Students' experiences and perceived benefits of a sex education curriculum: a qualitative analysis.

PubMed

Smith, Peggy B; Realini, Janet P; Buzi, Ruth S; Martinez, Mario

2011-01-01

A qualitative evaluation explored the experiences and perceived benefits of students who participated in an abstinence-plus sex education program at enrollment and conclusion. The sample included 1130 inner-city high school students, 73.7% of whom were Hispanic. Thematic analysis was used to identify main themes in responses made by students to 3 open-ended questions. The most common preparticipation request was for information about sexually transmitted infections. At program conclusion, the most common response theme involved the quality of course delivery. Students indicated that they appreciated the facilitators who allowed open conversations. The implications of these findings to sex education programs are discussed.

A mobile system for the improvement of heart failure management: Evaluation of a prototype.

PubMed

Haynes, Sarah C; Kim, Katherine K

2017-01-01

Management of heart failure is complex, often involving interaction with multiple providers, monitoring of symptoms, and numerous medications. Employing principles of user-centered design, we developed a high- fidelity prototype of a mobile system for heart failure self-management and care coordination. Participants, including both heart failure patients and health care providers, tested the mobile system during a one-hour one-on-one session with a facilitator. The facilitator interviewed participants about the strengths and weaknesses of the prototype, necessary features, and willingness to use the technology. We performed a qualitative content analysis using the transcripts of these interviews. Fourteen distinct themes were identified in the analysis. Of these themes, integration, technology literacy, memory, and organization were the most common. Privacy was the least common theme. Our study suggests that this integration is essential for adoption of a mobile system for chronic disease management and care coordination.

Sharing international experiences in disasters: summary and action plan.

PubMed

Andrews, R A; Austin, C; Brown, R; Chen, Y Z; Engindeniz, Z; Girouard, R; Leaman, P; Masellis, M; Nakayama, S; Polentsov, Y O; Suserud, B O

2001-01-01

The discussions in this theme provided an opportunity to share specific experiences with disasters that occurred outside of the Asia-Pacific Rim. Details of the methods used are provided in the preceding paper. The chairs moderated all presentations and produced a summary that was presented to an assembly of all of the delegates. Since the findings from the Theme 7 and Theme 3 groups were similar, the chairs of both groups presided over one workshop that resulted in the generation of a set of action plans that then were reported to the collective group of all delegates. The main points developed during the presentations and discussion included: (1) disaster response planning, (2) predetermined command and organizational structure, (3) rapid response capability, (4) mitigation, and (5) communications and alternatives. The action plans presented are in common with those presented by Theme 3, and include: (1) plan disaster responses including the different types, identification of hazards, training based on experiences, and provision of public education; (2) improving coordination and control; (3) maintaining communications assuming infrastructure breakdown; (4) maximizing mitigation through standardized evaluations, creation of a legal framework, and recognition of advocacy and public participation; and (5) providing resources and knowledge through access to existing therapies, using the media, and increasing decentralization of hospital inventories. Most of the problems that occurred outside the Asia-Pacific rim relative to disaster management are similar to those experienced within it. They should be addressed in common with the rest of the world.

The Immortal Life of Henrietta Lacks: Using a Common Read to Transform a Learning Community

ERIC Educational Resources Information Center

Virtue, Emily; Wells, Gayle; MacKusick, Carol; Murphy-Nugen, Amy; Rose, Amy

2018-01-01

First-year seminars and learning communities (LC) have been used to help increase retention, provide continuity, and support students as they transition to the university setting. Another high impact educational practice--common intellectual experiences (CIE)--includes student activities centered on a theme to help facilitate learning, increase…

Flipped Classroom Implementation: A Case Report of Two Higher Education Institutions in the United States and Australia

ERIC Educational Resources Information Center

McLaughlin, Jacqueline E.; White, Paul J.; Khanova, Julia; Yuriev, Elizabeth

2016-01-01

This case report explored the implementation of flipped classrooms at two higher education institutions. Experiences and publications from the institutions were used to identify and describe common themes, including successes and challenges encountered along with potential solutions to common misalignments, particularly as related to…

Impact of excipient interactions on solid dosage form stability.

PubMed

Narang, Ajit S; Desai, Divyakant; Badawy, Sherif

2012-10-01

Drug-excipient interactions in solid dosage forms can affect drug product stability in physical aspects such as organoleptic changes and dissolution slowdown, or chemically by causing drug degradation. Recent research has allowed the distinction in chemical instability resulting from direct drug-excipient interactions and from drug interactions with excipient impurities. A review of chemical instability in solid dosage forms highlights common mechanistic themes applicable to multiple degradation pathways. These common themes include the role of water and microenvironmental pH. In addition, special aspects of solid-state reactions with excipients and/or excipient impurities add to the complexity in understanding and modeling reaction pathways. This paper discusses mechanistic basis of known drug-excipient interactions with case studies and provides an overview of common underlying themes. Recent developments in the understanding of degradation pathways further impact methodologies used in the pharmaceutical industry for prospective stability assessment. This paper discusses these emerging aspects in terms of limitations of drug-excipient compatibility studies, emerging paradigms in accelerated stability testing, and application of mathematical modeling for prediction of drug product stability.

Transference and Countertransference in the Psychotherapy of Therapists Charged With Sexual Misconduct

PubMed Central

GABBARD, GLEN O.

1995-01-01

When psychotherapists accused of sexual misconduct are referred for personal psychotherapy, formidable challenges are presented to the clinician designated as the psychotherapist. The author outlines common transference-countertransference themes and discusses them in terms of their psychodynamic underpinnings and optimal management. These themes include the therapist as a law enforcement agent, the therapist as a corruptible object, the therapist as a love object, the therapist as a rescuer and absolver, the therapist as an authoritarian parent, and the therapist as a voyeur. A common thread in all of these transference-counter-transference paradigms involves the discomfort experienced by the treating psychotherapists when they recognize aspects of themselves in the accused professional. PMID:22700209

Some Female Professors' Experiences of Collaboration: Mapping the Collaborative Process through Rough Terrain.

ERIC Educational Resources Information Center

Elliott, Anne E.; Woloshyn, Vera E.

1997-01-01

Seven Canadian female faculty members described their involvement in collaborative projects, including collaborations with a school principal, school teachers, a former student, a graduate student, and other faculty. Common themes included building rapport, establishing goals and rewards, negotiation of tasks, commitment and interpersonal support,…

Building Dynamic Conceptual Physics Understanding

ERIC Educational Resources Information Center

Trout, Charlotte; Sinex, Scott A.; Ragan, Susan

2011-01-01

Models are essential to the learning and doing of science, and systems thinking is key to appreciating many environmental issues. The National Science Education Standards include models and systems in their unifying concepts and processes standard, while the AAAS Benchmarks include them in their common themes chapter. Hyerle and Marzano argue for…

Common Themes in the Experiences of Mother-Daughter Incest Survivors: Implications for Counseling.

ERIC Educational Resources Information Center

Ogilvie, Beverly; Daniluk, Judith

1995-01-01

Studied mother-daughter incest. Common themes were extracted from in-depth interviews with survivors of mother-perpetrated sexual abuse, some of which parallel the experience of survivors of other forms of child sexual abuse, and some of which are more specific to mother-daughter incest. Discusses themes and counseling implications. (JBJ)

Marital satisfaction through the lens of Iranian women: a qualitative study.

PubMed

Tavakol, Zeinab; Moghadam, Zahra Behboodi; Nasrabadi, Alireza Nikbakht; Iesazadeh, Nikzad; Esmaeili, Maryam

2016-01-01

One of the common concepts to show the happiness and stability of marriage is the concept of marital satisfaction. Marital satisfaction plays an important role in the stability of marriage. This study was conducted to explain the perception of marital satisfaction among Iranian women. This study was conducted between March and September 2015 by common qualitative content analysis approach through semi-structured interviews and 19 participants were selected by purposive sampling. With the analysis of data two themes: (maturity of personality) which included a sub-theme of blossoming of feelings, and (romantic interaction) consisted of three sub-themes of; mutual support, sense of peace and joyful dependence emerged. Marital life can lead to the development of people and lovely interaction between them. Surely it needs to passing of time and self-knowing and couple-knowing of each other. Family consultants need the perception of how couple's interaction is, also they need to understand about couples who can communicate well to each other so they can overcome many life's other deficiencies.

Parental Perspectives of Communication at the End of Life at a Pediatric Oncology Institution.

PubMed

Snaman, Jennifer M; Torres, Carlos; Duffy, Brian; Levine, Deena R; Gibson, Deborah V; Baker, Justin N

2016-03-01

The interaction of health care providers and hospital staff with patients and families at the end of life affects the parental grief experience. Both verbal and nonverbal communication are key components of this interaction. The study objective was to explore the communication between hospital staff members and patients and families at the time of patients' health decline near the end of life. Twelve bereaved parents participated in a focus group. Semantic content analysis was used to analyze the transcript. Parents' responses to the prompt about typical ways the medical team communicated yielded 109 codes, which were grouped into 12 themes. The most common themes were "patient inclusion" and "explanation of medical plan," both used in 17% of responses. Responses to the prompt about positive and negative aspects of communication generated 208 codes, yielding 15 different themes. The most common theme about positive communication was the "strong relationship between family and staff." The theme "variations in care with a negative impact" was used most frequently in describing negative communication. This study helps to identify techniques that should be used by clinicians as they work with children with cancer and their families, particularly including patients in treatment decisions, ongoing relationship building, communicating with caring and empathy, using an interdisciplinary team for additional support, and pairing bad news with a plan of action.

Play Therapy with Abused Children: A Review of the Literature.

ERIC Educational Resources Information Center

White, JoAnna; Allers, Christopher T.

1994-01-01

Presents review and critique of play therapy literature related to abused and neglected children. Discusses seven characteristic play behaviors and two common play themes of maltreated children. Offers recommendations for future research. Includes 50 citations. (Author/CRR)

Data specifications for INSPIRE

NASA Astrophysics Data System (ADS)

Portele, Clemens; Woolf, Andrew; Cox, Simon

2010-05-01

In Europe a major recent development has been the entering in force of the INSPIRE Directive in May 2007, establishing an infrastructure for spatial information in Europe to support Community environmental policies, and policies or activities which may have an impact on the environment. INSPIRE is based on the infrastructures for spatial information established and operated by the 27 Member States of the European Union. The Directive addresses 34 spatial data themes needed for environmental applications, with key components specified through technical implementing rules. This makes INSPIRE a unique example of a legislative "regional" approach. One of the requirements of the INSPIRE Directive is to make existing spatial data sets with relevance for one of the spatial data themes available in an interoperable way, i.e. where the spatial data from different sources in Europe can be combined to a coherent result. Since INSPIRE covers a wide range of spatial data themes, the first step has been the development of a modelling framework that provides a common foundation for all themes. This framework is largely based on the ISO 19100 series of standards. The use of common generic spatial modelling concepts across all themes is an important enabler for interoperability. As a second step, data specifications for the first set of themes has been developed based on the modelling framework. The themes include addresses, transport networks, protected sites, hydrography, administrative areas and others. The data specifications were developed by selected experts nominated by stakeholders from all over Europe. For each theme a working group was established in early 2008 working on their specific theme and collaborating with the other working groups on cross-theme issues. After a public review of the draft specifications starting in December 2008, an open testing process and thorough comment resolution process, the draft technical implementing rules for these themes have been approved by the INSPIRE Committee. After they enter into force they become part of the legal framework and European Member States have to implement these rules. The next step is the development of the remaining 25 spatial data themes, which include many themes of interest for the Earth Sciences including geology, meteorological and oceanographic geographic features, atmospheric conditions, habitats and biotopes, species distribution, environmental monitoring facilities, and land cover to name a few. The process will follow in general the same steps as for the first themes and the working groups are expected to start their work in March/April 2010. The first draft specifications for public comment are expected at the end of 2010 and the work is scheduled to be completed in 2012. At the same time, other initiatives like GMES (Global Monitoring for Environment and Security) and GEOSS (Global Earth Observation System of Systems) are also dealing with spatial data from the themes covered by INSPIRE. With the EU-funded project GIGAS, a support action, a step has been made towards architectural coherence between these initiatives. Recommendations to improve the coherence of the information architectures across the initiatives have been discussed in January 2010 with stakeholders from all initiatives, the standards organisations and EU-funded research projects. Based on the general agreements achieved in these discussions, the next step will be to start working towards the implementation of these recommendations, which are in line with the approach taken by the INSPIRE data specifications.

International neurosurgical volunteerism: a temporal, geographic, and thematic analysis of foundation for international education in neurological surgery volunteer reports.

PubMed

Sedney, Cara L; Siu, Jennifer; Rosseau, Gail; Dempsey, Robert; Bernstein, Mark

2014-12-01

To examine the experiences of volunteers of the Foundation for International Education in Neurological Surgery. A qualitative analysis of >150 volunteer reports from 2004-2013 was performed using grounded theory. Various themes were explored based on their occurrence in the reports. Volunteer reports of extended trips appeared to peak in 2009, with a heavy emphasis on activity in Africa. Prominent themes in the reports included volunteer contributions, successful strategies, challenges, and future directions. Volunteers demonstrated wide-ranging contributions. Successful strategies included continuity and collaboration with other organizations. Challenges were overwhelmingly related to equipment or infrastructure. Common suggestions for future directions included institutional collaboration and subspecialty development. Copyright © 2014 Elsevier Inc. All rights reserved.

The Experience of Women Veterans Coming Back from War.

PubMed

Maiocco, Gina; Smith, Mary Jane

2016-06-01

Issues surrounding mental health are common for women veterans who have served in Iraq and Afghanistan wars. The goal of this phenomenological study was to document themes in the stories gathered from eight women veterans who had come back from war. Themes in the stories were: arriving with mixed sentiments; evolving to a changed view of self; permeating aggravation; confounding broken relationships, frequent deployments, and change in military status; remembering war experiences; and seeking opportunity for what is possible. Mental health issues can be observed in the themes. Including story as part of the mental health visit with veterans may be beneficial to veterans as they deal with the transition of coming back. Copyright © 2016 Elsevier Inc. All rights reserved.

College student stressors: a review of the qualitative research.

PubMed

Hurst, Carrie S; Baranik, Lisa E; Daniel, Francis

2013-10-01

A total of 40 qualitative studies were reviewed and coded according to the college student stressors they represented. These studies utilized a variety of qualitative methods to examine stressors representing the following themes: relationships, lack of resources, academics, the environment, expectations, diversity, transitions and other stressors. Relationship stressors were the most commonly reported theme and covered areas including stress associated with family, romantic, peer and faculty relationships. Three of the themes (relationships, diversity and other) are novel categories of stressors compared with quantitative reviews on the topic, highlighting the importance of gathering both quantitative and qualitative pieces of information. This review contributes to the stress literature by synthesizing and identifying trends in the qualitative student stress research. Copyright © 2012 John Wiley & Sons, Ltd.

Converging cellular themes for the hereditary spastic paraplegias.

PubMed

Blackstone, Craig

2018-05-10

Hereditary spastic paraplegias (HSPs) are neurologic disorders characterized by prominent lower-extremity spasticity, resulting from a length-dependent axonopathy of corticospinal upper motor neurons. They are among the most genetically-diverse neurologic disorders, with >80 distinct genetic loci and over 60 identified genes. Studies investigating the molecular pathogenesis underlying HSPs have emphasized the importance of converging cellular pathogenic themes in the most common forms of HSP, providing compelling targets for therapy. Most notably, these include organelle shaping and biogenesis as well as membrane and cargo trafficking. Published by Elsevier Ltd.

Male nurses and chemical dependency: masterminding the nursing environment.

PubMed

Dittman, Patricia Welch

2008-01-01

Florida men in nursing who are chemically dependent represent a greater percentage of the total number of male nurses than female nurses who are chemically dependent. This study identifies characteristics of 9 men who completed the Florida Intervention Project for Nurses. All participants were interviewed independently and data were analyzed to determine common themes in their behaviors and relationships and how they successfully manipulated professional nursing systems to remain professionally active for prolonged period of time while impaired. A model of caring for nurses with professional impairment graphically depicted the interaction of 2 overarching themes of person and profession. The person theme had 3 subthemes of predetermined risk, altered values, and sensation-seeking behaviors. The profession theme had 6 subthemes of masterminding, professional heteronomy, getting caught, rehabilitation, spirituality, and the nurse becoming the nursed. Findings imply that chemical dependency among male nurses starts in childhood in an abusive family environment and continues throughout the educational process and into the work environment. Findings supporting diversion success include a lack of awareness of the signs and symptoms of impairment by supervisors, poor compliance to drug control procedures, and a common acceptance by peers that impaired men are clinically competent and clinical leaders. When these 3 situations are present, there is greater success in masterminding daily events to maintain undetected drug access.

Integration of the concepts of sustainability into teaching at post-secondary institutions

NASA Astrophysics Data System (ADS)

Davis, Sara Allison

The purpose of this study was to examine the incorporation of the concepts of sustainability into teaching at two post-secondary public education residential institutions, Northern Arizona University (NAU) and the University of South Carolina (USC). A total of 17 faculty members, six administrators, and 31 students were interviewed in the study. An individual case record for each participating institution was developed. The two case records were then qualitatively cross-case analyzed to derive crosscutting themes and patterns at the two participating institutions. Based on the findings of this study, several major themes emerged across the two post-secondary public institutions. Sustainability was consistently viewed by faculty members, administrators, and students as a very broad term. While faculty members and administrators differentiated between the ecological, economic, and social dimensions of sustainability, students commonly associated sustainability more narrowly with an ecological meaning. Several common factors that influenced faculty members' and administrators' understanding of sustainability included literature, campus-wide training, personal influences, and professional networking. Common methods used by faculty to incorporate the concepts of sustainability into teaching included assigned readings, class discussions, and class projects. Key benefits of incorporating the concepts of sustainability into teaching included increased student awareness, collaboration, vision development, and social implications, while key challenges included time, support, assessment, student understanding, and more realistic classroom experiences. Key driving forces for faculty members and administrators for incorporating the concepts of sustainability into teaching were the initiatives specifically developed at the institutions. Based on the common themes at the two institutions studied, it is recommended that post-secondary institutions desiring to deploy the concepts of sustainability into teaching include the multiple dimensions of sustainability in their campus-wide initiatives, faculty and student development, and policies. In addition, it is recommended that campus-wide sustainability initiatives emphasize the key benefits of increased student awareness, collaboration, social implications, and vision development, and that they consider the challenges of time, support, assessment, and student understanding, while rewarding faculty members for their efforts to incorporate the concepts of sustainability into teaching.

Conflict and the Common Good. Studies in Third World Societies, Publication Number Twenty-Four.

ERIC Educational Resources Information Center

Merrill, Robert S., Ed.; Willner, Dorothy, Ed.

The fundamental theme of these papers is what constitutes the common good and the issues and problems related to the understanding of that common good. Several anthropologists and a political scientist explore this theme in various geographic settings and from many theoretical and methodological perspectives. Among the countries and cultures…

Spiritual well-being in long-term colorectal cancer survivors with ostomies.

PubMed

Bulkley, Joanna; McMullen, Carmit K; Hornbrook, Mark C; Grant, Marcia; Altschuler, Andrea; Wendel, Christopher S; Krouse, Robert S

2013-11-01

Spiritual well-being (SpWB) is integral to health-related quality of life. The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Two-hundred-eighty-three long-term (≥ 5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents' greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the three-item SpWB sub-scale. Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as "positive attitude", "I am fortunate", "appreciate life more", and "strength through religious faith". Negative themes, expressed by only 29% of respondents, included "struggling to cope", "not feeling 'normal' ", and "loss". Fifty-five percent of respondents expressed ambivalent themes including "learning acceptance", "an ostomy is the price for survival", "reason to be around despite suffering", and "continuing to cope despite challenges". The majority (64%) had a high SpWB sub-scale score. Although CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes were often mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter connectedness, and belonging. Copyright © 2013 John Wiley & Sons, Ltd.

SPIRITUAL WELL-BEING IN LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMIES

PubMed Central

Bulkley, Joanna; McMullen, Carmit K.; Hornbrook, Mark C.; Grant, Marcia; Altschuler, Andrea; Wendel, Christopher S.; Krouse, Robert S.

2014-01-01

Objective Spiritual well-being (SpWB) is integral to health-related quality of life (HRQOL). The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Methods Two-hundred-eight-three long-term (≥5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents’ greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the 3-item SpWB sub-scale. Results Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as “positive attitude”, “I am fortunate”, “appreciate life more”, and “strength through religious faith”. Negative themes, expressed by only 29% of respondents, included “struggling to cope”, “not feeling ‘normal’”, and “loss”. Fifty-five percent of respondents expressed ambivalent themes including “learning acceptance”, “an ostomy is the price for survival”, “reason to be around despite suffering”, and “continuing to cope despite challenges”. The majority (64%) had a high SpWB sub-scale score. Conclusions While CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes often were mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter-connectedness, and belonging. PMID:23749460

Marital satisfaction through the lens of Iranian women: a qualitative study

PubMed Central

Tavakol, Zeinab; Moghadam, Zahra Behboodi; Nasrabadi, Alireza Nikbakht; Iesazadeh, Nikzad; Esmaeili, Maryam

2016-01-01

Introduction One of the common concepts to show the happiness and stability of marriage is the concept of marital satisfaction. Marital satisfaction plays an important role in the stability of marriage. This study was conducted to explain the perception of marital satisfaction among Iranian women. Methods This study was conducted between March and September 2015 by common qualitative content analysis approach through semi-structured interviews and 19 participants were selected by purposive sampling. Results With the analysis of data two themes: (maturity of personality) which included a sub-theme of blossoming of feelings, and (romantic interaction) consisted of three sub-themes of; mutual support, sense of peace and joyful dependence emerged. Conclusion Marital life can lead to the development of people and lovely interaction between them. Surely it needs to passing of time and self-knowing and couple-knowing of each other. Family consultants need the perception of how couple's interaction is, also they need to understand about couples who can communicate well to each other so they can overcome many life's other deficiencies. PMID:28292164

Copyright Resources for School Librarians

ERIC Educational Resources Information Center

Johnson, Yvonne M.; Johnson, Nicole M.

2016-01-01

This article provides a collection of annotated citations for online resources of interest to school librarians; the focus is on copyright law, related information, and guidelines. The citations are organized by themes based on common issues. Copyright protects originally created works, including movies, recorded music performances, novels,…

Teaching Invisible Culture: Classroom Practice and Theory.

ERIC Educational Resources Information Center

Lo Bianco, Joseph, Ed.; Crozet, Chantal, Ed.

This collection of papers discusses what researchers and classroom teachers think and do about culture in language education. There are nine chapters in two parts. Part 1, "Culture Theory," includes the following: (1) "Common Themes" (Joseph Lo Bianco); (2) "Culture: Visible, Invisible and Multiple" (Joseph Lo…

Transitions to Adulthood for Youth with Disabilities: Emerging Themes for Practice and Research

ERIC Educational Resources Information Center

Stewart, Debra; Gorter, Jan Willem; Freeman, Matt

2013-01-01

The three common themes are emerging from recent research on positive approaches to adult transitions for youth with disabilities. The first theme acknowledges that a person's condition is only one factor that influences the developmental process of transitioning into adulthood; the second theme addresses the complexity of the numerous…

Notes on the Lasting Effects of Early Child Abuse throughout the Life Cycle.

ERIC Educational Resources Information Center

Steele, Brandt F.

1986-01-01

Common themes in research on individuals who were abused as children are reviewed, noting transmission of a basic inability to provide good parenting. Psychological residues are discussed (including low self-esteem) along with delinquency, depression, attachment disorders, and sexual abuse. (CL)

Common Psycholinguistic Themes in Mass Murderer Manifestos

ERIC Educational Resources Information Center

Hamlett, Laura E.

2017-01-01

Mass murder in the United States is increasing, yet understanding of mass murderers is still relatively limited. Many perpetrators compose manifestos, which include journals, blogs, letters, videos, and other writings. Previous research has indicated that personal messages are of great social and psychological importance; however, there remains an…

Secondary Teacher and University Partnerships: Does Being in a Partnership Create Teacher Partners?

NASA Astrophysics Data System (ADS)

Burrows, Andrea C.

The purpose of this research was to understand how individuals, specifically secondary teachers and graduate engineering students, developed a working relationship in a grant funded project. I investigated three interrelated research questions about partnerships including: 1) What is the meaning of partnership to each individual? 2) How do the individuals negotiate the work in their partnership? and 3) Do the individual conceptions of partnership change as a result of their interactions? I used a qualitative descriptive case study methodology. I conducted nine interviews, four focus groups, 33 classroom field note observations, and collected emails. I detailed each of the three cases, and I conducted a cross case analysis of the three schools. I compared the similarities and differences between the cases in order to understand the partnership themes that defined a specific case and those that were generalized to several cases. Using grounded theory, my overall findings showed that each case generated six themes. These themes included product, perspective, expectations, decision making, relationships, and habit. I explored all six themes in current literature, and five of the six themes were prevalent there. In my study, habit was the core phenomenon but was not as common in the literature. It was related to the socio-cognitive theory of knowledge construction and Bourdieu's habitus. Additionally, it was connected to the concept of change in partnerships.

Always Kiss Me Good Night.

ERIC Educational Resources Information Center

Salt, J. S.

1997-01-01

Presents practical parenting tips obtained from 1,000 children ages 6 to 12 years from a variety of ethnic and economic backgrounds. Common themes included children's desire to receive respect, caring, and guidance from their parents. The most frequent instructions to parents were: "Don't yell at me,""Help me with my homework,"…

Magnitude Knowledge: The Common Core of Numerical Development

ERIC Educational Resources Information Center

Siegler, Robert S.

2016-01-01

The integrated theory of numerical development posits that a central theme of numerical development from infancy to adulthood is progressive broadening of the types and ranges of numbers whose magnitudes are accurately represented. The process includes four overlapping trends: (1) representing increasingly precisely the magnitudes of non-symbolic…

Magnitude Knowledge: The Common Core of Numerical Development

ERIC Educational Resources Information Center

Siegler, Robert S.

2016-01-01

The integrated theory of numerical development posits that a central theme of numerical development from infancy to adulthood is progressive broadening of the types and ranges of numbers whose magnitudes are accurately represented. The process includes four overlapping trends: 1) representing increasingly precisely the magnitudes of non-symbolic…

The College Transition for First-Year Students from Rural Oregon Communities

ERIC Educational Resources Information Center

Ganss, Karen M.

2016-01-01

This study explores the lived experiences of 10 students entering college from rural Oregon communities. Using narrative inquiry, the author examines students' transition, common experiences, and enrollment barriers. Resulting themes include: (a) unexpected emotional and social transition, (b) motivations for enrolling, (c) lack of social and…

Curriculum Integration = Course Disintegration: What Does This Mean for Anatomy?

ERIC Educational Resources Information Center

Bolender, David L.; Ettarh, Rajunor; Jerrett, David P.; Laherty, Richard F.

2013-01-01

Many basic scientists including anatomists are currently involved in decisions related to revisions of the undergraduate medical curriculum. Integration is a common theme in many of these decisions. As described by Harden, integration can occur along a multistep continuum from independent, discipline-based courses to a completely interdisciplinary…

U.S. History Framework for the 2010 National Assessment of Educational Progress

ERIC Educational Resources Information Center

National Assessment Governing Board, 2009

2009-01-01

This framework identifies the main ideas, major events, key individuals, and unifying themes of American history as a basis for preparing the 2010 assessment. The framework recognizes that U.S. history includes powerful ideas, common and diverse traditions, economic developments, technological and scientific innovations, philosophical debates,…

Foster Youth Who Have Succeeded in Higher Education: Common Themes

ERIC Educational Resources Information Center

Lovitt, Thomas; Emerson, John

2009-01-01

All young people, including foster youth and youth with disabilities, can succeed academically given adequate support and advocacy from educators, professionals, and their caregivers. Casey Family Programs (www.casey.org), a Seattle-based national operating foundation that has served children, youth, and families in the child welfare system since…

Interactive Whiteboards: Boon or Bandwagon? A Critical Review of the Literature

ERIC Educational Resources Information Center

Smith, Heather J.; Higgins, Steve; Wall, Kate; Miller, Jen

2005-01-01

This article reviews the literature concerning the introduction of interactive whiteboards (IWBs) in educational settings. It identifies common themes to emerge from a burgeoning and diverse literature, which includes reports and summaries available on the Internet. Although the literature reviewed is overwhelmingly positive about the impact and…

Surviving Sudden Cardiac Arrest: A Pilot Qualitative Survey Study of Survivors.

PubMed

Sawyer, Kelly N; Brown, Frances; Christensen, Roxanne; Damino, Colleen; Newman, Mary M; Kurz, Michael C

2016-06-01

Research describing survivors of sudden cardiac arrest (SCA) has centered on quantifying functional ability, perceived quality of life, and neurocognitive assessment. Many gaps remain, however, regarding survivors' psychosocial perceptions of life in the aftermath of cardiac arrest. An important influence upon those perceptions is the presence of support and its role in a survivor's life. An Internet-based pilot survey study was conducted to gather data from SCA survivors and friends and/or family members (FFMs) representing their support system. The survey was distributed to members of the Sudden Cardiac Arrest Foundation (SCAF) via the Internet by SCAF leadership. Questions included both discrete multiple-choice and open-ended formats. Inductive thematic analyses were completed by three independent researchers trained in qualitative research methodology to identify primary themes consistent among study participants until thematic saturation was achieved. No statistical inferences were made. A total of 205 surveys were returned over the 5-month study period (July to November 2013); nine were received blank, leaving 196 surveys available for review. Major themes identified for survivors (N = 157) include the significance of and desire to share experiences with others; subculture identification (unique experience from those suffering a heart attack); and the need to seek a new normal, both personally and inter-personally. Major themes identified for FFMs (N = 39) include recognition of loved one's memory loss; a lack of information at discharge, including expectations after discharge; and concern for the patient experiencing another cardiac arrest. This pilot, qualitative survey study suggests several common themes important to survivors, and FFMs, of cardiac arrest. These themes may serve as a basis for future patient-centered focus groups and the development of patient-centered guidelines for patients and support persons of those surviving cardiac arrest.

How do people with body dysmorphic disorder view themselves? A thematic analysis.

PubMed

Silver, Joanna; Reavey, Paula; Anne Fineberg, Naomi

2010-09-01

Abstract Objectives. To examine the accounts of people with body dysmorphic disorder (BDD) and qualitatively explore self perceptions. Methods. Eleven people with BDD were interviewed using a semi-structured schedule. Participants brought photographs of themselves and drew a self-portrait. Transcribed interviews were analysed using a thematic analysis. Results. The most common theme was increased threat perception resulting in disordered interpersonal relationships. Other themes included the wish for regularity and symmetry in appearance, an idealised childhood self, the duty to look good, and a focus on specific "defective" features rather than general ugliness. Conclusions. Using thematic analysis and visual methods, we identified core themes that appear to characterise the way individuals with BDD perceive themselves and their interpersonal relationships. Thematic analysis offers promise as a tool to explore the overlap between BDD and other putatively related mental health problems.

Toward a convergence of regenerative medicine, rehabilitation, and neuroprosthetics.

PubMed

Aravamudhan, Shyam; Bellamkonda, Ravi V

2011-11-01

No effective therapeutic interventions exist for severe neural pathologies, despite significant advances in regenerative medicine, rehabilitation, and neuroprosthetics. Our current hypothesis is that a specific combination of tissue engineering, pharmacology, cell replacement, drug delivery, and electrical stimulation, together with plasticity-promoting and locomotor training (neurorehabilitation) is necessary to interact synergistically in order to activate and enable all damaged circuits. We postulate that various convergent themes exist among the different therapeutic fields. Therefore, the objective of this review is to highlight the convergent themes, which we believe have a common goal of restoring function after neural damage. The convergent themes discussed in this review include modulation of inflammation and secondary damage, encouraging endogenous repair/regeneration (using scaffolds, cell transplantation, and drug delivery), application of electrical fields to modulate healing and/or activity, and finally modulation of plasticity.

Dilemmas and challenges for the shelter sector: lessons learned from the Sphere revision process.

PubMed

Saunders, Graham

2004-06-01

Key dilemmas and challenges for those involved in the shelter sector are described, based on issues that emerged from the extensive global consultative process undertaken to inform the revision of the Sphere handbook. The range of perspectives on the major themes is presented, with suggestions as to how these issues could be progressed. Themes include the poor definition of the sector and the lack of a consistent approach among the leading shelter actors; the absence of a common terminology; the conflict between "temporary" versus "durable" solutions; the disconnect between technical advisers and the field; the need for greater recognition of local coping strategies and the local context; the involvement of recipients and host governments in policy development; the need for better "how-to" guidance; and the limited incorporation of the emerging themes of livelihoods etc. to date.

Advances in ADHD Research through the Lifespan: Common Themes and Implications

ERIC Educational Resources Information Center

Houghton, Stephen

2006-01-01

This short commentary synthesises all of the articles presented in Volume 53, Special Issues 1 and 2 of the "International Journal of Disability, Development and Education" and identifies some common themes among them. It also links some of the research findings to the influential International Consensus Statement on Attention Deficit…

An assessment of US microbiome research.

PubMed

Stulberg, Elizabeth; Fravel, Deborah; Proctor, Lita M; Murray, David M; LoTempio, Jonathan; Chrisey, Linda; Garland, Jay; Goodwin, Kelly; Graber, Joseph; Harris, M Camille; Jackson, Scott; Mishkind, Michael; Porterfield, D Marshall; Records, Angela

2016-01-11

Genome-enabled technologies have supported a dramatic increase in our ability to study microbial communities in environments and hosts. Taking stock of previously funded microbiome research can help to identify common themes, under-represented areas and research priorities to consider moving forward. To assess the status of US microbiome research, a team of government scientists conducted an analysis of federally funded microbiome research. Microbiomes were defined as host-, ecosystem- or habitat-associated communities of microorganisms, and microbiome research was defined as those studies that emphasize community-level analyses using 'omics technologies. Single pathogen, single strain and culture-based studies were not included, except symbiosis studies that served as models for more complex communities. Fourteen governmental organizations participated in the data call. The analysis examined three broad research themes, eight environments and eight microbial categories. Human microbiome research was larger than any other environment studied, and the basic biology research theme accounted for half of the total research activities. Computational biology and bioinformatics, reference databases and biorepositories, standardized protocols and high-throughput tools were commonly identified needs. Longitudinal and functional studies and interdisciplinary research were also identified as needs. This study has implications for the funding of future microbiome research, not only in the United States but beyond.

Common themes in changing vector-borne disease scenarios.

PubMed

Molyneux, David H

2003-01-01

The impact of climate change on disease patterns is controversial. However, global burden of disease studies suggest that infectious diseases will contribute a proportionately smaller burden of disease over the next 2 decades as non-communicable diseases emerge as public health problems. However, infectious diseases contribute proportionately more in the poorest quintile of the population. Notwithstanding the different views of the impact of global warming on vector-borne infections this paper reviews the conditions which drive the changing epidemiology of these infections and suggests that such change is linked by common themes including interactions of generalist vectors and reservoir hosts at interfaces with humans, reduced biodiversity associated with anthropogenic environmental changes, increases in Plasmodium falciparum: P. vivax ratios and well-described land use changes such as hydrological, urbanization, agricultural, mining and forest-associated impacts (extractive activities, road building, deforestation and migration) which are seen on a global scale.

Residual Effects on Students of a College Poverty Immersion Experience

ERIC Educational Resources Information Center

Firmin, Michael W.; Markham, Ruth Lowrie; Stultz, Kurt J.; Johnson, Heidi J.; Garland, Elizabeth P.

2016-01-01

The authors report the results of a phenomenological, qualitative research study involving 20 students who participated in a weekend poverty immersion experience. Analysis of the tape-recorded interviews included coding, checks for internal validity, and the generation of themes common to most of the research participants. Two overall results were…

Looping: Supporting Student Learning through Long-Term Relationships.

ERIC Educational Resources Information Center

Northeast and Islands Regional Educational Lab. at Brown Univ., Providence, RI.

Looping refers to the increasingly common practice of keeping groups of students together for two or more years with the same teacher. This booklet, first in a series of "Themes in Education" provides information on the educational practice of looping and includes selected current references on the topic. The booklet outlines the history of this…

A Study on the Perceived Risk of Surface Sample Collection Systems in Proposal Formulation

NASA Technical Reports Server (NTRS)

Sunday, Cecily M.

2012-01-01

This project compares design and proposal elements from multiple proposals and presents conclusions and recommendations for sampling systems. Contributions from this project include a list of common evaluation themes, concept and proposal-related strengths and weaknesses and ways in which self-identified risks relate the evaluation of the mission.

The Good, the Bad, the Ugly: Internships in Principal Preparation.

ERIC Educational Resources Information Center

Williamson, Ronald; Hudson, Martha

A theme common to recommendations for change in school leader preparation is that preparation be grounded in practice and include field-based experience or internship. Despite recognition for reform, substantial change has been slow to emerge. This study was conducted in North Carolina in 1995 to assess revised leadership preparation programs…

Contexts for Promise: Noteworthy Practices and Innovations in the Identification of Gifted Students.

ERIC Educational Resources Information Center

Callahan, Carolyn M., Ed.; And Others

This monograph contains 11 papers describing model projects that address the identification of gifted students. An introduction by Carolyn M. Callahan and Carol A. Tomlinson identifies commonalities and themes in the promising practices highlighted in the papers. The papers include: (1) "Project STREAM: Support, Training and Resources for…

Perceptions from Students and the Community about Community Colleges

ERIC Educational Resources Information Center

Lendy, Shari J.

2009-01-01

In this study I explored the existing perceptions of community college in the western suburbs of Chicago, Illinois. Three different groups of people were interviewed in the research process including high school students, college students and citizens who lived in towns supported by a community college. Common themes of perception found within the…

Treating patients with bipolar disorder and substance dependence: lessons learned.

PubMed

Weiss, Roger D

2004-12-01

Although bipolar disorder is the Axis I psychiatric disorder associated with the highest rate of co-occurring substance use disorders, little research has focused on treatments specifically designed for these patients. The author and his colleagues have developed and studied Integrated Group Therapy (IGT) for this population. This paper describes common themes that have emerged in carrying out IGT for patients with bipolar disorder and substance dependence. These include the strong emphasis on depression, as opposed to mania; the predominance of hopelessness; specific patterns of medication noncompliance; and the implications of patients' labeling their substance use as self-medication. Therapeutic aspects involved in addressing these themes are discussed.

Pre-registration children's and young people's nurse preparation. A SWOT analysis.

PubMed

Richardson, Jim; McEwing, Gillian; Glasper, Edward Alan

2006-12-01

An investigation was undertaken into the views of nurse educators on current approaches to preparing children's and young people's nurses in the UK. A convenience sample of lead academics in 17 child health nursing departments of British universities was contacted by email and invited to liaise with colleagues to generate lists of the strengths, weaknesses, opportunities and threats (SWOT) of the educational system. Thirteen departments provided data that were analysed and themed. Major themes included the common foundation programme, clinical skills learning, clinical placements and employment. More detailed evaluative work should be undertaken before wholesale changes are made to a relatively new curriculum.

How leadership attributes influence employee loyalty in the aerospace industry: An exploratory qualitative inquiry

NASA Astrophysics Data System (ADS)

Harrison, Marriel

The influence leaders have on employee loyalty in the aerospace industry was examined through exploratory, qualitative inquiry. In-depth, semi-structured interviews were conducted to ascertain the influence of six leadership attributes on loyalty. These specific leadership attributes were addressed based on key themes from the scholarly leadership research and included communication, trust, accountability, understanding, compassion, and recognition. Data were analyzed to identify common themes and patterns among the 21 study participants. Based on the study findings, the majority of participants expressed that they want leaders to communicate--and to do so often and concisely. Participants also voiced that communication was a central component in resolving many of the problems associated with loyalty, such as clarity of direction or sense of inclusion in the organization. The central themes derived from the research include the following: (a) employee loyalty no longer exists when organizational leadership fails to challenge or empower employees or create an opportunity for growth, (b) effective leaders inspire employees by sharing the vision of an organization and including employees in the decision-making process, and (c) organizational culture, values, and effective leadership play an integral role in employee loyalty and long-term commitment to the organization.

Applying Common Latino Magazine Cover Line Themes to Health Communications

ERIC Educational Resources Information Center

Delaney, Colleen L.; Barrios, Pamela; Lozada, Carolina; Soto-Balbuena, Kenlly; Martin-Biggers, Jennifer; Byrd-Bredbenner, Carol

2016-01-01

This study aimed to describe strategies used in magazine cover lines to capture the attention of Latino consumers. A content analysis of cover lines (n = 581) from six top-selling Latino women's and parenting magazines (n = 217 issues) sold in the United States identified 12 common themes: great/inspiring, beauty/health, bad/negative,…

Attitudes toward Tobacco, Alcohol, and Non-Alcoholic Beverage Advertisement Themes among Adolescent Boys.

PubMed

Friedman, Katherine L; Roberts, Megan E; Keller-Hamilton, Brittney; Yates, Katherine A; Paskett, Electra D; Berman, Micah L; Slater, Michael D; Lu, Bo; Ferketich, Amy K

2018-02-13

Previous studies have examined what adolescents find appealing in tobacco and alcohol advertisements and how different themes in advertisements are used to manipulate consumer behaviors. Yet, we know little about the relationship between the themes portrayed in advertisements and youth attitudes towards those themes. This study compared attitudes towards advertisements for different consumer products in a sample of urban and rural adolescent boys in order to examine how key marketing themes impact adolescent attitudes towards those advertisements. Participants were 11- to 16-year-old boys (N = 1220) residing in either urban or rural Ohio Appalachian counties. Each participant viewed five print advertisements (one each for cigarettes, electronic cigarettes (e-cigarettes), smokeless tobacco (SLT), non-alcoholic beverages, and alcohol), presented in a random order, for eight seconds each. All advertisements had appeared in magazines that adolescent males commonly read. Attitudes towards each of the five advertisements were assessed. The advertisements were then coded for the presence of various themes, including social acceptance and masculinity. Analyses were conducted to determine associations between advertisement type and the attitude measure, and between the presence of a theme and the attitude measure. Overall, participants preferred non-tobacco advertisements to tobacco advertisements, rural participants had less positive attitudes and participants who had peers who used tobacco had more positive attitudes. Social acceptance and entertainment themes increased the appeal of SLT advertisements, and sex appeal increased the appeal of e-cigarette advertisements. Conclusions/Importance: Findings suggest that advertisements that promote the social nature of use in SLT advertisements may be of particular concern for their influence on adolescent boys.

Life-style themes of unwed pregnant adolescents who chose to keep their babies.

PubMed

Jorgensen, J A; Newlon, B J

1988-12-01

The authors point out that the largest increase in birthrate is accounted for by girls under age 15; the rise in teenage baby keeping is also a major source of alarm in America. The subjects interviewed for this study were currently enrolled in a Teenage Parent Program for girls aged 14-18 in a large southwestern city. All participants in the study were Anglos from middle to lower-middle income families. Participants included 2 15-year-olds, 2 16-year-olds, 3 17-year-olds, and 3 18-year-olds. All were unwed and kept their babies after birth. Each subject participated in a tape-recorded interview which lasted from 30 minutes to 1 hour and included early recollections and birth order information. Transcripts were analyzed and interpreted by 3 expert Adlerian therapists. Examination of these transcripts revealed themes common to the group as a whole. These themes centered around the desire for a close, idealized relationship with someone, the goal of excitement, and the expectation of being confused, unknowing, or afraid. The group also demonstrated a lack of themes centering on their own anger or victimization. They did, however, perceive themselves as being isolated from their parents. Those subjects who shared the same birth order position tended to have specific traits in common. The youngest in terms of birth order tended to use their confusion to keep others involved with them. The only and 1st borough tended to use their confusion and fear to deflect the burden of responsibility which was a strong component of their life-style. Lack of self-esteem was 1 commonly held characteristic. If society wishes to change the current increase in teenage pregnancies, a greater understanding of the importance of belonging and self-worth is needed by the significant adults in young people's lives. Increased understanding could lead to changes within the family and the educational institution. Self-esteem in young people would be encouraged and a sense of belonging developed through means other than adolescent pregnancy.

A qualitative phenomenological analysis of the subjective experience and understanding of the at risk mental state

PubMed Central

Brew, Benjamin; Shannon, Ciaran; Storey, Lesley; Boyd, Adrian; Mulholland, Ciaran

2017-01-01

ABSTRACT Over recent years there has been a growing interest in identifying the early stages of psychosis. The At Risk Mental State (ARMS) is characteristic of the prodromal stages of psychosis and its identification gives rise to a number of clinical and research opportunities including early intervention and prevention of psychosis. This study employs interpretative phenomenological analysis to gain insights into the subjective experience and individuals understanding of the development of their ARMS. Five participants took part and provided information on the experience of symptoms, life prior to onset of their ARMS and their understanding of symptoms and their development through a semi structured interview. From the analysis of transcripts eight themes emerged which were common across participants accounts. Three themes of experience (disturbed world/disturbed self, disconnection with the world, thunderstruck) and five themes of understanding (absence of understanding, use of others, identity, forming links, fragmented understanding) were identified. Themes are explored in detail and discussed in relation to existing literature and theory. Clinical implications, directions for future research, and limitations are discussed within. PMID:28689474

Identifying common values among seven health professions: An interprofessional analysis.

PubMed

Grace, Sandra; Innes, Ev; Joffe, Beverly; East, Leah; Coutts, Rosanne; Nancarrow, Susan

2017-05-01

This article reviews the competency frameworks of seven Australian health professions to explore relationships among health professions of similar status as reflected in their competency frameworks and to identify common themes and values across the professions. Frameworks were compared using a constructivist grounded theory approach to identify key themes, against which individual competencies for each profession were mapped and compared. The themes were examined for underlying values and a higher order theoretical framework was developed. In contrast to classical theories of professionalism that foreground differentiation of professions, our study suggests that the professions embrace a common structure and understanding, based on shared underpinning values. We propose a model of two core values that encompass all identified themes: the rights of the client and the capacity of a particular profession to serve the healthcare needs of clients. Interprofessional practice represents the intersection of the rights of the client to receive the best available healthcare and the recognition of the individual contribution of each profession. Recognising that all health professions adhere to a common value base, and exploring professional similarities and differences from that value base, challenges a paradigm that distinguishes professions solely on scope of practice.

Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

PubMed Central

2011-01-01

Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%), and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55); concerns with chiropractic treatment (n = 54); areas where chiropractic is perceived as effective (n = 43); unethical behavior (n = 43); patient interaction (n = 36); the scientific basis of chiropractic (n = 26); personal experiences with chiropractic (n = 21); and chiropractic training (n = 18). Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare. PMID:21970333

Gay Penguins, Sissy Ducklings ... and Beyond? Exploring Gender and Sexuality Diversity through Children's Literature

ERIC Educational Resources Information Center

DePalma, Renée

2016-01-01

From 2006 to 2008 UK-based primary school teachers in the "No Outsiders" project explored possibilities for addressing sexualities equality in their classrooms. What all teachers had in common was a resource pack that included 27 children's books exploring themes of gender and sexuality diversity either directly or indirectly (i.e. by…

Teaching "Islam and Human Rights" in the Classroom

ERIC Educational Resources Information Center

Muedini, Fait A.

2012-01-01

This article discusses my approach to teaching a course on Islam and human rights. I begin by examining the attention Islam has received in the media and classroom. Then, I discuss how I structure lectures on Islam and human rights, the various readings associated with the lectures, as well as common themes discussed in class that include but are…

Pinning down the Constitution: Interactively Teaching Congress's Power, Federalism, and Constitutional Interpretation

ERIC Educational Resources Information Center

Emenaker, Ryan

2014-01-01

"Pin-the-Tail-on-the-Constitution" is an engaged-learning activity that has been conducted in 26 classes over the past four years. The activity teaches multiple themes commonly included in a variety of courses on American politics such as federalism, congressional powers, the role of the federal courts, and the relevance of the commerce…

Novels of Initiation: A Guidebook for Teaching Literature to Adolescents.

ERIC Educational Resources Information Center

Peck, David

Intended as a guidebook for high school English teachers, this book contains analyses of American novels commonly read in high school English classes. Each chapter is divided into two sections: an analysis of the novel, including discussions of story and setting, characters, themes, and language and style; and a guide to teaching the novel in the…

Standardisation of delivery and assessment of research training for specialty trainees based on curriculum requirements: recommendations based on a scoping review.

PubMed

Rangan, Amar; Pitchford, James; Williams, Penny; Wood, Brian; Robson, Stephen

2017-02-06

(1) To conduct a scoping review of postgraduate specialty training (ST) curricula for doctors within Health Education England in order to identify common themes and variations in requirements for training and assessment of research competencies. (2) To make recommendations on standardisation of training for clinical research across ST programmes. Health Education England North East and National Institute for Health Research Clinical Research Network (CRN)-North East and North Cumbria. Annual Review of Competence Progression (ARCP); Certificate of Completion of Training (CCT) checklists and curricula for ST were obtained from Health Education England North East and reviewed between June and September 2015. Research competence requirements based on knowledge, skills or behaviour-based domains were identified and entered onto a spreadsheet for analysis. Common themes with levels of competence required were identified. This information was used to construct and propose a model for delivery of training in clinical research across ST programmes. Sixty-two ST curricula were reviewed and seven common themes for research training were found in up to 97% of the curricula. Requirement for good clinical practice (GCP) in research training was included in 15% of curricula. One of the common themes involved knowledge-based competency, and three each of the remaining seven involved skills or behaviour-based competencies. There was less clarity and larger variation between specialties in how research competencies were assessed; and what evidence was required for ARCP and CCT to assure competence. 63% (19/30) of curricula from medical specialties had no mention of research requirements within their ARCP guidelines. Given that the majority of specialty curricula contain consistent themes around core research knowledge, consideration should be given to standardising the delivery and assessment of generic research competencies within ST. Our recommendations from this review could form the basis for developing structured research training for specialty trainees involving: (1) a taught course for knowledge-based competencies; (2) clinical placements with CRN teams for practical workplace-based experience and (3) developing research tutors to help support placements and assessment of these competencies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Apical constriction: themes and variations on a cellular mechanism driving morphogenesis

PubMed Central

Martin, Adam C.; Goldstein, Bob

2014-01-01

Apical constriction is a cell shape change that promotes tissue remodeling in a variety of homeostatic and developmental contexts, including gastrulation in many organisms and neural tube formation in vertebrates. In recent years, progress has been made towards understanding how the distinct cell biological processes that together drive apical constriction are coordinated. These processes include the contraction of actin-myosin networks, which generates force, and the attachment of actin networks to cell-cell junctions, which allows forces to be transmitted between cells. Different cell types regulate contractility and adhesion in unique ways, resulting in apical constriction with varying dynamics and subcellular organizations, as well as a variety of resulting tissue shape changes. Understanding both the common themes and the variations in apical constriction mechanisms promises to provide insight into the mechanics that underlie tissue morphogenesis. PMID:24803648

Management of common gastrointestinal disorders: quality criteria based on patients' views and practice guidelines

PubMed Central

Jones, Roger; Hunt, Claire; Stevens, Richard; Dalrymple, Jamie; Driscoll, Richard; Sleet, Sarah; Smith, Jonathan Blanchard

2009-01-01

Background Although gastrointestinal disorders are common in general practice, clinical guidelines are not always implemented, and few patient-generated quality criteria are available to guide management. Aim To develop quality criteria for the management of four common gastrointestinal disorders: coeliac disease, gastro-oesophageal reflux disease (GORD), inflammatory bowel disease, and irritable bowel syndrome. Design of study Qualitative study including thematic analysis of transcripts from patient focus groups and content analysis of published clinical practice guidelines. Emergent themes were synthesised by a consensus panel, into quality criteria for each condition. Setting Community-based practice in England, UK. Methods Fourteen focus groups were conducted (four for coeliac disease, irritable bowel syndrome, and inflammatory bowel disease, and two for GORD) involving a total of 93 patients (64 females, 29 males; mean age 55.4 years). Quality criteria were based on patients' views and expectations, synthesised with an analysis of clinical practice guidelines. Results A chronic disease management model was developed for each condition. Key themes included improving the timeliness and accuracy of diagnosis, appropriate use of investigations, better provision of information for patients, including access to patient organisations, better communication with, and access to, secondary care providers, and structured follow-up and regular review, particularly for coeliac disease and inflammatory bowel disease. Conclusion This study provides a model for the development of quality markers for chronic disease management in gastroenterology, which is likely to be applicable to other chronic conditions. PMID:19520018

Complex Decision-Making in Heart Failure: A Systematic Review and Thematic Analysis.

PubMed

Hamel, Aimee V; Gaugler, Joseph E; Porta, Carolyn M; Hadidi, Niloufar Niakosari

Heart failure follows a highly variable and difficult course. Patients face complex decisions, including treatment with implantable cardiac defibrillators, mechanical circulatory support, and heart transplantation. The course of decision-making across multiple treatments is unclear yet integral to providing informed and shared decision-making. Recognizing commonalities across treatment decisions could help nurses and physicians to identify opportunities to introduce discussions and support shared decision-making. The specific aims of this review are to examine complex treatment decision-making, specifically implantable cardiac defibrillators, ventricular assist device, and cardiac transplantation, and to recognize commonalities and key points in the decisional process. MEDLINE, CINAHL, PsycINFO, and Web of Science were searched for English-language studies that included qualitative findings reflecting the complexity of heart failure decision-making. Using a 3-step process, findings were synthesized into themes and subthemes. Twelve articles met criteria for inclusion. Participants included patients, caregivers, and clinicians and included decisions to undergo and decline treatment. Emergent themes were "processing the decision," "timing and prognostication," and "considering the future." Subthemes described how participants received and understood information about the therapy, making and changing a treatment decision, timing their decision and gauging health status outcomes in the context of their decision, the influence of a life or death decision, and the future as a factor in their decisional process. Commonalities were present across therapies, which involved the timing of discussions, the delivery of information, and considerations of the future. Exploring this further could help support patient-centered care and optimize shared decision-making interventions.

A Millennial Challenge: Extremism in Uncertain Times

PubMed Central

Fiske, Susan T.

2014-01-01

This comment highlights the relevance and importance of the uncertainty-extremism topic, both scientifically and societally, identifies common themes, locates this work in a wider scientific and social context, describes what we now know and what we still do not, acknowledges some limitations, foreshadowing future directions, and discusses some potential policy relevance. Common themes emerge around the importance of social justice as sound anti-extremism policy. PMID:24511155

Dancing with the Devil: Information Technology and the New Competition in Higher Education. Jossey-Bass Higher and Adult Education Series.

ERIC Educational Resources Information Center

Katz, Richard N., Ed.

The six chapters of this volume address issues related to emerging technologies and competition as higher education leaders plan for their institutions' development. A preface identifies common themes of the individual papers, including changes in higher education enabled by or driven by information technology, the authors' shared belief that the…

The Earth Is Faster Now: Indigenous Observations of Arctic Environmental Change. Frontiers in Polar Social Science.

ERIC Educational Resources Information Center

Krupnik, Igor, Ed.; Jolly, Dyanna, Ed.

This book focuses on documenting and understanding the nature of environmental changes observed by indigenous residents of the Arctic. Common themes include increasing variability and unpredictability of the weather and seasonal climatic patterns, as well as changes in the sea ice and the health of wildlife. Nine papers focus on these changes,…

Understanding Collaborative Leadership in Theory and Practice

ERIC Educational Resources Information Center

Lawrence, Randee Lipson

2017-01-01

This final chapter provides a synthesis and analysis of the major themes in the previous chapters. Definitions of collaborative leadership are explored along with theoretical underpinnings, characteristics, and common themes. Implications for adult education are discussed.

Coping and acceptance: the greatest challenge for veterans with intestinal stomas.

PubMed

Krouse, Robert S; Grant, Marcia; Rawl, Susan M; Mohler, M Jane; Baldwin, Carol M; Coons, Stephen Joel; McCorkle, Ruth; Schmidt, C Max; Ko, Clifford Y

2009-03-01

Intestinal stomas (ostomies) create challenges for veterans. The goal of this qualitative analysis was to understand better patients' perspectives regarding their greatest challenge. Ostomates at three Veterans Affairs locations were surveyed using the modified City of Hope Quality of Life-Ostomy questionnaire that contained an open-ended request for respondents to describe their greatest challenge. The response rate was 51% (239 of 467); 68% (163 of 239) completed the open-ended item. Content analysis was performed by an experienced qualitative research team. Coping and acceptance were the most commonly addressed themes. The most frequently expressed issues and advice were related to a need for positive thinking and insight regarding adjustment over time. Coping strategies included the use of humor, recognition of positive changes resulting from the stoma, and normalization of life with an ostomy. Coping and acceptance are common themes described by veterans with an intestinal stoma. Health-care providers can assist veterans by utilizing ostomate self-management strategies, experience, and advice.

Overcoming Barriers to Integrating Behavioral Health and Primary Care Services

PubMed Central

Grazier, Kyle L.; Smiley, Mary L.; Bondalapati, Kirsten S.

2016-01-01

Objective: Despite barriers, organizations with varying characteristics have achieved full integration of primary care services with providers and services that identify, treat, and manage those with mental health and substance use disorders. What are the key factors and common themes in stories of this success? Methods: A systematic literature review and snowball sampling technique was used to identify organizations. Site visits and key informant interviews were conducted with 6 organizations that had over time integrated behavioral health and primary care services. Case studies of each organization were independently coded to identify traits common to multiple organizations. Results: Common characteristics include prioritized vulnerable populations, extensive community collaboration, team approaches that included the patient and family, diversified funding streams, and data-driven approaches and practices. Conclusions: While significant barriers to integrating behavioral health and primary care services exist, case studies of organizations that have successfully overcome these barriers share certain common factors. PMID:27380923

Writing on the board as students' preferred teaching modality in a physiology course.

PubMed

Armour, Chris; Schneid, Stephen D; Brandl, Katharina

2016-06-01

The introduction of PowerPoint presentation software has generated a paradigm shift in the delivery of lectures. PowerPoint has now almost entirely replaced chalkboard or whiteboard teaching at the undergraduate and graduate levels. This study investigated whether undergraduate biology students preferred to have lectures delivered by PowerPoint or written on the board as well as the reasons behind their preference. Two upper-division physiology courses were surveyed over a period of 7 yr. A total of 1,905 students (86.7%) indicated they preferred lectures delivered by "writing on the board" compared to 291 students (13.3%) who preferred PowerPoint. Common themes drawn from explanations reported by students in favor of writing on the board included: 1) more appropriate pace, 2) facilitation of note taking, and 3) greater alertness and attention. Common themes in favor of PowerPoint included 1) increased convenience, 2) focus on listening, and 3) more accurate and readable notes. Based on the students' very strong preference for writing on the board and the themes supporting that preference, we recommend that instructors incorporate elements of the writing on the board delivery style into whatever teaching modality is used. If instructors plan to use PowerPoint, the presentation should be paced, constructed, and delivered to provide the benefits of lectures written on the board. The advantages of writing on the board can be also incorporated into instruction intended to occur outside the classroom, such as animated narrated videos as part of the flipped classroom approach. Copyright © 2016 The American Physiological Society.

Ethical frameworks for surrogates’ end-of-life planning experiences: A qualitative systematic review

PubMed Central

Kim, Hyejin; Deatrick, Janet A; Ulrich, Connie M

2016-01-01

Despite the growing body of knowledge about surrogate decision making, we know very little about the use of ethical frameworks including ethical theories, principles, and concepts to understand surrogates’ day-to-day experiences in end-of-life care planning for incapacitated adults. This systematic review of 30 qualitative research papers was conducted to identify the types of ethical frameworks used to address surrogates’ experiences in end-of-life care planning for incapacitated adults as well as the most common themes or patterns found in surrogate decision making research.. Seven papers explicitly identified ethical theories, principles, or concepts for their studies, such as autonomy, substituted judgment, and best interests. Themes identified about surrogate decision making included: responsibilities and goals, factors affecting surrogates’ decision making, and outcomes for surrogates. In fact, an overarching theme of “wanting to do the right thing” for incapacitated adults and/or themselves was prominent. Understanding the complexity of surrogates’ experiences of end-of-life care planning is beyond the scope of conventional ethical frameworks. Ethical frameworks that address individuality and contextual variations related to decision making may more appropriately guide surrogate decision making research that explores surrogates’ end-of-life care planning experiences. PMID:27005954

Developing content for an interprofessional training on fear of cancer recurrence (FCR): Key informant interviews of healthcare professionals, researchers and cancer survivors.

