style and content for the two groups. Implications for music therapists and music educators are given regarding the influence of the media, characteristics of deaf culture, and teaching music to deaf students.

Assessment and Next Generation Standards: An Interview with Olivia Gude

ERIC Educational Resources Information Center

Sweeny, Robert

2014-01-01

This article provides a transcript of an interview with Olivia Gude, member of the National Coalition for Core Arts Standards Writing Team. In the interview, Gude provides an overview of the process for writing the new visual arts standards.

Problem solving strategies used by RN-to-BSN students in an online problem-based learning course.

PubMed

Oldenburg, Nancy L; Hung, Wei-Chen

2010-04-01

It is essential that nursing students develop the problem solving and critical thinking skills required in the current health care environment. Problem-based learning has been promoted as a way to help students acquire those skills; however, gaps exist in the knowledge base of the strategies used by learners. The purpose of this case study was to gain insight into the problem solving experience of a group of six RN-to-BSN students in an online problem-based learning course. Data, including discussion transcripts, reflective papers, and interview transcripts, were analyzed using a qualitative approach. Students expanded their use of resources and resolved the cases, identifying relevant facts and clinical applications. They had difficulty communicating their findings, establishing the credibility of sources, and offering challenging feedback. Increased support and direction are needed to facilitate the development of problem solving abilities of students in the problem-based learning environment.

The Clinical Interview and the Measurement of Conceptual Change.

ERIC Educational Resources Information Center

Posner, George J.; Gertzog, William A.

1982-01-01

Discusses the use of the clinical interview in assessing cognitive structure and in investigating conceptual change. They caution much more work is needed to increase the applicability and validity of the clinical interview method and point out that there is a lack of systematization in the analysis of interview transcripts. (Author/PB)

Can Japanese students embrace learner-centered methods for teaching medical interviewing skills? Focus groups.

PubMed

Saiki, Takuya; Mukohara, Kei; Otani, Takashi; Ban, Nobutaro

2011-01-01

Students' perceptions of learner-centered methods for teaching medical interviewing skills have not been fully explored. To explore Japanese students' perceptions of learner-centered methods for teaching medical interviewing skills such as role play with student-created scenarios, peer-assisted video reviews, and student-led small group debriefing. We conducted three focus groups with a total of 15 students who participated in the learner-centered seminars on medical interviewing skills at the Nagoya University School of Medicine. The transcripts were analyzed by two authors independently. Keywords and concepts were identified and a thematic framework was developed. Overall, students valued the experience of writing their own scenarios for role play, but some questioned their realism. Many students commented that peer-assisted video reviews provided them with more objective perspectives on their performance. However, some students expressed concerns about competitiveness during the video reviews. While students appreciated teachers' minimum involvement in the group debriefing, some criticized that teachers did not explain the objectives of the seminar clearly. Many students had difficulties in exchanging constructive feedback. We were able to gain new insights into positive and negative perceptions of students about learner-centered methods for teaching medical interviewing skills at one medical school in Japan.

A qualitative study of work-life balance amongst specialist orthodontists in the United Kingdom.

PubMed

Bateman, Lindsey E; Collins, Joanne M; Cunningham, Susan J

2016-12-01

To identify factors affecting work-life balance amongst male and female orthodontists in the UK. A qualitative interview-based study with a cross-sectional design. Specialist orthodontists working in specialist practice and the hospital service in the UK were selected by purposive sampling. In-depth semi-structured interviews were conducted with 18 orthodontic specialists. Interview transcripts were analyzed using Framework Analysis. Four main themes pertaining to work-life balance in orthodontics were identified: work factors affecting work-life balance, life factors affecting work-life balance, perception and effects of work-life balance and suggestions for managing work-life balance within the profession. There was substantial variation in the work-life balance of the orthodontists interviewed in this study; however the majority reported high levels of career satisfaction despite difficulties maintaining a good work-life balance. Whilst there were some clear distinctions in the factors affecting work-life balance between the hospital environment and specialist practice (including additional professional commitments and teaching/training-related issues), there were also a number of similarities. These included, the lack of flexibility in the working day, managing patient expectations, taking time off work at short notice and the ability to work part-time.

Health and illness concepts among lower income Nicaraguan women.

PubMed

Ailinger, Rita L; Gonzalez, Rose; Zamora, Lidya

2007-03-01

Concepts of health and illness are culturally defined; however, few researchers have reported on these concepts among Latina women. A purposive sample of 14 lower income Nicaraguan women living in a squatter settlement is the focus of this qualitative study. The authors used in-depth, tape-recorded interviews in Spanish to gather data on the women's concepts of health and illness for adults and babies and of health maintenance activities. The authors analyzed the verbatim transcripts and analyzed them for themes. The women's concepts of health and illness included four themes: activities, disposition, eating, and appearance. Health maintenance activities included hygiene and sanitation, medical intervention, nutrition, and the appearance of cleanliness. Nurses and other health care providers will find these themes instructive in developing and providing health services for similar Latina women.

Hotel Housekeeping Work Influences on Hypertension Management

PubMed Central

Sanon, Marie-Anne

2013-01-01

Background Characteristics of hotel housekeeping work increase the risk for hypertension development. Little is known about the influences of such work on hypertension management. Methods For this qualitative study, 27 Haitian immigrant hotel housekeepers from Miami-Dade County, FL were interviewed. Interview transcripts were analyzed with the assistance of the Atlas. ti software for code and theme identification. Results Influences of hotel housekeeping work on hypertension management arose both at the individual and system levels. Factors at the individual level included co-worker dynamics and maintenance of transmigrant life. Factors at the system level included supervisory support, workload, work pace, and work hiring practices. No positive influences were reported for workload and hiring practices. Conclusions Workplace interventions may be beneficial for effective hypertension management among hotel housekeepers. These work influences must be considered when determining effective methods for hypertension management among hotel housekeepers. PMID:23775918

Coping strategies used by national champion figure skaters.

PubMed

Gould, D; Finch, L M; Jackson, S A

1993-12-01

This investigation had two purposes: (a) to identify and describe the coping strategies used by national champion figure skaters and (b) to examine the relationship between coping strategies and particular stress sources. Participants were 17 of 20 (85%) Senior U.S. National Champion figure skaters who won titles between 1985 and 1990. All skaters were interviewed, and the interview transcripts were content analyzed. General coping dimensions reported by at least 40% of the skaters included (a) rational thinking and self-talk, (b) positive focus and orientation, (c) social support (e.g., receiving support from coach, talking with friends and family), (d) time management and prioritization, (e) precompetitive mental preparation and anxiety management (e.g., relaxation, visualization), (f) training hard and smart, (g) isolation and deflection (e.g., not letting things get to me, avoiding/screening media), and (h) ignoring the stressor(s). It was also found that the skaters implemented different coping strategies depending on the specific stressors encountered.

Cancer Worry Among Urban Dominican: A Qualitative Study

PubMed Central

Sepulveda-Pacsi, Alsacia L.; Hiraldo, Grenny; Frederickson, Keville

2017-01-01

Background Two thirds of respondents of a recent survey, primarily self-identified urban immigrant Dominican females, indicated that cancer was the health problem they worried about the most. Purpose The purpose of this qualitative study was to gain a greater understanding of the cancer worry experienced by Dominican women. Design Giorgi’s descriptive existential phenomenological framework and methodology guided the study. Setting: Washington Heights/Inwood community, New York City, New York. Participants Thirty-eight urban Dominican immigrant women were included in the study. Method Data were gathered using focus group interviews. All interviews were digitally recorded, transcribed verbatim from Spanish to English. The transcripts were analyzed using Giorgi’s existential phenomenological data analysis process. Findings Four essences unfolded: Cancer as Destiny, Faith, Influential Relationships and Knowledge Acquisition. Conclusion New knowledge was generated on the contextual factors that influence cancer worry among a major Hispanic subgroup. Implications for nursing research and practice are described. PMID:27758840

The uncertainty room: strategies for managing uncertainty in a surgical waiting room.

PubMed

Stone, Anne M; Lammers, John C

2012-01-01

To describe experiences of uncertainty and management strategies for staff working with families in a hospital waiting room. A 288-bed, nonprofit community hospital in a Midwestern city. Data were collected during individual, semistructured interviews with 3 volunteers, 3 technical staff members, and 1 circulating nurse (n = 7), and during 40 hours of observation in a surgical waiting room. Interview transcripts were analyzed using constant comparative techniques. The surgical waiting room represents the intersection of several sources of uncertainty that families experience. Findings also illustrate the ways in which staff manage the uncertainty of families in the waiting room by communicating support. Staff in surgical waiting rooms are responsible for managing family members' uncertainty related to insufficient information. Practically, this study provided some evidence that staff are expected to help manage the uncertainty that is typical in a surgical waiting room, further highlighting the important role of communication in improving family members' experiences.

Bereaved parents' experiences of music therapy with their terminally ill child.

PubMed

Lindenfelser, Kathryn J; Grocke, Denise; McFerran, Katrina

2008-01-01

The purpose of this study was to investigate bereaved parents' experiences of music therapy with their terminally ill child. In-depth interviews were conducted with 7 bereaved parents who were recruited through a community-based palliative care program. The parent participants' experiences varied as their children who received music therapy ranged in ages from 5 months to 12 years old. The interview transcripts were analyzed using phenomenological strategies. Five global themes emerged from the analysis. These included (a) music therapy was valued as a means of altering the child's and family's perception of their situation in the midst of adversity, (b) music therapy was a significant component of remembrance, (c) music therapy was a multifaceted experience for the child and family, (d) music therapy enhanced communication and expression, and (e) parents shared perceptions of and recommendations for improving music therapy services. These emergent themes yield knowledge into the relevance of music therapy within pediatric palliative care.

Implementing a Just Culture: Perceptions of Nurse Managers of Required Knowledge, Skills and Attitudes.

PubMed

Freeman, Michelle; Morrow, Linda A; Cameron, Margo; McCullough, Karen

2016-01-01

Healthcare organizations have been challenged to create a just culture as part of their culture of safety. To explore perceptions of nurse managers in developing personal competencies in order to enable them to effectively implement a just culture in their units. Qualitative content analysis of semi-structured interviews with nine nurse managers identified themes. Data were independently analyzed by three members of the research team. Analysis of interview transcripts identified the following four themes: need for education of managers and employees, need for a variety of new skills for nurse managers, need to change attitudes from the long-standing punitive culture and fault of individual and challenges in implementation because of time constraints. Implementing a just culture is complex. Education of nurse managers is crucial. A series of educational strategies is recommended. Findings support the need for new competencies to enable nurse managers to effectively implement a just culture in their units.

Problems with science teaching and learning for English Language Learners in one diverse elementary school

NASA Astrophysics Data System (ADS)

Rodriguez, Karen Margaret

This qualitative study centered on science instruction and learning that occurred in a Title I elementary school in a suburban district in southeast Texas. Twelve teachers were interviewed in order to understand their perceptions of their classroom practices in terms of science instruction and learning for English Language Learners (ELL). This study also analyzed information gathered from teacher lesson plan and classroom observations. The participants’ awareness of the instructional practices necessary for ELL student achievement in science was evident through analysis of interview transcripts. However, after observation of actual classroom instruction, it became apparent that the teaching and learning in most classrooms was not reflective of this awareness. This study proposes that this disconnect may be a result of a lack of quality professional development available to the teachers. The study also outlines and describes the characteristics of quality professional development and its relationship to focused instruction and continuous student improvement.

The role of culture and diversity in the prevention of falls among older Chinese people.

PubMed

Horton, Khim; Dickinson, Angela

2011-03-01

This grounded-theory study explored the perceptions of Chinese older people, living in England, on falls and fear of falling, and identified facilitators and barriers to fall prevention interventions. With a sample of 30 Chinese older people, we conducted two focus groups and 10 in-depth interviews in Mandarin or Cantonese. Interview transcripts, back translated, were analyzed using N6. Constant comparative analysis highlighted a range of health-seeking behaviors after a fall: Chinese older people were reluctant to use formal health services; talking about falls was avoided; older people hid falls from their adult children to avoid worrying them; and fatalistic views about falls and poor knowledge about availability and content of interventions were prevalent. Cost of interventions was important. Chinese older adults valued their independence, and cultural intergenerational relations had an impact on taking action to prevent falls. Cultural diversity affects older adults' acceptance of fall prevention interventions.

Barriers to Early Detection of Breast Cancer Among African American Females Over Age of 55

DTIC Science & Technology

2005-02-01

used for data analysis. NUDIST , software for qualitative data analysis will be used for systematic coding. All transcripts, as well as interviewer notes...will be coded in NUDIST . Dr. Smith and Mr. Worts will jointly develop the NUDIST coding system. Each of them will separately code each transcript and...already provided training in NUDIST to Dr. Smith and Mr. Worts. All interviews will be conducted by the Principal Investigator for this study who is

Couple relationships in families with dependent children after a diagnosis of maternal breast cancer in the United Kingdom: Perspectives from mothers and fathers.

PubMed

Corney, Roslyn; Puthussery, Shuby; Swinglehurst, Jane

2016-01-01

This article examines the facilitators and the barriers to couple relationships in families in the UK with dependent children after a diagnosis of maternal breast cancer. Qualitative data were collected through in-depth semi-structured interviews with 23 participants, including 10 couples and three women whose partners did not take part. Recorded interviews were analyzed using a thematic approach identifying themes and patterns in the interview transcripts and categorizing them using a framework. Key individual and contextual factors perceived as barriers or facilitators to couple relationships included: being a "young" family with young children, frustration and resentment from male partners, women's reactions to the illness, individual communication styles, differing needs for "personal space," body image concerns, and social support. Findings indicated the need for strengthening "family focus" in services with adequate support for male partners. Health and family services should consider variability in the experiences of couples with dependent children and be sensitive to the needs of partners alongside the women.

A qualitative study of male dental hygienists' experiences after graduation.

PubMed

Faust, C C

1999-01-01

This report is part of a larger study undertaken in 1996 and 1997 for the author's doctoral dissertation. The study's purpose was to explore the experiences of male dental hygienists--focusing on their experiences before, during, and after graduation. The researcher interviewed 14 practicing male dental hygienists from east of the Mississippi River and one participant from the Midwest. Because of the length of the study, only their experiences following graduation from a dental hygiene program are discussed. Qualitative research methods were used to evaluate the information gained from the interviews, which entails analyzing interview transcripts and developing themes from the data. Four post-graduation themes emerged: participants experienced (1) no job-search difficulties, although some participants experienced minor problems with securing a position, most had little trouble in finding a job; (2) societal gender discrimination, mainly in relation to societal stereotypes about what men and women should do; (3) mixed feelings of acceptance by the profession, although most felt the profession accepting, there were some feelings of not belonging; and (4) career satisfaction, all but one of the participants felt satisfied with his career choice.

Role of food and nutrition in the health perceptions of young children.

PubMed

Singleton, J C; Achterberg, C L; Shannon, B M

1992-01-01

Sixty healthy children, 4 to 7 years of age, were interviewed to evaluate their health perceptions in general and to determine the degree to which they included food and eating behavior in their perceptions. Individual interviews with children incorporated both closed-ended and open-ended questions. Concept maps were used to analyze interview transcripts. The pretest/posttest experimental design randomly assigned children to experimental and control groups. Children in the experimental group completed a 4-week, home-based, nutrition education program to determine the feasibility of changing children's health perceptions with an educational intervention. Pretest and posttest health perception scores were compared by analysis of covariance. Results indicated that children perceived nutrition as a meaningful concept in relation to their health perceptions at pretest, but that after program participation, children significantly increased their perception that health and nutrition were related concepts. Our findings indicate that young children are cognitively ready to learn more about food, nutrition, and health than previously thought, but closed-ended questions may not be sensitive enough to evaluate their learning at this age.

An Interview with Noam Chomsky

ERIC Educational Resources Information Center

Jack, Gavin

2006-01-01

This article presents a transcript of an interview that the author conducted with Noam Chomsky. In this interview, Chomsky talks about language acquisition and his theory of Universal Grammar. He then explains how the USA best exemplifies the individualist national culture. He also cites the challenges researchers should address in intercultural…

77 FR 40341 - Proposed Information Collection; Comment Request; Application for Appointment in the NOAA...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-09

... recommendation, and official transcripts. A personal interview must also be conducted. Eligibility requirements.../erecruit/login.jsp ) and then submit paper forms via mail. An in-person interview is also required. III... of Respondents: 1,800. Estimated Time per Response: written applications, 2 hours; interviews, 5...

Interviews with Allstate.

ERIC Educational Resources Information Center

DiGaetani, John

1982-01-01

Provides transcripts of interviews with various administrators at an insurance company that take into account management problems, needed communication skills, the use of role playing in business communication courses, and the reading/information needs of managers. (HOD)

Difficult Questions of Difficult Questions: The Role of The Researcher and Transcription Styles

ERIC Educational Resources Information Center

Henderson, Holly

2018-01-01

This paper refracts a comparison of three distinct transcription styles through questions of researcher reflexivity. It uses the data from a single question asked by the researcher in multiple interviews for a small empirical project. These data are transcribed in three ways, and the resulting transcripts are discussed in relation to the analysis…

A study of the effectiveness of machine learning methods for classification of clinical interview fragments into a large number of categories.

PubMed

Hasan, Mehedi; Kotov, Alexander; Carcone, April; Dong, Ming; Naar, Sylvie; Hartlieb, Kathryn Brogan

2016-08-01

This study examines the effectiveness of state-of-the-art supervised machine learning methods in conjunction with different feature types for the task of automatic annotation of fragments of clinical text based on codebooks with a large number of categories. We used a collection of motivational interview transcripts consisting of 11,353 utterances, which were manually annotated by two human coders as the gold standard, and experimented with state-of-art classifiers, including Naïve Bayes, J48 Decision Tree, Support Vector Machine (SVM), Random Forest (RF), AdaBoost, DiscLDA, Conditional Random Fields (CRF) and Convolutional Neural Network (CNN) in conjunction with lexical, contextual (label of the previous utterance) and semantic (distribution of words in the utterance across the Linguistic Inquiry and Word Count dictionaries) features. We found out that, when the number of classes is large, the performance of CNN and CRF is inferior to SVM. When only lexical features were used, interview transcripts were automatically annotated by SVM with the highest classification accuracy among all classifiers of 70.8%, 61% and 53.7% based on the codebooks consisting of 17, 20 and 41 codes, respectively. Using contextual and semantic features, as well as their combination, in addition to lexical ones, improved the accuracy of SVM for annotation of utterances in motivational interview transcripts with a codebook consisting of 17 classes to 71.5%, 74.2%, and 75.1%, respectively. Our results demonstrate the potential of using machine learning methods in conjunction with lexical, semantic and contextual features for automatic annotation of clinical interview transcripts with near-human accuracy. Copyright © 2016 Elsevier Inc. All rights reserved.

Systems theory as a framework for examining a college campus-based support program for the former foster youth.

PubMed

Schelbe, Lisa; Randolph, Karen A; Yelick, Anna; Cheatham, Leah P; Groton, Danielle B

2018-01-01

Increased attention to former foster youth pursuing post-secondary education has resulted in the creation of college campus based support programs to address their need. However, limited empirical evidence and theoretical knowledge exist about these programs. This study seeks to describe the application of systems theory as a framework for examining a college campus based support program for former foster youth. In-depth semi-structured interviews were conducted with 32 program stakeholders including students, mentors, collaborative members, and independent living program staff. Using qualitative data analysis software, holistic coding techniques were employed to analyze interview transcripts. Then applying principles of extended case method using systems theory, data were analyzed. Findings suggest systems theory serves as a framework for understanding the functioning of a college campus based support program. The theory's concepts help delineate program components and roles of stakeholders; outline boundaries between and interactions among stakeholders; and identify program strengths and weakness. Systems theory plays an important role in identifying intervention components and providing a structure through which to identify and understand program elements as a part of the planning process. This study highlights the utility of systems theory as a framework for program planning and evaluation.

Feasibility of Using Qualitative Interviews to Explore Patients' Treatment Goals: Experience from Dermatology.

PubMed

Blome, Christine; von Usslar, Kathrin; Augustin, Matthias

2016-06-01

Qualitative interviews are used to assess understandability and content validity of patient-reported outcomes. However, the common approach of asking patients to paraphrase items may not be sufficient to completely reveal item content as understood by patients. We used qualitative interviews to elicit more detailed information about patients' understanding of treatment goal items for the Patient Benefit Index 2.0 (PBI 2.0). This questionnaire measures patient-relevant benefit from treatments for skin diseases by assessing goal importance prior to and goal attainment after treatment. We interviewed 16 patients with psoriasis, atopic dermatitis, leg ulcers, and vitiligo. Patients were asked to elaborate in detail on their understanding of 15 treatment goal items. Subsequently, they were asked to suggest changes in item wording and to name missing treatment goals. Interview transcripts were analyzed according to an adapted approach of content analysis. The task was easy for the patients to understand, and they shared detailed information on what each goal meant to them. Results of the content analysis induced a range of revisions of the PBI 2.0 items, including changes in wording (four items) and item order (two items). Four items were deleted because they were found to be redundant or irrelevant, and one item was added to the list of treatment goals. Asking patients to elaborate on their item understanding in qualitative interviews provided detailed insight into item content and understandability. This method has helped considerably to improve feasibility and content validity of the PBI 2.0.

Identity processes, threat, and interpersonal relations: accounts from British Muslim gay men.

PubMed

Jaspal, Rusi; Cinnirella, Marco

2012-01-01

This study explores identity processes, identity threat, and interpersonal relations with other gay men in a qualitative interview study with a sample of young British Muslim gay men of Pakistani background. Transcripts were subjected to qualitative thematic analysis. Data were analyzed through the interpretive lens of Identity Process Theory. Three superordinate themes are reported: (a) self-continuity and the transition from straight to gay space; (b) interpersonal relations with other gay men and self- and other categorization; and (c) interpersonal contact or identification with White gay men as an identity enhancer. Theoretical and practical implications of the results are discussed.

[The street: a deceitful shelter to the children living in it].

PubMed

Ribeiro, Moneda Oliveira

2003-01-01

The paper focuses on the child in a street situation, through the address by a group of school-age children who used to frequent two public São Paulo city shelters. The purpose was to apprehend its representation on its reality. The data, gathered by means of interviews, were organized and analyzed according to the method of the Analysis of Contents. The thematic theories detached from the speech transcript were grouped into meaningful experiences for the children, among which "the street". The synthesis of the analyzed categories showed clearly that violence permeates the lives of children of/in the street, resulting in experiences that restrict their full development. The street represents a refuge to the child coming from a needy family and also to the one who has a history of abuse from its family.

Financial motivation to work among people with psychiatric disorders.

PubMed

Serowik, Kristin L; Rowe, Michael; Black, Anne C; Ablondi, Karen; Fiszdon, Joanna; Wilber, Charles; Rosen, Marc I

2014-08-01

Supported employment is an effective intervention for people with serious mental illnesses (SMI) but is underutilized. Clients' desire to work might be heightened by programs that provide counseling about managing one's funds, since money management helps people become more aware of the advantages of having money. To analyze the thoughts of recently homeless or hospitalized persons with SMI concerning their personal finances and employment. We interviewed 49 people with SMI about their finances, reviewed transcripts and analyzed their baseline characteristics. Twenty of the 49 participants spontaneously expressed a desire to work in order to earn more money. Those who expressed a desire to work managed their money significantly better than those who did not. Discussion of finances, such as that fostered by money management programs, may promote engagement in vocational rehabilitation and working for pay.

The impact of experience on undergraduate preregistration student nurses' responses to patients in pain: a 2-year qualitative longitudinal study.

PubMed

Mackintosh-Franklin, Carolyn

2014-03-01

The management of pain is consistently reported as a problematic area of practice, with limited evidence of improvements in the past 30 years. This study explores the impact of experience on student nurses' responses to patients in pain. Sixteen volunteers from a cohort of undergraduate student nurses in the U.K. participated in a qualitative longitudinal study that used two semistructured interviews 18 months apart. Interview transcripts were analyzed with the use of thematic content analysis for each individual interview stage and then additionally to identify relationships between each stage. Participants revealed an initial lack of interest in nearly all aspects of pain. At the second stage of interviews, some participants expressed increasing discernment and empathy toward patients in pain, although some continued to have minimal interest. Findings suggest that an active interest in pain is essential so that individuals can react critically to assumptions of the clinical culture they are exposed to. Further research is needed to identify how an active interest can by developed among those students for whom experience has little positive impact. Without active interest, apathy, aversion to change, and continued poor pain management practices are likely to continue. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

A conceptual framework toward identifying and analyzing challenges to the advancement of pharmacy.

PubMed

Bader, Lina R; McGrath, Simon; Rouse, Michael J; Anderson, Claire

Pharmacists and health care professionals are faced with increasing and changing health care needs around the world. To meet these demands, they are required to continuously upgrade and develop their professions. Reprofessionalization is therefore crucial to the successful delivery of health services, but traditional theories might provide little practical guidance to evaluating the overall status of a profession. This study proposes a new conceptual framework of three interrelated professional sectors: education, regulation and practice, and uses it to identify and analyze challenges facing the pharmacy profession in Jordan. A multiple-method qualitative study comprised of semi-structured interviews and focus groups was conducted in Amman, Jordan. To explore and identify the challenges, a purposively recruited cross-sector sample of 53 key informants, stakeholders and pharmacists were interviewed. Interview transcripts were translated and analyzed using QSR NVivo 10. Thematic analysis identified eight main challenges facing pharmacy in Jordan. The original participants were then invited to participate in focus groups, the purpose of which was to validate the interview findings, map them against the conceptual framework and discuss recommendations for development. The eight validated challenges span the following areas: graduates preparedness for practice, pharmacy education accreditation and quality assurance, pre-registration requirements, workforce development, workforce planning, remuneration and wage rate, pharmacy assistants, and Pharm.D. pharmacists. Focus group participants used the framework to map each of the challenges to the primary sector-to-sector disconnect that they perceived to explain it. A list of recommendations addressing each of the challenges was also devised. The framework was found to offer valuable insight as an explanatory and diagnostic tool in policy-relevant research. By emphasizing the processual and contextual nature of reprofessionalization, the framework presents an alternative approach to traditional theories. This study also raises important questions regarding the status of pharmacy in Jordan and aims to provide guidance for local development and much-needed reprofessionalization drives. Copyright © 2016 Elsevier Inc. All rights reserved.

Can Principals Promote Teacher Development as Evaluators? A Case Study of Principals' Views and Experiences.

PubMed

Kraft, Matthew A; Gilmour, Allison

2016-12-01

New teacher evaluation systems have expanded the role of principals as instructional leaders, but little is known about principals' ability to promote teacher development through the evaluation process. We conducted a case study of principals' perspectives on evaluation and their experiences implementing observation and feedback cycles to better understand whether principals feel as though they are able to promote teacher development as evaluators. We conducted interviews with a stratified random sample of 24 principals in an urban district that recently implemented major reforms to its teacher evaluation system. We analyzed these interviews by drafting thematic summaries, coding interview transcripts, creating data-analytic matrices, and writing analytic memos. We found that the evaluation reforms provided a common framework and language that helped facilitate principals' feedback conversations with teachers. However, we also found that tasking principals with primary responsibility for conducting evaluations resulted in a variety of unintended consequences which undercut the quality of evaluation feedback they provided. We analyze five broad solutions to these challenges: strategically targeting evaluations, reducing operational responsibilities, providing principal training, hiring instructional coaches, and developing peer evaluation systems. The quality of feedback teachers receive through the evaluation process depends critically on the time and training evaluators have to provide individualized and actionable feedback. Districts that task principals with primary responsibility for conducting observation and feedback cycles must attend to the many implementation challenges associated with this approach in order for next-generation evaluation systems to successfully promote teacher development.

Sociotechnical Challenges of Developing an Interoperable Personal Health Record

PubMed Central

Gaskin, G.L.; Longhurst, C.A.; Slayton, R.; Das, A.K.

2011-01-01

Objectives To analyze sociotechnical issues involved in the process of developing an interoperable commercial Personal Health Record (PHR) in a hospital setting, and to create guidelines for future PHR implementations. Methods This qualitative study utilized observational research and semi-structured interviews with 8 members of the hospital team, as gathered over a 28 week period of developing and adapting a vendor-based PHR at Lucile Packard Children’s Hospital at Stanford University. A grounded theory approach was utilized to code and analyze over 100 pages of typewritten field notes and interview transcripts. This grounded analysis allowed themes to surface during the data collection process which were subsequently explored in greater detail in the observations and interviews. Results Four major themes emerged: (1) Multidisciplinary teamwork helped team members identify crucial features of the PHR; (2) Divergent goals for the PHR existed even within the hospital team; (3) Differing organizational conceptions of the end-user between the hospital and software company differentially shaped expectations for the final product; (4) Difficulties with coordination and accountability between the hospital and software company caused major delays and expenses and strained the relationship between hospital and software vendor. Conclusions Though commercial interoperable PHRs have great potential to improve healthcare, the process of designing and developing such systems is an inherently sociotechnical process with many complex issues and barriers. This paper offers recommendations based on the lessons learned to guide future development of such PHRs. PMID:22003373

Experiences, feelings and thoughts of women undergoing second trimester medical termination of pregnancy.

PubMed

Andersson, Inga-Maj; Christensson, Kyllike; Gemzell-Danielsson, Kristina

2014-01-01

The objective of this study was to explore women's expectations and experiences of undergoing second trimester abortion. This is a cross-sectional study using a screening questionnaire and semi-structured interviews for data collection. Thirty-one women filled out the questionnaire and 23 of them were later interviewed. The questionnaires were analyzed by descriptive statistics. The interviews were recorded, transcribed verbatim and analyzed with qualitative content analysis. Indications for the abortion were fetal malformation or unintended pregnancy. The women expressed similar feelings and these were irrespective for the reason for having an abortion. Both physical and mental pain was experienced during the abortion process and described by the women. Taking the mifepristone-pill was experienced as especially emotionally difficult for many participants. Professional support from the staff together with support from the partner, a friend or relative helped in transforming the worries related to something unknown to feelings of coping with a new and hard experience. Prior to the abortion most women stated that they did not want to view the fetus but women who chose to view the fetus described this as a way of confronting the reality and an opportunity to say farewell to the pregnancy/fetus. The analysis of the interview transcripts revealed five themes mirroring the women's experiences, thoughts and feelings related to the abortion. The decision to undergo second trimester abortion sometimes exposes women to strong and conflicting emotions which are irrespective for the reason for having an abortion. Despite this women do not regret their decision to terminate the pregnancy. This analysis shows that their rational thinking outweighs their emotionally difficult feelings. It is important for the attending staff to be responsive to the needs of each individual woman whatever the indication is for the abortion.

Structured scaffolding for reflection and problem solving in diabetes self-management: qualitative study of mobile diabetes detective.

PubMed

Mamykina, Lena; Heitkemper, Elizabeth M; Smaldone, Arlene M; Kukafka, Rita; Cole-Lewis, Heather; Davidson, Patricia G; Mynatt, Elizabeth D; Tobin, Jonathan N; Cassells, Andrea; Goodman, Carrie; Hripcsak, George

2016-01-01

To investigate subjective experiences and patterns of engagement with a novel electronic tool for facilitating reflection and problem solving for individuals with type 2 diabetes, Mobile Diabetes Detective (MoDD). In this qualitative study, researchers conducted semi-structured interviews with individuals from economically disadvantaged communities and ethnic minorities who are participating in a randomized controlled trial of MoDD. The transcripts of the interviews were analyzed using inductive thematic analysis; usage logs were analyzed to determine how actively the study participants used MoDD. Fifteen participants in the MoDD randomized controlled trial were recruited for the qualitative interviews. Usage log analysis showed that, on average, during the 4 weeks of the study, the study participants logged into MoDD twice per week, reported 120 blood glucose readings, and set two behavioral goals. The qualitative interviews suggested that individuals used MoDD to follow the steps of the problem-solving process, from identifying problematic blood glucose patterns, to exploring behavioral triggers contributing to these patterns, to selecting alternative behaviors, to implementing these behaviors while monitoring for improvements in glycemic control. This qualitative study suggested that informatics interventions for reflection and problem solving can provide structured scaffolding for facilitating these processes by guiding users through the different steps of the problem-solving process and by providing them with context-sensitive evidence and practice-based knowledge related to diabetes self-management on each of those steps. This qualitative study suggested that MoDD was perceived as a useful tool in engaging individuals in self-monitoring, reflection, and problem solving. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Change and Diversity in Grandparenting Experience.

ERIC Educational Resources Information Center

Thomas, Jeanne L.; Datan, Nancy

In this study, change over time in grandparenting experience, sex differences in grandparenting, and differences among relationships with different grandchildren were explored. Thirteen grandmothers and six grandfathers were interviewed; content analysis and thematic analysis of interview transcripts were performed. Grandparents described changes…

"I Don't Know What a Proper Woman Means": What Women with Intellectual Disabilities Think about Sex, Sexuality and Themselves

ERIC Educational Resources Information Center

Fitzgerald, Christina; Withers, Paul

2013-01-01

There is very little literature concerning how women with intellectual disabilities conceptualise their sexuality or develop a sexual identity. Semi-structured interview schedules were used to guide interviews with 10 women with intellectual disabilities. Thematic analysis was used to analyse the interview transcripts. Many of the women could not…

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process.

PubMed

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O'Leary, James; Ruffner, B W; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2012-07-01

The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement.

Stakeholder Perspectives on Optimizing Communication in a School-Centered Asthma Program.

PubMed

Snieder, Hylke M; Nickels, Sarah; Gleason, Melanie; McFarlane, Arthur; Szefler, Stanley J; Allison, Mandy A

2017-12-01

School-centered asthma programs (SAPs) can be an effective intervention to improve asthma control for underserved populations but little is known about how key stakeholders communicate within these programs. Therefore, our aim was to identify key components of effective communication in a SAP. Primary care providers (PCPs), parents and school nurses associated with a SAP in Denver, Colorado participated in interviews and focus groups about their views on effective communication. Interview and focus group guides were developed using an appreciative inquiry approach and transcripts were analyzed via an iterative coding approach. We conducted 3 focus groups with school nurses (N = 13), interviews with parents (N = 12) and PCPs (N = 10). Stakeholders identified multiple themes that enable communication, namely personal relationships, clear roles, integration of technology, adequate resources, and accessibility. Communication in SAPs is most effective when there are clearly delineated roles with the school being the focal point for education and monitoring of asthmatic students and PCPs being the focal point for diagnosis and changes in care. Communication should take place using modern technology that is integrated into existing workflow. Information sharing is most likely to be successful if there is deliberate relationship building. © 2017, American School Health Association.

Post-disaster Gulf Coast Recovery Using Telehealth

PubMed Central

Kim, Thomas J.; Eastburn, Sasha L.; Icenogle, Marjorie L.; Slagle, Michelle; Nuriddin, Azizeh H.; Brantley, Katrina M.; Foreman, Rachel D.; Buckner, Ayanna V.

2013-01-01

Abstract Objective: The Gulf Coast continues to struggle with service need far outpacing available resources. Since 2005, the Regional Coordinating Center for Hurricane Response (RCC) at Morehouse School of Medicine, Atlanta, GA, has supported telehealth solutions designed to meet high service needs (e.g., psychiatry) within primary care and other healthcare organizations. The overall RCC vision is to support autonomous, useful, and sustainable telehealth programs towards mitigating unmet disaster-related needs. Subjects and Methods: To assess Gulf Coast telehealth experiences, we conducted semistructured interviews with both regional key informants and national organizations with Gulf Coast recovery interests. Using qualitative-descriptive analysis, interview transcripts were analyzed to identify shared development themes. Results: Thirty-eight key informants were interviewed, representing a 77.6% participation rate among organizations engaged by the RCC. Seven elements critical to telehealth success were identified: Funding, Regulatory, Workflow, Attitudes, Personnel, Technology, and Evaluation. These key informant accounts reveal shared insights with telehealth regarding successes, challenges, and recommendations. Conclusions: The seven elements critical to telehealth success both confirm and organize development principles from a diverse collective of healthcare stakeholders. The structured nature of these insights suggests a generalizable framework upon which other organizations might develop telehealth strategies toward addressing high service needs with limited resources. PMID:23427981

The meaning and use of spirituality among African American women living with HIV/AIDS.

PubMed

Dalmida, Safiya George; Holstad, Marcia McDonnell; DiIorio, Colleen; Laderman, Gary

2012-10-01

The purpose of this qualitative study was to explore the meaning and use of spirituality among African American (AA), predominantly Christian women with HIV. A nonrandom sample of 20 AA women from a large infectious disease clinic in Metro-Atlanta participated in the study. The study used focus groups and individual interviews to interview women about their lived spiritual experience. Content analysis and NUDIST software were used to analyze transcripts. The findings revealed the spiritual views and practices of AA women with HIV. The following themes (and subthemes) emerged: Spirituality is a process/journey or connection (connection to God, higher power, or spirit and HIV brought me closer to God), spiritual expression (religion/church attendance, prayer, helping others, having faith), and spiritual benefits (health/healing, spiritual support, inner peace/strength/ability to keep going, and here for a reason or purpose/a second chance). Findings highlight the importance of spirituality in health and well-being among AA women with HIV/AIDS.

The Meaning and Use of Spirituality Among African American Women Living With HIV/AIDS

PubMed Central

Dalmida, Safiya George; Holstad, Marcia McDonnell; DiIorio, Colleen; Laderman, Gary

2014-01-01

The purpose of this qualitative study was to explore the meaning and use of spirituality among African American (AA), predominantly Christian women with HIV. A nonrandom sample of 20 AA women from a large infectious disease clinic in Metro-Atlanta participated in the study. The study used focus groups and individual interviews to interview women about their lived spiritual experience. Content analysis and NUDIST software were used to analyze transcripts. The findings revealed the spiritual views and practices of AA women with HIV. The following themes (and subthemes) emerged: Spirituality is a process/journey or connection (connection to God, higher power, or spirit and HIV brought me closer to God), spiritual expression (religion/church attendance, prayer, helping others, having faith), and spiritual benefits (health/healing, spiritual support, inner peace/strength/ability to keep going, and here for a reason or purpose/a second chance). Findings highlight the importance of spirituality in health and well-being among AA women with HIV/AIDS. PMID:22566288

Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

PubMed Central

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2016-01-01

Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

What makes a good voice for radio: perceptions of radio employers and educators.

PubMed

Warhurst, Samantha; McCabe, Patricia; Madill, Catherine

2013-03-01

To inform vocal training and management of voice disorders of professional radio performers in Australia by determining radio employers' and educators' qualitative perceptions on (1) what makes a good voice for radio and (2) what communication characteristics are important when employing radio performers. Radio employers and educators (n=9) participated in semistructured interviews. Interview transcripts were coded line-by-line and analyzed for qualitative themes using principles of grounded theory. Radio performers sound easy-on-the-ear, natural, and have an ability to read and produce voices that suit the station. Many of these characteristics make them sound different to radio voices in the past. Content and personality are now also more significant than voice characteristics. A multidimensional model of these characteristics is presented. The model has implications for the training and management of voice disorders in radio performers and will guide future quantitative research on the vocal features of this population. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Caring in the Information Age: Personal Online Networks to Improve Caregiver Support.

PubMed

Piraino, Emily; Byrne, Kerry; Heckman, George A; Stolee, Paul

2017-06-01

It is becoming increasingly important to find ways for caregivers and service providers to collaborate. This study explored the potential for improving care and social support through shared online network use by family caregivers and service providers in home care. This qualitative study was guided by Rogers' Theory of Diffusion of Innovations [NY: Free Press; 1995], and involved focus group and individual interviews of service providers (n = 31) and family caregivers (n = 4). Interview transcriptions were analyzed using descriptive, topic, and analytic coding, followed by thematic analysis. The network was identified as presenting an opportunity to fill communication gaps presented by other modes of communication and further enhance engagement with families. Barriers included time limitations and policy-related restrictions, privacy, security, and information ownership. Online networks may help address longstanding home-care issues around communication and information-sharing. The success of online networks in home care requires support from care partners. Future research should pilot the use of online networks in home care using barrier and facilitator considerations from this study.

Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

PubMed

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2014-09-01

Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

PubMed

Watt, Melissa H; Dennis, Alexis C; Choi, Karmel W; Ciya, Nonceba; Joska, John A; Robertson, Corne; Sikkema, Kathleen J

2017-11-01

South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruited from a public clinic in Cape Town. Interviews explored trauma narratives, coping behaviors and care engagement, and transcripts were analyzed using a constant comparison method. Participants reported multiple and complex traumas across their lifetimes. Sexual trauma hindered HIV care engagement, especially immediately following HIV diagnosis, and there were indications that sexual trauma may interfere with future care engagement, via traumatic stress symptoms including avoidance. Disclosure of sexual trauma was limited; no women had disclosed to an HIV provider. Routine screening for sexual trauma in HIV care settings may help to identify individuals at risk of poor care engagement. Efficacious treatments are needed to address the psychological and behavioral sequelae of trauma.

Decision-making regarding organ donation in Korean adults: A grounded-theory study.

PubMed

Yeun, Eun Ja; Kwon, Young Mi; Kim, Jung A

2015-06-01

The aim of this study was to identify the hidden patterns of behavior leading toward the decision to donate organs. Thirteen registrants at the Association for Organ Sharing in Korea were recruited. Data were collected using in-depth interview and the interview transcripts were analyzed using Glaserian grounded-theory methodology. The main problem of participants was "body attachment" and the core category (management process) was determined to be "pursuing life." The theme consisted of four phases, which were: "hesitating," "investigating," "releasing," and "re-discovering. " Therefore, to increase organ donations, it is important to find a strategy that will create positive attitudes about organ donation through education and public relations. These results explain and provide a deeper understanding of the main problem that Korean people have about organ donation and their management of decision-making processes. These findings can help care providers to facilitate the decision-making process and respond to public needs while taking into account the sociocultural context within which decisions are made. © 2014 Wiley Publishing Asia Pty Ltd.

Comparing men's and women's experiences of work after cancer: a photovoice study.

PubMed

Morrison, T L; Thomas, R L

2015-10-01

Work is an important quality of life indicator for many cancer survivors. There is, however, a lack of appropriate support to help survivors with work integration. As a result, many survivors are forced to independently navigate their return to work, experiencing unnecessary pitfalls in the process. As a preliminary step toward addressing this current gap in survivorship support, we explored the work integration experiences of 20 cancer survivors, 10 women and 10 men. Photovoice methods were combined with two individual interviews per participant. Participant-produced photographs and interview transcripts were analyzed to identify key themes. Both commonalities and gender-differentiated motivations underlying work integration emerged. Female and male participants both demonstrated and discussed differentiated manners of coping. Men expressed a propensity for productivity and active engagements over talking used predominantly by women. Appreciation of men's proclivity for productivity and activity suggests that a gender-tailored approach to rehabilitation may enhance male survivors' participation and the utility of rehabilitation efforts.

Nursing Roles and Strategies in End-of-Life Decision Making Concerning Elderly Immigrants Admitted to Acute Care Hospitals: An Australian Study.

PubMed

Johnstone, Megan-Jane; Hutchinson, Alison M; Redley, Bernice; Rawson, Helen

2016-09-01

There is a lack of clarity regarding nursing roles and strategies in providing culturally meaningful end-of-life care to elderly immigrants admitted to Australian hospitals. This article redresses this ambiguity. A qualitative exploratory descriptive approach was used. Data were obtained by conducting in-depth interviews with a purposeful sample of 22 registered nurses, recruited from four health services. Interview transcripts were analyzed using content and thematic analysis strategies. Despite feeling underprepared for their role, participants fostered culturally meaningful care by "doing the ground work," "facilitating families," "fostering trust," and "allaying fear." The Australian nursing profession has a significant role to play in leading policy, education, practice, and consumer engagement initiatives aimed at ensuring a culturally responsive approach to end-of-life care for Australia's aging immigrant population. Enabling elderly immigrants to experience a "good death" at the end of their lives requires highly nuanced and culturally informed nursing care. © The Author(s) 2015.

Business Models, Vaccination Services, and Public Health Relationships of Retail Clinics: A Qualitative Study.

PubMed

Arthur, Bayo C; Fisher, Allison Kennedy; Shoemaker, Sarah J; Pozniak, Alyssa; Stokley, Shannon

2015-01-01

Despite the rapid growth of retail clinics (RCs), literature is limited in terms of how these facilities offer preventive services, particularly vaccination services. The purpose of this study was to obtain an in-depth understanding of the RC business model pertaining to vaccine offerings, profitability, and decision making. From March to June 2009, we conducted 15 interviews with key individuals from three types of organizations: 12 representatives of RC corporations, 2 representatives of retail hosts (i.e., stores in which the RCs are located), and 1 representative of an industry association. We analyzed interview transcripts qualitatively. Our results indicate that consumer demand and profitability were the main drivers in offering vaccinations. RCs in this sample primarily offered vaccinations to adults and adolescents, and they were not well integrated with local public health and immunization registries. Our findings demonstrate the potential for stronger linkages with public health in these settings. The findings also may help inform future research to increase patient access to vaccination services at RCs.

Modes of Hoping: Understanding hope and expectation in the context of a clinical trial of complementary and alternative medicine for chronic pain

PubMed Central

Eaves, Emery R; Ritenbaugh, Cheryl; Nichter, Mark; Hopkins, Allison L.; Sherman, Karen J

2014-01-01

This article explores the role of hope in participants’ assessments of their expectations, experiences and treatment outcomes. Data analysis focused on semi-structured, open-ended interviews with 44 participants, interviewed 3-5 times each over the course of a study evaluating Traditional Chinese Medicine (TCM) for Temporomandibular Disorders (TMD, a form of chronic orofacial pain). Transcripts were coded and analyzed using qualitative and ethnographic methods. A “Modes of Hoping”1 framework informed our analysis. Five modes of hoping emerged from participant narratives: Realistic Hope; Wishful Hope; Utopian Hope; Technoscience Hope; and Transcendent Hope. Using this framework, hope is demonstrated as exerting a profound influence over how participants assess and report their expectations. This suggests that researchers interested in measuring expectations and understanding their role in treatment outcomes should consider hope as exercising a multifaceted and dynamic influence on participants’ reporting of expectations and their experience and evaluation of treatment. PMID:25037665

Modes of hoping: understanding hope and expectation in the context of a clinical trial of complementary and alternative medicine for chronic pain.

PubMed

Eaves, Emery R; Ritenbaugh, Cheryl; Nichter, Mark; Hopkins, Allison L; Sherman, Karen J

2014-01-01

This article explores the role of hope in participants' assessments of their expectations, experiences and treatment outcomes. Data analysis focused on semi-structured, open-ended interviews with 44 participants, interviewed 3-5 times each over the course of a study evaluating Traditional Chinese Medicine (TCM) for temporomandibular disorders (TMD), a form of chronic orofacial pain. Transcripts were coded and analyzed using qualitative and ethnographic methods. A "Modes of Hoping" (Webb, 2007)(1) framework informed our analysis. Five modes of hoping emerged from participant narratives: Realistic Hope, Wishful Hope, Utopian Hope, Technoscience Hope, and Transcendent Hope. Using this framework, hope is demonstrated as exerting a profound influence over how participants assess and report their expectations. This suggests that researchers interested in measuring expectations and understanding their role in treatment outcomes should consider hope as exercising a multi-faceted and dynamic influence on participants' reporting of expectations and their experience and evaluation of treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Exploring and understanding academic leadership in family medicine

PubMed Central

Oandasan, Ivy; White, David; Hammond Mobilio, Melanie; Gotlib Conn, Lesley; Feldman, Kymm; Kim, Florence; Rouleau, Katherine; Sorensen, Leslie

2013-01-01

Abstract Objective To explore how family physicians understand the concept of academic leadership. Design Case study. Setting Department of Family and Community Medicine at the University of Toronto in Ontario. Participants Thirty family physician academic leaders. Methods Focus groups and interviews were conducted with family physicians from a large multisite urban university who were identified by peers as academic leaders at various career stages. Transcripts from the focus groups and interviews were anonymized and themes were analyzed and negotiated among 3 researchers. Main findings Participants identified qualities of leadership among academic leaders that align with those identified in the current literature. Despite being identified by others as academic leaders, participants were reluctant to self-identify as such. Participants believed they had taken on early leadership roles by default rather than through planned career development. Conclusion This study affirms the need to define academic leadership explicitly, advance a culture that supports it, and nurture leaders at all levels with a variety of strategies. PMID:23486818

Advisable in the National Interest? The Relief of General George C. Kenney

DTIC Science & Technology

1994-01-01

Baker later recalled." Arnold’s " people included Eakr and 63. Mmo, Bipdir Omml C . .L Kibome, AC/S, WPD, for do hi dof tdo Air Coqps, 21 Decmnber...January 1966. Oral History Interview 626, transcript. USAF Oral History Collection, AFHRC, Maxwell AFB, Alabama. Eake, Ira C . Interview by Charles...Collection, AFHRC, Maxwell AFB, Alabama. Irvine, C . S. Interview by Robert M. Kipp. March AFB, California, 17 December 1970. Oral History Interview

Oaxacan women with HIV/AIDS: resiliency in the face of poverty, stigma, and social isolation.

PubMed

Holtz, Carol Sue; Sowell, Richard; Velasquez, Gabriela

2012-01-01

HIV infection among Mexican women continues to increase. The purpose of the authors in this study was to explore the psychosocial issues of HIV-infected Mexican women's lives, and to support a request from the Mexican federal government for data to support the need for funding for the psychological care of these women. A Spanish-speaking researcher conducted private, in-depth, face-to-face interviews with 21 women receiving health services at the HIV/AIDS clinic, COESIDA, near Oaxaca City, Mexico. Data were collected during the time period of January 17 through 21st, 2011. The authors ascertained socio-demographic characteristics for all study participants. They transcribed audio-taped interviews verbatim, translated them into English, and analyzed transcribed interviews using content analysis, identifying consistent themes across the interviews. They also conducted language and cultural verification of the translation, and a third person, a master's prepared native Mexican woman, conducted content analysis. Ages of participants ranged from 20 to 48 years, with most having a third grade education. Most women lived at least two hours from the clinic. Themes emerging from the interview transcript analysis included: (1) resiliency; (2) fear; (3) social isolation; (4) anger/rage; and (5) availability of resources and support. Despite facing a variety of adverse factors, the Oaxacan women with HIV/AIDS who were interviewed demonstrated a sense of resiliency and hope for the future. Yet, a critical need remains for mental health support services to be provided to women to assist them in managing the psychological consequences of their HIV/AIDS diagnosis.

Designing a leadership development program for surgeons.

PubMed

Jaffe, Gregory A; Pradarelli, Jason C; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B

2016-01-01

Although numerous leadership development programs (LDPs) exist in health care, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons' motivations and desired goals for leadership training to design an evidence-based LDP in surgery. At a large academic health center, we conducted semistructured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding to extract major themes regarding surgeons' motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Three major themes emerged regarding surgeons' motivations for seeking leadership training: (1) Recognizing key gaps in their formal preparation for leadership roles; (2) Exhibiting an appetite for personal self-improvement; and (3) Seeking leadership guidance for career advancement. Participants' interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a LDP: (1) leadership and communication; (2) team building; (3) business acumen/finance; and (4) greater understanding of the health care context. Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A LDP that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. Copyright © 2016 Elsevier Inc. All rights reserved.

Teaching Melodic Dictation in Advanced Placement Music Theory

ERIC Educational Resources Information Center

Paney, Andrew S.; Buonviri, Nathan O.

2014-01-01

In this study approaches to teaching melodic dictation skills used by Advanced Placement (AP) Music Theory teachers were examined. Twelve high school teachers from four states were interviewed. Four themes emerged from the interview transcripts: cognitive frameworks, processing strategies, rhythm, and course design. Participants generally…

Linking experiences with emotions and the development of interpretive repertoires

NASA Astrophysics Data System (ADS)

McRae, Norah I.

2010-03-01

In this paper I consider the case of one student, Todd Alexander, through analyzing the transcripts of his interviews between him and his teacher (Wolff-Michael Roth). I examine the role that emotions play in the development of the interpretive repertoires that Todd employed as he talked about his scientific and his religious beliefs. I identify how lived experiences support the development of emotions and what educational conditions are necessary to allow for appropriate lived experiences. In so doing we might be able to support educational conditions that result in interpretive repertoires that allow for acceptance of multiple perspectives with a moral grounding, leading to students who are well positioned to be valuable contributors to society.

Health Coaching: An Update on the National Consortium for Credentialing of Health & Wellness Coaches

PubMed Central

2015-01-01

In September 2014, Global Advances in Health and Medicine editor Michele Mittelman, RN, MPH, interviewed four of the leaders in health and wellness coaching about trends in coaching and the progress of the National Consortium for Credentialing of Health & Wellness Coaches. Following are the transcripts of those interviews. Additionally, videos of the interviews are available at www.gahmj.com. PMID:25694854

Barriers and Facilitators to HIV Testing Among Women

PubMed Central

McDougall, Graham J.; Dalmida, Safiya George; Foster, Pamela Payne; Burrage, Joe

2017-01-01

Aim The purpose of this secondary analysis was to analyze for barriers and facilitators to HIV testing in women attending community health clinics. Introduction The Centers for Disease Control and Prevention (CDC), reported that all women account for 20% or 1 in 5 of new HIV cases (CDC, 2012). Of those new cases in heterosexual women, 5,300 were Black, 1,300 were White, and 1,200 were Hispanic/Latina. The CDC estimated that in 2012 there were 9,268 individuals living with a diagnosis of HIV or AIDS, of which 19% were women. Results The existing de-identified data consisted of thirty individual interviews conducted using a semi-structured interview guide was collected as the initial phase of the parent study, “HIV Testing and Women’s Attitudes on HIV Vaccine Trials”. This secondary analysis addressed the identification of key obstacles to HIV testing and only those related portions of the transcripts were analyzed. The major themes identified were familiarity with testing, stigma, fear, perceived risks, and access to care. Conclusion The themes implicated the need to further assess women for barriers and facilitators to testing, tailor community based interventions that have the ability to decrease fear and stigma, increase trust in testing methods and offer counseling to positive results. PMID:29607406

Exploring international clinical education in US-based programs: identifying common practices and modifying an existing conceptual model of international service-learning.

PubMed

Pechak, Celia M; Black, Jill D

2014-02-01

Increasingly physical therapist students complete part of their clinical training outside of their home country. This trend is understudied. The purposes of this study were to: (1) explore, in depth, various international clinical education (ICE) programs; and (2) determine whether the Conceptual Model of Optimal International Service-Learning (ISL) could be applied or adapted to represent ICE. Qualitative content analysis was used to analyze ICE programs and consider modification of an existing ISL conceptual model for ICE. Fifteen faculty in the United States currently involved in ICE were interviewed. The interview transcriptions were systematically analyzed by two researchers. Three models of ICE practices emerged: (1) a traditional clinical education model where local clinical instructors (CIs) focus on the development of clinical skills; (2) a global health model where US-based CIs provide the supervision in the international setting, and learning outcomes emphasized global health and cultural competency; and (3) an ICE/ISL hybrid where US-based CIs supervise the students, and the foci includes community service. Additionally the data supported revising the ISL model's essential core conditions, components and consequence for ICE. The ICE conceptual model may provide a useful framework for future ICE program development and research.

Complex collaborative problem-solving processes in mission control.

PubMed

Fiore, Stephen M; Wiltshire, Travis J; Oglesby, James M; O'Keefe, William S; Salas, Eduardo

2014-04-01

NASA's Mission Control Center (MCC) is responsible for control of the International Space Station (ISS), which includes responding to problems that obstruct the functioning of the ISS and that may pose a threat to the health and well-being of the flight crew. These problems are often complex, requiring individuals, teams, and multiteam systems, to work collaboratively. Research is warranted to examine individual and collaborative problem-solving processes in this context. Specifically, focus is placed on how Mission Control personnel-each with their own skills and responsibilities-exchange information to gain a shared understanding of the problem. The Macrocognition in Teams Model describes the processes that individuals and teams undertake in order to solve problems and may be applicable to Mission Control teams. Semistructured interviews centering on a recent complex problem were conducted with seven MCC professionals. In order to assess collaborative problem-solving processes in MCC with those predicted by the Macrocognition in Teams Model, a coding scheme was developed to analyze the interview transcriptions. Findings are supported with excerpts from participant transcriptions and suggest that team knowledge-building processes accounted for approximately 50% of all coded data and are essential for successful collaborative problem solving in mission control. Support for the internalized and externalized team knowledge was also found (19% and 20%, respectively). The Macrocognition in Teams Model was shown to be a useful depiction of collaborative problem solving in mission control and further research with this as a guiding framework is warranted.

