Adolescent Views of Diabetes-Related Parent Conflict and Support: A Focus Group Analysis

PubMed Central

WEINGER, KATIE; O'DONNELL, KATHERINE A.; RITHOLZ, MARILYN D.

2006-01-01

Purpose To increase understanding of adolescent–parent diabetes-related conflicts and supports in the management of type 1 diabetes by means of a focus group research approach. Methods Twenty-four adolescents (10 boys and 14 girls, age 13–15 years; 97% white) participated in three same-sex focus groups at two diabetes summer camps. The focus group leader used a prepared set of open-ended questions to guide the 90-minute sessions. Sessions were tape-recorded, transcribed, and analyzed by a set procedure for qualitative analysis to identify the adolescents' perspectives on parent–adolescent sources of diabetes-related conflict and support. Results Adolescents reported the following sources of diabetes-related conflict: parental worry and intrusive behaviors; parental lack of understanding and blaming behaviors, and the parents focus on the future vs. the adolescent focus on the present. With regard to diabetes-related support, the teens identified parental understanding of the demands of diabetes and parental provision of reassurance about their child's illness and normative functioning. Conclusions Adolescents' perceptions of parental worry, lack of understanding, and resulting intrusive and blaming behaviors are major areas of conflict that need to be addressed in the management of type 1 diabetes. PMID:11691594

Resident Physicians' Perspectives on Effective Outpatient Teaching: A Qualitative Study

ERIC Educational Resources Information Center

Kisiel, John B.; Bundrick, John B.; Beckman, Thomas J.

2010-01-01

Learning theories, which suggest that experienced faculty use collaborative teaching styles, are reflected in qualitative studies of learners in hospital settings. However, little research has used resident focus groups to explore characteristics of successful teachers in outpatient clinics. Therefore, focus group discussions with first through…

Group functioning of a collaborative family research team.

PubMed

Johnson, S K; Halm, M A; Titler, M G; Craft, M; Kleiber, C; Montgomery, L A; Nicholson, A; Buckwalter, K; Cram, E

1993-07-01

Collaborative research teams are an attractive means of conducting nursing research in the clinical setting because of the many opportunities that collaboration can supply. These opportunities include a chance to: (1) network with other nurses who have similar interests, (2) share knowledge and expertise for designing clinical studies that directly affect daily practice, (3) develop instruments, (4) write grant proposals, (5) collect and analyze data, and (6) prepare manuscripts for publication. The effectiveness of research teams, however, is strongly influenced by group functioning. This article describes the functioning of a collaborative family interventions research team of nursing faculty members and CNSs at a large Midwestern university setting. The formation of the group and membership characteristics are described, along with strategies used to identify the research focus and individual and group goals. Aspects related to the influence of the group on members and the internal operations of the group are also addressed. Future strategies to be explored will focus on the size of the group and joint authorship issues. The authors also set forth a number of recommendations for development of collaborative research groups.

Technology-enhanced focus groups as a component of instrument development.

PubMed

Strout, Tania D; DiFazio, Rachel L; Vessey, Judith A

2017-06-22

Background Bullying is a critical public health problem and a screening tool for use in healthcare is needed. Focus groups are a common tool for generating qualitative data when developing an instrument and evidence suggests that technology-enhanced focus groups can be effective in simultaneously engaging participants from diverse settings. Aim To examine the use of technology-enhanced focus groups in generating an item pool to develop a youth-bullying screening tool. Discussion The authors explore methodological and ethical issues related to conducting technology-enhanced focus groups, drawing on their experience in developing a youth-bullying measure. They conducted qualitative focus groups with professionals from the front lines of bullying response and intervention. They describe the experience of conducting technology-enhanced focus group sessions, focusing on the methodological and ethical issues that researchers engaging in similar work may encounter. Challenges associated with this methodology include establishing rapport among participants, privacy concerns and limited non-verbal communication. Conclusion The use of technology-enhanced focus groups can be valuable in obtaining rich data from a wide variety of disciplines and contexts. Organising these focus groups was inexpensive and preferred by the study's participants. Implications for practice Researchers should consider using technology-enhanced focus groups to generate data to develop health-related measurement tools.

Perceptions of interprofessional teamwork in low-acuity settings: a qualitative analysis.