PubMed

Berrett-Abebe, Julie; Cadet, Tamara; Vitello, Joan; Maramaldi, Peter

2018-04-10

Growing numbers of cancer survivors are receiving healthcare through primary care practitioners, who often lack cancer-specific expertise to effectively treat survivors' concerns. Addressing that gap, this study aimed to develop content for a training on fear of cancer recurrence (FCR), a common concern in survivorship. Grounded in naturalistic inquiry, 42 key-informant interviews were conducted, transcribed, and analyzed for themes. Participants were healthcare professionals, researchers, and cancer survivors Results: Results included themes ranging from: rich conceptualizations of FCR, opportunities and challenges for addressing FCR in healthcare settings, interventions to address FCR, and important information to include in a training on FCR. This paper provides content for an interprofessional training and highlights the importance of developing trainings for interprofessional teams, given identified barriers that physicians face in addressing FCR and other psychosocial concerns of survivors in primary care.

Barriers to diagnosing and managing hypertension - a qualitative study in Australian general practice.

PubMed

Howes, Faline; Hansen, Emily; Williams, Danielle; Nelson, Mark

2010-07-01

Elevated blood pressure (BP) is a major modifiable risk factor. However hypertension still remains underdiagnosed, untreated or suboptimally treated. This study aimed to identify and explore barriers to initiating medication and treating elevated BP to target levels in the general practice setting. Six focus groups involving 30 clinicians were audio recorded, transcribed in full and analysed for common emerging themes using an iterative thematic analysis. After making the decision to commence treatment, medication initiation was relatively straightforward. Clinical uncertainty about true underlying BP, distrust of measurement technology, and distrust of the evidence underpinning hypertension management were expressed. Patient age, gender and comorbidity influenced treatment strategy. Related themes included perceived patient attitude, clinical inertia, and patient centred care. Systems issues included lack of resources and lack of time. The management of an asymptomatic chronic disease within a patient centred, encounter based primary care context can be challenging.

Risk Taking and Decision Making in Kidney Paired Donation: A Qualitative Study by Semistructured Interviews.

PubMed

Baines, L S; Dulku, H; Jindal, R M; Papalois, V

2018-06-01

Despite excellent outcomes of kidney paired donation (KPD), little is known about how a patient's frame (apply cognitive bias) or weight (attribute value) and concerns relating to risk, justice, and equity affect his or her decision-making process. A pilot study consisting of 3 KPD transplant recipients and 3 KPD kidney donors in the last year was conducted to identify and explore themes in decision making and risk taking. The pilot study was followed by the main study comprised of 20 recipients who had already undergone KPD transplantation and 20 donors who had undergone donor nephrectomy. We conducted semistructured interviews in this cohort and analyzed the data thematically. Each donor-recipient pair was interviewed together to facilitate dyadic conversation and provide deeper insight into the decision-making process leading to transplant and donation. Common themes to both recipient and donor decision making included quality of life; characteristics of the unknown donor and post-transplant expectations. Recipient-specific themes included failure to reach life span milestones, experiences of fellow patients, and altruistic desire to expand the donor pool. Donor-specific themes included balancing existing life commitments with the recipient's need for a kidney, equity and mental accounting in kidney exchange (comparable quality of the kidney received versus the kidney donated), and logistical justice for the recipient. Donors and recipients frame and weight the concepts of risk, justice, and equity differently. This may have direct implications to facilitating patient-centered communication and engagement in KPD pairs. Copyright © 2018 Elsevier Inc. All rights reserved.

Integrated multi-cohort transcriptional meta-analysis of neurodegenerative diseases.

PubMed

Li, Matthew D; Burns, Terry C; Morgan, Alexander A; Khatri, Purvesh

2014-09-04

Neurodegenerative diseases share common pathologic features including neuroinflammation, mitochondrial dysfunction and protein aggregation, suggesting common underlying mechanisms of neurodegeneration. We undertook a meta-analysis of public gene expression data for neurodegenerative diseases to identify a common transcriptional signature of neurodegeneration. Using 1,270 post-mortem central nervous system tissue samples from 13 patient cohorts covering four neurodegenerative diseases, we identified 243 differentially expressed genes, which were similarly dysregulated in 15 additional patient cohorts of 205 samples including seven neurodegenerative diseases. This gene signature correlated with histologic disease severity. Metallothioneins featured prominently among differentially expressed genes, and functional pathway analysis identified specific convergent themes of dysregulation. MetaCore network analyses revealed various novel candidate hub genes (e.g. STAU2). Genes associated with M1-polarized macrophages and reactive astrocytes were strongly enriched in the meta-analysis data. Evaluation of genes enriched in neurons revealed 70 down-regulated genes, over half not previously associated with neurodegeneration. Comparison with aging brain data (3 patient cohorts, 221 samples) revealed 53 of these to be unique to neurodegenerative disease, many of which are strong candidates to be important in neuropathogenesis (e.g. NDN, NAP1L2). ENCODE ChIP-seq analysis predicted common upstream transcriptional regulators not associated with normal aging (REST, RBBP5, SIN3A, SP2, YY1, ZNF143, IKZF1). Finally, we removed genes common to neurodegeneration from disease-specific gene signatures, revealing uniquely robust immune response and JAK-STAT signaling in amyotrophic lateral sclerosis. Our results implicate pervasive bioenergetic deficits, M1-type microglial activation and gliosis as unifying themes of neurodegeneration, and identify numerous novel genes associated with neurodegenerative processes.

The use of social environment in a psychosocial clubhouse to facilitate recovery-oriented practice

PubMed Central

Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2016-01-01

Background Recovery-oriented language has been widely adopted in mental health policy; however, little is known about how recovery practices are implemented within individual services, such as psychosocial clubhouses. Aims To explore how recovery practices are implemented in a psychosocial clubhouse. Method Qualitative case study design informed by self-determination theory was utilised. This included 120 h of participant observation, interviews with 12 clubhouse members and 6 staff members. Field notes and interview transcripts were subject to theoretical thematic analysis. Results Two overarching themes were identified, each comprising three sub-themes. In this paper, the overarching theme of ‘social environment’ is discussed. It was characterised by the sub-themes, ‘community and consistency’, ‘participation and opportunity’ and ‘respect and autonomy’. Conclusions Social environment was used to facilitate recovery-oriented practice within the clubhouse. Whether recovery is experienced by clubhouse members in wider society, may well depend on supports and opportunities outside the clubhouse. Declaration of interests None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703771

Redefining self: patients' decision making about treatment for multiple sclerosis.

PubMed

Lowden, Diane; Lee, Virginia; Ritchie, Judith A

2014-08-01

The treatment of multiple sclerosis (MS) has become possible with the advent of disease-modifying therapies, but little is known about patients' experiences when faced with a complex array of treatment options. The purpose of this phenomenological study was to explore the lived experience of making a first decision about treatment with disease-modifying therapies for relapsing-remitting MS. Nine participants shared their perspectives on negotiating the decision to accept, refuse, or delay treatment. All individuals described a core theme in which decision making about treatment was part of a process of coming to a "redefined self." This core theme included reflections about self-image, quality of life, goals, and being a person with MS. Six common themes supporting this core theme were (a) weighing and deciding what's important, (b) acknowledging the illness as part of oneself, (c) playing the mental game, (d) seeking credible resources, (e) evaluating symptoms and fit with quality of life, and (f) managing the roles and involvement of family. The findings of this study provide a greater understanding about the experience of making a therapeutic choice for those with MS and offer insights for nurses when supporting patients faced with options about treatment.

Training Impact on Novice and Experienced Research Coordinators.

PubMed

Behar-Horenstein, Linda S; Potter, JoNell Efantis; Prikhidko, Alena; Swords, Stephanie; Sonstein, Stephen; Kolb, H Robert

2017-12-01

Competency-based training and professional development is critical to the clinical research enterprise. Understanding research coordinators' perspectives is important for establishing a common core curriculum. The purpose of this study was to describe participants' perspectives regarding the impact of online and classroom training sessions. 27 participants among three institutions, completed a two-day classroom training session. 10 novice and seven experienced research coordinators participated in focus group interviews. Grounded theory revealed similarities in novice and experienced coordinator themes including Identifying Preferences for Instruction and Changing Self Perceptions. Differences, seen in experienced participants, focused on personal change, in the theme of Re-Assessing Skills. Infrastructure and cultural issues were evident in their theme, Promoting Leadership and Advocacy. Novice participants recommended ways to improve training via their theme of Making Programmatic Improvements. Participants reported a clear preference for classroom learning. Training played an influential role in changing participants' self-perceptions by validating their experiences. The findings provided guidance for developing a standardized curriculum. Training must be carefully tailored to the needs of participants while considering audience needs based on work experience, how technology can be used and offering content that is most urgently needed.

Training Impact on Novice and Experienced Research Coordinators

PubMed Central

Behar-Horenstein, Linda S.; Potter, JoNell Efantis; Prikhidko, Alena; Swords, Stephanie; Sonstein, Stephen; Kolb, H. Robert

2017-01-01

Competency-based training and professional development is critical to the clinical research enterprise. Understanding research coordinators’ perspectives is important for establishing a common core curriculum. The purpose of this study was to describe participants’ perspectives regarding the impact of online and classroom training sessions. 27 participants among three institutions, completed a two-day classroom training session. 10 novice and seven experienced research coordinators participated in focus group interviews. Grounded theory revealed similarities in novice and experienced coordinator themes including Identifying Preferences for Instruction and Changing Self Perceptions. Differences, seen in experienced participants, focused on personal change, in the theme of Re-Assessing Skills. Infrastructure and cultural issues were evident in their theme, Promoting Leadership and Advocacy. Novice participants recommended ways to improve training via their theme of Making Programmatic Improvements. Participants reported a clear preference for classroom learning. Training played an influential role in changing participants’ self-perceptions by validating their experiences. The findings provided guidance for developing a standardized curriculum. Training must be carefully tailored to the needs of participants while considering audience needs based on work experience, how technology can be used and offering content that is most urgently needed. PMID:29308457

The Themes, Institutions, and People of Medical Education Research 1988-2010: Content Analysis of Abstracts from Six Journals

ERIC Educational Resources Information Center

Rotgans, Jerome I.

2012-01-01

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on…

Understanding ethical dilemmas in the emergency department: views from medical students' essays.

PubMed

House, Joseph B; Theyyunni, Nikhil; Barnosky, Andrew R; Fuhrel-Forbis, Andrea; Seeyave, Desiree M; Ambs, Dawn; Fischer, Jonathan P; Santen, Sally A

2015-04-01

For medical students, the emergency department (ED) often presents ethical problems not encountered in other settings. In many medical schools there is little ethics training during the clinical years. The benefits of reflective essay writing in ethics and professionalism education are well established. The purpose of this study was to determine and categorize the types of ethical dilemmas and scenarios encountered by medical students in the ED through reflective essays. During a 4(th)-year emergency medicine rotation, all medical students wrote brief essays on an ethical situation encountered in the ED, and participated in an hour debriefing session about these essays. Qualitative analysis was performed to determine common themes from the essays. The frequency of themes was calculated. The research team coded 173 essays. The most common ethical themes were autonomy (41%), social justice (32.4%), nonmaleficence (31.8%), beneficence (26.6%), fidelity (12%), and respect (8.7%). Many of the essays contained multiple ethical principles that were often in conflict with each other. In one essay, a student grappled with the decision to intubate a patient despite a preexisting do-not-resuscitate order. This patient encounter was coded with autonomy, beneficence, and nonmaleficence. Common scenarios included ethical concerns when caring for critical patients, treatment of pain, homeless or alcoholic patients, access to care, resource utilization, and appropriateness of care. Medical students encounter patients with numerous ethically based issues. Frequently, they note conflicts between ethical principles. Such essays constitute an important resource for faculty, resident, and student ethics training. Copyright © 2015 Elsevier Inc. All rights reserved.

Issues with data and analyses: Errors, underlying themes, and potential solutions

PubMed Central

Allison, David B.

2018-01-01

Some aspects of science, taken at the broadest level, are universal in empirical research. These include collecting, analyzing, and reporting data. In each of these aspects, errors can and do occur. In this work, we first discuss the importance of focusing on statistical and data errors to continually improve the practice of science. We then describe underlying themes of the types of errors and postulate contributing factors. To do so, we describe a case series of relatively severe data and statistical errors coupled with surveys of some types of errors to better characterize the magnitude, frequency, and trends. Having examined these errors, we then discuss the consequences of specific errors or classes of errors. Finally, given the extracted themes, we discuss methodological, cultural, and system-level approaches to reducing the frequency of commonly observed errors. These approaches will plausibly contribute to the self-critical, self-correcting, ever-evolving practice of science, and ultimately to furthering knowledge. PMID:29531079

A content analysis of tweets about high-potency marijuana.

PubMed

Cavazos-Rehg, Patricia A; Sowles, Shaina J; Krauss, Melissa J; Agbonavbare, Vivian; Grucza, Richard; Bierut, Laura

2016-09-01

"Dabbing" involves heating extremely concentrated forms of marijuana to high temperatures and inhaling the resulting vapor. We studied themes describing the consequences of using highly concentrated marijuana by examining the dabbing-related content on Twitter. Tweets containing dabbing-related keywords were collected from 1/1-1/31/2015 (n=206,854). A random sample of 5000 tweets was coded for content according to pre-determined categories about dabbing-related behaviors and effects experienced using a crowdsourcing service. An examination of tweets from the full sample about respiratory effects and passing out was then conducted by selecting tweets with relevant keywords. Among the 5000 randomly sampled tweets, 3540 (71%) were related to dabbing marijuana concentrates. The most common themes included mentioning current use of concentrates (n=849; 24%), the intense high and/or extreme effects from dabbing (n=763; 22%) and excessive/heavy dabbing (n=517; 15%). Extreme effects included both physiological (n=124/333; 37%) and psychological effects (n=55/333; 17%). The most common physiologic effects, passing out (n=46/333; 14%) and respiratory effects (n=30/333; 9%), were then further studied in the full sample of tweets. Coughing was the most common respiratory effect mentioned (n=807/1179; 68%), and tweeters commonly expressed dabbing with intentions to pass out (416/915; 45%). This study adds to the limited understanding of marijuana concentrates and highlights self-reported physical and psychological effects from this type of marijuana use. Future research should further examine these effects and the potential severity of health consequences associated with concentrates. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Health impacts of floods.

PubMed

Du, Weiwei; FitzGerald, Gerard Joseph; Clark, Michele; Hou, Xiang-Yu

2010-01-01

Floods are the most common hazard to cause disasters and have led to extensive morbidity and mortality throughout the world. The impact of floods on the human community is related directly to the location and topography of the area, as well as human demographics and characteristics of the built environment. The aim of this study is to identify the health impacts of disasters and the underlying causes of health impacts associated with floods. A conceptual framework is developed that may assist with the development of a rational and comprehensive approach to prevention, mitigation, and management. This study involved an extensive literature review that located >500 references, which were analyzed to identify common themes, findings, and expert views. The findings then were distilled into common themes. The health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the medium-term, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy. This article proposes a structured approach to the classification of the health impacts of floods and a conceptual framework that demonstrates the relationships between floods and the direct and indirect health consequences.

A mixed-method study on the generic and ostomy-specific quality of life of cancer and non-cancer ostomy patients.

PubMed

Jansen, Femke; van Uden-Kraan, Cornelia F; Braakman, J Annemieke; van Keizerswaard, Paulina M; Witte, Birgit I; Verdonck-de Leeuw, Irma M

2015-06-01

The aim of this study is to compare the generic and ostomy-specific quality of life (QoL) between cancer and non-cancer ostomy patients using a mixed-method design. All patients with an ostomy participating in the Stomapanel of the Dutch Ostomy Association were asked to complete a generic (RAND-36) and ostomy-specific (Stoma-QoL) QoL questionnaire. In addition, open-ended questions on symptoms, restrictions or adaptations influencing daily life were included. The generic and ostomy-specific QoL between cancer and non-cancer ostomy patients were compared using linear regression analyses. Qualitative responses were analysed using content analysis. In total, 668 patients were included: 379 cancer patients (80 % colorectal, 17 % bladder and 3 % other) and 289 non-cancer patients (38 % colitis ulcerosa, 22 % Crohn's disease and 40 % other) with a colostomy (55 %), ileostomy (31 %) and/or urostomy (16 %). Adjusted for gender, age, type of ostomy and time elapsed since ostomy surgery, cancer ostomy patients scored higher (better) on Stoma-QoL (β = 2.1) and all RAND-36 domains (9.1 < β ≤ 19.5) except on mental health compared to non-cancer ostomy patients. Of the 33 themes coded for in the content analysis, fatigue or sleeplessness, leakages, pain, bladder or bowel complaints, physical functioning or activity, travelling or being away from home, other daily activities (including work), clothing and diet were among the 10 most frequently reported themes, although ranking differed between both patient groups. Besides, cancer ostomy patients frequently reported on the impact on (engaging in a) relationship or sexual intimacy and non-cancer ostomy patients frequently reported to be relieved of symptoms and restrictions in daily life. Cancer patients reported better generic and ostomy-specific QoL than non-cancer ostomy patients. In both cancer and non-cancer ostomy patients, fatigue or sleeplessness, leakages, pain, bladder or bowel complaints, physical functioning or activity, travelling or being away from home, other daily activities (including work), clothing and diet were among the 10 most common reported themes influencing daily life. However, the ranking of these 10 most common themes was different in both patient groups.

Creative art and medical student development: a qualitative study.

PubMed

Jones, Elizabeth K; Kittendorf, Anne L; Kumagai, Arno K

2017-02-01

Although many medical schools include arts-based activities in their curricula, empirical evidence is lacking regarding how the creation of art might impact medical students and their professional development. We used a qualitative research design in order to understand this process. We conducted and analysed interviews with 16 medical students who had created and presented original artwork in the context of a required narrative-based undergraduate medical education programme. Teams of students collaborated to create interpretive projects based on common themes arising from conversations with individuals with chronic illness and their families. Open-ended questions were utilised to explore the conceptualisation and presentation of the projects, the dynamics of teamwork and the meaning(s) they might have for the students' professional development. We identified themes using repeated contextual reading of the transcripts, which also enhanced accuracy of the interpretations and ensured saturation of themes. Several major themes and sub-themes were identified. The creation of art led to a sense of personal growth and development, including reflection on past life experiences, self-discovery and an awareness of art as a creative outlet. Students also reported an enhanced sense of community and the development of skills in collaboration. Lastly, students reflected on the human dimensions of illness and medical care and identified an enhanced awareness of the experience of those with illness. A programme involving the creation of art based on stories of illness encouraged students' explorations of conceptions of the self, family and society, as well as illness and medical care, while enhancing the development of a collaborative and patient-centred worldview. Creative art can be a novel educational tool to promote a reflective, humanistic medical practice. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

What's on Your Mind? Conversation Topics Chosen by People With Degenerative Cognitive-Linguistic Disorders for Communication Boards

PubMed Central

Daniels, Darlene; Ettinger, Olivia; Mooney, Aimee; Noethe, Glory; Rowland, Charity

2015-01-01

Purpose Conversational topics chosen by a group of adults with degenerative cognitive-linguistic disorders for personalized communication board development were examined. The patient-generated themes commonly selected are presented to guide treatment planning and communication board development. Method Communication boards were created for 109 adults as part of a larger research project. One autobiographical topic that each participant would enjoy discussing multiple times was represented on each communication board with 16 pictures and word labels. For this review, topics were collapsed into general themes through a consensus process and examined by gender and age. Results Sixty unique conversational topics were identified from 109 participants and collapsed into 9 general themes: Hobbies, Family, Travel, Work, Home/Places I've Lived, Sports/Fitness, Religion, Animals, and World War II. Age and gender produced variations in themes chosen, though no significance in rank orders was found across groups. Conclusions Topics selected by adults with degenerative cognitive-linguistic disorders for communication boards resemble common conversational adult themes and do not center around basic needs or medical issues. Differences in gender and age for topic selection tend to be based on traditional roles. These general themes should be used when creating personalized communication boards for those who benefit from conversational aids. PMID:25835511

Biotechnology: the language of multiple views in Māori communities.

PubMed

Te Momo, O H Fiona

2007-09-01

In Aotearoa (New Zealand), the government funded studies on communicating biotechnology to different sectors in the community from 2003 to 2006. Subsequently, a researcher covering the Māori sector performed a content analysis of data gathered in the community. Qualitative analysis methods included examining text from participant interviews, focus groups, government documents, newspapers, Internet sites, and current literature. Content was coded by identifying common themes in the English and the Māori language. Words like genetic modification (GM), genetic engineering (GE), and biotechnology were explained to provide a basic understanding between the communities and researcher. The terminology applied in the research was essential to achieve communication between the researcher and the community. The resultant themes represented seven views to interpret the communities association with biotechnology: purist Māori, religious Māori, anti Māori, pro Māori, no Māori, uncertain Māori, and middle Māori views. The themes are taken from the analysis of data compiled after 3 years of completing different stages of a research project. The views indicate that a common understanding can be achieved in the diverse range of Māori tribal communities providing those communicating biotechnology can identify the view and interpretations communities associate with biotechnology. This knowledge is essential for government agencies, researchers, community practitioners, scientist, and businesses that desire to dialogue with Māori communities in the language of biotechnology.

Identification of patient-centered outcomes among African American women with type 2 diabetes.

PubMed

Miller, Stephania T; Akohoue, Sylvie A; Brooks, Malinda A

2014-12-01

African American women carry a disproportionate diabetes burden, yet there is limited information on strategies to identify outcomes women perceive as important intervention outcomes (patient-centered outcomes). This study presents a brief strategy to solicit these outcomes and to describe outcomes identified using the highlighted strategy. Thirty-four African-American women with type 2 diabetes were enrolled in group-based, diabetes/weight management interventions. A diabetes educator asked participants to write down their intervention expectations followed by verbal sharing of responses. Expectation-related themes were identified using an iterative, qualitative, team analytic approach based on audio-recorded responses. The majority of the expectation-related themes (6 of 10) were reflective of self-care education/management and weight loss-related patient-centered outcomes. The remaining themes were associated with desires to help others prevent or manage diabetes, reduce negative diabetes-related emotions, get rid of diabetes, and stop taking diabetes medications. This study adds to a limited body of knowledge regarding patient-centered outcomes among a group that experiences a disproportionate diabetes burden. Future work could include integrating outcomes that are less commonly addressed in diabetes-related lifestyle interventions (e.g., diabetes-related negative emotions), along with more commonly addressed outcomes (e.g., weight loss), to increase the patient-centeredness of the interventions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Exploring trends of nonmedical use of prescription drugs and polydrug abuse in the Twittersphere using unsupervised machine learning.

PubMed

Kalyanam, Janani; Katsuki, Takeo; R G Lanckriet, Gert; Mackey, Tim K

2017-02-01

Nonmedical use of prescription medications/drugs (NMUPD) is a serious public health threat, particularly in relation to the prescription opioid analgesics abuse epidemic. While attention to this problem has been growing, there remains an urgent need to develop novel strategies in the field of "digital epidemiology" to better identify, analyze and understand trends in NMUPD behavior. We conducted surveillance of the popular microblogging site Twitter by collecting 11 million tweets filtered for three commonly abused prescription opioid analgesic drugs Percocet® (acetaminophen/oxycodone), OxyContin® (oxycodone), and Oxycodone. Unsupervised machine learning was applied on the subset of tweets for each analgesic drug to discover underlying latent themes regarding risk behavior. A two-step process of obtaining themes, and filtering out unwanted tweets was carried out in three subsequent rounds of machine learning. Using this methodology, 2.3M tweets were identified that contained content relevant to analgesic NMUPD. The underlying themes were identified for each drug and the most representative tweets of each theme were annotated for NMUPD behavioral risk factors. The primary themes identified evidence high levels of social media discussion about polydrug abuse on Twitter. This included specific mention of various polydrug combinations including use of other classes of prescription drugs, and illicit drug abuse. This study presents a methodology to filter Twitter content for NMUPD behavior, while also identifying underlying themes with minimal human intervention. Results from the study track accurately with the inclusion/exclusion criteria used to isolate NMUPD-related risk behaviors of interest and also provides insight on NMUPD behavior that has a high level of social media engagement. Results suggest that this could be a viable methodology for use in big data substance abuse surveillance, data collection, and analysis in comparison to other studies that rely upon content analysis and human coding schemes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Use of health services among international migrant children - a systematic review.

PubMed

Markkula, Niina; Cabieses, Baltica; Lehti, Venla; Uphoff, Eleonora; Astorga, Sofia; Stutzin, Francisca

2018-05-16

Migrant children have specific health needs, and may face difficulties in accessing health care, but not enough is known about their health service use. This study aims to describe patterns of use of health services of international migrant children and differences to respective native populations. Electronic databases PubMed and Web of Science, references of identified publications, and websites of relevant international agencies were searched. We included observational studies published between 2006 and 2016 that reported use of formal health services by migrant children (0-18 years), including first and second generation migrants. Data on study characteristics, study theme, main outcome and study quality were extracted. One hundred seven full texts were included in the review. Of the studies that reported comparable outcomes, half (50%) indicated less use of healthcare by migrants compared with non-migrants; 25% reported no difference, 18% reported greater use, and 7% did not report this outcome. There was variation by theme, so that the proportion of conclusions "less use" was most common in the categories "general access to care", "primary care" and "oral health", whereas in the use of emergency rooms or hospitalisations, the most common conclusion was "greater use". Migrant children appear to use different types of healthcare services less than native populations, with the exception of emergency and hospital services. PROSPERO systematic review registration number: CRD42016039876 .

Modeling Multidisciplinary Science: Incorporating a Common Research Theme into Biology and Chemistry Courses.

ERIC Educational Resources Information Center

Reed, Kelynne E.; Stewart, Betty H.; Redshaw, Peggy A.

2003-01-01

Describes a project using a multidisciplinary approach for the simultaneous integration of a theme into several disciplines in which participating students apply techniques they learned during the semester and report their findings with a poster presentation. (YDS)

The characteristics of a good clinical teacher as perceived by resident physicians in Japan: a qualitative study.

PubMed

Kikukawa, Makoto; Nabeta, Hiromi; Ono, Maiko; Emura, Sei; Oda, Yasutomo; Koizumi, Shunzo; Sakemi, Takanobu

2013-07-25

It is not known whether the characteristics of a good clinical teacher as perceived by resident physicians are the same in Western countries as in non-Western countries including Japan. The objective of this study was to identify the characteristics of a good clinical teacher as perceived by resident physicians in Japan, a non-Western country, and to compare the results with those obtained in Western countries. Data for this qualitative research were collected using semi-structured focus group interviews. Focus group transcripts were independently analyzed and coded by three authors. Residents were recruited by maximum variation sampling until thematic saturation was achieved. Twenty-three residents participated in five focus group interviews regarding the perceived characteristics of a good clinical teacher in Japan. The 197 descriptions of characteristics that were identified were grouped into 30 themes. The most commonly identified theme was "provided sufficient support", followed by "presented residents with chances to think", "provided feedback", and "provided specific indications of areas needing improvement". Using Sutkin's main categories (teacher, physician, and human characteristics), 24 of the 30 themes were categorized as teacher characteristics, 6 as physician characteristics, and none as human characteristics. "Medical knowledge" of teachers was not identified as a concern of residents, and "clinical competence of teachers" was not emphasized, whereas these were the two most commonly recorded themes in Sutkin's study. Our results suggest that Japanese and Western resident physicians place emphasis on different characteristics of their teachers. We speculate that such perceptions are influenced by educational systems, educational settings, and culture. Globalization of medical education is important, but it is also important to consider differences in educational systems, local settings, and culture when evaluating clinical teachers.

Challenges of self-management when living with multiple chronic conditions

PubMed Central

Liddy, Clare; Blazkho, Valerie; Mill, Karina

2014-01-01

Abstract Objective To explore the perspectives of patients who live with multiple chronic conditions as they relate to the challenges of self-management. Data sources On September 30, 2013, we searched MEDLINE, EMBASE, and CINAHL using relevant key words including chronic disease, comorbidity, multimorbidity, multiple chronic conditions, self-care, self-management, perspective, and perception. Study selection Three reviewers assessed and extracted the data from the included studies after study quality was rated. Qualitative thematic synthesis method was then used to identify common themes. Twenty-three articles met the inclusion criteria, with most coming from the United States. Synthesis Important themes raised by people living with multiple chronic conditions related to their ability to self-manage included living with undesirable physical and emotional symptoms, with pain and depression highlighted. Issues with conflicting knowledge, access to care, and communication with health care providers were raised. The use of cognitive strategies, including reframing, prioritizing, and changing beliefs, was reported to improve people’s ability to self-manage their multiple chronic conditions. Conclusion This study provides a unique view into patients’ perspectives of living with multiple chronic conditions, which are clearly linked to common functional challenges as opposed to specific diseases. Future policy and programming in self-management support should be better aligned with patients’ perspectives on living with multiple chronic conditions. This might be achieved by ensuring a more patient-centred approach is adopted by providers and health service organizations. PMID:25642490

A Thematic Analysis of Online Discussion Boards for Brachial Plexus Injury.

PubMed

Morris, Marie T; Daluiski, Aaron; Dy, Christopher J

2016-08-01

Patients with brachial plexus injury (BPI) and their family members contribute to Internet discussion groups dedicated to BPI. We hypothesized that a thematic analysis of posts from BPI Internet discussion groups would reveal common themes related to the BPI patient experience, providing topics for patient education and counseling. Internet discussion boards were identified using the search term "brachial plexus injury support group" in Google, Bing, and Yahoo! search engines. Two discussion boards had substantially more posts than other Web sites and were chosen for analyses. Posts from January 1, 2015, through January 1, 2016, were examined. Using an iterative and established process, 2 investigators (M.T.M. and C.J.D) independently analyzed each post using thematic analysis in 3 steps (open coding, axial coding, and selective coding) to determine common themes. In this process, each post was reviewed 3 times. A total of 328 posts from the 2 leading discussion boards were analyzed. Investigators reached a consensus on themes for all posts. One central theme focused on emotional aspects of BPI. Four other central themes regarding information support were identified: BPI disease, BPI treatment, recovery after BPI treatment, and process of seeking care for BPI. Examination of posts on Internet support groups for BPI revealed recurring concerns, questions, and opinions of patients and their family members. The most common themes related to disease information, treatment, recovery, and the emotional element of BPI. These findings provide a helpful starting point in refining topics for patient education and support that are targeted on patients' interests and concerns. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

'You know I've joined your club… I'm the hot flush boy': a qualitative exploration of hot flushes and night sweats in men undergoing androgen deprivation therapy for prostate cancer.

PubMed

Eziefula, C U; Grunfeld, E A; Hunter, M S

2013-12-01

Hot flushes and night sweats are common amongst menopausal women, and psychological interventions for managing these symptoms have recently been developed for women. However, flushes in men with prostate cancer, which commonly occur following androgen deprivation therapy (ADT), remain under-researched. This study is a qualitative exploration of flush-related cognitive appraisals and behavioural reactions reported by a sample of these men. Semi-structured, in-depth interviews were conducted with 19 men who were experiencing flushes after receiving ADT for prostate cancer. Framework analysis was used to generate and categorise emergent themes and explore associations between themes. Five main cognitive appraisals included the following: changes in oneself, impact on masculinity, embarrassment/social-evaluative concerns, perceived control and acceptance/adjustment. There were men who held beliefs about the impact of flushes on their perceptions of traditional gender roles, who experienced shame and embarrassment due to concerns about the salience of flushes and perceptions by others and who experienced feelings of powerlessness over flushes. Powerlessness was associated with beliefs about the potentially fatal consequences of discontinuing treatment. Two other dominant themes included awareness/knowledge about flushes and management strategies. Experiences of flushes appeared to be influenced by upbringing and general experiences of prostate cancer and ADT. The range of men's appraisals of, and reactions to, flushes generated from this qualitative exploration were broadly similar to those of menopausal women but differed in terms of the influence of masculinity beliefs. These findings could be used to inform future research and psychological interventions in this under-researched field. Copyright © 2013 John Wiley & Sons, Ltd.

"Why did you really do it?" A mixed-method analysis of the factors underpinning motivations to register as a body donor.

PubMed

Cornwall, Jon; Poppelwell, Zoe; McManus, Ruth

2018-05-15

Individuals who register as body donors do so for various reasons, with aiding medical science a common motivation. Despite awareness of several key reasons for donation, there are few in-depth explorations of these motivations to contextualize persons' reasons for donating. This study undertakes a mixed-method exploration of motivations for body donation to facilitate deeper understanding of the reasons underpinning donor registration. A survey of all newly registered body donors at a New Zealand university was performed over a single year. The survey included basic demographic information, a categorical question on reason for donation, a free-text question on donation motivation, and a free-text question allowing "other" comments on body donation. Basic statistical analysis was performed on demographic and categorical data, and thematic analysis used on free-text responses. From 169 registrants, 126 people (average age 70.5 years; 72 female) returned completed surveys (response rate 75%). Categorical data indicate a primary motivation of aiding medical science (86%). Fifty-one respondents (40%) provided free-text data on motivation, with other comments related to motivation provided by forty-one (33%). Common themes included reference to usefulness, uniqueness (pathophysiology and anatomy), gift-giving, kinship, and impermanence of the physical body. Consistent with previous studies, the primary reason for body donation was aiding medical science, however underpinning this was a complex layer of themes and sub-themes shaping motivations for choices. Findings provide important information that can guide development of robust informed consent processes, aid appropriate thanksgiving service delivery, and further contextualize the importance of medical professionals in body donation culture. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

Sector activities and lessons learned around initial implementation of the United States national physical activity plan.

PubMed

Evenson, Kelly R; Satinsky, Sara B

2014-08-01

National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences. During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes. The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals. These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans.

Sector Activities and Lessons Learned Around Initial Implementation of the United States National Physical Activity Plan

PubMed Central

Evenson, Kelly R.; Satinsky, Sara B.

2016-01-01

Background National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences. Methods During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes. Results The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals. Conclusions These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans. PMID:24176800

Econometrics and Psychometrics: A Survey of Communalities

ERIC Educational Resources Information Center

Goldberger, Arthur S.

1971-01-01

Several themes which are common to both econometrics and psychometrics are surveyed. The themes are illustrated by reference to permanent income hypotheses, simultaneous equation models, adaptive expectations and partial adjustment schemes, and by reference to test score theory, factor analysis, and time-series models. (Author)

Common themes and differences in SAM recognition among SAM riboswitches

PubMed Central

Price, Ian R.; Grigg, Jason C.; Ke, Ailong

2014-01-01

The recent discovery of short cis-acting RNA elements termed riboswitches has caused a paradigm shift in our understanding of genetic regulatory mechanisms. The three distinct superfamilies of S-adenosyl-L-methionine (SAM) riboswitches are the most commonly found riboswitch classes in nature. These RNAs represent three independent evolutionary solutions to achieve specific SAM recognition. This review summarizes research on 1) modes of gene regulatory mechanisms, 2) common themes and differences in ligand recognition, and 3) ligand-induced conformational dynamics among SAM riboswitch families. The body of work on the SAM riboswitch families constitutes a useful primer to the topic of gene regulatory RNAs as a whole. PMID:24863160

The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trial.

PubMed

Yeh, Gloria Y; Chan, Caroline W; Wayne, Peter M; Conboy, Lisa

2016-01-01

To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF). We randomized 100 patients with chronic systolic HF (NYHA Class 1-3, ejection fraction≤40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States). The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient's experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility). Positive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.

Across the Atlantic cooperation to address international challenges in eHealth and health IT: managing toward a common goal.

PubMed

Friedman, Charles P; Iakovidis, Ilias; Debenedetti, Laurent; Lorenzi, Nancy M

2009-11-01

Countries on both sides of the Atlantic Ocean have invested in health information and communication technologies. Since eHealth challenges cross borders a European Union-United States of America conference on public policies relating to health IT and eHealth was held October 20-21, 2008 in Paris, France. The conference was organized around the four themes: (1) privacy and security, (2) health IT interoperability, (3) deployment and adoption of health IT, and (4) Public Private Collaborative Governance. The four key themes framed the discussion over the two days of plenary sessions and workshops. Key findings of the conference were organized along the four themes. (1) Privacy and security: Patients' access to their own data and key elements of a patient identification management framework were discussed. (2) Health IT interoperability: Three significant and common interoperability challenges emerged: (a) the need to establish common or compatible standards and clear guidelines for their implementation, (b) the desirability for shared certification criteria and (c) the need for greater awareness of the importance of interoperability. (3) Deployment and adoption of health IT: Three major areas of need emerged: (a) a shared knowledge base and assessment framework, (b) public-private collaboration and (c) and effective organizational change strategies. (4) Public Private Collaborative Governance: Sharing and communication are central to success in this area. Nations can learn from one another about ways to develop harmonious, effective partnerships. Three areas that were identified as highest priority for collaboration included: (1) health data security, (2) developing effective strategies to ensure healthcare professionals' acceptance of health IT tools, and (3) interoperability.

Using the Nine Common Themes of Good Practice checklist as a tool for evaluating the research priority setting process of a provincial research and program evaluation program.

PubMed

Mador, Rebecca L; Kornas, Kathy; Simard, Anne; Haroun, Vinita

2016-03-23

Given the context-specific nature of health research prioritization and the obligation to effectively allocate resources to initiatives that will achieve the greatest impact, evaluation of priority setting processes can refine and strengthen such exercises and their outcomes. However, guidance is needed on evaluation tools that can be applied to research priority setting. This paper describes the adaption and application of a conceptual framework to evaluate a research priority setting exercise operating within the public health sector in Ontario, Canada. The Nine Common Themes of Good Practice checklist, described by Viergever et al. (Health Res Policy Syst 8:36, 2010) was used as the conceptual framework to evaluate the research priority setting process developed for the Locally Driven Collaborative Projects (LDCP) program in Ontario, Canada. Multiple data sources were used to inform the evaluation, including a review of selected priority setting approaches, surveys with priority setting participants, document review, and consultation with the program advisory committee. The evaluation assisted in identifying improvements to six elements of the LDCP priority setting process. The modifications were aimed at improving inclusiveness, information gathering practices, planning for project implementation, and evaluation. In addition, the findings identified that the timing of priority setting activities and level of control over the process were key factors that influenced the ability to effectively implement changes. The findings demonstrate the novel adaptation and application of the 'Nine Common Themes of Good Practice checklist' as a tool for evaluating a research priority setting exercise. The tool can guide the development of evaluation questions and enables the assessment of key constructs related to the design and delivery of a research priority setting process.

Transforming nurse-patient relationships-A qualitative study of nurse self-disclosure in mental health care.

PubMed

Unhjem, Jeanette Varpen; Vatne, Solfrid; Hem, Marit Helene

2018-03-01

To describe what and why nurses self-disclose to patients in mental health care. Self-disclosure is common, but controversial and difficult to delineate. Extant research suggests that self-disclosure might have several potentially beneficial effects on therapeutic alliance and treatment outcome for patients in mental health care, but results are often mixed and limited by definitional inconsistencies. Multi-site study with purposive sampling and source triangulation. Qualitative descriptive study including data from 16 nurses taking part in participant observation, individual interviews and focus group interviews. Separate analyses resulted in four themes addressing the research question of what nurses self-disclose, and one main theme and four subthemes addressing why nurses self-disclose. The content of self-disclosure was captured in the four themes: Immediate family, Interests and activities, Life experiences and Identity. In addition, results showed that disclosures were common among the nurses. Self-disclosure's potential to transform the nurse-patient relationship, making it more open, honest, close, reciprocal and equal, was the overarching reason why nurses shared personal information. The nurses also chose to self-disclose to share existential and everyday sentiments, to give real-life advice, because it felt natural and responsive to patients' question to do so. Nurse self-disclosure is common and cover a variety of personal information. Nurses have several reasons for choosing to self-disclose, most of which are connected to improving the nurse-patient relationship. Self-disclosure controversy can make it difficult for nurses to know whether they should share personal information or not. Insights into the diversity of and reasons for nurse self-disclosure can help with deliberations on self-disclosure. © 2017 John Wiley & Sons Ltd.

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.

Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development.

PubMed

Vileito, A; Siebelink, M J; Verhagen, Aae

2018-05-01

Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Most countries use protocols for organ and tissue donation to ensure optimal care for the donor and family, but these mainly focus on adults. However, the donation process for children differs from adults in many ways. An overview of the literature was performed to identify protocols for the paediatric population. PubMed, Web of Science, EMBASE and the Internet were searched up to March 2016 for papers or other sources in English related to specific organ and tissue donation protocols for children and neonates. This comprised title, abstract and then full-text screening of relevant data. We included 12 papers and two electronic sources that were mainly from North America and Europe. Most discussed donations after cardiac death. The recurring themes included identifying potential donors, approaching parents, palliative care and collaboration with organ procurement organisations. Most papers called for paediatric donation policies to be standardised. Scientific publications in English on paediatric donation protocols are very scarce. No comprehensive paediatric donation protocol was found. We identified several recurring themes in the literature that could be used to develop such protocols. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Childbearing traditions of Indian women at home and abroad: An integrative literature review.

PubMed

Wells, Young-Oak; Dietsch, Elaine

2014-12-01

The percentage of overseas-born mothers giving birth in Australia has increased to 31.5% in 2012 and Indian women represent 10% (the highest proportion). It is important for midwives in Australia to be aware of the childbearing traditions of Indian women and how these influence Indian women birthing in Australia. To explore childbearing practices in India and Indian women's experience of giving birth abroad; and to discuss the relevant findings for midwives working with Indian women in Australia. An integrative literature review was employed. 32 items, including 18 original research articles were thematically reviewed to identify commonly occurring themes relating to Indian women's childbearing traditions. Five themes relating to traditional childbearing practices of women birthing in India were identified. These themes included diversity and disparity; social context of childbirth and marriage; diet based on Ayurveda; pollution theory and confinement; and finally, rituals and customs. Indian women giving birth abroad and by implication in Australia experience a transition to motherhood in a new culture. While adjusting to motherhood, they are also negotiating between their old and new cultural identities. To provide culturally safe care, it is essential that midwives reflect on their own culture while exploring what traditions are important for Indian women. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: A qualitative study.

PubMed

Çelik Ince, S; Partlak Günüşen, N; Serçe, Ö

2018-05-01

Individuals with mental illness have significantly higher mortality and morbidity than the general population due to physical illnesses. Mental health nurses play a key role in providing care for common physical problems and protecting and promoting healthy lifestyles. Little is known from previous studies in the international literature about the attitudes, behaviours and thoughts of mental health nurses on providing physical health care. Mental health nurses mostly focus on the existing physical health problems of individuals with mental illness. However, mental health nurses do not include practices of disease prevention and physical health promotion for individuals with mental illness. The desire to see positive changes in individuals with mental illness, receiving positive feedback, feeling useful and happy, and feeling satisfied with their profession motivate mental health nurses in terms of providing physical health care. The knowledge and skill required of mental health nurses to provide physical health care need to be increased. Institutions should employ expert nurses who are able to guide mental health nurses to provide physical health care. It is important to provide adequate physical infrastructure and human resources to provide better physical health care in mental health services. Background Mental health nurses play an important role in improving the physical health of individuals with mental illnesses. However, there are limited studies of their attitudes and practices about physical health. Therefore, there is a need for qualitative studies to clarify the issue. The aim of this study was to determine mental health nurses' opinions about physical health care for individuals with mental illness. This study was carried out in Turkey. A qualitative descriptive approach was taken in the study. The sample consisted of twelve mental health nurses selected by purposeful sampling. In-depth interviews were conducted using a semi-structured interview format. A thematic analysis was used to evaluate the interviews. Four main themes were determined. (1) The barriers to physical healthcare theme included barriers related to patients, illness and treatment, barriers related to patients' caregivers, barriers related to health professionals and barriers related to the healthcare system. (2) The physical healthcare practices theme included common physical health problems and current nursing practices. (3) Motivators theme included the desire to see positive changes in a patient, receiving positive feedback, feeling useful and happy, having a sense of conscience and feeling satisfied with their profession. (4) The needs for better physical healthcare theme included the nurses' recommendations for better physical health care. Mental health nurses believe that the physical health care provided to individuals with mental illness is not adequate. Many barriers to providing care for physical health, such as having psychiatric symptoms that are not seen as a priority by patients and health personnel, were determined. Mental health nurses should integrate physical healthcare practices into their routine care. In addition, mental health nurses' knowledge and skills about physical health care should be improved. © 2018 John Wiley & Sons Ltd.

A Conceptual Framework for Understanding Race, Class, Gender, and Sexuality.

ERIC Educational Resources Information Center

Weber, Lynn

1998-01-01

Presents six common themes that characterize scholarship about race, class, gender, and sexuality. These themes are contextual and socially constructed, and deal with systems of power relationships. They stress the social structural (macro) and social psychological (micro) nature of the issues and their simultaneous expression, as well as the…

The interdependence of the Rho GTPases and apicobasal cell polarity.

PubMed

Mack, Natalie Ann; Georgiou, Marios

2014-01-01

Signaling via the Rho GTPases provides crucial regulation of numerous cell polarization events, including apicobasal (AB) polarity, polarized cell migration, polarized cell division and neuronal polarity. Here we review the relationships between the Rho family GTPases and epithelial AB polarization events, focusing on the 3 best-characterized members: Rho, Rac and Cdc42. We discuss a multitude of processes that are important for AB polarization, including lumen formation, apical membrane specification, cell-cell junction assembly and maintenance, as well as tissue polarity. Our discussions aim to highlight the immensely complex regulatory mechanisms that encompass Rho GTPase signaling during AB polarization. More specifically, in this review we discuss several emerging common themes, that include: 1) the need for Rho GTPase activities to be carefully balanced in both a spatial and temporal manner through a multitude of mechanisms; 2) the existence of signaling feedback loops and crosstalk to create robust cellular responses; and 3) the frequent multifunctionality that exists among AB polarity regulators. Regarding this latter theme, we provide further discussion of the potential plasticity of the cell polarity machinery and as a result the possible implications for human disease.

Nightmare Themes: An Online Study of Most Recent Nightmares and Childhood Nightmares.

PubMed

Schredl, Michael; Göritz, Anja S

2018-03-15

Even though the common diagnostic criteria (ICSD-3, DSM-5) acknowledge that nightmares do not only contain anxiety/fear (definition of the ICD-10) but also other emotions such as grief, disgust, and anger, the definition of a nightmare still focuses on threats to survival, security, or physical integrity. However, empirical studies on nightmare content in larger samples are scarce. The current study elicited 1,216 of the most recent nightmares including childhood nightmares of a population-based sample. The findings show that nightmares encompass a diversity of different topics, being chased, physical aggression, including death/injury of close persons. Infrequent themes like being the aggressor and suicide are of special interest as they might be related to waking-life psychopathology. The variety of nightmare topics clearly indicate that current definitions of nightmare content are too narrow. Future studies should look into nightmare content of persons in whom nightmare disorder has been diagnosed. © 2018 American Academy of Sleep Medicine.

Applying usability testing techniques to improve a health promotion website.

PubMed

Hinchliffe, Anetta; Mummery, W Kerry

2008-04-01

Use of the Internet for health promotion is increasing; however, the lack of published research regarding website usability suggests that health promotion websites are being developed without consultation with their users or formal evaluation. This study conducted usability testing of an existing health promotion website to inform modifications and to identify common usability themes that should be addressed by organisations developing or maintaining a health promotion website. A combination of qualitative and quantitative techniques were implemented during the usability testing sessions to gather data from users while completing tasks on the website. Techniques included performance measures (time taken), direct observation (participant observation) and subjective user preferences (questionnaire and interview). Improvements to the website were measured in terms of reduced problems reported, reduced time taken to complete tasks and increased subjective reports. Seven usability themes emerged from the data: design, feedback, format, instructions, navigation, terminology and learnability. This study demonstrates the application of usability testing to the design and modification of a health promotion website and illustrates the areas or themes that can be used as a framework for testing and modification.

An evaluation of pharmacology curricula in Australian science and health-related degree programs.

PubMed

Lloyd, Hilary; Hinton, Tina; Bullock, Shane; Babey, Anna-Marie; Davis, Elizabeth; Fernandes, Lynette; Hart, Joanne; Musgrave, Ian; Ziogas, James

2013-11-19

Pharmacology is a biomedical discipline taught in basic science and professional degree programs. In order to provide information that would facilitate pharmacology curricula to be refined and developed, and approaches to teaching to be updated, a national survey was undertaken in Australia that investigated pharmacology course content, teaching and summative assessment methods. Twenty-two institutions participated in a purpose-built online questionnaire, which enabled an evaluation of 147 courses taught in 10 different degrees. To enable comparison, degrees were grouped into four major degree programs, namely science, pharmacy, medicine and nursing. The pharmacology content was then classified into 16 lecture themes, with 2-21 lecture topics identified per theme. The resultant data were analysed for similarities and differences in pharmacology curricula across the degree programs. While all lecture themes were taught across degree programs, curriculum content differed with respect to the breadth and hours of coverage. Overall, lecture themes were taught most broadly in medicine and with greatest coverage in pharmacy. Reflecting a more traditional approach, lectures were a dominant teaching method (at least 90% of courses). Sixty-three percent of science courses provided practical classes but such sessions occurred much less frequently in other degree programs, while tutorials were much more common in pharmacy degree programs (70%). Notably, problem-based learning was common across medical programs. Considerable diversity was found in the types of summative assessment tasks employed. In science courses the most common form of in-semester assessment was practical reports, whereas in other programs pen-and-paper quizzes predominated. End-of-semester assessment contributed 50-80% to overall assessment across degree programs. The similarity in lecture themes taught across the four different degree programs shows that common knowledge- and competency-based learning outcomes can be defined for pharmacology. The authors contend that it is the differences in breadth and coverage of material for each lecture theme, and the differing teaching modes and assessment that characterise particular degree programs. Adoption of pharmacology knowledge-based learning outcomes that could be tailored to suit individual degree programs would better facilitate the sharing of expertise and teaching practice than the current model where pharmacology curricula are degree-specific.

K-12 Neuroscience Education Outreach Program: Interactive Activities for Educating Students about Neuroscience.

PubMed

Deal, Alex L; Erickson, Kristen J; Bilsky, Edward J; Hillman, Susan J; Burman, Michael A

2014-01-01

The University of New England's Center for Excellence in the Neurosciences has developed a successful and growing K-12 outreach program that incorporates undergraduate and graduate/professional students. The program has several goals, including raising awareness about fundamental issues in neuroscience, supplementing science education in area schools and enhancing undergraduate and graduate/professional students' academic knowledge and skill set. The outreach curriculum is centered on core neuroscience themes including: Brain Safety, Neuroanatomy, Drugs of Abuse and Addiction, Neurological and Psychiatric Disorders, and Cognition and Brain Function. For each theme, lesson plans were developed based upon interactive, small-group activities. Additionally, we've organized our themes in a "Grow-up, Grow-out" approach. Grow-up refers to returning to a common theme, increasing in complexity as we revisit students from early elementary through high school. Grow-out refers to integrating other scientific fields into our lessons, such as the chemistry of addiction, the physics of brain injury and neuronal imaging. One of the more successful components of our program is our innovative team-based model of curriculum design. By creating a team of undergraduate, graduate/professional students and faculty, we create a unique multi-level mentoring opportunity that appears to be successful in enhancing undergraduate students' skills and knowledge. Preliminary assessments suggest that undergraduates believe they are enhancing their content knowledge and professional skills through our program. Additionally, we're having a significant, short-term impact on K-12 interest in science. Overall, our program appears to be enhancing the academic experience of our undergraduates and exciting K-12 students about the brain and science in general.

Architectural and functional commonalities between enhancers and promoters

PubMed Central

Kim, Tae-Kyung; Shiekhattar, Ramin

2015-01-01

Summary With the explosion of genome-wide studies of regulated transcription, it has become clear that traditional definitions of enhancers and promoters need to be revisited. These control elements can now be characterized in terms of their local and regional architecture, their regulatory components including histone modifications and associated binding factors and their functional contribution to transcription. This review discusses unifying themes between promoters and enhancers in transcriptional regulatory mechanisms. PMID:26317464

Qualitative evaluation of the Saleema campaign to eliminate female genital mutilation and cutting in Sudan.

PubMed

Johnson, Andrea C; Douglas Evans, W; Barrett, Nicole; Badri, Howida; Abdalla, Tamador; Donahue, Cody

2018-02-17

Female genital mutilation and cutting (FGM/C, herein FGM) is a widespread and harmful practice. The Government developed a national campaign in Sudan, called Saleema, to change social norms discouraging FGM. Saleema translates to being "whole", healthy in body and mind, unharmed, intact, pristine, and untouched, in a God-given condition. An interim evaluation was conducted using focus groups among Sudanese adults. The primary aim was to explore perceptions of the Saleema poster exemplars and to assess if the desired themes were being communicated. Secondary aims were to understand more about participants' information sources, values, and suggestions for the campaign broadly. The Saleema campaign evaluation included four focus groups from each of the 18 states in Sudan (72 total). Participants were presented with three poster stimuli from the Saleema campaign and asked about the content and their reactions. Themes were coded inductively by concepts that arose through content in the transcripts. Codes were also reviewed in conjunction with themes from the broader Saleema evaluation framework. Participants reported the most common source of information or admiration was from local leaders who are responsive to a community, media-based outlets, and discussions among community members. Participants held high value for education, community solidarity, and/or religious devotion. Participants had positive opinions of Saleema and responded positively to the branding elements in the posters and the campaign as a whole. The most common suggestion was continued awareness. Advocacy, training, and posters were suggested to highlight the harms of FGM through leaders or in community settings. Individuals suggested that these activities target older women and individuals in rural villages. There was also a burgeoning theme of targeting youth for support of the campaign. The results of this focus group analysis demonstrate support for future Saleema campaign efforts promoting awareness and community engagement. The campaign could capitalize on partnerships with young people and those who are respected in the community (e.g., religious leaders) or continue promoting common values aligning with the support of education and community solidarity. Continuing campaign efforts have promise to decrease the harms of FGM in Sudan.

How unique is continuity of care? A review of continuity and related concepts.

PubMed

Uijen, Annemarie A; Schers, Henk J; Schellevis, François G; van den Bosch, Wil J H M

2012-06-01

The concept of 'continuity of care' has changed over time and seems to be entangled with other care concepts, for example coordination and integration of care. These concepts may overlap, and differences between them often remain unclear. In order to clarify the confusion of tongues and to identify core values of these patient-centred concepts, we provide a historical overview of continuity of care and four related concepts: coordination of care, integration of care, patient-centred care and case management. We identified and reviewed articles including a definition of one of these concepts by performing an extensive literature search in PubMed. In addition, we checked the definition of these concepts in the Oxford English Dictionary. Definitions of continuity, coordination, integration, patient-centred care and case management vary over time. These concepts show both great entanglement and also demonstrate differences. Three major common themes could be identified within these concepts: personal relationship between patient and care provider, communication between providers and cooperation between providers. Most definitions of the concepts are formulated from the patient's perspective. The identified themes appear to be core elements of care to patients. Thus, it may be valuable to develop an instrument to measure these three common themes universally. In the patient-centred medical home, such an instrument might turn out to be an important quality measure, which will enable researchers and policy makers to compare care settings and practices and to evaluate new care interventions from the patient perspective.

Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses.

PubMed

Colquhoun, Heather L; Carroll, Kelly; Eva, Kevin W; Grimshaw, Jeremy M; Ivers, Noah; Michie, Susan; Sales, Anne; Brehaut, Jamie C

2017-09-29

Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions. Using purposive sampling, semi-structured 60-90-min telephone interviews were conducted with experts in theories related to A&F from a range of fields (e.g., cognitive, health and organizational psychology, medical decision-making, economics). Guided by detailed descriptions of A&F interventions from the health care literature, interviewees described how they would approach the problem of designing improved A&F interventions. Specific, theory-informed hypotheses about the conditions for effective design and delivery of A&F interventions were elicited from the interviews. The resulting hypotheses were assigned by three coders working independently into themes, and categories of themes, in an iterative process. We conducted 28 interviews and identified 313 theory-informed hypotheses, which were placed into 30 themes. The 30 themes included hypotheses related to the following five categories: A&F recipient (seven themes), content of the A&F (ten themes), process of delivery of the A&F (six themes), behavior that was the focus of the A&F (three themes), and other (four themes). We have identified a set of testable, theory-informed hypotheses from a broad range of behavioral and social science that suggest conditions for more effective A&F interventions. This work demonstrates the breadth of perspectives about A&F from non-healthcare-specific disciplines in a way that yields testable hypotheses for healthcare A&F interventions. These results will serve as the foundation for further work seeking to set research priorities among the A&F research community.

A Synthesis of Spiritual Intelligence Themes from Islamic and Western Philosophical Perspectives.

PubMed

Hanefar, Shamsiah Banu; Sa'ari, Che Zarrina; Siraj, Saedah

2016-12-01

Spiritual intelligence is an emerging term that is widely discussed and accepted as one of the main components that addresses and solves many life problems. Nonetheless there is no specific study being done to synthesize the spiritual intelligence themes from Western and Islamic philosophical perspectives. This research aimed to identify common spiritual intelligence themes from these two perspectives and elucidated its contents by the view of two well-known Islamic scholars; al-Ghazali and Hasan Langgulung. Seven spiritual intelligence themes were identified through thematic analysis; meaning/purpose of life, consciousness, transcendence, spiritual resources, self-determination, reflection-soul purification and spiritual coping with obstacles. These findings will be the groundwork for centered theory of spiritual intelligence themes that synthesize the Islamic and Western philosophical perspectives. It is hoped that this study will contribute significantly to the development of valid and reliable spiritual intelligence themes beyond the social and cultural boundaries.

Food for contagion: synthesis and future directions for studying host-parasite responses to resource shifts in anthropogenic environments.

PubMed

Altizer, Sonia; Becker, Daniel J; Epstein, Jonathan H; Forbes, Kristian M; Gillespie, Thomas R; Hall, Richard J; Hawley, Dana M; Hernandez, Sonia M; Martin, Lynn B; Plowright, Raina K; Satterfield, Dara A; Streicker, Daniel G

2018-05-05

Human-provided resource subsidies for wildlife are diverse, common and have profound consequences for wildlife-pathogen interactions, as demonstrated by papers in this themed issue spanning empirical, theoretical and management perspectives from a range of study systems. Contributions cut across scales of organization, from the within-host dynamics of immune function, to population-level impacts on parasite transmission, to landscape- and regional-scale patterns of infection. In this concluding paper, we identify common threads and key findings from author contributions, including the consequences of resource subsidies for (i) host immunity; (ii) animal aggregation and contact rates; (iii) host movement and landscape-level infection patterns; and (iv) interspecific contacts and cross-species transmission. Exciting avenues for future work include studies that integrate mechanistic modelling and empirical approaches to better explore cross-scale processes, and experimental manipulations of food resources to quantify host and pathogen responses. Work is also needed to examine evolutionary responses to provisioning, and ask how diet-altered changes to the host microbiome influence infection processes. Given the massive public health and conservation implications of anthropogenic resource shifts, we end by underscoring the need for practical recommendations to manage supplemental feeding practices, limit human-wildlife conflicts over shared food resources and reduce cross-species transmission risks, including to humans.This article is part of the theme issue 'Anthropogenic resource subsidies and host-parasite dynamics in wildlife'. © 2018 The Author(s).

A scoping review of patient discharge from intensive care: opportunities and tools to improve care.

PubMed

Stelfox, Henry T; Lane, Dan; Boyd, Jamie M; Taylor, Simon; Perrier, Laure; Straus, Sharon; Zygun, David; Zuege, Danny J

2015-02-01

We conducted a scoping review to systematically review the literature reporting patient discharge from ICUs, identify facilitators and barriers to high-quality care, and describe tools developed to improve care. We searched Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials. Data were extracted on the article type, study details for research articles, patient population, phase of care during discharge, and dimensions of health-care quality. From 8,154 unique publications we included 224 articles. Of these, 131 articles (58%) were original research, predominantly case series (23%) and cohort (16%) studies; 12% were narrative reviews; and 11% were guidelines/policies. Common themes included patient and family needs/experiences (29% of articles) and the importance of complete and accurate information (26%). Facilitators of high-quality care included provider-patient communication (30%), provider-provider communication (25%), and the use of guidelines/policies (29%). Patient and family anxiety (21%) and limited availability of ICU and ward resources (26%) were reported barriers to high-quality care. A total of 47 tools to facilitate patient discharge from the ICU were identified and focused on patient evaluation for discharge (29%), discharge planning and teaching (47%), and optimized discharge summaries (23%). Common themes, facilitators and barriers related to patient and family needs/experiences, communication, and the use of guidelines/policies to standardize patient discharge from ICU transcend the literature. Candidate tools to improve care are available; comparative evaluation is needed prior to broad implementation and could be tested through local quality-improvement programs.