The perceived organizational impact of the gender gap across a Canadian department of medicine and proposed strategies to combat it: a qualitative study.

PubMed

Pattani, Reena; Marquez, Christine; Dinyarian, Camellia; Sharma, Malika; Bain, Julie; Moore, Julia E; Straus, Sharon E

2018-04-10

Despite the gender parity existing in medical schools for over three decades, women remain underrepresented in academic medical centers, particularly in senior ranks and in leadership roles. This has consequences for patient care, education, research, and workplace culture within healthcare organizations. This study was undertaken to explore the perspectives of faculty members at a single department of medicine on the impact of the existing gender gap on organizational effectiveness and workplace culture, and to identify systems-based strategies to mitigate the gap. The study took place at a large university department of medicine in Toronto, Canada, with six affiliated hospitals. In this qualitative study, semi-structured individual interviews were conducted between May and September 2016 with full-time faculty members who held clinical and university-based appointments. Transcripts of the interviews were analyzed using thematic analysis. Three authors independently reviewed the transcripts to determine a preliminary list of codes and establish a coding framework. A modified audit consensus coding approach was applied; a single analyst reviewed all the transcripts and a second analyst audited 20% of the transcripts in each round of coding. Following each round, inter-rater reliability was determined, discrepancies were resolved through discussion, and modifications were made as needed to the coding framework. The analysis revealed faculty members' perceptions of the gender gap, potential contributing factors, organizational impacts, and possible solutions to bridge the gap. Of the 43 full-time faculty members who participated in the survey (29 of whom self-identified as female), most participants were aware of the existing gender gap within academic medicine. Participants described social exclusion, reinforced stereotypes, and unprofessional behaviors as consequences of the gap on organizational effectiveness and culture. They suggested improvements in (1) the processes for recruitment, hiring, and promotion; (2) inclusiveness of the work environment; (3) structures for mentorship; and (4) ongoing monitoring of the gap. The existing gender gap in academic medicine may have negative consequences for organizational effectiveness and workplace culture but many systems-based strategies to mitigate the gap exist. Although these solutions warrant rigorous evaluation, they are feasible to institute within most healthcare organizations immediately.

Experiences of employed women with attention deficit hyperactive disorder: A phenomenological study.

PubMed

Schreuer, N; Dorot, R

2017-01-01

Employees with attention-deficit/hyperactivity disorder (ADHD) face various risks in the workplace. Little is known of the specific challenges women with ADHD experience. To explore the experiences of working women with ADHD and learn the strategies and accommodations that facilitate their maintaining employment. Qualitative phenomenological approach was used to echo women's subjective perceptions and experiences representing their daily interactions in their workplace. In-depth interviews were conducted with eleven tertiary-educated employed women (M = 33.5; SD = 6.61 years), diagnosed with ADHD and the transcripts were analyzed by three researchers, using the qualitative phenomenological approach. Most interviewed women with ADHD described interactions with their workplace as confusing, overwhelming, and chaotic. They perceived their ADHD as a significant obstacle to success in employment that also conferred some advantages. Three interview themes are explored here (1) challenges in coping with job demands and the workplace, including the disclosure dilemma; (2) personal coping strategies; (3) useful accommodations. For the women interviewed, employment was important for their self-identity, beyond simply making a living. Their experiences indicate impaired executive functioning and inhibition and sensory sensitivity, consistently with theoretical models for ADHD. They identified gender-specific issues, such as using medication during pregnancy, which led them to seek for non-pharmacological coping mechanisms. They contributed practical knowledge regarding employee-led adaptations and employer-provided workplace accommodations.

Amelogenesis Imperfecta and Early Restorative Crown Therapy: An Interview Study with Adolescents and Young Adults on Their Experiences

PubMed Central

Wickström, Anette; Hasselblad, Tove; Dahllöf, Göran

2016-01-01

Patients with Amelogenesis imperfecta (AI) can present with rapid tooth loss or fractures of enamel as well as alterations in enamel thickness, color, and shape; factors that may compromise aesthetic appearance and masticatory function. The aim was to explore the experiences and perceptions of adolescents and young adults living with AI and receiving early prosthetic therapy. Seven patients with severe AI aged 16 to 23 years who underwent porcelain crown therapy participated in one-to-one individual interviews. The interviews followed a topic guide consisting of open-ended questions related to experiences of having AI. Transcripts from the interviews were analyzed using thematic analysis. The analysis process identified three main themes: Disturbances in daily life, Managing disturbances, and Normalization of daily life. These themes explain the experiences of patients living with enamel disturbances caused by AI and receiving early crown therapy. Experiences include severe pain and sensitivity problems, feelings of embarrassment, and dealing with dental staff that lack knowledge and understanding of their condition. The patients described ways to manage their disturbances and to reduce pain when eating or drinking, and strategies for meeting other people. After definitive treatment with porcelain crown therapy, they described feeling like a normal patient. In conclusion the results showed that adolescents and young adults describe a profound effect of AI on several aspects of their daily life. PMID:27359125

A Qualitative Secondary Evaluation of Statewide Follow-Up Interviews for Abnormal Newborn Screening Results for Cystic Fibrosis and Sickle Cell Hemoglobinopathy

PubMed Central

La Pean, Alison; Collins, Jenelle L.; Christopher, Stephanie A.; Eskra, Kerry L.; Roedl, Sara; Tluczek, Audrey; Farrell, Michael H.

2011-01-01

Purpose The purpose of this qualitative analysis was to assess parental acceptability of large-scale, telephone follow-up regarding their infants' newborn screening (NBS) results indicating carrier status for sickle cell hemoglobinopathy (SCH) and cystic fibrosis (CF). Methods Analysis of 195 interview transcripts focused on parents' responses to two open-ended questions “What was your reaction to being called by me?” and “What do you think of the state newborn screening program having follow-up people calling parents like you?” Responses were coded using conventional content analysis procedures and non-parametric tests were performed to analyze quantitative data. Results Most parents reported favorable opinions about the follow-up. Favorable opinions were associated with several emotional reactions to receiving follow-up (p<0.001), and three reasons why parents found the interview beneficial (p<0.05): it provided information, clarified NBS results, and answered questions. Seventeen parents of SCH carriers reportedly had not been told their infant's NBS results and received them for the first time during the follow-up interview. Conclusion Parents of CF and SCH carrier infants had favorable opinions and identified specific benefits to receiving follow-up contact. This analysis demonstrates an information deficit among carrier parents and illustrates the importance of NBS follow-up and need for comprehensive communication and counseling. PMID:22261754

Case Studies of Physics Graduates' Personal Theories of Evolution

ERIC Educational Resources Information Center

Chan, Ke-Sheng

2005-01-01

This paper reports an interview case study with two physics doctoral students designed to explore their conceptions about the theory of evolution. Analysis of interview transcripts reveals that both students mistakenly constructed a "theory of evolution by environmentally driven adaptation" instead of the commonly accepted "theory…

Rugged Practices: Embodying Authenticity in Outdoor Recreation

ERIC Educational Resources Information Center

Senda-Cook, Samantha

2012-01-01

When people recreate outdoors, they value the quality of the experience. This study examines rhetorical practices that sustain or undermine perceived authentic outdoor recreation experiences. I conducted a rhetorical analysis of my fieldnotes gathered through participant observation and interview transcripts of online and in-person interviews. I…

Oral History: Playing by the Rules.

ERIC Educational Resources Information Center

Oshinsky, David M.

1990-01-01

Describes oral history interviewing techniques that the author used to research his biography of Joseph McCarthy before the American Historical Association (AHA) issued its seven guidelines on interview use. These guidelines focus on taping sessions, signed releases, written transcripts, respecting human dignity, and placing materials in archive…

Landamatics Ten Years Later: An Interview with Lev N. Landa.

ERIC Educational Resources Information Center

Educational Technology, 1993

1993-01-01

Provides the transcript of an interview with Dr. Lev Landa that addressed issues related to his algorithmico-heuristic theories of learning and instruction, called Landamatics. Highlights include teaching thinking versus knowledge; algorithms; instructional design; improving training and performance in industry, business, and government;…

Time and Temporality in Early Childhood Educators' Work

ERIC Educational Resources Information Center

Nuttall, Joce; Thomas, Louise

2015-01-01

This article reports on the persistence and significance of notions of time and temporality in interviews with early childhood educators in Victoria and Queensland, Australia, in two studies designed to explore the concept of "pedagogical leadership". Interpretive analysis of the interview transcripts of the 19 participants identified…

Who We Are: A Case Study on the Institutional Identity of One Public Institution

ERIC Educational Resources Information Center

Driggers, Mallory C.

2016-01-01

This research examined the formation, change and sustainment of institutional identity over a period of almost three decades under one leader at a public research institution in the southwest. This qualitative case study used constant comparative analysis with interview transcripts and convocation address transcripts to examine the change in…

Hiring in a Hobbesian World. Social Infrastructure and Employers' Use of Information.

ERIC Educational Resources Information Center

Miller, Shazia Rafiullah; Rosenbaum, James E.

1997-01-01

Interviews of 51 employers showed they do not use transcripts or teacher recommendations in hiring. They mistrust applicant information from most sources, emphasizing interviews and "gut instinct," which often gives invalid results. They tend to use information from other employees or long-term social networks. (SK)

The Kodaikanal Experience: Chapter II. Kahn-Montessori Interview

ERIC Educational Resources Information Center

NAMTA Journal, 2013

2013-01-01

This article provides an interview transcript between David Kahn and Mario Montessori (1898-1982), son of Dr. Maria Montessori. Mario Montessori dedicated his life to the preservation, dissemination and application of Montessori's works. Herein Kahn asks Montessori about his time living in the hills of Kodaikanal, India. Montessori touches upon…

Home Language Policy of Second-Generation Turkish Families in the Netherlands

ERIC Educational Resources Information Center

Bezcioglu-Goktolga, Irem; Yagmur, Kutlay

2018-01-01

This study investigated the family language policy of second-generation Turkish immigrant families in the Netherlands by exploring their language ideologies, practices, and management strategies. Using an ethnographic approach, data were collected through a set of observations and interviews with 20 families. Transcriptions of interviews and memos…

Driven and No Regrets: A Qualitative Analysis of Students Earning Baccalaureate Degrees in Three Years

ERIC Educational Resources Information Center

Firmin, Michael W.; Gilson, Krista Merrick

2007-01-01

Using rigorous qualitative research methodology, twenty-four college students receiving their undergraduate degrees in three years were interviewed. Following analysis of the semi-structured interview transcripts and coding, themes emerged, indicating that these students possessed self-discipline, self-motivation, and drive. Overall, the results…

Futures Planning--Adult Sibling Perspectives

ERIC Educational Resources Information Center

Davys, Deborah; Mitchell, Duncan; Haigh, Carol

2015-01-01

A total of 15 adult siblings of people who have a learning disability were interviewed in relation to their future wishes and expectations of care giving. Interpretative Phenomenological Analysis (IPA) was used to analyse transcripts from the interviews where it was demonstrated that futures planning remains an area of difficulty for families of…

College Psychotherapy at a Nigerian University

ERIC Educational Resources Information Center

Adeyemo, David A.

2016-01-01

David Adeyemo works at the Department of Guidance and Counselling at the University of Ibadan in Ibadan, Nigeria. This article presents a transcript of an online interview with Adeyemo, focusing on his experience providing counseling services at the University. Topics in the interview include the percentage of campus students that come for…

Can Principals Promote Teacher Development as Evaluators? A Case Study of Principals’ Views and Experiences

PubMed Central

Kraft, Matthew A.; Gilmour, Allison

2017-01-01

Purpose New teacher evaluation systems have expanded the role of principals as instructional leaders, but little is known about principals’ ability to promote teacher development through the evaluation process. We conducted a case study of principals’ perspectives on evaluation and their experiences implementing observation and feedback cycles to better understand whether principals feel as though they are able to promote teacher development as evaluators. Research Methods We conducted interviews with a stratified random sample of 24 principals in an urban district that recently implemented major reforms to its teacher evaluation system. We analyzed these interviews by drafting thematic summaries, coding interview transcripts, creating data-analytic matrices, and writing analytic memos. Findings We found that the evaluation reforms provided a common framework and language that helped facilitate principals’ feedback conversations with teachers. However, we also found that tasking principals with primary responsibility for conducting evaluations resulted in a variety of unintended consequences which undercut the quality of evaluation feedback they provided. We analyze five broad solutions to these challenges: strategically targeting evaluations, reducing operational responsibilities, providing principal training, hiring instructional coaches, and developing peer evaluation systems. Implications The quality of feedback teachers receive through the evaluation process depends critically on the time and training evaluators have to provide individualized and actionable feedback. Districts that task principals with primary responsibility for conducting observation and feedback cycles must attend to the many implementation challenges associated with this approach in order for next-generation evaluation systems to successfully promote teacher development. PMID:28729742

Exploring Leadership Competencies in Established and Aspiring Physician Leaders: An Interview-based Study

PubMed Central

Taylor, Jay C.; Stoller, James K.

2008-01-01

Background and Objectives Academic health care institutions have become interested in understanding and supporting current leaders and preparing leaders for the future. We designed this exploratory study to better understand specific perceived leadership needs of physicians from the perspective of “aspiring” and “established” leaders within our institution. Design A qualitative, inductive, structured interview-based design was used to examine the study questions. Participants A purposeful sample of current and aspiring leaders was obtained, sampling across specialties and levels of leadership. Interventions All participants were interviewed by the same investigator (CT). Five open-ended questions were developed as prompts. Two of the investigators independently analyzed the transcripts, using an open coding method to identify themes within the narratives. Inter-observer comparisons were made and discrepancies were resolved through discussion. Results Four themes emerged from analyzing the responses to our questions. Aspiring and established leaders agreed that “knowledge”, “people skills” or emotional intelligence, and “vision” were all characteristics of effective leaders and critical to the success of aspiring leaders. Established leaders in our sample added a characteristic of “organizational orientation” that extended the description of “leaders” to include an understanding of the institution as well as dedication to its success (a trait we have called “organizational altruism”). Conclusions Our findings validate others’ regarding leadership competencies while extending these findings to the specific context of health care and physicians. Important implications for curricular design include: inclusion of emotional intelligence competencies and reducing formal didactics in favor of programs that are both interactive and problem-based. PMID:18327531

Evaluating pharmacy leader development through the seven action logics.

PubMed

Philip, Achsah; Desai, Avani; Nguyen, Phouc Anne; Birney, Patrick; Colavecchia, Anthony; Karralli, Rusol; Smith, Lindsey; Lorimer, Dirk; Burgess, Gwen; Munch, Kyle; Daniel, Nelvin; Lionetti, Jason; Garey, Kevin W

2016-01-15

Pharmacy leader development over time was analyzed using the seven action logics. As part of an ongoing leadership seminar series, students were required to select a visionary pharmacy leader and conduct a structured interview to evaluate pharmacy leaders' action logics. A standardized questionnaire comprising 13 questions was created by the class. Questions addressed leadership qualities during the leaders' early years, education years, and work years. Transcripts were then coded by two separate trained investigators based on the leader's stage of life to provide a score for each action logic individually over time. Kappa coefficient was used to evaluate interrater agreement. A total of 14 leaders were interviewed. All leaders were currently employed and had won national awards for their contributions to pharmacy practice. Overall, there was 82% agreement between the two evaluators' scores for the various characteristics. Action logics changed based on the leaders' life stage. Using aggregate data from all leader interviews, a progression from lower-order action logics (opportunist, diplomat, expert) to higher-order action logics (strategist, alchemist) was found. Ten leaders (71%) were diplomats during their early years. Six leaders (43%) were experts during their education years, and 4 (29%) were strategists or alchemists. During the third life stage analyzed (the work years), 6 leaders (43%) were strategists, and 2 were alchemists. During their work years, all leaders had a percentage of their answers coded as alchemist (range, 5-22%). Throughout their professional careers, pharmacy leaders continually develop skills through formal education and mentorship that follow action logics. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Creative teaching method as a learning strategy for student midwives: A qualitative study.

PubMed

Rankin, Jean; Brown, Val

2016-03-01

Traditional ways of teaching in Higher Education are enhanced with adult-based approaches to learning within the curriculum. Adult-based learning enables students to take ownership of their own learning, working in independence using a holistic approach. Introducing creative activities promotes students to think in alternative ways to the traditional learning models. The study aimed to explore student midwives perceptions of a creative teaching method as a learning strategy. A qualitative design was used adopting a phenomenological approach to gain the lived experience of students within this learning culture. Purposive sampling was used to recruit student midwives (n=30). Individual interviews were conducted using semi-structured interviews with open-ended questions to gain subjective information. Data were transcribed and analyzed into useful and meaningful themes and emerging themes using Colaizzi's framework for analyzing qualitative data in a logical and systematic way. Over 500 meaningful statements were identified from the transcripts. Three key themes strongly emerged from the transcriptions. These included'meaningful learning','inspired to learn and achieve', and 'being connected'. A deep meaningful learning experience was found to be authentic in the context of theory and practice. Students were inspired to learn and achieve and positively highlighted the safe learning environment. The abilities of the facilitators were viewed positively in supporting student learning. This approach strengthened the relationships and social engagement with others in the peer group and the facilitators. On a less positive note, tensions and conflict were noted in group work and indirect negative comments about the approach from the teaching team. Incorporating creative teaching activities is a positive addition to the healthcare curriculum. Creativity is clearly an asset to the range of contemporary learning strategies. In doing so, higher education will continue to keep abreast of the needs of graduating students in a complex and rapidly changing professional environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study.

PubMed

Thiessen, Kellie; Heaman, Maureen; Mignone, Javier; Martens, Patricia; Robinson, Kristine

2016-03-15

In 2000, midwifery was regulated in the Canadian Province of Manitoba. Since the establishment of the midwifery program, little formal research has analyzed the utilization of regulated midwifery services. In Manitoba, the demand for midwifery services has exceeded the number of midwives in practice. The specific objective of this study was to explore factors influencing the implementation and utilization of regulated midwifery services in Manitoba. The case study design incorporated qualitative exploratory descriptive methods, using data derived from two sources: interviews and public documents. Twenty-four key informants were purposefully selected to participate in semi-structured in-depth interviews. All documents analyzed were in the public domain. Content analysis was employed to analyze the documents and transcripts of the interviews. The results of the study were informed by the Behavioral Model of Health Services Use. Three main topic areas were explored: facilitators, barriers, and future strategies and recommendations. The most common themes arising under facilitators were funding of midwifery services and strategies to integrate the profession. Power and conflict, and lack of a productive education program emerged as the most prominent themes under barriers. Finally, future strategies for sustaining the midwifery profession focused on ensuring avenues for registration and education, improving management strategies and accountability frameworks within the employment model, enhancing the work environment, and evaluating both the practice and employment models. Results of the document analysis supported the themes arising from the interviews. These findings on factors that influenced the implementation and integration of midwifery in Manitoba may provide useful information to key stakeholders in Manitoba, as well as other provinces as they work toward successful implementation of regulated midwifery practice. Funding for new positions and programs was consistently noted as a successful strategy. While barriers such as structures of power within Regional Health Authorities and inter and intra-professional conflict were identified, the lack of a productive midwifery education program emerged as the most prominent barrier. This new knowledge highlights issues that impact the ongoing growth and capacity of the midwifery profession and suggests directions for ensuring its sustainability.

Topic models: A novel method for modeling couple and family text data

PubMed Central

Atkins, David C.; Rubin, Tim N.; Steyvers, Mark; Doeden, Michelle A.; Baucom, Brian R.; Christensen, Andrew

2012-01-01

Couple and family researchers often collect open-ended linguistic data – either through free response questionnaire items or transcripts of interviews or therapy sessions. Because participant's responses are not forced into a set number of categories, text-based data can be very rich and revealing of psychological processes. At the same time it is highly unstructured and challenging to analyze. Within family psychology analyzing text data typically means applying a coding system, which can quantify text data but also has several limitations, including the time needed for coding, difficulties with inter-rater reliability, and defining a priori what should be coded. The current article presents an alternative method for analyzing text data called topic models (Steyvers & Griffiths, 2006), which has not yet been applied within couple and family psychology. Topic models have similarities with factor analysis and cluster analysis in that topic models identify underlying clusters of words with semantic similarities (i.e., the “topics”). In the present article, a non-technical introduction to topic models is provided, highlighting how these models can be used for text exploration and indexing (e.g., quickly locating text passages that share semantic meaning) and how output from topic models can be used to predict behavioral codes or other types of outcomes. Throughout the article a collection of transcripts from a large couple therapy trial (Christensen et al., 2004) is used as example data to highlight potential applications. Practical resources for learning more about topic models and how to apply them are discussed. PMID:22888778

Topic models: a novel method for modeling couple and family text data.

PubMed

Atkins, David C; Rubin, Timothy N; Steyvers, Mark; Doeden, Michelle A; Baucom, Brian R; Christensen, Andrew

2012-10-01

Couple and family researchers often collect open-ended linguistic data-either through free-response questionnaire items, or transcripts of interviews or therapy sessions. Because participants' responses are not forced into a set number of categories, text-based data can be very rich and revealing of psychological processes. At the same time, it is highly unstructured and challenging to analyze. Within family psychology, analyzing text data typically means applying a coding system, which can quantify text data but also has several limitations, including the time needed for coding, difficulties with interrater reliability, and defining a priori what should be coded. The current article presents an alternative method for analyzing text data called topic models (Steyvers & Griffiths, 2006), which has not yet been applied within couple and family psychology. Topic models have similarities to factor analysis and cluster analysis in that they identify underlying clusters of words with semantic similarities (i.e., the "topics"). In the present article, a nontechnical introduction to topic models is provided, highlighting how these models can be used for text exploration and indexing (e.g., quickly locating text passages that share semantic meaning) and how output from topic models can be used to predict behavioral codes or other types of outcomes. Throughout the article, a collection of transcripts from a large couple-therapy trial (Christensen et al., 2004) is used as example data to highlight potential applications. Practical resources for learning more about topic models and how to apply them are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

‘What difference does it make?’ Finding evidence of the impact of mental health service user researchers on research into the experiences of detained psychiatric patients

PubMed Central

Gillard, Steven; Borschmann, Rohan; Turner, Kati; Goodrich‐Purnell, Norman; Lovell, Kathleen; Chambers, Mary

2010-01-01

Abstract Background  Interest in the involvement of members of the public in health services research is increasingly focussed on evaluation of the impact of involvement on the research process and the production of knowledge about health. Service user involvement in mental health research is well‐established, yet empirical studies into the impact of involvement are lacking. Objective  To investigate the potential to provide empirical evidence of the impact of service user researchers (SURs) on the research process. Design  The study uses a range of secondary analyses of interview transcripts from a qualitative study of the experiences of psychiatric patients detained under the Mental Health Act (1983) to compare the way in which SURs and conventional university researchers (URs) conduct and analyse qualitative interviews. Results  Analyses indicated some differences in the ways in which service user‐ and conventional URs conducted qualitative interviews. SURs were much more likely to code (analyse) interview transcripts in terms of interviewees’ experiences and feelings, while conventional URs coded the same transcripts largely in terms of processes and procedures related to detention. The limitations of a secondary analysis based on small numbers of researchers are identified and discussed. Conclusions  The study demonstrates the potential to develop a methodologically robust approach to evaluate empirically the impact of SURs on research process and findings, and is indicative of the potential benefits of collaborative research for informing evidence‐based practice in mental health services. PMID:20536538

Transcript of Audio Narrative Portion of: Scandinavian Heritage. A Set of Five Audio-Visual Film Strip/Cassette Presentations.

ERIC Educational Resources Information Center

Anderson, Gerald D.; Olson, David B.

The document presents the transcript of the audio narrative portion of approximately 100 interviews with first and second generation Scandinavian immigrants to the United States. The document is intended for use by secondary school classroom teachers as they develop and implement educational programs related to the Scandinavian heritage in…

Influence of interlocutor/reader on utterance in reflective writing and interview

NASA Astrophysics Data System (ADS)

Collyer, Vivian M.

2010-03-01

The influence of the Other on utterance is foundational to language study. This analysis contrasts this influence within two modes of communication: reflective writing and interview. The data source is derived from the reflective writings and interview transcripts of a twelfth-grade physics student. In this student's case, reflective writing includes extensive utterances, utilizing rhetorical devices to persuade and reconcile with his reader. In the interview, on-going back-and-forth utterances allow the two participants to negotiate a co-constructed meaning for religion. Implications for the classroom are briefly discussed.

The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

PubMed

McKenzie, D; Pifalo, V

1998-07-01

The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

PubMed Central

McKenzie, D; Pifalo, V

1998-01-01

The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association. PMID:9681172

The Oral History Program: III. Personal views of health sciences librarianship and the Medical Library Association.

PubMed Central

McKenzie, D; Pifalo, V

1998-01-01

The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association. PMID:9803287

Life Stories of People with Long-Term Spinal Cord Injury.

ERIC Educational Resources Information Center

Crewe, Nancy M.

1997-01-01

Conducted life story interviews with and administered psychometric inventories to 50 individuals who had lived with spinal cord injury for more than 22 years. Transcripts of the life story interviews were then categorized into one of four classic forms: comedy, romance, tragedy, and irony. A sample of each narrative category is provided. (RJM)

Interview with Jessica Utts

ERIC Educational Resources Information Center

Rossman, Allan; Utts, Jessica

2014-01-01

This article offers a transcript of author Allan Rossman's interview with Jessica Utts, Professor and Chair of Statistics at the University of California-Irvine. Utts is also a Fellow of the American Statistical Association and a recipient of a Founders Award from ASA. Additionally, she has been elected as President of ASA for the year 2016. The…

Exploring the Lived Experiences of Students Enrolled in Noncredit Workforce Education Programs

ERIC Educational Resources Information Center

Ozmun, Clifford D.

2011-01-01

The purpose of this phenomenological inquiry was to explore the lived experiences of students enrolled in noncredit workforce education programs as preparation for their work, life, and ongoing education. Ten students enrolled in a noncredit welding class were interviewed and the interview transcripts were subjected to analytic induction…

College Students' Uses and Perceptions of Social Networking Sites for Health and Wellness Information

ERIC Educational Resources Information Center

Zhang, Yan

2012-01-01

Introduction: This study explores college students' use of social networking sites for health and wellness information and their perceptions of this use. Method: Thirty-eight college students were interviewed. Analysis: The interview transcripts were analysed using the qualitative content analysis method. Results: Those who had experience using…

"No No, You Cannot Say that!" Perceptions and Experiences of Parents of Preschool Children with Intellectual Disabilities in Sweden

ERIC Educational Resources Information Center

Olsson, Ingrid; Roll-Pettersson, Lise

2012-01-01

Using semi-structured interviews this study investigated the personal experiences of parents of pre-school children with intellectual disabilities within the Swedish social support system. Thirteen parents of 10 children participated. Interview transcripts were qualitatively analysed using interpretative phenomenological analysis. Three themes…

Information Literacy in the Lab: Graduate Teaching Experiences in First-Year Biology

ERIC Educational Resources Information Center

Lantz, Catherine

2016-01-01

The author interviewed 10 graduate teaching assistants leading lab sessions for first-year biology about how they introduce students to scientific literature. Qualitative data analysis of the interview transcripts revealed that both first-year students and graduate teaching assistants (many of whom are first-year teachers) struggle with…

The Disputatiousness of Canadian Politicians of Education: A Partial Report of a National Study.

ERIC Educational Resources Information Center

Townsend, Richard G.

For an exploration of the components and sources of disputatiousness, Canadian education administrators identified 181 legislators and school board members in 5 regions (British Columbia, Quebec, Prairie provinces, Atlantic provinces, and Ontario) who provided data in interviews. Two coders' judgments of interview transcripts subjected to factor…

Assessment of the face validity of two pain scales in Kenya: a validation study using cognitive interviewing

PubMed Central

2012-01-01

Background Patients in sub-Saharan Africa commonly experience pain, which often is un-assessed and undertreated. One hindrance to routine pain assessment in these settings is the lack of a single-item pain rating scale validated for the particular context. The goal of this study was to examine the face validity and cultural acceptability of two single-item pain scales, the Numerical Rating Scale (NRS) and the Faces Pain Scale-Revised (FPS-R), in a population of patients on the medical, surgical, and pediatric wards of Moi Teaching and Referral Hospital in Kenya. Methods Swahili versions of the NRS and FPS-R were developed by standard translation and back-translation. Cognitive interviews were performed with 15 patients at Moi Teaching and Referral Hospital in Eldoret, Kenya. Interview transcripts were analyzed on a question-by-question basis to identify major themes revealed through the cognitive interviewing process and to uncover any significant problems participants encountered with understanding and using the pain scales. Results Cognitive interview analysis demonstrated that participants had good comprehension of both the NRS and the FPS-R and showed rational decision-making processes in choosing their responses. Participants felt that both scales were easy to use. The FPS-R was preferred almost unanimously to the NRS. Conclusions The face validity and acceptability of the Swahili versions of the NRS and FPS-R has been demonstrated for use in Kenyan patients. The broader application of these scales should be evaluated and may benefit patients who currently suffer from pain. PMID:22512923

PATIENT-REPORTED OUTCOMES IN RARE LYSOSOMAL STORAGE DISEASES: KEY INFORMANT INTERVIEWS AND A SYSTEMATIC REVIEW PROTOCOL.

PubMed

Miller, Patricia A; Mulla, Sohail M; Adams-Webber, Thomasin; Sivji, Yasmin; Guyatt, Gordon H; Johnston, Bradley C

2016-01-01

To investigate the use, challenges and opportunities associated with using patient-reported outcomes (PROs) in studies with patients with rare lysosomal storage diseases (LSDs), we conducted interviews with researchers and health technology assessment (HTA) experts, and developed the methods for a systematic review of the literature. The purpose of the review is to identify the psychometrically sound generic and disease-specific PROs used in studies with patients with five LSDs of interest: Fabry, Gaucher (Type I), Niemann-Pick (Type B) and Pompe diseases, and mucopolysaccharidosis (Types I and II). Researchers and HTA experts who responded to an email invitation participated in a telephone interview. We used qualitative content analysis to analyze the anonymized transcripts. We conducted a comprehensive literature search for studies that used PROs to investigate burden of disease or to assess the impact of interventions across the five LSDs of interest. Interviews with seven researchers and six HTA experts representing eight countries revealed five themes. These were: (i) the importance of using psychometrically sound PROs in studies with rare diseases, (ii) the paucity of disease-specific PROs, (iii) the importance of having PRO data for economic analyses, (iv) practical and psychometric limitations of existing PROs, and (v) suggestions for new PROs. The systematic review has been completed. The interviews highlight current challenges and opportunities experienced by researchers and HTA experts involved in work with rare LSDs. The ongoing systematic review will highlight the experience, opportunities, and limitations of PROs in LSDs and provide suggestions for future research.

Designing a Leadership Development Program for Surgeons

PubMed Central

Jaffe, Gregory A.; Pradarelli, Jason C.; Lemak, Christy Harris; Mulholland, Michael W.; Dimick, Justin B.

2015-01-01

Background Although numerous leadership development programs exist in healthcare, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons’ motivations and desired goals for leadership training in order to design an evidence-based Leadership Development Program (LDP) in surgery. Materials and Methods At a large academic health center, we conducted semi-structured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding in order to extract major themes regarding surgeons’ motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Results Three major themes emerged regarding surgeons’ motivations for seeking leadership training: 1) Recognizing key gaps in their formal preparation for leadership roles; 2) Exhibiting an appetite for personal self-improvement; and 3) Seeking leadership guidance for career advancement. Participants’ interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a leadership development program: 1) leadership and communication; 2) team building; 3) business acumen/finance; and 4) greater understanding of the healthcare context. Conclusions Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A Leadership Development Program that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. PMID:26323368

“We Are All Gonna Get Diabetic These Days”

PubMed Central

Pyatak, Elizabeth A.; Florindez, Daniella; Peters, Anne L.; Weigensberg, Marc J.

2014-01-01

Purpose The purpose of this study was to investigate how an intergenerational legacy of type 2 diabetes affected the knowledge, attitudes, and treatment strategies of Hispanic young adults with diabetes. Methods Eight Hispanic young adults (ages 18-30 years) participated in a series of in-home longitudinal qualitative interviews, and 11 of their family members completed single in-home interviews, regarding their diabetes management practices. Interview transcripts were analyzed thematically by a team of researchers. Results Five themes emerged that characterized the influence of an intergenerational legacy of diabetes on young adults: food and family (how meal preparation and eating are shared within families), doing together (activity participation is contingent on others’ participation), knowledge and expectations (expectations for the future and understandings of diabetes are shaped by family members), miscarried helping (well-intentioned actions have negative consequences), and reciprocal support (children and parents support each other’s diabetes care). Conclusions Hispanic young adults’ knowledge, attitudes, and self-care practices related to diabetes are strongly influenced by the diabetes management practices of family members with diabetes, which often depart from current standards of diabetes care. Care providers should consider family members as a potentially significant influence, either positive or negative, on the diabetes self-care practices of this population. PMID:24867918

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process

PubMed Central

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O’Leary, James; Ruffner, BW; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2013-01-01

Aims The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. Materials & methods The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. Results A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Conclusions Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement. PMID:23459832

Reproductive Decision Making and Genetic Predisposition to Sudden Cardiac Death

PubMed Central

Barlevy, Dorit; Wasserman, David; Stolerman, Marina; Erskine, Kathleen E.; Dolan, Siobhan M.

2012-01-01

Background With current genetic technology, it is possible to detect mutations associated with long QT syndrome (LQTS), a hereditary cardiac arrhythmia syndrome. As a result, prospective parents diagnosed with LQTS will have to decide whether or not to prevent its transmission to future generations, either by not procreating or through the use of assisted reproductive technologies or prenatal testing. This paper explores how a hereditary predisposition to sudden cardiac death can influence reproductive decision making. Methods This study draws from interviews and focus groups with individuals who have personal or family histories of cardiac arrhythmia or sudden death. A keyword search was conducted on interview transcripts to identify quotes for analysis. Results Participants expressed complex, often ambivalent attitudes about the prospect of having a child with a predisposition to sudden cardiac death. Their comments reveal conflicting understandings of genetic responsibility and reflect the variable effects of personal experience on reproductive decision making. This paper compares attitudes towards LQTS and other genetic conditions in analyzing the themes that emerged in interviews and focus groups. Conclusions The “disability critique” of prenatal testing should be applied carefully to a context of genetic predisposition to sudden cardiac death in order to understand reproductive decision making. Firsthand experience with the condition, among other factors, can weigh heavily in those decisions. PMID:22822470

Residents' perceptions of simulation as a clinical learning approach.

PubMed

Walsh, Catharine M; Garg, Ankit; Ng, Stella L; Goyal, Fenny; Grover, Samir C

2017-02-01

Simulation is increasingly being integrated into medical education; however, there is little research into trainees' perceptions of this learning modality. We elicited trainees' perceptions of simulation-based learning, to inform how simulation is developed and applied to support training. We conducted an instrumental qualitative case study entailing 36 semi-structured one-hour interviews with 12 residents enrolled in an introductory simulation-based course. Trainees were interviewed at three time points: pre-course, post-course, and 4-6 weeks later. Interview transcripts were analyzed using a qualitative descriptive analytic approach. Residents' perceptions of simulation included: 1) simulation serves pragmatic purposes; 2) simulation provides a safe space; 3) simulation presents perils and pitfalls; and 4) optimal design for simulation: integration and tension. Key findings included residents' markedly narrow perception of simulation's capacity to support non-technical skills development or its use beyond introductory learning. Trainees' learning expectations of simulation were restricted. Educators should critically attend to the way they present simulation to learners as, based on theories of problem-framing, trainees' a priori perceptions may delimit the focus of their learning experiences. If they view simulation as merely a replica of real cases for the purpose of practicing basic skills, they may fail to benefit from the full scope of learning opportunities afforded by simulation.

Residents’ perceptions of simulation as a clinical learning approach

PubMed Central

Walsh, Catharine M.; Garg, Ankit; Ng, Stella L.; Goyal, Fenny; Grover, Samir C.

2017-01-01

Background Simulation is increasingly being integrated into medical education; however, there is little research into trainees’ perceptions of this learning modality. We elicited trainees’ perceptions of simulation-based learning, to inform how simulation is developed and applied to support training. Methods We conducted an instrumental qualitative case study entailing 36 semi-structured one-hour interviews with 12 residents enrolled in an introductory simulation-based course. Trainees were interviewed at three time points: pre-course, post-course, and 4–6 weeks later. Interview transcripts were analyzed using a qualitative descriptive analytic approach. Results Residents’ perceptions of simulation included: 1) simulation serves pragmatic purposes; 2) simulation provides a safe space; 3) simulation presents perils and pitfalls; and 4) optimal design for simulation: integration and tension. Key findings included residents’ markedly narrow perception of simulation’s capacity to support non-technical skills development or its use beyond introductory learning. Conclusion Trainees’ learning expectations of simulation were restricted. Educators should critically attend to the way they present simulation to learners as, based on theories of problem-framing, trainees’ a priori perceptions may delimit the focus of their learning experiences. If they view simulation as merely a replica of real cases for the purpose of practicing basic skills, they may fail to benefit from the full scope of learning opportunities afforded by simulation. PMID:28344719

Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

PubMed

White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

2017-10-20

To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

Listening with a narrative ear: Insights from a study of fall stories in older adults.

PubMed

Pereles, Laurie; Jackson, Roberta; Rosenal, Tom; Nixon, Lara

2017-01-01

To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly. Qualitative study of interviews. A fall prevention clinic in Calgary, Alta. Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them. Participants' stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients' additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed. The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues. The addition of patient narratives to clinical assessments offers clinicians an understanding of patients' perspectives, which can be used to better engage patients in rehabilitation. Copyright© the College of Family Physicians of Canada.

Male Spouses of Women Physicians: Communication, Compromise, and Carving Out Time.

PubMed

Isaac, Carol; Petrashek, Kara; Steiner, Megan; Manwell, Linda Baier; Byars-Winston, Angela; Carnes, Molly

2013-01-01

As the numbers of female physicians continue to grow, fewer medical marriages are comprised of the traditional dyad of male physician and stay-at-home wife. The "two-career family" is an increasingly frequent state for both male and female physicians' families, and dual-doctor marriages are on the rise. This qualitative study explored the contemporary medical marriage from the perspective of male spouses of female physicians. In 2010, we conducted semi-structured, in-depth interviews with nine spouses of internal medicine resident and faculty physicians. Interviewers queried work-home balance, career choices, and support networks. We used an interpretive, inductive, iterative approach to thematically analyze interview transcripts and develop broad, consensus-derived themes. A conceptual framework based on three major themes emerged: "A time for us? Really?", "Supporting and protecting her, sometimes at my expense,'" and "Hers is a career, mine is a job." This framework described the inflexibility of physicians' time and its impact on spousal time, career development, and choices. Having a set time for synchronizing schedules, frequent verbal support, and shared decision-making were seen as important by the husbands of female, full-time physicians. This exploratory study examined the contemporary medical marriage from the male spouse's perspective and highlights specific strategies for success.

Yale University's Institute of Human Relations and the Spanish Civil War: Dollard and Miller's study of fear and courage under battle conditions.

PubMed

Gondra, José María; Sánchez de Miguel, Manuel

2009-11-01

In the late 1930s, the Institute of Human Relations of Yale University developed a research program on conflict and anxiety as an outcome of Clark Hull's informal seminar on the integration of Freud's and Pavlov's theories. The program was launched at the 1937 Annual Meeting of the APA in a session chaired by Clark L. Hull, and the experiments continued through 1941, when the United States entered the Second World War. In an effort to apply the findings from animal experiments to the war situation, John Dollard and Neal E. Miller decided to study soldiers' fear reactions in combat. As a first step, they arranged interviews with a few veterans of the Abraham Lincoln Brigade. Taking these interviews as a point of departure, Dollard devised a questionnaire to which 300 former Lincoln brigaders responded. The present paper analyzes the main outcomes of the questionnaire, together with the war experiences reported in the interview transcripts. Our purpose was to evaluate a project which was initially investigated by the FBI because of the communists among the Lincoln ranks, but eventually supported by the American Army, and which exerted great influence on the military psychology of the time.

Listening with a narrative ear

PubMed Central

Pereles, Laurie; Jackson, Roberta; Rosenal, Tom; Nixon, Lara

2017-01-01

Abstract Objective To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly. Design Qualitative study of interviews. Setting A fall prevention clinic in Calgary, Alta. Participants Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them. Methods Participants’ stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients’ additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed. Main findings The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues. Conclusion The addition of patient narratives to clinical assessments offers clinicians an understanding of patients’ perspectives, which can be used to better engage patients in rehabilitation. PMID:28115459

The challenge of providing infertility services to a low-income immigrant Latino population

PubMed Central

Nachtigall, Robert D.; Castrillo, Martha; Shah, Nina; Turner, Dylan; Harrington, Jennifer; Jackson, Rebecca

2009-01-01

Study Objective To provide insight into the experience of low income immigrant Latino couples seeking infertility treatment. Design Qualitative interview study. Setting Infertility Clinic at a University-affiliated urban public teaching hospital. Patients Infertile low-income immigrant Latino couples (105 women and 40 men). Interventions In-depth tape-recorded interviews. Main Outcome Measures After transcription and translation, the interviews were coded and analyzed for thematic content. Results We identified four major challenges to providing infertility services to this population: (1) Communication: Language and cultural barriers resulted in patients having difficulty both in understanding diagnoses and treatments and in communicating their questions, concerns and experiences to physicians; (2) Continuity: Because medical student and residents rotated frequently, patients usually saw a different physician at each visit. (3) Bureaucracy: Patients reported having difficulty with appointment scheduling, follow-up visits, and timed laboratory procedures. (4) Accessibility: Patients faced issues of limited availability and affordability of treatment. Conclusions At a large, urban, University-affiliated infertility clinic, challenges related to communication, comprehension, continuity, bureaucracy, accessibility, availability, and affordability impeded the delivery of optimal infertility care to many low income immigrant Latino patients. We recommend a greater availability of translators and both patient and physician cultural orientations to address these health care barriers. PMID:18710703

Self-perceived professional identity of pharmacy educators in South Africa.

PubMed

Burton, Sue; Boschmans, Shirley-Anne; Hoelson, Chris

2013-12-16

Objective. To identify, describe, and analyze the self-perceived professional identities of pharmacy educators within the South African context. Methods. Narrative interviews were conducted, recorded, and transcribed. Thematic analysis and interpretation of the transcripts were conducted using qualitative data analysis software. Results. Multiplicities of self-perceived professional identities were identified. All of these were multi-faceted and could be situated on a continuum between pharmacist identity on one end and academic identity on the other. In addition, 6 key determinants were recognized as underpinning the participants' self-perception of their professional identity. Conclusion. This study afforded a better understanding of who pharmacy educators in South Africa are as professionals. Moreover, the findings contribute to an international, collective understanding of the professional identity of pharmacy educators.

The experiences and adaptations of abortion providers practicing under a new TRAP law: a qualitative study.

PubMed

Mercier, Rebecca J; Buchbinder, Mara; Bryant, Amy; Britton, Laura

2015-06-01

Abortion laws are proliferating in the United States, but little is known about their impact on abortion providers. In 2011, North Carolina instituted the Woman's Right to Know (WRTK) Act, which mandates a 24-h waiting period and counseling with state-prescribed information prior to abortion. We performed a qualitative study to explore the experiences of abortion providers practicing under this law. We conducted semistructured interviews with 31 abortion providers (17 physicians, 9 nurses, 1 physician assistant, 1 counselor and 3 clinic administrators) in North Carolina. Interviews were audio-recorded and transcribed. Interview transcripts were analyzed using a grounded theory approach. We identified emergent themes, coded all transcripts and developed a thematic framework. Two major themes define provider experiences with the WRTK law: provider objections/challenges and provider adaptations. Most providers described the law in negative terms, though providers varied in the extent to which they were affected. Many providers described extensive alterations in clinic practices to balance compliance with minimization of burdens for patients. Providers indicated that biased language and inappropriate content in counseling can negatively impact the patient-physician relationship by interfering with trust and rapport. Most providers developed verbal strategies to mitigate the emotional impacts for patients. Abortion providers in North Carolina perceive WRTK to have a negative impact on their clinical practice. Compliance is burdensome, and providers perceive potential harm to patients. The overall impact of WRTK is shaped by interaction between the requirements of the law and the adaptations providers make in order to comply with the law while continuing to provide comprehensive abortion care. Laws like WRTK are burdensome for providers. Providers adapt their clinical practices not only to comply with laws but also to minimize the emotional and practical impacts on patients. The effects on providers, frequently not a central consideration, should be considered in ongoing debates regarding abortion regulation. Copyright © 2015. Published by Elsevier Inc.

Stuttering and work life: an interpretative phenomenological analysis.

PubMed

Bricker-Katz, Geraldine; Lincoln, Michelle; Cumming, Steven

2013-12-01

The experiential claims of nine people who stuttered were examined with the purpose of determining the impact of stuttering on their work lives and to further examine what meaning they derive from these experiences. Six male and three female participants aged 29-61 years (mean age, 41.4) who stuttered were interviewed and verbatim interview transcripts were analyzed using interpretative phenomenological analysis. Credibility was established by way of member checking, researcher comparison with only consensual themes and interpretations presented in the final analysis. Four Superordinate themes, "stuttering is always there; stuttering at work reveals a problem; stuttering limits communication; and stuttering limits occupational progression" were distilled by descriptive and interpretative treatment of the interview transcripts. The interpretative level of analysis identified self-stigma as central to the meaning derived from these experiences. Participants' expectation of stigmatizing public attitudes, together with their own self-validation of such attitudes perpetuated diminished feelings about self-esteem and self-efficacy. Fear of negative evaluation may be heightened in the work context and might mediate feelings of self-stigma in this context. Superordinate themes and their subthemes indicate that stuttering is problematic at work by way of perpetuating in the PWS an expectation of negative evaluation by others. Findings implicate issues of self-stigma as generating feelings of self-doubt and self-reproach in PWS in the workplace. The development and effects of self-stigma in PWS have broader implications than the workplace context alone and further examination of the issues of self-stigma in stuttering is recommended. At the end of this activity the reader will be able to: (a) describe how stuttering might affect workplace experiences; (b) describe the impact of stuttering on communication in the work context; (c) describe how qualitative methods can provide insights into the impact of stuttering in the work context; (d) describe the impact of self and public stigma on wellbeing in the work context. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluation of Time Spent by Pharmacists and Nurses Based on the Location of Pharmacist Involvement in Medication History Collection.

PubMed

Chhabra, Anmol; Quinn, Andrea; Ries, Amanda

2018-01-01

Accurate history collection is integral to medication reconciliation. Studies support pharmacy involvement in the process, but assessment of global time spent is limited. The authors hypothesized the location of a medication-focused interview would impact time spent. The objective was to compare time spent by pharmacists and nurses based on the location of a medication-focused interview. Time spent by the interviewing pharmacist, admitting nurse, and centralized pharmacist verifying admission orders was collected. Patient groups were based on whether the interview was conducted in the emergency department (ED) or medical floor. The primary end point was a composite of the 3 time points. Secondary end points were individual time components and number and types of transcription discrepancies identified during medical floor interviews. Pharmacists and nurses spent an average of ten fewer minutes per ED patient versus a medical floor patient ( P = .028). Secondary end points were not statistically significant. Transcription discrepancies were identified at a rate of 1 in 4 medications. Post hoc analysis revealed the time spent by pharmacists and nurses was 2.4 minutes shorter per medication when interviewed in the ED ( P < .001). The primary outcome was statistically and clinically significant. Limitations included inability to blind and lack of cost-saving analysis. Pharmacist involvement in ED medication reconciliation leads to time savings during the admission process.

Aging women with schizophrenia.

PubMed

Pentland, Wendy; Miscio, Gina; Eastabrook, Shirley; Krupa, Terry

2003-01-01

The purpose of this study was to describe the aging experiences of women with schizophrenia. The research focused on how participants viewed their own aging with schizophrenia, their perceived worries and concerns and how they were coping with aging with the disorder. Using a qualitative approach, data were collected using multiple in-depth interviews with six participants selected purposefully from the client list of a community mental health center. Interview transcriptions were coded and analyzed according to the study questions using QSR Nudist 4 software. Several categories and sub-categories emerged. These included the improvement in the illness over time; physical and daily living activity limitations; specific positive and negative changes that the women report have accompanied aging; the profound losses experienced by the participants when they were younger as a result of having schizophrenia; and how these losses have affected their present lives in terms of limiting available informal support, creating dependency on formal programs and services, and participants' fears of the future. Based on the study findings, implications for mental health practice and services are considered and suggestions are made to guide future research.

Exploring family physicians' reasons to continue or discontinue providing intrapartum care: Qualitative descriptive study.

PubMed

Dove, Marion; Dogba, Maman Joyce; Rodríguez, Charo

2017-08-01

To examine the reasons why family physicians continue or discontinue providing intrapartum care in their clinical practice. Qualitative descriptive study. Two hospitals located in a multicultural area of Montreal, Que, in November 2011 to June 2012. Sixteen family physicians who were current or former providers of obstetric care. Data were collected using semistructured qualitative interviews. Thematic analysis was used to analyze the interview transcripts. Three overarching themes that help create understanding of why family doctors continue to provide obstetric care were identified: their attraction, often initiated by role models early in their careers, to practising complete continuity of care and accompanying patients in a special moment in their lives; the personal, family, and organizational pressures experienced while pursuing a family medicine career that includes obstetrics; and their ongoing reflection about continuing to practise obstetrics. The practice of obstetrics was very attractive to family physician participants whether they provided intrapartum care or decided to stop. More professional support and incentives might help keep family doctors practising obstetrics. Copyright© the College of Family Physicians of Canada.

Embedding technology into inter-professional best practices in home safety evaluation.

PubMed

Burns, Suzanne Perea; Pickens, Noralyn Davel

2017-08-01

To explore inter-professional home evaluators' perspectives and needs for building useful and acceptable decision-support tools for the field of home modifications. Twenty semi-structured interviews were conducted with a range of home modification professionals from different regions of the United States. The interview transcripts were analyzed with a qualitative, descriptive, perspective approach. Technology supports current best practice and has potential to inform decision making through features that could enhance home evaluation processes, quality, efficiency and inter-professional communication. Technological advances with app design have created numerous opportunities for the field of home modifications. Integrating technology and inter-professional best practices will improve home safety evaluation and intervention development to meet client-centred and societal needs. Implications for rehabilitation Understanding home evaluators technology needs for home safety evaluations contributes to the development of app-based assessments. Integrating inter-professional perspectives of best practice and technological needs in an app for home assessments improves processes. Novice and expert home evaluators would benefit from decision support systems embedded in app-based assessments. Adoption of app-based assessment would improve efficiency while remaining client-centred.

Experiences of undergraduate African health sciences students: A hermeneutic inquiry.

PubMed

Inyama, Davis; Williams, Allison; McCauley, Kay

2015-06-01

While efforts have been made to understand the experiences of African students in predominantly white environments, the experiences of African students in clinical placement areas have rarely been explored. This paper is a report on a study designed to address the gap in educational research on the experiences of African health sciences students in clinical placements in predominantly white environments. Interviews adopting an open approach to conversations were conducted with nine African students from three health disciplines at one metropolitan university in Australia between 2012 and 2013. Interview transcripts were analyzed using philosophical hermeneutics, where shared meanings were arrived at by employing key Gadamerian hermeneutic components. Findings revealed a number of factors that had a direct effect on the meaning students derived from their clinical placement experiences. These, as revealed in the interlinked domains of body, space, relationships, and time included difference, acceptance, resilience, and cultural sensitivity. Insights from this study may lead to the adoption of strategies designed to improve the experiences of African students studying health sciences in predominantly white environments. © 2014 Wiley Publishing Asia Pty Ltd.

Health out of foster care as young adults age out of foster care: A phenomenological exploration of seeking healthcare services after aging out of the US foster care system.

PubMed

Collins, Jennifer L; Jimenez, Rosalinda; Thomas, Laura J

2018-05-17

Some adolescents in the United States who have been abused and/or neglected by caregivers and placed in permanent custody of the state leave, or "age out" of foster care at 18 years of age. Poor health outcomes among individuals who age out are notable, yet few studies describe the phenomenon of seeking healthcare services after leaving foster care. The investigators specifically queried the phenomenon of seeking healthcare services after foster care drawing from the Phenomenology of Practice approach. We interviewed 13 young adults who aged out of care. Investigators extracted lived experience descriptions (LEDs) from interview transcripts and analyzed under phenomenological themes. Healthcare experiences were marked by avoiding self-disclosure, having no choice but to wait, missing family history, and relying on the kindness of strangers. Healthcare providers who integrate the findings into care delivery models will engage young adults with more understanding and sensitivities of ethical practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

A qualitative analysis of immunization programs with sustained high coverage, 2000-2005.

PubMed

Kennedy, Allison; Groom, Holly; Evans, Victoria; Fasano, Nancy

2010-01-01

Despite record-high immunization coverage nationally, there is considerable variation across state and local immunization programs, which are responsible for the implementation of vaccine recommendations in their jurisdictions. The objectives of this study were to describe activities of state and local immunization programs that sustained high coverage levels across several years and to identify common themes and practical examples for sustaining childhood vaccination coverage rates that could be applied elsewhere. We conducted 95 semi-structured key informant interviews with internal staff members and external partners at the 10 immunization programs with the highest sustained childhood immunization coverage from 2000 to 2005, as measured by the National Immunization Survey. Interview transcripts were analyzed qualitatively using a general inductive approach. Common themes across the 10 programs included maintaining a strong program infrastructure, using available data to drive planning and decision making, a commitment to building and sustaining relationships, and a focus on education and communication. Given the challenges of an increasingly complex immunization system, the lessons learned from these programs may help inform others who are working to improve childhood immunization delivery and coverage in their own programs.

“I’m Not Going to Die from the AIDS”: Resilience in Aging with HIV Disease

PubMed Central

Emlet, Charles A.; Tozay, Shakima; Raveis, Victoria H.

2011-01-01

Purpose: Adults aging with HIV/AIDS can experience resilience in spite of the deleterious affects of the disease. This study seeks to examine the lived experiences of older adults with HIV/AIDS as it relates to strengths and resilience in dealing with this devastating disease. Design and methods: Semistructured in-depth interviews were conducted with 25 adults, 50 years and older, living with HIV/AIDS. The interview transcripts were analyzed using constant comparative methodology following the tenets of adaptive theory. Results: The majority of informants expressed experiences of resilience and strengths as related to living with HIV/AIDS. Seven major themes emerged from the analysis including self-acceptance, optimism, will to live, generativity, self-management, relational living, and independence. Implications: The research identified the importance of strengths and resilience among older adults living with HIV/AIDS. Further research is needed to explore these phenomena with larger samples. Practitioners should identify and implement methods for assessing resilience among older HIV-infected adults. PMID:20650948

The PATH project in eight European countries: an evaluation.

PubMed

Veillard, Jeremy Henri Maurice; Schiøtz, Michaela Louise; Guisset, Ann-Lise; Brown, Adalsteinn Davidson; Klazinga, Niek S

2013-01-01

This paper's aim is to evaluate the perceived impact and the enabling factors and barriers experienced by hospital staff participating in an international hospital performance measurement project focused on internal quality improvement. Semi-structured interviews involving international hospital performance measurement project coordinators, including 140 hospitals from eight European countries (Belgium, Estonia, France, Germany, Hungary, Poland, Slovakia and Slovenia). Inductively analyzing the interview transcripts was carried out using the grounded theory approach. Even when public reporting is absent, the project was perceived as having stimulated performance measurement and quality improvement initiatives in participating hospitals. Attention should be paid to leadership/ownership, context, content (project intrinsic features) and processes supporting elements. Generalizing the findings is limited by the study's small sample size. Possible implications for the WHO European Regional Office and for participating hospitals would be to assess hospital preparedness to participate in the PATH project, depending on context, process and structural elements; and enhance performance and practice benchmarking through suggested approaches. This research gathered rich and unique material related to an international performance measurement project. It derived actionable findings.