PubMed

van Schaik, Sandrijn M; O'Brien, Bridget C; Almeida, Sandra A; Adler, Shelley R

2014-06-01

Working effectively in interprofessional teams is a core competency for all health care professionals, yet there is a paucity of instruments with which to assess the associated skills. Published medical teamwork skills assessment tools focus primarily on high-acuity situations, such as cardiopulmonary arrests and crisis events in operating rooms, and may not generalise to non-high-acuity environments, such as in-patient wards and out-patient clinics. We undertook the current study to explore the constructs underlying interprofessional teamwork in non-high-acuity settings and team members' perspectives of essential teamwork attributes. We used an ethnographic approach to study four interprofessional teams in two different low-acuity settings: women's HIV (human immunodeficiency virus) clinics and in-patient paediatric wards. Over a period of 17 months, we collected qualitative data through direct observations, focus groups and individual interviews. We analysed the data using qualitative thematic analysis, following an iterative process: data from our observations (20 hours in total) informed the focus group guide and focus group data informed the interview guide. To enhance the integrity of our analysis, we triangulated data sources and verified themes through member checking. We conducted seven focus groups and 27 individual interviews with a total of 39 study participants representing eight professions. Participants emphasised shared leadership and collaborative decision making, mutual respect, recognition of one's own and others' limitations and strengths, and the need to nurture relationships. Team members also discussed tensions around hierarchy and questioned whether doctor leadership is appropriate for interprofessional teams. Our findings indicate that there are differences in teamwork between low-acuity and high-acuity settings, and also provide insights into potential barriers to effective interprofessional teamwork. Our study delineates essential elements of teamwork in low-acuity settings, including desirable attributes of team members, thus laying the foundation for the development of an individual teamwork skills assessment tool. © 2014 John Wiley & Sons Ltd.

Development of a tethered personal health record framework for early end-of-life discussions.

PubMed

Bose-Brill, Seuli; Kretovics, Matthew; Ballenger, Taylor; Modan, Gabriella; Lai, Albert; Belanger, Lindsay; Koesters, Stephen; Pressler-Vydra, Taylor; Wills, Celia

2016-06-01

End-of-life planning, known as advance care planning (ACP), is associated with numerous positive outcomes, such as improved patient satisfaction with care and improved patient quality of life in terminal illness. However, patient-provider ACP conversations are rarely performed or documented due to a number of barriers, including time required, perceived lack of skill, and a limited number of resources. Use of tethered personal health records (PHRs) may help streamline ACP conversations and documentations for outpatient workflows. Our objective was to develop an ACP-PHR framework that would be for use in a primary care, outpatient setting. Qualitative content analysis of focus groups and cognitive interviews (participatory design). A novel PHR-ACP tool was developed and tested using data and feedback collected from 4 patient focus groups (n = 13), 1 provider focus group (n = 4), and cognitive interviews (n = 22). Patient focus groups helped develop a focused, 4-question PHR communication tool. Cognitive interviews revealed that, while patients felt framework content and workflow were generally intuitive, minor changes to content and workflow would optimize the framework. A focused framework for electronic ACP communication using a patient portal tethered to the PHR was developed. This framework may provide an efficient way to have ACP conversations in busy outpatient settings.

Defining Student Success through Navajo Perspectives

ERIC Educational Resources Information Center

Bowman, Colleen Wilma

2013-01-01

The purpose of this qualitative study was to determine the definition of student success as defined by the Navajo people. The data collection method used was the focus group. The data were collected from two geographical settings from two public schools located within the boundaries of the Navajo Indian Reservation. The focus group participants…

A Qualitative Study to Explore How Parental Expectations and Rules Influence Beverage Choices in Early Adolescence

ERIC Educational Resources Information Center

Roth-Yousey, Lori; Chu, Yen Li; Reicks, Marla

2012-01-01

Objective: To understand parent beverage expectations for early adolescents (EAs) by eating occasion at home and in various settings. Methods: Descriptive study using focus group interviews and the constant comparative method for qualitative data analysis. Results: Six focus groups were completed, and 2 were conducted in Spanish. Participants (n =…

Group Conflict and Faculty Engagement: Is There a Moderating Effect of Group Trust?