Sexual and reproductive health issues facing Southeast Asian beer promoters: a qualitative pilot study

PubMed Central

2010-01-01

Background In Southeast Asia, hundreds of thousands of young rural women migrate from their villages to the larger cities in search of work. Many find employment with beer companies or in the clubs where beer is sold, promoting the sale of beer. Previous research suggests these young migrants are in a highly vulnerable position. This paper will describe the findings of an October 2009 meeting to develop a research agenda on the sexual and reproductive health of beer promoters and a subsequent pilot study of focus groups with beer promoters to review this agenda. Methods Participants of the research meeting representing beer promoters, academics, non-governmental organizations (NGOs), government and the beer industry from Cambodia, Thailand, Laos, and Vietnam collaborated in the development of three key research themes. The themes were verified in focus group discussions with beer promoters organized by local research partners in all four countries. The focus group participants were asked what they felt were the key sexual and reproductive health issues facing them in a non-directive and unstructured manner, and then asked to comment more specifically on the research priorities developed at the meeting. The focus groups were recorded digitally, transcribed, and translated into English. The data were analyzed by coding for common themes and then developing matrices to compare themes between groups. Results The participants of the meeting identified three key research themes: occupational health (including harassment and violence, working conditions, and fair pay), gender and social norms (focusing on the impact of power relations between the genders on women's health), and reproductive health (knowledge and access to reproductive health care services). The participants in the focus groups in all four countries agreed that these were key priorities for them, though the emphasis on the most important issues varied between groups of women. Sexual harassment in the workplace and challenges in accessing reproductive health care services because of the barriers of cost, shyness, and stigmatizing attitudes of health care providers were common problems for many of the women. Conclusions There is a need for regional research and programming for beer promotion women in Southeast Asia focusing on the three research themes of occupational health, gender norms and reproductive health. Such research and programs could provide important benefits for many beer promotion women who currently face significant risks to their sexual and reproductive health. PMID:20594342

A qualitative assessment of the perceived risks of electronic cigarette and hookah use in pregnancy.

PubMed

Kahr, Maike K; Padgett, Shannon; Shope, Cindy D; Griffin, Emily N; Xie, Susan S; Gonzalez, Pablo J; Levison, Judy; Mastrobattista, Joan; Abramovici, Adi R; Northrup, Thomas F; Stotts, Angela L; Aagaard, Kjersti M; Suter, Melissa A

2015-12-21

Studies reveal that electronic cigarette (e-cigarette) and hookah use are increasing among adolescents and young adults. However, the long-term health effects are unknown, especially with regards to pregnancy. Because of the increased use in women of reproductive age, and the unknown long-term health risks, our primary objectives were to determine the perceived risks of e-cigarette and hookah use in pregnancy, and learn common colloquial terms associated with e-cigarettes. Furthermore, we sought to determine if there is a stigma associated with e-cigarette use in pregnancy. Eleven focus groups including 87 participants were conducted immediately following regularly scheduled CenteringPregnancy® prenatal care with women at three different clinics in the greater Houston area. A minimum of two facilitators led the groups, using ten lead-in prompts, with Spanish translation as necessary. Facilitators took notes which were compared immediately following each group discussion and each group was audio recorded and transcribed. Three facilitators utilized NVivo 9.0 software to organize the transcribed data into nodes to identify major themes. To increase rigor, transcripts were further analyzed by two obstetricians who were instructed to find the major themes. Analyses revealed contradicting themes concerning e-cigarette use. In general, e-cigarettes were perceived as safer alternatives to regular tobacco cigarettes, especially if used as smoking cessation devices. A major theme is that use in pregnancy is harmful to the fetus. However, it was perceived that use for smoking cessation in pregnancy may have fewer side effects. We found that a common term for e-cigarettes is "Blu." In our discussion of hookah use, participants perceived use as popular among teenagers and that use in pregnancy is dangerous for the fetus. Although a strong theme emerged against hookah use, we found contradicting themes in our discussions on e-cigarette use in pregnancy. It is possible that e-cigarette use will not carry the same stigma as regular cigarette smoking in pregnancy. In addition, the impression of e-cigarettes as a healthier alternative to smoking may influence use in pregnancy. Clinicians need to be prepared for questions of e-cigarette safety and efficacy as smoking cessation devices from their pregnant patients who smoke, and women who smoke and are planning to become pregnant.

Sexual and reproductive health issues facing Southeast Asian beer promoters: a qualitative pilot study.

PubMed

Webber, Gail C; Spitzer, Denise L

2010-07-01

In Southeast Asia, hundreds of thousands of young rural women migrate from their villages to the larger cities in search of work. Many find employment with beer companies or in the clubs where beer is sold, promoting the sale of beer. Previous research suggests these young migrants are in a highly vulnerable position. This paper will describe the findings of an October 2009 meeting to develop a research agenda on the sexual and reproductive health of beer promoters and a subsequent pilot study of focus groups with beer promoters to review this agenda. Participants of the research meeting representing beer promoters, academics, non-governmental organizations (NGOs), government and the beer industry from Cambodia, Thailand, Laos, and Vietnam collaborated in the development of three key research themes. The themes were verified in focus group discussions with beer promoters organized by local research partners in all four countries. The focus group participants were asked what they felt were the key sexual and reproductive health issues facing them in a non-directive and unstructured manner, and then asked to comment more specifically on the research priorities developed at the meeting. The focus groups were recorded digitally, transcribed, and translated into English. The data were analyzed by coding for common themes and then developing matrices to compare themes between groups. The participants of the meeting identified three key research themes: occupational health (including harassment and violence, working conditions, and fair pay), gender and social norms (focusing on the impact of power relations between the genders on women's health), and reproductive health (knowledge and access to reproductive health care services). The participants in the focus groups in all four countries agreed that these were key priorities for them, though the emphasis on the most important issues varied between groups of women. Sexual harassment in the workplace and challenges in accessing reproductive health care services because of the barriers of cost, shyness, and stigmatizing attitudes of health care providers were common problems for many of the women. There is a need for regional research and programming for beer promotion women in Southeast Asia focusing on the three research themes of occupational health, gender norms and reproductive health. Such research and programs could provide important benefits for many beer promotion women who currently face significant risks to their sexual and reproductive health.

Apocalyptic suicide: from a pathological to an eschatological interpretation.

PubMed

Dein, Simon; Littlewood, Roland

2005-09-01

The authors examine the possible interpretations of apocalyptic suicide--a form of suicide amongst a group which believes that the world will end imminently. Through a literature search the authors identify a number of paradigmatic cases exemplifying this phenomenon including Jonestown, Waco, The Order of the Solar Temple and Heaven's Gate. Interpretations of apocalyptic suicide might consider individual factors--the most common approach--but also the social and eschatological themes which are found in the group's ideological work. Religious violence (including suicide) may be precipitated in a dialectical interaction between group members and the perceived outside world. We consider here the ideological aspects that commonly lead to a dualist epistemology for the group. Apocalyptic suicide involves a shift of personal self and agency to the social self of the charismatic group.

A Characterization of Student Reflections in an Introductory Pharmacy Practice Experience Discussion Course.

PubMed

Dinkins, Melissa M; Haltom, Wesley R

2018-04-01

Objective. To characterize weekly student reflections in an introductory pharmacy practice experience (IPPE) discussion course meeting concurrently with IPPE rotations in institutional pharmacy. Methods. A qualitative analysis was conducted to identify themes within weekly reflective statements submitted by second year pharmacy students (P2) enrolled in an IPPE rotation and concurrent discussion course. Weekly reflections from the 2015-2016 offering of the course were reviewed by investigators to identify common themes via an iterative process. Subsequently, investigators coded each submission into one of the identified categories. Initial agreement between investigators was assessed using the Cohen kappa coefficient. Discrepancies between coding were resolved through discussion to reach consensus. Results. A total of 402 reflection assignments were reviewed from 85 P2 students enrolled in the IPPE course. Ten themes were identified, with the most common themes being interprofessional teamwork, pharmacist and technician roles and responsibilities, and policies and procedures. Substantial initial agreement between investigators was found, with the most discrepancies arising within the themes of medication distribution and pharmacy administration/organizational structure. Conclusion. Student reflections on IPPEs centered on 10 key topics, primarily related to distributive, legal, and regulatory functions of institutional pharmacy practice. Structuring an IPPE rotation longitudinally in an academic term, with a concurrent discussion course, builds a framework for regular student reflection.

The impact of recent advances in laboratory astrophysics on our understanding of the cosmos.

PubMed

Savin, D W; Brickhouse, N S; Cowan, J J; Drake, R P; Federman, S R; Ferland, G J; Frank, A; Gudipati, M S; Haxton, W C; Herbst, E; Profumo, S; Salama, F; Ziurys, L M; Zweibel, E G

2012-03-01

An emerging theme in modern astrophysics is the connection between astronomical observations and the underlying physical phenomena that drive our cosmos. Both the mechanisms responsible for the observed astrophysical phenomena and the tools used to probe such phenomena-the radiation and particle spectra we observe-have their roots in atomic, molecular, condensed matter, plasma, nuclear and particle physics. Chemistry is implicitly included in both molecular and condensed matter physics. This connection is the theme of the present report, which provides a broad, though non-exhaustive, overview of progress in our understanding of the cosmos resulting from recent theoretical and experimental advances in what is commonly called laboratory astrophysics. This work, carried out by a diverse community of laboratory astrophysicists, is increasingly important as astrophysics transitions into an era of precise measurement and high fidelity modeling.

“Our Culture Is Medicine”: Perspectives of Native Healers on Posttrauma Recovery Among American Indian and Alaska Native Patients

PubMed Central

Bassett, Deborah; Tsosie, Ursula; Nannauck, Sweetwater

2012-01-01

American Indian and Alaska Native (Native) people experience more traumatic events and are at higher risk for developing posttraumatic stress disorder compared with the general population. We conducted in-depth interviews with six Native healers about their perspectives on traumatic injury and healing. We analyzed the interviews using an inductive approach to identify common themes. We categorized these themes into four categories: causes and consequences of traumatic injury, risk factors, protective factors, and barriers to care. The implications of our study include a need for improving cultural competence among health care and social services personnel working with Native trauma patients. Additional cumulative analyses of Native healers and trauma patients would contribute to a much-needed body of knowledge on improving recovery and promoting healing among Native trauma patients. PMID:22529755

Indigenous Knowledge Approach to Successful Psychotherapies with Aboriginal Suicide Attempters.

PubMed

Mehl-Madrona, Lewis

2016-11-01

Suicide is disproportionately common among Aboriginal people in Canada. Life stories were collected from 54 Aboriginal suicide attempters in northern Saskatchewan. Constant comparison techniques and modified grounded theory identified common themes expressed. Three common plots/themes preceded suicide attempts: 1) relationship breakup, usually sudden, unanticipated, involving a third person; 2) being publicly humiliated by another person(s), accompanied by high levels of shame; and 3) high levels of unremitting, chronic life stress (including poverty) with relative isolation. We found 5 common purposes for suicide attempts: 1) to "show" someone how badly they had hurt the attempter, 2) to stop the pain, 3) to save face in a difficult social situation, 4) to get revenge, and 5) don't know/don't remember/made sense at the time, all stated by people who were under the influence of alcohol and/or drugs at the time of their suicide attempt. We found 5 common beliefs about death: 1) you just cease to exist, and everything just disappears; 2) you go into the spirit world and can see and hear everything that is happening in this world; 3) you go to heaven or hell; 4) you go to a better place; and 5) don't know/didn't think about it. The idea of personal and cultural continuity is essential to understanding suicide among First Nations youth. Interventions targeted to the individual's beliefs about death, purpose for suicide, and consistent with the life story (plot) in which they find themselves may be more successful than one-size-fits-all programs developed outside of aboriginal communities. © The Author(s) 2016.

Systemic vulnerabilities to suicide among veterans from the Iraq and Afghanistan Conflicts: review of case reports from a National Veterans Affairs Database.

PubMed

Mills, Peter D; Huber, Samuel J; Vince Watts, Bradley; Bagian, James P

2011-02-01

While suicide among recently returned veterans is of great concern, it is a relatively rare occurrence within individual hospitals and clinics. Root cause analysis (RCA) generates a detailed case report that can be used to identify system-based vulnerabilities following an adverse event. Review of a national database of RCA reports may identify common vulnerabilities and assist in the development of more robust prevention strategies. Our objective was to identify and compare common themes among reports of suicide among veterans of Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) in the Veterans Affairs system. Common themes among root causes of suicide as identified in RCA reports were collected and compared as the primary outcome--systematic vulnerabilities. Actions recommended within the reports were coded as the secondary outcome--prevention strategies. Fifty-one RCA reports of OIF/OEF suicides were identified by our search. Coding generated 16 common categories among 132 root causes, and 13 categories among 108 recommended actions. Assessment of suicidal risk, coordination of care, timely access to care, and communication among providers were the most common root causes. Actions identified by RCA teams to reduce suicide included improving referral processes, staff education in suicide assessment, and follow-up with suicidal veterans. Review of multiple RCA reports can identify organizational vulnerabilities detected at the local level that may be applicable system wide. Attention to improving suicide assessment, coordination of care, and timely access may have the largest impact on reducing suicide among OIF/OEF veterans. © 2011 The American Association of Suicidology.

The Conversion of Teachers: Principal Influence and Teacher Autonomy.

ERIC Educational Resources Information Center

Bratlie, Mark P.

Instructional leadership literature presents two contrasting themes: (1) the school as a loosely coupled system allowing teachers considerable instructional autonomy; and (2) the school as a culture where the effective principal uses symbolic leadership to unite the staff in a common effort to achieve the school's mission. If both themes are…

Tracking Student Participants from a REU Site with NAE Grand Challenges as the Common Theme

ERIC Educational Resources Information Center

Burkett, Susan; Dye, Tabatha; Johnson, Pauline

2015-01-01

The National Academy of Engineering (NAE) Grand Challenges provides the theme for this NSFfunded Research Experience for Undergraduates (REU) site. Research topics, with their broad societal impact, allow undergraduate students from multiple engineering disciplines and computer science to work together on exciting and critical problems. The…

Cognitive Intervention in the Normal Developmental Problems of Young Adults

ERIC Educational Resources Information Center

Wilson, Stephen B.

1978-01-01

The common developmental problems of young adults--career focus, sex confidence, clarification of beliefs, and separation from parents--provide themes of interest to young adults. Using these themes and the human tendency to problem solve, specific information can be given to improve personal problem-solving skills without psychological games.…

Structure, Citizenship, and Professionalism: Exploring Rationale Development as Part of Graduate Education in Social Studies

ERIC Educational Resources Information Center

Hawley, Todd S.; Pifel, A. Robert; Jordan, Adam W.

2012-01-01

This article details an interpretive, qualitative interview study that explored rationales developed by seven social studies graduate students, all experienced teachers, at a large Midwestern university. Interviews revealed three common themes regarding the influence of the rationale development process. The three themes were: providing structure,…

Beliefs about weight and breast cancer: an interview study with high risk women following a 12 month weight loss intervention.

PubMed

Wright, Claire E; Harvie, Michelle; Howell, Anthony; Evans, D Gareth; Hulbert-Williams, Nick; Donnelly, Louise S

2015-01-01

Breast cancer is the most common cancer in the UK. Lifestyle factors including excess weight contribute to risk of developing the disease. Whilst the exact links between weight and breast cancer are still emerging, it is imperative to explore how women understand these links and if these beliefs impact on successful behaviour change. Overweight/obese premenopausal women (aged 35-45) with a family history of breast cancer (lifetime risk 17-40%) were invited to a semi-structured interview following their participation in a 12 month weight loss intervention aimed at reducing their risk of breast cancer. Interviews were carried out with 9 women who successfully achieved ≥5% weight loss and 11 who were unsuccessful. Data were transcribed verbatim and analysed using thematic analysis. Three themes were developed from the analysis. The first theme how women construct and understand links between weight and breast cancer risk is composed of two subthemes, the construction of weight and breast cancer risk and making sense of weight and breast cancer risk. This theme explores women's understanding of what contributes to breast cancer risk and whether they believe that weight loss could reduce their breast cancer risk. The second theme motivation and adherence to weight loss interventions explains that breast cancer risk can be a motivating factor for adherence to a weight loss intervention. The final theme, acceptance of personal responsibility for health is composed of two subthemes responsibility for one's own health and responsibility for family health through making sensible lifestyle choices. Beliefs about weight and breast cancer risk were informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer. Our study has highlighted common doubts, anxieties and questions and the importance of providing a credible rationale for weight control and weight loss which addresses individual concerns. Counselling and health education material should be tailored to facilitate understanding of both genetic and modifiable risk factors and should do more help individuals to visualise the weight and breast cancer link.

Gaining insight into how women conceptualize satisfaction: Western Australian women's perception of their maternity care experiences.

PubMed

Lewis, Lucy; Hauck, Yvonne L; Ronchi, Fiona; Crichton, Caroline; Waller, Liana

2016-02-04

The concept of maternal satisfaction is challenging, as women's and clinicians' expectations and experiences can differ. Our aim was to investigate women's experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum. This mixed method study was conducted at a public maternity hospital in Western Australia. A questionnaire was sent to 733 women two weeks post birth, which included an invitation for an audio-recorded, telephone interview. Frequency distributions and univariate comparisons were employed for quantitative data. Thematic analysis of interview transcripts was undertaken to extract common themes. A total of 54% (399 of 733) returned the questionnaire. Quantitative results indicated that women were less likely to feel: involved if they did not have a spontaneous vaginal birth (P = 0.020); supported by a midwife if they had a caesarean (P = <0.001); or supported by an obstetrician if they had a spontaneous vaginal birth (P = <0.001). Qualitative findings emerged from 63 interviews which highlighted the influence that organization of care, resources and facilities had on women's satisfaction. These paradigms unfolded as three broad themes constructed by four sub-themes, each illustrating a dichotomy of experiences. The first theme 'how care was provided' encompassed: familiar faces versus a different one every time and the best place to be as opposed to so disappointed. The second theme 'attributes of staff' included: above and beyond versus caring without caring and in good hands as opposed to handled incorrectly. The third theme 'engaged in care' incorporated: explained everything versus did not know why and had a choice as opposed to did not listen to my needs. Quantitative analysis confirmed that the majority of women surveyed were satisfied. Mode of birth influenced women's perception of being involved with their birth. Being able to explore the diversity of women's experiences in relation to satisfaction with their maternity care in an urban, tertiary obstetric setting has offered greater insight into what women value: a sensitive, respectful, shared relationship with competent clinicians who recognise and strive to provide woman focused care across the childbirth continuum.

Medical students’ perceptions and attitudes about family practice: a qualitative research synthesis

PubMed Central

2012-01-01

Background During the last decade medical students from most Western countries have shown little interest in family practice. Understanding the factors that influence medical students to choose family medicine is crucial. Objective To systematically review and synthesize published evidence about medical students’ attitudes and perceptions towards family practice. Methods A qualitative systematic review. The literature search was undertaken in July 2010 in PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Science Citation Index (SSCI), and ProQuest Dissertations & Theses. Two authors independently selected the studies for their inclusion and assessed their quality. The selected studies were thoroughly read. Key themes and categories were identified. A matrix was created for allowing the comparison of each theme across studies. Results Ten studies were finally included. Seven broad themes were identified across them: 1) Scope and context of practice was a broad theme comprising linked sub-themes: perception of a varied specialty, broad practice, holistic perspective and flexibility that allows having a family; 2) Lower interest or intellectually less challenging: treating common disease, repetitive, quasi administrative job; 3) Influence of role models, either positive and negative, and society: negative comments from other professionals, peers and family; 4) Lower prestige; 5) Poor remuneration; 6) Medical school influences, being important both the length and quality of the exposure; 7) Post graduate training, where the shorter duration and the lower intensity were perceived as positive aspects. After identifying these seven key themes, were also looked into patterns in the distribution of these themes among studies. Conclusions Our qualitative review provides a comprehensive picture of medical students’ attitudes towards family practice in the available literature. In general, although some students find family medicine appealing, it is regarded as a career of low interest and prestige. More research is needed on the influence of role models, medical school and post graduate training. PMID:22909189

Pseudologia Fantastica in the Emergency Department: A Case Report and Review of the Literature

PubMed Central

Teslyar, Polina; Friedman, Rohn

2017-01-01

Psychiatrists commonly encounter deception in the emergency department. This article presents the case of a patient who presents to the emergency department with an unusual and elaborate web of deceptions along multiple themes including feigning medical illness, multiple losses, and grandiose academic and athletic achievements. We review the clinical characteristics of pseudologia fantastica and discuss how this patient's constellation of malingering, factitious disorder, and personality disorder suggests this diagnosis. PMID:28573061

Enhancing Strategic Decision-Making: Lessons from History

DTIC Science & Technology

2012-03-16

tension. This theme is common in literature, art, movies and other media where rushing emotionally to the sound of the guns results in tragedy and...endless and exist in all forms of media . These include Erich Maria Ramarque’s classic 1929 novel turned 1930 movie All Quiet on the Western Front...gagged; political dissent loses its voice when faced by the hegemonic will of the mass of citizens.”39 The most difficult part of dissent is opposing

Spindle assembly in the oocytes of mouse and Drosophila--similar solutions to a problem.

PubMed

Doubilet, Susan; McKim, Kim S

2007-01-01

In the oocytes of many organisms a bipolar spindle is assembled in the absence of centrosomes. In this article we review how this occurs in two model organisms, Drosophila melanogaster and Mus musculus. Common themes include an important role for the chromosomes but paradoxically, organization of a bipolar spindle may not involve kinetochore microtubules. Some comparisons are not yet possible, however, since the same genes have usually not been studied in both systems.

Parents, adolescents, children and the human papillomavirus vaccine: a review.

PubMed

Walhart, T

2012-09-01

Human papillomavirus (HPV) is a sexually transmitted infection (STI). HPV is the most common sexually transmitted infection worldwide. It is also the most common STI in adolescents. This highlights a great clinical and public health concern that must be addressed. Parents are typically involved in the clinical decision-making process of vaccine administration to children and adolescents. Therefore, understanding the acceptability of the HPV vaccination as a method to prevent STIs and certain cancers is critical.   To present the three primary themes that emerged from the literature: parental attitudes, parental beliefs and parental barrier towards vaccinating children and adolescents with the HPV vaccine. A literature search using Scopus to determine parents' attitudes and beliefs towards vaccinating children and adolescents with the HPV vaccine. The initial search included the key search terms of 'children' and 'HPV vaccine'. The publication year was limited from 2006 to present. The three themes greatly influence parents' decisions to vaccinate their children. In the future, more attention needs to be paid to specific subgroups. Future research should include groups that are currently under-represented: fathers, urban populations, low socio-economic status and ethnic minorities. Since nurses worldwide are often sought as healthcare resources by parents in the clinical decision-making process, their understanding of the attitude, beliefs and barriers parents have towards the HPV vaccine is paramount. © 2012 The Author. International Nursing Review © 2012 International Council of Nurses.

OAST Space Theme Workshop. Volume 3: Working Group Summary. 5: Propulsion (P-1). A. Summary Statement. B. Technology Needs (Form 1). C. Priority Assessments (Form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

All themes require some form of advanced propulsion capabilities to achieve their stated objectives. Requirements cover a broad spectrum ranging from a new generation of heavy lift launch vehicles to low thrust, long lift system for on-orbit operations. The commonality extant between propulsive technologies was established and group technologies were grouped into vehicle classes by functional capability. The five classes of launch vehicles identified by the space transportation theme were augmented with a sixth class, encompassing planetary and on-orbit operations. Propulsion technologies in each class were then ranked, and assigned priority numbers. Prioritized technologies were matched to theme requirements.

Perceptions of cardiovascular health in underserved communities.

PubMed

Bryant, Lucinda L; Chin, Nancy P; Cottrell, Lesley A; Duckles, Joyce M; Fernandez, I Diana; Garces, D Marcela; Keyserling, Thomas C; McMilin, Colleen R; Peters, Karen E; Samuel-Hodge, Carmen D; Tu, Shin-Ping; Vu, Maihan B; Fitzpatrick, Annette L

2010-03-01

Cardiovascular disease is the leading cause of deaths and illnesses in US adults, and the prevalence is disproportionately high in underserved populations. In this study, we assessed respondents' understanding of context-specific differences in knowledge and perceptions of disease, risk, and prevention in 6 underserved communities, with the longer-term goal of developing appropriate interventions. Thirty-nine small-group sessions and 14 interviews yielded data from 318 adults. Each site's researchers coded, analyzed, and extracted key themes from local data. Investigators from all sites synthesized results and identified common themes and differences. Themes clustered in 3 areas (barriers to cardiovascular health, constraints related to multiple roles, and suggestions for effective communications and programs). Barriers spanned individual, social and cultural, and environmental levels; women in particular cited multiple roles (eg, competing demands, lack of self-care). Programmatic suggestions included the following: personal, interactive, social context; information in language that people use; activities built around cultural values and interests; and community orientation. In addition, respondents preferred health-related information from trusted groups (eg, AARP), health care providers (but with noticeable differences of opinion), family and friends, and printed materials. Interventions to decrease barriers to cardiovascular health are needed; these strategies should include family and community context, small groups, interactive methods, culturally sensitive materials, and trusted information sources. New-immigrant communities need culturally and linguistically tailored education before receiving more substantive interventions.

Sharing Pacific-Rim experiences in disasters: summary and action plan.

PubMed

Arias, E H; Asai, Y; Chen, J C; Cheng, H K; Ishii, N; Kinugasa, T; Ko, P C; Koido, Y; Murayama, Y; Kwong, P W; Ukai, T

2001-01-01

The discussions in this theme provided an opportunity to address the unique hazards facing the Pacific Rim. Details of the methods used are provided in the preceding paper. The chairs moderated all presentations and produced a summary that was presented to an assembly of all of the delegates. Since the findings from the Theme 3 and Theme 7 groups were similar, the chairs of both groups presided over one workshop that resulted in the generation of a set of action plans that then were reported to the collective group of all delegates. The main points developed during the presentations and discussion included: (1) communication, (2) coordination, (3) advance planning and risk assessment, and (4) resources and knowledge. Action plans were summarized in the following ideas: (1) plan disaster responses including the different types, identification of hazards, focusing training based on experiences, and provision of public education; (2) improve coordination and control; (3) maintain communications, assuming infrastructure breakdown; (4) maximize mitigation through standardized evaluations, the creation of a legal framework, and recognition of advocacy and public participation; and (5) provide resources and knowledge through access to existing therapies, the media, and increasing and decentralizing hospital inventories. The problems in the Asia-Pacific rim are little different from those encountered elsewhere in the world. They should be addressed in common with the rest of the world.

Sexual minority women's experiences of sexual pressure: a qualitative investigation of recipients' and initiators' reports.

PubMed

Budge, Stephanie L; Keller, Bethany L; Sherry, Alissa R

2015-05-01

Sexual pressure can have detrimental effects to individuals both physically and emotionally; however, research in this area is lacking regarding the experiences by lesbian, gay, bisexual, queer, and questioning (LGBQ) women. This online study qualitatively examined sexual pressure experienced and explained by LGBQ women (n = 50) using grounded theory methodology. Participants responded to open-ended questions by providing perspectives from both those who were on the receiving end of the sexual pressure (recipients) and from those who pressured their partners (initiators). Results indicated that there were eight overarching themes, 43 higher order categories, and 241 line-by-line codes. The eight overarching themes included: Reasons to Not Want Sex, Reasons for Pressuring, Reasons for Giving In, Actions of Initiators, Expectations, Communication, Negative Outcomes, and Positive Reactions. Negative Outcomes was the most common theme endorsed. Several higher order categories indicated the unique experiences of sexual minority women, namely trying to be "normal" (e.g., engaging in sexual acts as a result of internalized homophobia), experiencing more pressure from men, and self-consciousness (specifically related to lack of knowledge about sex with women). Implications for the current study include the importance of addressing sexual pressure with sexual minority women and creating interventions, such as assertiveness training and communication skills, that could assist both recipients and initiators with engaging in mutually satisfactory sexual practices.

Communication During Palliative Care and End of Life: Perceptions of Experienced Pediatric Oncology Nurses.

PubMed

Montgomery, Kathleen E; Sawin, Kathleen J; Hendricks-Ferguson, Verna

Communication between patients, families, and healthcare providers is a central component of end-of-life care. Nurse communication during palliative care (PC) and end of life (EOL) is a phenomenon with limited research. It is unclear how the level of nursing experience influences the perspectives of nurses communicating during EOL. The aim of this study is to describe the commonalities of experienced nurses' perceptions of communicating during PC and EOL and perceptions of barriers and facilitators to effective communication. This study was part of a larger multisite study that used a qualitative, empirical phenomenology design and represents focus group data gathered from pediatric oncology nurses with more than 5 years of experience or who were advanced practice nurses not involved in the direct evaluation of other nurses. Five core themes with corresponding themes and subthemes were identified. The core themes included (a) Evolution of PC/EOL, (b) Skill of Knowing, (c) Expanded Essence of Caring, (d) Experienced Nurse as Committed Advocate, and (e) Valuing Individual Response to Grief. Findings reflect how the concept of experience transcended the 5 core themes and captured how experience provided nurses the know-how to fulfill the roles of communication, caring, and advocacy for children and families. Enhancing nurse communication skills during EOL requires opportunities to gain experience coupled with clinical strategies, such as standardized curricula, simulation, competency-based orientation programs, mentorship, and peer support.

Strategies for enhancing medical student resilience: student and faculty member perspectives.

PubMed

Farquhar, Julia; Kamei, Robert; Vidyarthi, Arpana

2018-01-12

To improve programs aimed to enhance medical student resiliency, we examined both medical student and faculty advisor perspectives on resiliency-building in an Asian medical school. In two separate focus groups, a convenience sample of 8 MD-PhD students and 8 faculty advisors were asked to identify strategies for enhancing resilience. Using thematic analysis, two researchers independently examined discussion transcripts and field notes and determined themes through a consensus process. They then compared the themes to discern similarities and differences between these groups. Themes from the student suggestions for increasing resilience included "Perspective changes with time and experience", "Defining effective advisors," and "Individual paths to resiliency". Faculty-identified themes were "Structured activities to change student perspectives," "Structured teaching of coping strategies", and "Institution-wide social support". Students described themselves as individuals building their own resilience path and preferred advisors who were not also evaluators. Faculty, however, suggested systematic, structural ways to increase resilience. Students and advisors identified some common, and many distinct strategies for enhancing medical student resilience. Student/advisor discrepancies may exemplify a cultural shift in Singapore's medical education climate, where students value increased individualism and autonomy in their education. As medical schools create interventions to enhance resilience and combat potential student burnout, they should consider individually-tailored as well as system-wide programs to best meet the needs of their students and faculty.

The themes, institutions, and people of medical education research 1988-2010: content analysis of abstracts from six journals.

PubMed

Rotgans, Jerome I

2012-10-01

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on 10,168 abstracts extracted from the six most influential journals in medical education published since 1988. Twenty-nine major themes were identified, of which student assessment, clinical and communication skills, clinical clerkships, and problem-based learning were the most prominent ones. Some of these themes, such as multiple-choice examinations or computer-assisted instruction seemed to have had their day, whereas other topics, such as the study of clinical clerkships, clinical reasoning, and scholarship in education were on their way up. Medical education research turned out to be a thoroughly international affair to which both US and European research centers contribute. The medical education literature shows an overwhelming emphasis on the preparation of medical students for professional practice. Moreover, the emphasis is very much on the individual student; most research seems to have been conducted with a psychological perspective in mind. It is argued that medical education research would profit from broadening its scope, including sociological, economical, ecological, and system perspectives. These perspectives might bring answers to new questions relevant to the quality of medical education. It is suggested that medical education is in need of moving beyond the conventional effectiveness-driven research approach to a more theory- and discovery-driven approach.

Roles, perceptions and control of infant feeding among low-income fathers.

PubMed

Anderson, Kirsten E; Nicklas, Jennifer C; Spence, Marsha; Kavanagh, Katherine

2010-04-01

Introduction of solid foods before the recommended age of 4-6 months is a common practice in the USA, and appears to be especially prevalent among infants who are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Currently, little is known about how fathers influence early infant feeding decisions, outside the decision to breast- or formula-feed. The purpose of the current study was to explore how fathers perceive the role they play in feeding and caring for their infants. Participants were twenty-one male caregivers, who were fathers or partners of the mothers of WIC income-eligible infants residing in two rural East Tennessee counties. In-depth, audio-taped telephone interviews were completed. Interviews were transcribed, coded and analysed according to standard grounded theory procedures to identify emergent concepts. These concepts were explored and linked together to become themes. Three themes emerged: (i) fathers' roles; (ii) fathers' perceptions; and (iii) control. Concepts within the theme of fathers' roles included physical and emotional support for both mother and infant, validation of maternal decisions, and financial support. In the present study, fathers' perceptions were primarily shaped by their own experiences, advice from those with experience, and information sought by the fathers. The theme of control appears to be the linkage between the fathers' attempts to modify infant behaviour and infants' response. A final conceptual model was created to explain the interrelated nature of the themes and may be helpful to those who work with fathers and/or families of new infants.

Themes of Death and Violence in Lullabies of Different Countries.

ERIC Educational Resources Information Center

Achte, Kalle; And Others

1990-01-01

Lullabies are often divided into songs describing death or funeral of child and songs which threaten child with violence if he/she does not sleep. Survey of lullabies from 26 countries and various ethnic groups revealed that threat songs were more common than lullabies with death themes. Latter were frequent in Finno-Ugris and Slavic cultures, not…

Foster Youth Who Have Succeeded in Higher Education: Common Themes. Information Brief. Volume 7, Issue 1

ERIC Educational Resources Information Center

Lovitt, Thomas; Emerson, John

2008-01-01

The publication is based on interviews conducted by Casey Family Programs with eight foster youth who graduated from college to learn their perspectives on going to college and obtaining a degree despite numerous barriers. This report presents fifteen major themes concerning college success and their general outlook on life. Their accomplishments…

Mickey Mouse Goes to Jurassic Park: The Challenge of Technology for Leisure.

ERIC Educational Resources Information Center

Freeman, William H.

This paper examines the family vacation as a common leisure experience, with emphasis on the rise of the theme park. Theme parks, designed to enable parents to entertain everyone in the family with minimal frustration in organization and application, provide a single-price, inside-the-gate, complete experience. In 1955, Disneyland opened in…

Summary of small group discussions: Regional themes and next steps

Treesearch

Rick Turner

2013-01-01

At the conclusion of the workshop, a breakout group session discussed common themes that had emerged regarding forest degradation monitoring in the Southeast Asia region. The participants were also asked to list any important issues that may not have been sufficiently addressed during the workshop and that may require further discussion, and recommendations for next...

From Habits to Self-Regulation: How Do We Change?

PubMed Central

Gianessi, Carol A.

2012-01-01

The Yale Cognitive Science department hosted the conference “From Habits to Self-Regulation: How Do We Change?” on November 4 and 5, 2011, to showcase current research on self-control in cognitive science, psychology, and neuroscience. The conference included a panel discussion by four philosophers who gave context for the scope and limitations of research on self-control. The common theme concerning the best method to attain lasting change included becoming aware of what one wants to change, increasing commitment to the goal of change, and imagining all of the potential problems and solutions to those problems. PMID:22737058

Comparison of StrengthsQuest Signature Themes in Student Pharmacists and Other Health Care Profession Students.

PubMed

Bloom, Timothy J

2018-02-01

Objective. To determine whether there is a distinctive pattern of StrengthsQuest Signature Themes or leadership domains for Doctor of Pharmacy students compared to students in other health care professional programs. Methods. Students in Doctor of Pharmacy (PharmD), Master of Physician Assistant (PA), Doctor of Physical Therapy (DPT), and Doctor of Osteopathic Medicine (DO) programs at Campbell University completed the online Clifton StrengthsQuest assessment and received their Signature Themes. The frequency of individual themes and the leadership domains into which they are sorted by Gallup was analyzed for each program. Results were compared between programs and with national frequencies among undergraduate students. Results. The most common themes in the total population were Learner, Relator, Responsibility, Harmony, and Achiever. Learner and Relator were among the five most frequent themes for all four individual programs while Responsibility and Harmony were among the top five for three programs. The most frequently reported themes in PharmD and PA students (39% and 38% of all themes, respectively) are grouped by Gallup into the executing domain, and into the relationship-building domain for DO and DPT students (35% and 33% of all themes, respectively). The least frequent themes in PharmD, DO and PA students were those grouped into the influencing domain, reported by 10% or fewer students. Conclusion. Numerous similarities were found in theme frequencies among students in four different health care professions, suggesting there is not a distinctive Doctor of Pharmacy Signature Theme profile.

Knowledge management and informatics considerations for comparative effectiveness research: a case-driven exploration.

PubMed

Embi, Peter J; Hebert, Courtney; Gordillo, Gayle; Kelleher, Kelly; Payne, Philip R O

2013-08-01

As clinical data are increasingly collected and stored electronically, their potential use for comparative effectiveness research (CER) grows. Despite this promise, challenges face those wishing to leverage such data. In this paper we aim to enumerate some of the knowledge management and informatics issues common to such data reuse. After reviewing the current state of knowledge regarding biomedical informatics challenges and best practices related to CER, we then present 2 research projects at our institution. We analyze these and highlight several common themes and challenges related to the conduct of CER studies. Finally, we represent these emergent themes. The informatics challenges commonly encountered by those conducting CER studies include issues related to data information and knowledge management (eg, data reuse, data preparation) as well as those related to people and organizational issues (eg, sociotechnical factors and organizational factors). Examples of these are described in further detail and a formal framework for describing these findings is presented. Significant challenges face researchers attempting to use often diverse and heterogeneous datasets for CER. These challenges must be understood in order to be dealt with successfully and can often be overcome with the appropriate use of informatics best practices. Many research and policy questions remain to be answered in order to realize the full potential of the increasingly electronic clinical data available for such research.

The Canary in the Coal Mine Tweets: Social Media Reveals Public Perceptions of Non-Medical Use of Opioids.

PubMed

Chan, Brian; Lopez, Andrea; Sarkar, Urmimala

2015-01-01

Non-medical prescription opioid use is a growing public health concern. Social media is an emerging tool to understand health attitudes, beliefs, and behaviors. We retrieved a sample of publicly available Twitter messages in early 2014, using common opioid medication names and slang search terms. We used content analysis to code messages by user, context of message (personal vs general experiences), and key content themes. We reviewed 540 messages, of which 375 (69%) messages were related to opioid behaviors. Of these, 316 (84%) originated from individual user accounts; 125 messages expressed personal experience with opioids. The majority of personal messages referenced using opioids to obtain a "high", use for sleep, or other non-intended use (87,70%). General attitudes regarding opioid use included positive sentiment (52, 27%), comments on others peoples opioid use (57, 30%), and messages containing public health information or links (48, 25%). In a sample of social media messages mentioning opioid medications, the most common theme amongst English users related to various forms of opioid misuse. Social media can provide insights into the types of misuse of opioids that might aid public health efforts to reduce non-medical opioid use.

Plant cell surface receptor-mediated signaling - a common theme amid diversity.

PubMed

He, Yunxia; Zhou, Jinggeng; Shan, Libo; Meng, Xiangzong

2018-01-29

Sessile plants employ a diverse array of plasma membrane-bound receptors to perceive endogenous and exogenous signals for regulation of plant growth, development and immunity. These cell surface receptors include receptor-like kinases (RLKs) and receptor-like proteins (RLPs) that harbor different extracellular domains for perception of distinct ligands. Several RLK and RLP signaling pathways converge at the somatic embryogenesis receptor kinases (SERKs), which function as shared co-receptors. A repertoire of receptor-like cytoplasmic kinases (RLCKs) associate with the receptor complexes to relay intracellular signaling. Downstream of the receptor complexes, mitogen-activated protein kinase (MAPK) cascades are among the key signaling modules at which the signals converge, and these cascades regulate diverse cellular and physiological responses through phosphorylation of different downstream substrates. In this Review, we summarize the emerging common theme that underlies cell surface receptor-mediated signaling pathways in Arabidopsis thaliana : the dynamic association of RLKs and RLPs with specific co-receptors and RLCKs for signal transduction. We further discuss how signaling specificities are maintained through modules at which signals converge, with a focus on SERK-mediated receptor signaling. © 2018. Published by The Company of Biologists Ltd.

Why female sex workers participate in HIV research: the illusion of voluntariness.

PubMed

Reed, Elizabeth; Fisher, Celia B; Blankenship, Kim M; West, Brooke S; Khoshnood, Kaveh

2017-07-01

The purpose of this study was to examine factors influencing the motivation for and perceived voluntariness of participation in non-intervention HIV research among female sex workers (FSW) in India. FSW (n = 30) who participated in non-intervention HIV studies in the previous three years were recruited from a local community-based organization. Semi-structured qualitative interviews focused on women's personal and economic motivations for participation and their perceptions of the informed consent process. Interviews were audio-recorded, translated, transcribed, and reviewed for common themes. Content analysis indicated that while many women reported willing participation, reports of obligatory participation were also a common theme. Obligations included money-related pressures and coercion by other FSW, social pressures, not wanting to disappoint the researchers, and perceiving that they had a contractual agreement to complete participation as a result of signing the consent form. Findings suggest a need for additional efforts during and following informed consent to prevent obligatory participation in HIV research studies among FSW. Findings emphasize the importance of integrating ongoing participant feedback into research ethics practices to identify issues not well addressed via standard ethics protocols when conducting HIV research among vulnerable populations.

Community pharmacists' beliefs regarding improvement of Star Ratings scores using the Theory of Planned Behavior.

PubMed

George, David L; Smith, Michael J; Draugalis, JoLaine R; Tolma, Eleni L; Keast, Shellie L; Wilson, Justin B

The Centers for Medicare and Medicaid Services (CMS) is moving toward a value-based model, which includes the Five-Star Quality Rating System (Star Ratings). Prescription Drug Plans include multiple pharmacy measures associated with adherence and patient safety that contribute to CMS Star Ratings scores. This study, using the Theory of Planned Behavior (TPB), explored factors associated with community pharmacists' beliefs to improve Star Ratings scores. Exploratory, qualitative, use of focus groups, and the TPB. Focus groups were performed in conference rooms at the College of Pharmacy main and satellite campuses. Participants were community retail pharmacists with an active Oklahoma license and 1 year of work experience. Each focus group was audio recorded and the recording transcribed to documents and analyzed with the use of a hybrid deductive and inductive qualitative approach rooted in a constant comparative framework. Coding of the data back to the TPB constitutes a deductive approach. The generation of themes and subthemes from other coded nodes constitutes an inductive approach. Analysts agreed on common themes, differences in findings, and saturation of the data gathered. Four focus groups were conducted with 26 participants in 2 categories: pharmacists with and without experience improving Star Ratings. Pharmacists shared and contrasted in salient, normative, and control beliefs about patient outcomes, data, financial implications, staff, technology, and other stakeholders associated with performance of improving Star Ratings. Themes regarding medication adherence, patient safety, and intention were also found. The TPB was used to explore beliefs of community pharmacists about improving Star Ratings scores. Themes that were identified will assist in future research for measuring intention to improve CMS Star Ratings scores and the development of training and education programs. Published by Elsevier Inc.

Developing human functioning and rehabilitation research. Part II: Interdisciplinary university centers and national and regional collaboration networks.

PubMed

Stucki, Gerold; Celio, Marco

2007-05-01

There is a strong movement towards interdisciplinary research around common and scientifically competitive themes, both at universities and at the national and regional level. Human functioning and rehabilitation is a new, highly innovative and relevant theme. It has the potential to attract researchers from a wide range of disciplines, institutions and organizations. It is thus of interest for universities seeking to embark upon a new and unique research area. Similarly, it is a promising theme for individual researchers, institutions and organizations aiming to develop a national or regional collaboration network for interdisciplinary research. Human functioning and rehabilitation complements established themes from the biomedical perspective. In the context of the life sciences, it can be seen as an extension of the biosciences towards a comprehensive understanding of human life, including human interaction and communication, against the background of the natural and social environment. Based on a better understanding of human functioning and disability, there is a wide range of largely unexplored possibilities to optimize populations' functioning and minimize persons' experience of disability in the presence of a health condition. Rehabilitation research is uniquely positioned to integrate and translate scientific advances into benefits for people and the society. Rehabilitation research from the comprehensive perspective can thus become a catalyst of interdisciplinary research that crosses the boundaries of the natural sciences and engineering research, the human and behavioral sciences, the social sciences and a wide range of related scientific areas. Rehabilitation research is also uniquely positioned to cross the boundaries of medicine and the health sector at large, and to translate knowledge across sectors including education, labor and social affairs.

K-12 Neuroscience Education Outreach Program: Interactive Activities for Educating Students about Neuroscience

PubMed Central

Deal, Alex L.; Erickson, Kristen J.; Bilsky, Edward J.; Hillman, Susan J.; Burman, Michael A.

2014-01-01

The University of New England’s Center for Excellence in the Neurosciences has developed a successful and growing K-12 outreach program that incorporates undergraduate and graduate/professional students. The program has several goals, including raising awareness about fundamental issues in neuroscience, supplementing science education in area schools and enhancing undergraduate and graduate/professional students’ academic knowledge and skill set. The outreach curriculum is centered on core neuroscience themes including: Brain Safety, Neuroanatomy, Drugs of Abuse and Addiction, Neurological and Psychiatric Disorders, and Cognition and Brain Function. For each theme, lesson plans were developed based upon interactive, small-group activities. Additionally, we’ve organized our themes in a “Grow-up, Grow-out” approach. Grow-up refers to returning to a common theme, increasing in complexity as we revisit students from early elementary through high school. Grow-out refers to integrating other scientific fields into our lessons, such as the chemistry of addiction, the physics of brain injury and neuronal imaging. One of the more successful components of our program is our innovative team-based model of curriculum design. By creating a team of undergraduate, graduate/professional students and faculty, we create a unique multi-level mentoring opportunity that appears to be successful in enhancing undergraduate students’ skills and knowledge. Preliminary assessments suggest that undergraduates believe they are enhancing their content knowledge and professional skills through our program. Additionally, we’re having a significant, short-term impact on K-12 interest in science. Overall, our program appears to be enhancing the academic experience of our undergraduates and exciting K-12 students about the brain and science in general. PMID:25565921

Life impact of ankle fractures: qualitative analysis of patient and clinician experiences.

PubMed

McPhail, Steven M; Dunstan, Joel; Canning, Julie; Haines, Terry P

2012-11-21

Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

Consequences and coping strategies six years after a subarachnoid hemorrhage – A qualitative study

PubMed Central

Törnbom, Karin; Sunnerhagen, Katharina S.; Törnbom, Marie

2017-01-01

Background After a subarachnoid haemorrhage (SAH), continuing impairment is common and may impact the person’s life. There is a lack of knowledge regarding long-term consequences experienced. Purpose To explore experiences of the care and rehabilitation as well as the consequences and strategies used to cope with everyday life six years post SAH. Methods An explorative interview study with a qualitative design. Individual interviews, with open ended questions, using an interview guide were performed with sixteen participants (mean age 63, 8 men, 8 women) six years post SAH. Data was analyzed according to a descriptive thematic analysis, and themes were discovered inductively. Results Two major themes from the analysis, both including four sub-themes, were identified; these themes were consequences of the SAH and coping strategies. Participants were grateful to have survived the SAH and most were satisfied with their acute medical care. If discharged directly from the neurosurgical unit participants can feel abandoned. In contrast, participants who were referred to a rehabilitation clinic felt supported and informed. Cognitive problems, such as impaired memory and mental fatigue, were reported as still present six years post SAH. Coping strategies were; receiving support from family, society, employers, or technical equipment. At work, talking to colleagues and to taking breaks were common. Participants described hiding their symptoms from employers and friends, as well as trying to continue doing tasks in the same manner as prior to the SAH. If this was not possible, some refrained from doing these tasks. They went through a mourning process, fear, and worries. Conclusions Participants reported several long-term consequences which impacted on their daily lives post SAH, and different coping strategies were used to cope with these problems. Participants reported lack of awareness regarding the consequences of SAH and stressed the importance of structured multidisciplinary follow-ups, which mostly is missing. PMID:28854198

Patient attitudes about the clinical use of placebo: qualitative perspectives from a telephone survey.

PubMed

Ortiz, Robin; Chandros Hull, Sara; Colloca, Luana

2016-04-04

To examine qualitative responses regarding the use of placebo treatments in medical care in a sample of US patients.Survey studies suggest a deliberate clinical use of placebos by physicians, and prior research has found that although most US patients find placebo use acceptable, the rationale for these beliefs is largely unknown. Members of the Outpatient Clinic at the Kaiser Permanente Northern California interviewed research participants who had been seen for a chronic health problem at least once in the prior 6 months. 853 women (61%) and men, white (58%) and non-white participants aged 18-75 years. Qualitative responses on perceptions of placebo use from one-time telephone surveys were analysed for common themes and associations with demographic variables. Prior results indicated that a majority of respondents felt it acceptable for doctors to recommend placebo treatments. Our study found that a lack of harm (n=291, 46.1%) and potential benefit (n=250, 39.6%) were the most common themes to justify acceptability of placebo use. Responses citing potential benefit were associated with higher education (r=0.787; p<0.024). Of the minority of respondents who judged it never acceptable for doctors to recommend placebo treatments, the most often referenced rationale was obligation of the doctor to do more (n=102, 48.3%). Additional themes emerged around the issue of whether a doctor was transparent about placebo use, including honesty, patient's right to know and power of the mind. Older age was associated with likelihood to cite overall physician, as opposed to treatment, related themes (r=0.753; p<0.002). Participants seem to appreciate and understand the lack of harm and potential benefit associated with placebo treatments, while valuing the role of the physician and the patient in its implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Parent Perspective: “Being a Good Parent” When Making Critical Decisions in the PICU

PubMed Central

October, Tessie W.; Fisher, Kiondra R.; Feudtner, Chris; Hinds, Pamela S.

2015-01-01

Objective To identify factors important to parents making decisions for their critically ill child. Design Prospective cross-sectional study. Setting Single center, tertiary care PICU. Subjects Parents making critical treatment decisions for their child. Intervention One-on-one interviews that used the Good Parent Tool-2 open-ended question that asks parents to describe factors important for parenting their ill child and how clinicians could help them achieve their definition of “being a good parent” to their child. Parent responses were analyzed thematically. Parents also ranked themes in order of importance to them using the Good Parent Ranking Exercise. Measurement and Main Results Of 53 eligible parents, 43 (81%) participated. We identified nine themes through content analysis of the parent’s narrative statements from the Good Parent Tool. Most commonly (60% of quotes) components of being a good parent described by parents included focusing on their child’s quality of life, advocating for their child with the medical team, and putting their child’s needs above their own. Themes key to parental decision making were similar regardless of parent race and socioeconomic status or child’s clinical status. We identified nine clinician strategies identified by parents as helping them fulfill their parenting role, most commonly, parents wanted to be kept informed (32% of quotes). Using the Good Parent Ranking Exercise, fathers ranked making informed medical decisions as most important, whereas mothers ranked focusing on the child’s health and putting their child’s needs above their own as most important. However, mothers who were not part of a couple ranked making informed medical decisions as most important. Conclusion These findings suggest a range of themes important for parents to “be a good parent” to their child while making critical decisions. Further studies need to explore whether clinician’s knowledge of the parent’s most valued factor can improve family-centered care. PMID:24583502

Successful Students Who Are Deaf or Hard of Hearing and Culturally and/or Linguistically Diverse in Inclusive Settings.

PubMed

Ayantoye, Catherine Adekemi; Luckner, John L

2016-01-01

The population of students who are deaf or hard of hearing is becoming more culturally and/or linguistically diverse. However, there is a paucity of practitioner literature and research available to professionals and families to guide decision making about daily practices with these students and their families. The study identified factors that contribute to the success of students who are deaf or hard of hearing and from culturally and/or linguistically diverse backgrounds who receive the majority of their education in inclusive settings. Students were recruited from two schools in two school districts in a western state. Students, educators, interpreters, and parents participated in individual in-depth, semi-structured interviews. Observations of the students were also done. Analysis of the data included coding the transcribed interviews and the field notes to identify common themes. Seven themes emerged and are reported. Recommendations for future research are provided.

Introduction of interdisciplinary teaching: two case studies : commentary on "teaching science, technology, and society to engineering students: a sixteen year journey".

PubMed

Spitzer, Hartwig

2013-12-01

Interdisciplinary courses on science, engineering and society have been successfully established in two cases, at Bilkent University, Ankara, Turkey, and at the University of Hamburg, Germany. In both cases there were institutional and perceptual barriers that had to be overcome in the primarily disciplinary departments. The ingredients of success included a clear vision of interdisciplinary themes and didactics, and the exploitation of institutional opportunities. Haldun M. Ozaktas in Ankara used the dynamics of an accreditation process to establish courses on engineering and society. At the University of Hamburg the introduction of optional courses into all curricula allowed for the establishment of a seminar series on physics and society, as well as on peace education and peace building. Both of these approaches have a weakness in common: the courses can disappear once their initiators have left, unless the interdisciplinary themes are integrated into compulsory core curricula.

Authentic Community as an Educational Strategy for Advancing Professionalism: A National Evaluation of the Healer’s Art Course

PubMed Central

Wrubel, Judith; Remen, Rachel Naomi

2007-01-01

Background Efforts to promote medical professionalism often focus on cognitive and technical competencies, rather than professional identity, commitment, and values. The Healer’s Art elective is designed to create a genuine community of inquiry into these foundational elements of professionalism. Objective Evaluations were obtained to characterize course impact and to understand students’ conceptions of professionalism. Design Qualitative analysis of narrative course evaluation responses. Participants Healer’s Art students from U.S. and Canadian medical schools. Approach Analysis of common themes identified in response to questions about course learning, insights, and utility. Results In 2003–2004, 25 schools offered the course. Evaluations were obtained from 467 of 582 students (80.2%) from 22 schools participating in the study. From a question about what students learned about the practice of medicine from the Healer’s Art, the most common themes were “definition of professionalism in medicine” and “legitimizing humanism in medicine.” The most common themes produced by a question about the most valuable insights gained in the course were “relationship between physicians and patients” and “creating authentic community.” The most common themes in response to a question about course utility were “creating authentic community” and “filling a curricular gap.” Conclusions In legitimizing humanistic elements of professionalism and creating a safe community, the Healer’s Art enabled students to uncover the underlying values and meaning of their work—an opportunity not typically present in required curricula. Attempts to teach professionalism should address issues of emotional safety and authentic community as prerequisites to learning and professional affiliation. PMID:17619932

Pendulum migration and healthcare in border área.

PubMed

Zaslavsky, Ricardo; Goulart, Bárbara Niegia Garcia de

2017-12-01

This article aims to reflect about the importance and the potential impact of pendulum migration in the pursuance for healthcare, and, specifically, about the peculiarity of this kind of mobility in border areas. It describes the context in which the pendulum migration is inserted for the modification of the urban space in the 20th century, makes initial comments about legal aspects of the theme in health sector, and describes the reality of the Brazil-Argentina-Paraguay triple border as an important location of pendulum migration for the pursuance of healthcare as an illustrative fact. In this way, hypotheses are formulated about the causes of the pendulum migration impact on patient's health like the effect of the distance covered from home to healthcare facilities, and organizational aspects related to healthcare like the uncertainty about having or not health assistance due to international mobility. It concludes that this kind of mobility is very common in the pursuance of healthcare despite the traditional approach to the theme mentioning only work or study. Besides that, it is very important to study its impact on health and to include this theme on the cross border healthcare debate.

"The Whole Family Suffered, so the Whole Family Needs to Recover": Thematic Analysis of Substance-Abusing Mothers' Family Therapy Sessions.

PubMed

Brakenhoff, Brittany; Slesnick, Natasha

2015-03-01

Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children's discussion during family therapy. Mothers' ages ranged from 28 to 35 years and the children's ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families' ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology.

Low-Income Women's Feeding Practices and Perceptions of Dietary Guidance: A Qualitative Study.

PubMed

Savage, Jennifer S; Neshteruk, Cody D; Balantekin, Katherine N; Birch, Leann L

2016-12-01

Objectives Describe themes characterizing feeding behaviors of low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and identify the attitudes, beliefs, and sources of information that inform these practices. Methods Formative research was conducted including focus groups and semi-structured individual phone interviews with a total of 68 low-income women participating in WIC. Qualitative data were recorded, transcribed, imported into NVivo 8.0, and analyzed for common themes. Results Mothers reported feeding behaviors inconsistent with guidance from WIC and the American Academy of Pediatrics. Three main themes were identified. First, mothers reported receiving conflicting messaging/advice from medical professionals, WIC nutritionists, and family members, which was confusing. Mothers also reported dissatisfaction with the "one size fits most" approach. Lastly, mothers reported relying on their "instincts" and that "all babies are different" when deciding and rationalizing what feeding guidance to follow. Conclusions Future interventions targeting this high-risk population should consider developing personalized (individualized) messaging, tailored to the needs of each mother-child dyad. Focused efforts are needed to build partnerships between WIC providers and other health care providers to provide more consistent messages about responsive feeding to prevent early obesity.

Bounded agency in humanitarian settings: a qualitative study of adherence to antiretroviral therapy among refugees situated in Kenya and Malaysia.

PubMed

Mendelsohn, Joshua B; Rhodes, Tim; Spiegel, Paul; Schilperoord, Marian; Burton, John Wagacha; Balasundaram, Susheela; Wong, Chunting; Ross, David A

2014-11-01

HIV-positive refugees confront a variety of challenges in accessing and adhering to antiretroviral therapy (ART) and attaining durable viral suppression; however, there is little understanding of what these challenges are, how they are navigated, or how they may differ across humanitarian settings. We sought to document and examine accounts of the threats, barriers and facilitators experienced in relation to HIV treatment and care and to conduct comparisons across settings. We conducted semi-structured interviews among a purposive sample of 14 refugees attending a public, urban HIV clinic in Kuala Lumpur, Malaysia (July-September 2010), and 12 refugees attending a camp-based HIV clinic in Kakuma, Kenya (February-March 2011). We used framework methods and between-case comparison to analyze and interpret the data, identifying social and environmental factors that influenced adherence. The multiple issues that threatened adherence to antiretroviral therapy or precipitated actual adherence lapses clustered into three themes: "migration", "insecurity", and "resilience". The migration theme included issues related to crossing borders and integrating into treatment systems upon arrival in a host country. Challenges related to crossing borders were reported in both settings, but threats pertaining to integration into, and navigation of, a new health system were exclusive to the Malaysian setting. The insecurity theme included food insecurity, which was most commonly reported in the Kenyan setting; health systems insecurity, reported in both settings; and emotional insecurity, which was most common in the Kenyan setting. Resilient processes were reported in both settings. We drew on the concept of "bounded agency" to argue that, despite evidence of personal and community resilience, these processes were sometimes insufficient for overcoming social and environmental barriers to adherence. In general, interventions might aim to bolster individuals' range of action with targeted support that bolsters resilient processes. Specific interventions are needed to address locally-based food and health system insecurities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Long-Term Antiretroviral Treatment Adherence in HIV-Infected Adolescents and Adults in Uganda: A Qualitative Study

PubMed Central

Inzaule, Seth C.; Hamers, Raph L.; Kityo, Cissy; Rinke de Wit, Tobias F.; Roura, Maria

2016-01-01

Background Long-term success of HIV antiretroviral therapy requires near-perfect adherence, maintained throughout one’s lifetime. However, perceptions towards ART and patterns of adherence may change during the life course. We assessed challenges to long-term adherence in adolescents and adults in three regional HIV treatment centers in Uganda. Methods We conducted 24 in-depth interviews and 2 focus group discussions with a total of 33 health-care providers and expert clients (HIV patients on long-term ART who assist with adherence support of fellow patients). Interview topics included experiences with patients on long-term treatment with either declining adherence or persistent poor adherence. Transcribed texts were coded and analyzed based on the social-ecological framework highlighting differences and commonalities between adolescents and adults. Results The overarching themes in adolescents were unstructured treatment holidays, delays in disclosure of HIV status by caretakers, stigma, which was mainly experienced in boarding schools, and diminishing or lack of clinical support. In particular, there was minimal support for early and gradual disclosure for caretakers to the infected children, diminishing clinical support for young adults during transition to adult-based care and declining peer-to-peer support group activities. The predominating theme in adults was challenges with treatment access among temporary economic migrants. Common themes to adults and adolescents were challenges with disclosure in intimate relationships, treatment related factors including side effects, supply of single tablets in place of fixed-dose combined drugs, supply of drug brands with unfavorable taste and missed opportunities for counseling due to shortage of staff. Conclusion Adherence counseling and support should be adapted differently for adolescents and adults and to the emerging life course challenges in long-term treated patients. Programs should also address constraints experienced by temporary economic migrants to ensure continuity of treatment within the host country. PMID:27898736

Transition to Puberty as Experienced by 12-Year-Old Swedish Girls

ERIC Educational Resources Information Center

Rembeck, Gun I.; Hermansson, Evelyn

2008-01-01

The purpose of this study was to describe 12-year-old girls' experiences of entering puberty. A qualitative approach was used to gather data from focus group interviews, and content analysis was used to identify common themes from the responses of 18 girls. Findings revealed four main themes: (a) growing up--awareness, bodily changes, longing; (b)…

Chaotic Careers: A Narrative Analysis of Career Transition Themes and Outcomes Using Chaos Theory as a Guiding Metaphor

ERIC Educational Resources Information Center

Peake, Sharon; McDowall, Almuth

2012-01-01

In a rapidly changing world of work, little research exists on mid-career transitions. We investigated these using the open-systems approach of chaos theory as a guiding metaphor and conducted interviews with seven mid-career individuals chosen for their experience of a significant mid-career transition. Four common themes were identified through…

Science To Go: Fact and Fiction Learning Packs.