The Precarity of Older Adults Living Alone With Cognitive Impairment.

PubMed

Portacolone, Elena; Rubinstein, Robert L; Covinsky, Kenneth E; Halpern, Jodi; Johnson, Julene K

2018-01-24

To examine the lived experience of older adults living alone with cognitive impairment to better understand their needs and concerns. Based on our previous work suggesting that older adults living alone often experience a sense of precarity, we were interested in exploring this construct in older adults living alone with a diagnosis of cognitive impairment. The notion of precarity points to the uncertainty deriving from coping with cumulative pressures while trying to preserve a sense of independence. This is a qualitative study of 12 adults aged 65 and older living alone with cognitive impairment. Six participants had a diagnosis of Alzheimer's disease; 6 had a diagnosis of mild cognitive impairment. Participants' lived experiences were elicited through 40 ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Qualitative analysis of transcripts revealed three themes. Theme 1 described the distress stemming from the uncertainty of having cognitive impairment that has an unpredictable course. Theme 2 drew attention to the tendency of participants to feel responsible for managing their cognitive impairment. Theme 3 described the pressures stemming from the lack of appropriate services to support independent living for persons with cognitive impairment. These 3 themes all pointed to facets of precarity. Findings also suggest the dearth of programs to support older adults living alone with cognitive impairment and the need to develop novel programs and interventions. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Australian men with cancer practice complementary therapies (CTs) as a coping strategy.

PubMed

Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

2014-11-01

The aim of this study was to explore how and why Australian men with cancer practice complementary therapies (CTs) and how their significant others (SOs) contribute to the regular uptake of CTs. This qualitative study employed semi-structured interviews with 26 male cancer patients and 24 SOs. Participants were purposefully sampled from a preceding Australian survey investigating the use of CTs in men with cancer (94% response rate and 86% consent rate for follow-up interview). Interviews were conducted in a metropolitan location, and the 43 interview transcripts were analyzed thematically. Three core themes were identified: men used CTs as (a) problem-focused coping (e.g., diet modification), (b) emotion-focused coping (e.g., meditation), and (c) meaning-based coping (e.g., prayer). Practicing CTs helped men to cope with physical, emotional, and spiritual concerns, although some men spoke of difficulties with practicing meditation to regulate their emotions. SOs were supportive of men's coping strategies but were only rarely involved in men's emotion-focused coping. Complementary therapies have the potential to facilitate coping with cancer, independent of any measurable physiological benefit. Our findings suggest that when clinicians engage in conversations about CTs use, they should consider the type of coping strategy employed by their patient. Such information may enhance the efficacy of some interventions (e.g., meditation) and also provide for an opportunity to discuss patients' expectations concerning CTs. Copyright © 2014 John Wiley & Sons, Ltd.

Experiences, Feelings and Thoughts of Women Undergoing Second Trimester Medical Termination of Pregnancy

PubMed Central

Andersson, Inga-Maj; Christensson, Kyllike; Gemzell-Danielsson, Kristina

2014-01-01

Main Objective The objective of this study was to explore women's expectations and experiences of undergoing second trimester abortion. Methods This is a cross-sectional study using a screening questionnaire and semi-structured interviews for data collection. Thirty-one women filled out the questionnaire and 23 of them were later interviewed. The questionnaires were analyzed by descriptive statistics. The interviews were recorded, transcribed verbatim and analyzed with qualitative content analysis. Most Important Findings Indications for the abortion were fetal malformation or unintended pregnancy. The women expressed similar feelings and these were irrespective for the reason for having an abortion. Both physical and mental pain was experienced during the abortion process and described by the women. Taking the mifepristone-pill was experienced as especially emotionally difficult for many participants. Professional support from the staff together with support from the partner, a friend or relative helped in transforming the worries related to something unknown to feelings of coping with a new and hard experience. Prior to the abortion most women stated that they did not want to view the fetus but women who chose to view the fetus described this as a way of confronting the reality and an opportunity to say farewell to the pregnancy/fetus. The analysis of the interview transcripts revealed five themes mirroring the women's experiences, thoughts and feelings related to the abortion. Conclusions The decision to undergo second trimester abortion sometimes exposes women to strong and conflicting emotions which are irrespective for the reason for having an abortion. Despite this women do not regret their decision to terminate the pregnancy. This analysis shows that their rational thinking outweighs their emotionally difficult feelings. It is important for the attending staff to be responsive to the needs of each individual woman whatever the indication is for the abortion. PMID:25546416

Medical Education to Enhance Critical Consciousness: Facilitators' Experiences.

PubMed

Zaidi, Zareen; Vyas, Rashmi; Verstegen, Danielle; Morahan, Page; Dornan, Tim

2017-11-01

To analyze educators' experiences of facilitating cultural discussions in two global health professions education programs and what these experiences had taught them about critical consciousness. A multicultural research team conducted in-depth interviews with 16 faculty who had extensive experience facilitating cultural discussions. They analyzed transcripts of the interviews thematically, drawing sensitizing insights from Gramsci's theory of cultural hegemony. Collaboration and conversation helped the team self-consciously examine their positions toward the data set and be critically reflexive. Participant faculty used their prior experience facilitating cultural discussions to create a "safe space" in which learners could develop critical consciousness. During multicultural interactions they recognized and explicitly addressed issues related to power differentials, racism, implicit bias, and gender bias. They noted the need to be "facile in attending to pain" as learners brought up traumatic experiences and other sensitive issues including racism and the impact of power dynamics. They built relationships with learners by juxtaposing and exploring the sometimes-conflicting norms of different cultures. Participants were reflective about their own understanding and tendency to be biased. They aimed to break free of such biases while role modeling how to have the courage to speak up. Experience had given facilitators in multicultural programs an understanding of their responsibility to promote critical consciousness and social justice. How faculty without prior experience or expertise could develop those values and skills is a topic for future research.

PS1-10: How Can the Same Practice Be Classified as Having 2 and 900 MDs? NAMCS Data Collection in a Changing Ambulatory Care Environment

PubMed Central

Halley, Meghan; Gillespie, Katherine; Rendle, Katharine; Luft, Harold

2014-01-01

Background/Aims Since 1973, the National Ambulatory Medical Care Survey (NAMCS), administered by the National Center for Health Statistics (NCHS) has been widely used in studies of ambulatory care. With the growth in large multispecialty practices – including many members of the HMORN – there is a need to understand how NAMCS data are collected and whether current processes yield accurate and reliable data. NAMCS collects data from physicians about their practices and abstracts a sample of patient visit records. This study reports on the physician component. Methods In collaboration with NCHS, nine physicians were randomly sampled from a multispecialty clinic using standard NAMCS recruitment procedures; eight physicians were eligible and agreed to participate. Using their standard protocols, three Field Representatives (FRs) conducted NAMCS physician interviews while a trained ethnographer (MH, KR) observed and audio-recorded each interview. Transcripts and field notes were analyzed using a grounded theory approach to identify key themes. Results Data have been collected and analyzed. They are currently undergoing standard confidentiality review by NCHS. However, this process has been delayed due to the government shutdown. We fully anticipate that results will be released in time for presentation at the HMORN conference. Conclusions Though we are precluded from disseminating results at this time, we will provide a full report of our results in our HMORN conference presentation.

Exploring community faculty members’ engagement in educational scholarship

PubMed Central

Law, Marcus; Wright, Sarah; Mylopoulos, Maria

2016-01-01

Abstract Objective To obtain a deeper understanding of community faculty members’ perceptions about engagement in educational scholarship. Design One-on-one semistructured interviews that were audiorecorded, transcribed verbatim, and subsequently analyzed. Setting Toronto, Ont. Participants Purposive, theoretical sample of 8 physician faculty members at the University of Toronto. Methods Interview transcripts were analyzed using a grounded theory approach. Emergent themes were identified by the research team through a process of constant comparative analysis. Main findings Community faculty members identified themselves professionally as clinicians and teachers, and they did not see themselves as scholars in medical education. While they believed that educational scholarship was important for the field more broadly, they did not see the personal or professional value of being involved. This attitude stemmed from the perception that there was not a direct link between scholarly activity and improvement in teaching or patient care. Instead, participants viewed scholarly activity as a mode of career advancement rather than practice improvement. Furthermore, they equated educational scholarship with clinical research, thereby excluding themselves from participation in scholarly activities. Conclusion When developing strategies to engage community faculty members in educational scholarship, it is important to consider the implications of members’ professional identity, as well as implicit models of scholarship. To expand the concept of educational scholarship beyond research activities, additional scholarly contributions need to be supported, recognized, and valued. PMID:27629687

Censoring Textbooks: Is West Virginia the Tip of the Iceberg? A Transcript of "Options on Education," December 11, 1974.

ERIC Educational Resources Information Center

George Washington Univ., Washington, DC. Inst. for Educational Leadership.

Interviews with several individuals representing a variety of viewpoints about the recent controversy regarding textbooks and philosophy in the Kanawha County, West Virginia, public schools are presented in this transcript of a National Public Radio program broadcast in December 1974. Beginning with a discussion of the issue of textbook selection…

Reflections on the Development of Vocational Education in Florida. Volume III.

ERIC Educational Resources Information Center

Mock, David B.

This volume contains transcripts of four oral history interviews that were conducted during a study of the history of vocational education in Florida. The first interview is with Maxwell Samuel Thomas, a vocational educator who began his career in 1932 and has since served as a vocational education teacher and administrator, participated in…

What Makes Useful Evidence for Educational Leadership Practice? An Interview

ERIC Educational Resources Information Center

Addae-Kyeremeh, Eric; Fox, Alison

2018-01-01

This article presents a transcript of an interview with Eric Addae-Kyeremeh, a Senior Lecturer in Leadership and Management and a Chartered Fellow of both The Chartered Management Institute and BCS, The Chartered Institute for IT. He is currently the Associate Head of School Innovation in the School of Education, Childhood, Youth and Sport with…

The Voice Transcription Technique: Use of Voice Recognition Software to Transcribe Digital Interview Data in Qualitative Research

ERIC Educational Resources Information Center

Matheson, Jennifer L.

2007-01-01

Transcribing interview data is a time-consuming task that most qualitative researchers dislike. Transcribing is even more difficult for people with physical limitations because traditional transcribing requires manual dexterity and the ability to sit at a computer for long stretches of time. Researchers have begun to explore using an automated…

Crossing the Bridge: The Role of Lived Experiences in Shaping Noncredit Workforce Education Students' Educational Goals

ERIC Educational Resources Information Center

Ozmun, Cliff D.

2012-01-01

The purpose of this study was to explore the lived experiences of students enrolled in noncredit workforce education programs as preparation for ongoing education. Ten students enrolled in a noncredit welding class were interviewed and the interview transcripts were subjected to analytic induction. Notable findings indicate that students were…

Identity and Spatial Experience of Community Youth in Relation to Career Guidance

ERIC Educational Resources Information Center

Zhang, Yong; Han, Minghua

2010-01-01

In order to investigate the self identity and vocational identity among community youth in Shanghai and their associated spatial experience, 4 focus groups, made up of 14 individuals were interviewed. We assigned numbers to indicate each interviewee as well as the general theme of each transcription of the interview. Results are as follows:…

Children, Mathematics, and Videotape: Using Multimodal Analysis to Bring Bodies into Early Childhood Assessment Interviews

ERIC Educational Resources Information Center

Parks, Amy Noelle; Schmeichel, Mardi

2014-01-01

Despite the increased use of video for data collection, most research using assessment interviews in early childhood education relies solely upon the analysis of linguistic data, ignoring children's bodies. This trend is particularly troubling in studies of marginalized children because transcripts limited to language can make it difficult to…

Tipping Points: Teachers' Reported Reasons for Referring Primary School Children for Excessive Anxiety

ERIC Educational Resources Information Center

Hinchliffe, Kaitlin J.; Campbell, Marilyn A.

2016-01-01

The current study explored the reasons that primary school teachers reported were tipping points for them in deciding whether or not and when to refer a child to the school student support team for excessive anxiety. Twenty teachers in two Queensland primary schools were interviewed. Content analysis of interview transcripts revealed six themes…

Diagnostic Reasoning across the Medical Education Continuum.

PubMed

Smith, C Scott; Hill, William; Francovich, Chris; Morris, Magdalena; Robbins, Bruce; Robins, Lynne; Turner, Andrew

2014-07-15

We aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. We performed semi-structured interviews of premedical students, first year medical students, third year medical students, second year internal medicine residents, and experienced faculty (ten each) as they diagnosed three common causes of dyspnea. A second observer recorded emotional tone. All interviews were digitally recorded and blinded transcripts were created. Propositional analysis and concept mapping were performed. Grounded theory was used to identify salient categories and transcripts were scored with these categories. Transcripts were then unblinded. Systematic differences in propositional structure, number of concept connections, distribution of grounded theory categories, episodic and semantic memories, and emotional tone were identified. Summary concept maps were created and grounded theory concepts were explored for each learning level. We identified three major findings: (1) The "apprentice effect" in novices (high stress and low narrative competence); (2) logistic concept growth in intermediates; and (3) a cognitive state transition (between analytical and intuitive approaches) in experts. These findings warrant further study and comparison.

Expanding perspective on music therapy for symptom management in cancer care.

PubMed

Potvin, Noah; Bradt, Joke; Kesslick, Amy

2015-01-01

Symptom management is a frequently researched treatment topic in music therapy and cancer care. Representations in the literature of music interventions for symptom management, however, have often overlooked the human experiences shaping those symptoms. This may result in music therapy being perceived as a linear intervention process that does not take into account underlying experiences that contribute to symptom experiences. This study explored patient experiences underlying symptoms and symptom management in cancer care, and examined the role of music therapy in that clinical process. This study analyzed semi-structured, open-ended exit interviews obtained from 30 participants during a randomized controlled trial investigating the differential impact of music therapy versus music medicine interventions on symptom management in participants with cancer. Interviews were conducted by a research assistant not involved with the clinical interventions. Exit interview transcripts for 30 participants were analyzed using an inductive, latent, constructivist method of thematic analysis. Three themes-Relaxation, Therapeutic relationship, and Intrapersonal relating-capture elements of the music therapy process that (a) modified participants' experiences of adjustments in their symptoms and (b) highlighted the depth of human experience shaping their symptoms. These underlying human experiences naturally emerged in the therapeutic setting, requiring the music therapist's clinical expertise for appropriate support. Symptom management extends beyond fluctuation in levels and intensity of a surface-level symptom to incorporate deeper lived experiences. The authors provide recommendations for clinical work, entry-level training as related to symptom management, implications for evidence-based practice in music therapy, and methodology for future mixed methods research. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The use of cognitive task analysis to reveal the instructional limitations of experts in the teaching of procedural skills.

PubMed

Sullivan, Maura E; Yates, Kenneth A; Inaba, Kenji; Lam, Lydia; Clark, Richard E

2014-05-01

Because of the automated nature of knowledge, experts tend to omit information when describing a task. A potential solution is cognitive task analysis (CTA). The authors investigated the percentage of knowledge experts omitted when teaching a cricothyrotomy to determine the percentage of additional knowledge gained during a CTA interview. Three experts were videotaped teaching a cricothyrotomy in 2010 at the University of Southern California. After transcription, they participated in CTA interviews for the same procedure. Three additional surgeons were recruited to perform a CTA for the procedure, and a "gold standard" task list was created. Transcriptions from the teaching sessions were compared with the task list to identify omitted steps (both "what" and "how" to do). Transcripts from the CTA interviews were compared against the task list to determine the percentage of knowledge articulated by each expert during the initial "free recall" (unprompted) phase of the CTA interview versus the amount of knowledge gained by using CTA elicitation techniques (prompted). Experts omitted an average of 71% (10/14) of clinical knowledge steps, 51% (14/27) of action steps, and 73% (3.6/5) of decision steps. For action steps, experts described "how to do it" only 13% (3.6/27) of the time. The average number of steps that were described increased from 44% (20/46) when unprompted to 66% (31/46) when prompted. This study supports previous research that experts unintentionally omit knowledge when describing a procedure. CTA is a useful method to extract automated knowledge and augment expert knowledge recall during teaching.

"I'm on a Journey I Never Thought I'd Be On": Using Process Drama Pedagogy for the Literacy Programme

ERIC Educational Resources Information Center

Wells, Trish; Sandretto, Susan

2017-01-01

This paper argues that process drama is a productive pedagogy with multiple affordances for multiliteracies. We describe an exploratory study in which two teachers from a rural New Zealand primary school used process drama pedagogy in the literacy programme. Analysis of the initial and exit teacher interviews, lesson transcripts and transcripts of…

Under Pressure: An Exploration of the Module Design Experiences of Academic Staff Employed in One UK University

ERIC Educational Resources Information Center

Binns, Carole

2017-01-01

This paper discusses some of the qualitative data obtained from a small number (23) of semi-structured interviews of academic staff who are involved in module design, and who are employed within one UK university. Analysing the interview transcripts produced eight main themes. One of these themes was the perceived pressures or constraints on…

Qualitative Investigation of the "Cooking with Kids" Program: Focus Group Interviews with Fourth-Grade Students, Teachers, and Food Educators

ERIC Educational Resources Information Center

Lukas, Catherine V.; Cunningham-Sabo, Leslie

2011-01-01

Objective: Focus group (FG) interviews with students and adults were used to obtain a rich understanding of the "Cooking with Kids" classroom experience from the child and adult participant perspectives. Methods: FG topics included students' cooking experiences at school and home and perceptions of "Cooking with Kids". Verified transcripts of…

The use of in vitro transcription to probe regulatory functions of viral protein domains.

PubMed

Loewenstein, Paul M; Song, Chao-Zhong; Green, Maurice

2007-01-01

Adenoviruses (Ads), like other DNA tumor viruses, have evolved specific regulatory genes that facilitate virus replication by controlling the transcription of other viral genes as well as that of key cellular genes. In this regard, the E1A transcription unit contains multiple protein domains that can transcriptionally activate or repress cellular genes involved in the regulation of cell proliferation and cell differentiation. Studies using in vitro transcription have provided a basis for a molecular understanding of the interaction of viral regulatory proteins with the transcriptional machinery of the cell and continue to inform our understanding of transcription regulation. This chapter provides examples of the use of in vitro transcription to analyze transcriptional activation and transcriptional repression by purified, recombinant Ad E1A protein domains and single amino acid substitution mutants as well as the use of protein-affinity chromatography to identify host cell transcription factors involved in viral transcriptional regulation. A detailed description is provided of the methodology to prepare nuclear transcription extract, to prepare biologically active protein domains, to prepare affinity depleted transcription extracts, and to analyze transcription by primer extension and by run-off assay using naked DNA templates.

Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

An Optogenetic Platform for Real-Time, Single-Cell Interrogation of Stochastic Transcriptional Regulation.

PubMed

Rullan, Marc; Benzinger, Dirk; Schmidt, Gregor W; Milias-Argeitis, Andreas; Khammash, Mustafa

2018-05-17

Transcription is a highly regulated and inherently stochastic process. The complexity of signal transduction and gene regulation makes it challenging to analyze how the dynamic activity of transcriptional regulators affects stochastic transcription. By combining a fast-acting, photo-regulatable transcription factor with nascent RNA quantification in live cells and an experimental setup for precise spatiotemporal delivery of light inputs, we constructed a platform for the real-time, single-cell interrogation of transcription in Saccharomyces cerevisiae. We show that transcriptional activation and deactivation are fast and memoryless. By analyzing the temporal activity of individual cells, we found that transcription occurs in bursts, whose duration and timing are modulated by transcription factor activity. Using our platform, we regulated transcription via light-driven feedback loops at the single-cell level. Feedback markedly reduced cell-to-cell variability and led to qualitative differences in cellular transcriptional dynamics. Our platform establishes a flexible method for studying transcriptional dynamics in single cells. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

An Older Transgender Woman's Quest for Identity.

PubMed

Walker, Charles A; Cohen, Harriet; Jenkins, David

2016-02-01

Despite sensationalized media attention, transgender individuals are the most marginalized and misunderstood group in the lesbian, gay, bisexual, and transgender (LGBT) community. The current article presents a case study of one woman's quest for identity. Narrative inquiry was used to analyze data from interview transcripts and four themes emerged during analysis: (a) naming the ambiguity, (b) revealing-concealing the authentic self, (c) discovering the transgender community, and (d) embracing the "T" identity. Lifespan and empowerment theories were used to harvest meanings from these themes. Implications for nursing practice and research were examined based on study findings. Participatory action research offers an approach for future studies in which researchers advocate for transgender individuals and remove obstacles to their health care access. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 31-38.]. Copyright 2016, SLACK Incorporated.

Medical dominance within research ethics committees.

PubMed

Humphreys, Stephen; Thomas, Hilary; Martin, Robyn

2014-01-01

Qualitative research is reported which explores the perceptions of members of the U.K.'s independent Phase I ethics committees (IECs) about key issues identified following a literature review. Audio-recorded interviews were conducted with ten expert and ten lay members from all IECs except the one to which the lead author was attached. Transcripts were thematically analyzed following a broadly hermeneutical approach. The findings-dealing with such matters as recruitment strategies and length of service; attitudes towards member categories, published ethics guidelines, and the adequacy of insurance; levels of training and views on achieving a recognised level of competence-have an intrinsic interest, but it is when the findings are considered collectively using Freidson's theory of professional dominance that they reveal the influence the medical profession can have in shaping ethics review.

Self-Perceived Professional Identity of Pharmacy Educators in South Africa

PubMed Central

Boschmans, Shirley-Anne; Hoelson, Chris

2013-01-01

Objective. To identify, describe, and analyze the self-perceived professional identities of pharmacy educators within the South African context. Methods. Narrative interviews were conducted, recorded, and transcribed. Thematic analysis and interpretation of the transcripts were conducted using qualitative data analysis software. Results. Multiplicities of self-perceived professional identities were identified. All of these were multi-faceted and could be situated on a continuum between pharmacist identity on one end and academic identity on the other. In addition, 6 key determinants were recognized as underpinning the participants’ self-perception of their professional identity. Conclusion. This study afforded a better understanding of who pharmacy educators in South Africa are as professionals. Moreover, the findings contribute to an international, collective understanding of the professional identity of pharmacy educators. PMID:24371334

Making friends at antenatal classes: a qualitative exploration of friendship across the transition to motherhood.

PubMed

Nolan, Mary L; Mason, Victoria; Snow, Sarah; Messenger, Wendy; Catling, Jonathon; Upton, Penney

2012-01-01

This study explored how friendships made at antenatal classes preserve new mothers' well-being, postnatally. Eight women from the United Kingdom who had attended antenatal classes in the third trimester were interviewed following the birth of their first baby. Transcripts were analyzed using a constant comparative method. Findings suggest that friendships made at antenatal classes are not only unique but also support women's mental health and enhance self-efficacy because the women give and gain reassurance that their babies are developing normally. Such friendships may reduce demands on overstretched social and health-care services. Childbirth educators, midwives, and nurses can be encouraged to capitalize on the opportunity provided by antenatal classes to facilitate the formation of friendships that can help mothers to find "a new equilibrium."

Exploration of the impacts of distributed-site Research Experiences for Undergraduates using pre-/post- student interviews

NASA Astrophysics Data System (ADS)

Colella, H.; Hubenthal, M.; Brudzinski, M. R.

2013-12-01

The benefits for student participants of undergraduate research opportunities have been well documented. However, advancements in information and communications technologies (ICT) and cultural shifts around online education and virtual peer-to-peer interaction have lead to new models in which to structure such experiences. Currently, these ICT-enabled Research Experiences for Undergraduates (REU) programs connect geographically distributed interns in supportive e-learning communities while maintaining a traditional local mentoring arrangement. To document and explore the effects of distributed REU Sites in more depth, six interns from such a program, the Incorporated Research Institution for Seismology (IRIS) REU, were selected at random and asked to be interviewed about the REU experience. The primary targets of the interviews are to understand the mentor/mentee relationships, feeling of support and development and value of near-peer and far-peer relationships throughout their internship in a distributed REU program, and whether they receive the training necessary to gain confidence as a researcher. We also examine the various communication technologies as well as best practices and strategies that can increase intern connectedness. Pre-internship interviews were conducted in-person at the start of the centralized internship orientation week, while post-internship interviews were virtual (e.g. video chat with Skype or Google Hangout). These semi-structured interviews have full audio recordings and subsequent transcriptions. An additional, virtual follow-up interview will be conducted next spring after the interns have an opportunity to attend and present their research at a national conference (e.g., AGU). Interview material will be analyzed through a process of coding, sorting, local integration, and inclusive integration. Results will also be triangulated with pre- and post- survey data both from participants and other survey data from previous years of the IRIS program. Our presentation will highlight the key findings of these analyses. GeoCorps and RESESS will begin to employ this interview style assessment beginning this fall and next year, respectively, which will facilitate detailed comparisons between distributed and non-distributed REU approaches.

[The Lived Experience of Patients with Heart Transplantation: A Phenomenological Study].

PubMed

Hwang, Younghui; Yi, Myungsun

2017-02-01

The purpose of this study was to describe the lived experience of patients with heart transplantation in Korea. Individual indepth interviews and a focus group interview were used to collect the data from nine patients who had heart transplantations in 2015. All interviews were audio-taped and verbatim transcripts were made for the analysis. Data were analyzed using Colaizzi's phenomenological method. Among the nine participants, eight were men. Mean age was 57.30 years. Six theme clusters emerged from the analysis. 'Joy of rebirth obtained by good luck' describes the pleasure and expectation of new life after narrow survival. 'Suffering from adverse drug effects' illustrates various psychosocial difficulties, such as low self-esteem, helplessness, alienation, and burnout, arising from the side effects of medications. 'Body and mind of being bewildered' illustrates disintegrated health and haunting fear of death. 'Alienation disconnected with society' describes isolated feeling of existence due to misunderstandings from society. 'Suffering overcome with gratitude and responsibility' includes overcoming experience through various social supports and suitable jobs. Finally, 'acceptance of suffering accompanied with new heart' illustrate changed perspective of life itself. The findings in this study provide deep understanding and insights of the lived experience of heart related illness for these patients and should help in the development of tailored-interventions for patients with heart transplantation. © 2017 Korean Society of Nursing Science

Rural adults' perspectives on school food in a North Carolina county.

PubMed

Jeffries, Jayne K; Thayer, Linden M; Hennink-Kaminski, Heidi; Noar, Seth M

2015-04-23

To address alarming rates of youth obesity, multiple stakeholder perspectives must be understood and considered when developing nutrition interventions. The purpose of this qualitative study was to examine adults' perceptions of school food in rural North Carolina and their opinions about potential changes to encourage students to eat more fruits and vegetables in school meals. We conducted semistructured key informant interviews by telephone from February through March 2013 to determine adult opinions regarding elementary school food and child health. Participants included parents, teachers, school administrators, and a cafeteria staff member. Interview transcripts were thematically analyzed using Dedoose qualitative analysis software. Four themes emerged from key informant interviews regarding school meals and increasing fruit and vegetable consumption: 1) schools are an appropriate place for nutritious food, 2) current school food is bland and unappealing, 3) school cafeterias can use simple strategies to increase fruit and vegetable intake, and 4) federal school meal guidelines are perceived as barriers to increased fruit and vegetable intake during school meals. Study findings suggest that training and support for cafeteria staff on healthy food preparation and presentation are critical and that there should be a "meeting in the middle" between child appeal and health. Nutritious and appealing school food options may have the potential to greatly increase fruit and vegetable consumption in rural elementary schools in North Carolina.

Dependence on care experienced by people living with Duchenne muscular dystrophy and spinal cord injury.

PubMed

Martinsen, Bente; Dreyer, Pia

2012-04-01

Being dependent on care in a hospital or in a traditional homecare setting may generate an experience of inferiority in patients. In a private home, dependence is easier to bear if the dependent person has the possibility to influence the planning of care. Little is known about the experience of being dependent on care in a private home, where the dependent person employs his or her own helpers. The aim of this study was to describe the meaning of dependence on care in a private home setting among people living with help requirements for all aspects of daily life. The article draws on two interview studies of people with high cervical spinal cord injury and men with Duschenne muscular dystrophy. Transcriptions of the interviews were analyzed according to a phenomenological hermeneutic approach influenced by Paul Ricoeur's philosophy of interpretation. The meaning of all the interview texts is presented as four short stories. Four themes were identified: the helper as liberating, the paramount verbalization of own needs, the creative engagement in life, and accessibility as an issue in everyday life. Dependence on care was identified to be a movement between freedom and restriction, where the helpers played a crucial role, because it was key that they were sensitive to the signals they got and were able to transform words into meticulous actions.

Experiences of time: a qualitative inquiry into experiences of time as described by palliative care inpatients.

PubMed

Robertson, Matra

2015-02-01

In palliative care, health professionals provide support and care for patients for the duration of the unknown time toward death. While the experiences of patients diagnosed with a life limiting illness in palliative care have received some scholarly attention, little research has explored these experiences as described by palliative inpatients themselves. The purpose of this article is to explore how patients describe their lived experiences of time while in a palliative inpatient facility. This study used a qualitative phenomenological method and nine inpatients were recruited. They were interviewed utilizing in-depth semi-structured interviews, which were audio taped and transcribed. These interview transcripts of their descriptions were the data sources for this inquiry. Their description is part of a broader phenomenological inquiry on the experience of living with a life limiting illness described by palliative inpatients. Data were analyzed to identify essential themes within and across cases. Three essential themes were revealed: "brief time"; "waiting time," and "transcendental horizon: future time." These themes were not mutually exclusive and participant's experiences of time approaching death were described as a time of living toward death. The findings suggest that patients diagnosed with a life limiting illness have multi-dimensional experiences of time. Understanding the experiences of temporality for patients close to the gravity of death, from the patients' own words, can provide direction for patient informed interventions in clinical practice.

Data mining of mental health issues of non-bone marrow donor siblings.

PubMed

Takita, Morihito; Tanaka, Yuji; Kodama, Yuko; Murashige, Naoko; Hatanaka, Nobuyo; Kishi, Yukiko; Matsumura, Tomoko; Ohsawa, Yukio; Kami, Masahiro

2011-07-20

Allogenic hematopoietic stem cell transplantation is a curative treatment for patients with advanced hematologic malignancies. However, the long-term mental health issues of siblings who were not selected as donors (non-donor siblings, NDS) in the transplantation have not been well assessed. Data mining is useful in discovering new findings from a large, multidisciplinary data set and the Scenario Map analysis is a novel approach which allows extracting keywords linking different conditions/events from text data of interviews even when the keywords appeared infrequently. The aim of this study is to assess mental health issues on NDSs and to find helpful keywords for the clinical follow-up using a Scenario Map analysis. A 47-year-old woman whose younger sister had undergone allogenic hematopoietic stem cell transplantation 20 years earlier was interviewed as a NDS. The text data from the interview transcriptions was analyzed using Scenario Mapping. Four clusters of words and six keywords were identified. Upon review of the word clusters and keywords, both the subject and researchers noticed that the subject has had mental health issues since the disease onset to date with being a NDS. The issues have been alleviated by her family. This single subject study suggested the advantages of data mining in clinical follow-up for mental health issues of patients and/or their families.

Exploring patient experiences of participating in a group exercise class for the management of nonspecific shoulder pain.

PubMed

Barrett, Eva; Hayes, Amy; Kelleher, Mags; Conroy, Carmela; Robinson, Katie; O'Sullivan, Kieran; McCreesh, Karen

2018-06-01

Recent evidence has demonstrated that group-based physiotherapy interventions for musculoskeletal pain can have similar clinical outcomes compared to one-to-one treatment. This study qualitatively explored the experiences of individuals who participated in a physiotherapist-led group exercise class for people with nonspecific shoulder pain (NSSP). Semi-structured interviews were carried out with 23 people with NSSP, who had recently participated in a 6-week structured exercise class. All recorded verbal data were transcribed verbatim. Transcripts of interview data were verified by participants and analyzed using thematic analysis. The exercise class was positively evaluated by all participants. Four themes emerged from the data: (1) the participant's experiences of support, motivation, and learning from peers; (2) the preference for an exercise class compared to individual physiotherapy; (3) the physiotherapist as an educator and facilitator; and (4) beliefs about pain and exercise. Among those interviewed, the exercise class was described as providing an environment conducive to the development of relationships, friendships, humor and fun, gaining mastery of their exercises, and encouraging the transition toward self-management of their pain. For those who had previous experience of one-to-one physiotherapy, the exercise class was evaluated as the preferred mode of physiotherapy delivery. The findings of this study support a move away from traditional one-on-one physiotherapy sessions to the potentially more cost-effective group setting.

Rural Adults’ Perspectives on School Food in a North Carolina County

PubMed Central

Thayer, Linden M.; Hennink-Kaminski, Heidi; Noar, Seth M.

2015-01-01

Introduction To address alarming rates of youth obesity, multiple stakeholder perspectives must be understood and considered when developing nutrition interventions. The purpose of this qualitative study was to examine adults’ perceptions of school food in rural North Carolina and their opinions about potential changes to encourage students to eat more fruits and vegetables in school meals. Methods We conducted semistructured key informant interviews by telephone from February through March 2013 to determine adult opinions regarding elementary school food and child health. Participants included parents, teachers, school administrators, and a cafeteria staff member. Interview transcripts were thematically analyzed using Dedoose qualitative analysis software. Results Four themes emerged from key informant interviews regarding school meals and increasing fruit and vegetable consumption: 1) schools are an appropriate place for nutritious food, 2) current school food is bland and unappealing, 3) school cafeterias can use simple strategies to increase fruit and vegetable intake, and 4) federal school meal guidelines are perceived as barriers to increased fruit and vegetable intake during school meals. Conclusion Study findings suggest that training and support for cafeteria staff on healthy food preparation and presentation are critical and that there should be a “meeting in the middle” between child appeal and health. Nutritious and appealing school food options may have the potential to greatly increase fruit and vegetable consumption in rural elementary schools in North Carolina. PMID:25906435

A Qualitative Evaluation of Contact Centre Dietitian Support and Electronic Motivational Messaging for eaTracker My Goals Users.

PubMed

Lieffers, Jessica R L; Haresign, Helen; Mehling, Christine; Arocha, Jose F; Hanning, Rhona M

2018-06-01

To conduct a qualitative evaluation of adjunct supports (brief motivational messaging regarding goals delivered by email/website, contact centre dietitian assistance) offered by EatRight Ontario (ERO) for users of a website-based nutrition/activity goal setting/tracking feature (eaTracker "My Goals"). One-on-one semi-structured interviews were conducted with My Goals users in Ontario (n = 18) and Alberta (n = 5) recruited via the eaTracker website and ERO contact centre dietitians (n = 5). Interview transcripts were analyzed using content analysis. Participants had mixed experiences and perspectives with ERO motivational messaging. Messages targeted towards specific goals (e.g., tips, recipes) were generally well-liked, and generic messages (e.g., eaTracker login reminders) were less useful. No interviewed users had contacted ERO dietitians regarding goals, and dietitians reported encountering few callers asking for assistance while using My Goals. Limited user knowledge was one explanation for this finding. Participants provided suggestions to enhance these supports. Electronic motivational messaging and contact centre dietitian assistance have the potential to support achievement of goals set with website-based features. When considering using electronic messaging, researchers and practitioners should consider message content and delivery tailoring. Marketing that focuses on how contact centre dietitians can assist website users with their goals is needed when services are used in naturalistic settings.

Going Back: Adults Talk about What They're Doing in College and How They Feel about Returning to School.

ERIC Educational Resources Information Center

Carbone, John M.

This book consists of the edited transcripts of 19 interviews conducted with two- and four-year college students ranging in age from 25 to 65, who returned to school to complete degrees, work toward new degrees, or merely take classes. Drawing from the interviews, introductory comments offer generalizations about adult students returning to…

Social Support Following Perinatal Loss

PubMed Central

Kavanaugh, Karen; Trier, Darcie; Korzec, Michelle

2005-01-01

The purpose of this project was to examine parents' descriptions of the ways family and friends supported them after they had experienced a perinatal loss. For this project, a secondary analysis of data from two phenomenological studies on perinatal loss was performed. A combined total of 62 interview transcripts from 22 mothers and 9 fathers were examined. Data analysis included identifying all statements in the interview transcripts that pertained to the ways that family and friends supported parents. The modes of supportive behavior (emotional, advice/feedback, practical, financial, and socializing) in Vaux's theory of social support served as a useful framework for presenting the findings. Parents received emotional support most frequently. Findings from the current study provide data for health care professionals to use to provide guidance to family and friends of bereaved parents. PMID:17426820

Interdependence between transcription and mRNP processing and export, and its impact on genetic stability.

PubMed

Luna, Rosa; Jimeno, Sonia; Marín, Mercedes; Huertas, Pablo; García-Rubio, María; Aguilera, Andrés

2005-06-10

The conserved eukaryotic THO-TREX complex acts at the interface between transcription and mRNA export and affects transcription-associated recombination. To investigate the interdependence of nuclear mRNA processes and their impact on genomic integrity, we analyzed transcript accumulation and recombination of 40 selected mutants covering representative steps of the biogenesis and export of the messenger ribonucleoprotein particle (mRNP). None of the mutants analyzed shared the strong transcript-accumulation defect and hyperrecombination of THO mutants. Nevertheless, mutants in 3' end cleavage/polyadenylation, nuclear exosome, and mRNA export showed a weak but significant effect on recombination and transcript accumulation. Mutants of the nuclear exosome (rrp6) and 3' end processing factors (rna14 and rna15) showed inefficient transcription elongation and genetic interactions with THO. The results suggest a tight interdependence among mRNP biogenesis steps and transcription and an unexpected effect of the nuclear exosome and the cleavage/polyadenylation factors on transcription elongation and genetic integrity.

Finding resiliency in the face of financial barriers: Development of a conceptual framework for people with cardiovascular-related chronic disease.

PubMed

Campbell, David J T; Manns, Braden J; Leblanc, Pamela; Hemmelgarn, Brenda R; Sanmartin, Claudia; King-Shier, Kathryn

2016-12-01

Patients with chronic diseases often face financial barriers to optimize their health. These financial barriers may be related to direct healthcare costs such as medications or self-monitoring supplies, or indirect costs such as transportation to medical appointments. No known framework exists to understand how financial barriers impact patients' lives or their health outcomes.We undertook a grounded theory study to develop such a framework. We used semistructured interviews with a purposive sample of participants with cardiovascular-related chronic disease (hypertension, diabetes, heart disease, or stroke) from Alberta, Canada. Interview transcripts were analyzed in triplicate, and interviews continued until saturation was reached.We interviewed 34 participants. We found that the confluence of 2 events contributed to the perception of having a financial barrier-onset of chronic disease and lack of income or health benefits. The impact of having a perceived financial barrier varied considerably. Protective, predisposing, or modifying of factors determined how impactful a financial barrier would be. An individual's particular set of factors is then shaped by their worldview. This combination of factors and lens determines one's degree of resiliency, which ultimately impacts how well they cope with their disease.The role of financial barriers is complex. How well an individual copes with their financial barriers is intimately tied to resiliency, which is related to the composite of a personal circumstances and their worldview. Our framework for understanding the experience of financial barriers can be used by both researchers and clinicians to better understand patient behavior.

Strategies for Introducing Outpatient Specialty Palliative Care in Gynecologic Oncology.

PubMed

Hay, Casey M; Lefkowits, Carolyn; Crowley-Matoka, Megan; Bakitas, Marie A; Clark, Leslie H; Duska, Linda R; Urban, Renata R; Creasy, Stephanie L; Schenker, Yael

2017-09-01

Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care. We conducted a national qualitative interview study at six geographically diverse academic cancer centers with well-established palliative care clinics between September 2015 and March 2016. Thirty-four gynecologic oncologists participated in semistructured telephone interviews focusing on attitudes, experiences, and practices related to outpatient palliative care. A multidisciplinary team analyzed interview transcripts using constant comparative methods to inductively develop and refine a coding framework. This analysis focuses on practices for introducing palliative care. Mean participant age was 47 years (standard deviation, 10 years). Mean interview length was 25 minutes (standard deviation, 7 minutes). Gynecologic oncologists described the following three main strategies for introducing outpatient specialty palliative care: focus initial palliative care referral on symptom management to dissociate palliative care from end-of-life care and facilitate early relationship building with palliative care clinicians; use a strong physician-patient relationship and patient trust to increase acceptance of referral; and explain and normalize palliative care referral to address negative associations and decrease patient fear of abandonment. These strategies aim to decrease negative patient associations and encourage acceptance of early referral to palliative care specialists. Gynecologic oncologists have developed strategies for introducing palliative care services to alleviate patient concerns. These strategies provide groundwork for developing system-wide best practice approaches to the presentation of palliative care referral.

Health Coaching in Severe COPD After a Hospitalization: A Qualitative Analysis of a Large Randomized Study.

PubMed

Benzo, Roberto P; Kirsch, Janae L; Hathaway, Julie C; McEvoy, Charlene E; Vickers, Kristin S

2017-11-01

We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore the health-coaching intervention as seen from the perspective of the participants who received the intervention and the coaches who delivered it. Semistructured participant interviews ( n = 24) and a focus group of all health coaches ( n = 3) who participated in this study were conducted. Interviews and focus group were recorded and transcribed verbatim. Transcripts were analyzed using coding and categorizing techniques and thematic analysis. Mixed-method triangulation was used to merge quantitative and qualitative data. Content analysis revealed 4 predominant themes of the coaching intervention: health-coaching relationship, higher participant confidence and reassurance (most related to improvement in physical quality of life), improved health-care system access (most related to decreased hospital readmissions), and increased awareness of COPD symptoms (most related to improvement in emotional quality of life). The strongest theme was the relationship with the health coach, including coach style and motivational interviewing approach. Health coaches' focus group also noted the importance of the coaching relationship as the most significant theme. This study provided themes to further inform the delivery and implementation of health-coaching interventions in patients with COPD after hospital discharge. Health coaching forged partnerships and created a platform for patient engagement, which was confirmed by both participants and health coaches. Copyright © 2017 by Daedalus Enterprises.

Providing adolescent sexual health care in the pediatric emergency department: views of health care providers

PubMed Central

Miller, Melissa K.; Mollen, Cynthia J.; O’Malley, Donna; Owens, Rhea L.; Maliszewski, Genevieve A.; Goggin, Kathy; Patricia, Kelly

2014-01-01

Objective The purpose of this study was to explore health care providers’ (HCPs) attitudes and beliefs about adolescent sexual health care provision in the emergency department (ED) and to identify barriers to a role of a health educator-based intervention. Methods We conducted focused, semi-structured interviews of HCPs from the ED and Adolescent Clinic of a children’s hospital. The interview guide was based on the Theory of Planned Behavior and its constructs: attitudes, subjective norms, perceived behavioral control, and intention to facilitate care. We used purposive sampling and enrollment continued until themes were saturated. Interviews were recorded and transcribed. Transcripts were analyzed using directed content analysis. Results Twenty-nine interviews were required for saturation. Participants were 12 physicians, 12 nurses, 3 nurse practitioners and 2 social workers; the majority (83%) were female. Intention to facilitate care was influenced by HCP perception of 1) their professional role, 2) the role of the ED (focused vs. expanded care), and 3) need for patient safety. HCPs identified three practice referents: patients/families, peers and administrators, and professional organizations. HCPs perceived limited behavioral control over care delivery because of time constraints, confidentiality issues, and comfort level. There was overall support for a health educator and many felt the educator could help overcome barriers to care. Conclusion Despite challenges unique to the ED, HCPs were supportive of the intervention and perceived the health educator as a resource to improve adolescent care and services. Future research should evaluate efficacy and costs of a health educator in this setting. PMID:24457494

Collecting Practice-level Data in a Changing Physician Office-based Ambulatory Care Environment: A Pilot Study Examining the Physician induction interview Component of the National Ambulatory Medical Care Survey.

PubMed

Halley, Meghan C; Rendle, Katharine A; Gugerty, Brian; Lau, Denys T; Luft, Harold S; Gillespie, Katherine A

2017-11-01

Objective This report examines ways to improve National Ambulatory Medical Care Survey (NAMCS) data on practice and physician characteristics in multispecialty group practices. Methods From February to April 2013, the National Center for Health Statistics (NCHS) conducted a pilot study to observe the collection of the NAMCS physician interview information component in a large multispecialty group practice. Nine physicians were randomly sampled using standard NAMCS recruitment procedures; eight were eligible and agreed to participate. Using standard protocols, three field representatives conducted NAMCS physician induction interviews (PIIs) while trained ethnographers observed and audio recorded the interviews. Transcripts and field notes were analyzed to identify recurrent issues in the data collection process. Results The majority of the NAMCS items appeared to have been easily answered by the physician respondents. Among the items that appeared to be difficult to answer, three themes emerged: (a) physician respondents demonstrated an inconsistent understanding of "location" in responding to questions; (b) lack of familiarity with administrative matters made certain questions difficult for physicians to answer; and (c) certain primary care‑oriented questions were not relevant to specialty care providers. Conclusions Some PII survey questions were challenging for physicians in a multispecialty practice setting. Improving the design and administration of NAMCS data collection is part of NCHS' continuous quality improvement process. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Learners' decisions for attending Pediatric Grand Rounds: a qualitative and quantitative study.

PubMed

Dolcourt, Jack L; Zuckerman, Grace; Warner, Keith

2006-04-27

Although grand rounds plays a major educational role at academic medical centers, there has been little investigation into the factors influencing the learners' decision to attend. Greater awareness of attendees' expectations may allow grand rounds planners to better accommodate the learners' perspective, potentially making continuing education activities more attractive and inviting. We used both qualitative (part A) and quantitative (part B) techniques to investigate the motivators and barriers to grand rounds attendance. Part A investigated contextual factors influencing attendance as expressed through attendee interviews. Transcripts of the interviews were analyzed using grounded theory techniques. We created a concept map linking key factors and their relationships. In part B we quantified the motivators and barriers identified during the initial interviews through a survey of the grand rounds audience. Sixteen persons voluntarily took part in the qualitative study (part A) by participating in one of seven group interview sessions. Of the 14 themes that emerged from these sessions, the most frequent factors motivating attendance involved competent practice and the need to know. All sessions discussed intellectual stimulation, social interaction, time constraints and convenience, licensure, content and format, and absence of cost for attending sessions. The 59 respondents to the survey (part B) identified clinically-useful topics (85%), continuing education credit (46%), cutting-edge research (27%), networking (22%), and refreshments (8%) as motivators and non-relevant topics (44%) and too busy to attend (56%) as barriers. Greater understanding of the consumers' perspective can allow planners to tailor the style, content, and logistics to make grand rounds more attractive and inviting.

The natural history of recovery for the healthcare provider "second victim" after adverse patient events.

PubMed

Scott, S D; Hirschinger, L E; Cox, K R; McCoig, M; Brandt, J; Hall, L W

2009-10-01

When patients experience unexpected events, some health professionals become "second victims". These care givers feel as though they have failed the patient, second guessing clinical skills, knowledge base and career choice. Although some information exists, a complete understanding of this phenomenon is essential to design and test supportive interventions that achieve a healthy recovery. The purpose of this article is to report interview findings with 31 second victims. After institutional review board approval, second victim volunteers representing different professional groups were solicited for private, hour-long interviews. The semistructured interview covered demographics, participant recount of event, symptoms experienced and recommendations for improving institutional support. After interviews, transcripts were analyzed independently for themes, followed by group deliberation and reflective use with current victims. Participants experienced various symptoms that did not differ by sex or professional group. Our analysis identified six stages that delineate the natural history of the second victim phenomenon. These are (1) chaos and accident response, (2) intrusive reflections, (3) restoring personal integrity, (4) enduring the inquisition, (5) obtaining emotional first aid and (6) moving on. We defined the characteristics and typical questions second victims are desperate to have answered during these stages. Several reported that involvement in improvement work or patient safety advocacy helped them to once again enjoy their work. We now believe the post-event trajectory is largely predictable. Institutional programs could be developed to successfully screen at-risk professionals immediately after an event, and appropriate support could be deployed to expedite recovery and mitigate adverse career outcomes.

User-Centered Design of the eyeGuide, a Tailored Glaucoma Behavior Change Program

PubMed Central

Killeen, Olivia; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P.; Newman-Casey, Paula Anne

2016-01-01

PURPOSE We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. PATIENTS Glaucoma patients ≥ age 40 prescribed ≥1 glaucoma medication were included. METHODS The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semi-structured diagnostic and pre-testing interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audio recorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook and identified key themes using NVivo 10.0 to further refine the eyeGuide. RESULTS Twenty-one glaucoma patients were interviewed; mean age 72 ± 12.4 years, five (24%) African-Americans, nine (43%) with poor self-reported adherence, ten (47.6%) ≥ age 75, ten (47.6%) with poor vision and nine (42.9%) women. Qualitative analysis identified five important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients’ beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a web-based module. Participant feedback resulted in revised content. CONCLUSIONS User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content. PMID:27096721

Barriers to mesalamine adherence in patients with inflammatory bowel disease: a qualitative analysis.

PubMed

Devlen, Jennifer; Beusterien, Kathleen; Yen, Linnette; Ahmed, Awais; Cheifetz, Adam S; Moss, Alan C

2014-03-01

The causes for nonadherence to mesalamine in patients with inflammatory bowel disease (IBD) have been characterized using mostly indirect methods. Patient-reported barriers are lacking in this population. To identify patient-reported barriers to mesalamine adherence through direct interviews. Focus groups and one-on-one interviews were undertaken in adult patients with IBD. Transcripts from the focus groups and interviews were analyzed to identify themes and links between these themes, assisted by qualitative data software MaxQDA. Of 27 patients participating, 21 (78%) had ulcerative colitis, and 6 (22%) had Crohn's disease. Their self-reported adherence ranged from complete adherence (n = 3) to intermittent nonadherence (n = 24). Patients frequently indicated that they were resistant to taking medications for their condition. The barriers to adherence that emerged from interviews could be categorized under a number of themes: competing priorities, social stigma, refill inconvenience, costs, efficacy values, side effects, and pill characteristics. Efficacy values reported to influence adherence included doubts about efficacy, consequences of missed doses, and doubts about need for maintenance medication. Pill characteristics reported as barriers included pill size and pill frequency. Despite use of electronic prescribing, obtaining refills was reported as an obstacle to adherence in this cohort. Decanting of pills to multiple containers to increase accessibility was also reported. Patients with both ulcerative colitis and Crohn's disease report a number of common barriers to mesalamine adherence. Factors in medication-taking behavior and beliefs were reported in this study that may have implications for strategies to improve adherence by health care providers.

User-centered Design of the eyeGuide: A Tailored Glaucoma Behavior Change Program.

PubMed

Killeen, Olivia J; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P; Newman-Casey, Paula Anne

2016-10-01

We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. Glaucoma patients age 40 years and above prescribed ≥1 glaucoma medication were included. The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semistructured diagnostic and pretesting interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audiorecorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook, and identified key themes using NVivo 10.0 to further refine the eyeGuide. Twenty-one glaucoma patients were interviewed; mean age 72±12.4 years, 5 (24%) African Americans, 9 (43%) with poor self-reported adherence, 10 (47.6%) age 75 years and above, 10 (47.6%) with poor vision, and 9 (42.9%) women. Qualitative analysis identified 5 important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients' beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a Web-based module. Participant feedback resulted in revised content. User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content.

The development of a model of dignity in illness based on qualitative interviews with seriously ill patients.

PubMed

van Gennip, Isis E; Pasman, H Roeline W; Oosterveld-Vlug, Mariska G; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-08-01

While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine patients' dignity, and that is applicable to a wide patient population. Qualitative interview study. 34 patients with either cancer, early stage dementia, or a severe chronic illness were selected from an extensive cohort study into advance directives. In-depth interviews were carried out exploring the experiences of seriously ill patients with regard to their personal dignity. The interview transcripts were analyzed using thematic analysis and a conceptual model was constructed based on the resulting themes. We developed a two-step dignity model of illness. According to this model, illness related conditions do not affect patients' dignity directly but indirectly by affecting the way patients perceive themselves. We identified three components shaping self-perception: (a) the individual self: the subjective experiences and internally held qualities of the patient; (b) the relational self: the self within reciprocal interaction with others; and, (c) the societal self: the self as a social object in the eyes of others. The merits of the model are two-folded. First, it offers an organizing framework for further research into patients' dignity. Secondly, the model can serve to facilitate care for seriously ill patients in practice by providing insight into illness and dignity at the level of the individual patient where intervention can be effectively targeted. Copyright © 2013 Elsevier Ltd. All rights reserved.

Barriers and facilitators to family planning access in Canada.

PubMed

Hulme, Jennifer; Dunn, Sheila; Guilbert, Edith; Soon, Judith; Norman, Wendy

2015-02-01

Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes. Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system. Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada. Copyright © 2015 Longwoods Publishing.

Strategies for Effective On-Call Supervision for Internal Medicine Residents: The Superb/Safety Model

PubMed Central

Farnan, Jeanne M.; Johnson, Julie K.; Meltzer, David O.; Harris, Ilene; Humphrey, Holly J.; Schwartz, Alan; Arora, Vineet M.

2010-01-01

Background Supervision is central to resident education and patient safety, yet there is little published evidence to describe a framework for clinical supervision. The aim of this study was to describe supervision strategies for on-call internal medicine residents. Methods Between January and November 2006, internal medicine residents and attending physicians at a single hospital were interviewed within 1 week of their final call on the general medicine rotation. Appreciative inquiry and critical incident technique were used to elicit perspectives on ideal and suboptimal supervision practices. A representative portion of transcripts were analyzed using an inductive approach to develop a coding scheme that was then applied to the entire set of transcripts. All discrepancies were resolved via discussion until consensus was achieved. Results Forty-four of 50 (88%) attending physicians and 46 of 50 (92%) eligible residents completed an interview. Qualitative analysis revealed a bidirectional model of suggested supervisory strategies, the “SUPERB/SAFETY” model; an interrater reliability of 0.70 was achieved. Suggestions for attending physicians providing supervision included setting expectations, recognizing uncertainty, planning communication, having easy availability, reassuring residents, balancing supervision, and having autonomy. Suggested resident strategies for seeking supervision from attending physicians included seeking input early, contacting for active clinical decisions or feeling uncertain, end of life issues, transitions in care, or help with systems issues. Common themes suggested by trainees and attending physicians included easy availability and preservation of resident decision-making autonomy. Discussion Residents and attending physicians have explicit expectations for optimal supervision. The SUPERB/SAFETY model of supervision may be an effective resource to enhance the clinical supervision of residents. PMID:21975883

Prevention of Filipino Youth Behavioral Health Disparities: Identifying Barriers and Facilitators to Participating in “Incredible Years,” an Evidence-Based Parenting Intervention, Los Angeles, California, 2012

PubMed Central

Flores, Nicole; Supan, Jocelyn; Kreutzer, Cary B.; Samson, Allan; Coffey, Dean M.

2015-01-01

Introduction Evidence-based interventions for training parents are proven to prevent onset and escalation of childhood mental health problems. However, participation in such programs is low, especially among hard-to-reach, underserved populations such as Filipino Americans. Filipinos, the largest Asian subgroup in California, have significant behavioral health disparities compared with non-Hispanic whites and other Asian subgroups. The purpose of this study was to learn about Filipinos’ barriers and facilitators to participating in “Incredible Years” (IY), a parenting program. Methods We conducted 4 focus groups in Los Angeles, California, in 2012; the groups consisted of 20 Filipino parents of children aged 6 to 12 years who recently completed the IY parenting program, which was offered as a prevention workshop. Three reviewers, including two co-authors (A.S., J.J.) and a research assistant used content analysis to independently code the interview transcripts and extract subthemes. Grounded theory analytic methods were used to analyze interview transcripts. Results Parents’ perceived benefits of participation in IY were learning more effective parenting techniques, networking with other parents, improved spousal relationships, and improvements in their children's behavior. Parents’ most common motivating factor for enrollment in IY was to improve their parenting skills and their relationships with their children. The most common barriers to participation were being uncomfortable sharing problems with others and the fear of being stigmatized by others judging their parenting skills. Participants said that parent testimonials would be the most effective way to promote IY. Many recommended outreach at schools, pediatricians’ offices, and churches. Conclusion Increasing Filipino American parent enrollment in IY in culturally relevant ways will reduce the incidence of mental health disorders among children in this growing population. PMID:26491813

Prevention of Filipino Youth Behavioral Health Disparities: Identifying Barriers and Facilitators to Participating in "Incredible Years," an Evidence-Based Parenting Intervention, Los Angeles, California, 2012.

PubMed

Flores, Nicole; Supan, Jocelyn; Kreutzer, Cary B; Samson, Allan; Coffey, Dean M; Javier, Joyce R

2015-10-22

Evidence-based interventions for training parents are proven to prevent onset and escalation of childhood mental health problems. However, participation in such programs is low, especially among hard-to-reach, underserved populations such as Filipino Americans. Filipinos, the largest Asian subgroup in California, have significant behavioral health disparities compared with non-Hispanic whites and other Asian subgroups. The purpose of this study was to learn about Filipinos' barriers and facilitators to participating in "Incredible Years" (IY), a parenting program. We conducted 4 focus groups in Los Angeles, California, in 2012; the groups consisted of 20 Filipino parents of children aged 6 to 12 years who recently completed the IY parenting program, which was offered as a prevention workshop. Three reviewers, including two co-authors (A.S., J.J.) and a research assistant used content analysis to independently code the interview transcripts and extract subthemes. Grounded theory analytic methods were used to analyze interview transcripts. Parents' perceived benefits of participation in IY were learning more effective parenting techniques, networking with other parents, improved spousal relationships, and improvements in their children's behavior. Parents' most common motivating factor for enrollment in IY was to improve their parenting skills and their relationships with their children. The most common barriers to participation were being uncomfortable sharing problems with others and the fear of being stigmatized by others judging their parenting skills. Participants said that parent testimonials would be the most effective way to promote IY. Many recommended outreach at schools, pediatricians' offices, and churches. Increasing Filipino American parent enrollment in IY in culturally relevant ways will reduce the incidence of mental health disorders among children in this growing population.

Experiencing meditation - Evidence for differential effects of three contemplative mental practices in micro-phenomenological interviews.

PubMed

Przyrembel, Marisa; Singer, Tania

2018-07-01

Despite increasing interest in effects of meditation, systematic in-depth research on how it qualitatively feels to engage in different kinds of contemplative practices is still missing. To fill this gap, we explore the validity of Micro-phenomenological Interviews (MpI) to assess experiences during breathing meditation (BM), observing-thought meditation (OTM), and loving-kindness meditation (LKM). We performed psycholinguistic analyses, quantitative ratings and qualitative explorations of 104 MpI (N = 57). All results reveal differential affective, bodily and sensorial fingerprints: BM-transcripts contain the most body-related vocabulary, specifically sensations in nose and abdomen. OTM-transcripts contain the most cognition-related vocabulary. OTM is experienced in head and face. LKM-transcripts contain the most vocabulary related to socio-affective processes. LKM is associated to love, sensations around the heart, and warmth. The LKM-outcomes were replicated with another independent set of MpI. These findings verify the merit of MpI as a scientific tool to gain reliable first-person data beyond questionnaires or rating scales. Copyright © 2018 Elsevier Inc. All rights reserved.

In-office Discussions of Migraine: Results from the American Migraine Communication Study

PubMed Central

Hahn, Steven R.; Cady, Roger K.; Brandes, Jan Lewis; Simons, Suzanne E.; Bain, Philip A.; Nelson, Meaghan R.

2008-01-01

Background Research indicates that successful migraine assessment and treatment depends on information obtained during patient and healthcare professional (HCP) discussions. However, no studies outline how migraine is actually discussed during clinical encounters. Objective Record naturally occurring HCP–migraineur interactions, analyzing frequency and impairment assessment, and preventive treatment discussions. Design HCPs seeing high volumes of migraineurs were recruited for a communication study. Patients likely to discuss migraine were recruited immediately before their normally scheduled appointment and, once consented, were audio- and video-recorded without a researcher present. Separate post-visit interviews were conducted with patients and HCPs. All interactions were transcribed. Participants Sixty patients (83% female; mean age 41.7) were analyzed. Patients were diagnosed with migraine 14 years and experienced 5 per month, on average. Approach Transcripts were analyzed using sociolinguistic techniques such as number and type of questions asked and post-visit alignment on migraine frequency and impairment. American Migraine Prevalence and Prevention Study guidelines were utilized. Results Ninety-one percent of HCP-initiated, migraine-specific questions were closed-ended/short answer; assessments focused on frequency and did not focus on attention on impairment. Open-ended questions in patient post-visit interviews yielded robust impairment-related information. Post-visit, 55% of HCP–patient pairs were misaligned regarding frequency; 51% on impairment. Of the 20 (33%) patients who were preventive medication candidates, 80% did not receive it and 50% of their visits lacked discussion of prevention. Conclusions Sociolinguistic analysis revealed that HCPs often used narrowly focused, closed-ended questions and were often unaware of how migraine affected patients’ lives as a result. It is recommended that HCPs assess impairment using open-ended questions in combination with the ask-tell-ask technique. PMID:18459012

In-office discussions of migraine: results from the American Migraine Communication Study.

PubMed

Lipton, Richard B; Hahn, Steven R; Cady, Roger K; Brandes, Jan Lewis; Simons, Suzanne E; Bain, Philip A; Nelson, Meaghan R

2008-08-01

Research indicates that successful migraine assessment and treatment depends on information obtained during patient and healthcare professional (HCP) discussions. However, no studies outline how migraine is actually discussed during clinical encounters. Record naturally occurring HCP-migraineur interactions, analyzing frequency and impairment assessment, and preventive treatment discussions. HCPs seeing high volumes of migraineurs were recruited for a communication study. Patients likely to discuss migraine were recruited immediately before their normally scheduled appointment and, once consented, were audio- and video-recorded without a researcher present. Separate post-visit interviews were conducted with patients and HCPs. All interactions were transcribed. Sixty patients (83% female; mean age 41.7) were analyzed. Patients were diagnosed with migraine 14 years and experienced 5 per month, on average. Transcripts were analyzed using sociolinguistic techniques such as number and type of questions asked and post-visit alignment on migraine frequency and impairment. American Migraine Prevalence and Prevention Study guidelines were utilized. Ninety-one percent of HCP-initiated, migraine-specific questions were closed-ended/short answer; assessments focused on frequency and did not focus on attention on impairment. Open-ended questions in patient post-visit interviews yielded robust impairment-related information. Post-visit, 55% of HCP-patient pairs were misaligned regarding frequency; 51% on impairment. Of the 20 (33%) patients who were preventive medication candidates, 80% did not receive it and 50% of their visits lacked discussion of prevention. Sociolinguistic analysis revealed that HCPs often used narrowly focused, closed-ended questions and were often unaware of how migraine affected patients' lives as a result. It is recommended that HCPs assess impairment using open-ended questions in combination with the ask-tell-ask technique.

Perceptions of family history and genetic testing and feasibility of pedigree development among African Americans with hypertension

PubMed Central

Pettey, Christina M; McSweeney, Jean C; Stewart, Katharine E; Price, Elvin T; Cleves, Mario A; Heo, Seongkum; Souder, Elaine

2016-01-01

Background Pedigree development, family history, and genetic testing are thought to be useful in improving outcomes of chronic illnesses such as hypertension (HTN). However, the clinical utility of pedigree development is still unknown. Further, little is known about African Americans’ (AAs’) perceptions of family history and genetic testing. Aims This study examined the feasibility of developing pedigrees for AAs with HTN and explored perceptions of family history and genetic research among AAs with HTN. Methods The US Surgeon General’s My Family Health Portrait was administered, and 30–60 minute in-person individual interviews were conducted. Descriptive statistics were used to analyze pedigree data. Interview transcripts were analyzed with content analysis and constant comparison. Results Twenty-nine AAs with HTN were recruited from one free clinic (15 women, 14 men; mean age 49 years, SD 9.6). Twenty-six (90%) reported their family history in sufficient detail to develop a pedigree. Perceptions of family history included knowledge of HTN in the family, culturally influenced family teaching about HTN, and response to family history of HTN. Most participants agreed to future genetic testing and DNA collection because they wanted to help others; some said they needed more information and others expressed a concern for privacy. Conclusion The majority of AAs in this sample possessed extensive knowledge of HTN within their family and were able to develop a three generation pedigree with assistance. The majority were willing to participate in future genetic research. PMID:25322748

Perceptions of family history and genetic testing and feasibility of pedigree development among African Americans with hypertension.

PubMed

Pettey, Christina M; McSweeney, Jean C; Stewart, Katharine E; Price, Elvin T; Cleves, Mario A; Heo, Seongkum; Souder, Elaine

2015-02-01

Pedigree development, family history, and genetic testing are thought to be useful in improving outcomes of chronic illnesses such as hypertension (HTN). However, the clinical utility of pedigree development is still unknown. Further, little is known about the perceptions of African Americans (AAs) of family history and genetic testing. This study examined the feasibility of developing pedigrees for AAs with HTN and explored perceptions of family history and genetic research among AAs with HTN. The US Surgeon General's My Family Health Portrait was administered, and 30-60 min in-person individual interviews were conducted. Descriptive statistics were used to analyze pedigree data. Interview transcripts were analyzed with content analysis and constant comparison. Twenty-nine AAs with HTN were recruited from one free clinic (15 women, 14 men; mean age 49 years, standard deviation (SD) 9.6). Twenty-six (90%) reported their family history in sufficient detail to develop a pedigree. Perceptions of family history included knowledge of HTN in the family, culturally influenced family teaching about HTN, and response to family history of HTN. Most participants agreed to future genetic testing and DNA collection because they wanted to help others; some said they needed more information and others expressed a concern for privacy. The majority of AAs in this sample possessed extensive knowledge of HTN within their family and were able to develop a three-generation pedigree with assistance. The majority were willing to participate in future genetic research. © The European Society of Cardiology 2014.

Truth is at hand: How gesture adds information during investigative interviews

PubMed Central

Broaders, Sara C.; Goldin-Meadow, Susan

2010-01-01

The accuracy of information obtained in forensic interviews is critically important to credibility in our legal system. Research has shown that the way interviewers frame questions influences the accuracy of witnesses’ reports. A separate body of research has shown that speakers spontaneously gesture when they talk, and that these gestures can express information not found anywhere in the speaker’s talk. This study of children interviewed about an event that they witnessed joins these two literatures and demonstrates that (1) interviewers’ gestures serve as a source of information and, at times, misinformation that can lead witnesses to report incorrect details; (2) the gestures witnesses spontaneously produce during interviews convey substantive information that is often not conveyed anywhere in their speech, and thus would not appear in written transcripts of the proceedings. These findings underscore the need to attend to and document gestures produced in investigative interviews, particularly interviews conducted with children. PMID:20483837

A qualitative approach to recovery after open tibial fracture: the road to a novel, patient-derived recovery scale.

PubMed

Trickett, R W; Mudge, Elizabeth; Price, Patricia; Pallister, Ian

2012-07-01

The aim of this study was to describe how patients perceive their recovery following open tibial fractures using a qualitative approach. Following the appropriate ethical approval, adult patients with a diagnosis of open tibial fracture were recruited after completion of their surgical treatment and discharge from Morriston Hospital, a centre with orthoplastic surgical care. A purposive sampling method was employed to ensure that a range of injuries as well as clinical outcomes were included. All patients took part in an in-depth semi-structured interview, exploring aspects of their injury, treatment, rehabilitation and psychosocial and financial situations. Interviews were completed with two interviewers present and were recorded for verbatim transcription. Interview transcripts were analysed to identify items important to patients during their recovery. Nine patients with a mean injury to interview interval of 2.3 years were interviewed. A total of 538 items were identified and subsequently mapped onto 18 categories: pain; mobility; flexibility; temperature (effects on symptoms); fear; appearance; sleep; diet/weight; employment; social; finance; impact on others; self-care; recovery (patient perceptions of recovery); frustration; goal setting (by patients and health-care providers); and adaptation (both physical and mental). There is a wide range of factors that our cohort found important during their recovery from open tibial fracture. Despite being considered as 'healed' by the medical staff, patients did not report a corresponding full recovery and return to pre-injury normality. The categories identified will enable the development of a patient-reported recovery scale to be used in lower-limb trauma. Copyright © 2012 Elsevier Ltd. All rights reserved.

What Motivates Older Adults to Improve Diet and Exercise Patterns?

PubMed

Bardach, Shoshana H; Schoenberg, Nancy E; Howell, Britteny M

2016-02-01

Dietary intake and physical activity are lifestyle behaviors that are learned, developed, and practiced throughout an individual's lifetime. These lifestyle behaviors have a profound role on health and quality of life--with late-life changes still resulting in notable improvements. Despite well documented benefits of behavior change, such changes are extremely challenging. The purpose of this study is to better understand from the perspective of older adults themselves, the factors that may influence their likelihood of making lifestyle changes. Participants were recruited two primary care clinics. 104 older adults ranging in age from 65 to 95 were included. Participants were interviewed about their motivations and plans to change diet and physical activity behaviors following a routine primary care visit. All interviews were transcribed and transcripts were analyzed using a line-by-line coding approach. Older adults reported that their likelihood of making a lifestyle change related to perceptions of old age, personal motivation, and perceived confidence in the ability to make effective changes. These findings suggest the importance of creating more positive images of old age and tailoring health promotion efforts to older adults' motivations and confidence in their ability to make behavior changes.

Perceptions of emergency nurses during the human swine influenza outbreak: a qualitative study.

PubMed

Lam, Kam Ki; Hung, Shuk Yu Maria

2013-10-01

The primary aim of this study was to explore the perception of Hong Kong emergency nurses regarding their work during the human swine influenza pandemic outbreak. In this exploratory, qualitative study, 10 emergency nurses from a regional hospital in Hong Kong were recruited using purposive sampling. Semi-structured, face-to-face individual interviews were conducted. Qualitative content analysis was utilized to analyze the transcripts. The three following categories emerged from the interview data: concerns about health, comments on the administration, and attitudes of professionalism. Nurses viewed the human swine influenza as a threat to their personal and families' health. However, nurses perceived that the severity of the disease was exaggerated by the public. Improvements in planning the circulation of information, allocation of manpower, and utilization of personal protective equipment were indicated. The emergency nurses demonstrated a sense of commitment and professional morale in promoting a high quality of nursing care. Various factors affecting the perceptions of emergency nurses toward their professional duties during the influenza pandemic were identified. By understanding these perceptions, appropriate planning, policies, and guidelines can be formulated to meet the healthcare needs of patients during future pandemic outbreaks. Copyright © 2012 Elsevier Ltd. All rights reserved.

Stakeholders' Perceptions About a Newly Established Dental School with a Problem-Based, Student-Led, Patient-Centered Curriculum: A Qualitative Study.

PubMed

Ali, Kamran; Tredwin, Christopher; Kay, Elizabeth; Slade, Anita

2016-03-01

The aim of this study was to explore the perceptions of stakeholders regarding a newly established dental school with a problem-based, student-led, patient-centered curriculum in a community setting. Qualitative methods using 16 semistructured interviews and two focus groups were used to engage a range of stakeholders from students to faculty members to practitioners. Purposive sampling was employed with participants contacted through professional channels. Interview and focus group transcripts were transcribed verbatim. The data were analyzed thematically using an inductive approach. Themes related to preparedness of dental graduates were identified during data analyses. Early clinical exposure with patients in the first year of the course, holistic care using a patient-centered approach, and the acquisition of communication skills, professionalism, team-working skills, reflective practice, and evidence-informed clinical practice were perceived to be key strengths of the curriculum. The participants also expressed the need to strengthen teaching of life sciences and provide additional clinical experience in simulated general dental practice clinics. This study provides insight into the perceptions of a wide range of stakeholders and provides a deeper understanding of the merits and challenges of an innovative undergraduate dental curriculum.

Work-related barriers, facilitators, and strategies of breast cancer survivors working during curative treatment.

PubMed

Sun, Wenjun; Chen, Karen; Terhaar, Abigail; Wiegmann, Douglas A; Heidrich, Susan M; Tevaarwerk, Amye J; Sesto, Mary E

2016-01-01

Research has identified barriers and facilitators affecting cancer survivors' return to work (RTW) following the end of active treatment (surgery, chemotherapy and/or radiation therapy). However, few studies have focused on barriers and facilitators that cancer survivors experience while working during active treatment. Strategies used by cancer survivors to solve work-related problems during active treatment are underexplored. The aim of this study was to describe factors that impact, either positively or negatively, breast cancer survivors' work activities during active treatment. Semi-structured, recorded interviews were conducted with 35 breast cancer survivors who worked during active treatment. Transcripts of interviews were analyzed using inductive content analysis to identify themes regarding work-related barriers, facilitators and strategies. Barriers identified included symptoms, emotional distress, appearance change, time constraints, work characteristics, unsupportive supervisors and coworkers, family issues and other illness. Facilitators included positive aspects of work, support outside of work, and coworker and supervisor support. Strategies included activities to improve health-related issues and changes to working conditions and tasks. Breast cancer survivors encounter various barriers during active treatment. Several facilitators and strategies can help survivors maintain productive work activities.

Promoting interprofessional learning with medical students in home care settings.

PubMed

Solomon, Patricia; Risdon, Cathy

2011-01-01

The home care setting is ideal for medical students to learn about the importance of interprofessional collaboration in the community. This project examined the impact of a unique program designed to facilitate medical students' knowledge and awareness of the challenges of interprofessional care in the home. In pairs, medical students participated in two community visits with preceptors from different professions. Students completed a structured personal reflection after their first visit. Students and preceptors participated in focus groups or interviews to identify strengths and challenges of the experiences. The structured reflections and the focus group and interview transcripts were analyzed qualitatively. 164 medical students and 36 preceptors participated in 326 visits. There were high ratings of satisfaction from students and preceptors. Students developed unexpected insights into peoples' lives, developed a greater understanding of the patient's perspective and determinants of health, learned about others' scope of practice, and developed an appreciation of the limitations of their own scope of practice. Preceptors had high expectations for student performance and engagement and enjoyed the opportunity to impart their knowledge to future physicians. Although organizationally complex, the program evaluation suggestions that students and preceptors benefit from interprofessional experiences in the home.

Obese persons' physical activity experiences and motivations across weight changes: a qualitative exploratory study.

PubMed

Bombak, Andrea E

2015-11-14

Obese individuals are encouraged to participate in physical activity. However, few qualitative studies have explored obese individuals' motivations for and experiences with physical activity. The physical activity experiences of self-identified obese or formerly obese persons (n = 15) were explored through in-depth, semi-structured, audio-taped, repeated interviews and ethnography over one year. Participant observation occurred at multiple sites identified by participants as meaningful to them as obese persons. Data from interview transcripts and fieldnotes were analyzed via thematic content analysis. Underlying goals for engaging in physical activity were diverse. Emergent motivation themes included: protection, pressure, and pleasure. Participants were protective of maintaining functional capacity, establishing fit identities, and achieving weight loss. Participants also discussed feelings of excessive pressure to continue progressing toward weight and fitness goals. Enjoyment in physical activity was often a by-product for all participants and could become a sought-after endpoint. Finding an environment in which participants felt safe, accepted, and encouraged to be active was extremely important for continual engagement. Obese individuals enjoyed physical activity and were concerned about maintaining functional fitness. Stigmatization and untenable goals and monitoring could disrupt physical activity.

An Exploration of Smoking Behavior of African Male Immigrants Living in Glasgow

PubMed Central

Ezika, Ejiofor Augustine

2014-01-01

INTRODUCTION The aim of this research study was to explore the smoking behavior of adult African male immigrant smokers living in Glasgow to inform and contribute to primary health promotion frameworks. METHODS 25 adult African male immigrant smokers living in Glasgow were recruited via consecutive sampling by soliciting for participation through the use of flyers, posters and word of mouth. Data collection occurred via semi-structured face-to-face interviews. The interviews were audio taped, after which verbatim transcription was carried out and the data analyzed thematically. RESULTS The participants’ smoking habits were influenced by cold weather environment as well as societal norms that appear to make the smoking habit more acceptable in Glasgow than Africa. It appears the more educated the participants were, the fewer cigarettes they smoked. However, there was only a slight difference in the number of cigarettes smoked between participants with a degree and those with a postgraduate degree. CONCLUSION The participants’ smoking habits in Glasgow appear to have increased because of environmental variables associated with living in Glasgow, specifically the cold weather environment and high acceptability of smoking habits in Glasgow. PMID:25741179

The meaning of work for two high school seniors.

PubMed

Dale, Lucinda; Boenker, Julie; Easter, Dana; Niederhaus, Sara; Stach, Allison; Szuter, Kristin

2006-01-01

The workplace is increasingly serving as an important context for the development of work behaviors, interpersonal skills, and values for high school students. A lack of qualitative studies regarding the meaning of the subjective aspects of work for teens is evident. The purpose of this research study was to understand the meaning of work for two high school seniors through qualitative inquiry. The researchers interviewed two participants in a conference room to maintain privacy. Interviews were audio taped, transcribed verbatim, and returned to the interviewees for member check. The researchers analyzed transcriptions, coded for identification of themes, and shared them with the participants to ensure accuracy. The meaning of work for both participants included themes of gaining financial freedom, learning job-specific skills, learning the general work skill of time management, sacrificing and rearranging leisure time spent with friends and family, and helping to define choices related to future work and co-workers. The meaning of work for the participant who owned his own business included additional themes of improving interpersonal communication, marketing, budgeting, taking initiative and responsibility, prioritizing, organizing, and decision-making, all required to develop and expand a successful business.

What criteria do consumer health librarians use to develop library collections? a phenomenological study.

PubMed

Papadakos, Janet; Trang, Aileen; Wiljer, David; Cipolat Mis, Chiara; Cyr, Alaina; Friedman, Audrey Jusko; Mazzocut, Mauro; Snow, Michelle; Raivich, Valeria; Catton, Pamela

2014-04-01

The criteria for determining whether resources are included in consumer health library collections are summarized in institutional collection development policies (CDPs). Evidence suggests that CDPs do not adequately capture all of these criteria. The aim of this study was to describe the resource review experience of librarians and compare it to what is described in CDPs. A phenomenological approach was used to explore and describe the process. Four consumer health librarians independently evaluated cancer-related consumer health resources and described their review process during a semi-structured telephone interview. Afterward, these librarians completed online questionnaires about their approaches to collection development. CDPs from participating libraries, interview transcripts, and questionnaire data were analyzed. Researchers summarized the findings, and participating librarians reviewed results for validation. Librarians all utilized similar criteria, as documented in their CDPs; however, of thirteen criteria described in the study, only four were documented in CDPs. CDPs for consumer health libraries may be missing important criteria that are considered integral parts of the collection development process. A better understanding of the criteria and contextual factors involved in the collection development process can assist with establishing high-quality consumer health library collections.

What criteria do consumer health librarians use to develop library collections? a phenomenological study*

PubMed Central

Papadakos, Janet; Trang, Aileen; Wiljer, David; Mis, Chiara Cipolat; Cyr, Alaina; Friedman, Audrey Jusko; Mazzocut, Mauro; Snow, Michelle; Raivich, Valeria; Catton, Pamela

2014-01-01

Objectives: The criteria for determining whether resources are included in consumer health library collections are summarized in institutional collection development policies (CDPs). Evidence suggests that CDPs do not adequately capture all of these criteria. The aim of this study was to describe the resource review experience of librarians and compare it to what is described in CDPs. Methods: A phenomenological approach was used to explore and describe the process. Four consumer health librarians independently evaluated cancer-related consumer health resources and described their review process during a semi-structured telephone interview. Afterward, these librarians completed online questionnaires about their approaches to collection development. CDPs from participating libraries, interview transcripts, and questionnaire data were analyzed. Researchers summarized the findings, and participating librarians reviewed results for validation. Results: Librarians all utilized similar criteria, as documented in their CDPs; however, of thirteen criteria described in the study, only four were documented in CDPs. Conclusions: CDPs for consumer health libraries may be missing important criteria that are considered integral parts of the collection development process. Implications: A better understanding of the criteria and contextual factors involved in the collection development process can assist with establishing high-quality consumer health library collections. PMID:24860261

Therapeutic Change in Group Therapy For Interpersonal Trauma: A Relational Framework for Research and Clinical Practice.

PubMed

Chouliara, Zoë; Karatzias, Thanos; Gullone, Angela; Ferguson, Sandra; Cosgrove, Katie; Burke Draucker, Claire

2017-04-01

Our understanding of therapeutic change processes in group therapy for complex interpersonal trauma has been limited. The present study aimed at addressing this gap by developing a framework of therapeutic change in this field from a survivor and therapist perspective. This is a qualitative study, which utilized semistructured individual interviews. Transcripts were analyzed using interpretative phenomenological analysis (IPA) to identify recurrent themes. A final sample of n = 16 patients and n = 5 facilitators completed the interview. Main change processes identified by survivors were as follows: self versus others, trust versus threat, confrontation versus avoidance, and "patching up" versus true healing. Therapeutic processes identified by therapist facilitators included managing group dynamics, unpredictability and uncertainty, and process versus content. The proposed framework explains therapeutic change in group therapy in relational terms, that is, therapeutic dissonance, the dynamic interaction of self and experience as well as building empathic trusting relations. The importance of managing dissonance to aid personally meaningful recovery was highlighted. These findings have implications for the usefulness of relational and person-centered approaches to clinical practice in the area of interpersonal and complex trauma, especially in the early identification, prevention, and management of dropouts.

The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS

PubMed Central

Nevedal, Andrea; Sankar, Andrea

2016-01-01

Purpose of the Study: Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker’s (1997) life course disruption theory, we explored older African Americans’ experiences of living with HIV/AIDS. Design and Methods: A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Results: Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Implications: Older African Americans’ discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. PMID:26035889

Trying to find the quickest way: employed mothers' constructions of time for food.

PubMed

Jabs, Jennifer; Devine, Carol M; Bisogni, Carole A; Farrell, Tracy J; Jastran, Margaret; Wethington, Elaine

2007-01-01

The study sought to develop an understanding of how employed mothers constructed time for food provisioning for themselves and their families. A grounded theory approach and semistructured, in-depth interviews. A metropolitan area of approximately 1 million people in the northeastern United States. Thirty-five low-wage employed mothers were purposively recruited to vary in occupation, race/ethnicity, education, household composition, and age using workplace, community, convenience, and snowball sampling. Low-wage employed mothers' constructions of time for food. Interview transcripts were analyzed using the constant comparative method. Most mothers expressed feelings of time scarcity. Mothers described 3 timestyles that reflected how they constructed time. Timestyles reflected mothers' experiences of strain and time scarcity, usual time management strategies, and sense of control over time. Mothers prioritized feeding their children but wanted to complete meals quickly in order to move on to other tasks. Recognizing issues of time scarcity and individual differences of timestyles and time management strategies can help researchers better understand food choice practices and assist practitioners in identifying practical food provisioning strategies for low-wage employed mothers. Food policies and recommendations should be evaluated for their relevance to the time scarcity and work strain issues that these mothers faced.

Head Start Staff Reactions to a Novel Tobacco Intervention: A Qualitative Analysis.

PubMed

Keske, Robyn R; Barker, Kathryn M; Geller, Alan C; Hamasaka, Laura; Sparks, Michael; Moody-Thomas, Sarah; Jolicoeur, Denise; Rees, Vaughan W

2016-11-01

As tobacco use becomes increasingly concentrated in communities of low socio-economic position (SEP), scalable cessation interventions are needed. Head Start programs offer one setting in which a family-focused intervention can be implemented in low SEP communities. We assessed the experiences of Head Start (HS) staff who received training in a pilot motivational interviewing (MI) tobacco intervention, to improve future feasibility. Focus group interviews were conducted with HS staff to assess their reactions to MI training and their use of MI in their work with families. Transcripts were analyzed using thematic analysis and a 4-step approach informed by grounded theory. HS staff reported advantages of MI beyond its use as a tobacco intervention, despite systematic barriers to broad implementation. Facilitators of MI use included enhanced engagement with families, and opportunities for professional development. Barriers to MI use included limited institutional support and low priority for a tobacco intervention among families with pressing social and financial concerns. HS Staff voiced support for broader training in MI interventions in HS programs. System-wide standards to ensure adequate training and support for an MI tobacco intervention were identified as priorities.

Pregnant Mothers’ Perceptions of how Intimate Partner Violence affects Their Unborn Children

PubMed Central

Alhusen, Jeanne L.; Rahman, Damali

2014-01-01

Objective To explore the perceptions of pregnant women on the experience of intimate partner violence (IPV) as it affects maternal and fetal health. Design Secondary qualitative content analysis. Setting Individual interviews conducted within three urban obstetric and gynecologic clinics Participants Our sample included a subset of eight pregnant women experiencing IPV during the current pregnancy. Participants were selected from a larger parent study that included qualitative data from 13 women. Methods We analyzed in-depth individual interview transcripts in which participants discussed how they perceived IPV to affect their health as well as the health of their unborn children. Constant comparative techniques and conventional content analysis methodology were used in analysis. Results Three themes emerged to illustrate mothers’ perceptions of how IPV influenced maternal and fetal outcomes: protection, fetal awareness, and fetal well-being. Conclusions This analysis provides important insights into concerns that pregnant women experiencing IPV shared about maternal attachment and fetal well-being. Health care providers can use these findings to better assess the physical and psychological concerns of pregnant women experiencing IPV. Further research is needed to better understand how IPV contributes to adverse neonatal outcomes, particularly from a biological perspective. PMID:25651808

"All the money in the world …" patient perspectives regarding the influence of financial incentives.

PubMed

Reisinger, Heather Schacht; Brackett, Rachel Horner; Buzza, Colin D; Páez, Monica B Williams; Gourley, Ryan; Weg, Mark W Vander; Christensen, Alan J; Kaboli, Peter J

2011-12-01

To analyze patient perspectives of the use of financial incentives in a hypertension intervention. Study Setting. Twelve Veterans Affairs primary care clinics over a 9-month period. Qualitative semistructured interviews conducted with 54 hypertensive veterans participating in an intervention to promote guideline-consistent therapy. Intervention components included an intervention letter requesting patients talk with their providers, an offer of U.S.$20 to bring in the letter to their provider, and a health educator phone call. Semistructured interviews were conducted. Transcripts were coded for thematic content. The financial incentive theme was then subcoded for more detailed analysis. Most participants (n=48; 88.9 percent) stated the incentive had (or would have) no effect on their decision to initiate a discussion with their provider. Some participants articulated reservations about the effectiveness and/or appropriateness of financial incentives in health care decisions; however, a few expressed the opinion that there may be some potential benefits to the use of financial incentives if they encourage patients to be active in their health care. The findings of this study raise questions about the appropriateness and unintended consequences of employing patient-directed financial incentives in health care settings. © Health Research and Educational Trust.

Preventing Filipino Mental Health Disparities: Perspectives from Adolescents, Caregivers, Providers, and Advocates

PubMed Central

Javier, Joyce R.; Supan, Jocelyn; Lansang, Anjelica; Beyer, William; Kubicek, Katrina; Palinkas, Lawrence A.

2014-01-01

Filipino Americans are the second largest immigrant population and second largest Asian ethnic group in the U.S. Disparities in youth behavioral health problems and the receipt of mental health services among Filipino youth have been documented previously. However, few studies have elicited perspectives from community stakeholders regarding how to prevent mental health disparities among Filipino youth. The purpose of the current study is to identify intervention strategies for implementing mental health prevention programs among Filipino youth. We conducted semi-structured interviews (n=33) with adolescents, caregivers, advocates, and providers and focus groups (n=18) with adolescents and caregivers. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed using a methodology of “coding consensus, co-occurrence, and comparison” and was rooted in grounded theory. Four recommendations were identified when developing mental health prevention strategies among Filipino populations: address the intergenerational gap between Filipino parents and children, provide evidence-based parenting programs, collaborate with churches in order to overcome stigma associated with mental health, and address mental health needs of parents. Findings highlight the implementation of evidence-based preventive parenting programs in faith settings as a community-identified and culturally appropriate strategy to prevent Filipino youth behavioral health disparities. PMID:25667725

Preventing Filipino Mental Health Disparities: Perspectives from Adolescents, Caregivers, Providers, and Advocates.

PubMed

Javier, Joyce R; Supan, Jocelyn; Lansang, Anjelica; Beyer, William; Kubicek, Katrina; Palinkas, Lawrence A

2014-12-01

Filipino Americans are the second largest immigrant population and second largest Asian ethnic group in the U.S. Disparities in youth behavioral health problems and the receipt of mental health services among Filipino youth have been documented previously. However, few studies have elicited perspectives from community stakeholders regarding how to prevent mental health disparities among Filipino youth. The purpose of the current study is to identify intervention strategies for implementing mental health prevention programs among Filipino youth. We conducted semi-structured interviews (n=33) with adolescents, caregivers, advocates, and providers and focus groups (n=18) with adolescents and caregivers. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed using a methodology of "coding consensus, co-occurrence, and comparison" and was rooted in grounded theory. Four recommendations were identified when developing mental health prevention strategies among Filipino populations: address the intergenerational gap between Filipino parents and children, provide evidence-based parenting programs, collaborate with churches in order to overcome stigma associated with mental health, and address mental health needs of parents. Findings highlight the implementation of evidence-based preventive parenting programs in faith settings as a community-identified and culturally appropriate strategy to prevent Filipino youth behavioral health disparities.

Pregnant mothers' perceptions of how intimate partner violence affects their unborn children.

PubMed

Alhusen, Jeanne L; Wilson, Damali

2015-01-01

To explore the perceptions of pregnant women on the experience of intimate partner violence (IPV) as it affects maternal and fetal health. Secondary qualitative content analysis. Individual interviews conducted within three urban obstetric and gynecologic clinics. Our sample included a subset of eight pregnant women experiencing IPV during the current pregnancy. Participants were selected from a larger parent study that included qualitative data from 13 women. We analyzed in-depth individual interview transcripts in which participants discussed how they perceived IPV to affect their health as well as the health of their unborn children. Constant comparative techniques and conventional content analysis methodology were used in analysis. Three themes emerged to illustrate mothers' perceptions of how IPV influenced maternal and fetal outcomes: protection, fetal awareness, and fetal well-being. This analysis provides important insights into concerns that pregnant women experiencing IPV shared about maternal attachment and fetal well-being. Health care providers can use these findings to better assess the physical and psychological concerns of pregnant women experiencing IPV. Further research is needed to better understand how IPV contributes to adverse neonatal outcomes, particularly from a biological perspective. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Quality of care in American Indian child and adolescent behavioral health: A pilot study of patient and family perspectives

PubMed Central

Podlogar, Matthew C.; Novins, Douglas K.

2015-01-01

Research regarding the quality of behavioral health care for American Indian (AI) children and adolescents is extremely limited, and no study has considered the qualitative perspectives of the AI children receiving such services or that of their families. This pilot study investigated AI patient and family perspectives of what quality of care means to them. Data were drawn from interviews of parents (n = 15), and the youth (if they were age 11 or older; n = 11) of 16 children and adolescents who received treatment at three behavioral health programs serving AI communities. Interview transcripts were coded and analyzed for key themes that related to treatment structure, process, and outcomes. According to these participants, the principal indicator of treatment quality was “being able to trust the clinician.” The most valued treatment outcomes for improvement were the youth’s “self-efficacy and self-worth,” “functioning in school,” and “relationship with the family.” Future research is needed on how to best integrate these domains into specific and objective indicators for standardized quality of care assessments of AI child and adolescent behavioral health services. PMID:25961647

Work-related barriers, facilitators, and strategies of breast cancer survivors working during curative treatment

PubMed Central

Sun, Wenjun; Chen, Karen; Terhaar, Abigail; Wiegmann, Douglas A.; Heidrich, Susan M.; Tevaarwerk, Amye J.; Sesto, Mary E.

2017-01-01

BACKGROUND Research has identified barriers and facilitators affecting cancer survivors’ return to work (RTW) following the end of active treatment (surgery, chemotherapy and/or radiation therapy). However, few studies have focused on barriers and facilitators that cancer survivors experience while working during active treatment. Strategies used by cancer survivors to solve work-related problems during active treatment are underexplored. OBJECTIVE The aim of this study was to describe factors that impact, either positively or negatively, breast cancer survivors’ work activities during active treatment. METHODS Semi-structured, recorded interviews were conducted with 35 breast cancer survivors who worked during active treatment. Transcripts of interviews were analyzed using inductive content analysis to identify themes regarding work-related barriers, facilitators and strategies. RESULTS Barriers identified included symptoms, emotional distress, appearance change, time constraints, work characteristics, unsupportive supervisors and coworkers, family issues and other illness. Facilitators included positive aspects of work, support outside of work, and coworker and supervisor support. Strategies included activities to improve health-related issues and changes to working conditions and tasks. CONCLUSIONS Breast cancer survivors encounter various barriers during active treatment. Several facilitators and strategies can help survivors maintain productive work activities. PMID:28059814

Food and personal hygiene perceptions and practices among caregivers whose children have diarrhea: a qualitative study of urban mothers in Tangerang, Indonesia.

PubMed

Usfar, Avita A; Iswarawanti, Dwi N; Davelyna, Devy; Dillon, Drupadi

2010-01-01

To examine caregivers' perceptions and practices related to food and personal hygiene and its association with diarrhea in children 6 to 36 months of age who suffered recurrent diarrhea. This qualitative study, conducted in March and April 2006, used both in-depth interviews and direct observation data. Urban Tangerang, near Jakarta, Indonesia. Twenty-four mothers whose monthly household income was less than $160 US and had latrines in their homes. To examine the relationship between mothers' perceptions and behaviors related to diarrhea, food hygiene, and personal hygiene. Interview transcripts were analyzed based on the phenomenon of interest and coded for common themes. Mothers differentiated diarrhea episodes as either disease or nondisease. Most mothers associated the importance of food hygiene with disease prevention, contaminating agents, and health. Mothers commonly wiped cutting boards with a kitchen towel after slicing vegetables, whereas they washed the board with soap and water after cutting raw meat. Mothers perceived that the importance of personal hygiene was for maintaining health and cleanliness. The majority of mothers washed their hands without soap after performing housework and cooking. Improving mothers' knowledge while incorporating existing perceptions might lead to positive changes.

COMMUNICATING RISK IN THE CONTEXT OF METHADONE FORMULATION CHANGES: A QUALITATIVE STUDY OF OVERDOSE WARNING POSTERS IN VANCOUVER, CANADA

PubMed Central

Markwick, Nicole; McNeil, Ryan; Anderson, Solanna; Small, Will; Kerr, Thomas

2015-01-01

BACKGROUND British Columbia, Canada’s provincial methadone program recently replaced their existing methadone formulation with a formulation ten times more concentrated. The transition raised concerns about heightened risk of accidental overdose, leading two organizations to disseminate methadone overdose warning posters during the transitional period. This study explores people who use drugs’ (PWUD) perceptions of these warning posters. METHODS Qualitative interviews were conducted with thirty-four PWUD enrolled in methadone maintenance treatment in Vancouver. Participants were recruited from ongoing cohort studies of drug-using individuals. Interview transcripts were analyzed thematically, focusing on participants’ perceptions of the warning posters and potential impacts on drug-related risks. RESULTS Overdose warning posters constituted a key source of information about the methadone formulation change, but did not provide adequate information for all participants. Participants articulated a preference for descriptive language, focusing on changes in concentration rather than “strength”, and universal hazard symbols to effectively communicate overdose risks. CONCLUSION Participants indicated that warnings employing descriptive language more effectively communicated risk of methadone overdose. Future overdose warnings for drug-using populations must provide adequate information for the intended audience, and be communicated to PWUD through multiple channels. PMID:26644025

Diabetes and the Motivated Patient: Understanding Perlocutionary Effect in Health Communication.

PubMed

Roth, Erin G; Girling, Laura M; Chard, Sarah; Wallace, Brandy Harris; Eckert, J Kevin

2017-04-01

Health care providers (HCP) understand the importance of keeping patients motivated but may be unaware how their words may have unintended negative effects upon their patient's lives. People with diabetes report being told by their HCP that they are "cured" or that they are praised for strides made in weight loss and/or lowered blood glucose, and interpret these messages in unexpected ways. For this paper, we focus upon one case to illustrate the depth and nuance of the patient-provider communication as it emerged within a larger interview-based ethnographic study. Audio-recorded interviews and transcriptions were analyzed discursively. Discourse analysis reveals the ways ideology affects how the patient responds to HCP's utterances and how this affects diabetes self-care. Findings indicate significant perlocutionary effects upon health outcomes, varying both positively and/or negatively. This study points to the importance of carefully considering the power of words and whenever possible knowing the patient's ideological orientation to their world. HCPs should be explicit and deliberate with their communication. Sensitization to the various ways patients hear and react to messages in a clinical setting may lead to improved health outcomes, especially for those with chronic health conditions such as diabetes mellitus.

The role of comorbidities in patients' hypertension self-management.

PubMed

Fix, Gemmae M; Cohn, Ellen S; Solomon, Jeffrey L; Cortés, Dharma E; Mueller, Nora; Kressin, Nancy R; Borzecki, Ann; Katz, Lois A; Bokhour, Barbara G

2014-06-01

We sought to understand barriers to hypertension self-management in patients with hypertension and comorbidities. We conducted semi-structured, qualitative interviews with 48 patients with uncontrolled hypertension and at least one comorbidity to learn about beliefs and behaviors that might affect hypertension self-management. Using a grounded theory strategy, we analyzed interview transcripts detailing patients' hypertension self-management behaviors vis-à-vis a framework including Explanatory Models-a patient's understanding of the pathophysiology, cause, course, treatment, and severity of an illness, such as hypertension. We identified four factors that interfered with hypertension self-management. (1) Interdependence: Participants saw hypertension as interconnected to their comorbidities and subsequently had difficulty separating information about their illnesses. (2) Low priority: Compared to other conditions, participants assigned hypertension a lower priority. (3) Conflicts: Participants struggled with conflicts between hypertension self-management practices and those for comorbidities. (4) Managing multiple medications: Polypharmacy led to patients' confusion and concern about taking medications as prescribed. Participants did not experience hypertension as a discreet clinical condition; rather, they self-managed hypertension concurrently with other conditions, leading to a breakdown in hypertension self-management. We provide strategies to address each of the four barriers to better equip providers in addressing their clinically salient concerns.

Does the Fast Patrol Boat Have a Future in the Navy?

DTIC Science & Technology

2002-05-31

Admiral Dennis Blair (Commander and Chief, United States Pacific Command) testified to Congress “countering terrorism, weapons proliferation...United States Navy. Blair, Dennis C., Admiral, USN. 2001a. Interview by Maria Ressa, CNN Jakarta Bureau, December 1. Interview transcript on-line...Available from http://www. pacom.mil/speeches/sst2001/011201blairCNN.htm. Internet accessed 3 March 2002. Blair, Dennis C., Admiral, USN. 2001b

In and out of Place: Exploring the Discursive Effects of Teachers' Talk about Outdoor Education in Secondary Schools in New Zealand

ERIC Educational Resources Information Center

Mikaels, Jonas; Backman, Erik; Lundvall, Suzanne

2016-01-01

The purpose of this article is to explore and problematise teachers' talk about outdoor education in New Zealand. The focus is on what can be said, how it is said and the discursive effects of such ways of speaking. The inquiry draws on Foucauldian theoretical insights to analyse interview transcripts derived from semi-structured interviews with…

Oral History Interview Transcripts Tombigbee Historic Townsites Project. Volume 4 (Interview Numbers 117-122).

DTIC Science & Technology

1981-01-01

Creek. They had one family of Hamptons and one family of Bananas . Bull Banana’s widow lives over here about a mile from me. I believe that the Ellises... peeled . I don’t know whether she peeled apples or not, but she would peel the peaches. Spread them out in the sunshine on a plank or a piece of tin

When health care workers experience mental ill health: institutional practices of silence.

PubMed

Moll, Sandra; Eakin, Joan M; Franche, Renée-Louise; Strike, Carol

2013-02-01

Based on findings from an institutional ethnography in a large mental health organization, we explore how institutional forces shape the experiences of health care workers with mental health issues. We interviewed 20 employees about their personal experiences with mental health issues and work and 12 workplace stakeholders about their interactions with workers who had mental health issues. We also reviewed organizational texts related to health, illness, and productivity. In analyzing transcripts and texts, silence emerged as a core underlying process characterizing individual and organizational responses to employees with mental health issues. Silence was an active practice that took many forms; it was pervasive, complex, and at times, paradoxical. It served many functions for workers and the organization. We discuss the theoretical and practical implications of the findings for workers with mental health issues.

Recognizing and labeling sex-based and sexual harassment in the health care workplace.

PubMed

Madison, J; Minichiello, V

2000-01-01

To explore how registered nurses (RNs) recognized and labeled incidents of sex-based and sexual harassment in the Australian health care workplace. Qualitative, using 16 unstructured interviews with registered nurses in Australia. Verbatim transcripts were analyzed largely by inductive analysis. Key categories were identified as themes or concepts for analysis. RNs reported several indicators of sexual harassment, including the invasion of space, confirmation from others, lack of respect, the deliberate nature of the behavior, perceived power or control, overly friendly behavior, and a sexualized workplace. RNs rarely labeled harassing behaviors as sex-based or sexual harassment. Many forces reduce the likelihood that RNs will correctly recognize and label unwelcome sexualized behavior as sexual harassment. Recognition is associated with a variety of workplace behaviors that sometimes precede harassment. Implications for the health care workplace are discussed.

Implementing computerized physician order entry: the importance of special people.

PubMed

Ash, Joan S; Stavri, P Zoë; Dykstra, Richard; Fournier, Lara

2003-03-01

To articulate important lessons learned during a study to identify success factors for implementing computerized physician order entry (CPOE) in inpatient and outpatient settings. Qualitative study by a multidisciplinary team using data from observation, focus groups, and both formal and informal interviews. Data were analyzed using a grounded approach to develop a taxonomy of patterns and themes from the transcripts and field notes. The theme we call Special People is explored here in detail. A taxonomy of types of Special People includes administrative leaders, clinical leaders (champions, opinion leaders, and curmudgeons), and bridgers or support staff who interface directly with users. The recognition and nurturing of Special People should be among the highest priorities of those implementing computerized physician order entry. Their education and training must be a goal of teaching programs in health administration and medical informatics.

Makerere University Student Interview Transcript: MedlinePlus

MedlinePlus

... was a picture of people gathering under a tree, (shown) which is basically typical of our African culture. Mostly village meetings are conducted under the trees, under temporary shelter, it is something that somebody ...

Space Shuttle.

ERIC Educational Resources Information Center

Bierly, Ken; Dalheim, Mary

1981-01-01

Presents an elementary teaching unit on NASA's space program, including teacher background information, suggested student activities, and a list of resources. Appended is a transcript of an interview conducted by elementary children with astronaut candidate Sherwood (Woody) Spring. (SJL)

Putting informed and shared decision making into practice.

PubMed

Towle, Angela; Godolphin, William; Grams, Garry; Lamarre, Amanda

2006-12-01

To investigate the practice, experiences and views of motivated and trained family physicians as they attempt to implement informed and shared decision making (ISDM) in routine practice and to identify and understand the barriers they encounter. Patient involvement in decision making about their health care has been the focus of much academic activity. Although significant conceptual and experimental work has been done, ISDM rarely occurs. Physician attitudes and lack of training are identified barriers. Qualitative analysis of transcripts of consultations and key informant group interviews. Six family physicians received training in the ISDM competencies. Audiotapes of office consultations were made before and after training. Transcripts of consultations were examined to identify behavioural markers associated with each competency and the range of expression of the competencies. The physicians attended group interviews at the end of the study to explore experiences of ISDM. The physicians liked the ISDM model and thought that they should put it into practice. Evidence from transcripts indicated they were able to elicit concerns, ideas and expectations (although not about management) and agree an action plan. They did not elicit preferences for role or information. They sometimes offered choices. They had difficulty achieving full expression of any of the competencies and integrating ISDM into their script for the medical interview. The study also identified a variety of competency-specific barriers. A major barrier to the practice of ISDM by motivated physicians appears to be the need to change well-established patterns of communication with patients.

How do dentists and their teams incorporate evidence about preventive care? An empirical study.

PubMed

Sbaraini, Alexandra; Carter, Stacy Marie; Evans, Robin Wendell; Blinkhorn, Anthony

2013-10-01

To identify how dentists and their teams adopt evidence-based preventive care. A qualitative study using grounded theory methodology was conducted. We interviewed 23 participants working in eight dental practices about their experience and work processes, while adopting evidence-based preventive care. During the study, Charmaz's grounded theory methodology was employed to examine the social process of adopting preventive dental care in dental practices. Charmaz's iteration of the constant comparative method was used during the data analysis. This involved coding of interview transcripts, detailed memo-writing and drawing diagrams. The transcripts were analyzed as soon as possible after each round of interviews in each dental practice. Coding was conducted primarily by AS, supported by team meetings and discussions when researchers compared their interpretations. Participants engaged in a slow process of adapting evidence-based protocols and guidelines to the existing logistics of the practices. This process was influenced by practical, philosophical, and historical aspects of dental care, and a range of barriers and facilitators. In particular, dentists spoke spontaneously about two deeply held 'rules' underpinning continued restorative treatment, which acted as barriers to provide preventive care: (i) dentists believed that some patients were too 'unreliable' to benefit from prevention; and (ii) dentists believed that patients thought that only tangible restorative treatment offered 'value for money'. During the adaptation process, some dentists and teams transitioned from their initial state - selling restorative care - through an intermediary stage - learning by doing and educating patients about the importance of preventive care - and finally to a stage where they were offering patients more than just restorative care. Resources were needed for the adaptation process to occur, including: the ability to maintain the financial viability of the practice, appropriate technology, time, and supportive dental team relationships. The findings from this study show that with considerable effort, motivation and coordination, it is possible for dental practices to work against the dental 'mainstream' and implement prevention as their clinical norm. This study has shown that dental practice is not purely scientific, but it includes cultural, social, and economic resources that interfere with the provision of preventive care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

How can mass participation physical activity events engage low-active people? A qualitative study.

PubMed

Early, Frances; Corcoran, Paula

2013-08-01

Regular, moderate physical activity reduces the risk of mortality and morbidity; however increasing the physical activity levels of less active people is a public health challenge. This study explores the potential of mass participation physical activity events to engage less active people, through analyzing the accounts of participants in 2 events who identified themselves as low-active before entering. Seven participants in a sponsored run and 7 in a sponsored walk were interviewed and transcripts were analyzed using grounded theory techniques. Participants had positive experiences encapsulated in 3 categories: Performing (physical completion of the event culminating in a sense of achievement); Relating (enjoying relationships); Soaking up the Atmosphere (enjoying the event ambience). The way in which these categories were manifested was affected by the event context. Mass participation events have potential to engage low-active people. The impact of participation resonated with factors that are positively associated with physical activity in other settings, and event characteristics matched key criteria for attracting low-active groups identified through social marketing research. Suggestions are given for how to capitalize on the findings for health promotion.

Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals: A Grounded Theory Study

PubMed Central

Dauman, Nicolas; Erlandsson, Soly I.; Albarracin, Dolorès; Dauman, René

2017-01-01

Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51–79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model identifies a set of new attitudes toward oneself and others that tinnitus tolerance would entail. Conclusion: The subjective experience of frustration enlightens tinnitus-induced disablement, offering new perspectives for long-term self-management. Modulation of frustration, rather than moderation of tinnitus interference, is suggested as a new approach to the clinical management of tinnitus-related distress. PMID:28848429

Oral History Interview Transcripts Tombigbee Historic Townsites Project. Volume 3 (Interview Numbers 112-116).

DTIC Science & Technology

1981-01-01

put it in three or three-and-a-half-foot rows. But he put his corn in six-foot rows and put a row of cowpeas in between the corn when the corn got up...about knee-high. That row of cowpeas would get up this high and just be covered with peas. I’ve seen after Christmas where the cow would have been on

Oral History Interview Transcripts Tombigbee Historic Townsites Project. Volume 6 (Interview Numbers 129-133).

DTIC Science & Technology

1981-01-01

week that come-- I was working--I sent him a box of candy and cookies and stuff that I knew he liked. About once a month, I’d send a suit of khaki...put the dough down on it, put another collard leaf on top of the dough , and then put them ashes over it. When it gets done, you take it and wash it off

Developing a patient-centered outcome measure for complementary and alternative medicine therapies II: Refining content validity through cognitive interviews

PubMed Central

2011-01-01

Background Available measures of patient-reported outcomes for complementary and alternative medicine (CAM) inadequately capture the range of patient-reported treatment effects. The Self-Assessment of Change questionnaire was developed to measure multi-dimensional shifts in well-being for CAM users. With content derived from patient narratives, items were subsequently focused through interviews on a new cohort of participants. Here we present the development of the final version in which the content and format is refined through cognitive interviews. Methods We conducted cognitive interviews across five iterations of questionnaire refinement with a culturally diverse sample of 28 CAM users. In each iteration, participant critiques were used to revise the questionnaire, which was then re-tested in subsequent rounds of cognitive interviews. Following all five iterations, transcripts of cognitive interviews were systematically coded and analyzed to examine participants' understanding of the format and content of the final questionnaire. Based on this data, we established summary descriptions and selected exemplar quotations for each word pair on the final questionnaire. Results The final version of the Self-Assessment of Change questionnaire (SAC) includes 16 word pairs, nine of which remained unchanged from the original draft. Participants consistently said that these stable word pairs represented opposite ends of the same domain of experience and the meanings of these terms were stable across the participant pool. Five pairs underwent revision and two word pairs were added. Four word pairs were eliminated for redundancy or because participants did not agree on the meaning of the terms. Cognitive interviews indicate that participants understood the format of the questionnaire and considered each word pair to represent opposite poles of a shared domain of experience. Conclusions We have placed lay language and direct experience at the center of questionnaire revision and refinement. In so doing, we provide an innovative model for the development of truly patient-centered outcome measures. Although this instrument was designed and tested in a CAM-specific population, it may be useful in assessing multi-dimensional shifts in well-being across a broader patient population. PMID:22206409

HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study.

PubMed

Dombrowski, Julia C; Carey, James W; Pitts, Nicole; Craw, Jason; Freeman, Arin; Golden, Matthew R; Bertolli, Jeanne

2016-06-10

U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing "Data to Care" programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009-2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV-positive peer component and to ensure coordination with HIV care providers in the process of relinking patients to care. Health departments can build support for Data to Care efforts by gathering input of key stakeholders, such as HIV medical and social service providers, and coordinating with clinic-based efforts to re-engage patients in care.

Toward development of a Tophus Impact Questionnaire: a qualitative study exploring the experience of people with tophaceous gout.

PubMed

Aati, Opetaia; Taylor, William J; Horne, Anne; Dalbeth, Nicola

2014-08-01

Although tophi are known to affect physical function, the impact of tophi on the lives of people with gout has not been explored in detail. The aim of this qualitative study was to understand the experience of people living with tophaceous gout, as the first step to developing a patient-reported Tophus Impact Questionnaire. Twenty-five people with tophaceous gout (22 men; median age, 66 years; median gout disease duration, 26 years) participated in semistructured interviews that explored their experiences and perceptions of tophi. Interviews were recorded and transcribed. The transcripts were analyzed and coded to identify themes using content analysis. Three major interrelated themes arose from the interviews. The first theme was functional impact affecting body structures and functions (causing pain, restricted joint range of motion and deformity, and complications), and causing activity limitation and participation restriction (affecting day-to-day activities, leisure activities, employment participation, and family participation). The second theme was psychological impact including low self-esteem, embarrassment, resignation, but also optimism. The third theme was the lack of impact in some participants. Gouty tophi can have an important impact on many aspects of the patient's life. In addition to the impact of tophi on physical function, tophi may also influence social and psychological functioning. Capturing these aspects of the patient experience will be important in the development of a patient-reported outcome measure of tophus burden.

Healthcare Experiences Among Young Adults Who Identify as Genderqueer or Nonbinary.