ERIC Educational Resources Information Center

Sauerteig, Judy

This book demonstrates how to specifically pair a fiction and nonfiction book of the same theme and package them with copies of question and activity sheets to provide students with take-home learning packets for independent learning and family use. For each grade level in K-3, 15 topic areas are explored through two books with a common theme.…

The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website.

PubMed

Barbara, Angela M; Dobbins, Maureen; Haynes, R Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder; Levinson, Anthony J

2016-05-11

Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal's strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be applied by designers of health-related websites.

The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website

PubMed Central

Dobbins, Maureen; Haynes, R. Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder

2016-01-01

Background Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Objective Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Methods Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. Results A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal’s strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. Conclusions The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be applied by designers of health-related websites. PMID:27170443

Indigenous Knowledge Approach to Successful Psychotherapies with Aboriginal Suicide Attempters

PubMed Central

2016-01-01

Introduction: Suicide is disproportionately common among Aboriginal people in Canada. Methods: Life stories were collected from 54 Aboriginal suicide attempters in northern Saskatchewan. Constant comparison techniques and modified grounded theory identified common themes expressed. Results: Three common plots/themes preceded suicide attempts: 1) relationship breakup, usually sudden, unanticipated, involving a third person; 2) being publicly humiliated by another person(s), accompanied by high levels of shame; and 3) high levels of unremitting, chronic life stress (including poverty) with relative isolation. We found 5 common purposes for suicide attempts: 1) to “show” someone how badly they had hurt the attempter, 2) to stop the pain, 3) to save face in a difficult social situation, 4) to get revenge, and 5) don’t know/don’t remember/made sense at the time, all stated by people who were under the influence of alcohol and/or drugs at the time of their suicide attempt. We found 5 common beliefs about death: 1) you just cease to exist, and everything just disappears; 2) you go into the spirit world and can see and hear everything that is happening in this world; 3) you go to heaven or hell; 4) you go to a better place; and 5) don’t know/didn’t think about it. Discussion: The idea of personal and cultural continuity is essential to understanding suicide among First Nations youth. Interventions targeted to the individual’s beliefs about death, purpose for suicide, and consistent with the life story (plot) in which they find themselves may be more successful than one-size-fits-all programs developed outside of aboriginal communities. PMID:27738250

Exploring Students' Ideas About Cosmological Concepts

NASA Astrophysics Data System (ADS)

Bailey, Janelle M.

2012-03-01

As scientists seek to understand the nature of our Universe, we can also explore our students' understanding of cosmological concepts. What ideas about the origin, evolution, and fate of our Universe do students bring with them to the classroom? In this talk, I will describe an ongoing study in which students' preinstructional ideas are examined. Topics under investigation include the age of the universe; structure and composition, including dark matter and dark energy; the Big Bang; and how astronomers come to understand these topics. Approximately 1000 students have responded to open-ended questions at the start of their introductory astronomy courses. Analysis of the responses, through an iterative process of identifying self-emergent themes, suggests that students have a number of common ideas. For example, students frequently conflate structure terms such as solar system, galaxy, and universe or do not understand the relationship between the terms; believe the universe to be infinitely old; and may not be aware of dark matter or dark energy. Additional themes, as well as the frequencies of typical responses, will be discussed, and future research efforts.

An insider's perspective on entrepreneurial program development at a small and a large institution.

PubMed

Lehman, Michael S

2013-09-01

Entrepreneurship educators have an opportunity to learn from the entrepreneurship programs at both small colleges and large universities that have already sprouted up and experienced growth, challenges, failures, and ultimate successes. Programs that have contributed to the current entrepreneurship milieu can help leaders who are launching new programs or retooling existing ones, providing information to assist in defining their outcome objectives and refining their offerings. The development of new entrepreneurship programs, one at a private liberal arts institution and one at a large state-related research university, is evaluated. The common threads of "what worked" are identified, highlighting themes that other institutions of any size undertaking new initiatives can leverage. Themes discussed include the identification of institutional champions, communication with members of the "student supply chain," and offering both non-credit, experience-based opportunities and dynamic for-credit courses. In addition, implementing a strategy that includes faculty partnerships, designated advisory boards, and refined bootstrapping skills helps to ensure that robust human and capital resources are available for program delivery, growth, and sustainability.

Common themes and differences in SAM recognition among SAM riboswitches.

PubMed

Price, Ian R; Grigg, Jason C; Ke, Ailong

2014-10-01

The recent discovery of short cis-acting RNA elements termed riboswitches has caused a paradigm shift in our understanding of genetic regulatory mechanisms. The three distinct superfamilies of S-adenosyl-l-methionine (SAM) riboswitches are the most commonly found riboswitch classes in nature. These RNAs represent three independent evolutionary solutions to achieve specific SAM recognition. This review summarizes research on 1) modes of gene regulatory mechanisms, 2) common themes and differences in ligand recognition, and 3) ligand-induced conformational dynamics among SAM riboswitch families. The body of work on the SAM riboswitch families constitutes a useful primer to the topic of gene regulatory RNAs as a whole. This article is part of a Special Issue entitled: Riboswitches. Copyright © 2014 Elsevier B.V. All rights reserved.

Implementation of Community-Wide Teen Pregnancy Prevention Initiatives: Focus on Partnerships.

PubMed

Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Dee, Deborah L; Koumans, Emilia H

2017-03-01

Seeking to reduce teen pregnancy and births in communities with rates above the national average, the Centers for Disease Control and Prevention, in partnership with the U.S. Department of Health and Human Services Office of Adolescent Health Teen Pregnancy Prevention Program, developed a joint funding opportunity through which grantees worked to implement and test an approach involving community-wide teen pregnancy prevention initiatives. Once these projects had been in the field for 2.5 years, Centers for Disease Control and Prevention staff developed plans for a supplemental issue of the Journal of Adolescent Health to present findings from and lessons learned during implementation of the community-wide initiatives. When the articles included in the supplemental issue are considered together, common themes emerge, particularly those related to initiating, building, and maintaining strong partnerships. Themes seen across articles include the importance of (1) sharing local data with partners to advance initiative implementation, (2) defining partner roles from the beginning of the initiatives, (3) developing teams that include community partners to provide direction to the initiatives, and (4) addressing challenges to maintaining strong partnerships including partner staff turnover and delays in implementation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Social Listening: A Content Analysis of E-Cigarette Discussions on Twitter.

PubMed

Cole-Lewis, Heather; Pugatch, Jillian; Sanders, Amy; Varghese, Arun; Posada, Susana; Yun, Christopher; Schwarz, Mary; Augustson, Erik

2015-10-27

Electronic cigarette (e-cigarette) use has increased in the United States, leading to active debate in the public health sphere regarding e-cigarette use and regulation. To better understand trends in e-cigarette attitudes and behaviors, public health and communication professionals can turn to the dialogue taking place on popular social media platforms such as Twitter. The objective of this study was to conduct a content analysis to identify key conversation trends and patterns over time using historical Twitter data. A 5-category content analysis was conducted on a random sample of tweets chosen from all publicly available tweets sent between May 1, 2013, and April 30, 2014, that matched strategic keywords related to e-cigarettes. Relevant tweets were isolated from the random sample of approximately 10,000 tweets and classified according to sentiment, user description, genre, and theme. Descriptive analyses including univariate and bivariate associations, as well as correlation analyses were performed on all categories in order to identify patterns and trends. The analysis revealed an increase in e-cigarette-related tweets from May 2013 through April 2014, with tweets generally being positive; 71% of the sample tweets were classified as having a positive sentiment. The top two user categories were everyday people (65%) and individuals who are part of the e-cigarette community movement (16%). These two user groups were responsible for a majority of informational (79%) and news tweets (75%), compared to reputable news sources and foundations or organizations, which combined provided 5% of informational tweets and 12% of news tweets. Personal opinion (28%), marketing (21%), and first person e-cigarette use or intent (20%) were the three most common genres of tweets, which tended to have a positive sentiment. Marketing was the most common theme (26%), and policy and government was the second most common theme (20%), with 86% of these tweets coming from everyday people and the e-cigarette community movement combined, compared to 5% of policy and government tweets coming from government, reputable news sources, and foundations or organizations combined. Everyday people and the e-cigarette community are dominant forces across several genres and themes, warranting continued monitoring to understand trends and their implications regarding public opinion, e-cigarette use, and smoking cessation. Analyzing social media trends is a meaningful way to inform public health practitioners of current sentiments regarding e-cigarettes, and this study contributes a replicable methodology.

Parental Preference Assessment for Vesicoureteral Reflux Management in Children.

PubMed

Tran, Geraldine N; Bodapati, Anand V; Routh, Jonathan C; Saigal, Christopher S; Copp, Hillary L

2017-03-01

Parents of children with vesicoureteral reflux are presented with a variety of management options, which in many cases offer a similar risk-benefit ratio. To facilitate shared decision making, parental preferences regarding vesicoureteral reflux treatment options need to be acknowledged. We aimed to characterize the clinical experience of parents and elicit core themes affecting decision making in regard to managing vesicoureteral reflux in their child. A semistructured, qualitative interview script was developed and vetted by 25 pediatric urologists to discuss treatment options for vesicoureteral reflux. Additional patient interviews were conducted until new themes failed to arise. Content analysis was performed to extract all statements that described treatment options. Similar statements were combined until a final list of unique themes emerged. A total of 26 interviews were performed, yielding 689 statements about overall parent experiences with managing vesicoureteral reflux in the child and 450 statements (65%) pertaining to treatment options. Of the 13 themes that emerged, those most commonly considered were the prevention of future urinary tract infections by 85% of parents, the efficacy rate of treatment options by 85%, the burden of daily maintenance or compliance by 77%, antibiotic resistance by 69%, chronic kidney damage by 62% and invasiveness by 58%. Our study emphasizes that when choosing a treatment option for vesicoureteral reflux in their child, parent preferences regarding risks and benefits are variable. However, their chief concerns include whether a method decreases the risk of urinary tract infections, has an acceptable efficacy rate and aligns itself with the capabilities of the family. These themes help frame discussions between families and clinicians regarding vesicoureteral reflux management, and they can facilitate shared decision making. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

"Neither we are satisfied nor they"-users and provider's perspective: a qualitative study of maternity care in secondary level public health facilities, Uttar Pradesh, India.

PubMed

Bhattacharyya, Sanghita; Issac, Anns; Rajbangshi, Preety; Srivastava, Aradhana; Avan, Bilal I

2015-09-27

Quality of care provided during childbirth is a critical determinant of preventing maternal mortality and morbidity. In the studies available, quality has been assessed either from the users' perspective or the providers'. The current study tries to bring both perspectives together to identify common key focus areas for quality improvement. This study aims to assess the users' (recently delivered women) and care providers' perceptions of care to understand the common challenges affecting provision of quality maternity care in public health facilities in India. A qualitative design comprising of in-depth interviews of 24 recently delivered women from secondary care facilities and 16 health care providers in Uttar Pradesh, India. The data were analysed thematically to assess users' and providers' perspectives on the common themes. The common challenges experienced regarding provision of care were inadequate physical infrastructure, irregular supply of water, electricity, shortage of medicines, supplies, and gynaecologist and anaesthetist to manage complications, difficulty in maintaining privacy and lack of skill for post-delivery counselling. However, physical access, cleanliness, interpersonal behaviour, information sharing and out-of-pocket expenditure were concerns for only users. Similarly, providers raised poor management of referral cases, shortage of staff, non-functioning of blood bank, lack of incentives for work as their concerns. The study identified the common themes of care from both the perspectives, which have been foundrelevant in terms of challenges identified in many developing countries including India. The study framework identified new themes like management of emergencies in complicated cases, privacy and cost of care which both the group felt is relevant in the context of providing quality care during childbirth in low resource setting. The key challenges identified by both the groups can be prioritized, when developing quality improvement program in the health facilities. The identified components of care can match the supply with the demand for care and make the services truly responsive to user needs. The study highlights infrastructure, human resources, supplies and medicine as priority areas of quality improvement in the facility as perceived by both users and providers, nevertheless the interpersonal aspect of care primarily reported by the users must also not be ignored.

The use of negative themes in television food advertising.

PubMed

Pettigrew, Simone; Roberts, Michele; Chapman, Kathy; Quester, Pascale; Miller, Caroline

2012-04-01

The ability of food advertising to trigger food consumption and influence social norms relating to food consumption has resulted in increasing attention being given to the prevalence and nature of food advertising. The present study investigated the use of negative themes in food advertisements aired on Australian television to determine the prevalence of depictions of violence/aggression, mocking, nagging, boredom, loneliness, food craving, mood enhancement, and the emotional use of food across 61 days of programming time. The results suggest that advertisers are using negative themes to capture attention and invoke an emotional response in the target audience. Sixteen percent (14,611) of the 93,284 food advertisements contained negative themes, with mood enhancement and food craving being the most commonly depicted negative themes. Advertisements with negative themes were more likely to be for non-core foods and to be aired during children's popular viewing times than at other times. The potential for negative themes in food advertising to promote unhealthy food consumption behaviors among children is likely to be of concern to policy makers. Building on this exploratory study, further research is needed to investigate how nutrition-related decision making is affected by exposure to food advertisements employing negative emotional themes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Blues You Can Use: Teaching the Faust Theme through Music, Literature, and Film.

ERIC Educational Resources Information Center

Copeland, Matt; Goering, Chris

2003-01-01

Uses the blues to teach the universal Faust theme, which was a common motif expressed in many lyrics coming out of the Mississippi Delta region in the United States during the 1920s and 1930s. Uses this opportunity to open students' eyes to a musical form often overlooked and misinterpreted in mainstream culture, and to improve students' critical…

Uses of Rhetorical Strategies: A Comparative Analysis of the Pro-Slavery and Anti-Feminist Movements.

ERIC Educational Resources Information Center

Vaughn, Mina A.

An examination of the rhetoric of two social movements in the United States--the proslavery movement of the pre-Civil War Period and the anti-feminist movement of the 1970s--reveals that both contain a common theme, paternalism, and that both use similar rhetorical strategies to explicate the theme through a familial metaphor, Father. Examples of…

Common themes and cell type specific variations of higher order chromatin arrangements in the mouse

PubMed Central

Mayer, Robert; Brero, Alessandro; von Hase, Johann; Schroeder, Timm; Cremer, Thomas; Dietzel, Steffen

2005-01-01

Background Similarities as well as differences in higher order chromatin arrangements of human cell types were previously reported. For an evolutionary comparison, we now studied the arrangements of chromosome territories and centromere regions in six mouse cell types (lymphocytes, embryonic stem cells, macrophages, fibroblasts, myoblasts and myotubes) with fluorescence in situ hybridization and confocal laser scanning microscopy. Both species evolved pronounced differences in karyotypes after their last common ancestors lived about 87 million years ago and thus seem particularly suited to elucidate common and cell type specific themes of higher order chromatin arrangements in mammals. Results All mouse cell types showed non-random correlations of radial chromosome territory positions with gene density as well as with chromosome size. The distribution of chromosome territories and pericentromeric heterochromatin changed during differentiation, leading to distinct cell type specific distribution patterns. We exclude a strict dependence of these differences on nuclear shape. Positional differences in mouse cell nuclei were less pronounced compared to human cell nuclei in agreement with smaller differences in chromosome size and gene density. Notably, the position of chromosome territories relative to each other was very variable. Conclusion Chromosome territory arrangements according to chromosome size and gene density provide common, evolutionary conserved themes in both, human and mouse cell types. Our findings are incompatible with a previously reported model of parental genome separation. PMID:16336643

Toward Mentoring in Palliative Social Work: A Narrative Review of Mentoring Programs in Social Work.

PubMed

Toh, Ying Pin; Karthik, R; Teo, Chia Chia; Suppiah, Sarasvathy; Cheung, Siew Li; Krishna, Lalit

2018-03-01

Mentoring by an experienced practitioner enhances professional well-being, promotes resilience, and provides a means of addressing poor job satisfaction and high burnout rates among medical social workers. This is a crucial source of support for social workers working in fields with high risk of compassion fatigue and burnout like palliative care. Implementing such a program, however, is hindered by differences in understanding and application of mentoring practice. This narrative review of mentoring practice in social work seeks to identify key elements and common approaches within successful mentoring programs in social work that could be adapted to guide the design of new mentoring programs in medical social work. Methodology and Data Sources: A literature search of mentoring programs in social work between January 1, 2000, and December 31, 2015, using Pubmed, CINAHL, OVID, ERIC, Scopus, Cochrane and ScienceDirect databases, involving a senior experienced mentor and undergraduate and/or junior postgraduates, was carried out. A total of 1302 abstracts were retrieved, 22 full-text articles were analyzed, and 8 articles were included. Thematic analysis of the included articles revealed 7 themes pertaining to the mentoring process, outcomes and barriers, and the characteristics of mentoring relationships, mentors, mentees, and host organizations. Common themes in prevailing mentoring practices help identify key elements for the design of an effective mentoring program in medical social work. We conclude with a discussion of the implications of these findings upon clinical practice in palliative care and on sustaining such a program.

Primary Care Provider Views About Usefulness and Dissemination of a Web-Based Depression Treatment Information Decision Aid.

PubMed

Beaulac, Julie; Westmacott, Robin; Walker, John R; Vardanyan, Gohar

2016-06-08

Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences. The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings. Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff. The study design was a qualitative framework analytic approach of 5 focus groups. Focus groups were conducted during regular staff meetings, were digitally recorded, and transcripts created. Analysis involved a content and theme analysis. Seven key themes emerged including the key role of the primary care provider, common questions about treatments, treatment barriers, sources of patient information, concern about quality and quantity of available information, positive opinions about the IDA, and disseminating the IDA. The most common questions mentioned were about medication and side effects and alternatives to medication. Patients have limited access to alternative treatment options owing to cost and availability. Practitioners evaluated the IDA positively. The resources were described as useful, supportive of providers' messages, and accessible for patients. There was unanimous consensus that information needs to be available electronically through the Internet.

A Systematic Review of Primary Care Safety Climate Survey Instruments: Their Origins, Psychometric Properties, Quality, and Usage.

PubMed

Curran, Ciara; Lydon, Sinéad; Kelly, Maureen; Murphy, Andrew; Walsh, Chloe; OʼConnor, Paul

2018-06-01

Safety climate (SC) measurement is a common and feasible method of proactive safety assessment in primary care. However, there is no consensus on which instrument is "best" to use. The aim of the study was to identify the origins, psychometric properties, quality, and SC domains measured by survey instruments used to assess SC in primary care settings. Systematic searches were conducted using Medline, Embase, CINAHL, and PsycInfo in February 2016. English-language, peer-reviewed studies that reported the development and/or use of a SC survey in a primary care setting were included. Two reviewers independently extracted data (survey characteristics, origins, and psychometric properties) from studies and applied the Quality Assessment Tool for Studies with Diverse Designs to assess methodological rigour. Safety climate domains within surveys were deductively analyzed and categorized into common healthcare SC themes. Seventeen SC surveys were identified, of which 16 had been adapted from 2 main U.S. hospital-based surveys. Only 1 survey was developed de novo for a primary care setting. The quantity and quality of psychometric testing varied considerably across the surveys. Management commitment to safety was the most frequently measured SC theme (87.5%). Workload was infrequently measured (25%). Valid and reliable instruments, which are context specific to the healthcare environment for intentional use, are essential to accurately assess SC. Key recommendations include further establishing the construct and criterion-related validity of existing instruments as opposed to developing additional surveys.

Thematic Accuracy Assessment of the 2011 National Land ...

EPA Pesticide Factsheets

Accuracy assessment is a standard protocol of National Land Cover Database (NLCD) mapping. Here we report agreement statistics between map and reference labels for NLCD 2011, which includes land cover for ca. 2001, ca. 2006, and ca. 2011. The two main objectives were assessment of agreement between map and reference labels for the three, single-date NLCD land cover products at Level II and Level I of the classification hierarchy, and agreement for 17 land cover change reporting themes based on Level I classes (e.g., forest loss; forest gain; forest, no change) for three change periods (2001–2006, 2006–2011, and 2001–2011). The single-date overall accuracies were 82%, 83%, and 83% at Level II and 88%, 89%, and 89% at Level I for 2011, 2006, and 2001, respectively. Many class-specific user's accuracies met or exceeded a previously established nominal accuracy benchmark of 85%. Overall accuracies for 2006 and 2001 land cover components of NLCD 2011 were approximately 4% higher (at Level II and Level I) than the overall accuracies for the same components of NLCD 2006. The high Level I overall, user's, and producer's accuracies for the single-date eras in NLCD 2011 did not translate into high class-specific user's and producer's accuracies for many of the 17 change reporting themes. User's accuracies were high for the no change reporting themes, commonly exceeding 85%, but were typically much lower for the reporting themes that represented change. Only forest l

Strategies for enhancing medical student resilience: student and faculty member perspectives

PubMed Central

Kamei, Robert; Vidyarthi, Arpana

2018-01-01

Objectives To improve programs aimed to enhance medical student resiliency, we examined both medical student and faculty advisor perspectives on resiliency-building in an Asian medical school. Methods In two separate focus groups, a convenience sample of 8 MD-PhD students and 8 faculty advisors were asked to identify strategies for enhancing resilience. Using thematic analysis, two researchers independently examined discussion transcripts and field notes and determined themes through a consensus process. They then compared the themes to discern similarities and differences between these groups. Results Themes from the student suggestions for increasing resilience included “Perspective changes with time and experience”, “Defining effective advisors,” and “Individual paths to resiliency”. Faculty-identified themes were “Structured activities to change student perspectives,” “Structured teaching of coping strategies”, and “Institution-wide social support”. Students described themselves as individuals building their own resilience path and preferred advisors who were not also evaluators. Faculty, however, suggested systematic, structural ways to increase resilience. Conclusions Students and advisors identified some common, and many distinct strategies for enhancing medical student resilience. Student/advisor discrepancies may exemplify a cultural shift in Singapore’s medical education climate, where students value increased individualism and autonomy in their education. As medical schools create interventions to enhance resilience and combat potential student burnout, they should consider individually-tailored as well as system-wide programs to best meet the needs of their students and faculty. PMID:29334480

Important knowledge for parents of children with heart disease: parent, nurse, and physician views.

PubMed

Daily, Joshua; FitzGerald, Mike; Downing, Kimberly; King, Eileen; del Rey, Javier Gonzalez; Ittenbach, Richard; Marino, Bradley

2016-01-01

Parental understanding of their children's heart disease is inadequate, which may contribute to poor health outcomes. The purpose of this study was to determine what parental knowledge is important in the care of children with heart disease from the perspective of parents, nurses, and physicians. Focus groups were formed with parents of children with single ventricle congenital heart disease (CHD), biventricular CHD, and heart transplantation, and with nurses and physicians who provide care for these children. A nominal group technique was used to identify and prioritise important parental knowledge items and themes. The voting data for each theme were reported by participant type--parent, nurse, and physician--and patient diagnosis--single ventricle CHD, biventricular CHD, and heart transplantation. The following three themes were identified as important by all groups: recognition of and response to clinical deterioration, medications, and prognosis and plan. Additional themes that were unique to specific groups included the following: medical team members and interactions (parents), tests and labs (parents), neurodevelopmental outcomes and interventions (physicians), lifelong disease requiring lifelong follow-up (physicians and nurses), and diagnosis, physiology, and interventions (single ventricle and biventricular CHD). Parents, nurses, and physicians have both common and unique views regarding what parents should know to effectively care for their children with single ventricle CHD, biventricular CHD, or heart transplantation. Specific targeted parental education that incorporates these findings should be provided to each group. Further development of questionnaires regarding parental knowledge with appropriate content validity is warranted.

Medico-legal issues in cardiology.

PubMed

Abbott, Ryan; Cohen, Michael

2013-01-01

The aim of this article is to educate physicians about the current litigation climate in cardiology and cardiac surgery, with a focus on the most frequently litigated areas of practice, including failure to diagnose and treat myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention, and the use of tissue plasminogen activator. Empirical research on cardiology malpractice is presented, along with a sampling of up-to-date cases designed to illustrate common issues and important themes. The principles for reducing legal liability are also discussed, including the informed consent process, spoliation of records, and the role of documentation. Finally, practical recommendations are provided for cardiologists and cardiac surgeons to limit their legal liability.

Applied Graph-Mining Algorithms to Study Biomolecular Interaction Networks

PubMed Central

2014-01-01

Protein-protein interaction (PPI) networks carry vital information on the organization of molecular interactions in cellular systems. The identification of functionally relevant modules in PPI networks is one of the most important applications of biological network analysis. Computational analysis is becoming an indispensable tool to understand large-scale biomolecular interaction networks. Several types of computational methods have been developed and employed for the analysis of PPI networks. Of these computational methods, graph comparison and module detection are the two most commonly used strategies. This review summarizes current literature on graph kernel and graph alignment methods for graph comparison strategies, as well as module detection approaches including seed-and-extend, hierarchical clustering, optimization-based, probabilistic, and frequent subgraph methods. Herein, we provide a comprehensive review of the major algorithms employed under each theme, including our recently published frequent subgraph method, for detecting functional modules commonly shared across multiple cancer PPI networks. PMID:24800226

Learning Commons in Academic Libraries: Discussing Themes in the Literature from 2001 to the Present

ERIC Educational Resources Information Center

Blummer, Barbara; Kenton, Jeffrey M.

2017-01-01

Although the term lacks a standard definition, learning commons represent academic library spaces that provide computer and library resources as well as a range of academic services that support learners and learning. Learning commons have been equated to a laboratory for creating knowledge and staffed with librarians that serve as facilitators of…

Gendered Citizenship and the Individualization of Environmental Responsibility: Evaluating a Campus Common Reading Program

ERIC Educational Resources Information Center

Kennedy, Emily Huddart; Boyd, Amanda

2018-01-01

Campus common reading programs are intended to stimulate critical thinking and dialogue across disciplines yet scarce evidence exists to evaluate the success of such programs. We assess the extent to which engagement in an environmentally-themed common reading program is related to (1) concern for waste-related issues, (2) beliefs that addressing…

Experiences of appearance-related teasing and bullying in skin diseases and their psychological sequelae: results of a qualitative study.

PubMed

Magin, Parker; Adams, Jon; Heading, Gaynor; Pond, Dimity; Smith, Wayne

2008-09-01

Acne, psoriasis and atopic eczema are common diseases and have been consistently associated with adverse psychological sequelae including stigmatization. Being teased on the basis of appearance has been associated with psychiatric morbidity in children and adolescents. The objective of this qualitative study was to explore the experiences of teasing and bullying in patients with acne, psoriasis and eczema, and the role of appearance-related teasing and bullying as mediators of psychological morbidity in these patients. Data collection consisted of 62 in-depth semi-structured interviews with patients with acne, psoriasis or atopic eczema recruited from both specialist dermatology and general practices. Data analysis was cumulative and concurrent throughout the data collection period reflecting a grounded theory approach. Analysis followed the analytic induction method, allowing themes to emerge from the data. Teasing, taunting or bullying was a considerable problem for a significant minority of acne, psoriasis and atopic eczema participants. Themes that emerged were the universally negative nature of the teasing, the use of teasing as an instrument of social exclusion, and as a means of establishing or enforcing power relationships, teasing related to contagion and fear, the emotional and psychological sequelae of teasing and the theme of 'insensate' teasing. For those who had suffered teasing or bullying, this was causally linked in respondents' accounts with psychological sequelae, especially self-consciousness and effects on self-image and self-esteem. Experiences of teasing and bullying were found to have principally occurred during the adolescence of participants and the perpetrators were other adolescents, but there were findings of respondents with psoriasis also having been subjected to ridicule or derogatory remarks by health professionals. Teasing, taunting and bullying may represent an underappreciated source of psychological morbidity in children and adolescents with these common skin diseases.

An interpretive study of food, snack and beverage advertisements in rural and urban El Salvador.

PubMed

Amanzadeh, Baharak; Sokal-Gutierrez, Karen; Barker, Judith C

2015-05-30

Globalization and increased marketing of non-nutritious foods and beverages are driving a nutrition transition in developing countries, adversely affecting the health of vulnerable populations. This is a visual interpretive study of food, snack, and beverage advertisements (ads) in rural and urban El Salvador to discern the strategies and messages used to promote consumption of highly processed, commercialized products. Digital photographs of billboard and wall advertisements recorded a convenience sample of 100 advertisements, including 53 from rural areas and 47 from urban areas in El Salvador. Advertisements were coded for location, type of product, visual details, placement and context. Qualitative methods were used to identify common themes used to appeal to consumers. Advertisements depicted "modern" fast foods, processed snacks and sugary beverages. Overall, the most prominent themes were: Cheap Price, Fast, Large Size, and Modern. Other themes used frequently in combination with these were Refreshment, Sports/Nationalism, Sex and Gender Roles, Fun/Happy Feelings, Family, Friendship and Community, and Health. In rural areas, beverage and snack food ads with the themes of cheap price, fast, and large size tended to predominate; in urban areas, ads for fast food restaurants and the theme of modernity tended to be more prominent. The advertisements represented a pervasive bombardment of the public with both explicit and subliminal messages to increase consumerism and shift dietary patterns to processed foods and beverages that are low in micronutrients and high in carbohydrates, sugar, fat and salt--dietary changes that are increasing rates of child and adult diseases including tooth decay, obesity, cardiovascular disease and cancer. Global food and beverage industries must be held accountable for the adverse public health effects of their products, especially in low-middle income countries where there are fewer resources to prevent and treat the health consequences. In addition, public health and governmental authorities should learn from the advertising strategies to promote social marketing of public health messages, and enact and enforce regulations to limit the advertisement and sale of unhealthy products, particularly for children in and around schools. This will create healthier social norms and environments for the entire population.

Teaching in conflict contexts: dimensions of subjective wellbeing in Palestinian teachers living in Israel and the occupied Palestinian territory.

PubMed

Pepe, Alessandro; Addimando, Loredana; Dagdouke, Jamal; Yagi, Shaher; Veronese, Guido

2018-02-21

Subjective wellbeing can be defined in terms of good mental state, including positive and negative evaluations that people make of their affect and lives. The aim of this study was to identify specific domains of wellbeing that are salient to Palestinian teachers living in three different contexts (West Bank, Gaza Strip, and Israel) and to map how components of subjective wellbeing vary between the three cohorts. Data were gathered from interviews of teachers participating in 16 focus groups and from 36 key informants (including psychologists, counsellors, school principals, lawyers). Participants were divided into three groups according to their working locations. Data were analysed by using a mixed-method approach. We used thematic textual analysis, and data were cross-validated with results of statistical significance of lexical specificities (ie, domain-specific terms extracted from specific participants' lexicon) and semantic network analysis. We interviewed 104 teachers. First-order hierarchical categorisation of thematic analysis revealed four dimensions of subjective wellbeing: psychosocial, professional-related, economic issues, and contextual factors. Some second-order subcategories were quality of teaching work, personality aspects, emotional dimensions, political dimensions, and psychological dimensions. Analysis of lexical specificities and results of semantic network analysis revealed that the importance of different components of subjective wellbeing varied across geographical cohorts. Overall, the results of qualitative and quantitative data analysis showed a clear relationship between the teachers' subjective wellbeing and the places they lived. General themes were common in all populations, but the three cohorts differed in terms of the relative salience of each theme. The prominent themes for the Gazan group were quality of teaching, social dimensions, and religion. The key themes for the West Bank group were economic, social dimensions, and recognition. Salient themes for the Arab-Israeli group were professional, emotional, and social dimensions. Despite some differences between the diasporic Palestinian populations in the occupied Palestinian territories and Israel, the categories of wellbeing are supported in all cohorts. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Canary in the Coal Mine Tweets: Social Media Reveals Public Perceptions of Non-Medical Use of Opioids

PubMed Central

Chan, Brian; Lopez, Andrea; Sarkar, Urmimala

2015-01-01

Objective Non-medical prescription opioid use is a growing public health concern. Social media is an emerging tool to understand health attitudes, beliefs, and behaviors. Methods We retrieved a sample of publicly available Twitter messages in early 2014, using common opioid medication names and slang search terms. We used content analysis to code messages by user, context of message (personal vs general experiences), and key content themes. Results We reviewed 540 messages, of which 375 (69%) messages were related to opioid behaviors. Of these, 316 (84%) originated from individual user accounts; 125 messages expressed personal experience with opioids. The majority of personal messages referenced using opioids to obtain a “high”, use for sleep, or other non-intended use (87,70%). General attitudes regarding opioid use included positive sentiment (52, 27%), comments on others peoples opioid use (57, 30%), and messages containing public health information or links (48, 25%). Conclusions In a sample of social media messages mentioning opioid medications, the most common theme amongst English users related to various forms of opioid misuse. Social media can provide insights into the types of misuse of opioids that might aid public health efforts to reduce non-medical opioid use. PMID:26252774

Using Formative Research to Develop a Counselor Training Program for Newborn Screening in Ghana

PubMed Central

Anie, Kofi A.; Grant, Althea M.; Ofori-Acquah, Solomon F.; Ohene-Frempong, Kwaku

2015-01-01

Sickle cell disease (SCD), sickle cell trait (SCT) and related conditions are highly prevalent in sub-Saharan Africa. Despite the public health implications, there is limited understanding of the unique needs regarding establishing and implementing extensive screening for newborns and appropriate family counseling. We sought to gain understanding of community attitudes and beliefs about SCD/SCT from counselors and potential counselors in Ghana; obtain their input about goals for counseling following newborn screening; and obtain guidance about developing effective counselor education. Five focus groups with 32 health care providers and health educators from 9 of 10 regions in Ghana were conducted by trained facilitators according to a structured protocol. Qualitative data were coded and categorized to reflect common themes. Saturation was achieved in themes related to genetics/inheritance; common complications of SCD; potential for stigmatization; marital strain; and emotional stress. Misconceptions about SCT as a form of SCD were prevalent as were cultural and spiritual beliefs about the causes of SCD/SCT. Potential positive aspects included affected children's academic achievement as compensation for physical limitations, and family cohesion. This data informed recommendations for content and structure of a counselor training program that was provided to the Ministry of Health in Ghana. PMID:25193810

Families’ Experiences of Doubling Up After Homelessness

PubMed Central

Bush, Hannah; Shinn, Marybeth

2017-01-01

This study examined experiences of doubling up among families after episodes of homelessness. Doubling up refers to two or more adults or families residing in the same housing unit, which has been an increasing trend in the United States in recent decades. Within the past 14 years, the number of households containing more than one family, related or unrelated, has more than tripled. Although doubling up is increasingly common among families at all income levels, this study seeks to understand the experiences of doubling up among families who have been homeless. Through qualitative interviews with caregivers of 29 families, we analyzed advantages and disadvantages of doubling up with the caregiver’s parent, other family, and nonfamily. Experiences were rated on a four-point scale—(1) mostly negative, (2) negative mixed, (3) positive mixed, and (4) mostly positive—and coded for various positive and negative themes. Overall, we found that doubling up was a generally negative experience for families in our sample, regardless of their relationship to their hosts. Common themes included negative effects on children, undesirable environments, interpersonal tension, and feelings of impermanence and instability. For formerly sheltered families in this study, doubling up after shelter did not resolve their period of housing instability and may be only another stop in an ongoing cycle of homelessness. PMID:29326758

Emerging and continuing trends in vaccine opposition website content.

PubMed

Bean, Sandra J

2011-02-24

Anti-vaccination websites appeal to persons searching the Internet for vaccine information that reinforces their predilection to avoid vaccination for themselves or their children. Few published studies have systematically examined these sites. The aim of this study was to employ content analysis as a useful tool for examining and comparing anti-vaccination websites for recurring and changing emphases in content, design, and credibility themes since earlier anti-vaccination website content analyses were conducted. Between February and May 2010, using a commonly available search engine followed by a deep web search, 25 websites that contained anti-vaccination content were reviewed and analyzed for 24 content, 14 design, and 13 credibility attributes. Although several content claims remained similar to earlier analyses, two new themes emerged: (1) the 2009 H1N1 epidemic threat was "manufactured," and (2) the increasing presence of so-called "expert" testimony in opposing vaccination. Anti-vaccination websites are constantly changing in response to the trends in public health and the success of vaccination. Monitoring the changes can permit public health workers to mount programs more quickly to counter the opposition arguments. Additionally, opposition claims commonly appeal to emotions whereas the supporting claims appeal to reason. Effective vaccine support may be better served by including more emotionally compelling content. Copyright © 2011 Elsevier Ltd. All rights reserved.

Communication at an online infertility expert forum: provider responses to patients' emotional and informational cues.

PubMed

Aarts, J W M; van Oers, A M; Faber, M J; Cohlen, B J; Nelen, W L D M; Kremer, J A M; van Dulmen, A M

2015-01-01

Online patient-provider communication has become increasingly popular in fertility care. However, it is not known to what extent patients express cues or concerns and how providers respond. In this study, we investigated cues and responses that occur in online patient-provider communication at an infertility-specific expert forum. We extracted 106 threads from the multidisciplinary expert forum of two Dutch IVF clinics. We performed the following analyses: (1) thematic analysis of patients' questions; and (2) rating patients' emotional and informational cues and subsequent professionals' responses using an adaptation of the validated Medical Interview Aural Rating Scale. Frequencies of themes, frequencies of cues and responses, and sequences (what cue is followed by what response) were extracted. Sixty-five infertile patients and 19 providers participated. The most common themes included medication and lifestyle. Patients gave more informational than emotional cues (106 versus 64). Responses to informational cues were mostly adequate (61%). The most common response to emotional cues was empathic acknowledgment (72%). Results indicate that an online expert forum could have a positive effect on patient outcomes, which should guide future research. Offering infertile patients an expert forum to communicate with providers can be a promising supplement to usual care in both providing information and addressing patients' concerns.

[SciELO Public Health: the performance of Cadernos de Saúde Pública and Revista de Saúde Pública].

PubMed

Barata, Rita Barradas

2007-12-01

The aim of this paper was to analyze two Brazilian scientific journals included in the SciELO Library of Public Health, using a group of bibliometric indicators and scrutinizing the articles most viewed. Cadernos de Saúde Pública was accessed 3,743.59 times per month, with an average of 30.31 citations per article. The 50 articles most viewed (6.72 to 524.5 views) were mostly published in Portuguese (92%). 42% were theoretical essays, 20% surveys, and 16% descriptive studies. 42% used argumentative techniques, 34% quantitative techniques, 18% qualitative techniques, and 6% mathematical modeling. The most common themes were: health and work (50%), epidemiology (22%), and environmental health (8%). Revista de Saúde Pública was accessed 1,590.97 times per month, with an average of 26.27 citations per article. The 50 articles most viewed (7.33 and 56.50 views) were all published in Portuguese: 46% were surveys, 14% databases analysis, and 12% systematic reviews. Quantitative techniques were adopted in 66% of such articles, while mathematical modeling was the same as observed in Cadernos de Saúde Pública, as were qualitative techniques. The most common themes were health services organization (22%), nutrition (22%), health and work (18%), epidemiology (12%), and environmental health (12%).

Themes of grief.

PubMed

Carter, S L

1989-01-01

A thematic analysis of 30 narrative accounts of bereavement revealed nine themes that included five core themes in bereavement--being stopped, hurting, missing, holding, and seeking; three meta-themes about bereavement--change, expectations, and inexpressibility; and a contextual theme--personal history. The themes were compared with three theoretical perspectives on bereavement by Freud, Kübler-Ross, and one defined as existential-phenomenological. Features of bereavement that are dissimilar or unaddressed by the theoretical perspectives were: (a) the quality of grief's changing character, including "waves" and intense pain which may be triggered years after the death; (b) holding, an individual process of preserving the fact and meaning of the loved one's existence; (c) expectations, both social and personal, as to how the bereaved should be overlaying the experience; and (d) the critical importance of personal history in affecting the quality and meaning of individual bereavement.

Teachers Working Cooperatively with Parents and Caregivers when Implementing LGBT Themes in the Elementary Classroom

ERIC Educational Resources Information Center

Flores, Gabriel

2014-01-01

Many teachers are interested in having a more inclusive multicultural education that includes lesbian, gay, bisexual, and transgender (LGBT) themes and gay-themed children's literature; unfortunately, research has found that many teachers do not implement gay themes in their multicultural education curriculum because of fear of criticism from…

Qualitative thematic analysis of the phenomenology of near-death experiences.

PubMed

Cassol, Helena; Pétré, Benoît; Degrange, Sophie; Martial, Charlotte; Charland-Verville, Vanessa; Lallier, François; Bragard, Isabelle; Guillaume, Michèle; Laureys, Steven

2018-01-01

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers' (NDErs) lives. Previous studies have shown that NDEs memories are phenomenologically rich. In the present study, we therefore aimed to extract the common themes (referred to as "features" in the NDE literature) reported by NDErs by analyzing all the concepts stored in the narratives of their experiences. A qualitative thematic analysis has been carried out on 34 cardiac arrest survivors' NDE narratives. Our results shed the light on the structure of the narratives by identifying 10 "time-bounded" themes which refer to isolated events encountered during the NDE and 1 "transversal" theme which characterizes the whole narrative and generally appears as a retrospective comment of self-reflection on the experience. The division of narratives into themes provides us with detailed information about the vocabulary used by NDErs to describe their experience. This established thematic method enables a rigorous description of the phenomenon, ensuring the inclusion of all self-reported manifestations of themes in narratives.

OAST Space Theme Workshop. Volume 3: Working group summary. 1: Navigation, guidance, control (E-1) A. Statement. B. Technology needs (form 1). C. Priority assessment (form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

The six themes identified by the Workshop have many common navigation guidance and control needs. All the earth orbit themes have a strong requirement for attitude, figure and stabilization control of large space structures, a requirement not currently being supported. All but the space transportation theme have need for precision pointing of spacecraft and instruments. In addition all the themes have requirements for increasing autonomous operations for such activities as spacecraft and experiment operations, onboard mission modification, rendezvous and docking, spacecraft assembly and maintenance, navigation and guidance, and self-checkout, test and repair. Major new efforts are required to conceptualize new approaches to large space antennas and arrays that are lightweight, readily deployable, and capable of precise attitude and figure control. Conventional approaches offer little hope of meeting these requirements. Functions that can benefit from increasing automation or autonomous operations are listed.

Thematic Relations Affect Similarity via Commonalities

ERIC Educational Resources Information Center

Golonka, Sabrina; Estes, Zachary

2009-01-01

Thematic relations are an important source of perceived similarity. For instance, the "rowing" theme of boats and oars increases their perceived similarity. The mechanism of this effect, however, has not been specified previously. The authors investigated whether thematic relations affect similarity by increasing commonalities or by…

Posterior reversible encephalopathy syndrome in alcoholic hepatitis: Hepatic encephalopathy a common theme

PubMed Central

John, Elizabeth S; Sedhom, Ramy; Dalal, Ishita; Sharma, Ranita

2017-01-01

Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiologic diagnosis that has become more widely recognized and reported over the past few decades. As such, there are a number of known risk factors that contribute to the development of this syndrome, including volatile blood pressures, renal failure, cytotoxic drugs, autoimmune disorders, pre-eclampsia, and eclampsia. This report documents the first reported case of PRES in a patient with severe alcoholic hepatitis with hepatic encephalopathy and delves into a molecular pathophysiology of the syndrome. PMID:28127211

Advances in autism genetics: on the threshold of a new neurobiology

PubMed Central

Abrahams, Brett S.; Geschwind, Daniel H.

2009-01-01

Autism is a heterogeneous syndrome defined by impairments in three core domains: social interaction, language and range of interests. Recent work has led to the identification of several autism susceptibility genes and an increased appreciation of the contribution of de novo and inherited copy number variation. Promising strategies are also being applied to identify common genetic risk variants. Systems biology approaches, including array-based expression profiling, are poised to provide additional insights into this group of disorders, in which heterogeneity, both genetic and phenotypic, is emerging as a dominant theme. PMID:18414403

Genetic Regulatory Networks in Embryogenesis and Evolution

NASA Technical Reports Server (NTRS)

1998-01-01

The article introduces a series of papers that were originally presented at a workshop titled Genetic Regulatory Network in Embryogenesis and Evaluation. Contents include the following: evolution of cleavage programs in relationship to axial specification and body plan evolution, changes in cell lineage specification elucidate evolutionary relations in spiralia, axial patterning in the leech: developmental mechanisms and evolutionary implications, hox genes in arthropod development and evolution, heterochronic genes in development and evolution, a common theme for LIM homeobox gene function across phylogeny, and mechanisms of specification in ascidian embryos.

An Integrated Neuroscience Perspective on Formulation and Treatment Planning for Posttraumatic Stress Disorder: An Educational Review.

PubMed

Ross, David A; Arbuckle, Melissa R; Travis, Michael J; Dwyer, Jennifer B; van Schalkwyk, Gerrit I; Ressler, Kerry J

2017-04-01

Posttraumatic stress disorder (PTSD) is a common psychiatric illness, increasingly in the public spotlight in the United States due its prevalence in the soldiers returning from combat in Iraq and Afghanistan. This educational review presents a contemporary approach for how to incorporate a modern neuroscience perspective into an integrative case formulation. The article is organized around key neuroscience "themes" most relevant for PTSD. Within each theme, the article highlights how seemingly diverse biological, psychological, and social perspectives all intersect with our current understanding of neuroscience. Any contemporary neuroscience formulation of PTSD should include an understanding of fear conditioning, dysregulated circuits, memory reconsolidation, epigenetics, and genetic factors. Fear conditioning and other elements of basic learning theory offer a framework for understanding how traumatic events can lead to a range of behaviors associated with PTSD. A circuit dysregulation framework focuses more broadly on aberrant network connectivity, including between the prefrontal cortex and limbic structures. In the process of memory reconsolidation, it is now clear that every time a memory is reactivated it becomes momentarily labile-with implications for the genesis, maintenance, and treatment of PTSD. Epigenetic changes secondary to various experiences, especially early in life, can have long-term effects, including on the regulation of the hypothalamic-pituitary-adrenal axis, thereby affecting an individual's ability to regulate the stress response. Genetic factors are surprisingly relevant: PTSD has been shown to be highly heritable despite being definitionally linked to specific experiences. The relevance of each of these themes to current clinical practice and its potential to transform future care are discussed. Together, these perspectives contribute to an integrative, neuroscience-informed approach to case formulation and treatment planning. This may help to bridge the gap between the traditionally distinct viewpoints of clinicians and researchers.

Computational physics and applied mathematics capability review June 8-10, 2010

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Stephen R

2010-01-01

Los Alamos National Laboratory will review its Computational Physics and Applied Mathematics (CPAM) capabilities in 2010. The goals of capability reviews are to assess the quality of science, technology, and engineering (STE) performed by the capability, evaluate the integration of this capability across the Laboratory and within the scientific community, examine the relevance of this capability to the Laboratory's programs, and provide advice on the current and future directions of this capability. This is the first such review for CPAM, which has a long and unique history at the Laboratory, starting from the inception of the Laboratory in 1943. Themore » CPAM capability covers an extremely broad technical area at Los Alamos, encompassing a wide array of disciplines, research topics, and organizations. A vast array of technical disciplines and activities are included in this capability, from general numerical modeling, to coupled multi-physics simulations, to detailed domain science activities in mathematics, methods, and algorithms. The CPAM capability involves over 12 different technical divisions and a majority of our programmatic and scientific activities. To make this large scope tractable, the CPAM capability is broken into the following six technical 'themes.' These themes represent technical slices through the CPAM capability and collect critical core competencies of the Laboratory, each of which contributes to the capability (and each of which is divided into multiple additional elements in the detailed descriptions of the themes in subsequent sections), as follows. Theme 1: Computational Fluid Dynamics - This theme speaks to the vast array of scientific capabilities for the simulation of fluids under shocks, low-speed flow, and turbulent conditions - which are key, historical, and fundamental strengths of the Laboratory. Theme 2: Partial Differential Equations - The technical scope of this theme is the applied mathematics and numerical solution of partial differential equations (broadly defined) in a variety of settings, including particle transport, solvers, and plasma physics. Theme 3: Monte Carlo - Monte Carlo was invented at Los Alamos. This theme discusses these vitally important methods and their application in everything from particle transport, to condensed matter theory, to biology. Theme 4: Molecular Dynamics - This theme describes the widespread use of molecular dynamics for a variety of important applications, including nuclear energy, materials science, and biological modeling. Theme 5: Discrete Event Simulation - The technical scope of this theme represents a class of complex system evolutions governed by the action of discrete events. Examples include network, communication, vehicle traffic, and epidemiology modeling. Theme 6: Integrated Codes - This theme discusses integrated applications (comprised of all of the supporting science represented in Themes 1-5) that are of strategic importance to the Laboratory and the nation. The Laboratory has in approximately 10 million source lines of code in over 100 different such strategically important applications. Of these themes, four of them will be reviewed during the 2010 review cycle: Themes 1,2, 3, and 6. Because these reviews occur every three years, Themes 4 and 5 will be reviewed in 2013, along with Theme 6 (which will be reviewed during each review, owing to this theme's role as an integrator of the supporting science represented by the other five themes). Yearly written status reports will be provided to the CPAM Committee Chair during off-cycle years.« less

Salivary proline-rich protein may reduce tannin-iron chelation: a systematic narrative review.

PubMed

Delimont, Nicole M; Rosenkranz, Sara K; Haub, Mark D; Lindshield, Brian L

2017-01-01

Tannins are often cited for antinutritional effects, including chelation of non-heme iron. Despite this, studies exploring non-heme iron bioavailability inhibition with long-term consumption have reported mixed results. Salivary proline-rich proteins (PRPs) may mediate tannin-antinutritional effects on non-heme iron bioavailability. To review evidence regarding biochemical binding mechanisms and affinity states between PRPs and tannins, as well as effects of PRPs on non-heme iron bioavailability with tannin consumption in vivo. Narrative systematic review and meta-analysis. Common themes in biochemical modeling and affinity studies were collated for summary and synthesis; data were extracted from in vivo experiments for meta-analysis. Thirty-two studies were included in analysis. Common themes that positively influenced tannin-PRP binding included specificity of tannin-PRP binding, PRP and tannin stereochemistry. Hydrolyzable tannins have different affinities than condensed tannins when binding to PRPs. In vivo, hepatic iron stores and non-heme iron absorption are not significantly affected by tannin consumption ( d  = -0.64-1.84; -2.7-0.13 respectively), and PRP expression may increase non-heme iron bioavailability with tannin consumption. In vitro modeling suggests that tannins favor PRP binding over iron chelation throughout digestion. Hydrolyzable tannins are not representative of tannin impact on non-heme iron bioavailability in food tannins because of their unique structural properties and PRP affinities. With tannin consumption, PRP production is increased, and may be an initial line of defense against tannin-non-heme iron chelation in vivo . More research is needed to compare competitive binding of tannin-PRP to tannin-non-heme iron complexes, and elucidate PRPs' role in adaption to non-heme iron bioavailability in vivo.

Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.

PubMed

Shakespeare, Judy; Blake, Fiona; Garcia, Jo

2004-09-01

to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals. qualitative in-depth interview study. postnatal women of 22 general practices within Oxford City Primary Care Group area. 39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received 'listening visits' from health visitors. a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt. in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the 'Baby Friendly Initiative', may be a contributing factor. This needs to be explored in a further study.

Climate Impact and GIS Education Using Realistic Applications of Data.gov Thematic Datasets in a Structured Lesson-Based Workbook

NASA Astrophysics Data System (ADS)

Amirazodi, S.; Griffin, R.; Bugbee, K.; Ramachandran, R.; Weigel, A. M.

2016-12-01

This project created a workbook which teaches Earth Science education undergraduate and graduate students through guided in-class activities and take-home assignments organized around climate topics which use GIS to teach key geospatial analysis techniques and cartography skills. The workbook is structured to the White House's Data.gov climate change themes, which include Coastal Flooding, Ecosystem Vulnerability, Energy Infrastructure, Arctic, Food Resilience, Human Health, Transportation, Tribal Nations, Water. Each theme provides access to framing questions, associated data, interactive tools, and further reading (e.g. the US Climate Resilience Toolkit and National Climate Assessment). Lessons make use of the respective theme's available resources. The structured thematic approach is designed to encourage independent exploration. The goal is to teach climate concepts and concerns, GIS techniques and approaches, and effective cartographic representation and communication of results; and foster a greater awareness of publically available resources and datasets. To reach more audiences more effectively, a two level approach was used. Level 1 serves as an introductory study and relies on only freely available interactive tools to reach audiences with fewer resources and less familiarity. Level 2 presents a more advanced case study, and focuses on supporting common commercially available tool use and real-world analysis techniques.

“The Whole Family Suffered, so the Whole Family Needs to Recover”: Thematic Analysis of Substance-Abusing Mothers’ Family Therapy Sessions

PubMed Central

Brakenhoff, Brittany; Slesnick, Natasha

2014-01-01

Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children’s discussion during family therapy. Mothers’ ages ranged from 28 to 35 years and the children’s ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families’ ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology. PMID:25729116

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework

PubMed Central

Corazzini, Kirsten; Twersky, Jack; White, Heidi K.; Buhr, Gwendolen T.; McConnell, Eleanor S.; Weiner, Madeline; Colón-Emeric, Cathleen S.

2015-01-01

Purpose of the Study: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. Design and Methods: The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Results: Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implications: Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. PMID:24451896

Climate Impact and GIS Education Using Realistic Applications of Data.gov Thematic Datasets in a Structured Lesson-Based Workbook

NASA Technical Reports Server (NTRS)

Amirazodi, Sara; Griffin, Robert; Bugbee, Kaylin; Ramachandran, Rahul; Weigel, Amanda

2016-01-01

This project created a workbook which teaches Earth Science to undergraduate and graduate students through guided in-class activities and take-home assignments organized around climate topics which use GIS to teach key geospatial analysis techniques and cartography skills. The workbook is structured to the White House's Data.gov climate change themes, which include Coastal Flooding, Ecosystem Vulnerability, Energy Infrastructure, Arctic, Food Resilience, Human Health, Transportation, Tribal Nations, and Water. Each theme provides access to framing questions, associated data, interactive tools, and further reading (e.g. The US Climate Resilience Toolkit and National Climate Assessment). Lessons make use of the respective theme's available resources. The structured thematic approach is designed to encourage independent exploration. The goal is to teach climate concepts and concerns, GIS techniques and approaches, and effective cartographic representation and communication results; and foster a greater awareness of publicly available resources and datasets. To reach more audiences more effectively, a two level approach was used. Level 1 serves as an introductory study and relies on only freely available interactive tools to reach audiences with fewer resources and less familiarity. Level 2 presents a more advanced case study, and focuses on supporting common commercially available tool use and real-world analysis techniques.

Science and Technology Text Mining: Analytical Chemistry

DTIC Science & Technology

2001-01-01

Raynauds Syndrome papers and having a central theme(s) "b" and sub-themes "c." One interesting discovery was that dietary eicosapentaenoic acid (theme...disease (theme "c" from literature BC). There was no mention of eicosapentaenoic acid in the Raynaud’s Syndrome literature, but the acid was linked to the...theoretical approaches and analyses. The main types of COMPOUNDS (ANALYTES) examined include, in order of emphasis, AMINO ACIDS , ORGANIC COMPOUNDS

A systematic review and thematic synthesis of qualitative studies on maternal emergency transport in low- and middle-income countries.

PubMed

Wilson, Amie; Hillman, Sarah; Rosato, Mikey; Skelton, John; Costello, Anthony; Hussein, Julia; MacArthur, Christine; Coomarasamy, Arri

2013-09-01

Most maternal deaths are preventable with emergency obstetric care; therefore, ensuring access is essential. There is little focused information on emergency transport of pregnant women. The literature on emergency transport of pregnant women in low- and middle-income countries (LMICs) was systematically reviewed and synthesized to explore current practices, barriers, and facilitators for transport utilization. MEDLINE, EMBASE, BNI, Cochrane Library, CINAHL, African Index Medicus, ASSIA, QUALIDATA, RHL, and Science Citation Index (inception to April 2012) were searched without language restriction. Studies using qualitative methodology and reporting on emergency transportation in LMICs were included. Thematic framework and synthesis through examination and translation of common elements were used to analyze and synthesize the data. Twenty-nine articles were included. Eight major themes were identified: time for transport; transport options; geography; local support; autonomy; culture; finance; and ergonomics. Key issues were transport availability; transport speed; terrain; meteorology; support; dependence for decision making; cultural issues; cost; and lack of safe, comfortable positioning during transport. Themes should be appreciated within local contexts to illuminate barriers and facilitators. Potential solutions include motorcycle ambulance programs, collaboration with taxi services, community education, subsidies, and vehicle maintenance. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Magnitude knowledge: the common core of numerical development.

PubMed

Siegler, Robert S

2016-05-01

The integrated theory of numerical development posits that a central theme of numerical development from infancy to adulthood is progressive broadening of the types and ranges of numbers whose magnitudes are accurately represented. The process includes four overlapping trends: (1) representing increasingly precisely the magnitudes of non-symbolic numbers, (2) connecting small symbolic numbers to their non-symbolic referents, (3) extending understanding from smaller to larger whole numbers, and (4) accurately representing the magnitudes of rational numbers. The present review identifies substantial commonalities, as well as differences, in these four aspects of numerical development. With both whole and rational numbers, numerical magnitude knowledge is concurrently correlated with, longitudinally predictive of, and causally related to multiple aspects of mathematical understanding, including arithmetic and overall math achievement. Moreover, interventions focused on increasing numerical magnitude knowledge often generalize to other aspects of mathematics. The cognitive processes of association and analogy seem to play especially large roles in this development. Thus, acquisition of numerical magnitude knowledge can be seen as the common core of numerical development. © 2016 John Wiley & Sons Ltd.

What Are Some Common Outcomes of Stroke and Some Common Treatments for These Outcomes?

MedlinePlus

... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

Assessing Fidelity to Suicide Reporting Guidelines in Canadian News Media: The Death of Robin Williams.

PubMed

Creed, Michael; Whitley, Rob

2017-05-01

Mindset is a short recently-published booklet funded by the Mental Health Commission of Canada outlining evidence-based guidelines and best practices for journalists writing about mental health and suicide. Our study aimed to assess fidelity to Mindset recommendations in Canadian newspaper reports of a recent celebrity suicide. A secondary aim is to identify common themes discussed in these newspaper articles. Articles about Robin Williams' suicide from major Canadian newspapers were gathered and coded for presence or absence of each of the 14 recommendations in the "Covering Suicide" section of Mindset. A threshold of 80% was set to test for high fidelity to the guidelines. A qualitative content analysis of the articles was also undertaken to discern common themes and social issues discussed in the articles. Fifty-five per cent of articles surpassed the 80% threshold for high fidelity, while 85% applied at least 70% of the recommendations. The recommendation most commonly overlooked was "Do tell others considering suicide how they can get help," which was absent in 73% of articles. The most common themes discussed were those of addictions and stigma. The news articles generally follow the evidence-based guidelines regarding the reporting of suicide set out in Mindset. This is a welcome development. Future research should continue to examine reporting of suicide to assess for further improvements, while also examining the wider impact of Mindset on the reporting of mental illness per se.