PubMed

Lykens, James E; LeBlanc, Allen J; Bockting, Walter O

2018-04-01

Research on healthcare among gender-diverse populations has largely focused on people who describe their gender in binary terms, either as trans men or trans women. This qualitative study examined the healthcare experiences of young adults who identify as genderqueer or nonbinary (GQ/NB). Participants (N = 10) were interviewed about experiences seeking and accessing healthcare. All were young adults (ages 23-33) in the San Francisco Bay area who had accessed healthcare at least once in the prior 6 months. A semistructured interview guide elicited conversations about gender identity and experiences of healthcare. Interview transcripts were analyzed using emergent coding analysis to identify themes. Participants faced unique challenges even at clinics specializing in gender-affirming healthcare. They felt misunderstood by providers who approached them from a binary transgender perspective and consequently often did not receive care sensitive to nonbinary identities. In response to this perceived bias, participants sometimes "borrowed" a binary transgender label to receive care, modified the healthcare they were prescribed, or went without healthcare. The GQ/NB young adults in our study regularly felt disrespected and frustrated as they sought and accessed healthcare. Participants felt that the binary transgender narrative pressured them to conform to binary medical narratives throughout healthcare interactions. GQ/NB young adults have unique healthcare needs but often do not feel understood by their providers. There is a need for existing healthcare systems to serve GQ/NB young adults more effectively.

Children are aware of food insecurity and take responsibility for managing food resources.

PubMed

Fram, Maryah Stella; Frongillo, Edward A; Jones, Sonya J; Williams, Roger C; Burke, Michael P; DeLoach, Kendra P; Blake, Christine E

2011-06-01

Child food insecurity is measured using parental reports of children's experiences based on an adult-generated conceptualization. Research on other child experiences (e.g. pain, exposure to domestic violence) cautions that children generally best report their own experiences, and parents' reports of children's experiences may lack adequate validity and impede effective intervention. Because this may be true of child food insecurity, we conducted semistructured interviews with mothers, children (age 9-16 y), and other household adults in 26 South Carolina families at risk for food insecurity. Interview transcripts were analyzed using a constant comparative process combining a priori with inductive coding. Child interviews revealed experiences of food insecurity distinct from parent experiences and from parent reports of children's experiences. Children experienced cognitive, emotional, and physical awareness of food insecurity. Children took responsibility for managing food resources through participation in parental strategies, initiation of their own strategies, and generation of resources to provide food for the family. Adults were not always aware of children's experiences. Where adult experiences of food insecurity are conditioned on inadequate money for food, child experiences were grounded in the immediate household social and food environment: quality of child/parent interactions, parent affect and behavior, and types and quantities of foods made available for children to eat. The new, child-derived understanding of what children experience that results from this study provides a critical basis from which to build effective approaches to identify, assess, and respond to children suffering from food insecurity.

Characteristics of successful and failed mentoring relationships: a qualitative study across two academic health centers.

PubMed

Straus, Sharon E; Johnson, Mallory O; Marquez, Christine; Feldman, Mitchell D

2013-01-01

To explore the mentor-mentee relationship with a focus on determining the characteristics of effective mentors and mentees and understanding the factors influencing successful and failed mentoring relationships. The authors completed a qualitative study through the Departments of Medicine at the University of Toronto Faculty of Medicine and the University of California, San Francisco, School of Medicine between March 2010 and January 2011. They conducted individual, semistructured interviews with faculty members from different career streams and ranks and analyzed transcripts of the interviews, drawing on grounded theory. The authors completed interviews with 54 faculty members and identified a number of themes, including the characteristics of effective mentors and mentees, actions of effective mentors, characteristics of successful and failed mentoring relationships, and tactics for successful mentoring relationships. Successful mentoring relationships were characterized by reciprocity, mutual respect, clear expectations, personal connection, and shared values. Failed mentoring relationships were characterized by poor communication, lack of commitment, personality differences, perceived (or real) competition, conflicts of interest, and the mentor's lack of experience. Successful mentorship is vital to career success and satisfaction for both mentors and mentees. Yet challenges continue to inhibit faculty members from receiving effective mentorship. Given the importance of mentorship on faculty members' careers, future studies must address the association between a failed mentoring relationship and a faculty member's career success, how to assess different approaches to mediating failed mentoring relationships, and how to evaluate strategies for effective mentorship throughout a faculty member's career.

Factors that contribute to physician variability in decisions to limit life support in the ICU: a qualitative study.

PubMed

Wilson, Michael E; Rhudy, Lori M; Ballinger, Beth A; Tescher, Ann N; Pickering, Brian W; Gajic, Ognjen

2013-06-01

Our aim was to explore reasons for physician variability in decisions to limit life support in the intensive care unit (ICU) utilizing qualitative methodology. Single center study consisting of semi-structured interviews with experienced physicians and nurses. Seventeen intensivists from medical (n = 7), surgical (n = 5), and anesthesia (n = 5) critical care backgrounds, and ten nurses from medical (n = 5) and surgical (n = 5) ICU backgrounds were interviewed. Principles of grounded theory were used to analyze the interview transcripts. Eleven factors within four categories were identified that influenced physician variability in decisions to limit life support: (1) physician work environment-workload and competing priorities, shift changes and handoffs, and incorporation of nursing input; (2) physician experiences-of unexpected patient survival, and of limiting life support in physician's family; (3) physician attitudes-investment in a good surgical outcome, specialty perspective, values and beliefs; and (4) physician relationship with patient and family-hearing the patient's wishes firsthand, engagement in family communication, and family negotiation. We identified several factors which physicians and nurses perceived were important sources of physician variability in decisions to limit life support. Ways to raise awareness and ameliorate the potentially adverse effects of factors such as workload, competing priorities, shift changes, and handoffs should be explored. Exposing intensivists to long term patient outcomes, formalizing nursing input, providing additional training, and emphasizing firsthand knowledge of patient wishes may improve decision making.

Parental responses to involvement in rounds on a pediatric inpatient unit at a teaching hospital: a qualitative study.

PubMed

Latta, Linda C; Dick, Ronald; Parry, Carol; Tamura, Glen S

2008-03-01

In pediatric teaching hospitals, medical decisions are traditionally made by the attending and resident physicians during rounds that do not include parents. This structure limits the ability of the medical team to provide "family-centered care" and the attending physician to model communication skills. The authors thus set out to identify how parents responded to participation in interdisciplinary teaching rounds conducted in a large tertiary care children's teaching hospital. A qualitative descriptive study was conducted using data from semistructured interviews of parents who had participated in rounds on the inpatient medical unit of a large academic children's hospital. From December 2004 to April 2005, 18 parents were interviewed after their participation in rounds. Questions assessed their experiences, expectations, preferred communication styles, and suggestions for improvement. Transcripts of the interviews were analyzed using qualitative content analysis. Being able to communicate, understand the plan, and participate with the team in decision making about their child's care were the most frequently cited outcomes of importance to parents. All 18 participants described the overall experience as positive, and 17 of 18 described themselves as "comfortable" with inclusion in rounds. Use of lay terminology and inclusion of nurses in rounds were preferred. Including parents on ward rounds at a teaching hospital was viewed positively by parents. Specific themes of particular importance to parents were identified. Further study is needed to assess the impact of inclusion of parents on rounds on patient outcomes and the resident experience.

Paradox of Prescribing Late Chemotherapy: Oncologists Explain.

PubMed

Bluhm, Minnie; Connell, Cathleen M; De Vries, Raymond G; Janz, Nancy K; Bickel, Kathleen E; Silveira, Maria J

2016-12-01

The value of chemotherapy for patients with cancer in the last weeks of life warrants examination. Late chemotherapy may not improve survival or quality of life but typically precludes hospice enrollment and may result in additional symptoms, increased use of other aggressive treatments, and worsening quality of life. Few studies have explored oncologists' rationales for administering chemotherapy near death. This study examines the self-reported factors that influence oncologists' decisions about late chemotherapy. In-depth individual interviews were conducted with 17 oncologists through a semistructured interview guide. Interviews were audio recorded and transcribed verbatim. Transcripts were coded and analyzed using conventional content analysis, a qualitative method that allows the detection and analysis of patterns in the data. Clinical factors take priority in determining late chemotherapy decisions when clear treatment choices exist. When clinical factors are ambiguous, emotion becomes a highly salient influence. Oncologists view late chemotherapy to be patient driven and use it to palliate emotional distress and maintain patient hope even when physical benefit is unexpected. Oncologists experience unique and difficult challenges when caring for dying patients, including emotionally draining communication, overwhelming responsibility for life/death, limitations of oncology to heal, and prognostic uncertainty. These challenges are also eased by offering late chemotherapy. The findings reveal a nuanced understanding of why oncologists find it difficult to refuse chemotherapy treatment for patients near death. Optimal end-of-life treatment decisions require supportive interventions and system change, both of which must take into account the challenges oncologists face.

Lower-fat menu items in restaurants satisfy customers.

PubMed

Fitzpatrick, M P; Chapman, G E; Barr, S I

1997-05-01

To evaluate a restaurant-based nutrition program by measuring customer satisfaction with lower-fat menu items and assessing patrons' reactions to the program. Questionnaires to assess satisfaction with menu items were administered to patrons in eight of the nine restaurants that volunteered to participate in the nutrition program. One patron from each participating restaurant was randomly selected for a semistructured interview about nutrition programming in restaurants. Persons dining in eight participating restaurants over a 1-week period (n = 686). Independent samples t tests were used to compare respondents' satisfaction with lower-fat and regular menu items. Two-way analysis of variance tests were completed using overall satisfaction as the dependent variable and menu-item classification (ie, lower fat or regular) and one of eight other menu item and respondent characteristics as independent variables. Qualitative methods were used to analyze interview transcripts. Of 1,127 menu items rated for satisfaction, 205 were lower fat, 878 were regular, and 44 were of unknown classification. Customers were significantly more satisfied with lower-fat than with regular menu items (P < .001). Overall satisfaction did not vary by any of the other independent variables. Interview results indicate the importance of restaurant during as an indulgent experience. High satisfaction with lower-fat menu items suggests that customers will support restaurant providing such choices. Dietitians can use these findings to encourage restaurateurs to include lower-fat choices on their menus, and to assure clients that their expectations of being indulged are not incompatible with these choices.

"I know it because it happened to me!" Confrontations of children within forensic investigations.

PubMed

Katz, Carmit; Barnetz, Zion

2018-06-06

Confrontations and cross-examination are considered to be a vital stage in forensic investigations; however, laboratory and field studies have systematically shown their adverse effects on children`s testimonies. The current field study aimed to assess the strategies utilized, and the frequency with which they are used, in confrontations within forensic investigations involving children following suspected abuse, and to assess their effects on the children's testimonies. The forensic investigations were conducted using the National Institute of Child Health and Human Development (NICHD) Protocol. The transcripts of 224 children aged 4-14, who were referred for forensic investigation following suspected physical or sexual abuse, were analyzed. All the cases included external evidence suggesting a high probability of abuse. The results indicated that confrontations of children were utilized in more than 60% of the forensic interviews, regardless of the child`s age. The vast majority of the interviewers' confrontation strategies involved references to the alleged suspects, with the number of confrontations ranging from 1 to 18 per interview. An examination of the children`s responses to the confrontations revealed that most of the children insisted on their initial reported testimonies; however, some of the children displayed confusion or fear, and one child recanted the allegation. The discussion addresses how confrontations and cross-examination, as a necessary stage of forensic investigation, can affect children`s testimonies, and the implications of these effects for the forensic context. Copyright © 2018 Elsevier Ltd. All rights reserved.

Land application of treated sewage sludge: community health and environmental justice.

PubMed

Lowman, Amy; McDonald, Mary Anne; Wing, Steve; Muhammad, Naeema

2013-05-01

In the United States, most of the treated sewage sludge (biosolids) is applied to farmland as a soil amendment. Critics suggest that rules regulating sewage sludge treatment and land application may be insufficient to protect public health and the environment. Neighbors of land application sites report illness following land application events. We used qualitative research methods to evaluate health and quality of life near land application sites. We conducted in-depth interviews with neighbors of land application sites and used qualitative analytic software and team-based methods to analyze interview transcripts and identify themes. Thirty-four people in North Carolina, South Carolina, and Virginia responded to interviews. Key themes were health impacts, environmental impacts, and environmental justice. Over half of the respondents attributed physical symptoms to application events. Most noted offensive sludge odors that interfere with daily activities and opportunities to socialize with family and friends. Several questioned the fairness of disposing of urban waste in rural neighborhoods. Although a few respondents were satisfied with the responsiveness of public officials regarding sludge, many reported a lack of public notification about land application in their neighborhoods, as well as difficulty reporting concerns to public officials and influencing decisions about how the practice is conducted where they live. Community members are key witnesses of land application events and their potential impacts on health, quality of life, and the environment. Meaningful involvement of community members in decision making about land application of sewage sludge will strengthen environmental health protections.

Development of a conceptual framework for understanding financial barriers to care among patients with cardiovascular-related chronic disease: a protocol for a qualitative (grounded theory) study.

PubMed

Campbell, David J T; Manns, Braden J; Hemmelgarn, Brenda R; Sanmartin, Claudia; King-Shier, Kathryn M

2016-01-01

Patients with cardiovascular-related chronic diseases may face financial barriers to accessing health care, even in Canada, where universal health care insurance is in place. No current theory or framework is adequate for understanding the impact of financial barriers to care on these patients or how they experience financial barriers. The overall objective of this study is to develop a framework for understanding the role of financial barriers to care in the lives of patients with cardiovascular-related chronic diseases and the impact of such barriers on their health. We will perform an inductive qualitative grounded theory study to develop a framework to understand the effect of financial barriers to care on patients with cardiovascular-related chronic diseases. We will use semistructured interviews (face-to-face and telephone) with a purposive sample of adult patients from Alberta with at least 1 of hypertension, diabetes, heart disease or stroke. We will analyze interview transcripts in triplicate using grounded theory coding techniques, including open, focused and axial coding, following the principle of constant comparison. Interviews and analysis will be done iteratively to theoretical saturation. Member checking will be used to enhance rigour. A comprehensive framework for understanding financial barriers to accessing health care is instrumental for both researchers and clinicians who care for patients with chronic diseases. Such a framework would enable a better understanding of patient behaviour and nonadherence to recommended medical therapies and lifestyle modifications.

Post-transcriptional regulation tends to attenuate the mRNA noise and to increase the mRNA gain

NASA Astrophysics Data System (ADS)

Shi, Changhong; Wang, Shuqiang; Zhou, Tianshou; Jiang, Yiguo

2015-10-01

Post-transcriptional regulation is ubiquitous in prokaryotic and eukaryotic cells, but how it impacts gene expression remains to be fully explored. Here, we analyze a simple gene model in which we assume that mRNAs are produced in a constitutive manner but are regulated post-transcriptionally by a decapping enzyme that switches between the active state and the inactive state. We derive the analytical mRNA distribution governed by a chemical master equation, which can be well used to analyze the mechanism of how post-transcription regulation influences the mRNA expression level including the mRNA noise. We demonstrate that the mean mRNA level in the stochastic case is always higher than that in the deterministic case due to the stochastic effect of the enzyme, but the size of the increased part depends mainly on the switching rates between two enzyme states. More interesting is that we find that in contrast to transcriptional regulation, post-transcriptional regulation tends to attenuate noise in mRNA. Our results provide insight into the role of post-transcriptional regulation in controlling the transcriptional noise.

Perceptions of an older patient on the role of the family doctor in health promotion: a qualitative case study

PubMed Central

2013-01-01

Introduction Health promotion and disease prevention are important aspects of primary health care. However, limited data are available concerning the opinions of older patients towards the respective services offered by family doctors. The aim of the present study was to evaluate an older patient's perception of the role of the family doctor in promoting his health, and identify those components that are difficult to examine in quantitative research. Methods A qualitative case study of an 80-year-old man using an in-depth interview was carried out. The interview transcript was analyzed thematically. Our patient was an 80-year-old university-educated man, with stable social and financial circumstances, living with his wife. He had retired early on grounds of ill health (tuberculosis) and had received a disability pension prior to formal retirement. At the time of the interview, his medical problems included mild prostatic hypertrophy, scoliosis and hypertension. He considered his health status to be satisfactory. He had changed family doctor five years prior to the interview, as he had been dissatisfied with the care provided. Results We found that our patient expected the family doctor to be aware of, and to discuss, the following issues: physical activity, diet, management of stress and mental health, use of alcohol and tobacco, personal hygiene, health screening, use of medication, and social activity. At the same time, our patient perceived the doctor's role as supplementary to his own in terms of the appraisal and maintenance of his health. Conclusions Our findings provide evidence of what is important in the promotion of health among older people. PMID:23448254

Development of the Oxford Participation and Activities Questionnaire: constructing an item pool

PubMed Central

Kelly, Laura; Jenkinson, Crispin; Dummett, Sarah; Dawson, Jill; Fitzpatrick, Ray; Morley, David

2015-01-01

Purpose The Oxford Participation and Activities Questionnaire is a patient-reported outcome measure in development that is grounded on the World Health Organization International Classification of Functioning, Disability, and Health (ICF). The study reported here aimed to inform and generate an item pool for the new measure, which is specifically designed for the assessment of participation and activity in patients experiencing a range of health conditions. Methods Items were informed through in-depth interviews conducted with 37 participants spanning a range of conditions. Interviews aimed to identify how their condition impacted their ability to participate in meaningful activities. Conditions included arthritis, cancer, chronic back pain, diabetes, motor neuron disease, multiple sclerosis, Parkinson’s disease, and spinal cord injury. Transcripts were analyzed using the framework method. Statements relating to ICF themes were recast as questionnaire items and shown for review to an expert panel. Cognitive debrief interviews (n=13) were used to assess items for face and content validity. Results ICF themes relevant to activities and participation in everyday life were explored, and a total of 222 items formed the initial item pool. This item pool was refined by the research team and 28 generic items were mapped onto all nine chapters of the ICF construct, detailing activity and participation. Cognitive interviewing confirmed the questionnaire instructions, items, and response options were acceptable to participants. Conclusion Using a clear conceptual basis to inform item generation, 28 items have been identified as suitable to undergo further psychometric testing. A large-scale postal survey will follow in order to refine the instrument further and to assess its psychometric properties. The final instrument is intended for use in clinical trials and interventions targeted at maintaining or improving activity and participation. PMID:26056503

Development of the Oxford Participation and Activities Questionnaire: constructing an item pool.

PubMed

Kelly, Laura; Jenkinson, Crispin; Dummett, Sarah; Dawson, Jill; Fitzpatrick, Ray; Morley, David

2015-01-01

The Oxford Participation and Activities Questionnaire is a patient-reported outcome measure in development that is grounded on the World Health Organization International Classification of Functioning, Disability, and Health (ICF). The study reported here aimed to inform and generate an item pool for the new measure, which is specifically designed for the assessment of participation and activity in patients experiencing a range of health conditions. Items were informed through in-depth interviews conducted with 37 participants spanning a range of conditions. Interviews aimed to identify how their condition impacted their ability to participate in meaningful activities. Conditions included arthritis, cancer, chronic back pain, diabetes, motor neuron disease, multiple sclerosis, Parkinson's disease, and spinal cord injury. Transcripts were analyzed using the framework method. Statements relating to ICF themes were recast as questionnaire items and shown for review to an expert panel. Cognitive debrief interviews (n=13) were used to assess items for face and content validity. ICF themes relevant to activities and participation in everyday life were explored, and a total of 222 items formed the initial item pool. This item pool was refined by the research team and 28 generic items were mapped onto all nine chapters of the ICF construct, detailing activity and participation. Cognitive interviewing confirmed the questionnaire instructions, items, and response options were acceptable to participants. Using a clear conceptual basis to inform item generation, 28 items have been identified as suitable to undergo further psychometric testing. A large-scale postal survey will follow in order to refine the instrument further and to assess its psychometric properties. The final instrument is intended for use in clinical trials and interventions targeted at maintaining or improving activity and participation.

Bilateral childhood visual impairment: child and parent concerns.

PubMed

Liebermann, Laura; Leske, David A; Hatt, Sarah R; Castañeda, Yolanda S; Wernimont, Suzanne M; Cheng-Patel, Christina S; Birch, Eileen E; Holmes, Jonathan M

2017-06-01

To identify specific health-related quality of life and visual function concerns affecting children with bilateral visual impairment as expressed by children or one of their parents (proxy) and concerns affecting the parents themselves. A total of 37 children <16 years of age with visual impairment (visual acuity worse than 20/70 in the better eye) and one parent for each child were prospectively enrolled. Semistructured individual interviews were performed with children 5-15 years of age (n = 16) and with one parent for each child (ages 0-15 years, N = 37). Interview transcripts were analyzed using NVivo software. Categories of concern were identified from both child and parent interviews, from which broad themes were identified. The frequencies of the themes and specific categories of concerns were calculated. Regarding the child's experience, categories of concern were grouped into 6 themes: visual function (expressed by 13 of 16 children [81%] and 33 of 37 parents [89%]), treatment (63% and 54%), emotions (50% and 68%), social (50% and 70%), physical discomfort (50% and 22%), and worry (38% and 8%). Concerns expressed regarding the parents' own experience were grouped into 5 themes: worry (100%), compensate-adjust for condition (89%), treatment (84%), emotions (81%), and affects family (46%). Individual interviews identified a wide spectrum of concerns in children with visual impairment and their parents, affecting functional, emotional, social and physical domains. Specific concerns will be used to develop patient-derived questionnaires for quantifying the effects of visual impairment on children and parents in everyday life. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

"Music Therapy Helped Me Get Back Doing": Perspectives of Music Therapy Participants in Mental Health Services.

PubMed

McCaffrey, Tríona; Edwards, Jane

2016-01-01

Mental health service development internationally is increasingly informed by the collaborative ethos of recovery. Service user evaluation of experiences within music therapy programs allows new phenomena about participation in services to be revealed that might otherwise remain unnoticed. The aim of this study was to demonstrate how asking service users about their experience of music therapy can generate useful information, and to reflect upon the feedback elicited from such processes in order to gain a deeper understanding of how music therapy is received among service users in mental health. Six mental health service users described their experiences of music therapy in one or two individual interviews. Transcripts of interviews were analyzed using the procedures and techniques of Interpretative Phenomenological Analysis. Interviews with mental health service users provided rich, in-depth accounts reflecting the complex nature of music therapy participation. Super-ordinate themes refer to the context in which music therapy was offered, the rich sound world of music in music therapy, the humanity of music therapy, and the strengths enhancing opportunities experienced by service users. Participants indicated that they each experienced music therapy in unique ways. Opinions about the value of music therapy were revealed through an interview process in which the researcher holds an open attitude, welcoming all narrative contributions respectfully. These findings can remind practitioners of the importance of closely tuning into the perspectives and understandings of those who have valuable expertise to share about their experience of music therapy services in mental health. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Application of qualitative interviews in inheritance research of famous old traditional Chinese medicine doctors: ideas and experience].

PubMed

Luo, Jing; Fu, Chang-geng; Xu, Hao

2015-04-01

The inheritance of famous old traditional Chinese medicine (TCM) doctors plays an essential role in the fields of TCM research. Qualitative interviews allow for subjectivity and individuality within clinical experience as well as academic ideas of doctors, making it a potential appropriate research method for inheritance of famous old TCM doctors. We summarized current situations of inheritance research on famous old TCM doctors, and then discussed the feasibility of applying qualitative interviews in inheritance of famous old TCM doctors. By combining our experience in research on inheritance of famous old TCM doctors, we gave some advice on study design, interview implementation, data transcription and analyses , and report writing, providing a reference for further relevant research.

Intimate Partner Violence and Reproductive Health Among Methamphetamine-Using Women in Los Angeles: A Qualitative Pilot Study†

PubMed Central

Abdul-Khabir, Wajidah; Hall, Timothy; Swanson, Aimee-Noelle; Shoptaw, Steven

2014-01-01

Among women, methamphetamine (meth) use has been associated with intimate partner violence (IPV); however, few studies have looked at the context of IPV. This qualitative pilot study explored the experiences of meth-using women in Los Angeles County regarding (1) IPV in their most recent primary relationship, (2) use of contraception and reproductive health services, and (3) meth use during pregnancy. Participants (n=30) were recruited through community advertising and at 3 addiction treatment centers to participate in 15–20 minute, semi-structured interviews recorded with handwritten transcripts. The team analyzed transcripts for key themes. Participants reported IPV (n=19, 63%) as recipients (50%), perpetrators (40%), and/or both (27%), occurring mainly during active meth use or withdrawal. While most (n=25) continued meth use during at least one pregnancy, some (n=5, 17%) identified pregnancy as a motivation to quit or reduce use, suggesting an opportunity for intervention. Though most women knew about free and low-cost reproductive health services, few accessed them, with 33% citing aspects of meth use itself as a barrier. One third (45/133) of reported pregnancies were terminated by abortion. Most women (67%) began using before age 18, suggesting need for screening and intervention among adolescents. PMID:25188701

Temporal and Spatial Variations in Transcriptional Patterns among Closely Related Marine Microbial Taxa

NASA Astrophysics Data System (ADS)

Shilova, I. N.; Robidart, J.; DeLong, E.; Zehr, J. P.

2016-02-01

Marine microbial communities are complex, and even closely related marine microbial populations are genetically and physiologically diverse. Despite such great diversity, conserved and highly synchronized rhythmic transcriptional patterns have been observed in microbial communities worldwide. The current widely used approaches analyzing high-throughput sequence data from microbiomes are not designed to differentiate transcription at strain or ecotype level. We used a novel MicroArray-inspired Gene-Centric (MAGC) bioinformatics approach to discern daily transcription by individual strains in previously analyzed metatranscriptomes from two oceanic regions, California Current System and central North Pacific. The results demonstrated that marine microbial taxa (within cyanobacteria Prochlorococcus and Synechococcus, Alphaproteobacterium Pelagibacter and picoeukaryote Ostreococcus) have unique transcription patterns and respond differentially to variability in space and time in the ocean. For example, the timing of maximum transcription for the photosynthesis and pigments genes varied among Synechococcus strains in the California Current study, likely for optimizing light utilization based on their differences in genetics and physiology. While several Prochlorococcus genotypes were present in the North Pacific study, transcription of the phosphate transporter gene, pstS, in specific genotypes was negatively correlated with phosphate concentrations. These individual transcriptional patterns underlie whole microbial community responses and may be sensitive indicators of environmental conditions, including those associated with long-term environmental change. The MAGC applied here to ocean ecosystems is a promising complementary approach that can enhance the ability to analyze metatranscriptomic data from a variety of environmental microbiomes.

Intimate Partner Violence and Adherence to HIV Pre-exposure Prophylaxis (PrEP) in African Women in HIV Serodiscordant Relationships: A Prospective Cohort Study

PubMed Central

Haberer, Jessica; Celum, Connie; Mugo, Nelly; Ware, Norma C.; Cohen, Craig R.; Tappero, Jordan W.; Kiarie, James; Ronald, Allan; Mujugira, Andrew; Tumwesigye, Elioda; Were, Edwin; Irungu, Elizabeth; Baeten, Jared M.

2016-01-01

Background: Intimate partner violence (IPV) is associated with higher HIV incidence, reduced condom use, and poor adherence to antiretroviral therapy and other medications. IPV may also affect adherence to pre-exposure prophylaxis (PrEP). Methods: We analyzed data from 1785 HIV-uninfected women enrolled in a clinical trial of PrEP among African HIV serodiscordant couples. Experience of verbal, physical, or economic IPV was assessed at monthly visits by face-to-face interviews. Low PrEP adherence was defined as clinic-based pill count coverage <80% or plasma tenofovir levels <40 ng/mL. The association between IPV and low adherence was analyzed using generalized estimating equations, adjusting for potential confounders. In-depth interview transcripts were examined to explain how IPV could impact adherence. Results: Sixteen percent of women reported IPV during a median of 34.8 months of follow-up (interquartile range 27.0–35.0). Overall, 7% of visits had pill count coverage <80%, and 32% had plasma tenofovir <40 ng/mL. Women reporting IPV in the past 3 months had increased risk of low adherence by pill count (adjusted risk ratio 1.49, 95% confidence interval: 1.17 to 1.89) and by plasma tenofovir (adjusted risk ratio 1.51, 95% confidence interval: 1.06 to 2.15). Verbal, economic, and physical IPV were all associated with low adherence. However, the impact of IPV diminished and was not statistically significant 3 months after the reported exposure. In qualitative interviews, women identified several ways in which IPV affected adherence, including stress and forgetting, leaving home without pills, and partners throwing pills away. Conclusions: Women who reported recent IPV in the Partners PrEP Study were at increased risk of low PrEP adherence. Strategies to mitigate PrEP nonadherence in the context of IPV should be evaluated. PMID:27243900

Pregnant women's navigation of information on everyday household chemicals: phthalates as a case study.

PubMed

Ashley, Justin M; Hodgson, Alexandra; Sharma, Sapna; Nisker, Jeff

2015-11-25

Current developments in science and the media have now placed pregnant women in a precarious situation as they are charged with the responsibility to navigate through information sources to make the best decisions for her pregnancy. Yet little is known regarding how pregnant women want to receive and use health information in general, let alone information regarding the uncertain risks to pregnancy in everyday household products such as phthalates found in cosmetics and canned food liners. Using phthalates as an example, this study investigated how pregnant women obtain, evaluate, and act on information regarding their pregnancy. Pregnant women were recruited using pamphlets and posters distributed in prenatal clinics, prenatal fairs and physician offices in Southwestern Ontario Canada. Research participants were engaged in 20 to 40 min semi-structured interviews regarding their use of information sources in pregnancy, particularly regarding phthalates in cosmetics and canned food liners. Interviews were transcribed verbatim and analyzed using constructivist grounded theory techniques supported by NVivo 9™ software. Theoretical sufficiency was reached after 23 pregnant women were interviewed and their transcripts analyzed. Three overlapping themes resulted from the co-constructed analysis: I-Strength of Information Sources; II-Value Modifiers; and III-Deciding to Control Exposure. The research participants reported receiving information from a wide range of sources that they perceived varying in strength or believability. They then described the strategies employed to increase the validity of the message in order to avoid risk exposure. Pregnant women preferred a strong source of information such as physician, government but frequently used weak sources such as the internet or the opinions of friends. A model was developed from the relationship between themes that describes how pregnant women navigate the multiple sources of information available to them. Our study provides insight into how pregnant women receive, appraise, and act on information regarding everyday household chemicals. Clinicians and their professional organizations should produce specific educational materials to assist women in understanding exposure to everyday products in pregnancy.

Two Native Americans Speak on Art Values and the Value of Arts

ERIC Educational Resources Information Center

Zastrow, Leona M.

1977-01-01

The personal views of two southwestern Native Americans (an Acoma and a Pima) are presented in this transcript of informal taped interviews re: the value and preservation of traditional American Indian arts. (JC)

Protecting our Khmer daughters: ghosts of the past, uncertain futures, and the human papillomavirus vaccine.

PubMed

Burke, Nancy J; Do, Huyen H; Talbot, Jocelyn; Sos, Channdara; Ros, Srey; Taylor, Victoria M

2015-01-01

The FDA approved the first human papillomavirus (HPV) vaccine in 2006. Research into parental decision-making and concerns about HPV vaccination highlights questions about parenting and parents' role in the crafting of their daughters' future sexuality. In contrast to much of this literature, we explore narratives from interviews with Cambodian mothers of HPV vaccine-age eligible daughters who experienced genocide and came to the USA as refugees. We conducted in-depth, in-person interviews with 25 Cambodian mothers of HPV vaccine-age eligible daughters. Interviews were conducted in Khmer and translated into English for analysis. We followed standard qualitative analysis techniques including iterative data review, multiple coders, and 'member checking.' Five members of the research team reviewed all transcripts and two members independently coded each transcript for concepts and themes. Interview narratives highlight the presence of the past alongside desires for protection from uncertain futures. We turn to Quesada and colleagues' concept structural vulnerability to outline the constraints posed by these women's positionalities as genocide survivors when faced with making decisions in an area with which they have little direct knowledge or background: cervical cancer prevention. Our study sheds light on the prioritization of various protective health practices, including but not exclusive to HPV vaccination, for Khmer mothers, as well as the rationalities informing decision-making regarding their daughters' health.

Protecting our Khmer daughters: Ghosts of the past, uncertain futures, and the HPV vaccine

PubMed Central

Burke, Nancy J.; Do, Huyen H.; Talbot, Jocelyn; Sos, Channdara; Ros, Srey; Taylor, Victoria M.

2014-01-01

Objectives The FDA approved the first HPV vaccine in 2006. Research into parental decision-making and concerns about HPV vaccination highlight questions about parenting and parents’ role in the crafting of their daughters’ future sexuality. In contrast to much of this literature, we explore narratives from interviews with Cambodian mothers of HPV vaccine age-eligible daughters who experienced genocide and came to the United States as refugees. Design We conducted in-depth, in-person interviews with 25 Cambodian mothers of HPV vaccine-age eligible daughters. Interviews were conducted in Khmer and translated into English for analysis. We followed standard qualitative analysis techniques including iterative data review, multiple coders, and ‘member checking’. Five members of the research team reviewed all transcripts and two members independently coded each transcript for concepts and themes. Results Interview narratives highlight the presence of the past alongside desires for protection from uncertain futures. We turn to Quesada and colleagues’ (2011) concept structural vulnerability to outline the constraints posed by these women’s positionalities as genocide survivors when faced with making decisions in a area with which they have little direct knowledge or background: cervical cancer prevention. Conclusion Our study sheds light on the prioritization of various protective health practices, including but not exclusive to HPV vaccination, for Khmer mothers, as well as the rationalities informing decision-making regarding their daughters’ health. PMID:24905057

Quality Control for Interviews to Obtain Dietary Recalls from Children for Research Studies

PubMed Central

SHAFFER, NICOLE M.; THOMPSON, WILLIAM O.; BAGLIO, MICHELLE L.; GUINN, CAROLINE H.; FRYE, FRANCESCA H. A.

2005-01-01

Quality control is an important aspect of a study because the quality of data collected provides a foundation for the conclusions drawn from the study. For studies that include interviews, establishing quality control for interviews is critical in ascertaining whether interviews are conducted according to protocol. Despite the importance of quality control for interviews, few studies adequately document the quality control procedures used during data collection. This article reviews quality control for interviews and describes methods and results of quality control for interviews from two of our studies regarding the accuracy of children's dietary recalls; the focus is on quality control regarding interviewer performance during the interview, and examples are provided from studies with children. For our two studies, every interview was audio recorded and transcribed. The audio recording and typed transcript from one interview conducted by each research dietitian either weekly or daily were randomly selected and reviewed by another research dietitian, who completed a standardized quality control for interviews checklist. Major strengths of the methods of quality control for interviews in our two studies include: (a) interviews obtained for data collection were randomly selected for quality control for interviews, and (b) quality control for interviews was assessed on a regular basis throughout data collection. The methods of quality control for interviews described may help researchers design appropriate methods of quality control for interviews for future studies. PMID:15389417

A qualitative approach exploring the acceptability of yoga for minorities living with arthritis: 'Where are the people who look like me?'

PubMed

Middleton, Kimberly R; Magaña López, Miriam; Haaz Moonaz, Steffany; Tataw-Ayuketah, Gladys; Ward, Michael M; Wallen, Gwenyth R

2017-04-01

To examine the acceptability of yoga research tailored to recruit and retain a minority population (both English and Spanish speaking) with arthritis. Yoga research for arthritis often underrepresents minorities and acceptability for this population has not previously been investigated. Acceptability was evaluated using retention, adherence, journals, and semi-structured exit interviews from twelve participants with osteoarthritis or rheumatoid arthritis undergoing an 8-week yoga intervention. Journal quotes were analyzed using content analysis techniques. NVivo software was used to organize transcripts and assemble themes. Two methods of triangulation (data and investigator) were used to overcome potential bias from a single-perspective interpretation. Exit interview comments were content analyzed using a card sort method. The study was designed with a cultural infrastructure including a multicultural research team, translators, and bilingual materials and classes, to facilitate trust and acceptability for primarily Hispanic and Black/African-American adults. Washington, D.C. metropolitan area, USA. On average participants attended 10 of 16 classes, with home practice 2-3days a week. All who completed were still practicing yoga three-months later. Qualitative narrative analysis identified major themes related to facilitating factors and barriers for yoga practice, self-efficacy, and support. Participant comments indicated that offering an arthritis-based yoga intervention and using a culturally congruent research design was found to be acceptable. As yoga research grows, there is a need to understand and promote acceptability for typically under-represented populations. This study attempts to inform the expansion of multicultural research designed to recruit and retain those from diverse backgrounds. Published by Elsevier Ltd.

The Learning Environment Counts: Longitudinal Qualitative Analysis of Study Strategies Adopted by First-Year Medical Students in a Competency-Based Educational Program.

PubMed

Bierer, S Beth; Dannefer, Elaine F

2016-11-01

The move toward competency-based education will require medical schools and postgraduate training programs to restructure learning environments to motivate trainees to take personal ownership for learning. This qualitative study explores how medical students select and implement study strategies while enrolled in a unique, nontraditional program that emphasizes reflection on performance and competence rather than relying on high-stakes examinations or grades to motivate students to learn and excel. Fourteen first-year medical students volunteered to participate in three, 45-minute interviews (42 overall) scheduled three months apart during 2013-2014. Two medical educators used structured interview guides to solicit students' previous assessment experiences, preferred learning strategies, and performance monitoring processes. Interviews were digitally recorded and transcribed verbatim. Participants confirmed accuracy of transcripts. Researchers independently read transcripts and met regularly to discuss transcripts and judge when themes achieved saturation. Medical students can adopt an assessment for learning mind-set with faculty guidance and implement appropriate study strategies for mastery-learning demands. Though students developed new strategies at different rates during the year, they all eventually identified study and performance monitoring strategies to meet learning needs. Students who had diverse learning experiences in college embraced mastery-based study strategies sooner than peers after recognizing that the learning environment did not reward performance-based strategies. Medical students can take ownership for their learning and implement specific strategies to regulate behavior when learning environments contain building blocks emphasized in self-determination theory. Findings should generalize to educational programs seeking strategies to design learning environments that promote self-regulated learning.

Putting informed and shared decision making into practice

PubMed Central

Towle, Angela; Godolphin, William; Grams, Garry; LaMarre, Amanda

2006-01-01

Abstract Objective  To investigate the practice, experiences and views of motivated and trained family physicians as they attempt to implement informed and shared decision making (ISDM) in routine practice and to identify and understand the barriers they encounter. Background  Patient involvement in decision making about their health care has been the focus of much academic activity. Although significant conceptual and experimental work has been done, ISDM rarely occurs. Physician attitudes and lack of training are identified barriers. Design  Qualitative analysis of transcripts of consultations and key informant group interviews. Settings and participants  Six family physicians received training in the ISDM competencies. Audiotapes of office consultations were made before and after training. Transcripts of consultations were examined to identify behavioural markers associated with each competency and the range of expression of the competencies. The physicians attended group interviews at the end of the study to explore experiences of ISDM. Results  The physicians liked the ISDM model and thought that they should put it into practice. Evidence from transcripts indicated they were able to elicit concerns, ideas and expectations (although not about management) and agree an action plan. They did not elicit preferences for role or information. They sometimes offered choices. They had difficulty achieving full expression of any of the competencies and integrating ISDM into their script for the medical interview. The study also identified a variety of competency‐specific barriers. Conclusion  A major barrier to the practice of ISDM by motivated physicians appears to be the need to change well‐established patterns of communication with patients. PMID:17083559

Stories From the Field: The Use of Information and Communication Technologies to Address the Health Needs of Underserved Populations in Latin America and the Caribbean.

PubMed

Farach, Nasim; Faba, Gladys; Julian, Soroya; Mejía, Felipe; Cabieses, Báltica; D'Agostino, Marcelo; Cortinois, Andrea A

2015-01-01

As their availability grew exponentially in the last 20 years, the use of information and communication technologies (ICT) in health has been widely espoused, with many emphasizing their potential to decrease health inequities. Nonetheless, there is scarce availability of information regarding ICT as tools to further equity in health, specifically in Latin American and Caribbean settings. Our aim was to identify initiatives that used ICT to address the health needs of underserved populations in Latin America and Caribbean. Among these projects, explore the rationale behind the selection of ICT as a key component, probe perceptions regarding contributions to health equity, and describe the challenges faced during implementation. We conducted an exploratory qualitative study. Interviews were completed via Skype or face-to-face meetings using a semistructured interview guide. Following participant consent, interviews were audio recorded and verbatim transcriptions were developed. All transcriptions were coded using ATLASti7 software. The text was analyzed for patterns, shared themes, and diverging opinions. Emerging findings were reviewed by all interviewers and shared with participants for feedback. We interviewed representatives from eight organizations in six Latin American and Caribbean countries that prominently employed ICT in health communication, advocacy, or surveillance projects. ICT expanded project's geographic coverage, increased their reach into marginalized or hard-to-reach groups, and allowed real-time data collection. Perceptions of contributions to health equity resided mainly in the provision of health information and linkage to health services to members of groups experiencing greater morbidity because of poverty, remote place of residence, lack of relevant public programs, and/or stigma and discrimination, and in more timely responses by authorities to the health needs of these groups as a result of the increased availability of strategic information on morbidity and its social determinants. Most projects faced initial resistance to implementation because of lack of precedents. Their financial and technical sustainability was threatened by reliance on external funding and weak transitional structures amidst key staff changes. Projects often experienced challenges in establishing meaningful communication with target audience members, mainly because of divergent motivations behind ICT use between projects and its target audience and the lack of access or familiarity with ICT among the most underserved members of such audiences. ICT can benefit projects focusing on the health needs of underserved populations by expanding the breadth and depth of target audience coverage and improving data management. Most projects tended to be small, short-term pilot interventions with limited engagement with the formal health sector and did not include health equity as an explicit component. Collaborative projects with government institutions, particularly those with health surveillance objectives, seemed to be the most optimistic about long-term sustainability.

You have no Choice but to go on: How Physicians and Midwives in Ghana Cope with High Rates of Perinatal Death.

PubMed

Petrites, Alissa D; Mullan, Patricia; Spangenberg, Kathryn; Gold, Katherine J

2016-07-01

Objectives Healthcare providers in low-resource settings confront high rates of perinatal mortality. How providers cope with such challenges can affect their well-being and patient care; we therefore sought to understand how physicians and midwives make sense of and cope with these deaths. Methods We conducted semi-structured interviews with midwives, obstetrician-gynecologists, pediatricians and trainee physicians at a large teaching hospital in Kumasi, Ghana. Interviews focused on participants' coping strategies surrounding perinatal death. We identified themes from interview transcripts using qualitative content analysis. Results Thirty-six participants completed the study. Themes from the transcripts revealed a continuum of control/self-efficacy and engagement with the deaths. Providers demonstrated a commitment to push on with their work and provide the best care possible. In select cases, they described the transformative power of attitude and sought to be agents of change. Conclusions Physicians and midwives in a low-resource country in sub-Saharan Africa showed remarkable resiliency in coping with perinatal death. Still, future work should focus on training clinicians in coping and strengthening their self-efficacy and engagement.

Promoters and Barriers to Implementation of Tracheal Intubation Airway Safety Bundle: A Mixed-Method Analysis.

PubMed

Finn Davis, Katherine; Napolitano, Natalie; Li, Simon; Buffman, Hayley; Rehder, Kyle; Pinto, Matthew; Nett, Sholeen; Jarvis, J Dean; Kamat, Pradip; Sanders, Ronald C; Turner, David A; Sullivan, Janice E; Bysani, Kris; Lee, Anthony; Parker, Margaret; Adu-Darko, Michelle; Giuliano, John; Biagas, Katherine; Nadkarni, Vinay; Nishisaki, Akira

2017-10-01

To describe promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. Mixed methods. Thirteen PICUs of the National Emergency Airway Registry for Children network. Remote or on-site focus groups with interdisciplinary ICU staff. Two semistructured interviews with ICU quality improvement leaders with quantitative and qualitative data-based feedbacks. Bundle implementation success (compliance) was defined as greater than or equal to 80% use for tracheal intubations for 3 consecutive months. ICUs were classified as early or late adopters. Focus group discussions concentrated on safety concerns and promoters and barriers to bundle implementation. Initial semistructured quality improvement leader interviews assessed implementation tactics and provided recommendations. Follow-up interviews assessed degree of acceptance and changes made after initial interview. Transcripts were thematically analyzed and contrasted by early versus late adopters. Median duration to achieve success was 502 days (interquartile range, 182-781). Five sites were early (median, 153 d; interquartile range, 146-267) and eight sites were late adopters (median, 783 d; interquartile range, 773-845). Focus groups identified common "promoter" themes-interdisciplinary approach, influential champions, and quality improvement bundle customization-and "barrier" themes-time constraints, competing paperwork and quality improvement activities, and poor engagement. Semistructured interviews with quality improvement leaders identified effective and ineffective tactics implemented by early and late adopters. Effective tactics included interdisciplinary quality improvement team involvement (early adopter: 5/5, 100% vs late adopter: 3/8, 38%; p = 0.08); ineffective tactics included physician-only rollouts, lack of interdisciplinary education, lack of data feedback to frontline clinicians, and misconception of bundle as research instead of quality improvement intervention. Implementation of an airway safety quality improvement bundle with high compliance takes a long time across diverse ICUs. Both early and late adopters identified similar promoter and barrier themes. Early adopter sites customized the quality improvement bundle and had an interdisciplinary quality improvement team approach.

A geographically explicit ecological momentary assessment (GEMA) mixed method for understanding substance use.

PubMed

McQuoid, Julia; Thrul, Johannes; Ling, Pamela

2018-04-01

Tobacco use is increasingly concentrated within marginalized groups, including LGBTQ+ young adults. Developing tailored interventions to reduce tobacco-related health disparities requires understanding the mechanisms linking individual and contextual factors associated with tobacco use to behavior. This paper presents an in-depth exploration of three cases from a novel mixed method study designed to identify the situational factors and place-based practices of substance use among high-risk individuals. We combined geographically explicit ecological momentary assessment (GEMA) with an adapted travel diary-interview method. Participants (young adult bisexual smokers, ages 18-26) reported on non-smoking and smoking situations for 30 days with a smartphone app. GEMA surveys captured internal and external situational factors (e.g., craving intensity, location type, seeing others smoking). Continuous locational data was collected via smartphone GPS. Subsequently, participants completed in-depth interviews reviewing maps of their own GEMA data. GEMA data and transcripts were analyzed separately and integrated at the case level in a matrix. Using GEMA maps to guide the interview grounded discussion in participants' everyday smoking situations and routines. Interviews clarified participant interpretation of GEMA measures and revealed experiences and meanings of smoking locations and practices. The GEMA method identified the most frequent smoking locations/times for each participant (e.g., afternoons at university). Interviews provided description of associated situational factors and perceptions of smoking contexts (e.g., peer rejection of bisexual identity) and the roles of smoking therein (e.g., physically escape uncomfortable environments). In conclusion, this mixed method contributes to advancing qualitative GIS and other hypothesis-generating approaches working to reveal the richness of individuals' experiences of the everyday contexts of health behavior, while also providing reliable measures of situational predictors of behaviors of interest, such as substance use. Limitations of and future directions for the method are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

PubMed

Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

2016-03-22

Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of optimal care, implementation of effective systemic approaches should be considered.

The Effect of Positive Group Psychotherapy and Motivational Interviewing on Smoking Cessation: A Qualitative Descriptive Study.

PubMed

Lee, Eun Jin

The purpose of this study was to describe the process and evaluate the effect of positive group psychotherapy and motivational interviewing as an intervention for smoking cessation. A qualitative descriptive study was conducted at a university in South Korea. Positive group psychotherapy and motivational interviewing were attended by 36 smokers for 1 hour once a week, for 6 hours. A recorded exit interview was conducted after the intervention. The resulting transcripts were analyzed with content analysis and thematic analysis. Among the 36 study participants, the importance of stopping smoking was rated higher in the successful cessation (defined as those who ceased smoking for at least 3 months; hereafter, success group) group (8.6 ± 0.4, n = 10) than in the failed cessation (defined as those who did not cease smoking for at least 3 months; hereafter, failure group) group (7.75 ± 0.3, n = 26; p < .01). The confidence to stop smoking was rated higher by the successes (8.4 ± 0.3) than by the failures (5.5 ± 0.4; p < .01). More successes wanted to stop smoking for the sake of their loved ones (60%) and health (50%), whereas more failures wanted to stop smoking for saving money (45.5%). Failures had more cross-addiction than successes (three to four addictions: 31.5% vs. 20%). When participants were asked to find 10 personality merits, 78% of the successes and 47% of the failures found their 10 merits. The therapeutic process was described as "sharing the smoking cessation process with others," "detailed guidance for stress management and smoking cessation," and "compliments about efforts for smoking cessation." The importance of and confidence in smoking cessation were predictors for successful cessation for 3-6 months. Motivational interviewing increased motivations, whereas positive group psychotherapy increased positive thoughts and confidence.

Conception, pregnancy, and birth experiences of male and gender variant gestational parents: it's how we could have a family.

PubMed

Ellis, Simon Adriane; Wojnar, Danuta M; Pettinato, Maria

2015-01-01

Like members of any other population, transgender and gender variant people--individuals whose gender identity varies from the traditional norm or from the sex they were assigned at birth--often seek parenthood. Little is known about the decision making and experiences of these individuals, including male-identified and gender-variant natal females who wish to achieve parenthood by carrying a pregnancy. This pilot qualitative study used grounded theory methodology to explore the conception, pregnancy, and birth experiences of this population of parents. A grounded theory methodology was used to guide data collection and analysis. Eight male-identified or gender-variant gestational parents participated in the study. Data collection included individual 60-minute to 90-minute interviews conducted by recorded online video calls, as well as a self-administered online demographic survey. Data were collected from September 2011 through May 2012. Data saturation was achieved at 6 interviews, after which 2 more interviews were conducted. The interviews were transcribed verbatim, and a constant comparative method was used to analyze the interview transcripts. Loneliness was the overarching theme that permeated participants' experiences, social interactions, and emotional responses during every stage of achieving biologic parenthood. Within this context of loneliness, participants described complex internal and external processes of navigating identity. Navigating identity encapsulated 2 subthemes: undergoing internal struggles and engaging with the external world. The preconception period was identified as participants' time of greatest distress and least involvement with health care. The findings of this study suggest that culturally-sensitive preconception counseling could be beneficial for transgender and gender-variant individuals. The grounded theory produced by this pilot investigation also provides insights that will be useful to health care providers and others working with male-identified and gender-variant prospective parents. © 2014 by the American College of Nurse-Midwives.

Blessed alienation: the Christian monastery as a caring and restorative environment.

PubMed

Eriksson, Nadya T; Wiklund-Gustin, Lena

2014-02-01

Being mentally ill is often associated with experiencing alienation from society because sensations are not easily shared with others. Modern health care leads us to pose many questions. Some sufferers search and find their way to monasteries as they did centuries ago. We interviewed six persons staying in a monastery to understand the meaning of health and care in a monastic environment in contemporary Sweden. We analyzed the transcripts by means of a hermeneutic approach and discovered that the helping effect of the monastery was based on its contradictory/paradoxical structure that corresponded to the lifeworld of a person suffering from mental illness. The monastery was a place where one could be different but equal, and simultaneously provided freedom within boundaries, calmness and intensity, privacy and relations, demands and confirmation. This facilitated experiences of health and wholeness, necessary to manage the challenges of recovery.

From novice to master surgeon: improving feedback with a descriptive approach to intraoperative assessment.

PubMed

Huang, Emily; Wyles, Susannah M; Chern, Hueylan; Kim, Edward; O'Sullivan, Patricia

2016-07-01

A developmental and descriptive approach to assessing trainee intraoperative performance was explored. Semistructured interviews with 20 surgeon educators were recorded, transcribed, deidentified, and analyzed using a grounded theory approach to identify emergent themes. Two researchers independently coded the transcripts. Emergent themes were also compared to existing theories of skill acquisition. Surgeon educators characterized intraoperative surgical performance as an integrated practice of multiple skill categories and included anticipating, planning for contingencies, monitoring progress, self-efficacy, and "working knowledge." Comments concerning progression through stages, broadly characterized as "technician," "anatomist," "anticipator," "strategist," and "executive," formed a narrative about each stage of development. The developmental trajectory with narrative, descriptive profiles of surgeons working toward mastery provide a standardized vocabulary for communicating feedback, while fostering reflection on trainee progress. Viewing surgical performance as integrated practice rather than the conglomerate of isolated skills enhances authentic assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

The Recovery College: A unique service approach and qualitative evaluation.

PubMed

Newman-Taylor, Katherine; Stone, Nicola; Valentine, Paul; Hooks, Zoe; Sault, Katherine

2016-06-01

This study examined the impact of a Recovery College, an educational service model focusing specifically on health care to engage people's hope, agency, and opportunities for recovery. For the purpose of the study, a qualitative approach was used given the absence of research in this area. Eleven people completed semistructured interviews conducted by an independent researcher. Verbatim transcripts were analyzed using thematic analysis. The analyses yielded themes emphasizing the impact of the organizational structure of the college. Coproduction of service delivery was contrasted with traditional provision and identified as fundamental to personal and professional changes made. Recovery College participants described clear gains. These findings are discussed in relation to the recovery literature and highlight the need for routine coproduction of services to facilitate recovery from the often devastating impact of mental ill-health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Recovery and money management.

PubMed

Rowe, Michael; Serowik, Kristin L; Ablondi, Karen; Wilber, Charles; Rosen, Marc I

2013-06-01

Social recovery and external money management are important approaches in contemporary mental health care, but little research has been done on the relationship between the two or on application of recovery principles to money management for people at risk of being assigned a representative payee or conservator. Out of 49 total qualitative interviews, 25 transcripts with persons receiving Social Security insurance or Social Security disability insurance who were at risk of being assigned a money manager were analyzed to assess the presence of recognized recovery themes. The recovery principles of self-direction and responsibility were strong themes in participant comments related to money management. Money management interventions should incorporate peoples' recovery-related motivations to acquire financial management skills as a means to direct and assume responsibility for one's finances. Staff involved in money management should receive training to support client's recovery-related goals. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Transcending breast cancer: making meaning from diagnosis and treatment.

PubMed

Coward, Doris Dickerson; Kahn, David L

2005-09-01

This qualitative approach study describes the experience of self-transcendence in women newly diagnosed with breast cancer. Fourteen women participated from a larger sample of women in a support group project. Each woman was interviewed three times over an 8-month period. Audiotaped transcripts were analyzed using Colaizzi's phenomenological techniques. Loss of a personal perception of good health and fear of dying from cancer forced women to reach both inside and outside of themselves for support and information. Bonding with other women with breast cancer led to further expansion of self-boundaries that brought comfort, a desire to modify life priorities, and enhanced appreciation of supportive others and of life itself. Over time, clarification and modification of values and behaviors assisted women to create meaning from their experiences. Nurse referrals to support groups or other resources (such as cancer advocacy organizations) where women interact with similar others may facilitate transcending breast cancer.

Transition to adult-oriented health care: perspectives of youth and adults with complex physical disabilities.

PubMed

Young, Nancy L; Barden, Wendy S; Mills, Wendy A; Burke, Tricia A; Law, Mary; Boydell, Katherine

2009-01-01

The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain injuries of childhood, and their parents (n = 30). Respondents discussed their health care services, their experience with clinical transition, and contributing factors. We analyzed the transcripts using qualitative methods. All participants identified challenges in transition, including: lack of access to health care; lack of professionals' knowledge; lack of information and uncertainty regarding the transition process. Two solutions were identified: early provision of detailed information and more extensive support throughout the clinical transition process. The challenges of clinical transition were universal. More extensive information and support is needed during transition to ensure an efficient move to appropriate adult-oriented health care.

Roles of community helpers in using the Medicare Part D benefit

PubMed Central

Hensley, Melissa A.

2013-01-01

Objectives To examine the experiences of low-income Part D beneficiaries with mental illness and their use of community helpers to access prescription medicines. Methods Individual semi-structured interviews were conducted with 26 Medicare beneficiaries with mental illness in community settings. The transcripts were analyzed for content related to community help-seeking and attitudes toward family and professional helpers. Results Medicare Part D beneficiaries with mental illness used the assistance of community helpers extensively. Pharmacists, nurses, community mental health case managers, and family members assisted beneficiaries with understanding their benefit plans and interpreting paperwork from plans and government agencies. Community helpers also assisted with tasks related to medication adherence. Mental health consumers appreciated the help that they received from family members and professionals. Conclusion This group of Medicare beneficiaries would have experienced difficulty in using their benefits and obtaining their medication without considerable help from professionals and family members in the community. PMID:21317520

Translating Advances in Cardiogenetics Into Effective Clinical Practice

PubMed Central

Silverstein, Louise Bordeaux; Stolerman, Marina; Hidayatallah, Nadia; McDonald, Thomas; Walsh, Christine A.; Paljevic, Esma; Cohen, Lilian L.; Marion, Robert W.; Wasserman, David; Dolan, Siobhan M.

2015-01-01

In this article we describe a qualitative research study in which we explored individuals’ subjective experiences of both genetic testing and cardiogenetic disorders. Using a grounded theory approach, we coded and analyzed interview and focus group transcripts from 50 participants. We found that just under half of the participants who received their diagnosis during the study reported difficulty understanding information about both the purpose of genetic testing and their cardiac disease. A high level of anxiety about genetic testing and cardiac symptoms exacerbated individuals’ cognitive confusion. Participants reported both positive and negative interactions with the medical community, depending on health care professionals’ knowledge of cardiogenetic disorders. Overall, participants expressed a range of attitudes—positive, negative, and ambivalent—toward genetic testing. We conclude with a discussion of the barriers to achieving effective clinical care for genetic conditions and offer suggestions for improving collaborative decision making between physicians and patients. PMID:25114027

Motivators for physical activity among ambulatory nursing home older residents.

PubMed

Chen, Yuh-Min; Li, Yueh-Ping

2014-01-01

The purpose of this study was to explore self-identified motivators for regular physical activity among ambulatory nursing home older residents. A qualitative exploratory design was adopted. Purposive sampling was performed to recruit 18 older residents from two nursing homes in Taiwan. The interview transcripts were analyzed by qualitative content analysis. Five motivators of physical activity emerged from the result of analysis: eagerness for returning home, fear of becoming totally dependent, improving mood state, filling empty time, and previously cultivated habit. Research on physical activity from the perspectives of nursing home older residents has been limited. An empirically grounded understanding from this study could provide clues for promoting and supporting lifelong engagement in physical activity among older residents. The motivators reported in this study should be considered when designing physical activity programs. These motivators can be used to encourage, guide, and provide feedback to support older residents in maintaining physical activity.

Participatory assessment of the health of Latino immigrant men in a community with a growing Latino population.

PubMed

Documėt, Patricia I; Kamouyerou, Andrea; Pesantes, Amalia; Macia, Laura; Maldonado, Hernan; Fox, Andrea; Bachurski, Leslie; Morgenstern, Dawn; Gonzalez, Miguel; Boyzo, Roberto; Guadamuz, Thomas

2015-02-01

Latino immigrant men are an understudied population in the US, especially in areas with small yet growing Latino populations. For this community-based participatory health assessment we conducted four focus groups and 66 structured surveys with Latino immigrant men, and 10 openended interviews with service providers. We analyzed transcripts using content analysis and survey data using Pearson Chi-square tests. Overall, 53% of participating men had not completed high school. Our findings suggest that their social circumstances precluded men from behaving in a way they believe would protect their health. Loneliness, fear and lack of connections prompted stress among men, who had difficulty locating healthcare services. Newly immigrated men were significantly more likely to experience depression symptoms. Latino immigrant men face social isolation resulting in negative health consequences, which are amplified by the new growth community context. Men can benefit from interventions aimed at building their social connections.

Newborn screening for metabolic disorders: parental perceptions of the initial communication of results.

PubMed

Buchbinder, Mara; Timmermans, Stefan

2012-08-01

Positive newborn screening (NBS) results cause significant parental distress, but little is known about how parents find out about children's screening results and what they are told. This qualitative, exploratory study reports on parents' perceptions of the initial communication of NBS results. Participants included the parents of 75 infants referred to a metabolic clinic in California over a 3-year period (2007-2010). Parents provided information about the initial communication of NBS results during audiotaped clinical encounters and open-ended interviews. Transcripts were analyzed inductively using thematic coding. Responses fell into 3 primary themes: sources of news delivery, providing information, and mitigation strategies. The findings suggest that health care providers have access to a range of communicative resources to buffer the impact of positive screening results that may be mobilized in future interventions. Recommendations for improving the communication process and future research directions are discussed.

A developmentally informed adaptation of minority stress for sexual minority adolescents

PubMed Central

Goldbach, Jeremy T.; Gibbs, Jeremy J.

2017-01-01

Sexual minority adolescents (lesbian, gay, bisexual) experience disparities in behavioral health outcomes compared to their heterosexual peers, generally attributed to minority stress. Although evidence of the applicability of the minority stress model among adolescents exists, it is based on a primarily adult literature. Developmental and generational differences demand further examination of minority stress to confirm its applicability. Forty-eight life history interviews with sexual minority adolescents in California (age 14–19; M=19.27 SD = 1.38; 39.6% cismale, 35.4% cisfemale, 25% other gender) were completed, recorded, transcribed, and analyzed using thematic analysis in QSR NVivo. Following a consensus model, all transcripts were double coded. Results suggest that minority stress is appropriate for use with adolescents; however, further emphasis should be placed on social context, coping resources, and developmental processes regarding identity development. A conceptual model is provided, as are implications for research and practice. PMID:28033502

Optimizing Tailored Health Promotion for Older Adults

PubMed Central

Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.

2016-01-01

Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485

Finding myself: a theory on the maturation of spirituality and its influence on behavior during late adolescence.

PubMed

Mason, Deanna M

2014-01-01

This study employed a grounded theory research design to develop a theoretical model focused on the maturation of spirituality and its influence on behavior during late adolescence. Quantitative research studies have linked spirituality with decreased health-risk behaviors and increased health-promotion behaviors during late adolescence. Qualitative, theoretical data is proposed to discover the underlying reasons this relationship exists and increase the ability to apply this knowledge to practice. Twenty-one adolescents, age 16-21 years, were e-mail interviewed and transcripts analyzed using a conceptual lens of Blumer's symbolic interactionism. From this analysis, a theoretical model emerged with the core concept, finding myself that represents 5 core process concepts. Implications of this study illustrate that late adolescents are aware of their personal spiritual maturation as well as its influence on behavior. In addition, a distinction between the generic concept of spirituality, personal spirituality, and religion emerged.

Recovery and Money Management

PubMed Central

Rowe, Michael; Serowik, Kristin L.; Ablondi, Karen; Wilbur, Charles; Rosen, Marc I.

2014-01-01

Objective Social recovery and external money management are important approaches in contemporary mental health care, but little research has been done on the relationship between the two or on application of recovery principles to money management for people at risk of being assigned a representative payee or conservator. Methods Twenty-five transcripts out of forty-nine total qualitative interviews with persons receiving SSI or SSDI who were at risk of being assigned a money manager were analyzed to assess the presence of recognized recovery themes. Results The recovery principles of self-direction and responsibility were strong themes in participant comments related to money management. Conclusions and Implications for Practice Money management interventions should incorporate peoples’ recovery-related motivations to acquire financial management skills as a means to direct and assume responsibility for one’s finances. Staff involved in money management should receive training to support client’s recovery-related goals. PMID:23750764

The Subjective Experience of Patients Diagnosed with Hereditary Hemorrhagic Telangiectasia: a Qualitative Study.

PubMed

Geerts, Laura; Fantini-Hauwel, Carole; Brugallé, Elodie; Boute, Odile; Frénois, Frédéric; Defrance, Lydie; Manouvrier-Hanu, Sylvie; Petit, Florence; Antoine, Pascal

2017-06-01

The aim of the present study was to understand the context and psychological impact for patients diagnosed with hereditary hemorrhagic telangiectasia (HHT). Semi-structured interviews were conducted with 9 patients affected by HHT, and the transcripts were analyzed using interpretative phenomenological analysis. The results of this study allowed us to propose a new hypothesis to explain the delay in diagnosis: the trivialization of symptoms associated with HHT. Moreover, the results showed that a genetic diagnosis of HHT results in emotional shock, uncertainty about the future, and worry about one's children in parents who are confronted with the dilemma of facing the reality of the diagnosis or delaying dealing with the diagnosis until disease onset. Family and personal perceptions of the disease influenced not only the delay in diagnosis but also the emotional and behavioral reactions of patients following a genetic diagnosis.

The gendered construction and experience of difficulties and rewards in cancer care.

PubMed

Ussher, Jane M; Sandoval, Mirjana; Perz, Janette; Wong, W K Tim; Butow, Phyllis

2013-07-01

Women cancer carers have consistently been found to report higher levels of distress than men carers. However, there is little understanding of the mechanisms underlying these gender differences in distress, and a neglect of rewarding aspects of care. We conducted in-depth semistructured interviews with 53 informal cancer carers, 34 women and 19 men, to examine difficult and rewarding aspects of cancer care. Thematic analysis was used to analyze the transcripts. Women were more likely to report negative changes in the relationship with the person with cancer; neglect of self, social isolation, and physical health consequences; anxiety; personal strength and growth; and to position caring as a privilege. Men were more likely to report increased relational closeness with the person with cancer, and the burden of additional responsibilities within the home as a difficult aspect of caring. We interpret these findings in relation to a social constructionist analysis of gender roles.

Financial barriers and pricing strategies related to participation in sports activities: the perceptions of people of low income.

PubMed

Steenhuis, Ingrid H M; Nooy, Steffie B C; Moes, Machiel J G; Schuit, Albertine J

2009-11-01

Physical activity levels in most affluent countries are low and many people do not meet the current recommendations. Particularly for people with a low income, economic strategies seem promising to stimulate taking part in sports activities. This study investigated the importance of economic restraints for taking part in sports activities as well as perceptions of low-income people toward different pricing interventions. A qualitative study was conducted, using semistructured, individual interviews with 27 low-income men and women. The framework approach was used to analyze the transcripts of the interviews. The respondents considered finances to be an important barrier for participating in sports activities, together with some individual barriers. Promising pricing strategies are a discount on the subscription to the fitness or sports club, a 1 month free trial, and free entrance to the swimming pool once a week. Pricing strategies may be a promising intervention to increase physical activity levels of low-income people. However, this study indicates that this should be coupled with an intervention directed at individual barriers. Some pricing strategies will be used and appreciated more by low-income people than other pricing strategies. In addition, pricing strategies should be tailored to individual needs and preferences.

PREEMPTIVE PHARMACOGENETIC TESTING: EXPLORING THE KNOWLEDGE AND PERSPECTIVES OF UNITED STATES PAYERS

PubMed Central

Keeling, Nicholas J.; Rosenthal, Meagen M.; West-Strum, Donna; Patel, Amit; Haidar, Cyrine E.; Hoffman, James M.

2017-01-01

PURPOSE Preemptive pharmacogenetic testing aims to optimize medication use by having genetic information at the point of prescribing. Payers’ decisions influence implementation of this technology. We investigated U.S. payers’ knowledge, awareness, and perspectives on preemptive pharmacogenetic testing. METHODS A qualitative study was conducted using semi-structured interviews. Participants were screened for eligibility through an online survey. A blended inductive and deductive approach was used to analyze the transcripts. Two authors conducted an iterative reading process to code and categorize the data. RESULTS Medical or pharmacy directors from 14 payer organizations covering 122 million U.S. lives were interviewed. Three concept domains and ten dimensions were developed. Key findings include: clinical utility concerns and limited exposure to preemptive germline testing, continued preference for outcomes from randomized controlled trials, interest in guideline development, importance of demonstrating an impact on clinical decision making, concerns of downstream costs and benefit predictability, and the impact of public stakeholders such as the FDA and CMS. CONCLUSION Both barriers and potential facilitators exist to developing cohesive reimbursement policy for pharmacogenetics, and there are unique challenges for the preemptive testing model. Prospective outcome studies, more precisely defining target populations, and predictive economic models are important considerations for future research. PMID:29261180

Are “Anti-Aging Medicine” and “Successful Aging” Two Sides of the Same Coin? Views of Anti-Aging Practitioners

PubMed Central

2013-01-01

Objectives. This article analyzes data from interviews with anti-aging practitioners to evaluate how their descriptions of the work they do, their definitions of aging, and their goals for their patients intersect with gerontological views of “successful aging.” Method. Semistructured interviews were conducted with a sample of 31 anti-aging practitioners drawn from the directory of the American Academy for Anti-Aging Medicine. Results. Qualitative analysis of the transcripts demonstrate that practitioners’ descriptions of their goals, intentionally or unintentionally, mimic the dominant models of “successful aging.” These include lowered risk of disease and disability, maintenance of high levels of mental and physical function, and continuing social engagement. Yet, the means and modes of achieving these goals differ markedly between the two groups, as do the messages that each group puts forth in defending their positions. Discussion. Anti-aging practitioners’ adoption of the rhetoric of successful aging reflects the success of successful aging models in shaping popular conceptions of what aging is and an ethos of management and control over the aging process. The overlap between anti-aging and successful aging rhetoric also highlights some of the most problematic social, cultural, and economic consequences of efforts made to reconceptualize old age. PMID:24022620

How Exemplary Inpatient Teaching Physicians Foster Clinical Reasoning.

PubMed

Houchens, Nathan; Harrod, Molly; Fowler, Karen E; Moody, Stephanie; Saint, Sanjay

2017-09-01

Clinical reasoning is a crucial component of training in health professions. These cognitive skills are necessary to provide quality care and avoid diagnostic error. Much previous literature has focused on teaching clinical reasoning in nonclinical environments and does not include learner reflections. The authors sought to explore, through multiple perspectives including learners, techniques used by exemplary inpatient clinician-educators for explicitly cultivating clinical reasoning. The authors conducted (2014-2015) a multisite, exploratory qualitative study examining how excellent clinician-educators foster clinical reasoning during general medicine rounds. This was accomplished through interviews of educators, focus group discussions with learners, and direct observations of clinical teaching. The authors reviewed field notes and transcripts using techniques of thematic analysis. Twelve clinician-educators, 57 current learners, and 26 former learners participated in observations and interviews. The techniques and behaviors of educators were categorized into 4 themes, including 1) emphasizing organization and prioritization, 2) accessing prior knowledge, 3) thinking aloud, and 4) analyzing the literature. The findings of this comprehensive study both confirm strategies found in previous literature and provide novel approaches. This is the first study to incorporate the perspectives of learners. Educators' techniques and behaviors, identified through direct observation and supported by reflections from the entire team, can inform best practices for the teaching of clinical reasoning. Copyright © 2017 Elsevier Inc. All rights reserved.

Wanting better: a qualitative study of low-income parents about their children's oral health.

PubMed

Lewis, Charlotte W; Linsenmayer, Kristi A; Williams, Alexis

2010-01-01

Using qualitative methods, the purpose of this study was to understand low-income parents' experiences and how these influenced their oral health-related behavior toward their children. Twenty-eight parents were recruited from 7 sites that serve low-income families. Interviews, which were audiotaped and transcribed, were comprised of mostly open-ended questions. Transcripts were analyzed for common themes. Parents' experiences influenced their oral health-related beliefs, intentions, and behaviors. Finding dentists who accept Medicaid was the greatest barrier to realizing intended preventive dental care. Physicians appeared to have relatively little impact on these families' oral health care, even though parents believed that oral health is part of overall health care. WIC (the Supplemental Nutrition Program for Women, Infants and Children) played an important role in facilitating oral health knowledge and access to dental care. Most low-income parents had received little attention to their own oral health, yet wanted better for their children. This motivated the high value placed on their children's preventive oral health. Parents faced challenges finding dental care for their children. Difficulty finding a regular source of dental care for low-income adults, however, was nearly universal. The authors identified strategies, which emerged from their interviews, to improve the oral health knowledge and dental care access for these low-income families.

Holistic Care for Patients During Weaning from Mechanical Ventilation: A Qualitative Study

PubMed Central

Khalafi, Ali; Elahi, Nasrin; Ahmadi, Fazlollah

2016-01-01

Background Weaning patients from mechanical ventilation is a complex and highly challenging process. It requires continuity of care, the overall assessment of patients, and a focus on all aspects of patients’ needs by critical care nurses. Objectives The aim of the present study was to explore holistic care while patients are being weaned from mechanical ventilation from the perspective of the critical care nurses. Methods The study was carried out in the intensive care units (ICUs) of six hospitals in Ahvaz, Iran, from 2014 to 2015. In this qualitative study, 25 ICU staff including nurses, nurse managers, and nurse educators were selected by means of purposive sampling. Semi-structured interviews were used for data collection. The interview transcripts were then analyzed using qualitative content analysis. Results The four main themes that emerged to explain nurses’ experiences of holistic care when weaning patients from mechanical ventilation include continuous care, a holistic overview of the patient, promoting human dignity, and the overall development of well-being. Conclusions It was found that avoiding routine pivotal expertise, increasing consciousness of the nonphysical aspects of patients while providing treatment and presenting exclusive care, utilizing experienced ICU nurses, and placing more emphasis on effective communication with patients in order to honor them as human beings can all enhance the holistic quality of care. PMID:28191345

Lay versus expert understandings of workplace risk in the food service industry: a multi-dimensional model with implications for participatory ergonomics.

PubMed

Cann, Adam P; MacEachen, Ellen; Vandervoort, Anthony A

2008-01-01

The recent trend towards cooperative management and prevention of workplace injuries has introduced numerous health and safety actors to the workplace with varying amounts and types of expertise. The purpose of this qualitative research project was to explore the understandings of risk as experienced by food service workers (FSW) and how these compare with an 'expert' in risk assessment. In total 13 FSW, selected based on age, work location, and gender, and one experienced Ergonomist participated in the study. In-depth semi-structured telephone interviews were conducted with each participant and transcripts of the interviews were analyzed using thematic analysis by drawing on methods closely related to grounded theory. The findings of this study indicated that the risks for occupational injury as experienced by FSW were multi-dimensional in nature representing not only the physical requirements of the individual's job, but also the social interactions of the FSW with their coworkers, management, and the organization. FSW were also found to be a rich source of knowledge and experience concerning occupational risk and may be under-utilized when designing interventions. The results of this study support a cooperative team approach to reduce the risks of injury in the workplace, with a specific emphasis on inclusion of the worker.

Primary care physician management, referral, and relations with specialists concerning patients at risk for cancer due to family history.

PubMed

Wood, M E; Flynn, B S; Stockdale, A

2013-01-01

Risk stratification based on family history is a feature of screening guidelines for a number of cancers and referral guidelines for genetic counseling/testing for cancer risk. Our aim was to describe primary care physician perceptions of their role in managing cancer risk based on family history. Structured interviews were conducted by a medical anthropologist with primary care physicians in 3 settings in 2 north-eastern states. Transcripts were systematically analyzed by a research team to identify major themes expressed by participants. Forty interviews were conducted from May 2003 through May 2006. Physicians provided a diversity of views on roles in management of cancer risk based on family history, management practices and patient responses to risk information. They also provided a wide range of perspectives on criteria used for referral to specialists, types of specialists referred to and expected management roles for referred patients. Some primary care physicians appeared to make effective use of family history information for cancer risk management, but many in this sample did not. Increased focus on efficient assessment tools based on recognized guidelines, accessible guides to management options, and patient education and decision aids may be useful directions to facilitate broader use of family history information for cancer risk management. Copyright © 2013 S. Karger AG, Basel.

Clinical excellence in academia: perspectives from masterful academic clinicians.

PubMed

Christmas, Colleen; Kravet, Steven J; Durso, Samuel C; Wright, Scott M

2008-09-01

To better understand and characterize clinical excellence in academia by exploring the perspectives of clinically excellent faculty in the top American departments of medicine. Between March 1 and May 31, 2007, 2 investigators conducted in-depth semistructured interviews with 24 clinically excellent Department of Medicine physicians at 8 academic institutions. Interview transcripts were independently analyzed by 2 investigators and compared for agreement. Content analysis identified several major themes that relate to clinical excellence in academia. Physicians hailed from a range of internal medicine specialties; 20 (83%) were associate professors or professors and 8 (33%) were women. The mean percentage of time physicians spent in clinical care was 48%. Eight domains emerged as the major features of clinical excellence in academia: reputation, communication and interpersonal skills, professionalism and humanism, diagnostic acumen, skillful negotiation of the health care system, knowledge, scholarly approach to clinical care, and passion for clinical medicine. Understanding the core elements that contribute to clinical excellence in academia represents a pivotal step to defining clinical excellence in this setting. It is hoped that such work will lead to initiatives aimed at measuring and rewarding clinical excellence in our academic medical centers such that the most outstanding clinicians feel valued and decide to stay in academia to serve as role models for medical trainees.

Contributions of Health Care Coalitions to Preparedness and Resilience: Perspectives From Hospital Preparedness Program and Health Care Preparedness Coalitions.

PubMed

Acosta, Joie; Howard, Stefanie; Chandra, Anita; Varda, Danielle; Sprong, Sara; Uscher-Pines, Lori

2015-12-01

The purpose of this article was to describe how the Hospital Preparedness Program (HPP) and other health care coalitions conceptualize and measure progress or success and to identify strategies to improve coalition success and address known barriers to success. We conducted a structured literature review and interviews with key leaders from 22 HPPs and other coalitions. Interview transcripts were analyzed by using constant comparative analysis. Five dimensions of coalition success were identified: strong member participation, diversity of members, positive changes in members' capacity to respond to or recover from disaster, sharing of resources among members, and being perceived as a trendsetter. Common barriers to success were also identified (eg, a lack of funding and staff). To address these barriers, coalitions suggested a range of mitigation strategies (eg, establishing formal memoranda of agreement). Both dimensions of and barriers to coalition success varied by coalition type. Currently, the term health care coalition is a one-size-fits-all term. In reality, this umbrella term describes a variety of different configurations, member bodies, and capabilities. The analysis offered a typology to categorize health care coalitions by primary function during a disaster response. Developing a common typology that could be used to specify capabilities or functions of coalitions may be helpful to advancing their development.

Recognition as a patient-centered medical home: fundamental or incidental?

PubMed

Dohan, Daniel; McCuistion, Mary Honodel; Frosch, Dominick L; Hung, Dorothy Y; Tai-Seale, Ming

2013-01-01

Little is known about reasons why a medical group would seek recognition as a patient-centered medical home (PCMH). We examined the motivations for seeking recognition in one group and assessed why the group allowed recognition to lapse 3 years later. As part of a larger mixed methods case study, we conducted 38 key informant interviews with executives, clinicians, and front-line staff. Interviews were conducted according to a guide that evolved during the project and were audio-recorded and fully transcribed. Transcripts were analyzed and thematically coded. PCMH principles were consistent with the organization's culture and mission, which valued innovation and putting patients first. Motivations for implementing specific PCMH components varied; some components were seen as part of the organization's patient-centered culture, whereas others helped the practice compete in its local market. Informants consistently reported that National Committee for Quality Assurance recognition arose incidentally because of a 1-time incentive from a local group of large employers and because the organization decided to allocate some organizational resources to respond to the complex reporting requirements for about one-half of its clinics. Becoming patient centered and seeking recognition as such ran along separate but parallel tracks within this organization. As the Affordable Care Act continues to focus attention on primary care redesign, this apparent disconnect should be borne in mind.

A diaper bank and home visiting partnership: Initial exploration of research and policy questions.

PubMed

Sadler, Lois S; Condon, Eileen M; Deng, Shirley Z; Ordway, Monica Roosa; Marchesseault, Crista; Miller, Andrea; Alfano, Janet Stolfi; Weir, Alison M

2018-03-01

The cost of diapering an infant can place a significant financial strain on families living in poverty. Partnerships between diaper banks and home visiting programs for young families may offer an innovative solution to expanding the reach and impact of diaper banks in low-income communities. The purpose of this pilot study was to uncover preliminary information about the functions of diaper distribution through home visiting programs, and to inform future research and policy questions regarding diaper distribution to families in need. In this descriptive qualitative pilot study, semi-structured interviews were conducted with 6 home visitors from Minding the Baby ® (MTB), a home visiting intervention for young parents. MTB clinicians routinely distribute diapers in partnership with The Diaper Bank in Connecticut. We used directed content analysis to code and analyze interview transcripts. These preliminary findings indicate that partnerships between home visiting programs and diaper banks may benefit families by improving diaper access, reducing stigma, and fostering trusting relationships with home visitors. Home visiting program benefits including engagement or re-engagement with families may need to be balanced with potential effects on clinical and therapeutic relationships. Recommendations for next steps in research and related policy questions are discussed. © 2017 Wiley Periodicals, Inc.

"This Is a Partnership Between All of Us": Audiologists' Perceptions of Family Member Involvement in Hearing Rehabilitation.

PubMed

Meyer, Carly; Scarinci, Nerina; Ryan, Brooke; Hickson, Louise

2015-12-01

The purpose of the study was to explore the perceptions of audiologists about the role of family members in hearing rehabilitation for older adults with hearing impairment (HI), the influence of family member involvement on outcomes, and factors affecting family members' involvement. A qualitative descriptive research study was undertaken. Using a purposeful sampling strategy, 9 audiologists were recruited. Audiologists participated in individual semistructured interviews. Interview transcripts were analyzed using thematic analysis, and a process of member checking was used to enhance the trustworthiness of findings reported. The importance of promoting partnership emerged as the overarching theme. Audiologists valued promoting partnership with family members so that a shared understanding could be established, family members could be active participants with distinct roles in hearing rehabilitation, and the rehabilitation outcomes for the person with HI could be improved. Audiologists generally reported low attendance rates of family members to appointments and identified 5 major factors affecting family participation. There is growing recognition among audiologists of the importance of promoting partnership with family members during the hearing rehabilitation process. More research is needed to develop and evaluate a family-centered model of hearing health care that considers the service-level barriers identified by audiologists in the present study.

"…Part of My Identity": The Impact of Self-Management on the Sense of Self of Young Women With Type 1 Diabetes.

PubMed

Clausi, Laura; Schneider, Margaret

The purpose of this study was to explore the lived experiences of young women with type 1 diabetes and the ways in which their self-management of their illness may influence their perceived sense of self. Semistructured interviews were conducted with 7 women aged 18 to 22 years who had been formally given a diagnosis of type 1 diabetes. Interviews were audiotaped and transcribed verbatim, and subsequent member checks were completed. Returned member checks and transcriptions were then analyzed using a form of thematic analysis. Three main themes emerged from the data including (1) "I just want to be more free, I guess"; (2) "It's just, like another part of me"; and (3) "I just kind of want to be normal, like I don't even have diabetes." A number of subthemes within each theme were also identified. Findings indicated that many aspects of the young women's day-to-day illness management routine impacted the way in which they viewed themselves. Key aspects that were identified by these women included issues with wanting to feel more free in terms of how they self-manage, trying to stay positive, and wanting to be normal, yet feeling as though they are still different from their peers.

Medical students as teachers at CoSMO, Columbia University's student-run clinic: a pilot study and literature review.

PubMed

Hamso, Magni; Ramsdell, Amanda; Balmer, Dorene; Boquin, Cyrus

2012-01-01

Although medical students are expected to teach as soon as they begin residency, medical schools have just recently begun adding teacher training to their curricula. Student-run clinics (SRCs) may provide opportunities in clinical teaching before residency. The aim of this pilot study was to examine students' experiences in clinical teaching at Columbia Student Medical Outreach (CoSMO), Columbia University's SRC, during the 2009-2010 school year. A mixed-methods approach was used. Data included closed and open-ended surveys (n = 34), combined interviews with preclinical and clinical student pairs (n = 5), individual interviews (n = 10), and focus groups (n = 3). The transcripts were analyzed using the principles of grounded theory. Many students had their first clinical teaching experience while volunteering at CoSMO. Clinical students' ability to teach affected the quality of the learning experience for their preclinical peers. Preclinical students who asked questions and engaged in patient care challenged their clinical peers to balance teaching with patient care. Clinical students began to see themselves as teachers while volunteering at CoSMO. The practical experiences in clinical teaching that students have at SRCs can supplement classroom-based trainings. Medical schools might revisit their SRCs as places for exposure to clinical teaching.

Examining why ethics is taught to veterinary students: a qualitative study of veterinary educators' perspectives.

PubMed

Magalhães-Sant'Ana, Manuel; Lassen, Jesper; Millar, Kate M; Sandøe, Peter; Olsson, I Anna S

2014-01-01

Although it is widely agreed that veterinary students need to be introduced to ethics, there is limited empirical research investigating the reasons why veterinary ethics is being taught. This study presents the first extensive investigation into the reasons for teaching veterinary ethics and reports data collected in semi-structured interviews with educators involved in teaching undergraduate veterinary ethics at three European schools: the University of Copenhagen, the University of Nottingham, and the Technical University of Lisbon (curricular year 2010-2011). The content of the interview transcripts were analyzed using Toulmin's argumentative model. Ten objectives in teaching veterinary ethics were identified, which can be grouped into four overarching themes: ethical awareness, ethical knowledge, ethical skills, and individual and professional qualities. These objectives include recognizing values and ethical viewpoints, identifying norms and regulations, developing skills of communication and decision making, and contributing to a professional identity. Whereas many of the objectives complement each other, there is tension between the view that ethics teaching should promote knowledge of professional rules and the view that ethics teaching should emphasize critical reasoning skills. The wide range of objectives and the possible tensions between them highlight the challenges faced by educators as they attempt to prioritize among these goals of ethics teaching within a crowded veterinary curriculum.

Language acquisition: hesitations in the question/answer dialogic pair.

PubMed

Chacon, Lourenço; Villega, Cristyane de Camargo Sampaio

2015-01-01

(1) To verify the existence (or not) of hesitation marks in the beginning of utterances in children's discourse; and (2) to determine to what extent the presence/absence of these marks could be explained by retrievable facts in the production conditions of their discourses. Interview situations with four children aged 5-6 years attending Kindergarten level II in a public preschool at the time of the data collection were analyzed. The interviews were recorded on audio and video, inside a soundproof booth, with high fidelity equipment. Afterwards, the recordings were transcribed by six transcribers that were specially trained for this task. Transcription rules that prioritized the analyses of hesitations were used. For the analysis of retrievable facts in the production conditions of children's discourse, the dialogic pair question-answer was adopted. A correlation between presence/absence of hesitation in the beginning of utterances in children and type of question (open/closed) made by the collocutor was observed. When the question was closed ended, the utterances were preferably initiated without hesitation marks, and when the question was open ended, the utterances were preferably initiated with hesitation marks. The presence/absence of hesitation marks in the beginning of utterances in children was found to be dependent on the production conditions of their discourses.

Implementing high-performance work practices in healthcare organizations: qualitative and conceptual evidence.

PubMed

McAlearney, Ann Scheck; Robbins, Julie; Garman, Andrew N; Song, Paula H

2013-01-01

Studies across industries suggest that the systematic use of high-performance work practices (HPWPs) may be an effective but underused strategy to improve quality of care in healthcare organizations. Optimal use of HPWPs depends on how they are implemented, yet we know little about their implementation in healthcare. We conducted 67 key informant interviews in five healthcare organizations, each considered to have exemplary work practices in place and to deliver high-quality care, as part of an extensive study of HPWP use in healthcare. We analyzed interview transcripts inductively and deductively to examine why and how organizations implement HPWPs. We used an evidence-based model of complex innovation adoption to guide our exploration of factors that facilitate HPWP implementation. We found considerable variability in interviewees' reasons for implementing HPWPs, including macro-organizational (strategic level) and micro-organizational (individual level) reasons. This variability highlighted the complex context for HPWP implementation in many organizations. We also found that our application of an innovation implementation model helped clarify and categorize facilitators of HPWP implementation, thus providing insight on how these factors can contribute to implementation effectiveness. Focusing efforts on clarifying definitions, building commitment, and ensuring consistency in the application of work practices may be particularly important elements of successful implementation.

Facilitators and Barriers to Preparedness Partnerships: A Veterans Affairs Medical Center Perspective.

PubMed

Schmitz, Susan; Wyte-Lake, Tamar; Dobalian, Aram

2017-09-13

This study sought to understand facilitators and barriers faced by local US Department of Veterans Affairs Medical Center (VAMC) emergency managers (EMs) when collaborating with non-VA entities. Twelve EMs participated in semi-structured interviews lasting 60 to 90 minutes discussing their collaboration with non-VAMC organizations. Sections of the interview transcripts concerning facilitators and barriers to collaboration were coded and analyzed. Common themes were organized into 2 categories: (1) internal (ie, factors affecting collaboration from within VAMCs or by VA policy) and (2) external (ie, interagency or interpersonal factors). Respondents reported a range of facilitators and barriers to collaboration with community-based agencies. Internal factors facilitating collaboration included items such as leadership support. An internal barrier example included lack of clarity surrounding the VAMC's role in community disaster response. External factors noted as facilitators included a shared goal across organizations while a noted barrier was a perception that potential partners viewed a VAMC partnership with skepticism. Federal institutions are important partners for the success of community disaster preparedness and response. Understanding the barriers that VAMCs confront, as well as potential facilitators to collaboration, should enhance the development of VAMC-community partnerships and improve community health resilience. (Disaster Med Public Health Preparedness. 2017; page 1 of 6).

Return to drug use and overdose after release from prison: a qualitative study of risk and protective factors.

PubMed

Binswanger, Ingrid A; Nowels, Carolyn; Corsi, Karen F; Glanz, Jason; Long, Jeremy; Booth, Robert E; Steiner, John F

2012-01-01

Former inmates are at high risk for death from drug overdose, especially in the immediate post-release period. The purpose of the study is to understand the drug use experiences, perceptions of overdose risk, and experiences with overdose among former prisoners. This qualitative study included former prison inmates (N=29) who were recruited within two months after their release. Interviewers conducted in-person, semi-structured interviews which explored participants' experiences and perceptions. Transcripts were analyzed utilizing a team-based method of inductive analysis. The following themes emerged: 1) Relapse to drugs and alcohol occurred in a context of poor social support, medical co-morbidity and inadequate economic resources; 2) former inmates experienced ubiquitous exposure to drugs in their living environments; 3) intentional overdose was considered "a way out" given situational stressors, and accidental overdose was perceived as related to decreased tolerance; and 4) protective factors included structured drug treatment programs, spirituality/religion, community-based resources (including self-help groups), and family. Former inmates return to environments that strongly trigger relapse to drug use and put them at risk for overdose. Interventions to prevent overdose after release from prison may benefit from including structured treatment with gradual transition to the community, enhanced protective factors, and reductions of environmental triggers to use drugs.

The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS.

PubMed

Nevedal, Andrea; Sankar, Andrea

2016-08-01

Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker's (1997) life course disruption theory, we explored older African Americans' experiences of living with HIV/AIDS. A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Older African Americans' discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Holistic Care for Patients During Weaning from Mechanical Ventilation: A Qualitative Study.

PubMed

Khalafi, Ali; Elahi, Nasrin; Ahmadi, Fazlollah

2016-11-01

Weaning patients from mechanical ventilation is a complex and highly challenging process. It requires continuity of care, the overall assessment of patients, and a focus on all aspects of patients' needs by critical care nurses. The aim of the present study was to explore holistic care while patients are being weaned from mechanical ventilation from the perspective of the critical care nurses. The study was carried out in the intensive care units (ICUs) of six hospitals in Ahvaz, Iran, from 2014 to 2015. In this qualitative study, 25 ICU staff including nurses, nurse managers, and nurse educators were selected by means of purposive sampling. Semi-structured interviews were used for data collection. The interview transcripts were then analyzed using qualitative content analysis. The four main themes that emerged to explain nurses' experiences of holistic care when weaning patients from mechanical ventilation include continuous care, a holistic overview of the patient, promoting human dignity, and the overall development of well-being. It was found that avoiding routine pivotal expertise, increasing consciousness of the nonphysical aspects of patients while providing treatment and presenting exclusive care, utilizing experienced ICU nurses, and placing more emphasis on effective communication with patients in order to honor them as human beings can all enhance the holistic quality of care.

Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self-Care Behaviors, and Barriers to Care.

PubMed

Woith, Wendy M; Kerber, Cindy; Astroth, Kim S; Jenkins, Sheryl H

2017-07-01

Civility, rooted in social justice, is a fundamental value of nursing. Homeless people are particularly at risk for experiencing uncivil behavior from nurses. The purpose of this study was to explore homeless people's perceptions of their interactions with nurses. In this descriptive, qualitative study, we interviewed 15 homeless adults who described their experiences with nurses. The interview guide, developed by the researchers, consisted of open-ended questions and probes. Transcriptions and field notes were analyzed through thematic analysis. Three major themes emerged: nurses should be civil, self-care behaviors, and barriers to good care. Subthemes included listening, compassion, attentiveness, and judgment as components of civility; where they go for care and who cares for them as self-care behaviors; and lack of money and homeless status as barriers to care. Our findings indicate people who are homeless often perceive nurses to be uncivil and uncaring toward them; furthermore, our participants provide a unique description of healthcare interactions from the perspective of the homeless. These findings can be used as a basis for the development of education interventions for students and practicing nurses to assist them in learning to provide civil and compassionate care for the homeless. © 2016 Wiley Periodicals, Inc.

Strategies to Build Readiness in Community Mobilization Efforts for Implementation in a Multi-Year Teen Pregnancy Prevention Initiative.

PubMed

Bhuiya, Nazmim; House, L Duane; Desmarais, Jeffrey; Fletcher, Erica; Conlin, Maeve; Perez-McAdoo, Sarah; Waggett, Jessica; Tendulkar, Shalini A

2017-03-01

This paper describes an assessment of community readiness to implement a community-wide teen pregnancy prevention initiative, Youth First, and presents strategies used to enhance this readiness as informed by the assessment. Twenty-five community stakeholder interviews were conducted to assess four domains of readiness: (1) attitudes, perception, and knowledge of teen pregnancy; (2) perceived level of readiness; (3) resources, existing and current efforts; and (4) leadership. Interview transcripts were coded and analyzed to identify key themes. Stakeholders acknowledged teen pregnancy as an issue but lacked contextual information. They also perceived the community as ready to address the issue and recognized some organizations already championing efforts. However, many key players were not involved, and ongoing data collection to assess teen pregnancy and prevention efforts was limited. Though many stakeholders were ready to engage in teen pregnancy prevention efforts, they required additional information and training to appropriately address the issue. In response to the assessment findings, several strategies were applied to address readiness and build Youth First partners' capacity to implement the community-wide initiative. Thus, to successfully implement community-wide prevention efforts, it is valuable to assess the level of community readiness to address health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Helping students revise disruptive experientially supported ideas about thermodynamics: Computer visualizations and tactile models

NASA Astrophysics Data System (ADS)

Clark, Douglas; Jorde, Doris

2004-01-01

This study analyzes the impact of an integrated sensory model within a thermal equilibrium visualization. We hypothesized that this intervention would not only help students revise their disruptive experientially supported ideas about why objects feel hot or cold, but also increase their understanding of thermal equilibrium. The analysis synthesizes test data and interviews to measure the impact of this strategy. Results show that students in the experimental tactile group significantly outperform their control group counterparts on posttests and delayed posttests, not only on tactile explanations, but also on thermal equilibrium explanations. Interview transcripts of experimental and control group students corroborate these findings. Discussion addresses improving the tactile model as well as application of the strategy to other science topics. The discussion also considers possible incorporation of actual kinetic or thermal haptic feedback to reinforce the current audio and visual feedback of the visualization. This research builds on the conceptual change literature about the nature and role of students' experientially supported ideas as well as our understanding of curriculum and visualization design to support students in learning about thermodynamics, a science topic on which students perform poorly as shown by the National Assessment of Educational Progress (NAEP) and Third International Mathematics and Science Study (TIMSS) studies.

Impact of Integrated Watershed Management on Complex Interlinked Factors Influencing Health: Perceptions of Professional Stakeholders in a Hilly Tribal Area of India

PubMed Central

Nerkar, Sandeep S.; Tamhankar, Ashok J.; Johansson, Eva; Lundborg, Cecilia Stålsby

2016-01-01

Lack of access to water has a significant impact on the health of people in tribal areas, where water in households as well as for productive purposes is essential for life. In resource-limited settings such as hilly tribal areas, implementation of an integrated watershed management programme (IWMP) can have a significant impact on public health by providing a solution to water scarcity and related problems. The professional stakeholders in rural healthcare and development administration are important pillars of the system that implements various programmes and policies of government and non-government organizations, and act as facilitators for the improvement of public health in tribal areas. Information about the perceptions of these stakeholders on public health implications of the integrated watershed management programme is important in this context. A qualitative study was conducted using face to face semi-structured interviews and focus group discussions (FGDs) with stakeholders involved in healthcare provision, education and development administration. The transcripts of interviews and FGDs were analyzed using manifest and latent content analysis. The perceptions and experiences shared by healthcare and development administration stakeholders suggest that implementation of IWMP in tribal areas helps efficient water and agriculture management, which results in improved socio-economic conditions that lead to positive health outcomes. PMID:26959039

Doing what's right: A grounded theory of ethical decision-making in occupational therapy.

PubMed

VanderKaay, Sandra; Letts, Lori; Jung, Bonny; Moll, Sandra E

2018-04-20

Ethical decision-making is an important aspect of reasoning in occupational therapy practice. However, the process of ethical decision-making within the broader context of reasoning is yet to be clearly explicated. The purpose of this study was to advance a theoretical understanding of the process by which occupational therapists make ethical decisions in day-to-day practice. A constructivist grounded theory approach was adopted, incorporating in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings and years of experience. Initially, participants nominated as key informants who were able to reflect on their decision-making processes were recruited. Theoretical sampling informed subsequent stages of data collection. Participants were asked to describe their process of ethical decision-making using scenarios from clinical practice. Interview transcripts were analyzed using a systematic process of initial then focused coding, and theoretical categorization to construct a theory regarding the process of ethical decision-making. An ethical decision-making prism was developed to capture three main processes: Considering the Fundamental Checklist, Consulting Others, and Doing What's Right. Ethical decision-making appeared to be an inductive and dialectical process with the occupational therapist at its core. Study findings advance our understanding of ethical decision-making in day-to-day clinical practice.

A diaper bank and home visiting partnership: Initial exploration of research and policy questions

PubMed Central

Sadler, Lois S.; Condon, Eileen M.; Deng, Shirley Z.; Ordway, Monica Roosa; Marchesseault, Crista; Miller, Andrea; Alfano, Janet Stolfi; Weir, Alison M.

2018-01-01

Objectives The cost of diapering an infant can place a significant financial strain on families living in poverty. Partnerships between diaper banks and home visiting programs for young families may offer an innovative solution to expanding the reach and impact of diaper banks in low-income communities. The purpose of this pilot study was to uncover preliminary information about the functions of diaper distribution through home visiting programs, and to inform future research and policy questions regarding diaper distribution to families in need. Design and Sample In this descriptive qualitative pilot study, semi-structured interviews were conducted with 6 home visitors from Minding the Baby® (MTB), a home visiting intervention for young parents. MTB clinicians routinely distribute diapers in partnership with The Diaper Bank in Connecticut. We used directed content analysis to code and analyze interview transcripts. Results/Conclusion These preliminary findings indicate that partnerships between home visiting programs and diaper banks may benefit families by improving diaper access, reducing stigma, and fostering trusting relationships with home visitors. Home visiting program benefits including engagement or re-engagement with families may need to be balanced with potential effects on clinical and therapeutic relationships. Recommendations for next steps in research and related policy questions are discussed. PMID:29235668

The Role of Managers in Employee Wellness Programs: A Mixed-Methods Study.

PubMed

Passey, Deborah G; Hammerback, Kristen; Huff, Aaron; Harris, Jeffrey R; Hannon, Peggy A

2018-01-01

The purpose of this study is to evaluate managers' barriers and facilitators to supporting employee participation in the Washington State Wellness program. Exploratory sequential mixed methods. Four Washington State agencies located in Olympia and Tumwater, Washington. State employees in management positions (executive, middle, and line), whose job includes supervision of subordinates and responsibility for the performance and conduct of a subunit or group. We interviewed 23 managers and then used the results to create a survey that was fielded to all managers at the 4 agencies. The survey response rate was 65% (n = 607/935). We used qualitative coding techniques to analyze interview transcripts and descriptive statistics to summarize survey data. We used the Total Worker Health framework to organize our findings and conclusions. Managers support the wellness program, but they also face challenges with accommodating employees' participation due to workload, scheduling inflexibility, and self-efficacy to discuss wellness with direct reports. About half the managers receive support from the manager above them, and most have not received training on the wellness program. Our findings point to several strategies that can strengthen managers' role in supporting the wellness program: the provision of training, targeted messages, formal expectations, and encouragement (from the manager above) to support employees' participation.

Impact of Integrated Watershed Management on Complex Interlinked Factors Influencing Health: Perceptions of Professional Stakeholders in a Hilly Tribal Area of India.

PubMed

Nerkar, Sandeep S; Tamhankar, Ashok J; Johansson, Eva; Lundborg, Cecilia Stålsby

2016-03-04

Lack of access to water has a significant impact on the health of people in tribal areas, where water in households as well as for productive purposes is essential for life. In resource-limited settings such as hilly tribal areas, implementation of an integrated watershed management programme (IWMP) can have a significant impact on public health by providing a solution to water scarcity and related problems. The professional stakeholders in rural healthcare and development administration are important pillars of the system that implements various programmes and policies of government and non-government organizations, and act as facilitators for the improvement of public health in tribal areas. Information about the perceptions of these stakeholders on public health implications of the integrated watershed management programme is important in this context. A qualitative study was conducted using face to face semi-structured interviews and focus group discussions (FGDs) with stakeholders involved in healthcare provision, education and development administration. The transcripts of interviews and FGDs were analyzed using manifest and latent content analysis. The perceptions and experiences shared by healthcare and development administration stakeholders suggest that implementation of IWMP in tribal areas helps efficient water and agriculture management, which results in improved socio-economic conditions that lead to positive health outcomes.

Exploring gay couples' experience with sexual dysfunction after radical prostatectomy: a qualitative study.

PubMed

Hartman, Mary-Ellen; Irvine, Jane; Currie, Kristen L; Ritvo, Paul; Trachtenberg, Lianne; Louis, Alyssa; Trachtenberg, John; Jamnicky, Leah; Matthew, Andrew G

2014-01-01

This exploratory study examines the experience of three gay couples managing sexual dysfunction as a result of undergoing a radical prostatectomy. Semi-structured interviews were conducted as part of a larger study at an urban hospital in Toronto, Ontario, Canada. Interview transcripts were transcribed verbatim, and analyzed using interpretative phenomenological analysis. The authors clustered 18 subordinate themes under 3 superordinate themes: (a) acknowledging change in sexual experience (libido, erectile function, sexual activity, orgasmic function); (b) accommodating change in sexual experience (strategies: emphasizing intimacy, embracing plan B, focus on the other; barriers: side-effect concerns, loss of naturalness, communication breakdown, failure to initiate, trial and failure, partner confounds); and (c) accepting change in sexual experience (indicators: emphasizing health, age attributions, finding a new normal; barriers: uncertain outcomes, treatment regrets). Although gay couples and heterosexual couples share many similar challenges, we discovered that gay men have particular sexual roles and can engage in novel accommodation practices, such as open relationships, that have not been noted in heterosexual couples. All couples, regardless of their level of sexual functioning, highlighted the need for more extensive programming related to sexual rehabilitation. Equitable rehabilitative support is critical to assist homosexual couples manage distress associated with prostatectomy-related sexual dysfunction.

Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups.

PubMed

Yap, Tracey L; Kennerly, Susan; Corazzini, Kirsten; Porter, Kristie; Toles, Mark; Anderson, Ruth A

2014-07-25

The purpose of the manuscript is to describe long-term care (LTC) staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU) prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI) model guided staff interviews about their perceptions of the intervention's characteristics, outcomes, and sustainability. This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members). One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. The a priori codes (observability, trialability, compatibility, relative advantage and complexity) described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled "brainstormed ideas", focusing on strategies for improving the innovation. Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.

Calculus Students' Understanding of Volume

ERIC Educational Resources Information Center

Dorko, Allison; Speer, Natasha M.

2013-01-01

Researchers have documented difficulties that elementary school students have in understanding volume. Despite its importance in higher mathematics, we know little about college students' understanding of volume. This study investigated calculus students' understanding of volume. Clinical interview transcripts and written responses to volume…

Tending the Treasures of the Emerald Isle.

ERIC Educational Resources Information Center

Zeece, Pauline Davey

2000-01-01

Examines early childhood education and care in the Republic of Ireland. Highlights the work of two leaders in the field in Ireland through transcripts of an interview and a thumbnail sketch of national schools, preschools, nursery schools, and day care nurseries. (SD)

Intelligent Design and educational policy: The case of Kansas

NASA Astrophysics Data System (ADS)

Jones, John Yoshito

Advocates of an alternative explanation of life's origins, Intelligent Design, have lobbied hard since the 1987 Edwards v. Aguillard decision, which banned "creation science" from public schools, to effect educational policy change through local and state-level school boards. This study examines one such lobbying effort, the 2005 attempt to modify the Kansas Curricular Standards for Science so that biological evolution is actively challenged in the classroom, by analyzing the actions and motivations of several members of the Kansas Board of Education as well as non-Board participants through personal interviews and contemporary media reports. Board minutes from 1999 to 2007 and transcripts from the Board's May, 2005, public hearings on evolution are also analyzed. This study asks, "what strategies have creationists developed in the wake of the 1987 Edwards v. Aguillard Supreme Court decision striking down creation science and how have those strategies been employed?" The question's presumption, that Intelligent Design advocates have employed new strategies to advance a creationist agenda, is validated in the study through coding the language used by the interviewees, the Board minutes, and hearings transcripts, as well as a review of contemporary media coverage. Several themes emerged: the belief of participants on each side of the debate that their opponents were attempting to oppress their views, participants on each side claiming to have the best definition of "good science," the emergence of national-level organizations such as the Discovery Institute in coordinating science-related public advocacy at the state level, evolution's importance as a state-level public policy issue, and the importance of keeping the voting public informed of science-related educational policy. This case study should be useful to state and local-level educational policymakers grappling with debates over the place of evolution in public schools.

Interviewing Neuroscientists for an Undergraduate Honors Project

PubMed Central

Montiel, Catalina; Meitzen, John

2017-01-01

Honors projects that supplement standard coursework are a widely used practice in undergraduate curricula. These projects can take many forms, ranging from laboratory research projects to performing service learning to literature analyses. Here we discuss an honors project focused on interviewing neuroscientists to learn about individual scientific practice and career paths, and synthesizing the resulting information into a personal reflection essay. We detail step-by-step instructions for performing this type of project, including how to develop interview questions, a sample project timeline, deliverables, learning objectives and outcomes, and address potential pitfalls. We provide sample interview questions, an interview solicitation email, and in the supplemental materials an example student reflection essay, assessment rubrics, and the transcription of a student-conducted interview of Drs. John Godwin and Santosh Mishra of North Carolina State University. This type of project is a promising method to enable student-researcher communication, and potentially useful to a broad spectrum of both honors and non-honors neuroscience coursework. PMID:29371847

Interviewing Neuroscientists for an Undergraduate Honors Project.

PubMed

Montiel, Catalina; Meitzen, John

2017-01-01

Honors projects that supplement standard coursework are a widely used practice in undergraduate curricula. These projects can take many forms, ranging from laboratory research projects to performing service learning to literature analyses. Here we discuss an honors project focused on interviewing neuroscientists to learn about individual scientific practice and career paths, and synthesizing the resulting information into a personal reflection essay. We detail step-by-step instructions for performing this type of project, including how to develop interview questions, a sample project timeline, deliverables, learning objectives and outcomes, and address potential pitfalls. We provide sample interview questions, an interview solicitation email, and in the supplemental materials an example student reflection essay, assessment rubrics, and the transcription of a student-conducted interview of Drs. John Godwin and Santosh Mishra of North Carolina State University. This type of project is a promising method to enable student-researcher communication, and potentially useful to a broad spectrum of both honors and non-honors neuroscience coursework.

Telling Stories of Research

ERIC Educational Resources Information Center

Evelyn, Debra

2004-01-01

Experimental narrative forms of writing research can offer empowering representations for adult education and feminist researchers. This article presents a selection of academic storytelling in the form of scanned transcript poems or "Learning stories," produced through interviews with women who participated in a special access program…

Perspectives on Schizophrenia Over the Lifespan: A Qualitative Study

PubMed Central

Shepherd, Sally; Depp, Colin A.; Harris, Gloria; Halpain, Maureen; Palinkas, Lawrence A.; Jeste, Dilip V.

2012-01-01

Longitudinal data suggest heterogeneity in the long-term course of schizophrenia. It is unclear how older adults with schizophrenia perceive changes in their experience of schizophrenia over the lifespan. We interviewed 32 adults aged 50 years and older diagnosed with schizophrenia (mean duration 35 years) about their perceived changes in the symptoms of schizophrenia and functioning over the lifespan. Interview transcripts were analyzed using grounded theory techniques of coding, consensus, co-occurrence, and comparison. The study was conducted by a research partnership involving a multidisciplinary team of academic researchers, community members, and mental health clients engaged in all aspects of study design, interviewing, and analysis and interpretation of data. Results revealed that, in regard to early course of illness, participants experienced confusion about diagnosis, active psychotic symptoms, and withdrawal/losses in social networks. Thereafter, nearly all participants believed that their symptoms had improved, which they attributed to increased skills in self-management of positive symptoms. In contrast to consistency among participants in describing illness course, there was marked heterogeneity in perceptions about functioning. Some participants were in despair about the discrepancy between their current situations and life goals, others were resigned to remain in supported environments, and others working toward functional attainments and optimistic about the future. In conclusion, middle-aged and older adults with schizophrenia believed that their symptoms had improved over their lifespan, yet there was substantial variability among participants in how they perceived their functioning. Functional rehabilitation may need to be tailored to differences in perceptions of capacity for functional improvement. PMID:20603443

Sorting Through the Spheres of Influence: Using Modified Pile Sorting to Describe Who Influences Dairy Farmers' Decision-Making About Safety.

PubMed

Bendixsen, Casper; Barnes, Kathrine; Kieke, Burney; Schenk, Danielle; Simich, Jessica; Keifer, Matthew

2017-01-01

The primary goal of this study was to describe the mutually perceived influence of bankers and insurers on their agricultural clients' decision-making regarding health and safety. Semistructured interviews were conducted with 10 dairy farmers, 11 agricultural bankers, and 10 agricultural insurers from central Wisconsin. Three of the interview questions involved pile sorting. Pile sorting included 5-point Likert-like scales to help participants sort through 32 index cards. Each card represented an individual or group that was thought to possibly affect farmers' decision-making, both generally and about health and safety. Results (photographs of piles of cards quantified into spread sheets, fieldnotes, and interview transcripts) were analyzed with SAS and NVivo. All three groups expressed moderate-to-strong positive opinions about involving agricultural bankers (x2(2) = 2.8155, p = 0.2695), although bankers qualitatively expressed apprehension due to regulations on the industry. Insurance agents received more positive support, particularly from bankers but also from dairy farmers themselves, and expressed more confidence in being involved in designing and implementing a farm safety program. Agricultural bankers and insurers can influence individual farmer's decision-making about health and safety. Both are believed to be good purveyors of safety programs and knowledge, especially when leveraging financial incentives. Insurance agents are thought to be more critical in the design of safety programs. Insurers and bankers being financially tied to safety programs may prove both positive and negative, as farmers may be skeptical about the intention of the incentives, making messaging critical.

"Where's My Choice?" An Examination of Veteran and Provider Experiences With Hepatitis C Treatment Through the Veteran Affairs Choice Program.

PubMed

Tsai, Jack; Yakovchenko, Vera; Jones, Natalie; Skolnik, Avy; Noska, Amanda; Gifford, Allen L; McInnes, D Keith

2017-07-01

The Department of Veterans Affairs (VA) is the country's largest provider for chronic hepatitis C virus (HCV) infection. The VA created the Choice Program, which allows eligible veterans to seek care from community providers, who are reimbursed by the VA. This study aimed to examine perspectives and experiences with the VA Choice Program among veteran patients and their HCV providers. Qualitative study based on semistructured interviews with veteran patients and VA providers. Interview transcripts were analyzed using rapid assessment procedures based in grounded theory. A total of 38 veterans and 10 VA providers involved in HCV treatment across 3 VA medical centers were interviewed. Veterans and providers were asked open-ended questions about their experiences with HCV treatment in the VA and through the Choice Program, including barriers and facilitators to treatment access and completion. Four themes were identified: (1) there were difficulties in enrollment, ongoing support, and billing with third-party administrators; (2) veterans experienced a lack of choice in location of treatment; (3) fragmented care led to coordination challenges between VA and community providers; and (4) VA providers expressed reservations about sending veterans to community providers. The Choice Program has the potential to increase veteran access to HCV treatment, but veterans and VA providers have described substantial problems in the initial years of the program. Enhancing care coordination, incorporating shared decision-making, and establishing a wide network of community providers may be important areas for further development in designing community-based specialist services for needy veterans.