Assessing Fidelity to Suicide Reporting Guidelines in Canadian News Media: The Death of Robin Williams

PubMed Central

Creed, Michael

2016-01-01

Objective: Mindset is a short recently-published booklet funded by the Mental Health Commission of Canada outlining evidence-based guidelines and best practices for journalists writing about mental health and suicide. Our study aimed to assess fidelity to Mindset recommendations in Canadian newspaper reports of a recent celebrity suicide. A secondary aim is to identify common themes discussed in these newspaper articles. Methods: Articles about Robin Williams’ suicide from major Canadian newspapers were gathered and coded for presence or absence of each of the 14 recommendations in the “Covering Suicide” section of Mindset. A threshold of 80% was set to test for high fidelity to the guidelines. A qualitative content analysis of the articles was also undertaken to discern common themes and social issues discussed in the articles. Results: Fifty-five per cent of articles surpassed the 80% threshold for high fidelity, while 85% applied at least 70% of the recommendations. The recommendation most commonly overlooked was “Do tell others considering suicide how they can get help,” which was absent in 73% of articles. The most common themes discussed were those of addictions and stigma. Conclusions: The news articles generally follow the evidence-based guidelines regarding the reporting of suicide set out in Mindset. This is a welcome development. Future research should continue to examine reporting of suicide to assess for further improvements, while also examining the wider impact of Mindset on the reporting of mental illness per se. PMID:27600531

Obesity in social media: a mixed methods analysis.

PubMed

Chou, Wen-Ying Sylvia; Prestin, Abby; Kunath, Stephen

2014-09-01

The escalating obesity rate in the USA has made obesity prevention a top public health priority. Recent interventions have tapped into the social media (SM) landscape. To leverage SM in obesity prevention, we must understand user-generated discourse surrounding the topic. This study was conducted to describe SM interactions about weight through a mixed methods analysis. Data were collected across 60 days through SM monitoring services, yielding 2.2 million posts. Data were cleaned and coded through Natural Language Processing (NLP) techniques, yielding popular themes and the most retweeted content. Qualitative analyses of selected posts add insight into the nature of the public dialogue and motivations for participation. Twitter represented the most common channel. Twitter and Facebook were dominated by derogatory and misogynist sentiment, pointing to weight stigmatization, whereas blogs and forums contained more nuanced comments. Other themes included humor, education, and positive sentiment countering weight-based stereotypes. This study documented weight-related attitudes and perceptions. This knowledge will inform public health/obesity prevention practice.

Formative research to identify perceptions of e-cigarettes in college students: Implications for future health communication campaigns

PubMed Central

Case, Kathleen; Crook, Brittani; Lazard, Allison; Mackert, Michael

2016-01-01

Objective This formative study examined perceptions of e-cigarettes in college students with the goal of informing future health communication campaigns. Differences between e-cigarette users and nonusers were also examined. Participants: Thirty undergraduate students were recruited from a large southwestern public university (15 users, 15 nonusers). Methods Structured interviews were conducted and transcripts were coded for themes. Results Although users had more favorable attitudes toward e-cigarettes, both users and nonusers believed that e-cigarettes produce water vapor and reported that e-cigarettes were less harmful than conventional cigarettes. Potential health consequences and addiction concerns were the most common perceived threats for both users and nonusers. Both nonusers and users cited social stigma as a perceived disadvantage of e-cigarette use. Conclusions Ultimately, themes with particular relevance to future health communication campaigns included negative perceptions of e-cigarette users and social stigma, as well as harm perceptions and potential health consequences associated with e-cigarette use. PMID:26979833

A Multilevel Assessment of Barriers to Adoption of Dietary Approaches to Stop Hypertension (DASH) among African Americans of Low Socioeconomic Status

PubMed Central

Bertoni, Alain G.; Foy, Capri G.; Hunter, Jaimie C.; Quandt, Sara A.; Vitolins, Mara Z.; Whitt-Glover, Melicia C.

2013-01-01

Background We examined perceptions of Dietary Approaches to Stop Hypertension (DASH) and the food environment among African Americans (AA) with high blood pressure living in two low-income communities and objectively assessed local food outlets. Methods Focus groups were conducted with 30 AAs; participants discussed DASH and the availability of healthy foods in their community. Sessions were transcribed and themes identified. Fifty-four stores and 114 restaurants were assessed using the Nutrition Environment Measures Survey (NEMS). Results Common themes included poor availability, quality, and cost of healthy foods; tension between following DASH and feeding other family members; and lack of congruity between their preferred foods and DASH. Food outlets in majority AA census tracts had lower NEMS scores (stores: −11.7, p=.01, restaurants: −8.3, p=.001) compared with majority White areas. Conclusions Interventions promoting DASH among lower income AAs should reflect the food customs, economic concerns, and food available in communities. PMID:22080704

Inspiration from role models and advice for moving forward.

PubMed

Newman, Michelle G; McGinn, Lata K

2012-12-01

This Behavior Therapy series on overcoming the glass ceiling followed from a highly attended panel at ABCT on the same topic. The current paper summarizes the common themes across the various papers in this series with respect to obstacles prominent women have faced, and how we can learn from their stories to help inform the future. These themes include the importance of role models, messages from a supportive environment, difficulties balancing careers with children, coordinating careers with family, importance of taking charge of one's career, moving forward despite negative internal and external messages, and questions about whether things have changed substantially. In addition, this paper contains a summary of the helpful advice from accomplished women in academia for navigating the academic waters. It is our aspiration that going forward this series will stimulate other conversations as well as increase thought, behavior, solidarity, and awareness about this topic so that we can continue to work toward a future when things will continue to improve for women. Copyright © 2012. Published by Elsevier Ltd.

Effective Learning in an Ambulatory Family Medicine Clerkship: A Qualitative Study of Medical Student Midpoint Feedback.

PubMed

Bradner, Melissa K; Flores, Sharon Kaufer; Gary, Judy S; Zumbrunn, Sharon

2017-09-01

There is substantial research on the effectiveness of ambulatory medical preceptors' teaching skills, but less is known about the student perspective on what contributes most to effective learning in a busy clinical practice. As part of a formative midpoint assessment during the third-year clerkship in family medicine, students were asked to respond to the following open-ended reflective prompt: "My preceptor contributed to my learning by..." A qualitative assessment of student responses was conducted to identify themes describing effective learning in the ambulatory setting. Responses for all clerkship students from the years 2012-2014 were examined (N=314). The most common characteristic of effective learning identified by respondents was Autonomy in Practice. Other prominent themes included Stimulating Critical Thinking and Feedback. Understanding student perceptions of the critical components of learning in ambulatory settings will allow medical educators to design meaningful student learning experiences and coach community teachers on effective teaching practices.

Success in the workplace: From the voice of (dis)abled to the voice of enabled

PubMed Central

2014-01-01

The intention of this article is twofold; first to encourage a shift in seeing ‘the disabled’ not as people with disabilities but rather as people with unique abilities. Secondly, to explore ways of facilitating gainful employment for these uniquely abled people. The term disability is examined against a backdrop of definitions including the definition postulated by the International Classification of Functioning. In this article, the life experiences of a purposive sample of people with (dis)abilities who have been successful in the world of work are explored. A narrative approach gives voice to their experiences. Quotes from the participants’ responses are used to illustrate the common themes that emerged relating to their experiences. These themes are resonated against a backdrop of relevant literature. If disabled people are enabled to recognize and use their unique abilities, as well as develop various self-determination skills, imagine the endless possibilities which could arise for them and society in general. PMID:28729997

How definition of mental health problems can influence help seeking in rural and remote communities.

PubMed

Fuller, J; Edwards, J; Procter, N; Moss, J

2000-06-01

The present study sought to understand the rural and remote influences on people's identification of, and response to, mental health problems. Twenty-two key informants living in northern and western South Australia were interviewed. They included mental health and generalist health professionals, other human service workers and mental health consumers. Three themes are reported here: reluctance to acknowledge mental health problems and the avoidance of appropriate help; stigma and the avoidance of mental health services; and the influence of rural and remote circumstances. Most informants considered that many mental health problems were amenable to help from generalist workers, with backup support from mental health specialists. Informants thought this intervention to be appropriate because a common view of mental health problems as 'insanity' and a culture of self-reliance created a reluctance to seek help from a mental health specialist. These themes need to be taken into account when designing mental health interventions for rural and remote communities.

Formative research to identify perceptions of e-cigarettes in college students: Implications for future health communication campaigns.

PubMed

Case, Kathleen; Crook, Brittani; Lazard, Allison; Mackert, Michael

2016-07-01

This formative study examined perceptions of e-cigarettes in college students with the goal of informing future health communication campaigns. Differences between e-cigarette users and nonusers were also examined. Thirty undergraduate students were recruited from a large southwestern public university (15 users, 15 nonusers). Structured interviews were conducted and transcripts were coded for themes. Although users had more favorable attitudes toward e-cigarettes, both users and nonusers believed that e-cigarettes produce water vapor and reported that e-cigarettes were less harmful than conventional cigarettes. Potential health consequences and addiction concerns were the most common perceived threats for both users and nonusers. Both nonusers and users cited social stigma as a perceived disadvantage of e-cigarette use. Ultimately, themes with particular relevance to future health communication campaigns included negative perceptions of e-cigarette users and social stigma, as well as harm perceptions and potential health consequences associated with e-cigarette use.

Can social media be used as a hospital quality improvement tool?

PubMed

Lagu, Tara; Goff, Sarah L; Craft, Ben; Calcasola, Stephanie; Benjamin, Evan M; Priya, Aruna; Lindenauer, Peter K

2016-01-01

Many hospitals wish to improve their patients' experience of care. To learn whether social media could be used as a tool to engage patients and to identify opportunities for hospital quality improvement (QI), we solicited patients' narrative feedback on the Baystate Medical Center Facebook page during a 3-week period in 2014. Two investigators used directed qualitative content analysis to code comments and descriptive statistics to assess the frequency of selected codes and themes. We identified common themes, including: (1) comments about staff (17/37 respondents, 45.9%); (2) comments about specific departments (22/37, 59.5%); (3) comments on technical aspects of care, including perceived errors and inattention to pain control (9/37, 24.3%); and (4) comments describing the hospital physical plant, parking, and amenities (9/37, 24.3%). A small number (n = 3) of patients repeatedly responded, accounting for 30% (45/148) of narratives. Although patient feedback on social media could help to drive hospital QI efforts, any potential benefits must be weighed against the reputational risks, the lack of representativeness among respondents, and the volume of responses needed to identify areas of improvement. © 2015 Society of Hospital Medicine.

Prescriber barriers and enablers to minimising potentially inappropriate medications in adults: a systematic review and thematic synthesis.

PubMed

Anderson, Kristen; Stowasser, Danielle; Freeman, Christopher; Scott, Ian

2014-12-08

To synthesise qualitative studies that explore prescribers' perceived barriers and enablers to minimising potentially inappropriate medications (PIMs) chronically prescribed in adults. A qualitative systematic review was undertaken by searching PubMed, EMBASE, Scopus, PsycINFO, CINAHL and INFORMIT from inception to March 2014, combined with an extensive manual search of reference lists and related citations. A quality checklist was used to assess the transparency of the reporting of included studies and the potential for bias. Thematic synthesis identified common subthemes and descriptive themes across studies from which an analytical construct was developed. Study characteristics were examined to explain differences in findings. All healthcare settings. Medical and non-medical prescribers of medicines to adults. Prescribers' perspectives on factors which shape their behaviour towards continuing or discontinuing PIMs in adults. 21 studies were included; most explored primary care physicians' perspectives on managing older, community-based adults. Barriers and enablers to minimising PIMs emerged within four analytical themes: problem awareness; inertia secondary to lower perceived value proposition for ceasing versus continuing PIMs; self-efficacy in regard to personal ability to alter prescribing; and feasibility of altering prescribing in routine care environments given external constraints. The first three themes are intrinsic to the prescriber (eg, beliefs, attitudes, knowledge, skills, behaviour) and the fourth is extrinsic (eg, patient, work setting, health system and cultural factors). The PIMs examined and practice setting influenced the themes reported. A multitude of highly interdependent factors shape prescribers' behaviour towards continuing or discontinuing PIMs. A full understanding of prescriber barriers and enablers to changing prescribing behaviour is critical to the development of targeted interventions aimed at deprescribing PIMs and reducing the risk of iatrogenic harm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A Qualitative Analysis of Stress and Relaxation Themes Contributing to Burnout in First-Year Psychiatry and Medicine Residents.

PubMed

Benson, Nicole M; Chaukos, Deanna; Vestal, Heather; Chad-Friedman, Emma F; Denninger, John W; Borba, Christina P C

2018-05-14

Qualitative research on trainee well-being can add nuance to the understanding of propagators of burnout, and the role for interventions aimed at supporting well-being. This qualitative study was conducted to identify (i) situations and environments that cause stress for trainees, (ii) stress-reducing activities that trainees utilize, and (iii) whether trainees who report distress (high burnout and depression scores) describe different stressors and relaxation factors than those who do not. The study was conducted with a convenience sample of first-year medicine and psychiatry residents at a large urban teaching hospital. Participants were asked to complete electronic stress and relaxation diaries daily for 1 week. Diary entries were coded for recurrent themes. Participants were screened for burnout and depression. Codes were compared by subgroup based on baseline burnout and depression status to elucidate if specific themes emerged in these subgroups. Study sample included 51 interns. Sixteen (16/50, 32%) screened positive for burnout and three (3/50, 14%) had a positive depression screen. The most common stressors related to aspects of the learning environment, compounded by feeling under-equipped, overwhelmed, or out of time. The majority of relaxation activities involved social connection, food, other comforts, and occurred outside of the hospital environment. This study reveals that interns (regardless of burnout or depression screen) identify stressors that derive primarily from organizational, interpersonal, and cultural experiences of the learning environment; whereas relaxation themes are diversely represented across realms (home, leisure, social, health), though emphasize activities that occur outside of the work place.

Vaping on Instagram: cloud chasing, hand checks and product placement

PubMed Central

Chu, Kar-Hai; Allem, Jon-Patrick; Cruz, Tess Boley; Unger, Jennifer B

2016-01-01

Introduction This study documented images posted on Instagram of electronic cigarettes (e-cigarette) and vaping (activity associated with e-cigarette use). Although e-cigarettes have been studied on Twitter, few studies have focused on Instagram, despite having 500 million users. Instagram’s emphasis on images warranted investigation of e-cigarettes, as past tobacco industry strategies demonstrated that images could be used to mislead in advertisements, or normalise tobacco-related behaviours. Findings should prove informative to tobacco control policies in the future. Methods 3 months of publicly available data were collected from Instagram, including images and associated metadata (n=2208). Themes of images were classified as (1) activity, for example, a person blowing vapour; (2) product, for example, a personal photo of an e-cigarette device; (3) advertisement; (4) text, for example, ‘meme’ or image containing mostly text and (5) other. User endorsement (likes) of each type of image was recorded. Caption text was analysed to explore different trends in vaping and e-cigarette-related text. Results Analyses found that advertisement-themed images were most common (29%), followed by product (28%), and activity (18%). Likes were more likely to accompany activity and product-themed images compared with advertisement or text-themed images (p<0.01). Vaping-related text greatly outnumbered e-cigarette-related text in the image captions. Conclusions Instagram affords its users the ability to post images of e-cigarette-related behaviours and gives advertisers the opportunity to display their product. Future research should incorporate novel data streams to improve public health surveillance, survey development and educational campaigns. PMID:27660111

A Qualitative Analysis of Substance Use among Liberian Youth: Understanding Behaviors, Consequences, and Protective Factors Involving School Youth and the School Milieu.

PubMed

Pullen, Samuel J; Petruzzi, Liana; Lange, Brittany Cl; Parnarouskis, Lindsey; Dominguez, Silvia; Harris, Benjamin; Quiterio, Nicole; Durham, Michelle P; Lekpeh, Gondah; Manobah, Burgess; Slopadoe, Siede P; Diandy, Veronique C; Payne, Arthur J; Henderson, David C; Borba, Christina Pc

2016-02-01

Substance use is a significant and common problem among school-aged youths throughout Africa. Like other countries on this continent, the West-African nation of Liberia is recovering from civil war. A well-educated population of young people is critical to the recovery efforts and long-term success of Liberia. Substance use by school-aged youths has important public health consequences that could undermine Liberia's post-conflict recovery efforts. We wanted to better understand the culturally significant themes and subthemes related to substance use among youths attending public schools in Monrovia, Liberia. A qualitative research design was used to collect data from 72 students attending public school in Monrovia, Liberia. Nine focus groups of 6-8 students from three public schools were facilitated using a semi-structured format to guide discussions on substance use. Student narratives were translated and re-occurring themes and subthemes were coded and analyzed. Four emergent themes described in this study were: Behaviors associated with substance useConsequences associated with individual useConsequences of substance use that affected the school milieuSchool-related factors that were protective from substance use.Subthemes associated with substance use included concealment of substances, intoxication and disruption of the classroom environment, expulsion from school, school drop-out, and school as protective against substance use. Liberian school-aged youths described important themes and subthemes associated with substance use occurring within the school milieu. These data have germane public health ramifications, and could help inform larger epidemiologic study methods and public health interventions for Liberia and countries with similar profiles.

Common Leadership Responsibilities of Principals of Successful Turnaround Model Schools

ERIC Educational Resources Information Center

Fullwood, Jezelle

2016-01-01

Purpose: The purpose of this qualitative study was to discover which leadership responsibilities, within the domains of trust, communication, learning, and shared leadership, did elementary and middle school principals of successful turnaround schools commonly perceive as most necessary to lead a turnaround intervention model school. Themes were…

Fostering better policy adoption and inter-disciplinary communication in healthcare: A qualitative analysis of practicing physicians’ common interests

PubMed Central

Crowley-Matoka, Megan; Collins, Jeremy D.; Chrisman, Howard B.; Milad, Magdy P.; Vogelzang, Robert L.

2017-01-01

Purpose In response to limited physician adoption of various healthcare initiatives, we sought to propose and assess a novel approach to policy development where one first characterizes diverse physician groups’ common interests, using a medical student and constructivist grounded theory. Methods In 6 months, a medical student completed 36 semi-structured interviews with interventional radiologists, gynecologists, and vascular surgeons that were systematically analyzed according to constructivist grounded theory to identifying common themes. Common drivers of clinical decision making and professional values across 3 distinct specialty groups were derived from physicians’ descriptions of their clinical decision making, stories, and concerns. Results Common drivers of clinical decision making included patient preference/benefit, experience, reimbursement, busyness/volume, and referral networks. Common values included honesty, trustworthiness, loyalty, humble service, compassion and perseverance, and practical wisdom. Although personal gains were perceived as important interests, such values were easily sacrificed for the good of patients or other non-financial interests. This balance was largely dependent on the incentives and security provided by physicians’ environments. Conclusions Using a medical student interviewer and constructivist grounded theory is a feasible means of collecting rich qualitative data to guide policy development. Healthcare administrators and medical educators should consider incorporating this methodology early in policy development to anticipate how value differences between physician groups will influence their acceptance of policies and other broad healthcare initiatives. PMID:28235088

The Emerging Diabetes Online Community

PubMed Central

Hilliard, Marisa E.; Sparling, Kerri M.; Hitchcock, Jeff; Oser, Tamara K.; Hood, Korey K.

2015-01-01

Abstract: Background Diabetes self-management is complex and demanding, and isolation and burnout are common experiences. The Internet provides opportunities for people with diabetes to connect with one another to address these challenges. The aims of this paper are to introduce readers to the platforms on which Diabetes Online Community (DOC) participants interact, to discuss reasons for and risks associated with diabetes-related online activity, and to review research related to the potential impact of DOC participation on diabetes outcomes. Methods Research and online content related to diabetes online activity is reviewed, and DOC writing excerpts are used to illustrate key themes. Guidelines for meaningful participation in DOC activities for people with diabetes, families, health care providers, and industry are provided. Results Common themes around DOC participation include peer support, advocacy, self-expression, seeking and sharing diabetes information, improving approaches to diabetes data management, and humor. Potential risks include access to misinformation and threats to individuals’ privacy, though there are limited data on negative outcomes resulting from such activities. Likewise, few data are available regarding the impact of DOC involvement on glycemic outcomes, but initial research suggests a positive impact on emotional experiences, attitudes toward diabetes, and engagement in diabetes management behaviors. Conclusion The range of DOC participants, activities, and platforms is growing rapidly. The Internet provides opportunities to strengthen communication and support among individuals with diabetes, their families, health care providers, the health care industry, policy makers, and the general public. Research is needed to investigate the impact of DOC participation on self-management, quality of life, and glycemic control, and to design and evaluate strategies to maximize its positive impact. PMID:25901500

The emerging diabetes online community.

PubMed

Hilliard, Marisa E; Sparling, Kerri M; Hitchcock, Jeff; Oser, Tamara K; Hood, Korey K

2015-01-01

Diabetes self-management is complex and demanding, and isolation and burnout are common experiences. The Internet provides opportunities for people with diabetes to connect with one another to address these challenges. The aims of this paper are to introduce readers to the platforms on which Diabetes Online Community (DOC) participants interact, to discuss reasons for and risks associated with diabetes-related online activity, and to review research related to the potential impact of DOC participation on diabetes outcomes. Research and online content related to diabetes online activity is reviewed, and DOC writing excerpts are used to illustrate key themes. Guidelines for meaningful participation in DOC activities for people with diabetes, families, health care providers, and industry are provided. Common themes around DOC participation include peer support, advocacy, self-expression, seeking and sharing diabetes information, improving approaches to diabetes data management, and humor. Potential risks include access to misinformation and threats to individuals' privacy, though there are limited data on negative outcomes resulting from such activities. Likewise, few data are available regarding the impact of DOC involvement on glycemic outcomes, but initial research suggests a positive impact on emotional experiences, attitudes toward diabetes, and engagement in diabetes management behaviors. The range of DOC participants, activities, and platforms is growing rapidly. The Internet provides opportunities to strengthen communication and support among individuals with diabetes, their families, health care providers, the health care industry, policy makers, and the general public. Research is needed to investigate the impact of DOC participation on self-management, quality of life, and glycemic control, and to design and evaluate strategies to maximize its positive impact.

In their own words: why teenagers don't use social networking sites.

PubMed

Baker, Rosland K; White, Katherine M

2011-06-01

We explored common reasons for non-use of the rapidly growing popularity of social networking sites among a sample of Australian adolescents (N = 69). Transcripts were coded by grouping responses along similar themes for non-use that had been commonly stated by participants. The primary reasons offered by adolescents were: lack of motivation, poor use of time, preference for other forms of communication, preference for engaging in other activities, cybersafety concerns, and a dislike of self-presentation online. The identification of these themes allows for a greater understanding of teenagers' decisions not to engage in the popular medium of communication and points to possible strategies that could be utilised by Web site developers in efforts to appeal to a wider teenage audience.

Assistive Technology Provision Within the Navajo Nation

PubMed Central

Ripat, Jacquie D.

2014-01-01

In this study we explored the factors that affect assistive technology (AT) provision within the Navajo Nation using a qualitative approach to inquiry. Focus groups were held in which AT users discussed their awareness of AT and their need for, use of, and satisfaction with AT devices and services. Twenty-eight individuals who used wheelchairs, orthotics or prosthetics, hearing aids, communication aids, vision aids, and other AT participated in one of seven focus groups. Seven AT providers discussed the facilitators and barriers that affect AT provision. The findings revealed six themes common to both stakeholder groups and two additional themes for AT users. The central theme for AT users centered on (not) feeling understood; the central theme for AT providers revolved around the processes, activities, and roles the providers engaged in at times for different clients. Activities to increase awareness and to promote successful AT provision and satisfaction with AT devices were proposed. PMID:25147224

Pediatric obesity community programs: barriers & facilitators toward sustainability.

PubMed

Po'e, Eli K; Gesell, Sabina B; Lynne Caples, T; Escarfuller, Juan; Barkin, Shari L

2010-08-01

Our current generation of young people could become the first generation to live shorter lives than their parents. Families need resources in their community to address this issue. Identifying barriers and facilitators of community organizations to offer obesity-related services is a first step in understanding sustainable community programs. The objective of this study is to identify common barriers and facilitators in community organizational programs designed to prevent or reduce pediatric obesity. We conducted an exploratory qualitative research study based on grounded theory. Thirty-six community organizations were identified based on self-descriptions of goals involving pediatric obesity. Semi-structured, systematic, face-to-face interviews among program directors (n = 24) were recorded, transcribed, and coded for recurrent themes. Relevant themes were abstracted from interviews by a standardized iterative process by two independent reviewers between December 2007 and November 2008. Theme discordance was reconciled by a third reviewer. Seventy percent of organizations indicated that obesity prevention/treatment was their explicit goal with remaining groups indicating healthy lifestyles as a more general goal. Facilitators to provision of these programs included: programmatic enhancements such as improved curriculums (73%), community involvement such as volunteers (62.5%), and partnerships with other programs (54.2%). Barriers that threatened sustainability included lack of consistent funding (43.8%), lack of consistent participation from the target population (41.7%) and lack of support staff (20.8%). New approaches in fostering partnerships between organizations need to be developed. Building coalitions and engaging community members in developing community based programs may be a helpful strategy to strengthen community-based programs to address the pediatric obesity epidemic.

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.

Building successful coalitions for promoting advance care planning.

PubMed

Marchand, Lucille; Fowler, Kathryn J; Kokanovic, Obrad

2006-01-01

Advance care planning (ACP) has had few successful initiatives. This qualitative study explores the challenges and successes of an advance care planning coalition in Wisconsin called Life Planning 2000 using key informant interviews (n = 24) and grounded theory. Major themes included: commitment (the need for leadership, recruitment of key members, and funding); cohesiveness (disparate groups collaborating toward a common purpose), and outcomes (shift in paradigm from signing documents to process of advanced care planning, new-found collaborative relationships, and educational tool development). Coalitions need to define short-, intermediate-, and long-term goals that result in measurable outcomes and an evaluation process. Resources must be commensurate with goals. Strong leadership, paid staff adequate funding, and the collaboration of diverse groups working toward common goals are the basic requirements of a successful coalition.

The Most Common Feedback Themes in Communication Skills Training in an Internal Medicine Residency Program: Lessons from the Resident Audio-Recording Project.

PubMed

Han, Heeyoung; Papireddy, Muralidhar Reddy; Hingle, Susan T; Ferguson, Jacqueline Anne; Koschmann, Timothy; Sandstrom, Steve

2018-07-01

Individualized structured feedback is an integral part of a resident's learning in communication skills. However, it is not clear what feedback residents receive for their communication skills development in real patient care. We will identify the most common feedback topics given to residents regarding communication skills during Internal Medicine residency training. We analyzed Resident Audio-recording Project feedback data from 2008 to 2013 by using a content analysis approach. Using open coding and an iterative categorization process, we identified 15 emerging themes for both positive and negative feedback. The most recurrent feedback topics were Patient education, Thoroughness, Organization, Questioning strategy, and Management. The residents were guided to improve their communication skills regarding Patient education, Thoroughness, Management, and Holistic exploration of patient's problem. Thoroughness and Communication intelligibility were newly identified themes that were rarely discussed in existing frameworks. Assessment rubrics serve as a lens through which we assess the adequacy of the residents' communication skills. Rather than sticking to a specific rubric, we chose to let the rubric evolve through our experience.

Beach Books: 2011-2012. What Do Colleges and Universities Want Students to Read outside Class?

ERIC Educational Resources Information Center

Thorne, Ashley

2011-01-01

What books do colleges and universities assign as common reading? What themes do the books contain? Are they old books or recent ones? What kinds of colleges and universities have common reading programs? What does a typical common reading program look like? What does all this tell us about the state of American higher education today? To find…

Meteors in Australian Aboriginal Dreamings

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.; Norris, Ray P.

2010-06-01

We present a comprehensive analysis of Australian Aboriginal accounts of meteors. The data used were taken from anthropological and ethnographic literature describing oral traditions, ceremonies, and Dreamings of 97 Aboriginal groups representing all states of modern Australia. This revealed common themes in the way meteors were viewed between Aboriginal groups, focusing on supernatural events, death, omens, and war. The presence of such themes around Australia was probably due to the unpredictable nature of meteors in an otherwise well-ordered cosmos.

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis

PubMed Central

Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M

2017-01-01

Objectives In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter. Methods Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis. Results A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding. Conclusions This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media. PMID:28246145

Social Listening: A Content Analysis of E-Cigarette Discussions on Twitter

PubMed Central

Cole-Lewis, Heather; Pugatch, Jillian; Sanders, Amy; Varghese, Arun; Posada, Susana; Yun, Christopher; Schwarz, Mary

2015-01-01

Background Electronic cigarette (e-cigarette) use has increased in the United States, leading to active debate in the public health sphere regarding e-cigarette use and regulation. To better understand trends in e-cigarette attitudes and behaviors, public health and communication professionals can turn to the dialogue taking place on popular social media platforms such as Twitter. Objective The objective of this study was to conduct a content analysis to identify key conversation trends and patterns over time using historical Twitter data. Methods A 5-category content analysis was conducted on a random sample of tweets chosen from all publicly available tweets sent between May 1, 2013, and April 30, 2014, that matched strategic keywords related to e-cigarettes. Relevant tweets were isolated from the random sample of approximately 10,000 tweets and classified according to sentiment, user description, genre, and theme. Descriptive analyses including univariate and bivariate associations, as well as correlation analyses were performed on all categories in order to identify patterns and trends. Results The analysis revealed an increase in e-cigarette–related tweets from May 2013 through April 2014, with tweets generally being positive; 71% of the sample tweets were classified as having a positive sentiment. The top two user categories were everyday people (65%) and individuals who are part of the e-cigarette community movement (16%). These two user groups were responsible for a majority of informational (79%) and news tweets (75%), compared to reputable news sources and foundations or organizations, which combined provided 5% of informational tweets and 12% of news tweets. Personal opinion (28%), marketing (21%), and first person e-cigarette use or intent (20%) were the three most common genres of tweets, which tended to have a positive sentiment. Marketing was the most common theme (26%), and policy and government was the second most common theme (20%), with 86% of these tweets coming from everyday people and the e-cigarette community movement combined, compared to 5% of policy and government tweets coming from government, reputable news sources, and foundations or organizations combined. Conclusions Everyday people and the e-cigarette community are dominant forces across several genres and themes, warranting continued monitoring to understand trends and their implications regarding public opinion, e-cigarette use, and smoking cessation. Analyzing social media trends is a meaningful way to inform public health practitioners of current sentiments regarding e-cigarettes, and this study contributes a replicable methodology. PMID:26508089

Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites.

PubMed

Penney, Kali; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

2011-09-26

Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across the websites. Finally, brokers' roles in follow up care, their prices, and the speed of surgery were the most commonly included business dimensions on the reviewed websites. Canadian medical tourism brokers currently lack a common standard of care and accreditation, and are widely lacking in providing adequate risk communication for potential medical tourists. This has implications for the informed consent and consequent safety of Canadian medical tourists.

Risk communication and informed consent in the medical tourism industry: A thematic content analysis of canadian broker websites

PubMed Central

2011-01-01

Background Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. Methods An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Results Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across the websites. Finally, brokers' roles in follow up care, their prices, and the speed of surgery were the most commonly included business dimensions on the reviewed websites. Conclusion Canadian medical tourism brokers currently lack a common standard of care and accreditation, and are widely lacking in providing adequate risk communication for potential medical tourists. This has implications for the informed consent and consequent safety of Canadian medical tourists. PMID:21943392

A Year of Hands-on Science: Exciting Theme Units with More Than 100 Activities, Projects, and Experiments To Make Science Come Alive.

ERIC Educational Resources Information Center

Kepler, Lynne; Novelli, Joan, Ed.

This book contains 18 themed teaching units with 2 themes per chapter, organized seasonally around the traditional school year. Each theme includes natural connections and hands-on science activities that correspond to what children are already observing in their world. Each chapter begins with highlights of the month and a reproducible "Science…

“Hey Everyone, I’m Drunk.” An Evaluation of Drinking-Related Twitter Chatter

PubMed Central

Cavazos-Rehg, Patricia A.; Krauss, Melissa J.; Sowles, Shaina J.; Bierut, Laura J.

2015-01-01

Objective: The promotion of drinking behaviors correlates with increased drinking behaviors and intent to drink, especially when peers are the promotion source. Similarly, online displays of peer drinking behaviors have been described as a potential type of peer pressure that might lead to alcohol misuse when the peers to whom individuals feel attached value such behaviors. Social media messages about drinking behaviors on Twitter (a popular social media platform among young people) are common but understudied. In response, and given that drinking alcohol is a widespread activity among young people, we examined Twitter chatter about drinking. Method: Tweets containing alcohol- or drinking-related keywords were collected from March 13 to April 11, 2014. We assessed a random sample (n = 5,000) of the most influential Tweets for sentiment, theme, and source. Results: Most alcohol-related Tweets reflected a positive sentiment toward alcohol use, with pro-alcohol Tweets outnumbering anti-alcohol Tweets by a factor of more than 10. The most common themes of pro-drinking Tweets included references to frequent or heavy drinking behaviors and wanting/needing/planning to drink alcohol. The most common sources of pro-alcohol Tweets were organic (i.e., noncommercial). Conclusions: Our findings highlight the need for online prevention messages about drinking to counter the strong pro-alcohol presence on Twitter. However, to enhance the impact of anti-drinking messages on Twitter, it may be prudent for such Tweets to be sent by individuals who are widely followed on Twitter and during times when heavy drinking is more likely to occur (i.e., weekends, holidays). PMID:26098041

Study participant reported outcomes of mental health interventions: results from a randomized controlled trial among survivors of systematic violence in southern Iraq.

PubMed

Mahmooth, Z; Weiss, W M; Zangana, G A S; Bolton, P

2018-01-01

Common mental health problems experienced by survivors of systematic violence include trauma, depression, and anxiety. A trial of mental health interventions by community mental health workers for survivors of systematic violence in southern Iraq showed benefits from two psychotherapies on trauma, depression, anxiety, and function: Common Elements Treatment Approach (CETA) and cognitive processing therapy (CPT). This study assessed whether other non-predetermined changes reported by intervention participants were more common than in the control group. The trial involved 342 participants (CETA: 99 intervention, 50 control; CPT: 129 intervention, 64 control). Sixteen intervention-related changes since enrollment were identified from free-listing interviews of 15 early therapy completers. The changes were then added as a new quantitative module to the follow-up questionnaire. The changes were organized into eight groupings by thematic analysis - family, social standing, anger management, interest in regular activities, optimism, feeling close to God, avoiding smoking and drugs, and physical health. All participants were interviewed with this module and responses were compared between intervention and control participants. Multi-level, multi-variate regression models showed CETA intervention subjects with significant, positive changes relative to CETA controls on most themes. CPT intervention subjects showed little to no change compared with CPT controls in most themes. Participants receiving CETA reported more positive changes from therapy compared with controls than did participants receiving CPT. This study suggests differential effects of psychotherapy beyond the predetermined clinical outcome measures and that identification of these effects should be part of intervention evaluations.

Questions About Cervical and Breast Cancer Screening Knowledge, Practice, and Outcomes: A Review of Demographic and Health Surveys.

PubMed

Viens, Laura; Perin, Doug; Senkomago, Virginia; Neri, Antonio; Saraiya, Mona

2017-05-01

United Nation's Sustainable Development Goals and the World Health Organization's Global Monitoring Framework support a strong global commitment to reducing the high burden of cervical and breast cancers among low- and middle-income countries. Strategies include vaccination, screening, and early diagnosis. Population-based surveys, such as those conducted by the Demographic and Health Surveys (DHS) Program, can collect the information needed to guide cancer control efforts in a standardized comparable manner. We identified and evaluated the breadth of breast and cervical cancer screening information that was collected by the DHS from 1984 through 2015. Then, we determined if these surveys currently provide the specific and measurable data about both the quantity and quality of cancer screening needed to guide national efforts to reduce the overall effects of cervical and breast cancers. We searched the DHS website to identify surveys conducted between the start of the DHS Program in 1984 and November 2015 that included questions about breast and cervical cancer screening. The relevant questions were extracted from the questionnaire, translated into English, and grouped by themes. Of the 90 countries where DHS surveys have been implemented, cervical cancer screening questions were included in 22 countries (24.4%) and breast cancer screening questions in 18 countries (20.0%). The common themes identified were disease knowledge, screening knowledge, screening practice, and screening outcomes. Most countries with survey questionnaires available for review addressed at least one aspect of screening practice (88.9% of cervical and 87.5% of breast), although few countries queried knowledge and outcomes. Questions that assess varied aspects of breast and cervical cancer screening have been incorporated into relatively few DHS surveys. The themes identified could guide the design of a standard set of questions for use in future population-based surveys and enable evaluation beyond the existence of screening, which would include assessment of the quality and impact of cervical and breast cancer screening.

Qualitative thematic analysis of the phenomenology of near-death experiences

PubMed Central

Degrange, Sophie; Martial, Charlotte; Charland-Verville, Vanessa; Lallier, François; Bragard, Isabelle; Guillaume, Michèle; Laureys, Steven

2018-01-01

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers’ (NDErs) lives. Previous studies have shown that NDEs memories are phenomenologically rich. In the present study, we therefore aimed to extract the common themes (referred to as “features” in the NDE literature) reported by NDErs by analyzing all the concepts stored in the narratives of their experiences. A qualitative thematic analysis has been carried out on 34 cardiac arrest survivors’ NDE narratives. Our results shed the light on the structure of the narratives by identifying 10 “time-bounded” themes which refer to isolated events encountered during the NDE and 1 “transversal” theme which characterizes the whole narrative and generally appears as a retrospective comment of self-reflection on the experience. The division of narratives into themes provides us with detailed information about the vocabulary used by NDErs to describe their experience. This established thematic method enables a rigorous description of the phenomenon, ensuring the inclusion of all self-reported manifestations of themes in narratives. PMID:29444184

Teaching Local History.

ERIC Educational Resources Information Center

Singer, Alan, Ed.

2003-01-01

This Social Science Docket theme issue focuses on teaching local history and included theme and non-themed articles, lesson plans, learning activities, and book, movie, and museum reviews designed for K-12 social studies teachers. Articles and materials in this issue are: "Editing Is Not Censorship" (Alan Singer); "Teachers Respond…

A decade review of publications in Families, Systems, & Health: 2005-2015.

PubMed

Mendenhall, Tai J; Li, Yiting; Schulz, Catherine L

2016-09-01

The purpose of this investigation was to review recent publication content and trends in Families, Systems, & Health ( FSH ). How do the journal’s articles reflect current and emerging challenges in health care? We hope that our findings can guide special issues and content foci. All work published in FSH between 2005 and 2015 was included (n = 452); each piece was coded for article type, general foci, and specific foci. The most common type of article published over the 10-year time frame was research reports (43%; n = 195), followed by other types (e.g., tribute pieces, poems), commentaries, conceptual/theory papers, literature reviews, and case studies. The most common general focus included family health and/or functioning (28%; n = 128). The most common specific foci centered on children (15%; n = 55). Common themes found in FSH ’s most frequently cited publications included family relationships in care, chronic physical illnesses, and mental health. Marked trends in journal content included increases in articles targeting family health and/or functioning and primary care and decreased attention to theory. FSH’s emphasis on research reports to inform current and evolving interventions that target contemporary health challenges suggests that the journal is keeping stride with the most pressing issues in health care today. Future special issues can continue to serve and meet these needs. FSH’s robust inclusion of other article types sustains the journal’s mission to advance multiple ways of understanding health-care phenomena. PsycINFO Database Record (c) 2016 APA, all rights reserved

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

PubMed

Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

2015-01-01

Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records

PubMed Central

Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.

2015-01-01

Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns. PMID:26604874

The Electronic FERPA: Access in the Digital Age

ERIC Educational Resources Information Center

McConahay, Mark; Hanson, Karen; West, Ann; Woodbeck, Dean

2009-01-01

On every college and university campus, common themes weave throughout identity and access management (IAM) and its relationship to Family Educational Rights and Privacy Act (FERPA). Institutions approach IAM differently as there is not a one-size-fits-all solution. Nevertheless, all face common elements. Over the past few years, a number of…

Understanding and Accommodating Online Social Communities: A Common Sense Approach

ERIC Educational Resources Information Center

Lennon, Sean M.

2013-01-01

Online social networks such as Facebook have changed the context and definitions of socialization. Focusing on teacher use, this article considers the size and impact of these forums and the importance many young professionals feel toward them. Themed as a common sense approach, the author uses anecdotal points and discussions with…

Articles of Faith & Hope for Public Education.

ERIC Educational Resources Information Center

Houston, Paul D.

America's common schools are at a crossroads. This collection of speeches, articles and columns, written by the executive director of the American Association of School Administrators (AASA), between 1994-1997, addresses many of the issues today. The overriding theme is the need to preserve common schools, which are presented as the key instrument…

Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

PubMed

Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

2018-02-01

In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

Thematic accuracy assessment of the 2011 National Land Cover Database (NLCD)

USGS Publications Warehouse

Wickham, James; Stehman, Stephen V.; Gass, Leila; Dewitz, Jon; Sorenson, Daniel G.; Granneman, Brian J.; Poss, Richard V.; Baer, Lori Anne

2017-01-01

Accuracy assessment is a standard protocol of National Land Cover Database (NLCD) mapping. Here we report agreement statistics between map and reference labels for NLCD 2011, which includes land cover for ca. 2001, ca. 2006, and ca. 2011. The two main objectives were assessment of agreement between map and reference labels for the three, single-date NLCD land cover products at Level II and Level I of the classification hierarchy, and agreement for 17 land cover change reporting themes based on Level I classes (e.g., forest loss; forest gain; forest, no change) for three change periods (2001–2006, 2006–2011, and 2001–2011). The single-date overall accuracies were 82%, 83%, and 83% at Level II and 88%, 89%, and 89% at Level I for 2011, 2006, and 2001, respectively. Many class-specific user's accuracies met or exceeded a previously established nominal accuracy benchmark of 85%. Overall accuracies for 2006 and 2001 land cover components of NLCD 2011 were approximately 4% higher (at Level II and Level I) than the overall accuracies for the same components of NLCD 2006. The high Level I overall, user's, and producer's accuracies for the single-date eras in NLCD 2011 did not translate into high class-specific user's and producer's accuracies for many of the 17 change reporting themes. User's accuracies were high for the no change reporting themes, commonly exceeding 85%, but were typically much lower for the reporting themes that represented change. Only forest loss, forest gain, and urban gain had user's accuracies that exceeded 70%. Lower user's accuracies for the other change reporting themes may be attributable to the difficulty in determining the context of grass (e.g., open urban, grassland, agriculture) and between the components of the forest-shrubland-grassland gradient at either the mapping phase, reference label assignment phase, or both. NLCD 2011 user's accuracies for forest loss, forest gain, and urban gain compare favorably with results from other land cover change accuracy assessments.

Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care.

PubMed

Luckett, Tim; Davidson, Patricia M; Green, Anna; Boyle, Frances; Stubbs, John; Lovell, Melanie

2013-08-01

Cancer pain is a common, burdensome problem, which is not well managed despite evidence-based guidelines. To develop insights for managing barriers and optimizing facilitators to adult cancer pain assessment and management within a comprehensive framework of patient care. We undertook a systematic review and synthesis of qualitative studies. Medline, PsycINFO, Embase, AMED, CINAHL, and Sociological Abstracts were searched from May 20 to 26, 2011. To be included, the articles had to be published in a peer-reviewed journal since 2000; written in English; and report original qualitative studies on the perspectives of patients, their significant others, or health care providers. Article quality was rated using the checklist of Kitto et al. Thematic synthesis followed a three-stage approach using Evidence for Policy and Practice Information and Co-ordinating Centre-Reviewer 4 software: 1) free line-by-line coding of "Results," 2) organization into "descriptive" themes, and 3) development of "analytical" themes informative to our objective. At Stage 3, a conceptual framework was selected from the peer-reviewed literature according to prima facie "fit" for descriptive themes. Of 659 articles screened, 70 met the criteria, reporting 65 studies with 48 patient, 19 caregiver, and 21 health care provider samples. Authors rarely reported reflexivity or negative cases. Mead and Bower's model of patient-centered care accommodated 85% of the descriptive themes; 12% more related to the caregiver and service/system factors. Three themes could not be accommodated. Findings highlight the need to integrate patient/family education within improved communication, individualize care, use more nonpharmacological strategies, empower patients/families to self-manage pain, and reorganize multidisciplinary roles around patient-centered care and outcomes. These conclusions require validation via consensus and intervention trials. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Two perspectives on the needs of individuals bereaved by suicide.

PubMed

Gall, Terry Lynn; Henneberry, Jesse; Eyre, Melissa

2014-01-01

To qualitatively explore the needs of suicidally bereaved individuals, researchers interviewed 11 suicide bereaved individuals and 4 mental health workers. Common themes of bereaved persons included the suicide grief experience, coping, interpersonal domain, struggle with meaning, self-reflection, and moving forward. Mental health workers emphasized the nature of the helping relationship, the need to emotionally process the grief, the centrality of meaning making, importance of support groups, and the role of individual counseling. These 2 perspectives informed "best practices" for postvention (e.g., understanding the need for meaning-making while recognizing when to move on).

A 3-Component Approach Incorporating Focus Groups in Strategic Planning for Sexual Violence Prevention.

PubMed

Cruz, Theresa H; Hess, Julia Meredith; Woelk, Leona; Bear, Samantha

2016-01-01

Sexual violence is of special concern in New Mexico because of the presence of large priority populations in which its prevalence is high. This article describes a 3-component approach to developing a strategic plan to prevent sexual violence in the state that consisted of an advisory group, subject matter experts, and focus groups from geographically and demographically diverse communities. Both common and community-specific themes emerged from the focus groups and were included in the strategic plan. By incorporating community needs and experiences, this approach fosters increased investment in plan implementation.

[Therapeutic restraint management in Intensive Care Units: Phenomenological approach to nursing reality].

PubMed

Acevedo-Nuevo, M; González-Gil, M T; Solís-Muñoz, M; Láiz-Díez, N; Toraño-Olivera, M J; Carrasco-Rodríguez-Rey, L F; García-González, S; Velasco-Sanz, T R; Martínez-Álvarez, A; Martin-Rivera, B E

2016-01-01

To identify nursing experience on physical restraint management in Critical Care Units. To analyse similarities and differences in nursing experience on physical restraint management according to the clinical context that they are involved in. A multicentre phenomenological study was carried out including 14 Critical Care Units in Madrid, classified according to physical restraint use: Common/systematic use, lacking/personalised use, and mixed use. Five focus groups (23 participants were selected following purposeful sampling) were convened, concluding in data saturation. Data analysis was focused on thematic content analysis following Colaizzi's method. Six main themes: Physical restraint meaning in Critical Care Units, safety (self-retreat vital devices), contribution factors, feelings, alternatives, and pending issues. Although some themes are common to the 3 Critical Care Unit types, discourse differences are found as regards to indication, feelings, systematic use of pain and sedation measurement tools. In order to achieve real physical restraint reduction in Critical Care Units, it is necessary to have a deep understanding of restraints use in the specific clinical context. As self-retreat vital devices emerge as central concept, some interventions proposed in other settings could not be effective, requiring alternatives for critical care patients. Discourse variations laid out in the different Critical Care Unit types could highlight key items that determine the use and different attitudes towards physical restraint. Copyright © 2015 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Nurse Perceptions of Pain in Pediatric Traumatic Brain Injury: A Pilot Study.

PubMed

McCaa, Robin

2017-01-01

Pain assessment in the pediatric population is challenging because of age, developmental stage, and patient cooperation. Cognitive impairment, impaired communication, and physical disability that may accompany traumatic brain injury (TBI) further complicate pain assessments. A pilot descriptive qualitative research study was conducted to investigate nurse perceptions of pain in pediatric patients diagnosed with TBI. Specifically, this study sought to answer the following questions: a) Is pain accurately assessed in this population? b) Is pain adequately treated in this population? and c) What obstacles exist, if any, to the assessment and treatment of pain? A convenience sample of three registered nurses employed in a pediatric neurosurgery setting participated in this study. Each nurse participated in one individual, semi-structured, face-to-face interview lasting approximately 30 minutes. Interviews were transcribed verbatim and analyzed for common themes. Common themes identified across all interviews were a) challenging assessments; b) limited, although effective, treatments; and c) communication as an area of opportunity for improvement. Implications for practice and policy include a need for more sensitive pain assessment tools to improve the objectivity and accuracy of pain assessment, clarification of care priorities and organization of care from clinical and management perspectives, and additional research in alternative pain treatments for this population. Findings from this study will guide the development of a larger, more comprehensive study, with the aim of improving practice and policy in pain management for this population.

The New Nuffield Combined Science Themes for the Middle Years

ERIC Educational Resources Information Center

Bingham, C. D.

1976-01-01

Described are the development, materials, and use of English developed science activities for junior high schools, the Nuffield Combined Science Themes for the Middle Years. The program, when completed will present 24 themes including: color, water, air, plastics, metals, insects, food, light, and electricity. (SL)

Hispanic Graduate Students' Mentoring Themes: Gender Roles in a Bicultural Context

ERIC Educational Resources Information Center

Rudolph, Bonnie A.; Castillo, Carlos P.; Garcia, Vanessa G.; Martinez, Alina; Navarro, Fernando

2015-01-01

Male and female focus groups at a Hispanic Serving Institution (HSI) discussed mentoring of Hispanic graduate students. Using Thematic Analysis, investigators identified three main themes: Relationship Initiation and Development, Valued Relationship Qualities, and Context and Barriers. Relationship themes included mentor openness, trust,…

Coping behaviors among sexual minority female youth.

PubMed

Pendragon, Diane K

2010-01-01

This article summarizes data from a qualitative study investigating the ways in which female youth perceive and respond to challenges related to the interplay of late adolescence and a minority sexual orientation. Fifteen sexual minority females in late adolescence were interviewed individually and in focus groups. The interviews focused on participants' perceptions of challenges, the impact those stressors have in their lives, and methods they utilize to cope with them. The most common negative experiences reported were isolation, lack of acceptance, harassment, and violence. Sub-themes include: hearing negative messages about gender and sexual orientation, pressures to conform to a variety of cultural norms including gender norms, fears of future violence, and pressure to identify sexual orientation. Collectively, the participants described these negative consequences of experiences of heterosexism, sexism, and racism as their most difficult experiences. The most common responses to these stressors reported by participants were finding support in relationships, engaging in coping responses, pursuing education and activism, rebellion and resistance, and avoidance and deferment.

The history of stress hyperglycaemia.

PubMed

Balasanthiran, A; Shotliff, K

2015-01-01

Stress hyperglycaemia, is a common phenomenon, frequently associated with adverse outcomes in a number of prevalent conditions including myocardial infarction and stroke. Knowledge on stress hyperglycaemia evolved in tandem with knowledge relating to homeostasis, stress and disease and involved some of the world's most eminent thinkers. Despite this, it still remains under-recognised. This paper illustrates significant points in the history of stress hyperglycaemia, from antiquity through to the present day, as well as the challenges faced in translating research into clinical benefit for patients. Profiles of significant protagonists including Claude Bernard, Walter Cannon and Hans Seyle are presented, as well their roles in the emergence of modern-day terminology and pathophysiological models. Major themes such as 'fight or flight' and homeostasis are central to this discussion. Closer to the present day, the role of stress hyperglycaemia in a number of common medical conditions is explored in more detail. Contention around evidence for treatment and the future risk of diabetes mellitus are also discussed.

Reasons why persons living with HIV include individuals in their chosen families.

PubMed

Grant, Joan S; Vance, David E; Keltner, Norman L; White, Worawan; Raper, James L

2013-01-01

HIV influences those with the disease as well as their families and social relationships. The chosen families of persons living with HIV (PLWH) provide structure, social support, and security. Our study identified reasons why PLWH included specific individuals in their chosen families (or families of choice). This mixed-method design used a convenience sample of 150 PLWH, ages 19-68 years. Self-reported reasons for including specific individuals in their chosen families were love and acceptance (n = 135; 90.0%), support (n = 100; 66.7%), blood and family ties (n = 37; 24.7%), and commonality (n = 28; 18.7%). Demographic and personal characteristics were unrelated to these themes, supporting the conclusion that reasons for choosing family members are universal across these variables. These findings emphasize the need for health care providers to encourage the development of friendships and relationships between PLWH and those who provide love and acceptance, support, blood/familial ties, and common interests. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Spiritual Resources for the Pastoral Care and Counseling of the Alcoholic: An Approach Implementing Spiritual Interventions

DTIC Science & Technology

2002-04-01

Personal God. Journal of Feminist Family Therapy 7, No. 1/2: 123-139. Gross, Don H. 1978. The Case for Spiritual Healing. New York: Thomas Nelson...healing and wellness. The third chapter is a discussion of narrative therapy and why it is such a vital spiritual resource in the pastoral care of...While method and theory vary among healers who practice the spiritual therapy of inner healing, there are common themes. These themes call into

New applications of the renormalization group method in physics: a brief introduction.

PubMed

Meurice, Y; Perry, R; Tsai, S-W

2011-07-13

The renormalization group (RG) method developed by Ken Wilson more than four decades ago has revolutionized the way we think about problems involving a broad range of energy scales such as phase transitions, turbulence, continuum limits and bifurcations in dynamical systems. The Theme Issue provides articles reviewing recent progress made using the RG method in atomic, condensed matter, nuclear and particle physics. In the following, we introduce these articles in a way that emphasizes common themes and the universal aspects of the method.

'Her cry is my cry': resettlement experiences of refugee women at risk recently resettled in Australia.

PubMed

Vromans, L; Schweitzer, R D; Farrell, L; Correa-Velez, I; Brough, M; Murray, K; Lenette, C

2018-05-01

Refugee women entering resettlement countries on woman-at-risk visas represent a particularly vulnerable population. While their specific gender-based resettlement will likely differ from the general refugee population, little is known about their experiences of early resettlement, with which to inform resettlement policy and practice. This research aimed to explore lived experiences of recently resettled refugee women at risk in Australia. Qualitative research used focus groups and a framework approach to identify and explicate common themes in participants' experience. Two focus groups with a purposive sample of African and Afghan refugee women at risk (N = 10), aged 22-53 years, were conducted in South East Queensland, Australia (October 2016), recruited with the assistance of a local resettlement service. Discussions were audiotaped, transcribed, and themes explicated. Six superordinate themes emerged: (1) sentiment of gratitude; (2) sense of loneliness and disconnection; (3) feeling incapable; (4) experiencing distress and help-seeking; (5) experiencing financial hardship; and (6) anticipating the future. Findings indicate that resettlement policy, programs, and practice that explicitly target the needs of women-at-risk refugees are warranted, including a longer period of active service provision with specific attention to strategies that address the women's social connection, self-efficacy, emotional well-being, and financial hardships. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Mild cognitive impairment: coping with an uncertain label.

PubMed

Joosten-Weyn Banningh, Liesbeth; Vernooij-Dassen, Myrra; Rikkert, Marcel Olde; Teunisse, Jan-Pieter

2008-02-01

The recently introduced diagnostic label of Mild Cognitive Impairment (MCI) identifies patients with a cognitive decline that is more pronounced than is usual for a person's age and educational level but does not notably interfere with activities of daily living (ADL). The natural course of the syndrome is uncertain although MCI sufferers have a higher risk of developing dementia. To investigate how patients fulfilling MCI criteria experience and cope with their cognitive decline with the secondary aim to derive key themes for a prospective MCI support-group programme. The grounded theory approach. Analysis of guided interviews with eight MCI patients revealed four common themes. Changes related to cognitive abilities, mobility, affect, vitality and somatic complaints. Attributions were numerous and concerned aetiologies such as personality traits and overload of information. Consequences were all negative and concerned the patients themselves such as anxiety and loss of self-confidence, others such as feelings of irritation and anger towards others or activities like abandoning leisure activities. Patients applied emotion-oriented, problem-focused and avoidant coping strategies. MCI patients encounter stress-inducing practical, social and psychological difficulties. Based on the current preliminary findings, the key themes for an MCI support-group programme should include the provision of information about the syndrome's causes, course, concomitant symptoms, attributions, social consequences, and available treatments. The impact of receiving an MCI label warrants further investigation. Copyright (c) 2007 John Wiley & Sons, Ltd.

Kurdish men's experiences of migration-related mental health issues.

PubMed

Taloyan, Marina; Al-Windi, Ahmad; Johansson, Leena Maria; Saleh-Stattin, Nuha

2011-10-01

The migration process may impose stress on the mental health of immigrants. To describe the experiences of immigrant men of Kurdish ethnicity during and after migration to Sweden with regard to mental health issues. Using the grounded theory method, we conducted a focus group interview with four Kurdish men and in-depth individual interviews with 10 other Kurdish men. A model with two major themes and interlinked categories was developed. The themes were (1) protective factors for good mental health (sense of belonging, creation and re-creation of Kurdish identity, sense of freedom, satisfaction with oneself) and (2) risk factors for poor mental health (worry about current political situation in the home country, yearning, lack of sense of freedom, dissatisfaction with Swedish society). The study provides insights into the psychological and emotional experiences of immigrant men of Kurdish ethnicity during and after migration to Sweden. It is important for primary health care providers to be aware of the impact that similar migration-related and life experiences have on the health status of immigrants, and also to be aware that groups are comprised of unique individuals with differing experiences and reactions to these experiences. The findings highlight the common themes of the men's experiences and suggest ways to ameliorate mental health issues, including feeling like one is seen as an individual, is a full participant in society, and can contribute to one's own culture.

Public Health Dental Hygienists in Massachusetts: A Qualitative Study.

PubMed

Rainchuso, Lori; Salisbury, Helen

2017-06-01

Purpose: The aim of this qualitative, phenomenological study was to explore the attitudes and perceptions of public health dental hygienists on providing preventive care to underserved populations in Massachusetts. Methods: Non-probability purposive sampling was used for initial participant recruitment, and snowball sampling occurred thereafter. Data collection occurred through semi-structured interviews. Qualitative analysis was conducted using Pitney and Parker's eight-step CREATIVE process. Results: Data saturation occurred with 10 participants (n=10), one-third of the public health dental hygienists who are practicing in Massachusetts. The majority of practice settings included school-based programs (70%), while programs for children with special needs (10%) were the least common. Two major themes emerged from the data; (a) the opportunity to be an oral health change agent and (b) barriers to practice. Six subcategories emerged from the data and are reviewed within the context of their associated themes. Additionally, career satisfaction emerged as an unintended theme, and was reported as the driving force for the majority of participants. Conclusion: This study revealed a better understanding of the public health dental hygiene workforce model in Massachusetts. Public health dental hygienists in Massachusetts perceive themselves as change agents within the health care profession, and although barriers to practice are plentiful, these oral health care professionals are committed to improving access to dental care. Copyright © 2017 The American Dental Hygienists’ Association.