Stages and Processes of Change Utilized by Female Sex Workers Participating in an Alcohol-Reduction Intervention in Mombasa, Kenya.

PubMed

Velloza, Jennifer; L'Engle, Kelly; Mwarogo, Peter; Chokwe, Jackie; Magaria, Loice; Sinkele, William; Kingola, Nzioki

2015-01-01

According to the transtheoretical model (TTM) behavior change occurs through a series of steps when an individual becomes aware of a behavior, prepares to change, and executes those changes using certain processes. This model has not yet been used to describe alcohol-reduction behavior change processes in resource-limited settings. This qualitative analysis aimed to describe and characterize the stages and processes of change employed by female sex workers in Mombasa, Kenya during the course of their participation in a 6-month alcohol reduction intervention. In 2011-2012, clinical interviews were conducted with 45 female sex workers. One interview was conducted each month during the intervention period, resulting in a total of six transcripts per participant. During each interview, the counselor noted the participant's stage of change and recent alcohol use. The clinical notes were analyzed via qualitative coding techniques and organized into matrices to classify alcohol reduction strategies discussed by participants. Participants discussed using the stage-specific processes of change described by the TTM to reduce their alcohol use and maintain the behavior change. Participants who were HIV-positive at the start of the intervention seemed to progress to the action/maintenance stage more quickly than HIV-negative participants. Results suggest that the TTM constructs may be relevant in understanding the alcohol reduction behavior change process of an at-risk population in a resource-limited setting. Future quantitative research should seek to validate the TTM's application internationally. Alcohol interventions should consider tailoring content to participants' stages of change and HIV-status for increased effectiveness.

Neuropsychology reports for childhood brain tumor survivors: implementation of recommendations at home and school.

PubMed

Cheung, Lorraine L T; Wakefield, Claire E; Ellis, Sarah J; Mandalis, Anna; Frow, Eleanor; Cohn, Richard J

2014-06-01

As pediatric brain tumor survivors may experience cognitive decline post-treatment, a neuropsychology assessment is often conducted. The assessment evaluates the child's cognitive functioning and highlights potential challenges. Whilst neuropsychology reports provide recommendations for the home and school, how this translates in practice is under researched. This study explored parent and teacher understanding of neuropsychology reports, implementation rates for recommendations and their perceived effectiveness. Barriers to implementation were also investigated. Twenty-five semi-structured interviews were conducted with 17 parents and 8 teachers of childhood brain tumor survivors from 15 Australian families who had received a neuropsychology report within 2 years of the interview. Twenty-four neuropsychology reports encompassing 131 recommendations were reviewed. The qualitative methodological framework of Miles and Huberman [Miles M, Huberman A. Qualitative data analysis: An expanded sourcebook. London: Sage; 1994] was used to analyze interview transcripts with QSR NVivo 9.0. The majority of parents and teachers had a sound understanding of the report. Implementation of recommendations at home and school was 47% and 41%, respectively. Recommendations that did not require extra effort and organization appeared more likely to be implemented, however, those perceived to be more effective or helpful did not necessarily have higher implementation rates. Key reported barriers to implementation barrier were patient reluctance, and a lack of parents' willingness to adopt the recommendation. Patient understanding and willingness play a significant role in the implementation of neuropsychology recommendations. Collaboration and clear communication between the patient, teacher, parent, and neuropsychologist is vital for effective management. © 2014 Wiley Periodicals, Inc.

Value of a regional family practice residency training program site: perceptions of residents, nurses, and physicians.

PubMed

Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

2014-09-01

To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Interviews and focus groups were conducted. Nanaimo, BC. A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients' perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. Copyright© the College of Family Physicians of Canada.

Responsibility and confidence

PubMed Central

Austin, Zubin

2013-01-01

Background: Despite the changing role of the pharmacist in patient-centred practice, pharmacists anecdotally reported little confidence in their clinical decision-making skills and do not feel responsible for their patients. Observational findings have suggested these trends within the profession, but there is a paucity of evidence to explain why. We conducted an exploratory study with an objective to identify reasons for the lack of responsibility and/or confidence in various pharmacy practice settings. Methods: Pharmacist interviews were conducted via written response, face-to-face or telephone. Seven questions were asked on the topic of responsibility and confidence as it applies to pharmacy practice and how pharmacists think these themes differ in medicine. Interview transcripts were analyzed and divided by common theme. Quotations to support these themes are presented. Results: Twenty-nine pharmacists were asked to participate, and 18 responded (62% response rate). From these interviews, 6 themes were identified as barriers to confidence and responsibility: hierarchy of the medical system, role definitions, evolution of responsibility, ownership of decisions for confidence building, quality and consequences of mentorship and personality traits upon admission. Discussion: We identified 6 potential barriers to the development of pharmacists’ self-confidence and responsibility. These findings have practical applicability for educational research, future curriculum changes, experiential learning structure and pharmacy practice. Due to bias and the limitations of this form of exploratory research and small sample size, evidence should be interpreted cautiously. Conclusion: Pharmacists feel neither responsible nor confident for their clinical decisions due to social, educational, experiential and personal reasons. Can Pharm J 2013;146:155-161. PMID:23795200

Barriers and Facilitators of Transition from Pediatric to Adult Long-Term Follow-Up Care in Childhood Cancer Survivors.

PubMed

Rosenberg-Yunger, Zahava R S; Klassen, Anne F; Amin, Leila; Granek, Leeat; D'Agostino, Norma M; Boydell, Katherine M; Greenberg, Mark; Barr, Ronald D; Nathan, Paul C

2013-09-01

Despite the risk for late effects in adult survivors of cancer in childhood or adolescence, many survivors fail to transition from pediatric to adult long-term follow-up (LTFU) care. The purpose of this study was to identify the barriers and facilitators of transition from pediatric to adult LTFU care. In this qualitative study, 38 Canadian survivors of cancer in childhood or adolescence, currently aged 15-26 years, were interviewed using semi-structured, open-ended questions. Participants belonged to one of four groups: pre-transition (n=10), successful transition (n=11), failed to transition (n=7), and transitioned to an adult center but then dropped out of adult care (n=10). A constructivist grounded theory approach was used to analyze the interview data. This approach consisted of coding transcripts line by line to develop categories and using constant comparison to examine relationships within and across codes and categories. Interviewing continued until saturation was reached. Three interrelated themes were identified that affected the transition process: micro-level patient factors (e.g., due diligence, anxiety), meso-level support factors (e.g., family, friends), and macro-level system factors (e.g., appointments, communication, healthcare providers). Factors could act as facilitators to transition (e.g., family support), barriers to transition (e.g., difficulty booking appointments), or as both a barrier and a facilitator (e.g., anxiety). This study illustrates the interaction between multiple factors that facilitate and/or prevent transition from pediatric to adult LTFU cancer care. A number of recommendations are presented to address potential macro-level system barriers to successful transition.

Value of a regional family practice residency training program site

PubMed Central

Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

2014-01-01

Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693

Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.

PubMed

Whittle, Henry J; Palar, Kartika; Napoles, Tessa; Hufstedler, Lee Lemus; Ching, Irene; Hecht, Frederick M; Frongillo, Edward A; Weiser, Sheri D

2015-01-01

Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM). Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were coded and analyzed according to content analysis methods using an inductive-deductive approach. Food insecurity was reported to be a strong contributor to risky sexual practices among MSM and female participants. Individuals described engaging in transactional sex for food or money to buy food, often during times of destitution. Participants also explained how food insecurity could lead to condomless sex despite knowledge of and desire to use safe sexual practices, largely because the need to obtain food in the short term was prioritized over the desire to use barrier protection. Our data extend previous research by demonstrating that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among MSM. These findings underscore the importance of public health and social intervention efforts focused on structural inequalities.

The business case for provider participation in clinical trials research: an application to the National Cancer Institute's community clinical oncology program.

PubMed

Song, Paula H; Reiter, Kristin L; Weiner, Bryan J; Minasian, Lori; McAlearney, Ann Scheck

2013-01-01

Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. The aim of this study was to explore whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. We use a multiple case study methodology approach to examine the National Cancer Institute's community clinical oncology program, a long-standing federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semistructured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally funded PBRNs outside of oncology or to providers considering participation in any clinical trials research.

Land Application of Treated Sewage Sludge: Community Health and Environmental Justice

PubMed Central

McDonald, Mary Anne; Wing, Steve; Muhammad, Naeema

2013-01-01

Background: In the United States, most of the treated sewage sludge (biosolids) is applied to farmland as a soil amendment. Critics suggest that rules regulating sewage sludge treatment and land application may be insufficient to protect public health and the environment. Neighbors of land application sites report illness following land application events. Objectives: We used qualitative research methods to evaluate health and quality of life near land application sites. Methods: We conducted in-depth interviews with neighbors of land application sites and used qualitative analytic software and team-based methods to analyze interview transcripts and identify themes. Results: Thirty-four people in North Carolina, South Carolina, and Virginia responded to interviews. Key themes were health impacts, environmental impacts, and environmental justice. Over half of the respondents attributed physical symptoms to application events. Most noted offensive sludge odors that interfere with daily activities and opportunities to socialize with family and friends. Several questioned the fairness of disposing of urban waste in rural neighborhoods. Although a few respondents were satisfied with the responsiveness of public officials regarding sludge, many reported a lack of public notification about land application in their neighborhoods, as well as difficulty reporting concerns to public officials and influencing decisions about how the practice is conducted where they live. Conclusions: Community members are key witnesses of land application events and their potential impacts on health, quality of life, and the environment. Meaningful involvement of community members in decision making about land application of sewage sludge will strengthen environmental health protections. PMID:23562940

Breast Cancer Survivors’ Experiences of Lymphedema-Related Symptoms

PubMed Central

Fu, Mei Rosemary; Rosedale, Mary

2009-01-01

The purpose of this study was to explore and describe breast cancer survivors’ lymphedema-related symptom experiences. As a serious chronic condition from breast cancer treatment, lymphedema, or persistent swelling, is caused by chronic accumulation of lymph fluid in the interstitial spaces of the affected limb or surrounding areas. While significant prevalence of ongoing multiple symptoms have been reported, little is known about how survivors with lymphedema perceive and respond to lymphedema-related symptoms in their daily lives. This study employed a descriptive phenomenological method. Thirty-four participants were recruited in the US. Three in-depth interviews were conducted with each participant; a total of 102 interviews were completed, audio-taped, and transcribed. Interview transcripts and field notes were the data sources for this analysis, which was part of three larger studies. Data were analyzed to identify the essential themes within and across cases. Four essential themes were revealed: living with perpetual discomfort; confronting the unexpected; losing pre-lymphedema being; and feeling handicapped. Participants experienced multiple symptoms on a daily basis. Distress was heightened when women expected symptoms to disappear but instead they remained as a “perpetual discomfort.” Moreover, distress was intensified when symptoms evoked unexpected situations or when symptoms elicited emotional responses powerful enough to change perceived personal identity. Findings suggest that symptom distress may encompass temporal, situational and attributive dimensions. Prospective studies are needed to examine lymphedema-related symptom distress in terms of these dimensions so that more specific interventions can be developed to target distress occurring in each dimension. PMID:19819668

Characteristics of Successful and Failed Mentoring Relationships: A Qualitative Study Across Two Academic Health Centers

PubMed Central

Straus, Sharon E.; Johnson, Mallory O.; Marquez, Christine; Feldman, Mitchell D.

2013-01-01

Purpose To explore the mentor–mentee relationship with a focus on determining the characteristics of effective mentors and mentees and understanding the factors influencing successful and failed mentoring relationships. Method The authors completed a qualitative study through the Departments of Medicine at the University of Toronto Faculty of Medicine and the University of California, San Francisco, School of Medicine between March 2010 and January 2011. They conducted individual, semistructured interviews with faculty members from different career streams and ranks and analyzed transcripts of the interviews, drawing on grounded theory. Results The authors completed interviews with 54 faculty members and identified a number of themes, including the characteristics of effective mentors and mentees, actions of effective mentors, characteristics of successful and failed mentoring relationships, and tactics for successful mentoring relationships. Successful mentoring relationships were characterized by reciprocity, mutual respect, clear expectations, personal connection, and shared values. Failed mentoring relationships were characterized by poor communication, lack of commitment, personality differences, perceived (or real) competition, conflicts of interest, and the mentor’s lack of experience. Conclusions Successful mentorship is vital to career success and satisfaction for both mentors and mentees. Yet challenges continue to inhibit faculty members from receiving effective mentorship. Given the importance of mentorship on faculty members’ careers, future studies must address the association between a failed mentoring relationship and a faculty member’s career success, how to assess different approaches to mediating failed mentoring relationships, and how to evaluate strategies for effective mentorship throughout a faculty member’s career. PMID:23165266

Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting

PubMed Central

Whittle, Henry J; Palar, Kartika; Napoles, Tessa; Hufstedler, Lee Lemus; Ching, Irene; Hecht, Frederick M; Frongillo, Edward A; Weiser, Sheri D

2015-01-01

Background Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM). Methods Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were coded and analyzed according to content analysis methods using an inductive-deductive approach. Results Food insecurity was reported to be a strong contributor to risky sexual practices among MSM and female participants. Individuals described engaging in transactional sex for food or money to buy food, often during times of destitution. Participants also explained how food insecurity could lead to condomless sex despite knowledge of and desire to use safe sexual practices, largely because the need to obtain food in the short term was prioritized over the desire to use barrier protection. Conclusions Our data extend previous research by demonstrating that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among MSM. These findings underscore the importance of public health and social intervention efforts focused on structural inequalities. PMID:26546789

Living My Family's Story

PubMed Central

Underhill, Meghan L.; Lally, Robin M.; Kiviniemi, Marc T.; Murekeyisoni, Christine; Dickerson, Suzanne S.

2013-01-01

Background Based on known or suggested genetic risk factors, a growing number of women now live with knowledge of a potential cancer diagnosis that may never occur. Given this, it is important to understand the meaning of living with high risk for hereditary breast cancer. Objective The objective of the study was to explore how women at high risk for hereditary breast cancer (1) form self-identity, (2) apply self-care strategies toward risk, and (3) describe the meaning of care through a high-risk breast program. Methods Interpretive hermeneutic phenomenology guided the qualitative research method. Women at high risk for hereditary breast cancer were recruited from a high-risk breast program. Open-ended interview questions focused on experiences living as women managing high risk for breast cancer. Consistent with hermeneutic methodology, the principal investigator led a team to analyze the interview transcripts. Results Twenty women participated in in-depth interviews. Analysis revealed that women describe their own identity based on their family story and grieve over actual and potential familial loss. This experience influences self-care strategies, including seeking care from hereditary breast cancer risk experts for early detection and prevention, as well as maintaining a connection for early treatment “when” diagnosis occurs. Conclusions Healthy women living with high risk for hereditary breast cancer are living within the context of their family cancer story, which influences how they define themselves and engage in self-care. Implications for Practice Findings present important practical, research, and policy information regarding health promotion, psychosocial assessment, and support for women living with this risk. PMID:22544165

The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer’s Disease When One Lives Alone

PubMed Central

Portacolone, Elena; Johnson, Julene K.; Covinsky, Kenneth E.; Halpern, Jodi; Rubinstein, Robert L.

2018-01-01

Background One third of older adults with cognitive impairment live alone and are at high risk for poor health outcomes. Little is known about how older adults who live alone experience the process of receiving a diagnosis of mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Objective The aim of this study was to understand the effects and meanings of receiving a diagnosis of MCI or AD on the lived experience of older adults living alone. Methods This is a qualitative study of adults age 65 and over living alone with cognitive impairment. Participants’ lived experiences were elicited through ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Results Twenty-nine older adults and 6 members of their social circles completed 114 ethnographic interviews. Core themes included: relief, distress, ambiguous recollections, and not knowing what to do. Participants sometimes felt uplifted and relieved by the diagnostic process. Some participants did not mention having received a diagnosis or had only partial recollections about it. Participants reported that, as time passed, they did not know what to do with regard to the treatment of their condition. Sometimes they also did not know how to prepare for a likely worsening of their condition, which they would experience while living alone. Conclusion Findings suggest the need for more tailored care and follow-up as soon as MCI or AD is diagnosed in persons living alone. PMID:29376864

The Attitudes, Needs, and Requirements at End of Life in the Republic of Georgia (Comparative Analysis of Groups of Patients With Cancer and Elders).

PubMed

Chikhladze, Nana; Tebidze, Nino; Chabukiani, Tamar; Chabukiani, Nana; Chkhartishvili, Nikoloz; Jincharadze, Memed; Kordzaia, Dimitri

2018-01-01

In developing a model of palliative care, the attitudes, needs, and requirements of its beneficiaries recognizing the limited remaining life expectancy need to be met. We aimed to map and compare these issues at the end of life in the groups of patients with advanced cancer and elderly individuals. The prospective study based on the analysis of semistructured interviews was conducted. Fifty individuals aged older than 85 and 50 incurable patients with advanced cancer were studied. Transcripts of interviews were analyzed qualitatively (the interviews were divided into logically completed themes, and the compliance of each with one of the levels of Abraham Maslow pyramid was determined) and quantitatively (data comparisons of 2 groups were tested in bivariate analysis using Pearson χ 2 or Fisher exact test. Two-sided significance tests were used; P value of <.05 was deemed significant). It was assumed that 120 themes were relevant to a certain level of Maslow pyramid. Their comparison showed small differences in the narratives of the patients with advanced cancer and elderly individuals aged 85 and older-concerning the past, present, and future terms of lives. In studied themes explicitly prevail the stories that are consistent with satisfaction of the upper levels of the hierarchy of needs and demands of Maslow: social relation (belonging), love, esteem, and transcendence. The attitudes, needs, and requirements at the end of life of the people are basically similar, regardless of what determined the sense of limitation of the remaining life-incurable disease or advanced age.

Stakeholders' Perspectives on Stakeholder-engaged Research (SER): Strategies to Operationalize Patient-centered Outcomes Research Principles for SER.

PubMed

Mackie, Thomas I; Sheldrick, Radley C; de Ferranti, Sarah D; Saunders, Tully; Rojas, Erick G; Leslie, Laurel K

2017-01-01

US federal funding agencies increasingly incentivize stakeholder-engaged research which represents a paradigm shift toward incorporating a range of stakeholders in research design, conduct, and dissemination. We use qualitative methods to capture experience-based recommendations on how to operationalize 4 Patient-Centered Outcomes Research (PCOR) principles in stakeholder-engaged research, specifically: (1) reciprocal relationships; (2) colearning; (3) partnership; and (4) trust, transparency, and honesty. We conducted semistructured interviews with members of a stakeholder panel who participated in a 2-year comparative effectiveness study of cholesterol screening and treatment among young adults. Participants included 8 young adults and parent panelists and 11 professional panelists (clinicians, researchers, policy developers, and disseminators). The interview guide included questions about the 4 PCOR principles and queried preferred strategies to attain them. Interview transcripts were analyzed using an a priori and emergent coding structure. Participants provided strategies to promote the 4 PCOR principles. Although some stakeholder-identified strategies were complementary, others conflicted due to (1) competing ideologies identified among the principles, and (2) distinct stakeholder preferences. Illustrative of competing ideologies, participants simultaneously preferred receiving relevant articles before calls (to facilitate colearning) but also minimal outside reading (to achieve partnership). Illustrative of distinct stakeholder preferences, young adult and parent panelists generally preferred calls to occur on weekends/evenings, whereas professional panelists preferred mid-week work hours. Our exploratory study provides stakeholder-identified strategies to achieve the 4 PCOR principles, and demonstrates the need to identify, acknowledge, and address potentially conflicting strategies due to the potential for competing ideologies or variation in stakeholder preferences.

Adult birth mothers who made open infant adoption placements after adolescent unplanned pregnancy.

PubMed

Clutter, Lynn B

2014-01-01

To summarize birth mothers' descriptions of how their adolescent or young adult unplanned pregnancies and decision for open infant adoption placement influenced their lives. Naturalistic inquiry using unstructured interviews. One to 2-hour telephone interviews with participants in their home settings were recorded and transcribed. Deidentified transcripts were analyzed for qualitative content themes. Fifteen women who had experienced unplanned adolescent or young adult pregnancy and relinquished their infants through open adoption were interviewed. Birth mothers who had been members of an agency support group were identified by an agency representative as having been typical of open adoption and were purposively recruited for study participation. Participants described the open adoption decision as "one of the most difficult but best" choices of their lives. Themes were summarized using the acronym AFRESH: A--adoption accomplishments, F--fresh start, R--relationship changes, E--emotions, S--support, H--healing. Findings indicated that benefits of open adoption outweighed challenges of pregnancy, birth, and emotional transitions. Birth children were perceived as thriving with adoptive families who were cherished like extended family. Birth mothers perceived themselves as being better people with better lives than before the unintended pregnancy. Growth with improved life direction was seen as a result of personal maturation from the experience. Open adoption is reinforced as a positive resolution of adolescent unintended pregnancy. Birth mothers believed teens who feel "stuck" with a pregnancy should consider open adoption; nurses should provide support and uphold the process. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Understanding burden of illness for child growth hormone deficiency.

PubMed

Brod, Meryl; Alolga, Suzanne Lessard; Beck, Jane F; Wilkinson, Lars; Højbjerre, Lise; Rasmussen, Michael Højby

2017-07-01

Research demonstrates that children and adolescents with growth hormone deficiency (GHD) are impacted in multiple ways beyond their short stature; however, there are no disease-specific measures to assess these impacts. The purpose of this study was to examine the burden of GHD on children and adolescents, and to conduct concept elicitation to develop a model of the impact of GHD to support a disease-specific outcome measure. Four focus groups and 52 telephone interviews were conducted with children with GHD and parents/guardians of children with GHD to understand the experience and impacts from the child's perspective, reported by children or parent-observers about the impact on the child. The interviews and focus groups were conducted in Germany, the United Kingdom, and the United States. Interview transcripts were analyzed thematically based on modified grounded theory principles. There were 73 descriptions of patient's experiences elicited from 70 respondents, as three respondents spoke for two children each. A majority of GHD descriptive narratives refer to boy children (n = 51, 69.9%) and a majority of children had taken GHD treatment (n = 64, 89%). Analysis identified four major areas of GHD impact: Signs and Symptoms (beyond short stature), Physical Aspects of Daily Life, Social Well-Being, and Emotional Well-Being. The burden of GHD in children and adolescents is considerable and not limited to short stature. The severity of GHD impact on children and adolescents appears to be variable and individualized, but these data indicate that early identification and growth hormone treatment may lead to fewer impacts.

Surviving the housing crisis: Social violence and the production of evictions among women who use drugs in Vancouver, Canada.

PubMed

Collins, Alexandra B; Boyd, Jade; Damon, Will; Czechaczek, Sandra; Krüsi, Andrea; Cooper, Hannah; McNeil, Ryan

2018-05-01

Single room accommodation (SRA) housing is among the only forms of accessible housing to marginalized women who use illicit drugs in many urban settings. However, SRA housing environments may create specific health and drug risks for women. Little research has examined the gendered mechanisms contributing to housing vulnerability for women who use drugs and the subsequent ways they aim to mitigate harm. This study examines the gendered vulnerabilities to, and harms stemming from, evictions from SRAs in Vancouver, Canada. Qualitative interviews were conducted with 56 people who use drugs who were recently evicted (past 60 days) from SRAs in Vancouver's Downtown Eastside neighbourhood, 19 of whom identified as women which informed this analysis. Participants were recruited by Peer Researcher Assistants for baseline and follow-up interviews three to six months later. Interview transcripts were analyzed thematically and interpreted by drawing on concepts of social violence. Findings underscore how gendered violence and forms of social control operationalized within SRAs normalized violence against women and restricted their agency. Surveillance mechanisms increased women's experiences of violence as they sought to evade such interventions. Post-eviction, women faced pronounced vulnerability to harm which reinforced their social and spatial marginality within a drug scene. Collectively, women's experiences within SRAs highlight how the hybrid forms of disciplinary mechanisms used within these housing environments significantly impacted women's experiences of harm. Greater attention to the impacts of housing and building policies on women who use drugs is needed to better address the morbidity and mortality of this population. Copyright © 2018 Elsevier Ltd. All rights reserved.

The role of complementary and alternative medicine (CAM) routines and rituals in men with cancer and their significant others (SOs): a qualitative investigation.

PubMed

Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

2014-05-01

Complementary and alternative medicine (CAM) is frequently used in cancer patients, often with contribution of the significant others (SOs), but without consultation of healthcare professionals. This research explored how cancer patients integrate and maintain CAM use in their everyday life, and how SOs are involved in it. In this qualitative study, male participants were selected from a preceding Australian survey on CAM use in men with cancer (94 % response rate and 86 % consent rate for follow-up interview). Semistructured interviews were conducted with 26 men and 24 SOs until data saturation was reached. Interview transcripts were coded and analyzed thematically, thereby paying close attention to participants' language in use. A major theme associated with high CAM use was "CAM routines and rituals," as it was identified that men with cancer practiced CAM as (1) functional routines, (2) meaningful rituals, and (3) mental/spiritual routines or/and rituals. Regular CAM use was associated with intrapersonal and interpersonal benefits: CAM routines provided men with certainty and control, and CAM rituals functioned for cancer patients and their SOs as a means to create meaning, thereby working to counter fear and uncertainty consequent upon a diagnosis of cancer. SOs contributed most to men's uptake and maintenance of dietary-based CAM in ritualistic form resulting in interpersonal bonding and enhanced closeness. CAM routines and rituals constitute key elements in cancer patients' regular and satisfied CAM use, and they promote familial strengthening. Clinicians and physicians can convey these benefits to patient consultations, further promoting the safe and effective use of CAM.

Rural Latino caregivers' beliefs and behaviors around their children's salt consumption.

PubMed

Hoeft, Kristin S; Guerra, Claudia; Gonzalez-Vargas, M Judy; Barker, Judith C

2015-04-01

Prevalence of high blood pressure has been increasing in U.S. children, with implications for long term health consequences. Sodium consumption, a modifiable risk factor for high blood pressure, is above recommended limits and increasing. Very little is known about Latino caregiver beliefs and behaviors around their children's salt consumption. In California's Central Valley, qualitative interviews in Spanish investigated low-income caregivers' views and understandings of their children's dietary salt consumption. Thirty individual interviews and 5 focus groups were conducted (N=61). Interview transcripts were translated and transcribed, coded and thematically analyzed. Seven primary topic areas around children's salt intake and its impact on health were identified: children's favorite foods, children's dietary salt sources, superiority of home-cooked foods, salty and sweet foods, managing salt for health, developing children's tastes, and adding salt added at the table. Parents recognize common sources of sodium such as "junk food" and processed food and made efforts to limit their children's consumption of these foods, but may overlook other significant sodium sources, particularly bread, cheese, prepared soups and sports drinks. Caregivers recognize excess salt as unhealthy for children, but don't believe health problems (like high blood pressure) can occur in young children. Nevertheless, they made efforts to limit how much salt their children consumed through a variety of strategies; school meals were a source of high sodium that they felt were outside of their control. Latino caregivers are concerned about their children's salt intake and attempt to limit consumption, but some common sources of sodium are under-recognized. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Lived Experiences of Persons Hospitalized for Construction of an Urgent Fecal Ostomy.

PubMed

Herlufsen, Per; Brødsgaard, Anne

The purpose of this study was to describe the lived experiences of hospital stays for patients undergoing urgent ostomy surgery. Qualitative, descriptive, phenomenological study. Six persons undergoing acute hospital admission and urgent ileostomy or colostomy surgery (either permanent or temporary) participated in the study. Participants were of Danish ethnicity and between the ages of 48 and 75 years. The research setting was the surgical department at a university hospital in the Capital Region of Denmark. Data collection and analyses were guided by a Reflective Lifeworld Research approach; this approach is based on phenomenological philosophy. Data were collected during in-depth interviews using a semistructured interview guide. Their average length was 50 minutes (range, 30-65 minutes). Interviews were digitally recorded and transcribed. Transcriptions were analyzed in 4 phases according to the principles of Reflective Lifeworld Research. The phenomenon we labeled "lived experiences of acute hospitalization with construction of an urgent unplanned fecal ostomy" comprised 4 constituents: (1) undergoing unexpected bodily changes, (2) partnership with professional caregivers, (3) experience of vulnerability, and (4) a lack of continuity. These constituents can be described as a number of challenges due to both hospitalization and ostomy creation. We found that individuals experience a number of challenges due to acute hospitalization and urgent construction of a fecal ostomy. These challenges are due to the unexpected bodily changes and interpersonal and organizational conditions. Nurses should be aware of not only the physical implications of urgent creation of a fecal ostomy but also the individual and psychological implications of this event.

Timing of the breath analyzer: does it make a difference?

PubMed

Cherpitel, C J

1993-09-01

The purpose of this article is to examine in an emergency room (ER) population the concordance of self-reports of no alcohol consumption prior to injury with breath-analyzer readings in two groups: (1) those patients from whom reports were obtained after they were breath analyzed compared to (2) patients from whom reports were obtained prior to obtaining the breath-analyzer reading. Data were collected on a probability sample of patients attending three health maintenance organization ERs. Among those sampled were 159 patients admitted for initial treatment of an injury, who were breath analyzed within 6 hours of the event and reported no drinking following the event that lead to injury. Of these, 119 were breath analyzed prior to the interview, and none who reported not drinking were positive on the breath analyzer, while of the 37 breath analyzed after the interview, only one was positive who had reported not drinking. Obtaining the breath-analyzer reading following the interview was not found to affect the rate of refusal to provide a breath-analyzer reading; however, it was found to adversely affect obtaining the breath-analyzer reading for other reasons. The data suggest that the concordance of negative self-reports of consumption with breath-analyzer readings remains high in ER populations regardless of when the breath-analyzer reading is obtained; however, it appears best to obtain the reading prior to interviewing the patient for reasons explained below.

Effects of an antenatal mindfulness-based childbirth and parenting programme on the postpartum experiences of mothers: a qualitative interview study.

PubMed

Roy Malis, Françoise; Meyer, Thorsten; Gross, Mechthild M

2017-02-07

Applications of mindfulness during the perinatal period have recently been explored and appear to offer a decrease in stress, anxiety and depression during this period. However, it still remains unclear what practical use women make of mindfulness during the postpartum period and the mechanisms through which it works. The subjective experience of mindfulness practice by mothers is not fully understood. The aim of the present study was to explore how women enrolled in a "Mindfulness-Based Childbirth and Parenting programme" experienced mindfulness practice during the postpartum period. Ten pregnant women over 18 years of age with singleton pregnancies, no diagnoses of mental illness and participation in a "Mindfulness-Based Childbirth and Parenting programme" were recruited to take part in a postpartum interview. Audio recordings of the interviews were transcribed and analysed thematically based on a phenomenological approach. The transcripts of nine interviews were submitted to a coding process consisting of the identification of words, sentences or paragraphs expressing common ideas. These ideas were classified in codes, each code representing a specific description, function or action (e.g. self-perception, personal organization, formal/informal meditation practice). Progressively, a framework of thematic ideas was extracted from the transcripts, allowing the interviews to be systematically organized and their content analysed in depth. Five themes emerged from the descriptions of practices of mindfulness during the postpartum period: perception of the present moment, breathing, acceptance, self-compassion and the perception of mindfulness as a shelter. Mindfulness practices during the postpartum period may contribute to a mother's psychological wellbeing. The perception of mindfulness as a shelter had not previously been reported. Future research could address whether this role is specific to the postpartum period.

Use of patient ethnography to support quality improvement in benign prostatic hyperplasia.

PubMed

Kaplan, A L; Klein, M P; Tan, H J; Setlur, N P; Agarwal, N; Steinberg, K; Saigal, C S

2014-12-01

Patient-centeredness is a primary aim of quality improvement (QI) but optimal strategies to achieve that goal remain elusive. Benign prostatic hyperplasia (BPH) is one of the commonest urologic diagnoses and significantly affects quality of life. Patient ethnography is an emerging qualitative method of observation and dynamic interviews to understand the context through which the patient experiences care. We implemented patient ethnography to support our QI infrastructure and improve patient-centeredness in BPH. Little is known about how to measure whether processes of care are patient-centered. We did not know whether the care processes our patients experienced provided value from their perspective. We sought to discover previously unrecognized components of care that patients perceived to be of low value. Our primary goal was to develop QI initiatives that targeted low-value themes identified in the ethnography. Our secondary goal was a rapid rollout of three targeted initiatives. We used a 4-step patient ethnography: (1) created detailed process maps to define phases of care, (2) interviewed patients, (3) synthesized transcript data in focus groups using the Crawford Slip method, and (4) targeted undesirable components of care for QI. Semi-structured interviews with seven representative patients identified low-value themes. Focus groups, comprised of primary care physicians, case coordinators, nurses, and urologists, evaluated the interview transcripts and generated improvement opportunities prioritized based on feasibility, patient value, scalability, and innovation. We used affinity mapping and priority matrix techniques to prioritize QI opportunities. We identified five low-value themes from the patient interviews and developed corresponding QI opportunities. These included issues surrounding the referral and consultation process as well as postoperative care, especially home urinary catheter maintenance. Six months after completing the ethnography three of five targeted improvement opportunities had been implemented. Copyright © 2014 Elsevier Inc. All rights reserved.

Computer-aided personal interviewing. A new technique for data collection in epidemiologic surveys.

PubMed

Birkett, N J

1988-03-01

Most epidemiologic studies involve the collection of data directly from selected respondents. Traditionally, interviewers are provided with the interview in booklet form on paper and answers are recorded therein. On receipt at the study office, the interview results are coded, transcribed, and keypunched for analysis. The author's team has developed a method of personal interviewing which uses a structured interview stored on a lap-sized computer. Responses are entered into the computer and are subject to immediate error-checking and correction. All skip-patterns are automatic. Data entry to the final data-base involves no manual data transcription. A pilot evaluation with a preliminary version of the system using tape-recorded interviews in a test/re-test methodology revealed a slightly higher error rate, probably related to weaknesses in the pilot system and the training process. Computer interviews tended to be longer but other features of the interview process were not affected by computer. The author's team has now completed 2,505 interviews using this system in a community-based blood pressure survey. It has been well accepted by both interviewers and respondents. Failure to complete an interview on the computer was uncommon (5 per cent) and well-handled by paper back-up questionnaires. The results show that computer-aided personal interviewing in the home is feasible but that further evaluation is needed to establish the impact of this methodology on overall data quality.

Reimagining Educational Research: A Conversation

ERIC Educational Resources Information Center

Carter, Prudence L.; Nasir, Na'ilah Suad

2017-01-01

The following is a transcript of an interview between the Dean of the University of California (UC) Berkeley's Graduate School of Education, Prudence Carter, and UC Berkeley's outgoing Vice Chancellor for Equity and Inclusion, Na'ilah Suad Nasir, recorded at the 2017 Graduate School of Education Research Day.

Parenting.

ERIC Educational Resources Information Center

Spock, Benjamin; And Others

Various aspects of child-rearing are covered in this transcript of a program broadcast in the National Public Radio weekly series, "Options in Education." Authors of current popular books on parenting are interviewed. Benjamin Spock discusses changes (including sex role revisions) in his "Baby and Child Care" since the 1946…

How does uncertainty shape patient experience in advanced illness? A secondary analysis of qualitative data.

PubMed

Etkind, Simon Noah; Bristowe, Katherine; Bailey, Katharine; Selman, Lucy Ellen; Murtagh, Fliss Em

2017-02-01

Uncertainty is common in advanced illness but is infrequently studied in this context. If poorly addressed, uncertainty can lead to adverse patient outcomes. We aimed to understand patient experiences of uncertainty in advanced illness and develop a typology of patients' responses and preferences to inform practice. Secondary analysis of qualitative interview transcripts. Studies were assessed for inclusion and interviews were sampled using maximum-variation sampling. Analysis used a thematic approach with 10% of coding cross-checked to enhance reliability. Qualitative interviews from six studies including patients with heart failure, chronic obstructive pulmonary disease, renal disease, cancer and liver failure. A total of 30 transcripts were analysed. Median age was 75 (range, 43-95), 12 patients were women. The impact of uncertainty was frequently discussed: the main related themes were engagement with illness, information needs, patient priorities and the period of time that patients mainly focused their attention on (temporal focus). A typology of patient responses to uncertainty was developed from these themes. Uncertainty influences patient experience in advanced illness through affecting patients' information needs, preferences and future priorities for care. Our typology aids understanding of how patients with advanced illness respond to uncertainty. Assessment of these three factors may be a useful starting point to guide clinical assessment and shared decision making.

Barriers and facilitators to the implementation of a school-based physical activity policy in Canada: application of the theoretical domains framework.

PubMed

Weatherson, Katie A; McKay, Rhyann; Gainforth, Heather L; Jung, Mary E

2017-10-23

In British Columbia Canada, a Daily Physical Activity (DPA) policy was mandated that requires elementary school teachers to provide students with opportunities to achieve 30 min of physical activity during the school day. However, the implementation of school-based physical activity policies is influenced by many factors. A theoretical examination of the factors that impede and enhance teachers' implementation of physical activity policies is necessary in order to develop strategies to improve policy practice and achieve desired outcomes. This study used the Theoretical Domains Framework (TDF) to understand teachers' barriers and facilitators to the implementation of the DPA policy in one school district. Additionally, barriers and facilitators were examined and compared according to how the teacher implemented the DPA policy during the instructional school day. Interviews were conducted with thirteen teachers and transcribed verbatim. One researcher performed barrier and facilitator extraction, with double extraction occurring across a third of the interview transcripts by a second researcher. A deductive and inductive analytical approach in a two-stage process was employed whereby barriers and facilitators were deductively coded using TDF domains (content analysis) and analyzed for sub-themes within each domain. Two researchers performed coding. A total of 832 items were extracted from the interview transcripts. Some items were coded into multiple TDF domains, resulting in a total of 1422 observations. The most commonly coded TDF domains accounting for 75% of the total were Environmental context and resources (ECR; n = 250), Beliefs about consequences (n = 225), Social influences (n = 193), Knowledge (n = 100), and Intentions (n = 88). Teachers who implemented DPA during instructional time differed from those who relied on non-instructional time in relation to Goals, Behavioural regulation, Social/professional role and identity, Beliefs about Consequences. Forty-one qualitative sub-themes were identified across the fourteen domains and exemplary quotes were highlighted. Teachers identified barriers and facilitators relating to all TDF domains, with ECR, Beliefs about consequences, Social influences, Knowledge and Intentions being the most often discussed influencers of DPA policy implementation. Use of the TDF to understand the implementation factors can assist with the systematic development of future interventions to improve implementation.

Tobacco use induces anti-apoptotic, proliferative patterns of gene expression in circulating leukocytes of Caucasian males

PubMed Central

Charles, Peter C; Alder, Brian D; Hilliard, Eleanor G; Schisler, Jonathan C; Lineberger, Robert E; Parker, Joel S; Mapara, Sabeen; Wu, Samuel S; Portbury, Andrea; Patterson, Cam; Stouffer, George A

2008-01-01

Background Strong epidemiologic evidence correlates tobacco use with a variety of serious adverse health effects, but the biological mechanisms that produce these effects remain elusive. Results We analyzed gene transcription data to identify expression spectra related to tobacco use in circulating leukocytes of 67 Caucasian male subjects. Levels of cotinine, a nicotine metabolite, were used as a surrogate marker for tobacco exposure. Significance Analysis of Microarray and Gene Set Analysis identified 109 genes in 16 gene sets whose transcription levels were differentially regulated by nicotine exposure. We subsequently analyzed this gene set by hyperclustering, a technique that allows the data to be clustered by both expression ratio and gene annotation (e.g. Gene Ontologies). Conclusion Our results demonstrate that tobacco use affects transcription of groups of genes that are involved in proliferation and apoptosis in circulating leukocytes. These transcriptional effects include a repertoire of transcriptional changes likely to increase the incidence of neoplasia through an altered expression of genes associated with transcription and signaling, interferon responses and repression of apoptotic pathways. PMID:18710571

Health care providers' perceived barriers to and need for the implementation of a national integrated health care standard on childhood obesity in the Netherlands - a mixed methods approach.

PubMed

Schalkwijk, Annemarie A H; Nijpels, Giel; Bot, Sandra D M; Elders, Petra J M

2016-03-08

In 2010, a national integrated health care standard for (childhood) obesity was published and disseminated in the Netherlands. The aim of this study is to gain insight into the needs of health care providers and the barriers they face in terms of implementing this integrated health care standard. A mixed-methods approach was applied using focus groups, semi-structured, face-to-face interviews and an e-mail-based internet survey. The study's participants included: general practitioners (GPs) (focus groups); health care providers in different professions (face-to-face interviews) and health care providers, including GPs; youth health care workers; pediatricians; dieticians; psychologists and physiotherapists (survey). First, the transcripts from the focus groups were analyzed thematically. The themes identified in this process were then used to analyze the interviews. The results of the analysis of the qualitative data were used to construct the statements used in the e-mail-based internet survey. Responses to items were measured on a 5-point Likert scale and were categorized into three outcomes: 'agree' or 'important' (response categories 1 and 2), 'disagree' or 'not important'. Twenty-seven of the GPs that were invited (51 %) participated in four focus groups. Seven of the nine health care professionals that were invited (78 %) participated in the interviews and 222 questionnaires (17 %) were returned and included in the analysis. The following key barriers were identified with regard to the implementation of the integrated health care standard: reluctance to raise the subject; perceived lack of motivation and knowledge on the part of the parents; previous negative experiences with lifestyle programs; financial constraints and the lack of a structured multidisciplinary approach. The main needs identified were: increased knowledge and awareness on the part of both health care providers and parents/children; a social map of effective intervention; structural funding; task rearrangements; a central care coordinator and structural information feedback from the health care providers involved. The integrated health care standard stipulate that the care of overweight or obese children be provided using an integrated approach. The barriers and needs identified in this study can be used to define strategies to improve the implementation of the integrated health care standard pertaining to overweight and obese children in the Netherlands.

The potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education.

PubMed

Stenov, Vibeke; Wind, Gitte; Skinner, Timothy; Reventlow, Susanne; Hempler, Nana Folmann

2017-09-18

Healthcare professionals' person-centered communication skills are pivotal for successful group-based diabetes education. However, healthcare professionals are often insufficiently equipped to facilitate person-centeredness and many have never received post-graduate training. Currently, assessing professionals' skills in conducting group-based, person-centered diabetes education primarily focus on experts measuring and coding skills on various scales. However, learner-centered approaches such as adequate self-reflective tools have been shown to emphasize professional autonomy and promote engagement. The aim of this study was to explore the potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education. The study entails of two components: 1) Field observations of five different educational settings including 49 persons with diabetes and 13 healthcare professionals, followed by interviews with 5 healthcare professionals and 28 persons with type 2 diabetes. 2) One professional development workshop involving 14 healthcare professionals. Healthcare professionals were asked to assess their person-centered communication skills using a self-assessment tool based on challenges and skills related to four educator roles: Embracer, Facilitator, Translator, and Initiator. Data were analyzed by hermeneutic analysis. Theories derived from theoretical model 'The Health Education Juggler' and techniques from 'Motivational Interviewing in Groups' were used as a framework to analyze data. Subsequently, the analysis from the field notes and interview transcript were compared with healthcare professionals' self-assessments of strengths and areas in need to effectively facilitate group-based, person-centered diabetes education. Healthcare professionals self-assessed the Translator and the Embracer to be the two most skilled roles whereas the Facilitator and the Initiator were identified to be the most challenged roles. Self-assessments corresponded to observations of professional skills in educational programs and were confirmed in the interviews. Healthcare professionals self-assessed the same professional skills as observed in practice. Thus, a tool to self-assess professional skills in facilitating group-based diabetes education seems to be useful as a starting point to promote self-reflections and identification of healthcare professionals' strengths and areas of need of professional development.

Ambiguous Loss Experienced by Transnational Mexican Immigrant Families.

PubMed

Solheim, Catherine; Zaid, Samantha; Ballard, Jaime

2016-06-01

In this study, an ambiguous loss framework as described by Boss (1999, Ambiguous loss: Learning to live with unresolved grief, First Harvard University Press, Cambridge, MA) was used to examine and understand the family experiences of Mexican immigrant agricultural workers in Minnesota. Transcripts from interviews with 17 workers in Minnesota and 17 family members in Mexico were analyzed using qualitative methodology to identify experiences of ambiguous loss in the participants' narratives. Key dimensions of ambiguous loss identified in the transcripts include: psychological family, feelings of chronic/recurring loss, finding support, and meaning making. In the category of psychological family, participants in both Mexico and the United States mourned the physical absence of their family members and experienced ambiguity regarding family responsibilities, but worked to maintain their psychological roles within the family. In the category of chronic/recurring loss, participants in both countries experienced chronic worry from not knowing if family members were safe, ambiguity regarding when the immigrant would return, and chronic stressors that compounded these feelings of loss. Participants in both countries coped with both real and ambiguous losses by accessing family support and by using ambiguous communication to minimize worry. Participants in Mexico also accessed work and community-based support. Participants in both countries made meaning of the ambiguous loss by identifying ways their lives were improved and goals were met as a result of the immigration for agricultural work in Minnesota. © 2015 Family Process Institute.

Parents' and professionals' perceptions of family-centered care for children with autism spectrum disorder across service sectors.

PubMed

Hodgetts, Sandra; Nicholas, David; Zwaigenbaum, Lonnie; McConnell, David

2013-11-01

Family-centered care (FCC) has been linked with improved parent and child outcomes, yet its implementation can be challenging due to family, professional, organizational and systemic factors and policies. This study aims to increase knowledge and understanding of how families with children with autism spectrum disorder (ASD) experience FCC in Alberta, Canada. 152 parents with a child with ASD completed the Measure of Processes of Care, separately for each utilized service sector, and 146 professionals working with persons with ASD completed the Measure of Processes of Care - Service Providers. Additionally, in-depth interviews were conducted with a sub-sample of 19 parents, purposefully sampled for diversity in child and family characteristics. Data were collected in 2011. Descriptive and inferential statistics were used to analyze quantitative data. Interview transcripts were analyzed using grounded theory constant comparison methods, yielding a data generated theoretical model depicting families' experiences with FCC over time and across service sectors. There were no statistically significant differences in FCC scores across service sectors, but statistically significant differences in FCC scores between parents' and professionals' were found. Qualitative data revealed positive experiences and perceptions of receiving FCC from professionals "on the ground" across sectors, but negative experiences and perceptions of FCC at the systems level (i.e., administration, funders). These broad experiences emerged as a core theme "System of Exclusion", which integrated the key themes: (1) "The Fight", (2) "Roles and Restrictions of Care", and (3) "Therapeutic Rapport". Professionals and service providers can use findings to ensure that services reflect current conceptualizations of FCC, and decision and policy makers can use findings to recognize systemic barriers to implementing FCC and inform policy change. Copyright © 2013 Elsevier Ltd. All rights reserved.

Undergraduate nursing students integrating health literacy in clinical settings.

PubMed

Zanchetta, Margareth; Taher, Yasmin; Fredericks, Suzanne; Waddell, Janice; Fine, Carol; Sales, Rona

2013-09-01

Analyzing students' performance and self-criticism of their roles in promoting health literacy can inform nursing education in a social environment that expects new graduates to be health promoters. The pilot study reported here aimed to a) analyze students' understanding of and sensitivity to issues of health literacy, (b) identify students' perceptions of structural, organizational, and political barriers to the promotion of health literacy in social and health care organizations, and (c) document students' suggestions for curriculum changes that would develop their skills and competencies as health-literacy promoters. A qualitative pilot study. A collaborative undergraduate nursing degree program in the metropolitan area of Toronto, Canada. Sixteen undergraduate, Year 4 nursing students. Signed informed consent was obtained from the participants. Participation was unpaid and voluntary. Recruitment was through an email invitation sent by the School of Nursing Student Affairs Coordinator. Three, one-time individual interviews and three focus groups were conducted. All were audio-recorded. Recordings were transcribed, and the transcriptions were coded using the qualitative software ATLAS ti 6.0. The interview data were submitted to thematic analysis. Additional data were gathered from the two-page self-assessments in students' academic portfolios. Sensitivity to health literacy was documented. Students performed best as health promoters in supportive teaching hospitals. Their performance was hindered by clinical settings unsupportive of health education, absence of role models, and insufficient theoretical preparation for health teaching. Students' sensitivity to their clients' diversity reportedly reinforced the interconnection, in multicultural healthcare settings, between health literacy and other social determinants of health and a growing demand for educating future nurses in expanding their role also as health promoters. Students recommended more socially inclusive and experiential learning initiatives related to health teaching to address education gaps in classrooms and practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Strategies used by breast cancer survivors to address work-related limitations during and after treatment.

PubMed

Sandberg, Joanne C; Strom, Carla; Arcury, Thomas A

2014-01-01

The primary objective of this exploratory study was to delineate the broad range of adjustments women breast cancer survivors draw upon to minimize cancer-related limitations at the workplace. The study also analyzed whether survivors used strategies to address work-related limitations in isolation or in combination with other strategies, and whether they used formal or informal strategies. Semi-structured, in-depth interviews were conducted with 14 women who were employed at the time of diagnosis of breast cancer and who continued to work during treatment or returned to work. Interviews were conducted 3 to 24 months after diagnosis. An iterative process was used to systematically analyze the data (the transcripts) using qualitative methods. Participants who worked during or after treatment adjusted their work schedule, performed fewer or other tasks, modified or changed their work environment, reduced non-work activities at the workplace, used cognitive prompts, and acted preemptively to make work tasks manageable after their return to work. Survivors used multiple adjustments and drew upon both formal and informal tactics to minimize or prevent cancer- or treatment-related effects from negatively affecting job performance. Knowledge about the broad range of both formal and informal strategies identified in this study may enable health care and social services providers, as well as cancer survivors and employers, to identify a wide range of specific strategies that may reduce the negative effects of work-related limitations in specific work settings. Insights gained from this analysis should inform future research on work and cancer survivorship. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Oral History Interview Transcripts Tombigbee Historic Townsites Project. Volume 5 (Interview Numbers 123-128).

DTIC Science & Technology

1981-01-01

and Mama had throe in college when the Depression hit. I was still in junior high sceaool. At that time, they consolidated the Aberdeen Separate School...What brought you to Clay County? A: Well, I was just hunting labor. That was in the Depression days. We were hunting labor and moved down to the...all through the Depression period! 780 A: Yes, ma’am, and then plumb up to the Second World War. We started sawmilling just before World War II when

The Activities, Roles, and Relationships of Successful First-Generation College Students

ERIC Educational Resources Information Center

Demetriou, Cynthia; Meece, Judith; Eaker-Rich, Deborah; Powell, Candice

2017-01-01

This qualitative study describes the experiences of 16 successful first-generation college students (FGCS) utilizing a theoretical lens, informed significantly by bioecological systems theory (Bronfenbrenner, 1979), which guided our qualitative analyses of interview transcripts to examine the activities, roles, and relationships of these students…

A Relational Metric, Its Application to Domain Analysis, and an Example Analysis and Model of a Remote Sensing Domain

DOT National Transportation Integrated Search

1995-07-01

An objective and quantitative method has been developed for deriving models of complex and specialized spheres of activity (domains) from domain-generated verbal data. The method was developed for analysis of interview transcripts, incident reports, ...

Analysis of Students' Arguments on Evolutionary Theory

ERIC Educational Resources Information Center

Basel, Nicolai; Harms, Ute; Prechtl, Helmut

2013-01-01

A qualitative exploratory study was conducted to reveal students' argumentation skills in the context of the topic of evolution. Transcripts from problem-centred interviews on secondary students' beliefs about evolutionary processes of adaptation were analysed using a content analysis approach. For this purpose two categorical systems were…

The nurse theorists: 21st-century updates--Madeleine M. Leininger.

PubMed

Fawcett, Jacqueline

2002-04-01

This edited transcript of an interview with Madeleine Leininger presents Leininger's recent thoughts about the development and current state of the discipline of nursing, the development of the theory of culture care diversity and universality, methods for nursing research, mentorship, and transcultural nursing practice.

Stories From the Field: The Use of Information and Communication Technologies to Address the Health Needs of Underserved Populations in Latin America and the Caribbean

PubMed Central

Faba, Gladys; Julian, Soroya; Mejía, Felipe; Cabieses, Báltica; D'Agostino, Marcelo; Cortinois, Andrea A

2015-01-01

Background As their availability grew exponentially in the last 20 years, the use of information and communication technologies (ICT) in health has been widely espoused, with many emphasizing their potential to decrease health inequities. Nonetheless, there is scarce availability of information regarding ICT as tools to further equity in health, specifically in Latin American and Caribbean settings. Objective Our aim was to identify initiatives that used ICT to address the health needs of underserved populations in Latin America and Caribbean. Among these projects, explore the rationale behind the selection of ICT as a key component, probe perceptions regarding contributions to health equity, and describe the challenges faced during implementation. Methods We conducted an exploratory qualitative study. Interviews were completed via Skype or face-to-face meetings using a semistructured interview guide. Following participant consent, interviews were audio recorded and verbatim transcriptions were developed. All transcriptions were coded using ATLASti7 software. The text was analyzed for patterns, shared themes, and diverging opinions. Emerging findings were reviewed by all interviewers and shared with participants for feedback. Results We interviewed representatives from eight organizations in six Latin American and Caribbean countries that prominently employed ICT in health communication, advocacy, or surveillance projects. ICT expanded project's geographic coverage, increased their reach into marginalized or hard-to-reach groups, and allowed real-time data collection. Perceptions of contributions to health equity resided mainly in the provision of health information and linkage to health services to members of groups experiencing greater morbidity because of poverty, remote place of residence, lack of relevant public programs, and/or stigma and discrimination, and in more timely responses by authorities to the health needs of these groups as a result of the increased availability of strategic information on morbidity and its social determinants. Most projects faced initial resistance to implementation because of lack of precedents. Their financial and technical sustainability was threatened by reliance on external funding and weak transitional structures amidst key staff changes. Projects often experienced challenges in establishing meaningful communication with target audience members, mainly because of divergent motivations behind ICT use between projects and its target audience and the lack of access or familiarity with ICT among the most underserved members of such audiences. Conclusions ICT can benefit projects focusing on the health needs of underserved populations by expanding the breadth and depth of target audience coverage and improving data management. Most projects tended to be small, short-term pilot interventions with limited engagement with the formal health sector and did not include health equity as an explicit component. Collaborative projects with government institutions, particularly those with health surveillance objectives, seemed to be the most optimistic about long-term sustainability. PMID:27227124

Understanding Responses to High School Exit Exams in Literacy: A Bourdieusian Analysis of Poetic Transcriptions

ERIC Educational Resources Information Center

Huddleston, Andrew P.

2012-01-01

In this article, the author demonstrates how a Bourdieusian analysis of poetic transcriptions offers great potential for helping teachers and students to understand how they are responding to state policy mandates in schools. Specifically, the author uses Bourdieu's concepts of field, capital, and habitus to analyze two poetic transcriptions,…

How I remember my parents' divorce: a phenomenological investigation.

PubMed

Stambaugh, Suzanne E; Hector, Mark A; Carr, Austin R

2011-01-01

In order to examine the experience of parental divorce for adult women, a phenomenological method was used. Ten women were interviewed and the interviews were transcribed verbatim and thematized. The themes that came from the texts of the interviews transcripts and the researchers' reflections on the phenomenological research group analysis were: Before the Divorce, During the Divorce, and After the Divorce. These themes were centered on a contextual ground of Time Frame of the Divorce. The results of this study can provide individuals with a context for understanding their own experiences of parental divorce. These results could also be helpful for mental health clinicians in anticipating the themes that clients will discuss relative to the stages of their parents' divorce.

The Meaning of the Child Interview: A new procedure for assessing and understanding parent-child relationships of 'at-risk' families.

PubMed

Grey, Ben; Farnfield, Steve

2017-04-01

Reder and Duncan's well-known studies of the 1990s on fatal child abuse drew attention to how parental scripts regarding their children could dangerously distort relationships in ways that were sometimes fatal to children. This article reports on a new system for assessing the 'meaning of the child to the parent', called the Meaning of the Child Interview (MotC). Parents are interviewed using the established Parent Development Interview, or equivalent, and the transcript of the interview is then analysed according to parental sensitivity and likely risk to the child. The MotC constructs were developed from those used in observed parent-child interaction (specifically, the CARE-Index) and the form of discourse analysis used in the Dynamic Maturational Model - Adult Attachment Interview, allowing a more systemic and inter-subjective understanding of parenting representations than often put forward. This article discusses the theoretical background to the MotC, gives a brief review of similar measures and then introduces the coding system and patterns of caregiving. The validity of the MotC is addressed elsewhere.