Twitter chatter about marijuana.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa; Fisher, Sherri L; Salyer, Patricia; Grucza, Richard A; Bierut, Laura Jean

2015-02-01

We sought to examine the sentiment and themes of marijuana-related chatter on Twitter sent by influential Twitter users and to describe the demographics of these Twitter users. We assessed the sentiment and themes of a random sample (n = 7,000) of influential marijuana-related tweets (sent from February 5, 20114, to March 5, 2014). Demographics of the users tweeting about marijuana were inferred using a social media analytics company (Demographics Pro for Twitter). Most marijuana-related tweets reflected a positive sentiment toward marijuana use, with pro-marijuana tweets outnumbering anti-marijuana tweets by a factor of greater than 15. The most common theme of pro-marijuana tweets included the Tweeter stating that he/she wants/plans to use marijuana, followed by tweeting about frequent/heavy/or regular marijuana use, and that marijuana has health benefits and/or should be legalized. Tweeters of marijuana-related content were younger and a greater proportion was African-American compared with the Twitter average. Marijuana Twitter chatter sent by influential Twitter users tends to be pro-marijuana and popular among African-Americans and youth/young adults. Marijuana-related harms may afflict some individuals; therefore, our findings should be used to inform online and offline prevention efforts that work to target individuals who are most at risk for harms associated with marijuana use. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Exploring Key Sustainable Development Themes through Learning Activities

ERIC Educational Resources Information Center

Cruickshank, Heather; Fenner, Richard

2012-01-01

Purpose: The purpose of the paper is to examine how a number of key themes are introduced in the Master's programme in Engineering for Sustainable Development, at Cambridge University, through student-centred activities. These themes include dealing with complexity, uncertainty, change, other disciplines, people, environmental limits, whole life…

A Qualitative Analysis of Substance Use among Liberian Youth: Understanding Behaviors, Consequences, and Protective Factors Involving School Youth and the School Milieu

PubMed Central

Pullen, Samuel J; Petruzzi, Liana; Lange, Brittany CL; Parnarouskis, Lindsey; Dominguez, Silvia; Harris, Benjamin; Quiterio, Nicole; Durham, Michelle P; Lekpeh, Gondah; Manobah, Burgess; Slopadoe, Siede P; Diandy, Veronique C; Payne, Arthur J; Henderson, David C; Borba, Christina PC

2016-01-01

Objective Substance use is a significant and common problem among school-aged youths throughout Africa. Like other countries on this continent, the West-African nation of Liberia is recovering from civil war. A well-educated population of young people is critical to the recovery efforts and long-term success of Liberia. Substance use by school-aged youths has important public health consequences that could undermine Liberia’s post-conflict recovery efforts. We wanted to better understand the culturally significant themes and subthemes related to substance use among youths attending public schools in Monrovia, Liberia. Methods A qualitative research design was used to collect data from 72 students attending public school in Monrovia, Liberia. Nine focus groups of 6–8 students from three public schools were facilitated using a semi-structured format to guide discussions on substance use. Student narratives were translated and re-occurring themes and subthemes were coded and analyzed. Results Four emergent themes described in this study were: Behaviors associated with substance use Consequences associated with individual use Consequences of substance use that affected the school milieu School-related factors that were protective from substance use. Subthemes associated with substance use included concealment of substances, intoxication and disruption of the classroom environment, expulsion from school, school drop-out, and school as protective against substance use. Conclusion Liberian school-aged youths described important themes and subthemes associated with substance use occurring within the school milieu. These data have germane public health ramifications, and could help inform larger epidemiologic study methods and public health interventions for Liberia and countries with similar profiles. PMID:27158680

"I don't eat when I'm sick": Older people's food and mealtime experiences in hospital.

PubMed

Hope, Kelti; Ferguson, Maree; Reidlinger, Dianne P; Agarwal, Ekta

2017-03-01

Inadequate dietary intake is a common problem amongst older acute-care patients and has been identified as an independent risk factor for in-hospital mortality. This study aimed to explore whether food and mealtime experiences contribute to inadequate dietary intake in older people during hospitalisation. This was a qualitative phenomenological study, data for which were collected using semi-structured interviews over a three-week period. During this time, 26 patients aged 65 years or more, admitted to medical and surgical wards in a tertiary acute-care hospital, were asked to participate if they were observed to eat less than half of the meal offered at lunch. Participants provided their perspectives on food and mealtimes in hospital. Responses were recorded as hand-written notes, which were agreed with the interviewee, and analysed thematically using the framework method. Twenty-five older people were interviewed across six wards. Two main themes, 'validating circumstances' and 'hospital systems', were identified. Each theme had several sub-themes. The sub-themes within validating circumstances included 'expectations in hospital', 'prioritising medical treatment', 'being inactive', and 'feeling down'. Those within 'hospital systems' were 'accommodating inconvenience', 'inflexible systems', and 'motivating encouragement'. Inadequate dietary intake by older hospital patients is complex and influenced by a range of barriers. Multilevel and multidisciplinary interventions based on a shared understanding of food and nutrition as an important component of hospital care are essential to improve dietary intake and reduce the risk of adverse clinical outcomes. Improving awareness of the importance of food for recovery amongst hospitalised older people and healthcare staff is a priority. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Vaping on Instagram: cloud chasing, hand checks and product placement.

PubMed

Chu, Kar-Hai; Allem, Jon-Patrick; Cruz, Tess Boley; Unger, Jennifer B

2016-09-01

This study documented images posted on Instagram of electronic cigarettes (e-cigarette) and vaping (activity associated with e-cigarette use). Although e-cigarettes have been studied on Twitter, few studies have focused on Instagram, despite having 500 million users. Instagram's emphasis on images warranted investigation of e-cigarettes, as past tobacco industry strategies demonstrated that images could be used to mislead in advertisements, or normalise tobacco-related behaviours. Findings should prove informative to tobacco control policies in the future. 3 months of publicly available data were collected from Instagram, including images and associated metadata (n=2208). Themes of images were classified as (1) activity , for example, a person blowing vapour; (2) product , for example, a personal photo of an e-cigarette device; (3) advertisement ; (4) text , for example, 'meme' or image containing mostly text and (5) other . User endorsement (likes) of each type of image was recorded. Caption text was analysed to explore different trends in vaping and e-cigarette-related text. Analyses found that advertisement -themed images were most common (29%), followed by product (28%), and activity (18%). Likes were more likely to accompany activity and product -themed images compared with advertisement or text -themed images (p<0.01). Vaping-related text greatly outnumbered e-cigarette-related text in the image captions. Instagram affords its users the ability to post images of e-cigarette-related behaviours and gives advertisers the opportunity to display their product. Future research should incorporate novel data streams to improve public health surveillance, survey development and educational campaigns. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Perceptions of Approved Clinical Instructors: Barriers in the Implementation of Evidence-Based Practice

PubMed Central

Hankemeier, Dorice A.; Van Lunen, Bonnie L.

2013-01-01

Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood. Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.81 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview data were analyzed and coded for common themes and subthemes regarding barriers and educational emphases. Themes were triangulated through multiple-analyst triangulation and interpretive verification. Results: Barriers to EBP incorporation and educational emphasis placed on EBP were the main themes reported. Resources, personnel, and student characteristics were subthemes identified as barriers. Resource barriers included time, equipment, access to current literature, and knowledge. Coworkers, clinicians, and coaches who were unwilling to accept evidence regarding advancements in treatment were identified as personnel barriers. Programmatic improvement and communication improvement were subthemes of the educational emphasis placed on EBP theme. The ACIs reported the need for better integration between the clinical setting and the classroom and expressed the need for EBP to be integrated throughout the athletic training education program. Conclusions: Integration of the classroom and clinical experience is important in advancing ACIs' use of EBP with their students. Collaborative efforts within the clinical and academic program could help address the barriers ACIs face when implementing EBP. This collaboration could positively affect the ability of ACIs to implement EBP within their clinical practices. PMID:23675798

How equity is addressed in clinical practice guidelines: a content analysis

PubMed Central

Shi, Chunhu; Tian, Jinhui; Wang, Quan; Petkovic, Jennifer; Ren, Dan; Yang, Kehu; Yang, Yang

2014-01-01

Objectives Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). Setting Content analysis of methodological publications. Eligibility criteria for selecting studies Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs. Data sources We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes. Primary outcomes The primary outcomes were methodological themes and processes on how to address equity issues in guideline development. Results 8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes (‘scoping questions’, ‘searching relevant evidence’, ‘appraising evidence and recommendations’, ‘formulating recommendations’, ‘monitoring implementation’, ‘providing a flow chart to include equity in CPGs’, and ‘others: reporting of guidelines and comments from stakeholders’ for CPG developers and ‘assessing the quality of CPGs’ for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above. Conclusions For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual. PMID:25479795

Attempting to be active: Self-efficacy and barrier limitation differentiate activity levels of working mothers.

PubMed

Gierc, Madelaine; Locke, Sean; Jung, Mary; Brawley, Lawrence

2016-07-01

Working mothers are less physically active than working women without children and mothers who do not work. The purpose of this study was to examine concurrent self-regulatory efficacy and barriers to physical activity in a sample of working mothers. Women completed a mixed-methods survey which included measures of physical activity, concurrent self-regulatory efficacy, and barriers. Sufficiently active women experienced significantly greater concurrent self-regulatory efficacy and significantly less barrier limitation and frequency. No significant group differences were found for age, domestic duties performed, and children's extracurricular activities. Thematic analysis of barriers revealed six themes of common and unique factors, including limited time and family activities. © The Author(s) 2014.

Techniques for the rapid display and manipulation of 3-D biomedical data.

PubMed

Goldwasser, S M; Reynolds, R A; Talton, D A; Walsh, E S

1988-01-01

The use of fully interactive 3-D workstations with true real-time performance will become increasingly common as technology matures and economical commercial systems become available. This paper provides a comprehensive introduction to high speed approaches to the display and manipulation of 3-D medical objects obtained from tomographic data acquisition systems such as CT, MR, and PET. A variety of techniques are outlined including the use of software on conventional minicomputers, hardware assist devices such as array processors and programmable frame buffers, and special purpose computer architecture for dedicated high performance systems. While both algorithms and architectures are addressed, the major theme centers around the utilization of hardware-based approaches including parallel processors for the implementation of true real-time systems.

The Achilles' heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability.

PubMed

Rodriguez, Violeta J; LaCabe, Richard P; Privette, C Kyle; Douglass, K Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo Willy; Horigian, Viviana; Weiss, Stephen M; Jones, Deborah L

2017-12-01

The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff-patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention.

The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability

PubMed Central

Rodriguez, Violeta J.; LaCabe, Richard P.; Privette, C. Kyle; Douglass, K. Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo “Willy”; Horigian, Viviana; Weiss, Stephen M.; Jones, Deborah L.

2017-01-01

Abstract The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff–patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention. PMID:28922974

Play It Again, Sam! Adapting Common Games into Multimedia Models Used for Student Reviews.

ERIC Educational Resources Information Center

Metcalf, Karen K.; Barlow, Amy; Hudson, Lisa; Jones, Elizabeth; Lyons, Dennis; Piersall, James; Munfus, Laureen

1998-01-01

Provides guidelines on how to adapt common games such as checkers, tic tac toe, obstacle courses, and memory joggers into interactive games in multimedia courseware. Emphasizes creating generic games that can be recycled and used for multiple topics to save development time and keep costs low. Discusses topic themes, game structure, and…

Chinese and German Teachers' Conceptions of Play and Learning and Children's Play Behaviour

ERIC Educational Resources Information Center

Wu, Shu-Chen; Rao, Nirmala

2011-01-01

Commonalities and distinctions in Hong Kong-Chinese and German kindergarten teachers' conceptions of play and learning were examined. Six video clips of play episodes reflecting common play behavior and themes were selected from observations made during free play in two kindergartens in Hong Kong and two in Germany. Ten Chinese and seven German…

Paediatric patient navigation models of care in Canada: An environmental scan.

PubMed

Luke, Alison; Doucet, Shelley; Azar, Rima

2018-05-01

(1) To provide other organizations with useful information when implementing paediatric navigation programs and (2) to inform the implementation of a navigation care centre in New Brunswick for children with complex health conditions. This environmental scan consisted of a literature review of published and grey literature for paediatric patient navigation programs across Canada. Additional programs were found following discussions with program coordinators and navigators. Interviews were conducted with key staff from each program and included questions related to patient condition; target population and location; method delivery; navigator background; and navigator roles. Data analysis included analysis of interviews and identification of common themes across the different programs. We interviewed staff from 19 paediatric navigation programs across Canada. Programs varied across a number of different themes, including: condition and disease type, program location (e.g., hospital or clinic), navigator background (e.g., registered nurse or peer/lay navigator) and method of delivery (e.g., phone or face-to-face). Overall, navigator roles are similar across all programs, including advocacy, education, support and assistance in accessing resources from both within and outside the health care system. This scan offers a road map of Canadian paediatric navigation programs. Knowledge learned from this scan will inform stakeholders who are either involved in the delivery of paediatric patient navigation programs or planning to implement such a program. Specifically, our scan informed the development of a navigation centre for children with complex health conditions in New Brunswick.

Microaggressions experienced by persons with mental illnesses: An exploratory study.

PubMed

Gonzales, Lauren; Davidoff, Kristin C; Nadal, Kevin L; Yanos, Philip T

2015-09-01

Microaggressions are subtle verbal or behavioral communications of disparaging messages to people based upon membership in a socially marginalized group. Their negative impact has been demonstrated for racial/ethnic groups, gender, sexual orientation, and physical disability, but currently no research exists on microaggressions as experienced by persons with mental illnesses. Qualitative data were gathered from 4 focus groups with 2 samples: adult mental health consumers in an assertive community treatment program and college students with mental illness diagnoses. Focus group transcripts were then analyzed using an open coding approach (Strauss & Corbin, 1990) to identify hierarchical themes and categories. Five major themes were identified, including invalidation, assumption of inferiority, fear of mental illness, shaming of mental illness, and second class citizen. Perpetrators of microaggressions were most commonly identified as being close friends, family members, and authority figures. Importantly, participants reported experiencing more overt discrimination experiences than subtle microaggression experiences. Reported negative outcomes related to microaggression experiences included isolation, negative emotions, and treatment nonadherence. Reported consequences of microaggressions have important implications for mental health treatment, especially as perpetrators were reported to include treatment providers and were usually unaware of such negative social exchanges. Loss of social support reported by participants and the frequent occurrence of microaggressions within close relationships implies these experiences could contribute to internalization of stigmatizing attitudes toward mental illness. Directions for future research include an investigation of motivation and reasoning behind perpetration of microaggressions against persons with mental illnesses. (c) 2015 APA, all rights reserved).

Chinese perspectives on primary care for common mental disorders: Barriers and policy implications.

PubMed

Sun, Kai Sing; Lam, Tai Pong; Wu, Dan

2018-05-01

The World Health Organization (WHO) has called for integration of mental health into primary care for a decade. In Western countries, around 15% to 25% of patients with common mental disorders including mood and anxiety disorders seek help from primary care physicians (PCPs). The rate is only about 5% in China. This article reviews the Chinese findings on the barriers to primary care for common mental disorders and how they compared with Western findings. A narrative literature review was conducted, focusing on literature published from mid-1990s in English or Chinese. Patient, PCP and health system factors were reviewed. Although Chinese and Western findings show similar themes of barriers, the Chinese have stronger barriers in most aspects, including under-recognition of the need for treatment, stigma on mental illness, somatization, worries about taking psychiatric drugs, uncertainties in the role, competency and legitimacy of PCPs in mental health care and short consultation time. Current policies in China emphasize enhancement of mental health facilities and workforce in the community. Our review suggests that patients' intention to seek help and PCPs' competency in mental health care are other fundamental factors to be addressed.

Role of Pore-Forming Toxins in Bacterial Infectious Diseases

PubMed Central

Los, Ferdinand C. O.; Randis, Tara M.

2013-01-01

SUMMARY Pore-forming toxins (PFTs) are the most common bacterial cytotoxic proteins and are required for virulence in a large number of important pathogens, including Streptococcus pneumoniae, group A and B streptococci, Staphylococcus aureus, Escherichia coli, and Mycobacterium tuberculosis. PFTs generally disrupt host cell membranes, but they can have additional effects independent of pore formation. Substantial effort has been devoted to understanding the molecular mechanisms underlying the functions of certain model PFTs. Likewise, specific host pathways mediating survival and immune responses in the face of toxin-mediated cellular damage have been delineated. However, less is known about the overall functions of PFTs during infection in vivo. This review focuses on common themes in the area of PFT biology, with an emphasis on studies addressing the roles of PFTs in in vivo and ex vivo models of colonization or infection. Common functions of PFTs include disruption of epithelial barrier function and evasion of host immune responses, which contribute to bacterial growth and spreading. The widespread nature of PFTs make this group of toxins an attractive target for the development of new virulence-targeted therapies that may have broad activity against human pathogens. PMID:23699254

Measuring what matters to patients: Using goal content to inform measure choice and development.

PubMed

Jacob, Jenna; Edbrooke-Childs, Julian; Law, Duncan; Wolpert, Miranda

2017-04-01

Personalised care requires personalised outcomes and ways of feeding back clinically useful information to clinicians and practitioners, but it is not clear how to best personalise outcome measurement and feedback using existing standardised outcome measures. The constant comparison method of grounded theory was used to compare goal themes derived from goals set at the outset of therapy for 180 children aged between 4 and 17 years, visiting eight child and adolescent mental health services, to existing standardised outcome measures used as part of common national datasets. In all, 20 out of 27 goal themes corresponded to items on at least one commonly used outcome measure. Consideration of goal themes helped to identify potential relevant outcome measures. However, there were several goal themes that were not captured by items on standardised outcome measures. These seemed to be related to existential factors such as understanding, thinking about oneself and future planning. This presents a powerful framework for how clinicians can use goals to help select a standardised outcome measure (where this is helpful) in addition to the use of a goal-based outcome measure and personalise choices. There may be areas not captured by standardised outcome measures that may be important for children and young people and which may only be currently captured in goal measurement. There is an indication that we may not be measuring what is important to children and young people. We may need to develop or look for new measures that capture these areas.

Internationalization of the animal science undergraduate curriculum: a survey of its current status, barriers to its implementation and its value.

PubMed

Forsberg, N E; Taur, J S; Xiao, Y; Chesbrough, H

2003-04-01

The goal of this project was to identify the current level at which internationalization has been adopted as a theme in the North American animal science curriculum and to identify its value and the barriers to its implementation. We surveyed animal, dairy, and poultry science departments across Canada and the United States. One hundred twenty-four surveys were mailed and 60% were returned. Associations between aspects of internationalization and student outcomes (admission to veterinary and graduate schools and starting salaries) were examined. Although administrators strongly believed internationalization had value, implementation was limited. The most common practices included international content in core animal science classes, advising, international internships, and participation of faculty in international scholarly activities. Few departments have incorporated internationalization into their mission statements or developed a specific international-themed class, scholarships devoted to international activities, or roles for international students. Few departments reported participation of students in international programs. Barriers included finances and limited commitment from higher administration. Student outcomes were positively associated with faculty size, percentage of international faculty, the ratio of international students to the total student population, international content in core animal science classes, a specific international-themed class, availability of international internships, and exchange of class material internationally via the Internet. Departments that did not offer international opportunities had a negative association (r = -0.79) with starting salary, but these relationships may not be causal. Alternatively, progressive departments may attract and retain exceptional students. The analysis indicated an awareness of the value of international programs, positive impacts in student outcomes, and financial barriers to implementation.

Constraints to microbial food safety policy: opinions from stakeholder groups along the farm to fork continuum.

PubMed

Sargeant, J M; Ramsingh, B; Wilkins, A; Travis, R G; Gavrus, D; Snelgrove, J W

2007-01-01

This exploratory qualitative study was conducted to identify constraints to microbial food safety policy in Canada and the USA from the perspective of stakeholder groups along the farm to fork continuum. Thirty-seven stakeholders participated in interviews or a focus group where semi-structured questions were used to facilitate discussion about constraints to policy development and implementation. An emergent grounded theory approach was used to determine themes and concepts that arose from the data (versus fitting the data to a hypothesis or a priori classification). Despite the plurality of stakeholders and the range of content expertise, participant perceptions emerged into five common themes, although, there were often disagreements as to the positive or negative attributes of specific concepts. The five themes included challenges related to measurement and objectives of microbial food safety policy goals, challenges arising from lack of knowledge, or problems with communication of knowledge coupled with current practices, beliefs and traditions; the complexity of the food system and the plurality of stakeholders; the economics of producing safe food and the limited resources to address the problem; and, issues related to decision-making and policy, including ownership of the problem and inappropriate inputs to the decision-making process. Responsibilities for food safety and for food policy failure were attributed to all stakeholders along the farm to fork continuum. While challenges regarding the biology of food safety were identified as constraints, a broader range of policy inputs encompassing social, economic and political considerations were also highlighted as critical to the development and implementation of effective food safety policy. Strategies to address these other inputs may require new, transdisciplinary approaches as an adjunct to the traditional science-based risk assessment model.

Loss and Transcendence Life Themes.

ERIC Educational Resources Information Center

Weenolsen, Patricia

Psychologists have often observed an underlying pattern or theme in the accounts that individuals give of their lives. To test a humanistic-existential approach to human development, 48 women were interviewed with the Loss and Transcendence (L/T) Life History Form. The L/T Life Theme is expressed in two ways: the expanded version includes the…

What Goes around Comes around: Re-Emerging Themes in Sport and Exercise Psychology

ERIC Educational Resources Information Center

Weiss, Maureen R.; Gill, Diane L.

2005-01-01

Sport and exercise psychology research appearing in Research Quarterly for Exercise and Sport (RQES) over the past 75 years can be characterized by re-emerging themes--hot topics in the 1930s remain hot topics now. Re-emerging themes include sportsmanship/moral development, social development/significant others, self-perceptions,…

Knowledge and Method in the Human Sciences. HSRC Series in Methodology.

ERIC Educational Resources Information Center

Mouton, Johann, Ed.; Joubert, Dian, Ed.

Issues and themes in the contemporary social sciences are explored in a collection of papers by South African scholars. Thirty-five papers are organized by 10 themes. The first theme, metatheory in the social sciences, includes: "Beyond Relativism in the Natural and Social Sciences" (M. Hesse); and "A Critique of Bhaskar's…

Gout Self-Management in African American Veterans: A Qualitative Exploration of Challenges and Solutions From Patients' Perspectives.

PubMed

Singh, Jasvinder A; Herbey, Ivan; Bharat, Aseem; Dinnella, Janet E; Pullman-Mooar, Sally; Eisen, Seth; Ivankova, Nataliya

2017-11-01

To explore gout self-management and associated challenges and solutions in African Americans. We conducted semistructured interviews with 35 African American veterans with gout, who received health care at Birmingham or Philadelphia Veterans Affairs (VA) medical centers, had filled urate-lowering therapy (ULT; most commonly allopurinol) for at least 6 months, and had a ULT medication possession ratio ≥80%. The interview protocol was constructed to explore key concepts related to gout self-management, including initial diagnosis of gout, beginning medical care for gout, the course of the gout, ULT medication adherence, dietary strategies, comorbidity and side effects, and social support. Thirty-five African American male veterans with gout who had ≥80% ULT adherence (most commonly, allopurinol) were interviewed at Birmingham (n = 18) or Philadelphia (n = 17) VA medical centers. Mean age was 65 years, mean body mass index was 31.9 kg/m 2 , 97% had hypertension, 23% had coronary artery disease, and 31% had renal failure. The main themes motivating African American veterans to better gout self-management were fear of pain, adherence to medications, self-discipline, lifestyle changes, information gathering, and developing a positive outlook. Birmingham participants more frequently revealed skipping gout medications. More Philadelphia participants discussed lifestyle/diet changes to prevent gout flares, indicated limiting social activities that involved drinking, and sought more information about gout self-management from health care providers and internet sources. Identified themes, including cultural differences by site, led to the development of a patient-centered intervention to improve gout self-management in African American men with gout. © 2017, American College of Rheumatology.

Using the Theoretical Domains Framework (TDF) to understand adherence to multiple evidence-based indicators in primary care: a qualitative study.

PubMed

Lawton, Rebecca; Heyhoe, Jane; Louch, Gemma; Ingleson, Emma; Glidewell, Liz; Willis, Thomas A; McEachan, Rosemary R C; Foy, Robbie

2016-08-08

There are recognised gaps between evidence and practice in general practice, a setting posing particular implementation challenges. We earlier screened clinical guideline recommendations to derive a set of 'high-impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. Here, we explore health professionals' perceived determinants of adherence to these indicators, examining the degree to which determinants were indicator-specific or potentially generalisable across indicators. We interviewed 60 general practitioners, practice nurses and practice managers in West Yorkshire, the UK, about adherence to four indicators: avoidance of risky prescribing; treatment targets in type 2 diabetes; blood pressure targets in treated hypertension; and anticoagulation in atrial fibrillation. Interview questions drew upon the Theoretical Domains Framework (TDF). Data were analysed using framework analysis. Professional role and identity and environmental context and resources featured prominently across all indicators whilst the importance of other domains, for example, beliefs about consequences, social influences and knowledge varied across indicators. We identified five meta-themes representing more general organisational and contextual factors common to all indicators. The TDF helped elicit a wide range of reported determinants of adherence to 'high-impact' indicators in primary care. It was more difficult to pinpoint which determinants, if targeted by an implementation strategy, would maximise change. The meta-themes broadly underline the need to align the design of interventions targeting general practices with higher level supports and broader contextual considerations. However, our findings suggest that it is feasible to develop interventions to promote the uptake of different evidence-based indicators which share common features whilst also including content-specific adaptations.

Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement.

PubMed

Aherne, Declan; Farrant, Katie; Hickey, Louise; Hickey, Emma; McGrath, Lisa; McGrath, Deirdre

2016-08-18

Medical practitioners and students are at increased risk of a number of personal and psychological problems. Stress and anxiety due to work-load and study requirements are common and self-care methods are important in maintaining well-being. The current study examines perceptions of and satisfaction ratings with a mindfulness based stress reduction (MBSR) programme for 1(st) year (compulsory) and 2(nd) year (optional) Graduate Entry Medical School students. A mixed method pre and post study of Year 1 (n = 140) and Year 2 (n = 88) medical students completing a 7 week MBSR course compared student satisfaction ratings. Thematic analysis of feedback from the students on their perception of the course was also carried out. Year 1 students (compulsory course) were less satisfied with content and learning outcomes than Year 2 students (optional course) (p < .0005). Thematic analysis of year 1 student feedback identified themes including great concept, poorly executed; and less discussion, more practice. Year 2 themes included session environment and satisfaction with tutors. The MBSR course was associated with high levels of satisfaction and positive feedback when delivered on an optional basis. Catering for the individual needs of the participant and promoting a safe environment are core elements of a successful self-care programme.

A Social Constructionist Approach to Diversity and Social Relations Among Muslim Americans.

PubMed

Ajrouch, Kristine J

2017-06-01

Social relations among Muslim elders in the U.S. were examined to investigate diversity within an ethnic group whose members share a common religious belief system. Data included a web-based survey (N = 264) and semi-structured interviews (N = 18). A social constructionist perspective was used recognizing that ethnicity is fluid, not static and culture was highlighted as a way of seeing as opposed to a way of being. Regression analysis was conducted using survey data to investigate diversity among Muslims elders concerning social contact and activities. Social contact was predominantly with older adults for both African American and European compared to South Asian Muslims. Concerning social activities, the U.S. born was less likely than immigrants to be satisfied with activities for elders. Grounded analysis of semi-structured data uncovered two themes: social connectedness and communication. Each theme provided in-depth understandings of how culture, as ways of seeing the world, shape social relations in diverse ways, leading to the proposition that though family may be necessary for well-being in old age, it is not sufficient. By focusing on one religious group that included both immigrants and those born in the U.S., with various ancestral origins, findings advance a systematic and critical approach to challenge essentialist assumptions in the study of ethnic aging.

Evaluation of complex community-based childhood obesity prevention interventions.

PubMed

Karacabeyli, D; Allender, S; Pinkney, S; Amed, S

2018-05-16

Multi-setting, multi-component community-based interventions have shown promise in preventing childhood obesity; however, evaluation of these complex interventions remains a challenge. The objective of the study is to systematically review published methodological approaches to outcome evaluation for multi-setting community-based childhood obesity prevention interventions and synthesize a set of pragmatic recommendations. MEDLINE, CINAHL and PsycINFO were searched from inception to 6 July 2017. Papers were included if the intervention targeted children ≤18 years, engaged at least two community sectors and described their outcome evaluation methodology. A single reviewer conducted title and abstract scans, full article review and data abstraction. Directed content analysis was performed by three reviewers to identify prevailing themes. Thirty-three studies were included, and of these, 26 employed a quasi-experimental design; the remaining were randomized control trials. Body mass index was the most commonly measured outcome, followed by health behaviour change and psychosocial outcomes. Six themes emerged, highlighting advantages and disadvantages of active vs. passive consent, quasi-experimental vs. randomized control trials, longitudinal vs. repeat cross-sectional designs and the roles of process evaluation and methodological flexibility in evaluating complex interventions. Selection of study designs and outcome measures compatible with community infrastructure, accompanied by process evaluation, may facilitate successful outcome evaluation. © 2018 World Obesity Federation.

Swedish medical students' expectations of their future life

PubMed Central

Andersson, Jenny; Johansson, Eva E.; Verdonk, Petra; Lagro-Janssen, Antoine; Hamberg, Katarina

2011-01-01

Objectives: To investigate future life expectations among male and female medical students in their first and final year. Methods The study was cross-sectional and conducted at a Swedish medical school. Out of 600 invited students, 507 (85%) answered an open-ended question about their future life, 298 (59%) first-year students and 209 (41%) last-year students. Women constituted 60% of the respondents. A mixed model design was applied; qualitative content analysis was utilized to create statistically comparable themes and categories. Results Students’ written answers were coded, categorized and clustered into four themes: “Work”, “Family”, “Leisure” and “Quality of personal life”. Almost all students included aspects of work in their answers. Female students were more detailed than male ones in their family concerns. Almost a third of all students reflected on a future work-life balance, but considerations regarding quality of personal life and leisure were more common among last-year students. Conclusions Today’s medical students expect more of life than work, especially those standing on the doorstep of working life. They intend to balance work not only with a family but also with leisure activities. Our results reflect work attitudes that challenge the health care system for more adaptive working conditions. We suggest that discussions about work-life balance should be included in medical curricula.

The experiences of frequent users of crisis helplines: A qualitative interview study.

PubMed

Middleton, Aves; Gunn, Jane; Bassilios, Bridget; Pirkis, Jane

2016-11-01

To understand why some users call crisis helplines frequently. Nineteen semi-structured telephone interviews were conducted with callers to Lifeline Australia who reported calling 20 times or more in the past month and provided informed consent. Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis was used to generate common themes. Approval was granted by The University of Melbourne Human Research Ethics Committee. Three overarching themes emerged from the data and included reasons for calling, service response and calling behaviours. Respondents called seeking someone to talk to, help with their mental health issues and assistance with negative life events. When they called, they found short-term benefits in the unrestricted support offered by the helpline. Over time they called about similar issues and described reactive, support-seeking and dependent calling behaviours. Frequent users of crisis helplines call about ongoing issues. They have developed distinctive calling behaviours which appear to occur through an interaction between their reasons for calling and the response they receive from the helpline. The ongoing nature of the issues prompting frequent users to call suggests that a service model that includes a continuity of care component may be more efficient in meeting their needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Understanding the experiences of fathers of children with congenital heart disease: An interpretative phenomenological analysis.

PubMed

Gower, Carla; Higgins, Aiveen; Doherty, Nicola; McCormack, David

2017-09-01

Little is known about the experiences of fathers of children with congenital heart disease. Using interpretative phenomenological analysis, the lived experiences of six fathers were explored. Two master themes emerged: 'relinquishing and reclaiming control' and 'living in the shadow of illness'. Subordinate themes included playing the support act, a pragmatic/emotional dichotomy, and becoming the child's protector. Other themes included living in limbo and redefining 'normality' to encompass the condition. Theoretical links are made between these findings and existing literature while clinical implications include the need to involve fathers in decision-making and to respect their need to maintain control.

Health systems facilitators and barriers to the integration of HIV and chronic disease services: a systematic review.

PubMed

Watt, Nicola; Sigfrid, Louise; Legido-Quigley, Helena; Hogarth, Sue; Maimaris, Will; Otero-García, Laura; Perel, Pablo; Buse, Kent; McKee, Martin; Piot, Peter; Balabanova, Dina

2017-11-01

Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is limited. We report the findings of a systematic review that sought to identify health system factors, extrinsic to the integration process, which either facilitated or hindered the integration of services for two common disorders, HIV and chronic non-communicable diseases. Findings were initially extracted and organized around a health system framework, followed by a thematic cross-cutting analysis and validation steps. Of the 150 articles included, 67% (n = 102) were from high-income countries. The articles explored integration with services for one or several chronic disorders, the most studied being alcohol or substance use disorders (47.7%), and mental health issues (29.5%). Four cross-cutting themes related to the health system were identified. The first and most common theme was the requirement for effective collaboration and coordination: formal and informal productive relationships throughout the system between providers and within teams, and between staff and patients. The second was the need for adequate and appropriately skilled and incentivized health workers-with the right expertise, training and operational support for the programme. The third was the need for supportive institutional structures and dedicated resources. The fourth was leadership in terms of political will, effective managerial oversight and organizational culture, indicating that actual implementation is as important as programme design. A fifth theme, outside the health system, but underpinning all aspects of the system operation, was that placing the patient at the centre of service delivery and responding holistically to their diverse needs. This was an important facilitator of integration. These findings confirm that integration processes in service delivery depend substantially for their success on characteristics of the health systems in which they are embedded. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Health systems facilitators and barriers to the integration of HIV and chronic disease services: a systematic review

PubMed Central

Watt, Nicola; Sigfrid, Louise; Legido-Quigley, Helena; Hogarth, Sue; Maimaris, Will; Otero-García, Laura; Perel, Pablo; Buse, Kent; McKee, Martin; Piot, Peter; Balabanova, Dina

2017-01-01

Abstract Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is limited. We report the findings of a systematic review that sought to identify health system factors, extrinsic to the integration process, which either facilitated or hindered the integration of services for two common disorders, HIV and chronic non-communicable diseases. Findings were initially extracted and organized around a health system framework, followed by a thematic cross-cutting analysis and validation steps. Of the 150 articles included, 67% (n = 102) were from high-income countries. The articles explored integration with services for one or several chronic disorders, the most studied being alcohol or substance use disorders (47.7%), and mental health issues (29.5%). Four cross-cutting themes related to the health system were identified. The first and most common theme was the requirement for effective collaboration and coordination: formal and informal productive relationships throughout the system between providers and within teams, and between staff and patients. The second was the need for adequate and appropriately skilled and incentivized health workers—with the right expertise, training and operational support for the programme. The third was the need for supportive institutional structures and dedicated resources. The fourth was leadership in terms of political will, effective managerial oversight and organizational culture, indicating that actual implementation is as important as programme design. A fifth theme, outside the health system, but underpinning all aspects of the system operation, was that placing the patient at the centre of service delivery and responding holistically to their diverse needs. This was an important facilitator of integration. These findings confirm that integration processes in service delivery depend substantially for their success on characteristics of the health systems in which they are embedded. PMID:28666336

A content analysis of the representation of statins in the British newsprint media.

PubMed

Chisnell, Julia; Marshall, Tom; Hyde, Chris; Zhelev, Zhivko; Fleming, Lora E

2017-08-21

This study reviewed the news media coverage of statins, seeking to identify specific trends or differences in viewpoint between media outlets and examine common themes. The study is a content analysis of the frequency and content of the reporting of statins in a selection of the British newsprint media. It involved an assessment of the number, timing and thematic content of articles followed by a discourse analysis examining the underlying narratives. The sample was the output of four UK newspapers, covering a broad-spectrum readership, over a six month timeframe 1 October 2013 to 31 March 2014. A total of 67 articles included reference to statins. The majority (39, 58%) were reporting or responding to publication of a clinical study. The ratio of negative to positive coverage was greater than 2:1 overall. In the more politically right-leaning newspapers, 67% of coverage was predominantly negative (30/45 articles); 32% in the more left-leaning papers (7/22 articles). Common themes were the perceived 'medicalisation' of the population; the balance between lifestyle modification and medical treatments in the primary prevention of heart disease; side effects and effectiveness of statins; pharmaceutical sponsorship and implications for the reliability of evidence; trust between the public and government, institutions, research organisations and the medical profession. Newsprint media coverage of statins was substantially influenced by the publication of national guidance and by coverage in the medical journals of clinical studies and comment. Statins received a predominantly negative portrayal, notably in the more right-leaning press. There were shared themes: concern about the balance between medication and lifestyle change in the primary prevention of heart disease; the adverse effects of treatment; and a questioning of the reliability of evidence from research institutions, scientists and clinicians in the light of their potential allegiances and funding. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Identifying acne treatment uncertainties via a James Lind Alliance Priority Setting Partnership

PubMed Central

Layton, Alison; Eady, E Anne; Peat, Maggie; Whitehouse, Heather; Levell, Nick; Ridd, Matthew; Cowdell, Fiona; Patel, Mahenda; Andrews, Stephen; Oxnard, Christine; Fenton, Mark; Firkins, Lester

2015-01-01

Objectives The Acne Priority Setting Partnership (PSP) was set up to identify and rank treatment uncertainties by bringing together people with acne, and professionals providing care within and beyond the National Health Service (NHS). Setting The UK with international participation. Participants Teenagers and adults with acne, parents, partners, nurses, clinicians, pharmacists, private practitioners. Methods Treatment uncertainties were collected via separate online harvesting surveys, embedded within the PSP website, for patients and professionals. A wide variety of approaches were used to promote the surveys to stakeholder groups with a particular emphasis on teenagers and young adults. Survey submissions were collated using keywords and verified as uncertainties by appraising existing evidence. The 30 most popular themes were ranked via weighted scores from an online vote. At a priority setting workshop, patients and professionals discussed the 18 highest-scoring questions from the vote, and reached consensus on the top 10. Results In the harvesting survey, 2310 people, including 652 professionals and 1456 patients (58% aged 24 y or younger), made submissions containing at least one research question. After checking for relevance and rephrasing, a total of 6255 questions were collated into themes. Valid votes ranking the 30 most common themes were obtained from 2807 participants. The top 10 uncertainties prioritised at the workshop were largely focused on management strategies, optimum use of common prescription medications and the role of non-drug based interventions. More female than male patients took part in the harvesting surveys and vote. A wider range of uncertainties were provided by patients compared to professionals. Conclusions Engaging teenagers and young adults in priority setting is achievable using a variety of promotional methods. The top 10 uncertainties reveal an extensive knowledge gap about widely used interventions and the relative merits of drug versus non-drug based treatments in acne management. PMID:26187120

Physician as teacher: promoting health and wellness among elementary school students.

PubMed

Stefaniak, Jill E; Lucia, Victoria C

2014-01-01

Every day, physicians engage in teaching during their patient encounters. It may be that medical students who are introduced to the principles of teaching and learning are more likely to become good communicators and learners. Service-learning may be an effective way for medical students to practice skills in teaching and communication in a real-world setting, while also filling a need within the community. The purpose of this study was to identify common themes within medical students' reflections on what they learned through participating in a teaching exercise with local elementary school children. As a required component of a longitudinal prevention and public health course that spans the first and second years of undergraduate medical education, second year students at the Oakland University William Beaumont School of Medicine, in Detroit, Michigan, in the USA completed a service-learning activity, which included teaching a standardized curricular module to local elementary school children. Students were required to complete a reflection assignment based on their teaching experience. Medical students' responses to assignment's three guided questions were qualitatively coded to identify common themes among the responses related to the teaching activity. Qualitative analysis of students' reflections revealed several themes regarding what the students learned and viewed as the benefits of the activity: The importance of early education and parental involvement; the importance of understanding your audience when teaching; the importance of simplifying complex concepts to the audience's level; and the importance of preparation for teaching. Medical students identified the difficulties of communicating at an audience appropriate level and providing patient education outside the confines of a controlled classroom setting. This activity provided medical students with hands-on experience presenting to an audience age-appropriate, health-related topics. Presenting in an elementary school environment helped students better understand what health information various age groups knew about and the importance of clarifying information when communicating with a younger audience.

Barriers to patient-centered human immunodeficiency virus (HIV) care with African American patients who use drugs: Social construction of the typical and ideal care visit.

PubMed

Carlberg-Racich, Suzanne; Roden, Lindsey

2017-01-01

A successful patient-provider relationship ensures that patients are treated as individuals and receive appropriate care for their unique circumstances. For this to occur, the relationship needs open communication and trust. African American persons who inject drugs (PWIDs) and who smoke crack cocaine are at elevated risks of poor health outcomes and are often lost to care. In addition, providers often experience difficulty serving this population. Although some barriers are documented in the peer-reviewed literature, this study sought to provide in-depth context to the relationship and how it is constructed. Individual, semistructured interviews were conducted with human immunodeficiency virus (HIV) care providers and their patients, specifically PWIDs and persons who smoke crack cocaine, in publicly funded HIV clinics in low-resource urban communities. n = 31 patients and n = 7 providers were interviewed about their perceptions of the other and the relationship. Interview transcripts were coded and analyzed for common themes, which were used to generate a conceptual, constructionist model of the HIV care visit. Common patient themes included the tendency to describe providers in familial terms, match between their current provider and ideal provider, concern about stigma related to their use, and expression of unmet needs. Provider themes revealed less match with their ideal patient-preferring patients who were both abstinent and adherent, and expressing frustration with patient refusal to change. Thematic results were used to create a visual and conceptual model for the HIV care visit. The model demonstrates both the positive and negative perceptions that inform the visit, and the barriers that impede a more fruitful patient-provider dynamic with a shared power structure. Provider training in communication and other identified topics may begin to lay the foundation for a shift in this structure.

Computational physics and applied mathematics capability review June 8-10, 2010 (Advance materials to committee members)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Stephen R

2010-01-01

Los Alamos National Laboratory will review its Computational Physics and Applied Mathematics (CPAM) capabilities in 2010. The goals of capability reviews are to assess the quality of science, technology, and engineering (STE) performed by the capability, evaluate the integration of this capability across the Laboratory and within the scientific community, examine the relevance of this capability to the Laboratory's programs, and provide advice on the current and future directions of this capability. This is the first such review for CPAM, which has a long and unique history at the laboratory, starting from the inception of the Laboratory in 1943. Themore » CPAM capability covers an extremely broad technical area at Los Alamos, encompassing a wide array of disciplines, research topics, and organizations. A vast array of technical disciplines and activities are included in this capability, from general numerical modeling, to coupled mUlti-physics simulations, to detailed domain science activities in mathematics, methods, and algorithms. The CPAM capability involves over 12 different technical divisions and a majority of our programmatic and scientific activities. To make this large scope tractable, the CPAM capability is broken into the following six technical 'themes.' These themes represent technical slices through the CP AM capability and collect critical core competencies of the Laboratory, each of which contributes to the capability (and each of which is divided into multiple additional elements in the detailed descriptions of the themes in subsequent sections): (1) Computational Fluid Dynamics - This theme speaks to the vast array of scientific capabilities for the simulation of fluids under shocks, low-speed flow, and turbulent conditions - which are key, historical, and fundamental strengths of the laboratory; (2) Partial Differential Equations - The technical scope of this theme is the applied mathematics and numerical solution of partial differential equations (broadly defined) in a variety of settings, including particle transport, solvers, and plasma physics; (3) Monte Carlo - Monte Carlo was invented at Los Alamos, and this theme discusses these vitally important methods and their application in everything from particle transport, to condensed matter theory, to biology; (4) Molecular Dynamics - This theme describes the widespread use of molecular dynamics for a variety of important applications, including nuclear energy, materials science, and biological modeling; (5) Discrete Event Simulation - The technical scope of this theme represents a class of complex system evolutions governed by the action of discrete events. Examples include network, communication, vehicle traffic, and epidemiology modeling; and (6) Integrated Codes - This theme discusses integrated applications (comprised of all of the supporting science represented in Themes 1-5) that are of strategic importance to the Laboratory and the nation. The laboratory has in approximately 10 million source lines of code in over 100 different such strategically important applications. Of these themes, four of them will be reviewed during the 2010 review cycle: Themes 1, 2, 3, and 6. Because these capability reviews occur every three years, Themes 4 and 5 will be reviewed in 2013, along with Theme 6 (which will be reviewed during each review, owing to this theme's role as an integrator of the supporting science represented by the other 5 themes). Yearly written status reports will be provided to the Capability Review Committee Chair during off-cycle years.« less

Primary and secondary analysis of local elected officials' decisions to support or oppose pharmacy sale of syringes in California.

PubMed

Backes, Glenn; Rose, Valerie J

2010-07-01

Under California law, local governments may authorize pharmacies within their jurisdictions to sell ten or fewer syringes to an adult without prescription, proof of identity, or proof of medical need. Local governments may simultaneously exempt adults from prosecution for violation of state drug paraphernalia codes for possession of ten or fewer syringes for personal use. Both of these provisions are temporary and sunset on December 31, 2010, unless subsequent state legislation amends that date. The objective of our study was to ascertain how and why local policymakers made their decisions regarding non-prescription syringe sale (NPSS). We examined influences on their decisions, including specific messengers and the arguments that were most salient to their decision making. We selected jurisdictions that were geographically representative of California counties; those with and without syringe exchange programs, and those that had passed or rejected NPSS. We conducted nine semi-structured interviews in five jurisdictions. To enrich primary data collection, we analyzed secondary data by reviewing audio, video, and written transcripts of public hearings and newspaper coverage in five jurisdictions, including three jurisdictions without primary interview data. Among proponents of NPSS, we identified common themes, including: (1) public health research provided conclusive evidence for reduction in HIV and hepatitis transmission without problems of crime, drug use, or unsafe discard of syringes; (2) the local health officer was the key to influencing local policymakers; (3) recall of prior debates over syringe exchange served to inform their decision making; and (4) a lack of local opposition or controversy. Common concerns among opponents of NPSS included: (1) that there would be an increase in unsafe discard of syringes; (2) loss of an important law enforcement tool; (3) that drug users were incapable of desired behavior change; and (4) that research was inconclusive, or proved that syringe access would not work in reducing rates of disease. Themes held in common by proponents and opponents of NPSS were identified as well. Syringe access through NPSS is in fact supported by a robust body of public health research and is considered an important component of a comprehensive strategy to reduce HIV and hepatitis transmission. Our study highlights the importance of understanding the perspectives of elected officials in order to ameliorate their concerns without undermining the public health goal of reducing death, disease, and suffering in at-risk communities.

Methodological challenges in qualitative content analysis: A discussion paper.

PubMed

Graneheim, Ulla H; Lindgren, Britt-Marie; Lundman, Berit

2017-09-01

This discussion paper is aimed to map content analysis in the qualitative paradigm and explore common methodological challenges. We discuss phenomenological descriptions of manifest content and hermeneutical interpretations of latent content. We demonstrate inductive, deductive, and abductive approaches to qualitative content analysis, and elaborate on the level of abstraction and degree of interpretation used in constructing categories, descriptive themes, and themes of meaning. With increased abstraction and interpretation comes an increased challenge to demonstrate the credibility and authenticity of the analysis. A key issue is to show the logic in how categories and themes are abstracted, interpreted, and connected to the aim and to each other. Qualitative content analysis is an autonomous method and can be used at varying levels of abstraction and interpretation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study.

PubMed

Vaismoradi, Mojtaba; Turunen, Hannele; Bondas, Terese

2013-09-01

Qualitative content analysis and thematic analysis are two commonly used approaches in data analysis of nursing research, but boundaries between the two have not been clearly specified. In other words, they are being used interchangeably and it seems difficult for the researcher to choose between them. In this respect, this paper describes and discusses the boundaries between qualitative content analysis and thematic analysis and presents implications to improve the consistency between the purpose of related studies and the method of data analyses. This is a discussion paper, comprising an analytical overview and discussion of the definitions, aims, philosophical background, data gathering, and analysis of content analysis and thematic analysis, and addressing their methodological subtleties. It is concluded that in spite of many similarities between the approaches, including cutting across data and searching for patterns and themes, their main difference lies in the opportunity for quantification of data. It means that measuring the frequency of different categories and themes is possible in content analysis with caution as a proxy for significance. © 2013 Wiley Publishing Asia Pty Ltd.

Back home: a qualitative study exploring re-entering cross-cultural missionary aid workers' loss and grief.

PubMed

Selby, Susan; Moulding, Nicole; Clark, Sheila; Jones, Alison; Braunack-Mayer, Annette; Beilby, Justin

2009-01-01

Over 200 Australian, American, and British Non-Government Organizations send aid workers overseas including missionaries. On re-entry, they may suffer psychological distress; however, there is little research about their psychosocial issues and management in the family practice setting. Research suggests loss and grief as a suitable paradigm for family practitioners dealing with psychosocial issues. The aim of this study was to explore loss and grief issues for adult Australian missionary cross-cultural aid workers during their re-entry adjustment. Mixed methods were used and this study reports the qualitative method: semi-structured interviews conducted with 15 participants. Results were analyzed using framework analysis. Themes of re-entry loss and grief were identified with sub-themes of multiple varied losses, mechanisms of loss, loss of control, common grief phenomena, disenfranchised grief, and reactivation of past grief. Theoretical and clinical implications are discussed. Findings of this study suggest that loss and grief is an appropriate paradigm for the management of these workers in the family practice setting. Further research is needed to enable appropriate care.

Measles outbreak in an unvaccinated family and a possibly associated international traveler - Orange County, Florida, December 2012-January 2013.

PubMed

Slade, Tania A; Klekamp, Benjamin; Rico, Edhelene; Mejia-Echeverry, Alvaro

2014-09-12

The Florida Department of Health in Orange County (DOH-Orange) was notified by a child care facility on January 11, 2013, that a parent had reported that an attendee and three siblings were ill with measles. All four siblings were unvaccinated for measles and had no travel history outside of Orange County during the periods when they likely had been exposed. A fifth, possibly associated case was later reported in a Brazilian citizen who had become ill while vacationing in Florida. The outbreak investigation that was conducted at multiple community settings in Orange County, including at an Orlando-area theme park, identified no additional cases. The genotype sequence was identical for cases 2-5, and visits to the same theme park suggested an unknown, common exposure and link between the cases. Sources of measles exposure can be difficult to identify for every measles case. Measles should be considered in the differential diagnosis of febrile rash illness, especially in unvaccinated persons. Reporting a confirmed or suspected case immediately to public health authorities is critical to limit the spread of measles.

Coping with pediatric cancer: strategies employed by children and their parents to manage cancer-related stressors during treatment.

PubMed

Hildenbrand, Aimee K; Clawson, Kathleen J; Alderfer, Melissa A; Marsac, Meghan L

2011-01-01

Pediatric cancer patients and their families face significant physical, emotional, and psychosocial challenges. Few studies have investigated how children manage these challenges and how parents may help in the process. This qualitative study aimed to explore common cancer-related stressors for children and to examine child coping and parental assistance in coping with these stressors during treatment. Fifteen children undergoing cancer treatment and their parents participated in semistructured interviews. Four themes emerged capturing cancer-related stressors: cancer treatment/side effects, distressing emotions, disruption in daily routines, and social challenges. Six themes emerged regarding child coping strategies that were classified within an approach/avoidance coping framework. Approach coping strategies included the following: cognitive restructuring, relaxation, practical strategies, seeking social support, and emotional expression. Distraction was the only avoidant coping strategy. Parents tended to encourage approach coping strategies (eg, cognitive restructuring, social support). Within families, few coping strategies were reported (child: M = 1.47, SD = 0.99; parent: M = 3.33, SD = 1.18), suggesting that early family-based interventions teaching coping techniques for cancer-related stressors may be beneficial.

Aminoacyl-tRNA synthetase deficiencies in search of common themes.

PubMed

Fuchs, Sabine A; Schene, Imre F; Kok, Gautam; Jansen, Jurriaan M; Nikkels, Peter G J; van Gassen, Koen L I; Terheggen-Lagro, Suzanne W J; van der Crabben, Saskia N; Hoeks, Sanne E; Niers, Laetitia E M; Wolf, Nicole I; de Vries, Maaike C; Koolen, David A; Houwen, Roderick H J; Mulder, Margot F; van Hasselt, Peter M

2018-06-06

Pathogenic variations in genes encoding aminoacyl-tRNA synthetases (ARSs) are increasingly associated with human disease. Clinical features of autosomal recessive ARS deficiencies appear very diverse and without apparent logic. We searched for common clinical patterns to improve disease recognition, insight into pathophysiology, and clinical care. Symptoms were analyzed in all patients with recessive ARS deficiencies reported in literature, supplemented with unreported patients evaluated in our hospital. In literature, we identified 107 patients with AARS, DARS, GARS, HARS, IARS, KARS, LARS, MARS, RARS, SARS, VARS, YARS, and QARS deficiencies. Common symptoms (defined as present in ≥4/13 ARS deficiencies) included abnormalities of the central nervous system and/or senses (13/13), failure to thrive, gastrointestinal symptoms, dysmaturity, liver disease, and facial dysmorphisms. Deep phenotyping of 5 additional patients with unreported compound heterozygous pathogenic variations in IARS, LARS, KARS, and QARS extended the common phenotype with lung disease, hypoalbuminemia, anemia, and renal tubulopathy. We propose a common clinical phenotype for recessive ARS deficiencies, resulting from insufficient aminoacylation activity to meet translational demand in specific organs or periods of life. Assuming residual ARS activity, adequate protein/amino acid supply seems essential instead of the traditional replacement of protein by glucose in patients with metabolic diseases.

Assessing the impact of healthcare research: A systematic review of methodological frameworks.

PubMed

Cruz Rivera, Samantha; Kyte, Derek G; Aiyegbusi, Olalekan Lee; Keeley, Thomas J; Calvert, Melanie J

2017-08-01

Increasingly, researchers need to demonstrate the impact of their research to their sponsors, funders, and fellow academics. However, the most appropriate way of measuring the impact of healthcare research is subject to debate. We aimed to identify the existing methodological frameworks used to measure healthcare research impact and to summarise the common themes and metrics in an impact matrix. Two independent investigators systematically searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica Database (EMBASE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL+), the Health Management Information Consortium, and the Journal of Research Evaluation from inception until May 2017 for publications that presented a methodological framework for research impact. We then summarised the common concepts and themes across methodological frameworks and identified the metrics used to evaluate differing forms of impact. Twenty-four unique methodological frameworks were identified, addressing 5 broad categories of impact: (1) 'primary research-related impact', (2) 'influence on policy making', (3) 'health and health systems impact', (4) 'health-related and societal impact', and (5) 'broader economic impact'. These categories were subdivided into 16 common impact subgroups. Authors of the included publications proposed 80 different metrics aimed at measuring impact in these areas. The main limitation of the study was the potential exclusion of relevant articles, as a consequence of the poor indexing of the databases searched. The measurement of research impact is an essential exercise to help direct the allocation of limited research resources, to maximise research benefit, and to help minimise research waste. This review provides a collective summary of existing methodological frameworks for research impact, which funders may use to inform the measurement of research impact and researchers may use to inform study design decisions aimed at maximising the short-, medium-, and long-term impact of their research.

Faculty development through simulation-based education in physical therapist education.

PubMed

Greenwood, Kristin Curry; Ewell, Sara B

2018-01-01

The use of simulation-based education (SBE) in health professions, such as physical therapy, requires faculty to expand their teaching practice and development. The impact of this teaching on the individual faculty member, and how their teaching process changes or develops, is not fully understood. The purpose of this study was to explore individual physical therapist faculty members' experience with SBE and how those experiences may have transformed their teaching practice to answer the research questions: How do physical therapist faculty develop through including SBE and are there commonalities among educators? An interpretive phenomenological analysis approach was used with a small sample of subjects who participated in three individual semi-structured interviews. Interview questions were created through the lens of transformative learning theory to allow faculty transformations to be uncovered. A two-step thematic coding process was conducted across participants to identify commonalities of faculty experiences with SBE in physical therapist education. Credibility and trustworthiness were achieved through member checking and expert external review. Thematic findings were validated with transcript excerpts and research field notes. Eight physical therapist faculty members (25% male) with a range of 3 to 16 years of incorporating SBE shared their individual experiences. Four common themes related to faculty development were identified across the participants. Themes identified are the following: faculty strengthen their professional identity as physical therapists, faculty are affected by their introduction and training with simulation, faculty develop their interprofessional education through SBE, and faculty experiences with SBE facilitate professional growth. Physical therapist educators had similarities in their experiences with SBE that transformed their teaching practice and professional development. This study provides insight into what physical therapist faculty may experience when adopting SBE.

Medical applications: a database and characterization of apps in Apple iOS and Android platforms.

PubMed

Seabrook, Heather J; Stromer, Julie N; Shevkenek, Cole; Bharwani, Aleem; de Grood, Jill; Ghali, William A

2014-08-27

Medical applications (apps) for smart phones and tablet computers are growing in number and are commonly used in healthcare. In this context, there is a need for a diverse community of app users, medical researchers, and app developers to better understand the app landscape. In mid-2012, we undertook an environmental scan and classification of the medical app landscape in the two dominant platforms by searching the medical category of the Apple iTunes and Google Play app download sites. We identified target audiences, functions, costs and content themes using app descriptions and captured these data in a database. We only included apps released or updated between October 1, 2011 and May 31, 2012, with a primary "medical" app store categorization, in English, that contained health or medical content. Our sample of Android apps was limited to the most popular apps in the medical category. Our final sample of Apple iOS (n = 4561) and Android (n = 293) apps illustrate a diverse medical app landscape. The proportion of Apple iOS apps for the public (35%) and for physicians (36%) is similar. Few Apple iOS apps specifically target nurses (3%). Within the Android apps, those targeting the public dominated in our sample (51%). The distribution of app functions is similar in both platforms with reference being the most common function. Most app functions and content themes vary considerably by target audience. Social media apps are more common for patients and the public, while conference apps target physicians. We characterized existing medical apps and illustrated their diversity in terms of target audience, main functions, cost and healthcare topic. The resulting app database is a resource for app users, app developers and health informatics researchers.

Neonatal hypoglycaemia: learning from claims

PubMed Central

Hawdon, Jane M; Beer, Jeanette; Sharp, Deborah; Upton, Michele

2017-01-01

Objectives Neonatal hypoglycaemia is a potential cause of neonatal morbidity, and on rare but tragic occasions causes long-term neurodevelopmental harm with consequent emotional and practical costs for the family. The organisational cost to the NHS includes the cost of successful litigation claims. The purpose of the review was to identify themes that could alert clinicians to common pitfalls and thus improve patient safety. Design The NHS Litigation Authority (NHS LA) Claims Management System was reviewed to identify and review 30 claims for injury secondary to neonatal hypoglycaemia, which were notified to the NHS LA between 2002 and 2011. Setting NHS LA. Patients Anonymised documentation relating to 30 neonates for whom claims were made relating to neonatal hypoglycaemia. Dates of birth were between 1995 and 2010. Interventions Review of documentation held on the NHS LA database. Main outcome measures Identifiable risk factors for hypoglycaemia, presenting clinical signs, possible deficits in care, financial costs of litigation. Results All claims related to babies of at least 36 weeks’ gestation. The most common risk factor for hypoglycaemia was low birth weight or borderline low birth weight, and the most common reported presenting sign was abnormal feeding behaviour. A number of likely deficits in care were reported, all of which were avoidable. In this 10-year reporting period, there were 25 claims for which damages were paid, with a total financial cost of claims to the NHS of £162 166 677. Conclusions Acknowledging that these are likely to be the most rare but most seriously affected cases, the clinical themes arising from these cases should be used for further development of training and guidance to reduce harm and redivert NHS funds from litigation to direct care. PMID:27553590

Systematic thematic review of e-health research in the Gulf Cooperation Council (Arabian Gulf): Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates.

PubMed

Weber, Alan S; Turjoman, Rebal; Shaheen, Yanal; Al Sayyed, Farah; Hwang, Mu Ji; Malick, Faryal

2017-05-01

Introduction The Gulf Cooperation Council (GCC or 'Arabian Gulf'), comprising Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates, is a political organization sharing a common history and culture. All GCC nations have made substantial investments in telecommunications and electronic health infrastructure since 2000. Methods We conducted a literature search in English and Arabic on peer-reviewed e-health research up to December 2014 originating in the GCC. The objective was to retrieve all research on e-health in the GCC and to categorize and analyse it qualitatively to reveal the current state of e-health research and development in the region. Inclusion criteria included peer-reviewed articles, books, book chapters, conference papers and graduate theses written on e-health in the GCC. Blogs, health websites and non-peer-reviewed literature were excluded. Results Three hundred and six articles were retrieved, categorized and analysed qualitatively to reveal the state of e-health research in the GCC. Both country-specific and GCC-wide major themes were identified using NVivo 10.0 qualitative software and summarized. The most common type of study was an overview (35.0%), with common study designs of case studies (26.8%) and descriptive articles (46.4%). Significant themes were: prospective national benefits from e-health, implementation and satisfaction with electronic health records, online technologies in medical education, innovative systems (case studies), and information security and personal health information. Discussion This is the first comprehensive analytical literature review of e-health in the GCC. Important research gaps were identified: few cost-benefit analyses, controlled interventional studies, or research targeting gender and religious issues were retrieved.

Tapping into the "Hidden" Home and Community Resources of Students

ERIC Educational Resources Information Center

Moll, Luis C.

2015-01-01

The author provides an overview of a "funds of knowledge" approach and presents three different adaptations of the approach with a common theme of expanding teachers' and students' resources for learning.

Nursing Students' Qualitative Experiences in the Medical-Surgical Clinical Learning Environment: A Cross-Cultural Integrative Review.

PubMed

Hooven, Katie

2015-08-01

The nature of the clinical learning environment has a huge impact on student learning. For instance, research has supported the idea that a positive learning environment increases student learning. Therefore, the ability to gain information from the student perspective about the learning environment is essential to nursing education. This article reviews qualitative research on nursing students' experiences of the clinical learning environment. The significance of the issue, the purpose of the integrative review, the methods used in the literature search, and the results of the review are presented. Seventeen studies from 12 countries are identified for review, and six common themes are discussed. An exhaustive literature review revealed that among the 17 articles evaluated, six themes were common. The findings indicate the need to continue quality improvement to advance clinical education. Copyright 2015, SLACK Incorporated.

The Patient Passport Program: An Intervention to Improve Patient-Provider Communication for Hospitalized Minority Children and Their Families.

PubMed

Lee, Lois K; Mulvaney-Day, Norah; Berger, Anne M; Bhaumik, Urmi; Nguyen, Hiep T; Ward, Valerie L

2016-07-01

Effective patient-provider communication is essential to improve health care delivery and satisfaction and to minimize disparities in care for minorities. The objective of our study was to evaluate the impact of a patient-provider communication program, the Patient Passport Program, to improve communication and satisfaction for hospitalized minority children. This was a qualitative evaluation of a communication project for families with hospitalized children. Families were assigned to either the Patient Passport Program or to usual care. The Passport Program consisted of a personalized Passport book and additional medical rounds with medical providers. Semistructured interviews at the time of patient discharge were conducted with all participants to measure communication quality and patient/family satisfaction. Inductive qualitative methods were used to identify common themes. Of the 40 children enrolled in the Passport Program, 60% were boys; the mean age was 9.7 years (range, 0.16-19 years). The most common themes in the qualitative analysis of the interviews were: 1) organization of medical care; 2) emotional expressions about the hospitalization experience; and 3) overall understanding of the process of care. Spanish- and English-speaking families had similar patient satisfaction experiences, but the Passport families reported improved quality of communication with the medical care team. The Patient Passport Program enhanced the quality of communication among minority families of hospitalized children with some common themes around the medical care expressed in the Passport book. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

An Analysis of the Status of Curriculum Reform and Textbook Production in Indonesia.

ERIC Educational Resources Information Center

Theisen, Gary; And Others

Curriculum reform in Indonesia during the past 2 decades has been marked by several themes. These themes include an increased emphasis on educational outcomes, greater standardization in instructional practices, improved teacher quality, and increased locally relevant curricula. Some problems recognized include an overloading of instructional time…

Qualitative Methods in the Development of a Bilingual and Bicultural Quality of Life Outcomes Measure for Pediatric Patients With Craniofacial Conditions.

PubMed

Tapia, Viridiana Juarez; Drizin, Julia Helene; Dalle Ore, Cecilia; Nieto, Marcelo; Romero, Yajahira; Magallon, Sandra; Nayak, Rohith; Sigler, Alicia; Malcarne, Vanessa; Gosman, Amanda

2017-05-01

Craniofacial surgeons treat patients with diverse craniofacial conditions (CFCs). Yet, little is known about the health-related quality of life (HRQoL) impact of diverse CFCs. Currently, there are no suitable instruments that measure the HRQoL of patients with diverse CFCs from the perspective of children and parents. The objective of this study was to develop the items and support the content validity of a comprehensive patient and parent-reported outcomes measure. An iterative process consisting of a systematic literature review, expert opinion and in-depth interviews with patients and parents of patients with diverse CFCs was used. The literature review and expert opinion were used to generate in-depth interview questions. We interviewed 127 subjects: 80 parents of patients ages 0 to 18 years or older and 47 patients ages 7 to 18 years or older. English and Spanish speakers were represented in our sample. The majority of subjects originated from the United States and Mexico (83%). Craniofacial conditions included were cleft lip/palate, craniosynostosis, craniofacial microsomia, microtia, and dermatological conditions. Semistructured interviews were conducted until content saturation was achieved. Line-by-line analysis of interview transcripts identified HRQoL themes. Themes were interpreted and organized into larger domains that represent the conceptual framework of CFC-associated HRQoL. Themes were operationalized into items that represent the HRQoL issues of patients for both parent and patient versions. Six final bilingual and bicultural scales based on the domains derived from the literature review, expert opinion, and in-depth interviews were developed: (1) "Social Impact," (2) "Psychological Function," (3) "Physical Function," (4) "Family Impact," (5) "Appearance," And (6) "Finding Meaning." Some cultural differences were identified: in contrast to children from Mexico and other developing nations, families from the United States did not report public harassment or extremely negative public reactions to patients' CFC. Religion and spirituality were common themes in interviews of Spanish-speaking subjects but less common in interviews of English-speaking subjects. Qualitative methods involving pediatric patients with diverse CFCs and their parents in the item development process support the content validity for this bilingual and bicultural HRQoL instrument. The items developed in this study will now undergo psychometric testing in national multisite studies for validation.

Global History. A Curriculum Guide. Second Semester. Theme V: The Industrial Revolution Had Global Impact. Teacher Strategies. Experimental Edition.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

Designed to assist teachers and supervisors in the implementation of the global history course, this bulletin presents learning activities which include the rationale, performance objectives, and teaching strategies related to Theme V entitled, "The Industrial Revolution Had Global Impact." This theme has seven subthemes: (1)…

A holistic conceptual framework model to describe medication adherence in and guide interventions in diabetes mellitus.

PubMed

Jaam, Myriam; Awaisu, Ahmed; Mohamed Ibrahim, Mohamed Izham; Kheir, Nadir

2018-04-01

Nonadherence to medications in patients with diabetes, which results in poor treatment outcomes and increased healthcare costs, is commonly reported globally. Factors associated with medication adherence have also been widely studied. However, a clear and comprehensive, disease-specific conceptual framework model that captures all possible factors has not been established. This study aimed to develop a conceptual framework that addresses the complex network of barriers to medication adherence in patients with diabetes. Fourteen databases and grey literature sources were systematically searched for systematic reviews reporting barriers to medication adherence in patients with diabetes. A thematic approach was used to categorize all identified barriers from the reviews and to create a matrix representing the complex network and relations of the different barriers. Eighteen systematic reviews were identified and used for the development of the conceptual framework. Overall, six major themes emerged: patient-, medication-, disease-, provider-, system-, and societal-related factors. Each of these themes was further classified into different sub-categories. It was noted that most interactions were identified to be within the patient-related factors, which not only interact with other themes but also within the same theme. Patient's demographics as well as cultural beliefs were the most notable factors in terms of interactions with other categories and themes. The intricate network and interaction of factors identified between different themes and within individual themes indicate the complexity of the problem of adherence. This framework will potentially enhance the understanding of the complex relation between different barriers for medication adherence in diabetes and will facilitate design of more effective interventions. Future interventions for enhancing medication adherence should look at the overall factors and target multiple themes of barriers to improve patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

A Fair Slice of the Pie? Problematising the Dispersal of Government Funds to Australian Universities

ERIC Educational Resources Information Center

Heffernan, Troy A.

2017-01-01

A common theme in higher education research is the factors that affect university funding. Studies frequently examine how universities cope with funding cuts and the changes that have stemmed from operating in a neoliberal age, a period that now sees institutions commonly functioning on a cost/benefit basis. This paper offers an original…

Using a Template to Facilitate External Peer Preview of Curriculum: A Variation on the PRoT Theme

ERIC Educational Resources Information Center

Sealey, Rebecca

2013-01-01

Peer reviewing of teaching and curriculum in Higher Education is a common practice aimed at both quality assurance and professional development. External review of curriculum prior to implementation appears less common. The aim of this project was to develop, implement and evaluate a user-friendly process for external peer preview of teaching…

An investigation of the international literature on nurse practitioner private practice models.

PubMed

Currie, J; Chiarella, M; Buckley, T

2013-12-01

To investigate and synthesize the international literature surrounding nurse practitioner (NP) private practice models in order to provide an exposition of commonalities and differences. NP models of service delivery have been established internationally and most are based in the public healthcare system. In recent years, opportunities for the establishment of NP private practice models have evolved, facilitated by changes in legislation and driven by identification of potential patient need. To date, NP private practice models have received less attention in the literature and, to the authors' knowledge, this is the first international investigation of NP private practice models. Integrative literature review. A literature search was undertaken in October 2012. Database sources utilized included Medical Literature Analyses and Retrieval (MEDLINE), the Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Scopus and the Cochrane Database of Systematic Reviews (CDSR). The grey literature was also searched. The following Medical Subject Headings (MeSH) and search terms used both individually and in combination included nurse practitioners; private practice; joint practice; collaboration; and insurance, health and reimbursement. Once literature had been identified, a thematic analysis was undertaken to extract themes. Thirty manuscripts and five publications from the grey literature were included in the final review. Private practice NP roles were identified in five countries, with the majority of the literature emanating from the USA. The thematic analysis resulted in the identification of five themes: reimbursement, collaborative arrangements, legislation, models of care and acceptability. Proportionally, there are very few NPs engaged in private practice internationally. The most common NP private practice models were community based, with NPs working in clinic settings, either alone or with other health professionals. Challenges in the context of legislation and financial reimbursement were identified in each country where private practice is being undertaken. © 2013 International Council of Nurses.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

PubMed

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

PubMed Central

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making. PMID:26295159

Attributions and private theories of mental illness among young adults seeking psychiatric treatment in Nairobi: an interpretive phenomenological analysis.

PubMed

Mbuthia, Judy Wanjiru; Kumar, Manasi; Falkenström, Fredrik; Kuria, Mary Wangari; Othieno, Caleb Joseph

2018-01-01

Mental illness affects every segment of population including young adults. The beliefs held by young patients regarding the causes of mental illness impact their treatment-seeking behaviour. It is pertinent to know the commonly held attributions around mental illness so as to effectively provide psychological care, especially in a resource constrained context such as Kenya. This helps in targeting services around issues such as stigma and extending youth-friendly services. Guided by the private theories interview (PTI-P) and attributional framework, individual semi-structured interviews were carried out with ten young adults of ages 18-25 years about their mental health condition for which they were undergoing treatment. Each interview took 30-45 min. We mapped four attributions (locus of control, stability, controllability and stigma) on PTI-P questions. Data was transcribed verbatim to produce transcripts coded using interpretive phenomenological analysis. These codes were then broken down into categories that could be used to understand various attributions. We found PTI-P to be a useful tool and it elicited three key themes: (a) psychosocial triggers of distress (with themes of negative thoughts, emotions around mental health stigma and negative childhood experiences, parents' separation or divorce, death of a loved one etc.), (b) biological conditions and psychopathologies limiting intervention, and (c) preferences and views on treatment. Mapping these themes on our attributional framework, PTI-P themes presented as causal attributions explaining stigma, locus of control dimensions and stability. External factors were mainly ascribed to be the cause of unstable and uncontrollable attributions including persistent negative emotions and thoughts further exacerbating psychological distress. Nine out of the ten participants expressed the need for more intense and supportive therapy. Our study has provided some experiential evidence in understanding how stigma, internal vs external locus of control, stability vs instability attributions play a role in shaping attitudes young people have towards their mental health. Our study points to psychosocial challenges such as stigma, poverty and lack of social support that continue to undermine mental well-being of Kenyan youth. These factors need to be considered when addressing mental health needs of young people in Kenya.

Human reproduction in art: from myths to history.

PubMed

Petraglia, Felice; Bettini, Maurizio

2010-08-01

Conception, gestation, and birth, including maternal-fetal health, have been the subject of narrative and art since early human history. Myth and histories related to pregnancy were represented by sculptors and painters as well as the subject of several operas: the mystery of reproduction was always a fascinating theme. This mystery was commonly represented across cultures and time, in the old world, from Egypt to India, to Greece and Rome continuing until the Renaissance and the Modern period. To be an artist meant also to be a scientist in several societies. The current paper reports 12 examples of the fusion of art and reproductive science.

30 years of Physics Education Research at the University of Washington

NASA Astrophysics Data System (ADS)

Shaffer, Peter S.

2017-01-01

Over the past 30 years, members of the UW Physics Education Group have examined student learning in courses serving a wide range of populations. Most of the focus has been on elementary, middle, and high school teachers and students in introductory university physics courses, but more recently, the effort has expanded to include physics majors in upper-division courses on quantum mechanics and electrodynamics. In general, the group has taken a practical approach that focuses on identifying instructional strategies that are effective at promoting conceptual understanding and student reasoning ability. Examples will be drawn from across these courses to illustrate common themes and connections.

Unraveling the "known unknowns": lessons and reflections from the new directions in leukemia research 2012 conference.

PubMed

White, Deborah L; Brown, Anna L; D'Andrea, Richard J; Rice, Alison M

2012-09-01

Patients diagnosed with leukemia approach their treatment with the hope of cure despite the effect on their quality of life. Some patients will be cured, others will die from treatment, and some will die of their disease. A common theme at the New Directions in Leukemia Research (NDLR 2012) meeting was that cure will come if the drivers of the disease are better understood. Key messages included the power of combination platforms to understand the genetic and epigenetic modifications in leukemia to enable development of rational therapies, which can be tested via new clinical trial designs ensuring rapid clinical implementation. ©2012 AACR.

Experiences of Sleep and Benzodiazepine Use among Older Women

PubMed Central

Rubinstein, Robert L.

2015-01-01

Sleep disturbances are common among older women; however, little is known about sleep experiences among chronic benzodiazepine users. The experience of sleep, sleep troubles, and management of sleep problems were explored through semi-structured interviews with 12 women aged 65 to 92 who had used a benzodiazepine for three months or longer to treat a sleep disturbance. Themes that emerged from an interpretive phenomenological analysis included multiple reasons for sleep disruptions (health problems, mental disturbances, and sleeping arrangements); opposing effects of benzodiazepines on sleep (helps or does not work); and several supplemental sleep strategies (modification of the environment, distraction, and consumption). PMID:25581296

Surviving in a frozen desert: environmental stress physiology of terrestrial Antarctic arthropods.

PubMed

Teets, Nicholas M; Denlinger, David L

2014-01-01

Abiotic stress is one of the primary constraints limiting the range and success of arthropods, and nowhere is this more apparent than Antarctica. Antarctic arthropods have evolved a suite of adaptations to cope with extremes in temperature and water availability. Here, we review the current state of knowledge regarding the environmental physiology of terrestrial arthropods in Antarctica. To survive low temperatures, mites and Collembola are freeze-intolerant and rely on deep supercooling, in some cases supercooling below -30°C. Also, some of these microarthropods are capable of cryoprotective dehydration to extend their supercooling capacity and reduce the risk of freezing. In contrast, the two best-studied Antarctic insects, the midges Belgica antarctica and Eretmoptera murphyi, are freeze-tolerant year-round and rely on both seasonal and rapid cold-hardening to cope with decreases in temperature. A common theme among Antarctic arthropods is extreme tolerance of dehydration; some accomplish this by cuticular mechanisms to minimize water loss across their cuticle, while a majority have highly permeable cuticles but tolerate upwards of 50-70% loss of body water. Molecular studies of Antarctic arthropod stress physiology are still in their infancy, but several recent studies are beginning to shed light on the underlying mechanisms that govern extreme stress tolerance. Some common themes that are emerging include the importance of cuticular and cytoskeletal rearrangements, heat shock proteins, metabolic restructuring and cell recycling pathways as key mediators of cold and water stress in the Antarctic.

Factors Associated With Utilization of Cardiac Rehabilitation Among Patients With Ischemic Heart Disease in the Veterans Health Administration: A QUALITATIVE STUDY.

PubMed

Schopfer, David W; Priano, Susan; Allsup, Kelly; Helfrich, Christian D; Ho, P Michael; Rumsfeld, John S; Forman, Daniel E; Whooley, Mary A

2016-01-01

Cardiac rehabilitation (CR) programs reduce morbidity and mortality in patients with ischemic heart disease but are vastly underutilized in the United States, including the Veterans Health Administration (VA) Healthcare System. Numerous barriers affecting utilization have been identified in other health care systems, but the specific factors affecting Veterans are unknown. We sought to identify barriers and facilitators associated with utilization of CR in VA facilities. We performed a qualitative study of 56 VA patients, providers, and CR program managers at 30 VA facilities across the United States. We conducted semistructured interviews with key informants to explore their attitudes and knowledge toward CR. Interviews were conducted until thematic saturation occurred. Analyses using grounded theory to identify key themes were conducted using the qualitative data analysis package ATLAS.ti. We identified 6 themes as barriers and 5 as facilitators. The most common barriers to participation in CR were patient transportation issues (68%), lack of patient willingness to participate (41%), and no access to a nearby VA hospital with a CR program (30%). The most common facilitators were involvement of a dedicated provider or "clinical champion" (50%), provider knowledge of or experience with CR (48%), and patient desire for additional medical support (32%). Our findings suggest that addressing access issues and educating and activating providers on CR may increase utilization of CR programs. Targeting these specific factors may improve utilization of CR programs.

Global History. A Curriculum Guide. Third Semester. Theme VI: Nineteenth Century Imperialism Affected the Imperial Powers and the Colonies. Teacher Strategies. Experimental Edition.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

Designed to assist teachers and supervisors in the implementation of the global history course, this bulletin presents learning activities which include the rationale, performance objectives, and teaching strategies related to Theme VI entitled, "Nineteenth Century Imperialism Affected the Imperial Powers and the Colonies." This theme has seven…

Supporting Lesbian, Gay, Bisexual, & Transgender Inclusivity in Long-Term Care Homes: A Canadian Perspective.

PubMed

Sussman, Tamara; Brotman, Shari; MacIntosh, Heather; Chamberland, Line; MacDonnell, Judith; Daley, Andrea; Dumas, Jean; Churchill, Molly

2018-06-01

ABSTRACTIt is critical to ensure that long-term care (LTC) homes are sensitive to the needs of lesbian, gay, bisexual, and transgender (LGBT) older adults. However, the extent to which the LTC home sector has adopted recommended strategies is unknown. This qualitative study reports findings from two initiatives: Semi-structured telephone interviews with Canadian LTC home administrators on strategies adopted to support LGBT inclusivity (n = 32), and discussions with participants attending a 2-day meeting on supporting LGBT inclusivity in LTC (n = 25). We found that LGBT inclusivity training was the most commonly adopted strategy among the LTC homes surveyed. Study findings further suggested that practices more visible to residents and families, such as LGBT-themed programming, inclusive language and symbols, or joint initiatives with LGBT communities, were less commonly adopted because of anticipated negative resident/family reactions. The importance and benefits of comprehensive strategies that include staff, residents, and family are discussed.

Conceptual boundaries and distances: Students' and experts' concepts of the scale of scientific phenomena

NASA Astrophysics Data System (ADS)

Tretter, Thomas R.; Jones, M. Gail; Andre, Thomas; Negishi, Atsuko; Minogue, James

2006-03-01

To reduce curricular fragmentation in science education, reform recommendations include using common, unifying themes such as scaling to enhance curricular coherence. This study involved 215 participants from five groups (grades 5, 7, 9, and 12, and doctoral students), who completed written assessments and card sort tasks related to their conceptions of size and scale, and then completed individual interviews. Results triangulated from the data sources revealed the boundaries between and characteristics of scale size ranges that are well distinguished from each other for each group. Results indicate that relative size information was more readily understood than exact size, and significant size landmarks were used to anchor this relational web of scales. The nature of past experiences situated along two dimensions - from visual to kinesthetic in one dimension, and wholistic to sequential in the other - were shown to be key to scale cognition development. Commonalities and differences between the groups are highlighted and discussed.

The future of meat: a qualitative analysis of cultured meat media coverage.

PubMed

Goodwin, J N; Shoulders, C W

2013-11-01

This study sought to explore the informational themes and information sources cited by the media to cover stories of cultured meat in both the United States and the European Union. The results indicated that cultured meat news articles in both the United States and the European Union commonly discuss cultured meat in terms of benefits, history, process, time, livestock production problems, and skepticism. Additionally, the information sources commonly cited in the articles included cultured meat researchers, sources from academia, People for the Ethical Treatment of Animals (PETA), New Harvest, Winston Churchill, restaurant owners/chefs, and sources from the opposing countries (e.g. US use some EU sources and vice versa). The implications of this study will allow meat scientists to understand how the media is influencing consumers' perceptions about the topic, and also allow them to strategize how to shape future communication about cultured meat. Published by Elsevier Ltd.

Is anybody listening? A phenomenological study of pain in hospitalized persons with AIDS.

PubMed

Newshan, G

1998-01-01

Pain is a common problem among hospitalized persons with AIDS (PWAs), yet it has not been well studied. The purpose of this study was to understand, using the phenomenological method, the experience of pain in hospitalized PWAs. Multiple sources of data, including interviews with 11 hospitalized PWAs, literature, poetry, and film, were used to investigate the phenomenon. Five broad themes emerged: knowing pain, battling pain, having AIDS, pain's influence, and being a drug user. Multiple barriers to effective pain management were identified. Although there were commonalities in the experience of pain in chemically dependent and nonchemically dependent PWAs, unique challenges for the chemically dependent PWAs were identified. The findings indicate the importance of listening to and believing reports of pain. In addition, the findings underscore the delicate balance that exists between pain relief and relapse in PWAs with a history of chemical dependency.

Priorities of Legislatively-Active Veteran Services Organizations: A Content Analysis and Review for Health Promotion Initiatives

PubMed Central

Jahnke, Sara A.; Haddock, Christopher K.; Carlos Poston, Walker S.; Jitnarin, Nattinee

2014-01-01

Military and Veterans Service Organizations (MVSOs) have a unique opportunity to influence legislation and advocate for the interests of their members. However, little is known about what legislative priorities MVSOs see as important. Understanding the legislative priorities of MVSOs can inform efforts by health scientists to promote policy and laws designed to improve the health of our nation’s veterans. Using a mixed methods approach, we conducted a thematic analysis of legislative priorities MVSOs promote with their legislative agendas. Most commonly, MVSOs addressed issues related to disability evaluations and ratings with the Veterans Administration (VA) and access to VA services. Other common themes identified as priorities include benefits such as retirement, education, housing assistance for veterans, and TRICARE benefits. Findings highlight the broad range of topics MVSOs identify as legislative priorities as well as some health issues that receive relatively limited attention. PMID:25373063

Squamous cell carcinoma – similarities and differences among anatomical sites

PubMed Central

Yan, Wusheng; Wistuba, Ignacio I; Emmert-Buck, Michael R; Erickson, Heidi S

2011-01-01

Squamous cell carcinoma (SCC) is an epithelial malignancy involving many anatomical sites and is the most common cancer capable of metastatic spread. Development of early diagnosis methods and novel therapeutics are important for prevention and mortality reduction. In this effort, numerous molecular alterations have been described in SCCs. SCCs share many phenotypic and molecular characteristics, but they have not been extensively compared. This article reviews SCC as a disease, including: epidemiology, pathology, risk factors, molecular characteristics, prognostic markers, targeted therapy, and a new approach to studying SCCs. Through this comparison, several themes are apparent. For example, HPV infection is a common risk factor among the four major SCCs (NMSC, HNSC, ESCC, and NSCLC) and molecular abnormalities in cell-cycle regulation and signal transduction predominate. These data reveal that the molecular insights, new markers, and drug targets discovered in individual SCCs may shed light on this type of cancer as a whole. PMID:21938273

The Interface between Fungal Biofilms and Innate Immunity.

PubMed

Kernien, John F; Snarr, Brendan D; Sheppard, Donald C; Nett, Jeniel E

2017-01-01

Fungal biofilms are communities of adherent cells surrounded by an extracellular matrix. These biofilms are commonly found during infection caused by a variety of fungal pathogens. Clinically, biofilm infections can be extremely difficult to eradicate due to their resistance to antifungals and host defenses. Biofilm formation can protect fungal pathogens from many aspects of the innate immune system, including killing by neutrophils and monocytes. Altered immune recognition during this phase of growth is also evident by changes in the cytokine profiles of monocytes and macrophages exposed to biofilm. In this manuscript, we review the host response to fungal biofilms, focusing on how these structures are recognized by the innate immune system. Biofilms formed by Candida, Aspergillus , and Cryptococcus have received the most attention and are highlighted. We describe common themes involved in the resilience of fungal biofilms to host immunity and give examples of biofilm defenses that are pathogen-specific.

Experiences and concerns of family caregivers providing support to people with dementia: a cross-cultural perspective.

PubMed

Ivey, Susan L; Laditka, Sarah B; Price, Anna E; Tseng, Winston; Beard, Renée L; Liu, Rui; Fetterman, David; Wu, Bei; Logsdon, Rebecca G

2013-11-01

We examined experiences and concerns among caregivers of community-dwelling people with dementia from two ethnic groups. We conducted a thematic analysis of responses to the question, 'What is your life like as a caregiver?' in nine focus groups (n = 75) with Filipino and non-Hispanic White caregivers. Constant comparison methods identified themes by ethnicity. Experiences and concerns expressed across groups were related to care recipient symptoms commonly associated with dementia, including severe memory loss and behavioral changes. Participants in both ethnic groups described strategies that help them cope, such as receiving help from family and friends, receiving respite support, and participating in support groups. Filipino caregivers more often emphasized positive aspects of caregiving, whereas Whites often expressed that others do not understand the daily experiences of caregiving. Filipinos more commonly described caregivers as a 'good person' or 'saint' and emphasized that caregiving made them stronger.

Latino Definitions of Success: A Cultural Model of Intercultural Competence

PubMed Central

Torres, Lucas

2010-01-01

The present study sought to examine Latino intercultural competence via two separate methodologies. Phase 1 entailed discovering and generating themes regarding the features of intercultural competence based on semistructured interviews of 15 Latino adults. Phase 2 included conducting a cultural consensus analysis from the quantitative responses of 46 Latino adults to determine the cultural model of intercultural competence. The major results indicated that the participants, despite variations in socioeconomic and generational statuses, shared a common knowledge base regarding the competencies needed for Latinos to successfully navigate different cultures. Overall, the cultural model of Latino intercultural competence includes a set of skills that integrates traditional cultural values along with attributes of self-efficacy. The findings are discussed within a competence-based conceptualization of cultural adaptation and potential advancements in acculturation research. PMID:20333325

Professional formation and deformation: repression of personal values and qualities in medical education.

PubMed

Rabow, Michael W; Evans, Carrie N; Remen, Rachel N

2013-01-01

During medical training, students gain professional competence but may lose elements of personal humanity. Little is known about what personal qualities or values students themselves experience to be at risk or surrendered during medical school. Medical students participating in the Healer's Art elective in the United States and internationally during 2008--2009 were asked to reflect, identify, and draw a part of themselves that they were wary about revealing, not comfortable showing, or felt may be diminished in medical school and label this part with a word. Using a team-based qualitative approach, these words were categorized into common themes and the themes analyzed using descriptive and chi-square statistics. Words from 673 students from 31 medical schools were analyzed. Most students were female (58.7%) and in their first year (86.3%). Eleven themes were identified: spirituality, emotional engagement, identity/self-expression, freedom/spontaneity, relationships, self-care, creativity, negative emotions, values, other, and joy/happiness. The most common individual words used were creativity, family, balance, freedom, love, peace, compassion, relationships, and reflection. There were only rare differences in distributions of themes across gender, year in school, school size, or school nationality. An international cadre of Healer's Art students identified core personal qualities and values that they may not reveal or feel may be diminished in medical school. Medical training involves not only professional formation but exposure to professional deformation as well. Educators must attend to both gains in professional competence and the personal qualities and values that are at risk in the course of professional development.

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis.

PubMed

Stautz, Kaidy; Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M

2017-02-28

In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter. Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis. A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding. This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Parents' descriptions of young children's dissociative reactions after trauma.

PubMed

Cintron, Gabriela; Salloum, Alison; Blair-Andrews, Zoe; Storch, Eric A

2017-10-09

There is limited research on the phenomenology of how young children who have been exposed to trauma express the intrusive symptom of dissociative reactions. The current qualitative study utilized interviews from a semi-structured diagnostic clinical interview with 74 caregivers of young children (ages 3 to 7) who were exposed to trauma to identify parents' descriptions of their children's dissociative reactions during a clinical interview. Based on results from the interview, 45.9% of the children had dissociative reactions (8.5% had flashbacks and 41.9% had dissociative episodes). Interviews were transcribed to identify themes of dissociative reactions in young children. Common themes to flashbacks and dissociative episodes included being triggered, being psychologically in their own world (e.g., spaced out and shut down), and displaying visible signs (e.g., crying and screaming). For flashbacks, caregivers reported that it seemed as if the child was re-experiencing the trauma (e.g., yelling specific words and having body responses). For dissociative episodes, caregivers noted that the child not only seemed psychologically somewhere else (e.g., distant and not there) but also would be physically positioned somewhere else (e.g., sitting and not responding). Caregivers also expressed their own reactions to the child's dissociative episode due to not understanding what was occurring, and trying to interrupt the occurrences (e.g., calling out to the child). Themes, descriptions, and phrases to describe dissociative reactions in young children after trauma can be used to help parents and professionals more accurately identify occurrences of dissociative reactions.

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

PubMed

Corazzini, Kirsten; Twersky, Jack; White, Heidi K; Buhr, Gwendolen T; McConnell, Eleanor S; Weiner, Madeline; Colón-Emeric, Cathleen S

2015-08-01

To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. © The Author 2014. 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.

Exploring the Sexuality of African American Older Women

PubMed Central

Laganá, Luciana; White, Theresa; Bruzzone, Daniel E.; Bruzzone, Cristine E.

2014-01-01

Aims To identify sexually-related themes of the sexuality of older African American women. Study Design Mixed method. Place and Duration of Study Department of Psychology, California State University Northridge, between July 2009 and June 2011. Methodology We included 13 African American older women (57 to 82 years of age), 11 of whom self-identified as heterosexual, one as bisexual, and one as lesbian. We used a semi-structured interview protocol through which we explored some aspects of the respondents’ sexuality (assessed at a superficial level, to be as tactful as possible). Moreover, we collected information on demographics and self-rated physical health. Two co-authors served as coders, and used content analysis to identify the most salient sexuality themes. Results Emerging themes were (in order from most to least endorsed): having sexual desire (often unfulfilled); engaging in less sexual activity in older age; experiencing changes in one’s sexual life as a function of absence of a spouse; and exercising control over how one’s sexual life is conducted. Motivated by the paucity of our sexuality data, we have also provided suggestions to scholars interested in conducting more in-depth further research on this topic with older African American women. Conclusion Our findings indicate that the common notion that older women are asexual is a myth, while lack of a suitable sexual partner is a problem reported by many African American older women who would otherwise enjoy sexual interaction. PMID:25632380

OAST Theme Workshop. Volume 3: Working group summary. 8: Structures, dynamics (M-2). A. Statement. B. Technology needs (form 1). C. Priority assessments (form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

A technology program on large space structures was defined to respond to common need perceived for five of the six themes. Greatly expanded power, facilities, and communications/sensing requirements appear to demand a new structures technology for construction in space. Requirements to construct huge structural arrays with precision surfaces in space will need creative research efforts to identify practical structural elements and construction techniques. Requirements for advanced transportation structures were defined to respond to the space transportation theme. Because of the criticality of thermal structures to achieve lower cost transportation systems, renewed emphasis on technology in this area is recommended. A second technology needing renewed emphasis is the area of recovery and landing technology structures to permit full reuse of launch vehicle propulsion elements.

Pharmacy Students' Attitudes Toward Debt.

PubMed

Park, Taehwan; Yusuf, Akeem A; Hadsall, Ronald S

2015-05-25

To examine pharmacy students' attitudes toward debt. Two hundred thirteen pharmacy students at the University of Minnesota were surveyed using items designed to assess attitudes toward debt. Factor analysis was performed to identify common themes. Subgroup analysis was performed to examine whether students' debt-tolerant attitudes varied according to their demographic characteristics, past loan experience, monthly income, and workload. Principal component extraction with varimax rotation identified 3 factor themes accounting for 49.0% of the total variance: tolerant attitudes toward debt (23.5%); contemplation and knowledge about loans (14.3%); and fear of debt (11.2%). Tolerant attitudes toward debt were higher if students were white or if they had had past loan experience. These 3 themes in students' attitudes toward debt were consistent with those identified in previous research. Pharmacy schools should consider providing a structured financial education to improve student management of debt.

A qualitative meta-synthesis and theory of postpartum depression.

PubMed

Mollard, Elizabeth K

2014-09-01

To synthesize existing qualitative literature on the first-hand experiences of women suffering from postpartum depression (PPD), to uncover potential common themes, a meta-synthesis of 12 qualitative studies using Noblit and Hare's 7-phase model of meta-ethnography was used. Four themes were discovered: crushed maternal role expectation, going into hiding, loss of sense of self, intense feelings of vulnerability, plus practical life concerns. A preliminary theory of PPD as a 4-step process is proposed, based on the relationships between the themes in this meta-synthesis. This 4-step process is compared and contrasted with Cheryl Tatano Beck's 4-stage theory of PPD "Teetering on the Edge". This meta-synthesis and theory offers a significant contribution to the literature in helping identify PPD distinctly from depression outside of the postpartum period, and deserves further study.

Women's experiences of three early miscarriage management options a qualitative study

PubMed Central

Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

2006-01-01

Background Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. Aim To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Design of study Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Setting Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Method Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5–2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Results Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the ‘baby’; and pain and bleeding. Conclusions Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and problems from the women's point of view. Competence and caring from professionals are especially important. PMID:16536960

Women's experiences of three early miscarriage management options: a qualitative study.

PubMed

Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

2006-03-01

Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5-2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the 'baby'; and pain and bleeding. Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and problems from the women's point of view. Competence and caring from professionals are especially important.

Transient disablement in the physically active with musculoskeletal injuries, part I: a descriptive model.

PubMed

Vela, Luzita I; Denegar, Craig

2010-01-01

Disablement theory has been characterized as the sequence of events that occurs after an injury, but little research has been conducted to establish how disablement is experienced and described by physically active persons. To describe the disablement process in physically active persons with musculoskeletal injuries. Concurrent, embedded mixed-methods study. For the qualitative portion, interviews were conducted to create descriptive disablement themes. For the quantitative portion, frequencies analysis was used to identify common terminology. National Collegiate Athletic Association Division I collegiate and club sports, collegiate intramural program, large high school athletics program, and outpatient orthopaedic center. Thirty-one physically active volunteers (15 males, 16 females; mean age  =  21.2 years; range, 14-53 years) with a current injury (18 lower extremity injuries, 13 upper extremity injuries) participated in individual interviews. Six physically active volunteers (3 males, 3 females; mean age  =  22.2 years; range, 16-28 years) participated in the group interview to assess trustworthiness. We analyzed interviews through a constant-comparison method, and data were collected until saturation occurred. Common limitations were transformed into descriptive themes and were confirmed during the group interview. Disablement descriptors were identified with frequencies and fit to the themes. A total of 15 overall descriptive themes emerged within the 4 disablement components, and descriptive terms were identified for each theme. Impairments were marked by 4 complaints: pain, decreased motion, decreased muscle function, and instability. Functional limitations were denoted by problems with skill performance, daily actions, maintaining positions, fitness, and changing directions. Disability consisted of problems with participation in desired activities. Lastly, problems in quality of life encompassed uncertainty and fear, stress and pressure, mood and frustration, overall energy, and altered relationships. A preliminary generic outcomes instrument was generated from the findings. Our results will help clinicians understand how disablement is described by the physically active. The findings also have implications for how disablement outcomes are measured.

What are the characteristics of perinatal events perceived to be traumatic by midwives?

PubMed

Sheen, Kayleigh; Spiby, Helen; Slade, Pauline

2016-09-01

there is potential for midwives to indirectly experience events whilst providing clinical care that fulfil criteria for trauma. This research aimed to investigate the characteristics of events perceived as traumatic by UK midwives. as part of a postal questionnaire survey conducted between December 2011 and April 2012, midwives (n=421) who had witnessed and/or listened to an account of an event and perceived this as traumatic for themselves provided a written description of their experience. A traumatic perinatal event was defined as occurring during labour or shortly after birth where the midwife perceived the mother or her infant to be at risk, and they (the midwife) had experienced fear, helplessness or horror in response. Descriptions of events were analysed using thematic analysis. Witnessed (W; n=299) and listened to (H; n=383) events were analysed separately and collated to identify common and distinct themes across both types of exposure. six themes were identified, each with subthemes. Five themes were identified in both witnessed and listened to accounts and one was salient to witnessed accounts only. Themes indicated that events were characterised as severe, unexpected and complex. They involved aspects relating to the organisational context; typically limited or delayed access to resources or personnel. There were aspects relating to parents, such as having an existing relationship with the parents, and negative perceptions of the conduct of colleagues. Traumatic events had a common theme of generating feelings of responsibility and blame Finally for witnessed events those that were perceived as traumatic sometimes held personal salience, so resonated in some way with the midwife's own life experience midwives are exposed to events as part of their work that they may find traumatic. Understanding the characteristics of the events that may trigger this perception may facilitate prevention of any associated distress and inform the development of supportive interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Initiation Theme in Adolescent Literature.

ERIC Educational Resources Information Center

Ramsey, Joseph; Thompson, C. Lamar

1979-01-01

A Package of classroom activities is presented on the theme of initiation, with suggestions of many titles from adolescent literature. Ideas for including rock music, movies, and television programs are also given. (SJL)

Health impact assessment of urban waterway decisions.

PubMed

Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B J; Daniell, William; Erdmann, Jared; Garrison, Valerie

2014-12-25

Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a "health lens". This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond.

Health Impact Assessment of Urban Waterway Decisions

PubMed Central

Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B.J.; Daniell, William; Erdmann, Jared; Garrison, Valerie

2014-01-01

Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a “health lens”. This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond. PMID:25547399

Treatment of Child Victims of Incest.

ERIC Educational Resources Information Center

Boatman, Bonny; And Others

1981-01-01

Reviews three treatment methods (individual, group, and family therapy) used over a five-year period for child incest victims. Presents common themes, issues, and pitfalls that arose during therapy. Stresses potential benefits of psychotherapy to this population. (Author)

Kierkegaard's Philosophy: Implications for Counseling.

ERIC Educational Resources Information Center

Dopson, Lorraine; Gade, Eldon

1981-01-01

Discusses how the philosophy of Soren Kierkegaard can provide useful guidelines for the study of the counseling process. Compares Kierkegaard's philosophy with selected contributions of Freud, Skinner, Rogers, and May and with four common themes of counseling and psychotherapy. (Author)

Deck the Halls. Animated Displays: Coupled Mechanical Oscillators.

ERIC Educational Resources Information Center

Pizzo, Joe, Ed.

1992-01-01

Describes a set of displays on the theme of coupled mechanical oscillators. Displays encompass three common demonstrations: (1) a coupled pair of identical pendulums; (2) a multiple-pendulum resonance demonstration; and (3) a Wilberforce coupled oscillator. (MDH)

Typology of intimate partner homicide: personal, interpersonal, and environmental characteristics of men who murdered their female intimate partner.

PubMed

Elisha, Ety; Idisis, Yael; Timor, Uri; Addad, Moshe

2010-08-01

Fifteen inmates from Ayalon prison, a maximum-security prison in Israel, who were convicted of murder, attempted murder, or manslaughter of their female intimate partner, have participated in a study designed to examine integrated variables-personal, interpersonal, and environmental-familial-connected with this phenomenon. Analyses of the in-depth interviews demonstrate that despite the different motivations the perpetrators displayed with regard to the murder, they share some common themes. On the basis of these themes, three primary types of female intimate partner murderers have been identified; each of them represents a personal narrative as follows: the betrayed, the abandoned, and the tyrant. The proposed typology might be used for establishing a common language among researchers, scholars, and workers in this field. It can also contribute to the existing clinical tools in terms of prediction, prevention, and treatment initiatives that currently focus on violence.

Commentary on the treatment of gender variant and gender dysphoric children and adolescents: common themes and ethical reflections.

PubMed

Stein, Edward

2012-01-01

This commentary offers preliminary ethical reflections on the range of treatments for gender variant and gender dysphoric children, adolescents, and young adults described in the preceding five clinical articles. After clarifying the terminology used to discuss these issues, this commentary reviews several common themes of the clinical articles. Focusing on ethical values of informed consent, full disclosure, the minimization or avoidance of harm, and the maximization of life options, the commentary expresses concerns about various treatment options endorsed by some of the articles. In particular, this commentary focuses on how these practices problematically reproduce social prejudices and stereotypes and how they fail to acknowledge and embrace the multiple pathways for expressing one's gender. It also compares and contrasts the ethical issues related to gender variant and gender dysphoric youths and youths who identify as lesbian, gay, bisexual, or queer.

Papers and Proceedings of the Annual Meeting of the Midwest History of Education Society (13th, Chicago, Illinois, October 28-29, 1977).

ERIC Educational Resources Information Center

Rutkowski, Edward, Ed.

1978-01-01

The papers in this document feature four themes: religion and education, the nature of childhood and its relationship to education, urban educational problems, and the character of educational journalism. Part 1 begins with "A Common Faith for the Common School? Religion and Education in Kansas, 1861-1900" (J. C. Carper) which compares…

Seeking unique and common biological themes in multiple gene lists or datasets: pathway pattern extraction pipeline for pathway-level comparative analysis.

PubMed

Yi, Ming; Mudunuri, Uma; Che, Anney; Stephens, Robert M

2009-06-29

One of the challenges in the analysis of microarray data is to integrate and compare the selected (e.g., differential) gene lists from multiple experiments for common or unique underlying biological themes. A common way to approach this problem is to extract common genes from these gene lists and then subject these genes to enrichment analysis to reveal the underlying biology. However, the capacity of this approach is largely restricted by the limited number of common genes shared by datasets from multiple experiments, which could be caused by the complexity of the biological system itself. We now introduce a new Pathway Pattern Extraction Pipeline (PPEP), which extends the existing WPS application by providing a new pathway-level comparative analysis scheme. To facilitate comparing and correlating results from different studies and sources, PPEP contains new interfaces that allow evaluation of the pathway-level enrichment patterns across multiple gene lists. As an exploratory tool, this analysis pipeline may help reveal the underlying biological themes at both the pathway and gene levels. The analysis scheme provided by PPEP begins with multiple gene lists, which may be derived from different studies in terms of the biological contexts, applied technologies, or methodologies. These lists are then subjected to pathway-level comparative analysis for extraction of pathway-level patterns. This analysis pipeline helps to explore the commonality or uniqueness of these lists at the level of pathways or biological processes from different but relevant biological systems using a combination of statistical enrichment measurements, pathway-level pattern extraction, and graphical display of the relationships of genes and their associated pathways as Gene-Term Association Networks (GTANs) within the WPS platform. As a proof of concept, we have used the new method to analyze many datasets from our collaborators as well as some public microarray datasets. This tool provides a new pathway-level analysis scheme for integrative and comparative analysis of data derived from different but relevant systems. The tool is freely available as a Pathway Pattern Extraction Pipeline implemented in our existing software package WPS, which can be obtained at http://www.abcc.ncifcrf.gov/wps/wps_index.php.

The Use of Online Health Forums by Patients With Chronic Cough: Qualitative Study

PubMed Central

Porter, Tom; Wilson, Andrew

2018-01-01

Background Online health discussion forums are used by different patient groups for sharing advice and information. Chronic cough is a common problem, and people with chronic cough use online health forums alongside formal medical therapies. Objective The objective of this study was to assess how chronic cough sufferers use online health forums, including the treatment advice they share with one another and the possible clinical uses of online forums in chronic cough. Methods Three open-access health forums were searched for threads related to chronic cough. Identified threads were screened against inclusion and exclusion criteria adapted from the British Thoracic Society (BTS) Guidelines related to chronic cough diagnosis. Included data were subjected to qualitative thematic analysis. All study data were cross-validated by a second author and discrepancies were resolved. Results In total, 96 threads were included in the analysis, consisting of posts by 223 forum users. Three main themes were identified: the effect of chronic cough on the lives of patients, the treatment advice shared between users, and the provision of support within forums. Conclusions Chronic cough symptoms had impacts on multiple aspects of patients’ health and well-being. To try and combat these issues, forum users suggested a variety of treatments to one another, ranging from mainstream traditional therapies to odd alternative remedies. The provision of support and empathy were also prominent themes in discussion threads. Online forums themselves may provide increasing benefit to users through the addition of a moderator. PMID:29367181

Evaluating Palliative Care Resources Available to the Public Using the Internet and Social Media.

PubMed

Claudio, Celeste H; Dizon, Zoelle B; October, Tessie W

2018-01-01

Accessible information about palliative care available to the public on the Internet is growing. We do not know whether this information is consistent with the current accepted definition of palliative care. To identify resources on the Internet and social media regarding palliative care and evaluate the information conveyed. A cross-sectional study of "palliative care" search results. Top 10 Google websites, top 10 most viewed YouTube videos, and social media platforms, Facebook and Twitter, were searched. The most popular Google websites were mostly from national organizations promoting palliative care, whose definitions of palliative care consistently mention "quality of life" and "relief from symptoms and stress." None of the websites mentioned children, and 77% cited palliative care as treatment for cancer with less focus on other diseases. No personal stories were included in Google websites, while 60% of YouTube videos included personal stories. Five main themes were generated from 266 YouTube video comments analyzed. The most common theme was emotionality, of which 91% were positive statements. Facebook and Twitter were mostly used by health-care professionals and not the public. Palliative care resources are mostly positive and consistent with the current definition of palliative care. Major Internet search engines such as Google and YouTube provide valuable insight into information the public receives about palliative care. Future development of Internet resources on palliative care should consider including children and emphasizing palliative care for all life-limiting illnesses.

How Can We Mobilize Action to Realize UHC in Asia?

PubMed

Akaza, Hideyuki; Kawahara, Norie; Fukuda, Takashi; Horie, Shigeo; Thabrany, Hasbullah; Nozaki, Shinjiro

2017-11-26

The 2016 World Cancer Congress, organised by UICC, was held in Paris in November 2016, under the theme “Mobilizing action – Inspiring Change.” As part of Track 4 presentations on the theme of “Strengthening cancer control: optimizing outcomes of health systems,” UICC-Asian Regional Office (UICC-ARO) held a symposium to discuss the issue of mobilizing action to realize UHC in Asia. Introducing the symposium, Hideyuki Akaza noted that universal health coverage (UHC) is included in the Sustainable Development Goals and one of the key issues for achieving UHC will be how to balance patient needs with the economic burden of cancer. Speakers from Japan and Indonesia addressed various issues, including the current status and challenges for medical economic evaluation in Asia, the importance of resource stratification, prospects for precision medicine, and the outlook for cancer control and UHC in developing and emerging countries in Asia. Key issues raised included how to respond to the rising costs of treating cancer as new and increasingly expensive drugs come to the market. Speakers and participants noted that health technology assessment programs are being developed around Asia in order to evaluate the cost-effectiveness of drugs in the face of budgetary constraints within increasingly pressurized national health systems. The importance of screening and early detection was also noted as effective means that have the potential to reduce reliance on expensive drugs for advanced cancers. The symposium was chaired jointly by Hideyuki Akaza and Shinjiro Nozaki (WHO Kobe Centre). Creative Commons Attribution License

Documenting moral agency: a qualitative analysis of abortion decision making for fetal indications.

PubMed

Gawron, Lori M; Watson, Katie

2017-02-01

We explored whether the decision-making process of women aborting a pregnancy for a fetal indication fit common medical ethical frameworks. We applied three ethical frameworks (principlism, care ethics, and narrative ethics) in a secondary analysis of 30 qualitative interviews from women choosing 2nd trimester abortion for fetal indications. All 30 women offered reasoning consistent with one or more ethical frameworks. Principlism themes included avoidance of personal suffering (autonomy), and sparing a child a poor quality of life and painful medical interventions (beneficence/non-maleficence). Care ethics reasoning included relational considerations of family needs and resources, and narrative ethics reasoning contextualized this experience into the patient's life story. This population's universal application of commonly accepted medical ethical frameworks supports the position that patients choosing fetal indication abortions should be treated as moral decision-makers and given the same respect as patients making decisions about other medical procedures. These findings suggest recent political efforts blocking abortion access should be reframed as attempts to undermine the moral decision-making of women. Published by Elsevier Inc.

Strategies to improve chronic disease management in seven metro Boston community health centers.

PubMed

Ndumele, Chima D; Russell, Beverley E; Ayanian, John Z; Landon, Bruce E; Keegan, Thomas; O'Malley, A James; Hicks, Leroi S

2009-01-01

The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts. We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers. Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit. Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented. Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.

Do children with gender dysphoria have intense/obsessional interests?

PubMed

VanderLaan, Doug P; Postema, Lori; Wood, Hayley; Singh, Devita; Fantus, Sophia; Hyun, Jessica; Leef, Jonathan; Bradley, Susan J; Zucker, Kenneth J

2015-01-01

This study examined whether children clinically referred for gender dysphoria (GD) show increased symptoms of autism spectrum disorder (ASD). Circumscribed preoccupations or intense interests were considered as overlapping symptoms expressed in GD and ASD. In gender-referred children (n = 534; 82.2% male) and their siblings (n = 419; 57.5% male), we examined Items 9 and 66 on the Child Behavior Checklist, which measure obsessions and compulsions, respectively. Non-GD clinic-referred (n = 1,201; 48.5% male) and nonreferred (n = 1,201; 48.5% male) children were also examined. Gender-referred children were elevated compared to all other groups for Item 9, and compared to siblings and nonreferred children for Item 66. A gender-related theme was significantly more common for gender-referred boys than male siblings on Item 9 only. A gender-related theme was not significantly more common for gender-referred girls compared to their female siblings on either item. The findings for Item 9 support the idea that children with GD show an elevation in obsessional interests. For gender-referred boys in particular, gender-related themes constituted more than half of the examples provided by their mothers. Intense/obsessional interests in children with GD may be one of the factors underlying the purported link between GD and ASD.

Qualitative Analysis of Common Definitions for Core Advanced Pharmacy Practice Experiences

PubMed Central

Danielson, Jennifer; Weber, Stanley S.

2014-01-01

Objective. To determine how colleges and schools of pharmacy interpreted the Accreditation Council for Pharmacy Education’s (ACPE’s) Standards 2007 definitions for core advanced pharmacy practice experiences (APPEs), and how they differentiated community and institutional practice activities for introductory pharmacy practice experiences (IPPEs) and APPEs. Methods. A cross-sectional, qualitative, thematic analysis was done of survey data obtained from experiential education directors in US colleges and schools of pharmacy. Open-ended responses to invited descriptions of the 4 core APPEs were analyzed using grounded theory to determine common themes. Type of college or school of pharmacy (private vs public) and size of program were compared. Results. Seventy-one schools (72%) with active APPE programs at the time of the survey responded. Lack of strong frequent themes describing specific activities for the acute care/general medicine core APPE indicated that most respondents agreed on the setting (hospital or inpatient) but the student experience remained highly variable. Themes were relatively consistent between public and private institutions, but there were differences across programs of varying size. Conclusion. Inconsistencies existed in how colleges and schools of pharmacy defined the core APPEs as required by ACPE. More specific descriptions of core APPEs would help to standardize the core practice experiences across institutions and provide an opportunity for quality benchmarking. PMID:24954931

Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ)-Themed Literature for Teens: Are School Libraries Providing Adequate Collections?

ERIC Educational Resources Information Center

Hughes-Hassell, Sandra; Overberg, Elizabeth; Harris, Shannon

2013-01-01

The purpose of this study was to determine if young adults have access through school libraries to LGBTQ-themed literature. The library collections in 125 high schools in one Southern U.S. state were examined for the inclusion of LGBTQ-themed fiction, nonfiction, and biographies, including a core collection of 21 recommended titles. Results showed…

A Theme-Based Course: Hydrogen as the Fuel of the Future

ERIC Educational Resources Information Center

Shultz, Mary Jane; Kelly, Matthew; Paritsky, Leonid; Wagner, Julia

2009-01-01

A theme-based course focusing on the potential role of hydrogen as a future fuel is described. Numerous topics included in typical introductory courses can be directly related to the issue of hydrogen energy. Beginning topics include Avogadro's number, the mole, atomic mass, gas laws, and the role of electrons in chemical transformations. Reaction…

Compulsory Education: Social Expectations. National Reports on the Theme for 1977 in Their Original Languages. 26th Assembly of Delegates.

ERIC Educational Resources Information Center

World Confederation of Organizations of the Teaching Profession, Morges (Switzerland).

Reports prepared by various countries for presentation at the 1977 annual assembly of the World Confederation of Organizations of the Teaching Profession (WCOTP) are included in this document. The theme of the assembly was "Compulsory Education: Social Expectations." Countries reporting include: Austria, Bangladesh, Brazil, Brunei, Canada, Ivory…

Exploring experienced nurses' attitudes, views and expectations of new graduate nurses: a critical review.

PubMed

Freeling, Michelle; Parker, Steve

2015-02-01

This critical review evaluates the existing primary research literature to identify experienced registered nurses' attitudes, views and expectations of graduate nurses which may create a barrier for optimal graduate nurse performance. Relevant primary studies were identified by searching online databases using a wide variety of appropriate keyword combinations. Online databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO and Google Scholar were comprehensively searched for relevant research. The selected studies were subjected to a rigorous critical appraisal to evaluate the studies and to determine if the findings were applicable to practice. A manual method of thematic analysis was conducted to highlight explicit and implicit themes from the reviewed studies. Themes were grouped and continually reduced until only essential themes remain. Themes and subthemes emerged which were then compared and contrasted to analyse results. The four major themes identified include nursing skills, inadequate preparation during academic program, attitudes and ward culture and concerns with confidence. Subthemes were identified within these categories. Findings indicate experienced registered nurses discussed themes including 'nursing skills', 'inadequate preparation during academic program', 'attitudes and ward culture' and 'concerns with confidence'. Concerns were raised including the value of traditional training versus tertiary education programs, coping with unprofessional behaviour and inadequate preparation for practice. Further research is required to fully address management of the theory-practice gap, as well as the attitudes of experienced registered nurses educated in traditional programs versus those in tertiary education programs. Nurse managers should be aware of the possible occurrence of unprofessional behaviour, and increased workplace training regarding lateral violence would assist in raising awareness regarding negative and unacceptable behaviour. Copyright © 2014 Elsevier Ltd. All rights reserved.

Screening for modulators of cisplatin sensitivity: unbiased screens reveal common themes.

PubMed

Nijwening, Jeroen H; Kuiken, Hendrik J; Beijersbergen, Roderick L

2011-02-01

Cisplatin is a widely used chemotherapeutic agent to treat a variety of solid tumors. The cytotoxic mode of action of cisplatin is mediated by inducing conformational changes in DNA including intra- and inter-strand crosslink adducts. Recognition of these adducts results in the activation of the DNA damage response resulting in cell cycle arrest, repair, and potentially, apoptosis. Despite the clinical efficacy of cisplatin, many tumors are either intrinsically resistant or acquire resistance during treatment. The identification of cisplatin drug response modulators can help us understand these resistance mechanisms, provide biomarkers for treatment strategies, or provide drug targets for combination therapy. Here we discuss functional genetic screens, including one performed by us, set up to identify genes whose inhibition results in increased sensitivity to cisplatin. In summary, the validated genes identified in these screens mainly operate in DNA damage response including nucleotide excision repair, translesion synthesis, and homologous recombination.

Racial/ethnic differences in midlife women's attitudes toward physical activity.

PubMed

Im, Eun-Ok; Ko, Young; Hwang, Hyenam; Chee, Wonshik; Stuifbergen, Alexa; Walker, Lorraine; Brown, Adama

2013-01-01

Women's racial/ethnic-specific attitudes toward physical activity have been pointed out as a plausible reason for their low participation rates in physical activity. However, very little is actually known about racial/ethnic commonalities and differences in midlife women's attitudes toward physical activity. The purpose of this study was to explore commonalities and differences in midlife women's attitudes toward physical activity among 4 major racial/ethnic groups in the United States (whites, Hispanics, African Americans, and Asians). This was a secondary analysis of the qualitative data from a larger study that explored midlife women's attitudes toward physical activity. Qualitative data from 4 racial/ethnic-specific online forums among 90 midlife women were used for this study. The data were analyzed using thematic analysis, and themes reflecting commonalties and differences in the women's attitudes toward physical activity across the racial/ethnic groups were extracted. The themes reflecting the commonalities were: 1) physical activity is good for health, 2) not as active as I could be, 3) physical activity was not encouraged, 4) inherited diseases motivated participation in physical activity, and 5) lack of accessibility to physical activity. The themes reflecting the differences were: 1) physical activity as necessity or luxury, 2) organized versus natural physical activity, 3) individual versus family-oriented physical activity, and 4) beauty ideal or culturally accepted physical appearance. Developing an intervention that could change the social influences and environmental factors and address the women's racial/ethnic-specific attitudes would be a priority in increasing physical activity of racial/ethnic minority midlife women. © 2013 by the American College of Nurse-Midwives.

Developments in the field of allergy in 2014 through the eyes of Clinical and Experimental Allergy.

PubMed

Hales, B J; Hizawa, N; Jenmalm, M; Sverremark-Ekström, E; Wardlaw, A J

2015-12-01

The pathogenesis of asthma continues to be a major topic of interest to our authors with reviews and original papers on the role of viruses, mechanisms of inflammation, biomarkers, and phenotypes of asthma being major topics. A number of papers described new treatments for asthma focusing on blocking the Th2 response reflecting the fact that two decades of work in this area is finally bearing fruit. The pathogenesis of chronic rhinosinusitis is a growing area of interest, but there has been less on the genetics of airways disease than in previous years possibly reflecting the degree of rigour (and therefore a smaller body of work), with which these sorts of studies are now being undertaken. There continues to be a wide range of papers dealing with mechanisms of allergic disease ranging from clinical-based studies to basic research and the use of in vivo animal models especially mice. As before, mechanisms and new approaches to immunotherapy are common themes. Several were published in the allergens section investigating modification of allergens to increase their effectiveness and reduce the risk of adverse events. Risk factors for allergic disease was a common theme in the epidemiology section and food allergy a common theme in clinical allergy with papers on the development of protocols to induce tolerance and attempts to find biomarkers to distinguish sensitization from allergic disease. This was another exciting year for the editors, and we hope the readers of the journal. © 2015 John Wiley & Sons Ltd.

The experience of return to work in individuals with traumatic brain injury (TBI): A qualitative study.

PubMed

Libeson, Lauren; Downing, Marina; Ross, Pamela; Ponsford, Jennie

2018-05-10

Traumatic Brain Injury (TBI) is a leading cause of disability in young people, with return to work (RTW) a major goal of recovery. This qualitative study aimed to understand the RTW experience of individuals with TBI who received comprehensive vocational rehabilitation, and to identify facilitating and limiting factors in the RTW process. Semi-structured interviews were conducted with 15 individuals (mean age = 47.33 years) approximately 4.5 years post-injury, of whom 14 had moderate to severe TBI. Twelve individuals had successfully returned to work. Thematic analysis of transcribed interviews identified three key factors affecting RTW: client, work and rehabilitation factors. Across these factors, 12 themes reported to be critical to the success or failure of the RTW programme were identified. Client themes included social support, cognitive difficulties and motivation, with RTW too early associated with unfavourable outcomes. Work themes included work modifications, employer support and financial incentives. Rehabilitation themes included the RTW programme, the role of the vocational occupational therapist and work preparation. These key factors were reported to have impacted the RTW outcome, comprising three further themes: work satisfaction, future vocational outlook, and quality of life. Consideration of these factors can inform vocational rehabilitation programmes, potentially improving employment outcomes following TBI.

Themes in the literature related to cardiovascular disease risk reduction.

PubMed

Cohen, Shannon Munro; Kataoka-Yahiro, Merle

2009-01-01

This article aimed to identify themes in the literature related to patient-healthcare provider beliefs, barriers to adherence, and interventions pertaining to cardiovascular disease risk reduction. Twenty quantitative and qualitative primary research studies including 2 meta-analyses published between 1995 and 2008 were analyzed for themes and practice implications to synthesize existing research on cardiovascular disease risk reduction. Databases searched included EBSCO, CINAHL, MEDLINE, ScienceDirect, HealthSource, and PsychLit using the search terms patient- provider adherence, adherence and shared decision making, adherence and decision support, patient- provider goal setting, and cardiovascular disease risk reduction. The emergent themes found in this literature review included (1) complex medication regimens; (2) risk perception, quality of life, and competing priorities; (3) motivation for change; (4) provider clinical inertia; and (5) goal setting, feedback, and reminders. Studies reporting the highest rates of adherence to cardiovascular disease risk reduction recommendations incorporated patient-provider goal setting and decision support, self-management techniques, and personalized printed communication. Goal setting in cardiovascular disease risk reduction is a relatively unexplored area and is an important component of shared decision making and adherence to cardiovascular disease health recommendations. The following review will address the 5 themes identified in more detail and provide a basis for improved clinical practice.