Illegitimate transcription: transcription of any gene in any cell type.

PubMed Central

Chelly, J; Concordet, J P; Kaplan, J C; Kahn, A

1989-01-01

Using in vitro amplification of cDNA by the polymerase chain reaction, we have detected spliced transcripts of various tissue-specific genes (genes for anti-Müllerian hormone, beta-globin, aldolase A, and factor VIIIc) in human nonspecific cells, such as fibroblasts, hepatoma cells, and lymphoblasts. In rats, erythroid- and liver-type pyruvate kinase transcripts were also detected in brain, lung, and muscle. The abundance of these "illegitimate" transcripts is very low; yet, their existence and the possibility of amplifying them by the cDNA polymerase chain reaction provide a powerful tool to analyze pathological transcripts of any tissue-specific gene by using any accessible cell. Images PMID:2495532

Computer assessment of interview data using latent semantic analysis.

PubMed

Dam, Gregory; Kaufmann, Stefan

2008-02-01

Clinical interviews are a powerful method for assessing students' knowledge and conceptualdevelopment. However, the analysis of the resulting data is time-consuming and can create a "bottleneck" in large-scale studies. This article demonstrates the utility of computational methods in supporting such an analysis. Thirty-four 7th-grade student explanations of the causes of Earth's seasons were assessed using latent semantic analysis (LSA). Analyses were performed on transcriptions of student responses during interviews administered, prior to (n = 21) and after (n = 13) receiving earth science instruction. An instrument that uses LSA technology was developed to identify misconceptions and assess conceptual change in students' thinking. Its accuracy, as determined by comparing its classifications to the independent coding performed by four human raters, reached 90%. Techniques for adapting LSA technology to support the analysis of interview data, as well as some limitations, are discussed.

Integrity of Practice in Lecturers' Accounts of Teaching Decisions

ERIC Educational Resources Information Center

Young, Pat; Irving, Zoe

2005-01-01

This article draws on data collected during a funded research project on undergraduate teaching within a single discipline, social policy. Starting from observations drawn from analysis of the interview transcripts, the article develops the concept of "integrity of practice" from the literature on reflective practice and the scholarship of…

The Context of Medical Decision-Making: An Analysis of Practitioner/Patient Communication.

ERIC Educational Resources Information Center

Fisher, Sue

This paper examines how the exchange of information in medical interviews is organized, and how that organization produces and constrains the negotiation of treatment decisions. The analysis is drawn from the verbatim transcripts of audio-taped practitioner/patient communications, information gathered from medical files, and other ethnographic…

Swedish Upper Secondary Students' Perspectives on the Typical Mathematics Lesson

ERIC Educational Resources Information Center

Andrews, Paul; Larson, Niclas

2017-01-01

This paper presents a group interview study of Swedish upper secondary students' perspectives on the typical mathematics lesson. Students, from four demographically different schools, constructed a collective synthesis of their many years' experience of mathematics classrooms. Transcriptions were subjected to a constant comparison analysis, which…

Anti-Americanism: A Perfect Addition to a Russian Authoritarian’s Political Toolbox

DTIC Science & Technology

2013-12-01

Putin’s autobiographical interview book First Person. Primary source transcripts from the Russian government’s public online archives will be...80. 36 Ibid., 106. 20 could not directly affect the repeated snubbing that Yeltsin incurred from the West, the memories of how the United

High and Low Visualization Skills and Pedagogical Decision of Preservice Secondary Mathematics Teachers

ERIC Educational Resources Information Center

Unal, Hasan

2011-01-01

The purpose of this study was to investigate the preservice secondary mathematics teachers' development of pedagogical understanding in the teaching of modular arithmetic problems. Data sources included, written assignments, interview transcripts and filed notes. Using case study and action research approaches cases of three preservice teachers…

Understanding the Memorable Messages First-Generation College Students Receive from On-Campus Mentors

ERIC Educational Resources Information Center

Wang, Tiffany R.

2012-01-01

The current study examined the memorable messages first-generation college students received from their on-campus mentors about college and family. Accordingly, 30 first-generation college students shared mentors' memorable messages during in-depth, semistructured, responsive interviews. Four hundred sixty-seven pages of transcripts were analyzed…

Women's Leadership Development: A Study of Defining Moments

ERIC Educational Resources Information Center

Dahlvig, Jolyn E.; Longman, Karen A.

2010-01-01

This article reports the findings of a grounded theory study of "defining moments" that were described as pivotal in the personal and professional journeys of women who had been identified as emerging leaders within Christian higher education. Analysis of transcripts from interviews with 16 participants in a Women's Leadership Development…

Frontline Worker Responses to Domestic Violence Disclosure in Public Welfare Offices

ERIC Educational Resources Information Center

Lindhorst, Taryn; Casey, Erin; Meyers, Marcia

2010-01-01

Although substantial numbers of women seeking Temporary Assistance for Needy Families (TANF) report domestic violence, few receive mandated services through the Family Violence Option (FVO). This study used transcripts of interviews between welfare caseworkers and their clients to identify and classify the responses made by workers to client…

Tiempos Pasados (Past Times). Grass-Roots Oral History.

ERIC Educational Resources Information Center

Hunsaker, Alan, Ed.

Compiled with learning objectives, suggested lesson plans, learning center activities, and selected teacher and student bibliographies for use at the elementary level, transcripts of oral history interviews with 11 Mexican Americans in San Bernardino County's West End provide understanding of the mass movement of Mexicans to the United States in…

A Chinese Teacher's Perspective on Professional Development in Literacy Education

ERIC Educational Resources Information Center

Syed, Khalida Tanvir

2008-01-01

This paper presents the teaching and learning experiences of a Chinese literacy teacher in narrative form. The participant's story is presented in his own voice, as constructed from interview transcripts. Challenges and struggles faced by the participant include limited professional autonomy in a hierarchal school system, awareness of conflict…

Live Supervision in Family Therapy: An Interview With Barbara Okun and Fred Piercy.

ERIC Educational Resources Information Center

West, John D.; And Others

1989-01-01

Describes special program on live supervision in family therapy given at 1988 annual American Association for Counseling and Development (AACD) Conference that featured experts Barbara Okun and Fred Piercy discussing "cotherapy" and "one-way mirror" live supervision approaches. Provides edited transcript of their program.…

Pharmacists Views and Practices in Regard to Sales of Antibiotics Without a Prescription in Madinah, Saudi Arabia.

PubMed

Bahnassi, Anas

2016-09-01

The aim of this study was to investigate pharmacists views and practices in Madinah, Saudi Arabia, through conducting direct interviews including direct questions and hypothetical scenarios. A purposeful sample of 150 community pharmacists of different ethnic and educational backgrounds were approached to participate in the study. Semistructured interviews including general questions and 5 hypothetical scenarios were used for the investigation. Complete transcripts of the interviews were prepared. All transcripts were coded and categorized into main themes using a computer software. Fifty-four pharmacists agreed to participate (response rate, 36%). Sale of antibiotics without prescription is commonly practiced in Saudi Arabia. Lack of legislation enforcement has exacerbated this practice. Economic hardship, patient's age, emotional factors, and pharmacists' self confidence in diagnosing and prescribing medications in general and antibiotics in particular were the themes included in the interviews and influenced pharmacists' decision to sell antibiotics without a prescription.Many pharmacists did not see the practice as a problem and felt capable of continuing to dispense antibiotics without a prescription. Pharmacists who saw the practice as a problem sees legislation enforcement to be the solution of the problem. Pharmacist views and practices are alarming. The results of this study show that this practice will continue to spread unless strict enforcement is put in place, Lack of clear understanding of the limitations of pharmacist's scope of practice. Results of these studies can be extrapolated to other countries in the region and other countries of the similar social and professional development status.

Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

PubMed

Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

2018-05-15

MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

Identification of Reference Genes for Real-Time Quantitative PCR Experiments in the Liverwort Marchantia polymorpha

PubMed Central

Dolan, Liam; Langdale, Jane A.

2015-01-01

Real-time quantitative polymerase chain reaction (qPCR) has become widely used as a method to compare gene transcript levels across different conditions. However, selection of suitable reference genes to normalize qPCR data is required for accurate transcript level analysis. Recently, Marchantia polymorpha has been adopted as a model for the study of liverwort development and land plant evolution. Identification of appropriate reference genes has therefore become a necessity for gene expression studies. In this study, transcript levels of eleven candidate reference genes have been analyzed across a range of biological contexts that encompass abiotic stress, hormone treatment and different developmental stages. The consistency of transcript levels was assessed using both geNorm and NormFinder algorithms, and a consensus ranking of the different candidate genes was then obtained. MpAPT and MpACT showed relatively constant transcript levels across all conditions tested whereas the transcript levels of other candidate genes were clearly influenced by experimental conditions. By analyzing transcript levels of phosphate and nitrate starvation reporter genes, we confirmed that MpAPT and MpACT are suitable reference genes in M. polymorpha and also demonstrated that normalization with an inappropriate gene can lead to erroneous analysis of qPCR data. PMID:25798897

Systematic analysis of transcribed loci in ENCODE regions using RACE sequencing reveals extensive transcription in the human genome.

PubMed

Wu, Jia Qian; Du, Jiang; Rozowsky, Joel; Zhang, Zhengdong; Urban, Alexander E; Euskirchen, Ghia; Weissman, Sherman; Gerstein, Mark; Snyder, Michael

2008-01-03

Recent studies of the mammalian transcriptome have revealed a large number of additional transcribed regions and extraordinary complexity in transcript diversity. However, there is still much uncertainty regarding precisely what portion of the genome is transcribed, the exact structures of these novel transcripts, and the levels of the transcripts produced. We have interrogated the transcribed loci in 420 selected ENCyclopedia Of DNA Elements (ENCODE) regions using rapid amplification of cDNA ends (RACE) sequencing. We analyzed annotated known gene regions, but primarily we focused on novel transcriptionally active regions (TARs), which were previously identified by high-density oligonucleotide tiling arrays and on random regions that were not believed to be transcribed. We found RACE sequencing to be very sensitive and were able to detect low levels of transcripts in specific cell types that were not detectable by microarrays. We also observed many instances of sense-antisense transcripts; further analysis suggests that many of the antisense transcripts (but not all) may be artifacts generated from the reverse transcription reaction. Our results show that the majority of the novel TARs analyzed (60%) are connected to other novel TARs or known exons. Of previously unannotated random regions, 17% were shown to produce overlapping transcripts. Furthermore, it is estimated that 9% of the novel transcripts encode proteins. We conclude that RACE sequencing is an efficient, sensitive, and highly accurate method for characterization of the transcriptome of specific cell/tissue types. Using this method, it appears that much of the genome is represented in polyA+ RNA. Moreover, a fraction of the novel RNAs can encode protein and are likely to be functional.

Re-focusing the ethical discourse on personalized medicine: a qualitative interview study with stakeholders in the German healthcare system.

PubMed

Schleidgen, Sebastian; Marckmann, Georg

2013-05-24

In recent years, personalized medicine (PM) has become a highly regarded line of development in medicine. Yet, it is still a relatively new field. As a consequence, the discussion of its future developments, in particular of its ethical implications, in most cases can only be anticipative. Such anticipative discussions, however, pose several challenges. Nevertheless, they play a crucial role for shaping PM's further developments. Therefore, it is vital to understand how the ethical discourse on PM is conducted, i.e. on what - empirical and normative - assumptions ethical arguments are based regarding PM's current and future developments. To gather this information, we conducted a qualitative interview study with stakeholders in the German health care system. Our purposive sample included 17 representatives of basic research, clinical research, health economics, regulatory authorities, reimbursement institutions, pharmaceutical industry, patient organizations, as well as clinicians and legal experts involved in PM developments or policy making. We used an interview guide with open-ended questions and analyzed transcriptions of the interviews by means of qualitative content analysis. The respondents addressed a multitude of concerns in the context of research on as well as application of personalized preventive and therapeutic measures both on the individual and on the societal level. Interestingly, regarding future developments of PM the ethical evaluation seemed to follow the rule: the less likely its application, the more problematic a PM measure is assessed. The more likely its application, on the other hand, the less problematic it is evaluated. The results of our study suggest re-focusing the ethical discourse on PM in Germany towards a constructive ethical monitoring which ensures to include only, nevertheless all of the actual and/or potential concerns that are ethically relevant in order to allow balancing them against the actual and potential ethically relevant benefits of PM measures. To render this possible, we propose a strategy for evaluating ethical concerns in the context of PM.

Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences

PubMed Central

Anderson, Kevin; Burford, Oksana; Emmerton, Lynne

2016-01-01

Objective Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications (‘apps’) for consumers’ self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps. Materials and Methods ‘Health app’ was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively. Results Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26–35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers’ data. Conclusions The semi-structured interviews provided insight into usage, benefits and challenges of health monitoring using apps. Understanding the range of consumer experiences and expectations can inform design of health apps to encourage persistence in self-monitoring. PMID:27214203

Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists’ perspectives

PubMed Central

Kennelty, Korey A.; Chewning, Betty; Wise, Meg; Kind, Amy; Roberts, Tonya; Kreling, David

2015-01-01

Background Community pharmacists play a vital part in reconciling medications for patients transitioning from hospital to community care, yet their roles have not been fully examined in the extant literature. Objectives The objectives of this study were to: 1) examine the barriers and facilitators community pharmacists face when reconciling medications for recently discharged patients; and 2) identify pharmacists’ preferred content and modes of information transfer regarding updated medication information for recently discharged patients. Methods Community pharmacists were purposively and conveniently sampled from the Wisconsin (U.S. state) pharmacist-based research network, Pharmacy Practice Enhancement and Action Research Link (PEARL Rx). Community pharmacists were interviewed face-to-face, and transcriptions from audio recordings were analyzed using directed content analysis. The Theory of Planned Behavior (TPB) guided the development of questions for the semi-structured interviews. Results Interviewed community pharmacists (N = 10) described the medication reconciliation process to be difficult and time-consuming for recently discharged patients. In the context of the TPB, more barriers than facilitators of reconciling medications were revealed. Themes were categorized as organizational and individual-level themes. Major organizational-level factors affecting the medication reconciliation process included: pharmacy resources, discharge communication, and hospital resources. Major individual-level factors affecting the medication reconciliation process included: pharmacists’ perceived responsibility, relationships, patient perception of pharmacist, and patient characteristics. Interviewed pharmacists consistently responded that several pieces of information items would be helpful when reconciling medications for recently discharged patients, including the hospital medication discharge list and stop-orders for discontinued medications. Conclusions The TPB was useful for identifying barriers and facilitators of medication reconciliation for recently discharged patients from community pharmacists’ perspectives. The elucidation of these specific facilitators and barriers suggest promising avenues for future research interventions to improve exchange of medication information between the community pharmacy, hospitals, and patients. PMID:25586885

Approved Clinical Instructors' Perspectives on Implementation Strategies in Evidence-Based Practice for Athletic Training Students

PubMed Central

Hankemeier, Dorice A.; Van Lunen, Bonnie L.

2011-01-01

Context: Understanding implementation strategies of Approved Clinical Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice. Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.8 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview transcripts were analyzed and coded for common themes and subthemes regarding implementation strategies. Established themes were triangulated through peer review and member checking to verify the data. Results: The ACIs identified EBP implementation as important for validation of the profession, changing paradigm shift, improving patient care, and improving student educational experiences. They promoted 3 methods of implementing EBP concepts with their students: self-discovery, promoting critical thinking, and sharing information. They assisted students with the steps of EBP and often faced challenges in implementation of the first 3 steps of EBP: defining a clinical question, literature searching, and literature appraisal. Finally, ACIs indicated that modeling the behavior of making clinical decisions based on evidence was the best way to encourage students to continue using EBP. Conclusions: Athletic training education program directors should encourage and recommend specific techniques for EBP implementation in the clinical setting. The ACIs believed that role modeling is a strategy that can be used to promote the use of EBP with students. Training of ACIs should include methods by which to address the steps of the EBP process while still promoting critical thinking. PMID:22488192

Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives.

PubMed

Kennelty, Korey A; Chewning, Betty; Wise, Meg; Kind, Amy; Roberts, Tonya; Kreling, David

2015-01-01

Community pharmacists play a vital part in reconciling medications for patients transitioning from hospital to community care, yet their roles have not been fully examined in the extant literature. The objectives of this study were to: 1) examine the barriers and facilitators community pharmacists face when reconciling medications for recently discharged patients; and 2) identify pharmacists' preferred content and modes of information transfer regarding updated medication information for recently discharged patients. Community pharmacists were purposively and conveniently sampled from the Wisconsin (U.S. state) pharmacist-based research network, Pharmacy Practice Enhancement and Action Research Link (PEARL Rx). Community pharmacists were interviewed face-to-face, and transcriptions from audio recordings were analyzed using directed content analysis. The Theory of Planned Behavior (TPB) guided the development of questions for the semi-structured interviews. Interviewed community pharmacists (N = 10) described the medication reconciliation process to be difficult and time-consuming for recently discharged patients. In the context of the TPB, more barriers than facilitators of reconciling medications were revealed. Themes were categorized as organizational and individual-level themes. Major organizational-level factors affecting the medication reconciliation process included: pharmacy resources, discharge communication, and hospital resources. Major individual-level factors affecting the medication reconciliation process included: pharmacists' perceived responsibility, relationships, patient perception of pharmacist, and patient characteristics. Interviewed pharmacists consistently responded that several pieces of information items would be helpful when reconciling medications for recently discharged patients, including the hospital medication discharge list and stop-orders for discontinued medications. The TPB was useful for identifying barriers and facilitators of medication reconciliation for recently discharged patients from community pharmacists' perspectives. The elucidation of these specific facilitators and barriers suggest promising avenues for future research interventions to improve exchange of medication information between the community pharmacy, hospitals, and patients. Published by Elsevier Inc.

Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences.

PubMed

Anderson, Kevin; Burford, Oksana; Emmerton, Lynne

2016-01-01

Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications ('apps') for consumers' self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps. 'Health app' was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively. Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26-35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers' data. The semi-structured interviews provided insight into usage, benefits and challenges of health monitoring using apps. Understanding the range of consumer experiences and expectations can inform design of health apps to encourage persistence in self-monitoring.

"911" Among West African immigrants in New York City: a qualitative study of parents' disciplinary practices and their perceptions of child welfare authorities.

PubMed

Rasmussen, Andrew; Akinsulure-Smith, Adeyinka; Chu, Tracy; Keatley, Eva

2012-08-01

Immigrant parents' perceptions of child protective services may have important implications for their engagement in public institutions that are central to their children's well being. The current study examined West African immigrants' perceptions of child welfare authorities and the role of disciplining and monitoring in these communities' meaning making. A multiethnic group of 59 West African immigrants (32 parents and 27 adolescent children) living in the United States were interviewed in 18 focus groups and eight individual interviews between December 2009 and July 2010. Data were analyzed using a grounded theory approach; strategies for rigor included triangulation (multiple interview formats, varied composition of groups, multiple coders for each transcript), verification (follow-up interviewing, feedback to community-based organizations), and auditability. Primary among parents' concerns were "911" (used to refer to the police and child protective authorities), the loss of collective child monitoring networks, and threats to their children posed by "American" values and neighborhood violence. Children were concerned with parents' close monitoring that resulted in boredom and a sense that parents did not recognize them for adhering to their families' values. Feedback from CBOs suggested that parents got their information about child protective policies from children but that although misinformed they were accurate in their negative assessment of contact. Not unlike in other urban populations, West African immigrants' disciplinary tactics are instrumental, oriented toward protecting their children from the multiple dangers perceived in their surroundings, but may also put them at risk for contact with child protective services. Results suggest that "911" results from a "loss spiral" (Hobfoll, 1989) that begins as West Africans resettle without collective child monitoring networks, leading to increased concern for their children's safety, and interacting with a school-home disciplinary mismatch that may increase the likelihood of contact with child protection. Copyright © 2012 Elsevier Ltd. All rights reserved.

The needs and preferences of pregnant smokers regarding tailored Internet-based smoking cessation interventions: a qualitative interview study.

PubMed

Herbec, Aleksandra; Beard, Emma; Brown, Jamie; Gardner, Benjamin; Tombor, Ildiko; West, Robert

2014-10-14

Internet-based Smoking Cessation Interventions (ISCIs) may help pregnant smokers who are unable, or unwilling, to access face-to-face stop smoking support. Targeting ISCIs to specific groups of smokers could increase their uptake and effectiveness. The current study explored the needs and preferences of pregnant women seeking online stop smoking support with an aim to identify features and components of ISCIs that might be most attractive to this population. We conducted qualitative interviews with thirteen pregnant women who completed the intervention arm of a pilot randomized controlled trial of a novel ISCI for pregnant smokers ('MumsQuit'). The interviews explored women's views towards MumsQuit and online support with quitting smoking in general, as well as their suggestions for how ISCIs could be best targeted to pregnancy. Interview transcripts were analyzed using Framework Analysis. Participants expressed preferences for an accessible, highly engaging and targeted to pregnancy smoking cessation website, tailored to individuals' circumstances as well as use of cessation medication, offering comprehensive and novel information on smoking and quitting smoking in pregnancy, ongoing support with cravings management, as well as additional support following relapse to smoking. Participants also viewed as important targeting of the feedback and progress reports to baby's health and development, offering personal support from experts, and providing a discussion forum allowing for communication with other pregnant women wanting to quit . The present study has identified a number of potential building blocks for ISCIs targeted to quitting smoking in pregnancy. Pregnant smokers willing to try using ISCI may particularly value an engaging intervention offering a high degree of targeting of comprehensive information to them as a group and tailoring support and advice to their individual needs, as well as one providing post-relapse support, peer-to-peer communication and personal support from experts.

A coordination class analysis of college students' judgments about animated motion

NASA Astrophysics Data System (ADS)

Thaden-Koch, Thomas Christian

The coordination class construct was invented by di5essa and Sherin to clarify what it means to learn and use scientific concepts. A coordination class is defined to consist of readout strategies, which guide observation, and the causal net, which contains knowledge necessary for making inferences from observations. A coordination class, as originally specified, reliably extracts a certain class of information from a variety of situations. The coordination class construct is relatively new. To examine its utility, transcripts of interviews with college students were analyzed in terms of the coordination class construct. In the interviews, students judged the realism of several computer animations depicting balls rolling on a pair of tracks. When shown animations with only one ball, students made judgments consistent with focusing on the ball's speed changes. Adding a second ball to each animation strongly affected judgments made by students taking introductory physics courses, but had a smaller effect on judgments made by students taking a psychology course. Reasoning was described in this analysis as the coordination of readouts about animations with causal net elements related to realistic motion. Decision-making was characterized both for individual students and for groups by the causal net elements expressed, by the types of readouts reported, and by the coordination processes involved. The coordination class construct was found useful for describing the elements and processes of student decision-making, but little evidence was found to suggest that the students studied possessed reliable coordination classes. Students' causal nets were found to include several appropriate expectations about realistic motion. Several students reached judgments that appeared contrary to their expectations and reported mutually incompatible expectations. Descriptions of students' decision-making processes often included faulty readouts, or feedback loops in which causal net elements or readouts were adjusted. Comparisons of the interviewed groups' coordination were found to echo differences and similarities in animation judgments made by larger groups of students who were not interviewed.

Conceptual and institutional gaps: understanding how the WHO can become a more effective cross-sectoral collaborator.

PubMed

Gopinathan, Unni; Watts, Nicholas; Hougendobler, Daniel; Lefebvre, Alex; Cheung, Arthur; Hoffman, Steven J; Røttingen, John-Arne

2015-11-24

Two themes consistently emerge from the broad range of academics, policymakers and opinion leaders who have proposed changes to the World Health Organization (WHO): that reform efforts are too slow, and that they do too little to strengthen WHO's capacity to facilitate cross-sectoral collaboration. This study seeks to identify possible explanations for the challenges WHO faces in addressing the broader determinants of health, and the potential opportunities for working across sectors. This qualitative study used a mixed methods approach of semi-structured interviews and document review. Five interviewees were selected by stratified purposive sampling within a sampling frame of approximately 45 potential interviewees, and a targeted document review was conducted. All interviewees were senior WHO staff at the department director level or above. Thematic analysis was used to analyze data from interview transcripts, field notes, and the document review, and data coded during the analysis was analyzed against three central research questions. First, how does WHO conceptualize its mandate in global health? Second, what are the barriers and enablers to enhancing cross-sectoral collaboration between WHO and other intergovernmental organizations? Third, how do the dominant conceptual frames and the identified barriers and enablers to cross-sectoral collaboration interact? Analysis of the interviews and documents revealed three main themes: 1) WHO's role must evolve to meet the global challenges and societal changes of the 21st century; 2) WHO's cross-sectoral engagement is hampered internally by a dominant biomedical view of health, and the prevailing institutions and incentives that entrench this view; and 3) WHO's cross-sectoral engagement is hampered externally by siloed areas of focus for each intergovernmental organization, and the lack of adequate conceptual frameworks and institutional mechanisms to facilitate engagement across siloes. There are a number of external and internal pressures on WHO which have created an organizational culture and operational structure that focuses on a narrow, technical approach to global health, prioritizing disease-based, siloed interventions over more complex approaches that span sectors. The broader approach to promoting human health and wellbeing, which is conceptualized in WHO's constitution, requires cultural and institutional changes for it to be fully implemented.

Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study.

PubMed

Lee, Wei Wei; Alkureishi, Maria A; Ukabiala, Obioma; Venable, Laura Ruth; Ngooi, Samantha S; Staisiunas, Daina D; Wroblewski, Kristen E; Arora, Vineet M

2016-11-01

While concerns remain regarding Electronic Medical Records (EMR) use impeding doctor-patient communication, resident and faculty patient perspectives post-widespread EMR adoption remain largely unexplored. We aimed to describe patient perspectives of outpatient resident and faculty EMR use and identify positive and negative EMR use examples to promote optimal utilization. This was a prospective mixed-methods study. Internal medicine faculty and resident patients at the University of Chicago's primary care clinic participated in the study. In 2013, one year after EMR implementation, telephone interviews were conducted with patients using open-ended and Likert style questions to elicit positive and negative perceptions of EMR use by physicians. Interview transcripts were analyzed qualitatively to develop a coding classification. Satisfaction with physician EMR use was examined using bivariate statistics. In total, 108 interviews were completed and analyzed. Two major themes were noted: (1) Clinical Functions of EMR and (2) Communication Functions of EMR; as well as six subthemes: (1a) Clinical Care (i.e., clinical efficiency), (1b) Documentation (i.e., proper record keeping and access), (1c) Information Access, (1d) Educational Resource, (2a) Patient Engagement and (2b) Physical Focus (i.e., body positioning). Overall, 85 % (979/1154) of patient perceptions of EMR use were positive, with the majority within the "Clinical Care" subtheme (n = 218). Of negative perceptions, 66 % (115/175) related to the "Communication Functions" theme, and the majority of those related to the "Physical Focus" subtheme (n = 71). The majority of patients (90 %, 95/106) were satisfied with physician EMR use: 59 % (63/107) reported the computer had a positive effect on their relationship and only 7 % (8/108) reported the EMR made it harder to talk with their doctors. Despite concerns regarding EMRs impeding doctor-patient communication, patients reported largely positive perceptions of the EMR with many patients reporting high levels of satisfaction. Future work should focus on improving doctors "physical focus" when using the EMR to redirect towards the patient.

Using interpretative phenomenology to understand the food-related experiences and beliefs of a select group of low-income UK women.

PubMed

Dibsdall, Louise Anne; Lambert, Nigel; Frewer, Lynn Jayne

2002-01-01

The purpose of this study was to provide an in-depth account of the beliefs and experiences pertaining to food and health from a specific group of low-income women in the United Kingdom. Data for this in-depth, qualitative study were collected using audiotaped semistructured interviews. Fourteen white, European women (aged 40 to 60 years) from a defined low-income group were recruited using systematic, nonprobabilistic sampling. Participants lived in a small city in a largely rural region of the United Kingdom. Interview transcripts were analyzed using an interpretative phenomenological approach. They were evaluated independently by several investigators, and, following discussions, a series of "shared themes" were agreed upon. All of the shared themes identified could be grouped into three superthemes or "drivers," which seemed to govern the women's attitudes and behaviors toward food choice and health. "Egocentric systems" related to the uniqueness of the participants and the social worlds they inhabit. "Information characteristics" described what information the participants were exposed to and how it was processed. Finally, "control issues" described how perceptions of control influenced attitudes toward food and health. The study highlights the need for health professionals to consider the different value systems of target groups in health promotion policies. The impact of "New Age" beliefs and the Human Genome Project on public health nutrition are two areas that particularly merit further research.

It’s who I am and what we eat: Mothers’ food-related identities in family food choice

PubMed Central

Johnson, Cassandra M.; Sharkey, Joseph R.; Dean, Wesley R.; McIntosh, W. Alex; Kubena, Karen S.

2011-01-01

This study aimed to understand mothers’ everyday food choices using one type of visual method-participant-driven photo-elicitation (PDPE). The sample consisted of 12 low/moderate income mothers (26–53 years) living in Bryan/College Station, Texas. Each mother completed a photography activity, where she created photographs of her food experience, and an in-depth interview using the mother’s photographs. Interview transcripts were analyzed using a grounded theory approach and coded using qualitative data analysis software ATLAS.ti. Mothers emphasized their identities related to food and eating as they described food-related decisions and activities. These identities influenced a mother’s food choices for herself and those she made for her children. Analysis revealed that mothers with a more defined health identity made healthier choices for themselves and similar food choices for their children. In addition, they exhibited behaviors that positively influenced their children’s food choices. Mothers who struggled to see themselves as healthy indulged with more junk food and indicated feelings of anxiety and guilt; these mothers’ food choices were more disconnected from their children’s. These findings underscore the importance of understanding how identities related to food and eating can influence food choices. Encouraging mothers to develop and maintain health identities may be one way to improve food and eating habits in families. PMID:21600253

Development of the LaComm 1.0, A French medical communication analysis software: A study assessing its sensitivity to change.

PubMed

Gibon, Anne-Sophie; Durieux, Jean-François; Merckaert, Isabelle; Delvaux, Nicole; Farvacques, Christine; Libert, Yves; Marchal, Serge; Moucheux, Angélique; Slachmuylder, Jean-Louis; Razavi, Darius

2017-02-01

To test and compare the sensitivity to change of a communication analysis software, the LaComm 1.0, to the CRCWEM's using data from a randomized study assessing the efficacy of a communication skills training program designed for nurses. The program assessment included the recording of two-person simulated interviews at baseline and after training or 3 months later. Interview transcripts were analyzed using the CRCWEM and the LaComm 1.0 tools. One hundred and nine oncology nurses (mainly graduated or certified) were included in the study. The CRCWEM detected 5 changes out of 13 expected changes (38%) (e.g., more open directive questions after training) and the LaComm 1.0, 4 changes out of 7 expected changes (57%) (e.g., more empathic statements after training). For open directive question, the effect sizes of the group-by-time changes were slightly different between tools (CRCWEM: Cohen's d=0.97; LaComm 1.0: Cohen's d=0.67). This study shows that the LaComm 1.0 is sensitive to change. The LaComm 1.0 is a valid method to assess training effectiveness in French. The use of the Lacomm 1.0 in future French communication skills training programs will allow comparisons of studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Experience of being a low priority patient during waiting time at an emergency department

PubMed Central

Dahlen, Ingrid; Westin, Lars; Adolfsson, Annsofie

2012-01-01

Background Work in the emergency department is characterized by fast and efficient medical efforts to save lives, but can also involve a long waiting time for patients. Patients are given a priority rating upon their arrival in the clinic based on the seriousness of their problem, and nursing care for lower priority patients is given a lower prioritization. Regardless of their medical prioritization, all patients have a right to expect good nursing care while they are waiting. The purpose of this study was to illustrate the experience of the low prioritized patient during their waiting time in the emergency department. Methods A phenomenological hermeneutic research method was used to analyze an interview transcript. Data collection consisted of narrative interviews. The interviewees were 14 patients who had waited more than three hours for surgical, orthopedic, or other medical care. Results The findings resulted in four different themes, ie, being dependent on care, being exposed, being vulnerable, and being secure. Lower priority patients are not paid as much attention by nursing staff. Patients reported feeling powerless, insulted, and humiliated when their care was delayed without their understanding what was happening to them. Not understanding results in exposure that violates self-esteem. Conclusion The goal of the health care provider must be to minimize and prevent suffering, prevent feelings of vulnerability, and to create conditions for optimal patient well being. PMID:22334799

"From Snail Mode to Rocket Ship Mode": Adolescents and Young Adults' Experiences of Returning to Work and School After Hematopoietic Cell Transplantation.

PubMed

Brauer, Eden R; Pieters, Huibrie C; Ganz, Patricia A; Landier, Wendy; Pavlish, Carol; Heilemann, MarySue V

2017-12-01

Resuming normal activities, such as work and school, is an important dimension of psychosocial recovery in cancer survivorship. Minimal data exist regarding adolescents or young adults' experiences of returning to school or work after cancer. The purpose of this study was to explore the processes of resuming work and school among adolescents and young adults after hematopoietic cell transplantation (HCT). In-depth interviews were conducted with 18 adolescents and young adults, who were 15-29 years when they underwent HCT and 6-60 months post-transplant at study enrollment. Interview transcripts were systematically analyzed using Grounded Theory methodology. Participants described the context in which they attempted to return to work or school, specific challenges they faced, and strategies they developed in these environments. Feeling left behind from their peers and their pre-diagnosis selves, participants described "rushing" back to school and work impulsively, taking on too much too quickly while facing overwhelming physical and cognitive demands. Factors motivating this sense of urgency as well as barriers to successful and sustainable reentry in these settings are also addressed. Findings are discussed in the context of important opportunities for clinical management, age-appropriate interventions, and implications for future research. A better understanding of psychosocial late effects, specifically related to school and work trajectories after cancer, is critical to survivorship care for adolescent and young adult cancer survivors.

Wearing my heart on my chest: dating, new relationships, and the reconfiguration of self-esteem after breast cancer.

PubMed

Kurowecki, Darya; Fergus, Karen D

2014-01-01

This study investigated women's experiences of establishing an intimate relationship with a new partner after breast cancer diagnosis and treatment. Fifteen breast cancer survivors, who were either actively dating or in a new intimate relationship that began post-diagnosis, participated in semi-structured interviews. Interview transcripts were analyzed using the grounded theory method. The analysis yielded Wearing My Heart on My Chest as the core category with three underlying categories: (1) Losing and Regaining Self and Bodily Esteem; (2) Taking the Leap: Dating and the Obligation to Disclose; and (3) Reclaiming of Self through the New Relationship. The categories refer to the experience of profound vulnerability invoked by the history of breast cancer and the act of verbally and physically revealing this past to a new intimate partner. Disclosure entailed a series of successive 'tests' of the new partner for his ability to accept the physical and psychological ramifications of breast cancer, with the resulting relationship becoming a vehicle through which women regained self-esteem. The process of dating and starting a new intimate relationship had the potential to restore women's self and bodily esteem previously diminished by breast cancer. The reconfiguration of self-esteem following breast cancer is thus experienced as an ongoing process that begins with diagnosis and continues well into the new relationship. Copyright © 2013 John Wiley & Sons, Ltd.

"Choosing Life": Birth Mothers on Abortion and Reproductive Choice.

PubMed

Sisson, Gretchen

2015-01-01

As the least-chosen option when faced with an unplanned pregnancy, adoption remains largely unexamined as a reproductive choice. Although the anti-abortion movement promotes adoption as its preferred alternative to abortion, little is known of birth mothers' pregnancy decision making and whether adoption was chosen in lieu of abortion. I conducted in-depth interviews with 40 women who had placed infants for adoption from 1962 to 2009. Participants were asked about all aspects of their adoption experiences, including their pregnancy decision making and thoughts on abortion. Interview transcripts were analyzed using grounded theory to find unifying themes speaking to reproductive choice. Participants' stories revealed widely varying ideas about abortion. Many were opposed to abortion, but a greater number supported abortion as a reproductive choice, although one they did not choose for themselves. Birth mothers were most often choosing between adoption and parenting, not adoption and abortion. Most participants would have preferred to parent, but did not because of external variables. Mixed experiences with adoption also influenced participants' long-term ideas about reproductive choice. Findings suggest that the anti-abortion framing of adoption as a preferable alternative to abortion is inconsistent with birth mothers' pregnancy decision-making experiences and their feelings about adoption. Reducing social barriers to both abortion and parenting will ensure that adoption is situated as a true reproductive choice. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Disability Experiences and Perspectives Regarding Reproductive Decisions, Parenting, and the Utility of Genetic Services: a Qualitative Study.

PubMed

Roadhouse, C; Shuman, C; Anstey, K; Sappleton, K; Chitayat, D; Ignagni, E

2018-06-16

Genetic counselors adopt seemingly contradictory roles: advocating for individuals with genetic conditions while offering prenatal diagnosis and the option of selective termination to prevent the birth of a child with a disability. This duality contributes to the tension between the disability and clinical genetics communities. Varying opinions exist amongst the disability community: some value genetic services while others are opposed. However, there is limited research exploring the opinions of individuals with a disability regarding issues related to reproduction and genetic services in the context of personal experience. This exploratory qualitative study involved interviews with seven women and three men who self-identify as having a disability. We sought to gain their perspectives on experiences with disability, thoughts about reproduction and parenting, and perceptions of genetic services. Transcripts of the interviews were analyzed thematically using qualitative content analysis. Data analysis showed that societal views of disability affected the lived experience and impacted reproductive decision-making for those with a disability. It also showed differing interest in genetic services. Concerns about the perceived collective implications of genetic services were also raised. These findings contribute to the understanding of the disability perspective toward reproductive decision-making and genetic services. A further goal is to promote a meaningful dialogue between the genetics and disability communities, with the potential to enhance the genetic and reproductive care provided to individuals with disabilities.

Policy-Relevant Context of Waterpipe Tobacco Smoking among University Students in Six Countries Across the Eastern Mediterranean Region: A Qualitative Study

PubMed Central

Salloum, Ramzi G; Abu-Rmeileh, Niveen; Hamadeh, Randah; Thomas, Justin; Mostafa, Aya; Yusufali, Afzalhussein; Kheirallah, Khalid A; Macauda, Mark M; Theis, Ryan P; Kadi, Lama El; Johnson, Evan J; Darawad, Muhammad W; Nakkash, Rima

2017-01-01

Background: Waterpipe tobacco smoking rates in the Eastern Mediterranean region are some of the highest worldwide, especially among young people. This study aimed to improve our knowledge of the policy-relevant context of waterpipe smoking among six countries in the Eastern Mediterranean region. Methods: In-depth interviews were conducted in Bahrain, Egypt, Jordan, Lebanon, Palestine, and the United Arab Emirates. Participants were young adult university students (18-29 years) from both genders who had ever smoked the waterpipe, recruited from universities participating in this study. Directed content analysis was used to analyze the transcripts. Results: A total of 53 in-depth interviews were conducted in Arabic in 2016. Findings were organized around 5 themes: waterpipe product characteristics; patterns of waterpipe smoking; the waterpipe café setting; perceived health consequences; and health warning labels. Waterpipe smoking was commonly perceived as a safe alternative to cigarettes. Waterpipe tobacco was reported to be widely accessible and affordable to young participants. There is a lack of knowledge among waterpipe smokers about the associated health effects. Warning labels are effective at communicating health risks associated with waterpipe smoking. Conclusions: Regulatory frameworks for waterpipe tobacco smoking should be developed and enforced, including waterpipe-specific health warning labels that elucidate the harmful effects of waterpipe smoking. PMID:28952296

Re-designing Orem's Self-care Theory for Patients with Chronic Hepatitis.

PubMed

Hasanpour-Dehkordi, Ali; Mohammadi, Nooredin; Nikbakht-Nasrabadi, Alireza

2016-01-01

Hepatitis is an inflammatory disease which has many adverse effects on patients' life because of its chronic nature. Since Orem's theory of self-care is a grounded theory, the concepts and applications of this theory in patients with chronic hepatitis who have special needs may lead to some challenges. The purpose of this study was to explore self-care in patients with chronic hepatitis. A directed content analysis was used in this qualitative study. Participants were recruited from a metropolitan area. Data were collected through semi-structured interviews. The verbatim transcripts of the participants' interviews were analyzed according to directed content analysis. In this study, four themes, suggested by Orem, were drawn from the data according to directed content analysis. The codes generated from the data were classified into concepts and then the concepts were assigned into these four themes. These themes were needs in the matrix of time and place, self-care agency, need for change in self-care and consequences of hepatitis. The use of Orem's self-care theory cannot meet the need for self-care in hepatitis patients because these patients have vital sexual, respect and belonging, physical, economical, and psychological-behavioral needs, and lack adequate knowledge about self-care. Consequently, the specific self-care model developed in this study helps health professionals identify self-care activities in patients with chronic hepatitis.

Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

PubMed

Gilmore, Kelly; Hoopes, Andrea J; Cady, Janet; Amies Oelschlager, Anne-Marie; Prager, Sarah; Vander Stoep, Ann

2015-06-01

The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners. We conducted 14 semistructured interviews with key informants involved in the implementation of LARC services. Key informants included SBHC clinicians and administrators, public health officials, and community partners. We used a content analysis approach to analyze interview transcripts for themes. We explored barriers to and facilitators of LARC service delivery across and within key informant groups. The most cited barriers across key informant groups were as follows: perceived lack of provider procedural skills and bias and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC administrative staff. LARC counseling and procedural services can be implemented in an SBHC setting to promote access to effective contraceptive options for adolescent women. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Why Vascular Surgeons and Interventional Radiologists Collaborate or Compete: A Look at Endovascular Stent Placements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Keller, Eric J.; Collins, Jeremy D.; Crowley-Matoka, Megan

PurposeTo understand how cultural differences between vascular surgeons (VSs) and interventional radiologists (IRs) affect their clinical decision making and inter-specialty relationships.MethodsTwenty-four conversational interviews were conducted with IRs and VSs about their approaches to patient care, views of their specialty and others, and solutions to any expressed concerns. Interview transcripts were systematically analyzed to identify and compare key themes according to the constructivist grounded theory and content analysis using NVivo 10 software. These data were supplemented with a retrospective analysis of 3658 endovascular stent placements performed at a large medical academic center over 11 years. Aggregate counts were divided by provider specialty,more » and trends were assessed via correlation coefficients.ResultsEndovascular stent placements were relatively equally divided between IR and VS over 11 years with some variability from placements by cardiology. IRs tend to lay claim to treatments as masters of procedures, whereas VSs base their claims on being masters of the treated diseases, leading to collaboration in some practices and bitter competition in others. The level of perceived competition was most associated with specialists’ awareness of and appreciation for specialty-specific values rather than differences in practice structure/reimbursement.ConclusionsUnderstanding cultural differences between IRs and VSs is imperative for fostering better collaboration to grow shared territory rather than competing for the same slice of the pie.« less

A qualitative study of parents' perceptions and use of portion size strategies for preschool children's snacks.

PubMed

Blake, Christine E; Fisher, Jennifer Orlet; Ganter, Claudia; Younginer, Nicholas; Orloski, Alexandria; Blaine, Rachel E; Bruton, Yasmeen; Davison, Kirsten K

2015-05-01

Increases in childhood obesity correspond with shifts in children's snacking behaviors and food portion sizes. This study examined parents' conceptualizations of portion size and the strategies they use to portion snacks in the context of preschool-aged children's snacking. Semi-structured qualitative interviews were conducted with non-Hispanic white (W), African American (AA), and Hispanic (H) low-income parents (n = 60) of preschool-aged children living in Philadelphia and Boston. The interview examined parents' child snacking definitions, purposes, contexts, and frequency. Verbatim transcripts were analyzed using a grounded theory approach. Coding matrices compared responses by race/ethnicity, parent education, and household food security status. Parents' commonly referenced portion sizes when describing children's snacks with phrases like "something small." Snack portion sizes were guided by considerations including healthfulness, location, hunger, and timing. Six strategies for portioning snacks were presented including use of small containers, subdividing large portions, buying prepackaged snacks, use of hand measurement, measuring cups, scales, and letting children determine portion size. Differences in considerations and strategies were seen between race/ethnic groups and by household food security status. Low-income parents of preschool-aged children described a diverse set of considerations and strategies related to portion sizes of snack foods offered to their children. Future studies should examine how these considerations and strategies influence child dietary quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

A qualitative study of parents’ perceptions and use of portion size strategies for preschool children’s snacks

PubMed Central

Blake, Christine E.; Fisher, Jennifer Orlet; Ganter, Claudia; Younginer, Nicholas; Orloski, Alexandria; Blaine, Rachel E.; Bruton, Yasmeen; Davison, Kirsten K.

2014-01-01

Objective Increases in childhood obesity correspond with shifts in children’s snacking behaviors and food portion sizes. This study examined parents’ conceptualizations of portion size and the strategies they use to portion snacks in the context of preschool-aged children’s snacking. Methods Semi-structured qualitative interviews were conducted with non-Hispanic white (W), African American (AA), and Hispanic (H) low-income parents (n=60) of preschool-aged children living in Philadelphia and Boston. The interview examined parents’ child snacking definitions, purposes, contexts, and frequency. Verbatim transcripts were analyzed using a grounded theory approach. Coding matrices compared responses by race/ethnicity, parent education, and household food security status. Results Parents’ commonly referenced portion sizes when describing children’s snacks with phrases like “something small.” Snack portion sizes were guided by considerations including healthfulness, location, hunger, and timing. Six strategies for portioning snacks were presented including use of small containers, subdividing large portions, buying prepackaged snacks, use of hand measurement, measuring cups, scales, and letting children determine portion size. Differences in considerations and strategies were seen between race/ ethnic groups and by household food security status. Conclusions Low-income parents of preschool-aged children described a diverse set of considerations and strategies related to portion sizes of snack foods offered to their children. Future studies should examine how these considerations and strategies influence child dietary quality. PMID:25447008

Coping strategies used by poorly adherent patients for self-managing bipolar disorder.

PubMed

Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

2016-01-01

Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual's coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness.

A conceptual framework for evaluating impairments in myasthenia gravis.

PubMed

Barnett, Carolina; Bril, Vera; Kapral, Moira; Kulkarni, Abhaya; Davis, Aileen M

2014-01-01

Myasthenia gravis is characterized by weakness and fatigability of different muscle groups, including ocular, bulbar and the limbs. Therefore, a measure of disease severity at the impairment level in myasthenia needs to reflect all the relevant impairments, as well as their variations with activity and fatigue. We conducted a qualitative study of patients with myasthenia, to explore their experiences and related impairments, aimed at developing a conceptual framework of disease severity at the impairment level in myasthenia gravis. Twenty patients representing the spectrum of disease participated in semi-structured interviews. Interviews were recorded and the transcripts were analyzed by content analysis using an inductive approach with line-by-line open coding. Themes were generated from these codes. Two main themes were identified: the severity of the impairments and fatigability (i.e., triggering or worsening of an impairment with activity). The impairments were further classified within body regions (ocular, bulbar and axial/limbs). Fatigability was described as a phenomenon affecting the whole body but also affecting specific impairments, and was associated with fluctuation of the symptoms. Patients were concerned that clinical examination at a single point in time might not reflect their true clinical state due to fatigability and fluctuations in severity. This conceptual framework reflects the relevance of both severity and fatigability in understanding impairment-based disease severity in myasthenia. This framework could inform the development of impairment measures in myasthenia gravis.

Pigment Production Analysis in Human Melanoma Cells.

PubMed

Hopkin, Amelia Soto; Paterson, Elyse K; Ruiz, Rolando; Ganesan, Anand K

2016-05-25

The human epidermal melanocyte is a highly specialized pigmented cell that serves to protect the epidermis from ultraviolet (UV) damage through the production of melanin, or melanogenesis. Misregulation in melanogenesis leading to either hyper- or hypo-pigmentation is found in human diseases such as malasma and vitiligo. Current therapies for these diseases are largely unsuccessful and the need for new therapies is necessary. In order to identify genes and or compounds that can alter melanogenesis, methods are required that can detect changes in pigment production as well as expression of key melanogenesis transcription factors and enzymes. Here we describe methods to detect changes in melanogenesis in a human melanoma cell line, MNT-1, by (1) analyzing pigment production by measuring the absorbance of melanin present by spectrophotometry, (2) analyzing transcript expression of potent regulators of melanogenesis by qunatitative reverse-transcription (RT)PCR and (3) analyzing protein expression of potent regulators of melanogenesis by Western blot (WB).

The relationship between gene transcription and combinations of histone modifications

NASA Astrophysics Data System (ADS)

Cui, Xiangjun; Li, Hong; Luo, Liaofu

2012-09-01

Histone modification is an important subject of epigenetics which plays an intrinsic role in transcriptional regulation. It is known that multiple histone modifications act in a combinatorial fashion. In this study, we demonstrated that the pathways within constructed Bayesian networks can give an indication for the combinations among 12 histone modifications which have been studied in the TSS+1kb region in S. cerevisiae. After Bayesian networks for the genes with high transcript levels (H-network) and low transcript levels (L-network) were constructed, the combinations of modifications within the two networks were analyzed from the view of transcript level. The results showed that different combinations played dissimilar roles in the regulation of gene transcription when there exist differences for gene expression at transcription level.

Diversity in eMental Health Practice: An Exploratory Qualitative Study of Aboriginal and Torres Strait Islander Service Providers

PubMed Central

Bird, Jennifer; Rotumah, Darlene; Singer, Judy

2017-01-01

Background In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. Objective The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Methods Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. Results It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally specific and mainstream. While they referred clients to online treatment programs, they used only eMH resources designed for mobile devices in their face-to-face contact with clients. Conclusions This paper provides Aboriginal and Torres Strait islander service providers and the eMH field with findings that may inform and guide the implementation of eMH resources. It may help policy developers locate this workforce within broader service provision planning for eMH. The findings could, with adaptation, have wider application to other workforces who work with Aboriginal and Torres Strait Islander clients. The findings highlight the importance of identifying and addressing the particular needs of minority groups for eMH services and resources. PMID:28554880

Frameworks of reference: How (some) college students think about biological evolution

NASA Astrophysics Data System (ADS)

Filisky, Michael

1999-12-01

Evolution, a key concept for understanding all of biology, is often misunderstood by students from elementary school to graduate school. In order to teach evolution effectively, as well as to teach the biological concepts necessary for understanding evolution, teachers need to understand the initial ideas that students bring with them to the learning experience. Research has shown that many students are likely to hold alternative conceptions that may block their ability to learn evolution. The goal of this study is to contribute to the effectiveness of teaching evolution at the high school and college levels both by investigating concepts that students bring with them to their first college study of evolution, and by examining the conceptual frameworks that support these students as they construct new understanding. This study was executed in two stages. An initial survey of evolutionary understanding was administered to 203 undergraduate students in two courses at two universities in the area of Boston, MA. The surveys elicited short, written responses to five real and fictitious scenarios about biological inheritance and evolutionary change. Responses were coded into categories of concepts. The data were analyzed for patterns of understanding. Students exhibiting concepts from each of the major categories were randomly selected to participate in the subsequent interview stage of the study. Interviews with six of the students were conducted based on an interview guide employing scenarios similar to those from the survey. Analyses of the interview transcripts included the construction of detailed concept maps for each response followed by narratives of each interviewee's conceptual frameworks. The results of both stages of the study revealed a range of alternative conceptions about evolution, including scientifically acceptable Darwinian ideas and other ideas---including Lamarckian inheritance of acquired characteristics---are not accepted by modern science. The interviews revealed a range of reasoning styles and frameworks that explained how students could find these ideas plausible. The study concludes with recommendations for further research on the understanding of evolutionary topics; for adaptations of the research methods; and for teaching strategies to address the findings.

Evidence for a hierarchical transcriptional circuit in Drosophila male germline involving testis-specific TAF and two gene-specific transcription factors, Mod and Acj6.

PubMed

Jiang, Mei; Gao, Zhengliang; Wang, Jian; Nurminsky, Dmitry I

2018-01-01

To analyze transcription factors involved in gene regulation by testis-specific TAF (tTAF), tTAF-dependent promoters were mapped and analyzed in silico. Core promoters show decreased AT content, paucity of classical promoter motifs, and enrichment with translation control element CAAAATTY. Scanning of putative regulatory regions for known position frequency matrices identified 19 transcription regulators possibly contributing to tTAF-driven gene expression. Decreased male fertility associated with mutation in one of the regulators, Acj6, indicates its involvement in male reproduction. Transcriptome study of testes from male mutants for tTAF, Acj6, and previously characterized tTAF-interacting factor Modulo implies the existence of a regulatory hierarchy of tTAF, Modulo and Acj6, in which Modulo and/or Acj6 regulate one-third of tTAF-dependent genes. © 2017 Federation of European Biochemical Societies.

Barriers and facilitators to antiretroviral therapy adherence among Peruvian adolescents living with HIV: A qualitative study

PubMed Central

Wong, Milagros; Muñoz, Maribel; Valle, Emiliano; Leon, Segundo R.; Díaz Perez, Dayana; Kolevic, Lenka; Franke, Molly

2018-01-01

AIDS deaths among adolescents are increasing globally. This qualitative study investigated the barriers and facilitators to cART adherence among Peruvian adolescents living with HIV. Guided by a social ecological model, we analyzed transcripts from 24 psychosocial support groups for HIV-positive adolescents aged 13–17 years and 15 individual, in-depth interviews with cART providers and caregivers to identify the barriers and facilitators to cART adherence at the individual, family/caregiver and hospital levels. Most barriers and facilitators to cART adherence clustered at the individual and family/caregiver levels, centering on support provided to adolescents; history of declining health due to suboptimal cART adherence; side effects from antiretroviral drugs; and cART misinformation. Interventions to support adolescent HIV cART adherence should begin at the individual and family/caregiver levels and include an educational component. No adolescent living with HIV should die from AIDS in an era of accessible cART. PMID:29447226

“It's Just a Way of Fitting In:” Tobacco Use and the Lived Experience of Lesbian, Gay, and Bisexual Appalachians

PubMed Central

Bennett, Keisa; Ricks, JaNelle M.; Howell, Britteny M.

2014-01-01

Lesbian, gay, and bisexual (LGB) people are affected by multiple health disparities and risk factors, including tobacco use. Few studies to date have examined tobacco use specifically in rural LGB populations, and none has investigated the intersections of identity, rural LGB culture, and tobacco. The purpose of this study was to explore the perspective of Appalachian LGB people regarding tobacco use. Methods Nineteen LGB-identified Appalachian residents participated in audiotaped, semi-structured interviews. Two authors analyzed and coded transcripts through constant comparison, and determined themes through consensus. Results Five themes emerged: the convergence of Appalachian and LGB identities, tacit awareness of LGB identity by others, culture and tobacco use, perceived associations with tobacco use, and health beliefs and health care. Conclusions LGB Appalachians connect stress and culture to tobacco, but seem less aware that partial concealment of their identity might be a source of the stress that could influence their smoking. PMID:25418233

Translating knowledge into practice: An exploratory study of dementia-specific training for community-based service providers.

PubMed

O'Sullivan, Grace; Hocking, Clare; McPherson, Kathryn

2017-08-01

Objective To develop, deliver, and evaluate dementia-specific training designed to inform service delivery by enhancing the knowledge of community-based service providers. Methods This exploratory qualitative study used an interdisciplinary, interuniversity team approach to develop and deliver dementia-specific training. Participants included management, care staff, and clients from three organizations funded to provide services in the community. Data on the acceptability, applicability, and perceived outcomes of the training were gathered through focus group discussions and individual interviews. Transcripts were analyzed to generate open codes which were clustered into themes and sub-themes addressing the content, delivery, and value of the training. Findings Staff valued up-to-date knowledge and "real stories" grounded in practice. Clients welcomed the strengths-based approach. Contractual obligations impact on the application of knowledge in practice. Implications The capacity to implement new knowledge may be limited by the legislative policies which frame service provision, to the detriment of service users.