Perspectives on seizure clusters: Gaps in lexicon, awareness, and treatment.

PubMed

Buelow, Janice M; Shafer, Patricia; Shinnar, Ruth; Austin, Joan; Dewar, Sandra; Long, Lucretia; O'Hara, Kathryn; Santilli, Nancy

2016-04-01

Seizure clusters in epilepsy can result in serious outcomes such as missed work or school, postictal psychosis, emergency room visits, or hospitalizations, and yet they are often not included in discussions between health-care professionals (HCPs) and their patients. The purpose of this paper was to describe and compare consumer (patient and caregivers) and professional understanding of seizure clusters and to describe how consumers and HCPs communicate regarding seizure clusters. We reviewed social media discussion sites to explore consumers' understanding of seizure clusters. We analyzed professional (medical) literature to explore the HCPs' understanding of seizure clusters. Major themes were revealed in one or both groups, including: communication about diagnosis; frequency, duration, and time frame; seizure type and pattern; severity; and self-management. When comparing discussions of professionals and consumers, both consumers and clinicians discussed the definition of seizure clusters. Discussions of HCPs were understandably clinically focused, and consumer discussions reflected the experience of seizure clusters; however, both groups struggled with a common lexicon. Seizure cluster events remain a problem associated with serious outcomes. Herein, we outline the lack of a common understanding and recommend the development of a common lexicon to improve communication regarding seizure clusters. Copyright © 2016 Upsher-Smith Laboratories, Inc. Published by Elsevier Inc. All rights reserved.

Constructing an Overarching Framework for Learning--Connecting the Dots

ERIC Educational Resources Information Center

Amey, Marilyn J.

2014-01-01

This chapter highlights a variety of ways researchers use learning theories with respect to different stakeholder groups. The chapter brings together common themes across these areas and proposes ways to use these ideas for future research on learning.

An Analysis of the Climate Data Initiative's Data Collection

NASA Astrophysics Data System (ADS)

Ramachandran, R.; Bugbee, K.

2015-12-01

The Climate Data Initiative (CDI) is a broad multi-agency effort of the U.S. government that seeks to leverage the extensive existing federal climate-relevant data to stimulate innovation and private-sector entrepreneurship to support national climate-change preparedness. The CDI project is a systematic effort to manually curate and share openly available climate data from various federal agencies. To date, the CDI has curated seven themes, or topics, relevant to climate change resiliency. These themes include Coastal Flooding, Food Resilience, Water, Ecosystem Vulnerability, Human Health, Energy Infrastructure, and Transportation. Each theme was curated by subject matter experts who selected datasets relevant to the topic at hand. An analysis of the entire Climate Data Initiative data collection and the data curated for each theme offers insights into which datasets are considered most relevant in addressing climate resiliency. Other aspects of the data collection will be examined including which datasets were the most visited or popular and which datasets were the most sought after for curation by the theme teams. Results from the analysis of the CDI collection will be presented in this talk.

Prevention and control of chronic chest diseases: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan.

PubMed

Nishtar, Sania; Ahmed, Ashfaq; Kazi, Yawar; Khan, Aslam; Mohamud, Khalif Bile

2004-12-01

The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) does not include surveillance of Chronic Respiratory Diseases (CRDs) into the integrated NCD surveillance model due to issues with assessing the magnitude of the burden of CRD in general and chronic obstructive pulmonary disease (COPD) in particular, within populations. Tobacco has been used as a proxy for the magnitude of COPD in the population. However, it stresses on the need to develop acceptable criteria for the diagnosis of CRDs and methodologies to monitor CRDs. The CRD component of the NAP-NCD integrates prevention of CRDs with a comprehensive NCD prevention and control framework with specific emphasis on tobacco as a cross-cutting theme. It prioritizes the examination of trends in outdoor air pollution levels and their determinants in order to develop appropriate public health interventions. Other priority areas include research to quantify the magnitude and determinants of chronic lung diseases attributable to indoor air pollution both in the rural and urban areas; the development of appropriate public health strategies to reduce risks in such settings and the integration of guidance on CRD prevention with an NCD behaviour change communication strategy. The cross-cutting theme of environmental pollution and occupational exposure to toxins develops common action areas for CRD and cancer prevention.

Creating potential for common ground and communication between early childhood program staff and parents about young children's eating.

PubMed

Johnson, Susan L; Ramsay, Samantha; Shultz, Jill Armstrong; Branen, Laurel J; Fletcher, Janice W

2013-01-01

To explore child care staff and parent perspectives and communications about children's eating in child care. Focus groups (FGs) conducted with child care staff and parents. Four Western states in the United States. Thirty-nine child care staff in 7 FGs and 25 parents in 6 FGs. Thoughts and concerns about children's eating and opportunities to improve communication between staff and parents. Content analysis (FG coding inter-rater reliability: staff = 0.74; parents = 0.81) and identification of meta-themes. Three meta-themes were identified: (1) recognition of positive influences of the child care setting in children's development of healthy eating; (2) concerns about children's eating in child care and at home; and (3) strategies to improve communications and transactions related to children's eating. Staff reported that their roles included informing parents about food at mealtimes in child care (eg, menus, recipes) but also educating parents about child nutrition and feeding. Parents valued daily information about their child's eating to adjust home mealtimes and to feel connected to their child. Barriers to effective communication included limited time and concerns regarding parent reactions and defensiveness. Staff requested training about child nutrition and feeding and about sensitive communications with parents. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Experience of Native Peer Facilitators in the Campaign Against Type 2 Diabetes

PubMed Central

Struthers, Roxanne; Hodge, Felicia Schanche; De Cora, Lorelei; Geishirt-Cantrell, Betty

2011-01-01

Context The use of peer facilitators in health-programs has great potential. One important application is prevention and control of type 2 diabetes among American Indians. Purpose To explore the experience of American Indian facilitators in a culturally appropriate intervention (Talking Circles) on 2 Northern Plains reservations. The Talking Circles offered a forum for educational dialogue on diabetes risk factors and the management of type 2 diabetes. Methods Phenomenology, a qualitative research approach, was used to answer the research question: “What did Native Talking Circle facilitators-experience?” Participants were 4 lay health workers from the intervention reservations who had been trained to present a diabetes curriculum while coordinating and guiding the group discussion. During open-ended, taped interviews, the facilitators shared their experiences conducting the Talking Circles. Analysis categorized the experiences into common themes to explain the phenomena and cultural construction of oral discussions (Talking Circles) of diabetes. Findings Themes included the concept of “a calling” to do the work, which included a self-growth process, a blending of 2 worldviews as a diabetes intervention strategy, the importance of translating educational materials in a liaison role, and commitment to tribal people and communities. Conclusions The experience of the facilitators was positive because they were knowledgeable about American Indian culture arid worldview arid were trained in both Talking Circle facilitation and type 2 diabetes. PMID:12696854

Leaders' experiences and perceptions implementing activity-based funding and pay-for-performance hospital funding models: A systematic review.

PubMed

Baxter, Pamela E; Hewko, Sarah J; Pfaff, Kathryn A; Cleghorn, Laura; Cunningham, Barbara J; Elston, Dawn; Cummings, Greta G

2015-08-01

Providing cost-effective, accessible, high quality patient care is a challenge to governments and health care delivery systems across the globe. In response to this challenge, two types of hospital funding models have been widely implemented: (1) activity-based funding (ABF) and (2) pay-for-performance (P4P). Although health care leaders play a critical role in the implementation of these funding models, to date their perspectives have not been systematically examined. The purpose of this systematic review was to gain a better understanding of the experiences of health care leaders implementing hospital funding reforms within Organisation for Economic Cooperation and Development countries. We searched literature from 1982 to 2013 using: Medline, EMBASE, CINAHL, Academic Search Complete, Academic Search Elite, and Business Source Complete. Two independent reviewers screened titles, abstracts and full texts using predefined criteria. We included 2 mixed methods and 12 qualitative studies. Thematic analysis was used in synthesizing results. Five common themes and multiple subthemes emerged. Themes include: pre-requisites for success, perceived benefits, barriers/challenges, unintended consequences, and leader recommendations. Irrespective of which type of hospital funding reform was implemented, health care leaders described a complex process requiring the following: organizational commitment; adequate infrastructure; human, financial and information technology resources; change champions and a personal commitment to quality care. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

Looking for Solutions: Gender Differences in Relationship and Parenting Challenges Among Low-Income, Young Parents

PubMed Central

Albritton, Tashuna; Angley, Meghan; Grandelski, Valen; Hansen, Nathan; Kershaw, Trace

2015-01-01

The need for parenting and relationship strengthening programs is important among low-income minority parents where the burden of relational and parental stressors contributes to relationship dissolution. We examine these stressors among young parents. Data were collected from four focus groups (N = 35) with young parents. Data were audio-recorded and transcribed. Inductive coding was used to generate themes and codes, and analysis was completed using NVivo. Relationship and parenting challenges, values, and areas of need were the three major themes that emerged. Women's relationship challenges were family interference and unbalanced parenting, and men reported feeling disrespected and having limited finances. Common relationship challenges for women and men were family interference and unbalanced parenting. Both genders valued trust, communication, and honesty in relationships. Areas of need for women and men included: improving communication and understanding the impact of negative relationships on current relationships. Parenting challenges for women were unbalanced parenting, child safety, and feeling unprepared to parent; men reported limited finances. Both genders valued quality time with child to instill family morals. Areas of need for women and men included learning child discipline techniques and increasing knowledge about child development. Finally, women and men have relationship and parenting similarities and differences. Young parents are interested in learning how to improve relationships and co-parent to reduce relationship distress, which could reduce risk behaviors and improve child outcomes. PMID:24980026

Men in Midwifery: A National Survey.

PubMed

Kantrowitz-Gordon, Ira; Adriane Ellis, Simon; McFarlane, Ann

2014-01-01

Midwifery in the United States suffers from a lack of diversity. More than 91% of midwives are white, and more than 98% are women. Little research has explored the experiences of midwives who are men or transgender. Invitation to an Internet survey was sent to the membership of the American College of Nurse-Midwives. Thirty-one participants who identified as men or transgender completed the survey, which included quantitative and open-ended questions about the impact of gender on education and practice. Data analysis of qualitative responses used qualitative description methodology to identify common themes. Four themes described participating men's experiences of education and practice of midwifery. Challenges included feeling singled out as different and being excluded. Supportive factors came from the social support of family, friends, colleagues, and patients, as well as from taking pride in one's work as a midwife. Midwives who identify as transgender described the challenges of others' confusion about their gender, having to hide their true gender identity, and struggling with the resulting loneliness. This survey highlights the challenges faced by midwives who are men or transgender in education and practice. Midwifery values of respect and acceptance for all women and families need to be applied internally to all members of the profession. This will support increased diversity and openness in midwifery. © 2014 by the American College of Nurse‐Midwives.

Promoting and Protecting Against Stigma in Assisted Living and Nursing Homes

PubMed Central

Zimmerman, Sheryl; Dobbs, Debra; Roth, Erin G.; Goldman, Susan; Peeples, Amanda D.; Wallace, Brandy

2016-01-01

Purpose of the Study: To determine the extent to which structures and processes of care in multilevel settings (independent living, assisted living, and nursing homes) result in stigma in assisted living and nursing homes. Design and Methods: Ethnographic in-depth interviews were conducted in 5 multilevel settings with 256 residents, families, and staff members. Qualitative analyses identified the themes that resulted when examining text describing either structures of care or processes of care in relation to 7 codes associated with stigma. Results: Four themes related to structures of care and stigma were identified, including the physical environment, case mix, staff training, and multilevel settings; five themes related to processes of care and stigma, including dining, independence, respect, privacy, and care provision. For each theme, examples were identified illustrating how structures and processes of care can potentially promote or protect against stigma. Implications: In no instance were examples or themes identified that suggested the staff intentionally promoted stigma; on the other hand, there was indication that some structures and processes were intentionally in place to protect against stigma. Perhaps the most important theme is the stigma related to multilevel settings, as it has the potential to reduce individuals’ likelihood to seek and accept necessary care. Results suggest specific recommendations to modify care and reduce stigma. PMID:24928555

Work Habits Are Valid Components of Evaluations of Anesthesia Residents Based on Faculty Anesthesiologists' Daily Written Comments About Residents.

PubMed

Dexter, Franklin; Masursky, Danielle; Szeluga, Debra; Hindman, Bradley J

2016-05-01

In our department, faculty anesthesiologists routinely evaluate the resident physicians with whom they worked in an operative setting the day before, providing numerical scores to questions. The faculty can also enter a written comment if so desired. Because residents' work habits are important to anesthesiology program directors, and work habits can improve with feedback, we hypothesized that faculty comments would include the theme of the anesthesia resident's work habits. We analyzed all 6692 faculty comments from January 1, 2011, to June 30, 2015. We quantified use of the theme of Dannefer et al.'s work habit scale, specifically the words and phrases in the scale, and synonyms to the words. Approximately half (50.7% [lower 99.99% confidence limit, 48.4%]) of faculty comments contained the theme of work habits. Multiple sensitivity analyses were performed excluding individual faculty, residents, and words. The lower confidence limits for comments containing the theme were each >42.7%. Although faculty anesthesiologists completed (numerical) questions based on the American College of Graduate Medical Education competencies to evaluate residents, an important percentage of written comments included the theme of work habits. The implication is that the theme has validity as one component of the routine evaluation of anesthesia residents.

Analysis of comments in a petition defending electronic cigarettes.

PubMed

Sumner, Holly Marie; McQueen, Amy; Scott, Michael John; Sumner, Walton

2014-11-01

A 2009 petition opposing a Food and Drug Administration (FDA) ban on electronic cigarettes (e-cigs) garnered international attention from e-cig users (vapers). Petitioners' comments described the perceived benefits of vaping. We conducted a qualitative and quantitative analysis of petitioners' comments. A sample of 200 petitioner names was sought in public records. Reviewers identified 13 major themes in a sample of comments, and themes related to current controversies were added. For each theme, software pattern-matching instructions (regular expressions) were developed and were used to scan comments. Agreement between reviewers and software was calculated; theme prevalence and clustering was ascertained. A total of 13,414 signatures and 8,285 comments from 50 states and 75 nations were collected in 6 months. Temporal patterns and name matches in public records suggest that most petitioners are authentic. Agreement between reviewers and software was moderate to high (κ = 0.4-0.8). Commonly cited themes were "e-cigs helped me quit" (34%), "a ban would be counterproductive" (15%), and "my health improved with e-cigs" (13%). Two clusters of themes emerged: the first combined comments about smoking cessation, health benefits, and smoking relapse that an e-cig ban would cause; the second combined themes that a "ban would be counterproductive," it would infringe on personal liberties, and it was motivated by government or industrial greed. People who cited mental health issues often mentioned avoiding withdrawal as a benefit of e-cigs. Early e-cig adopters were both frustrated and confused by discussion of a ban. They believed that e-cigs safely delivered nicotine and helped them quit smoking. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Conduct of Continuous Operations,

DTIC Science & Technology

1987-04-30

INTRODUCTION The great campaigns of the twentieth century have one thing in common : at least one operational pause occurred between the commencement of...and General Staff College published a series of books on the conduct of war by armies and army groups. Common themes in these works were: the importance...be so located that It can be carried out without interruption from the enemy; sufficient time should be available for placing troops in relative

Cinematherapy and film as an educational tool in undergraduate psychiatry teaching: a case report and review of the literature.

PubMed

Hankir, Ahmed; Holloway, David; Zaman, Rashid; Agius, Mark

2015-09-01

Film possesses an extraordinary power and offers an unrivalled medium for entertainment and escapism. There are many films that revolve around a mental illness theme and the medical specialty that most commonly features in motion picture is psychiatry. Over the last few decades films have become increasingly used as an educational tool in the teaching of psychiatry topics such as mental state examination to undergraduate students. Above and beyond its utility in pedagogy, film also has the power to heal and the term cinematherapy has been coined to reflect this. Indeed, there are case studies of people with first-hand experience of psychopathology who report that watching films with a mental illness theme has contributed to their recovery. We provide a first person narrative from an individual with schizophrenia in which he expounds on the concepts of cinematherpy and metaphorical imagery in films which theme on psychosis.

Nursing student perceptions of community in online learning.

PubMed

Gallagher-Lepak, Susan; Reilly, Janet; Killion, Cheryl M

2009-01-01

Nursing faculty need to understand the unique aspects of online learning environments and develop new pedagogies for teaching in the virtual classroom. The concept of community is important in online learning and a strong sense of community can enhance student engagement and improve learning outcomes in online courses. Student perceptions of community in online learning environments were explored in this study. Five focus group sessions were held and online nursing students were asked to give examples of experiences related to sense of community. Fifteen major themes emerged: class structure, required participation, teamwork, technology, becoming, commonalities, disconnects, mutual exchange, online etiquette, informal discussions, aloneness, trepidation, unknowns, nonverbal communication and anonymity. Themes sorted into the categories of structural, processual and emotional factors. Theme descriptions show how sense of community can be enhanced and/or diminished in online courses. This study adds depth and detail to the limited body of research on sense of community in distance education in nursing courses.

THROUGH THE LENS OF RACE: BLACK AND WHITE WOMEN'S PERCEPTIONS OF WOMANHOOD.

PubMed

Settles, Isis H; Pratt-Hyatt, Jennifer S; Buchanan, NiCole T

2008-01-01

The intersection of race and gender may create unique experiences for Black and White women in terms of work, family, domestic roles, and interpersonal relationships. Dissimilar gender-role norms may foster different perceptions of gender for these two groups of women. In the current study, we examined similarities and differences in Black and White women's perceptions of their gender using qualitative focus group methodology and grounded theory data analysis. The results identified five themes that were common to Black and White women: Gender-Based Mistreatment, Perceived Advantage, Friendships and Community, Caretaking, and Work and Family Options. One additional theme, Inner Strength, emerged only for Black women. Although many of the broad perceptions of womanhood were similar for Black and White women, analysis of the content within each theme highlighted important differences. We discuss the results in terms of how they may reflect socio-historical factors, gender discrimination, stereotypes, and gender-role norms.

Qualitative Analysis of Written Reflections during a Teaching Certificate Program

PubMed Central

Castleberry, Ashley N.; Payakachat, Nalin; Ashby, Sarah; Nolen, Amanda; Carle, Martha; Neill, Kathryn K.

2016-01-01

Objective. To evaluate the success of a teaching certificate program by qualitatively evaluating the content and extent of participants’ reflections. Methods. Two investigators independently identified themes within midpoint and final reflection essays across six program years. Each essay was evaluated to determine the extent of reflection in prompted teaching-related topic areas (strengths, weaknesses, assessment, feedback). Results. Twenty-eight themes were identified within 132 essays. Common themes encompassed content delivery, student assessment, personal successes, and challenges encountered. Deep reflection was exhibited, with 48% of essays achieving the highest level of critical reflection. Extent of reflection trended higher from midpoint to final essays, with significant increases in the strengths and feedback areas. Conclusion. The teaching certificate program fostered critical reflection and self-reported positive behavior change in teaching, thus providing a high-quality professional development opportunity. Such programs should strongly consider emphasizing critical reflection through required reflective exercises at multiple points within program curricula. PMID:26941436

Pharmacy Students’ Attitudes Toward Debt

PubMed Central

Yusuf, Akeem A.; Hadsall, Ronald S.

2015-01-01

Objective. To examine pharmacy students’ attitudes toward debt. Methods. Two hundred thirteen pharmacy students at the University of Minnesota were surveyed using items designed to assess attitudes toward debt. Factor analysis was performed to identify common themes. Subgroup analysis was performed to examine whether students’ debt-tolerant attitudes varied according to their demographic characteristics, past loan experience, monthly income, and workload. Results. Principal component extraction with varimax rotation identified 3 factor themes accounting for 49.0% of the total variance: tolerant attitudes toward debt (23.5%); contemplation and knowledge about loans (14.3%); and fear of debt (11.2%). Tolerant attitudes toward debt were higher if students were white or if they had had past loan experience. Conclusion. These 3 themes in students’ attitudes toward debt were consistent with those identified in previous research. Pharmacy schools should consider providing a structured financial education to improve student management of debt. PMID:26089561

Global History. A Curriculum Guide. Second Semester. Theme III: The Emergence of the Modern World. Student Worksheets. Experimental Edition.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

This bulletin of student worksheets complements teacher strategies for Theme III entitled, "Changes in Thought and Action Led to the Emergence of the Modern World." The worksheets contain materials corresponding to specific strategies, and the questions which accompany each worksheet are included on the appropriate strategy page. Included are…

Theme: Urban Agriculture.

ERIC Educational Resources Information Center

Ellibee, Margaret; And Others

1990-01-01

On the theme of secondary agricultural education in urban areas, this issue includes articles on opportunities, future directions, and implications for the profession; creative supervised experiences for horticulture students; floral marketing, multicultural education; and cultural diversity in urban agricultural education. (JOW)

Accessing Transgenerational Themes Through Dreamwork.

ERIC Educational Resources Information Center

Andrews, Jennifer; And Others

1988-01-01

Proposes use of dreamwork to evoke historical patterns or transgenerational themes. Describes new variant of dreamwork which combines aspects of both gestalt and family systems therapies. Implications of therapeutic dramatization for couple therapy are suggested. Examples are included. (Author/NB)

Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings.

PubMed

Iheduru-Anderson, Kechinyere C; Wahi, Monika M

2018-04-01

Successful transition to practice of internationally educated nurses (IENs) can critically affect quality of care. The aim of this study was to characterize the facilitators and barriers to transition of Nigerian IENs (NIENs) to the United States health care setting. Using a descriptive phenomenology approach, 6 NIENs were interviewed about their transitional experiences in the United States. Thematic methods were used for data analysis. The three major themes identified from the participants' stories were "fear/anger and disappointment" (FAD), "road/journey to success/overcoming challenges" (RJO), and "moving forward" (MF). The FAD theme predominated, including experiences of racism, bullying, and inequality. The RJO theme included resilience, and the MF theme encompassed personal growth. NIENs face personal and organizational barriers to adaptation, especially fear, anger and disappointment. Future research should seek to develop a model for optimal adaptation that focuses on improving both personal and organizational facilitators and decreasing barriers.

Meanings of Falls and Prevention of Falls According to Rehabilitation Nurses: A Qualitative Descriptive Study.

PubMed

Bok, Amy; Pierce, Linda L; Gies, Cheryl; Steiner, Victoria

2016-01-01

Guided by Friedemann's theoretical framework, this survey explored the meaning of a fall of an institutionalized older adult or fall prevention to rehabilitation registered nurses and whether the experience changed the nurse's practice. Qualitative, descriptive survey. A convenience sample of 742 rehabilitation nurses was asked to describe these experiences and the impact on their practice. Themes discovered related to the meaning of a fall include negative feelings (incongruence) and positive feelings (congruence). Themes related to the meaning of preventing a fall include positive feelings (congruence). Practice change themes emerged from both the experience of a fall and fall prevention. Practice change themes were drawn to Friedemann's (1995) process dimensions. Nurses' experiences and meanings of falls uncovered negative and positive feelings about these falls. New findings of this study were the positive feelings expressed by nurses, when there was no injury or when a fall was prevented. © 2015 Association of Rehabilitation Nurses.

Concerns and needs of children with epilepsy and their parents.

PubMed

McNelis, Angela M; Buelow, Janice; Myers, Jennifer; Johnson, Elizabeth Ann

2007-01-01

Having epilepsy often interferes with a child's and his or her family's quality of life, but specific concerns have not been explored. The purpose of the study was to explore in-depth the self-reported concerns and needs of children with epilepsy and their parents. A focus group methodology was used with 2 child groups and 2 parent groups. Themes were independently identified by each investigator, who then met to discuss the themes until 100% agreement was reached. Child themes included "talking at my level" and "feeling different from others." Parent themes included "difficulties, struggles and problems," "need for information," and "fears and concerns." Findings from this study suggest that attention needs to be directed to assessing informational and emotional support needs during the diagnostic process. Ongoing assessment is also necessary because children and parents have continuing needs beyond the initial encounter with healthcare professionals.

Complex evolutionary footprints revealed in an analysis of reused protein segments of diverse lengths

PubMed Central

Nepomnyachiy, Sergey; Ben-Tal, Nir; Kolodny, Rachel

2017-01-01

Proteins share similar segments with one another. Such “reused parts”—which have been successfully incorporated into other proteins—are likely to offer an evolutionary advantage over de novo evolved segments, as most of the latter will not even have the capacity to fold. To systematically explore the evolutionary traces of segment “reuse” across proteins, we developed an automated methodology that identifies reused segments from protein alignments. We search for “themes”—segments of at least 35 residues of similar sequence and structure—reused within representative sets of 15,016 domains [Evolutionary Classification of Protein Domains (ECOD) database] or 20,398 chains [Protein Data Bank (PDB)]. We observe that theme reuse is highly prevalent and that reuse is more extensive when the length threshold for identifying a theme is lower. Structural domains, the best characterized form of reuse in proteins, are just one of many complex and intertwined evolutionary traces. Others include long themes shared among a few proteins, which encompass and overlap with shorter themes that recur in numerous proteins. The observed complexity is consistent with evolution by duplication and divergence, and some of the themes might include descendants of ancestral segments. The observed recursive footprints, where the same amino acid can simultaneously participate in several intertwined themes, could be a useful concept for protein design. Data are available at http://trachel-srv.cs.haifa.ac.il/rachel/ppi/themes/. PMID:29078314

Method Analysis of Microbial Resistant Gypsum Products

EPA Science Inventory

Abstract: Several commercially available gypsum products are marketed as microbial-resistant. During previous test method research on a microbial resistant gypsum wallboard study, a common theme from both stakeholders and product vendors was the need for a unified and accepted m...

What Are Common Treatments for Problems of Puberty?

MedlinePlus

... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

Rock Music and Music Videos.

PubMed

Hendren; Strasburger

1993-10-01

Sex, violence, sexual violence, drugs, suicide, satanic worship, and racism are common themes in modern rock lyrics. The authors examine their effect on adolescent development and identity, concluding with a discussion of the roles of parents and health care professionals in addressing the problem.

Community Readiness as a Multidimensional Construct

ERIC Educational Resources Information Center

Chilenski, Sarah M.; Greenberg, Mark T.; Feinberg, Mark E.

2007-01-01

Both the organizational studies literature and the community psychology literature discuss the importance of readiness when implementing change. Although each area emphasizes different characteristics, several common themes are present within the literature. The current study integrates and applies organizational and community psychology…

"Would a man smell a rose then throw it away?" Jordanian men's perspectives on women's breast cancer and breast health.

PubMed

Taha, Hana; Al-Qutob, Raeda; Nyström, Lennarth; Wahlström, Rolf; Berggren, Vanja

2013-10-25

Breast cancer is the most common malignancy afflicting women, and the most common cancer overall in Jordan. A woman's decision to go for screening is influenced by her social support network. This study aims to explore Jordanian men's individual and contextual perspectives on women's breast cancer and their own role in the breast health of the females within their families. An explorative qualitative design was used to purposively recruit 24 married men aged 27 to 65 years (median 43 years) from four governorates in Jordan. Data in the form of interviews transcriptions was subjected to qualitative content analysis. Three themes were identified: a) Supporting one's wife; b) Marital needs and obligations; c) Constrained by a culture of destiny and shame. The first theme was built on men's feelings of responsibility for the family's health and well-being, their experiences of encouraging their wives to seek health care and their providing counselling and instrumental support. The second theme emerged from men's views about other men's rejection of a wife inflicted by breast cancer, their own perceptions of diminished femininity due to mastectomy and their own concerns about protecting the family from the hereditary risk of breast cancer. The third theme was seen in men's perception of breast cancer as an inevitable act of God that is far away from one's own family, in associating breast cancer with improper behaviour and in their readiness to face the culture of Eib (shame). Jordanian men perceive themselves as having a vital role in supporting, guiding and encouraging their wives to follow breast cancer early detection recommendations. Breast health awareness campaigns could involve husbands to capitalize on family support.

Violent Attacks and Damaged Victims: An Exploration of the Rape Scripts of European American and African American U.S. College Women.

PubMed

Littleton, Heather L; Dodd, Julia C

2016-02-25

Scripts are influential in shaping sexual behaviors. Prior studies have examined the influence of individuals' rape scripts. However, these scripts have not been evaluated among diverse groups. The current study examined the rape scripts of African American (n = 72) and European American (n = 99) college women. Results supported three rape scripts: the "real rape," the "party rape," and the mismatched intentions rape, that were equally common. However, there were some differences, with African Americans' narratives more often including active victim resistance and less often containing victim vulnerability themes. Societal and cultural influences on rape scripts are discussed. © The Author(s) 2016.

Life-history strategies of ungulates

USGS Publications Warehouse

Leslie, David M.; Bowyer, R.T.; Kie, J.G.

1999-01-01

This Special Feature resulted from a symposium on life-history strategies of ungulates presented at the 78th Annual Meeting of the American Society of Mammalogists in Blacksburg, Virginia, in June 1998. The presentations at the symposium represented only a vignette of the wide variety of life-history strategies that exists among ungulates. The four papers that follow include treatises on birth-site selection of moose (Alces alces), sex-ratio correlates with dimorphism and risk of predation, optimal foraging relative to risk of predation, and the role of density dependence in shaping life-history traits of ungulates. A theme of risk of predation in shaping life-history traits is common to three of four papers.

Medical student career choice: a qualitative study of fourth-year medical students at Memorial University, Newfoundland

PubMed Central

Pianosi, Kiersten; Bethune, Cheri; Hurley, Katrina F.

2016-01-01

Background: Specialty career choice is a critical decision for medical students, and research has examined factors influencing particular specialties or assessed it from a demographic perspective. The purpose of this study was to explore and describe influential factors in students' decision-making, irrespective of their particular specialty in a Canadian medical school. Methods: Study participants were recruited from fourth-year medical classes at the Memorial University of Newfoundland in 2003, 2006, 2007 and 2008. Sixteen focus groups (n = 70) were led by a nonfaculty facilitator to uncover factors affecting medical student career choice. The analysis was guided by principles of grounded theory methodology. The focus group transcripts were sequentially coded based on recurring topics and themes that arose in the students' discussions. A set of key themes emerged and representative quotations for each theme were tracked. Results: Twenty themes were identified from the focus group discussions: 7 major, 3 intermediate and 10 minor themes. The major themes were undergraduate experience, exposure, public perception and recruitment, teacher influence, family/outside influences, residency issues and personal philosophy. Intermediate themes included lifestyle, bad-mouthing/negative perceptions and context. Minor themes included critical incidents/experiences, information gaps, uncertainty, nature of the work, extracurricular programs, timing of decision-making, financial issues, prestige, fit with colleagues and gender issues. Interpretation: Exposure to specialties and the timing of this exposure appears to be crucial to career choice, as does the context (who, what, when, where) of any particular rotation. Given the influence of personal philosophy, future research examining students' level of self-assessment and self-reflection in their decision-making processes and level of certainty about their selected specialty would be useful. PMID:27398357

Medical student career choice: a qualitative study of fourth-year medical students at Memorial University, Newfoundland.

PubMed

Pianosi, Kiersten; Bethune, Cheri; Hurley, Katrina F

2016-01-01

Specialty career choice is a critical decision for medical students, and research has examined factors influencing particular specialties or assessed it from a demographic perspective. The purpose of this study was to explore and describe influential factors in students' decision-making, irrespective of their particular specialty in a Canadian medical school. Study participants were recruited from fourth-year medical classes at the Memorial University of Newfoundland in 2003, 2006, 2007 and 2008. Sixteen focus groups (n = 70) were led by a nonfaculty facilitator to uncover factors affecting medical student career choice. The analysis was guided by principles of grounded theory methodology. The focus group transcripts were sequentially coded based on recurring topics and themes that arose in the students' discussions. A set of key themes emerged and representative quotations for each theme were tracked. Twenty themes were identified from the focus group discussions: 7 major, 3 intermediate and 10 minor themes. The major themes were undergraduate experience, exposure, public perception and recruitment, teacher influence, family/outside influences, residency issues and personal philosophy. Intermediate themes included lifestyle, bad-mouthing/negative perceptions and context. Minor themes included critical incidents/experiences, information gaps, uncertainty, nature of the work, extracurricular programs, timing of decision-making, financial issues, prestige, fit with colleagues and gender issues. Exposure to specialties and the timing of this exposure appears to be crucial to career choice, as does the context (who, what, when, where) of any particular rotation. Given the influence of personal philosophy, future research examining students' level of self-assessment and self-reflection in their decision-making processes and level of certainty about their selected specialty would be useful.

New Strategy for Exploration Technology Development: The Human Exploration and Development of Space (HEDS) Exploration/Commercialization Technology Initiative

NASA Technical Reports Server (NTRS)

Mankins, John C.

2000-01-01

In FY 2001, NASA will undertake a new research and technology program supporting the goals of human exploration: the Human Exploration and Development of Space (HEDS) Exploration/Commercialization Technology Initiative (HTCI). The HTCI represents a new strategic approach to exploration technology, in which an emphasis will be placed on identifying and developing technologies for systems and infrastructures that may be common among exploration and commercial development of space objectives. A family of preliminary strategic research and technology (R&T) road maps have been formulated that address "technology for human exploration and development of space (THREADS). These road maps frame and bound the likely content of the HTCL Notional technology themes for the initiative include: (1) space resources development, (2) space utilities and power, (3) habitation and bioastronautics, (4) space assembly, inspection and maintenance, (5) exploration and expeditions, and (6) space transportation. This paper will summarize the results of the THREADS road mapping process and describe the current status and content of the HTCI within that framework. The paper will highlight the space resources development theme within the Initiative and will summarize plans for the coming year.

Examining mindfulness-based stress reduction: Perceptions from minority older adults residing in a low-income housing facility

PubMed Central

2011-01-01

Background Mindfulness-based stress reduction (MBSR) programs are becoming increasingly common, but have not been studied in low income minority older populations. We sought to understand which parts of MBSR were most important to practicing MBSR members of this population, and to understand whether they apply their training to daily challenges. Methods We conducted three focus groups with 13 current members of an MBSR program. Participants were African American women over the age of 60 in a low-income housing residence. We tape recorded each session and subsequently used inductive content analysis to identify primary themes. Results and discussion Analysis of the focus group responses revealed three primary themes stress management, applying mindfulness, and the social support of the group meditation. The stressors they cited using MBSR with included growing older with physical pain, medical tests, financial strain, and having grandchildren with significant mental, physical, financial or legal hardships. We found that participants particularly used their MBSR training for coping with medical procedures, and managing both depression and anger. Conclusion A reflective stationary intervention delivered in-residence could be an ideal mechanism to decrease stress in low-income older adult's lives and improve their health. PMID:21627807

e-Ana and e-Mia: A Content Analysis of Pro–Eating Disorder Web Sites

PubMed Central

Schenk, Summer; Wilson, Jenny L.; Peebles, Rebecka

2010-01-01

Objectives. The Internet offers Web sites that describe, endorse, and support eating disorders. We examined the features of pro–eating disorder Web sites and the messages to which users may be exposed. Methods. We conducted a systematic content analysis of 180 active Web sites, noting site logistics, site accessories, “thinspiration” material (images and prose intended to inspire weight loss), tips and tricks, recovery, themes, and perceived harm. Results. Practically all (91%) of the Web sites were open to the public, and most (79%) had interactive features. A large majority (84%) offered pro-anorexia content, and 64% provided pro-bulimia content. Few sites focused on eating disorders as a lifestyle choice. Thinspiration material appeared on 85% of the sites, and 83% provided overt suggestions on how to engage in eating-disordered behaviors. Thirty-eight percent of the sites included recovery-oriented information or links. Common themes were success, control, perfection, and solidarity. Conclusions. Pro–eating disorder Web sites present graphic material to encourage, support, and motivate site users to continue their efforts with anorexia and bulimia. Continued monitoring will offer a valuable foundation to build a better understanding of the effects of these sites on their users. PMID:20558807

A framework for mentoring of medical students: thematic analysis of mentoring programmes between 2000 and 2015.

PubMed

Tan, Yin Shuen; Teo, Shao Wen Amanda; Pei, Yiying; Sng, Julia Huina; Yap, Hong Wei; Toh, Ying Pin; Krishna, Lalit K R

2018-03-17

A consistent mentoring approach is key to unlocking the full benefits of mentoring, ensuring effective oversight of mentoring relationships and preventing abuse of mentoring. Yet consistency in mentoring between senior clinicians and medical students (novice mentoring) which dominate mentoring processes in medical schools is difficult to achieve particularly when mentors practice in both undergraduate and postgraduate medical schools. To facilitate a consistent approach to mentoring this review scrutinizes common aspects of mentoring in undergraduate and postgraduate medical schools to forward a framework for novice mentoring in medical schools. Four authors preformed independent literature searches of novice mentoring guidelines and programmes in undergraduate and postgraduate medical schools using ERIC, PubMed, CINAHL, OVID and Science Direct databases. 25,605 abstracts were retrieved, 162 full-text articles were reviewed and 34 articles were included. The 4 themes were identified-preparation, initiating and supporting the mentoring process and the obstacles to effective mentoring. These themes highlight 2 key elements of an effective mentoring framework-flexibility and structure. Flexibility refers to meeting the individual and changing needs of mentees. Structure concerns ensuring consistency to the mentoring process and compliance with prevailing codes of conduct and standards of practice.

The informal curriculum - general practitioner perceptions of ethics in clinical practice.

PubMed

Sturman, Nancy J; Parker, Malcolm; van Driel, Mieke L

2012-12-01

Australian medical students should graduate with an understanding of the principles of medical law and ethics, and their application to clinical settings. Although student perspectives have been studied previously, the teacher experience of ethical issues also needs to be understood, particularly in the general practice setting. Interviews were conducted with a convenience sample of 13 general practitioner teachers. They were asked to reflect on common and/or important ethical issues in their day-to-day practice. An inductive thematic analysis of the data was performed by two investigators, who reached a consensus on major themes using an iterative, dialogic process. Participants reported negotiating ethical issues frequently. Major themes included patient-doctor relationships, professional differences, truth-telling, ethically 'grey' areas and the personal demands of ethical decision making. General practitioners in this study describe sometimes needing to apply judgement and compromise in situations involving legal or ethical issues, in order to act in the best interests of patients and to successfully negotiate the patient-doctor relationship. Students learning in this clinical context may perceive mixed messages and ethical lapses in these challenging 'grey' areas. The ethical acumen and emotional resilience of both students and clinical teachers may be enhanced by ongoing reflective discussion with colleagues.

A qualitative study of medical educators' perspectives on remediation: Adopting a holistic approach to struggling residents.

PubMed

Krzyzaniak, Sara M; Wolf, Stephen J; Byyny, Richard; Barker, Lisa; Kaplan, Bonnie; Wall, Stephen; Guerrasio, Jeannette

2017-09-01

During residency, some trainees require the identification and remediation of deficiencies to achieve the knowledge, skills and attitudes necessary for independent practice. Given the limited published frameworks for remediation, we characterize remediation from the perspective of educators and propose a holistic framework to guide the approach to remediation. We conducted semistructured focus groups to: explore methods for identifying struggling residents; categorize common domains of struggle; describe personal factors that contribute to difficulties; define remediation interventions and understand what constitutes successful completion. Data were analyzed through conventional content analysis. Nineteen physicians across multiple specialties and institutions participated in seven focus groups. Thirteen categories emerged around remediation. Some themes addressed practical components of remediation, while others reflected barriers to the process and the impact of remediation on the resident and program. The themes were used to inform development of a novel holistic framework for remediation. The approach to remediation requires comprehensive identification of individual factors impacting performance. The intervention should not only include a tailored learning plan but also address confounders that impact likelihood of remediation success. Our holistic framework intends to guide educators creating remediation plans to ensure all domains are addressed.

Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City.

PubMed

Shmool, Jessie L C; Yonas, Michael A; Newman, Ogonnaya Dotson; Kubzansky, Laura D; Joseph, Evelyn; Parks, Ana; Callaway, Charles; Chubb, Lauren G; Shepard, Peggy; Clougherty, Jane E

2015-09-01

There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community-academic partnered approach, we designed a multi-community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish-speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter-related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.

Intersegmental Articulation.

ERIC Educational Resources Information Center

CATESOL Journal, 1996

1996-01-01

This English-as-a-Second Language (ESL) journal periodically devotes entire issues to specific themes. The theme of this issue is "Intersegmental Articulation" (especially in California schools). Articles include: "Why Is ESL a Burning Issue?" (Robby Ching, Anne Ediger, Debbie Poole); "Challenges Facing California ESL…

Pediatric physical therapists' use of support walkers for children with disabilities: a nationwide survey.

PubMed

Low, Sheryl A; McCoy, Sarah Westcott; Beling, Janna; Adams, Janet

2011-01-01

This study investigated pediatric physical therapists' use of support walkers (SWs) for children with disabilities. An 8-page survey was mailed to 2500 randomly selected members of the Section on Pediatrics of the American Physical Therapy Association. Respondents to the survey included 513 pediatric physical therapists who were users of SWs. Descriptive statistics were calculated and themes were analyzed. Several SWs were reported as used most often to improve gait, mobility, participation at school, and interaction with peers. Use commonly included a month trial before purchase and 9 sessions of physical therapy to train a child for use in school. Reasons given for the use of SWs were improving impairments, functional limitations, and participation with peers. Pediatric physical therapists use SWs to increase postural control, mobility, and children's participation in school.

Pragmatics in discourse performance: insights from aphasiology.

PubMed

Ulatowska, Hanna K; Olness, Gloria Streit

2007-05-01

This article examines the preservation of pragmatic abilities of individuals with aphasia, as manifested in the discourse they produce. The construct of coherence is used as a framework for understanding this pragmatic preservation. Discourse coherence is largely derived from the structure, selection, and highlighting of information expressed in a discourse. Personal narratives, as one type of discourse, represent an extended turn-in-conversation on a topic of personal relevance to the speaker, common in everyday life. As such, they provide a valuable source of information about a speaker's pragmatic ability. Examples of personal narratives told by individuals with aphasia are used to illustrate and discuss the means by which discourse coherence is achieved. These include a tightly structured temporal-causal event line, development of theme, and evaluation of information. Possible approaches to clinical assessment are considered, including use of global rating systems.

Urban Stormwater Characterization, Control, and Treatment.

PubMed

Moore, Trisha L; Rodak, Carolyn M; Vogel, Jason R

2017-10-01

A summary of 246 studies published in 2016 on topics related to the characterization and management of urban stormwater runoff is presented in the following review. The review is structured along three major topical areas: (1) general characterization of stormwater quantity and quality; (2) engineered systems for stormwater control and treatment, including erosion and sediment control practices, constructed stormwater ponds and wetlands, bioretention, permeable pavement, greenroofs, and rainwater harvesting and (3) watershedscale application of stormwater treatment and control practices. Common research themes and needs highlighted throughout this review include efforts to better understand stormwater transport and treatment mechanisms and their representation in models, advancements to optimize the design of stormwater control measures to meet specific hydrologic and/or water quality targets, and increasing understanding of the biophysical and social factors that influence watershed-scale implementation of low impact development and other stormwater control measures.

Primary and Secondary Analysis of Local Elected Officials’ Decisions to Support or Oppose Pharmacy Sale of Syringes in California

PubMed Central

Rose, Valerie J.

2010-01-01

Under California law, local governments may authorize pharmacies within their jurisdictions to sell ten or fewer syringes to an adult without prescription, proof of identity, or proof of medical need. Local governments may simultaneously exempt adults from prosecution for violation of state drug paraphernalia codes for possession of ten or fewer syringes for personal use. Both of these provisions are temporary and sunset on December 31, 2010, unless subsequent state legislation amends that date. The objective of our study was to ascertain how and why local policymakers made their decisions regarding non-prescription syringe sale (NPSS). We examined influences on their decisions, including specific messengers and the arguments that were most salient to their decision making. We selected jurisdictions that were geographically representative of California counties; those with and without syringe exchange programs, and those that had passed or rejected NPSS. We conducted nine semi-structured interviews in five jurisdictions. To enrich primary data collection, we analyzed secondary data by reviewing audio, video, and written transcripts of public hearings and newspaper coverage in five jurisdictions, including three jurisdictions without primary interview data. Among proponents of NPSS, we identified common themes, including: (1) public health research provided conclusive evidence for reduction in HIV and hepatitis transmission without problems of crime, drug use, or unsafe discard of syringes; (2) the local health officer was the key to influencing local policymakers; (3) recall of prior debates over syringe exchange served to inform their decision making; and (4) a lack of local opposition or controversy. Common concerns among opponents of NPSS included: (1) that there would be an increase in unsafe discard of syringes; (2) loss of an important law enforcement tool; (3) that drug users were incapable of desired behavior change; and (4) that research was inconclusive, or proved that syringe access would not work in reducing rates of disease. Themes held in common by proponents and opponents of NPSS were identified as well. Syringe access through NPSS is in fact supported by a robust body of public health research and is considered an important component of a comprehensive strategy to reduce HIV and hepatitis transmission. Our study highlights the importance of understanding the perspectives of elected officials in order to ameliorate their concerns without undermining the public health goal of reducing death, disease, and suffering in at-risk communities. PMID:20352356

Education for a Global Community: National Reports on the Theme for 1976 in Their Original Languages. 25th Annual Assembly of Delegates.

ERIC Educational Resources Information Center

World Confederation of Organizations of the Teaching Profession, Morges (Switzerland).

Reports prepared by various countries for presentation at the 1976 annual assembly of the World Confederation of Organizations of the Teaching Profession (WCOTP) are included in this document. The theme of the assembly was "Education for a Global Community." Countries reporting include Bangladesh, Canada, Ivory Coast, West Germany, England and…

Thirty Years of Disparities Intervention Research:What are We Doing to Close Racial and Ethnic Gaps in Health Care?

PubMed Central

Clarke, Amanda R.; Goddu, Anna P.; Nocon, Robert S.; Stock, Nicholas W.; Chyr, Linda C.; Akuoko, Jaleesa A.S.; Chin, Marshall H.

2013-01-01

Background A systematic scan of the disparities intervention literature will allow researchers, providers, and policymakers to understand which interventions are being evaluated to improve minority health and which areas require further research. Methods We systematically categorized 391 disparities intervention articles published between 1979 and 2011, covering 11 diseases. We developed a taxonomy of disparities interventions using qualitative theme analysis. We identified the tactic, or what was done to intervene; the strategy, or a group of tactics with common characteristics; and the level, or who was targeted by the effort. Results The taxonomy included 44 tactics, nine strategies, and six levels. Delivering education and training was the most common strategy (37%). Within education and training, the most common tactics were education about disease (14%) and self-management (11%), while communication-skills training (3%) and decision-making aids (1%) were less frequent. The strategy of actively engaging the community through tactics such as community health workers and outreach efforts accounted for 6.5% of tactics. Interventions most commonly targeted patients (50%) and community members who were not established patients of the intervening organization (32%). Interventions targeting providers (7%), the microsystem (immediate care team) (9%), organizations (3%), and policies (0.1%) were less common. Conclusions Disparities researchers have predominantly focused on the patient as the target for change; future research should also investigate how to improve the system that serves minority patients. Areas for further study include interventions that engage the community, educational interventions that address communication barriers, and the impact of policy reform on disparities in care. PMID:24128746

Novice Counselors' Conceptualizations and Experiences of Therapeutic Relationships

ERIC Educational Resources Information Center

Schwing, Alison E.; LaFollette, Julie R.; Steinfeldt, Jesse A.; Wong, Y. Joel

2011-01-01

This qualitative study investigated three novice counselors' experiences and characterizations of therapeutic relationships. Thematic analyses of interviews and diaries revealed six common themes: (a) the centrality of supervision and training experiences to navigating interpersonal experiences with clients; (b) anxiety about counselors' roles in…

Five Levels of Curriculum Integration Defined, Refined, and Described.

ERIC Educational Resources Information Center

Schumacher, Donna H.

1995-01-01

Provides a description of five levels of curriculum integration at the middle level, specifically: departmentalization, reinforcement, complementary or shared units, webbed, and integrated themes. Discusses curriculum integration in relation to preservice and inservice programs, common planning time, team composition, time issues, and…

Higher Education Trends (1997-1999): Administration. ERIC-HE Trends.

ERIC Educational Resources Information Center

Kezar, Adrianna J.

Several themes are prevalent in the literature on college administration. Motivating staff, planning, conflict management, ethics, power and influence, communication, strategy and decision making, vision, and financial issues are consistently discussed. However, common administrative processes such as planning, morale, and administrative climate…

A Rasch Perspective

ERIC Educational Resources Information Center

Schumacker, Randall E.; Smith, Everett V., Jr.

2007-01-01

Measurement error is a common theme in classical measurement models used in testing and assessment. In classical measurement models, the definition of measurement error and the subsequent reliability coefficients differ on the basis of the test administration design. Internal consistency reliability specifies error due primarily to poor item…

Concluding Thoughts

ERIC Educational Resources Information Center

Zilvinskis, John; Borden, Victor M. H.

2017-01-01

Constructively engaging with learning analytics enables institutions of higher education to support students in more personalized, empowering ways, but to do so requires sustained levels of collaboration not commonly found within colleges and universities. Themes that emerge from the chapters of this volume provide useful principles for leveraging…

GPs' experiences of children with anxiety disorders in primary care: a qualitative study.

PubMed

O'Brien, Doireann; Harvey, Kate; Young, Bridget; Reardon, Tessa; Creswell, Cathy

2017-12-01

Anxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs' perspectives on and experiences of supporting children with these disorders. To explore the experiences of GPs in relation to identification, management, and access to specialist services for children (<12 years) with anxiety disorders. Twenty semi-structured interviews were conducted with GPs in primary care throughout England. GPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis. Data from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services). GPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children's mental health, as well as potential for greater collaboration between primary and specialist services. © British Journal of General Practice 2017.

Understanding self-harm in older people: a systematic review of qualitative studies.

PubMed

Wand, Anne Pamela Frances; Peisah, Carmelle; Draper, Brian; Brodaty, Henry

2018-03-01

Rates of suicide in older adults are generally higher than other age groups. Although risk factors for suicide attempts, and self-harm more generally, in this population are well-characterised, many of these vulnerabilities are common to older people and individual motivations are less well understood. Qualitative research may reveal more about the underlying thought processes, meaning and experiences of older people who self-harm. A systematic review of qualitative studies examining the reasons why older people have self-harmed was undertaken by searching databases and screening the reference lists of articles. The quality of studies was critically appraised. A content analysis was performed to identify themes. The search yielded eight studies of variable quality which met the inclusion criteria; three pertained to indirect self-harm (refusal to eat or take medications and self-neglect) and five related to suicidal behaviour. Themes emerging from the analysis of studies of people who had self-neglected included control, impaired decision-making and coping skills and threats to self-identity and continuity. In those who had suicidal behaviour, themes related to loss of and regaining control; alienation, disconnectedness and invisibility; meaningless and raison d'etre; and accumulated suffering and a 'painful life'. There is scant literature evaluating self-harm in older people using qualitative methods. Nonetheless, this review suggests that active and passive self-harm should be considered as distinct entities as the underlying motivations and intents differ. Understanding individual perceptions and experiences which lead to self-harm may guide clinicians in delivering more sensitive, holistic interventions and counter ageism.

A Comparison of the Influence of Anticipated Death Trajectory and Personal Values on End-of-Life Care Preferences: A Qualitative Analysis.

PubMed

Supiano, Katherine P; McGee, Nancy; Dassel, Kara B; Utz, Rebecca

2017-08-17

We examined anticipated preferences for end-of-life (EOL) care in healthy older adults in the context of various terminal disease scenarios to explore the relationship between personal values and diseases and conditions that would influence EOL care choices. Qualitative Descriptive Analysis was used to derive themes and the relationship between EOL preference themes and personal value themes in 365 respondents in a national sample of healthy older adults who completed a survey on their anticipated preferences for end-of-life (EOL) care. Reluctance to burden close others was the most frequently voiced personal value across all conditions affecting EOL preferences, followed by the personal value of quality of life. Concern about whether one's wishes would be honored was more commonly voiced in the context of hypothetical, prospective terminal cancer than in neurological conditions. Respondents who voiced desire for autonomy in how they would die clearly attributed extreme pain as the primary influence on EOL preferences. Comprehensive assessment of patient personal values should include consideration of particular chronic disease scenarios and death trajectories to fully inform EoL preferences. Because personal values do influence EOL preferences, care should be taken to ascertain patient values when presenting diagnoses, prognoses, and treatment options. In particular, patients and families of patients with progressive neurological diseases will likely face a time when the patient cannot self-represent EOL wishes. Early discussion of values and preferences, particularly in the context of cognitive disease is vital to assure patient-directed care.

GPs’ experiences of children with anxiety disorders in primary care: a qualitative study

PubMed Central

O’Brien, Doireann; Harvey, Kate; Young, Bridget; Reardon, Tessa; Creswell, Cathy

2017-01-01

Background Anxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs’ perspectives on and experiences of supporting children with these disorders. Aim To explore the experiences of GPs in relation to identification, management, and access to specialist services for children (<12 years) with anxiety disorders. Design and setting Twenty semi-structured interviews were conducted with GPs in primary care throughout England. Method GPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis. Results Data from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services). Conclusion GPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children’s mental health, as well as potential for greater collaboration between primary and specialist services. PMID:29061716

AWARE-AWAreness during REsuscitation-a prospective study.

PubMed

Parnia, Sam; Spearpoint, Ken; de Vos, Gabriele; Fenwick, Peter; Goldberg, Diana; Yang, Jie; Zhu, Jiawen; Baker, Katie; Killingback, Hayley; McLean, Paula; Wood, Melanie; Zafari, A Maziar; Dickert, Neal; Beisteiner, Roland; Sterz, Fritz; Berger, Michael; Warlow, Celia; Bullock, Siobhan; Lovett, Salli; McPara, Russell Metcalfe Smith; Marti-Navarette, Sandra; Cushing, Pam; Wills, Paul; Harris, Kayla; Sutton, Jenny; Walmsley, Anthony; Deakin, Charles D; Little, Paul; Farber, Mark; Greyson, Bruce; Schoenfeld, Elinor R

2014-12-01

Cardiac arrest (CA) survivors experience cognitive deficits including post-traumatic stress disorder (PTSD). It is unclear whether these are related to cognitive/mental experiences and awareness during CPR. Despite anecdotal reports the broad range of cognitive/mental experiences and awareness associated with CPR has not been systematically studied. The incidence and validity of awareness together with the range, characteristics and themes relating to memories/cognitive processes during CA was investigated through a 4 year multi-center observational study using a three stage quantitative and qualitative interview system. The feasibility of objectively testing the accuracy of claims of visual and auditory awareness was examined using specific tests. The outcome measures were (1) awareness/memories during CA and (2) objective verification of claims of awareness using specific tests. Among 2060 CA events, 140 survivors completed stage 1 interviews, while 101 of 140 patients completed stage 2 interviews. 46% had memories with 7 major cognitive themes: fear; animals/plants; bright light; violence/persecution; deja-vu; family; recalling events post-CA and 9% had NDEs, while 2% described awareness with explicit recall of 'seeing' and 'hearing' actual events related to their resuscitation. One had a verifiable period of conscious awareness during which time cerebral function was not expected. CA survivors commonly experience a broad range of cognitive themes, with 2% exhibiting full awareness. This supports other recent studies that have indicated consciousness may be present despite clinically undetectable consciousness. This together with fearful experiences may contribute to PTSD and other cognitive deficits post CA. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Themes and methods of research presented at European General Practice Research Network conferences.

PubMed

Kruschinski, Carsten; Lange, Maaike; Lionis, Christos; van Weel, Chris; Hummers-Pradier, Eva

2010-08-01

The World Organization of Family Doctors (Wonca) defined core characteristics of general practice and general practitioners' competencies. It is unclear to which extent research has addressed these issues so far. To determine themes and research methods of general practice research as reflected by presentations at the European General Practice Research Network (EGPRN) meetings. Descriptive and retrospective study. All abstracts presented at each of the 14 EGPRN conferences between June 2001 and October 2007 were analysed for content and study design/methodology. Categories for content were developed inductively; a predefined hierarchical scheme was used for study designs. A total of N=614 abstracts were classified. The main research topics were related to GP/health service issues (n=232), clinical (n=148) and patient-related themes (n=118). Original data (n=558) were mainly derived from cross-sectional designs (38.7%). Intervention studies (11.0%), longitudinal designs including case-control and cohort studies (13.3%) as well as instrumental research (2.2%) were less common. More than one-fourth of all original studies were qualitative studies (27.6%). Stratified analysis revealed that cross-sectional designs were less frequent in the second half of conferences. Analysis by country showed that, in contrast to different quantitative designs, the proportion of qualitative studies was comparable. To test effectiveness of diagnostic and therapeutic interventions under primary care conditions, a higher proportion of experimental studies would be preferable. This could increase the acceptance of general practitioners' specific approaches and provide clear guidance on approaches and procedures, especially in health care systems not predominantly based on primary care.

Theme: Staying Current--Small Animals and Specialty Crops.

ERIC Educational Resources Information Center

Knight, James A.; And Others

1986-01-01

Six theme articles examine ways that vocational agriculture teachers can keep current, including related hobbies, resource persons, beekeeping as a supervised occupational experience, specialty crops such as fruits and nuts, an inservice poultry project, and trade and industry organizations. (SK)

OAST Space Theme Workshop. Volume 1: Summary report. 1: Introduction. 2: General observations and some key findings. 3: Follow-on activity. Quick-look comments and working papers

NASA Technical Reports Server (NTRS)

1976-01-01

The Outlook for Space Study, consideration of National needs and OAST technology goals were factors in the selection of the following themes for candidate technical initiative and supporting program plans: space power station; search for extraterrestrial life; industrialization of space; global service station; exploration of the solar system; and advanced space transportation system. An overview is presented of the Space Theme Workshop activities in developing technology needs, program requirements, and proposed plans in support of each theme. The unedited working papers used by team members are included.

Replication Proteins and Human Disease

PubMed Central

Jackson, Andrew P.; Laskey, Ronald A.; Coleman, Nicholas

2014-01-01

In this article, we discuss the significance of DNA replication proteins in human disease. There is a broad range of mutations in genes encoding replication proteins, which result in several distinct clinical disorders that share common themes. One group of replication proteins, the MCMs, has emerged as effective biomarkers for early detection of a range of common cancers. They offer practical and theoretical advantages over other replication proteins and have been developed for widespread clinical use. PMID:23881941

An Analysis of Anxiety-Related Postings on Sina Weibo.

PubMed

Tian, Xianyun; He, Fang; Batterham, Philip; Wang, Zheng; Yu, Guang

2017-07-13

This study examines anxiety-related postings on Sina Weibo to gain insight into social networking about mental health. The themes of a random sample of anxiety-related postings ( n = 1000) were assessed. The disclosure of anxiety was the most common theme. The prevalence of anxiety was higher in certain areas where the economy is stronger than others, and the people living there suffered from more stress. Users who talked about feeling anxious tended to be more active on social media during leisure hours and less active during work hours. Our findings may be developed to detect and help individuals who may suffer from anxiety disorders at a low cost.

Barrier-free design: a review and critique of the occupational therapy perspective.

PubMed

Cooper, B A; Cohen, U; Hasselkus, B R

1991-04-01

This review of the occupational therapy literature on barrier-free design identifies both a paucity of related occupational therapy research on the topic and a lack of a common conceptual base with which to guide the development and use of environmental assessments. Nonetheless, two fledgling themes can be extrapolated: the consistent reference to the concepts of accessibility, mobility, function, and safety and an increased awareness among occupational therapists regarding the accessibility standards developed by the American National Standards Institute (ANSI) (ANSI, 1971, 1980). A problem-solving model suggested by designers for the 1979 revision of ANSI standards that incorporates these conceptual themes is described and discussed.

Learning Across Time Scales: Science, Policy, Management, and Communication

NASA Astrophysics Data System (ADS)

Stewart, M. M.

2002-05-01

This presentation will draw together common themes raised in the session and discuss lessons learned across time scales and their implications for managers and policy makers concerned with both climate change and variability. Session themes will be examined in the context of the upcoming World Summit on Sustainable Development (WSSD) and considered as opportunities for linking climate change policy discussions with lessons learned from the study of adaptation on seasonal to interannual time scales. The presentation will raise questions about future research directions, discuss recommendations for promoting learning across time scales, and explore options for better communicating the links between climate change and variability.

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.