ERIC Educational Resources Information Center

Selmer, Jan; Jonasson, Charlotte; Lauring, Jakob

2013-01-01

In educational settings, substantial scholarly interest has focused on student engagement as an antecedent for educational development and positive school outcomes. Very limited research, however, has focused on the engagement of academic staff members. This may be a crucial oversight because engagement has been argued to lead to more satisfied,…

Exploratory Research to Design a School Nurse-Delivered Intervention to Treat Adolescent Overweight and Obesity

ERIC Educational Resources Information Center

Gellar, Lauren; Druker, Sue; Osganian, Stavroula K.; Gapinski, Mary Ann; LaPelle, Nancy; Pbert, Lori

2012-01-01

Objective: In preparation for a pilot study to evaluate the efficacy of a school nurse-delivered intervention, focus groups were conducted to gain insight into the perceptions of stakeholders regarding the design and implementation of the intervention. Setting and Participants: Fifteen focus groups at participating schools. One hundred subjects,…

Capturing exposures: using automated cameras to document environmental determinants of obesity.

PubMed

Barr, Michelle; Signal, Louise; Jenkin, Gabrielle; Smith, Moira

2015-03-01

Children's exposure to food marketing across multiple everyday settings, a key environmental influence on health, has not yet been objectively documented. Wearable automated cameras (ACs) may have the potential to provide an objective account of this exposure. The purpose of this study is to assess the feasibility of using ACs to document children's exposure to food marketing in multiple settings. A convenience sample of six participants (aged 12) wore a SenseCam device for two full days. Following which, participants attended a focus group to ascertain their experiences of using the device. The collected data were analysed to determine participants' daily and setting specific exposure to 'healthy' and 'unhealthy' food marketing (in minutes). The focus group transcript was analysed using thematic analysis to identify the common themes. Participants collected usable data that could be analysed to determine participant's daily exposure (in minutes) to 'unhealthy' food marketing across a number of everyday settings. Results from the focus group discussion indicated that participants were comfortable wearing the device, after an initial adjustment period. ACs may be an effective tool for documenting children's exposure to food marketing in multiple settings. ACs provide a new method for documenting environmental determinants of obesity and likely other environmental impacts on health. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Staffs’ and managers’ perceptions of how and when discrete event simulation modelling can be used as a decision support in quality improvement: a focus group discussion study at two hospital settings in Sweden

PubMed Central

Hvitfeldt-Forsberg, Helena; Mazzocato, Pamela; Glaser, Daniel; Keller, Christina; Unbeck, Maria

2017-01-01

Objective To explore healthcare staffs’ and managers’ perceptions of how and when discrete event simulation modelling can be used as a decision support in improvement efforts. Design Two focus group discussions were performed. Setting Two settings were included: a rheumatology department and an orthopaedic section both situated in Sweden. Participants Healthcare staff and managers (n=13) from the two settings. Interventions Two workshops were performed, one at each setting. Workshops were initiated by a short introduction to simulation modelling. Results from the respective simulation model were then presented and discussed in the following focus group discussion. Results Categories from the content analysis are presented according to the following research questions: how and when simulation modelling can assist healthcare improvement? Regarding how, the participants mentioned that simulation modelling could act as a tool for support and a way to visualise problems, potential solutions and their effects. Regarding when, simulation modelling could be used both locally and by management, as well as a pedagogical tool to develop and test innovative ideas and to involve everyone in the improvement work. Conclusions Its potential as an information and communication tool and as an instrument for pedagogic work within healthcare improvement render a broader application and value of simulation modelling than previously reported. PMID:28588107

Delivering perinatal depression care in a rural obstetric setting: a mixed methods study of feasibility, acceptability and effectiveness.

PubMed

Bhat, Amritha; Reed, Susan; Mao, Johnny; Vredevoogd, Mindy; Russo, Joan; Unger, Jennifer; Rowles, Roger; Unützer, Jürgen

2017-09-07

Universal screening for depression during pregnancy and postpartum is recommended, yet mental health treatment and follow-up rates among screen-positive women in rural settings are low. We studied the feasibility, acceptability and effectiveness of perinatal depression treatment integrated into a rural obstetric setting. We conducted an open treatment study of a screening and intervention program modified from the Depression Attention for Women Now (DAWN) Collaborative Care model in a rural obstetric clinic. Depression screen-positive pregnant and postpartum women received problem-solving therapy (PST) with or without antidepressants. A care manager coordinated communication between patient, obstetrician and psychiatric consultant. We measured change in the Patient Health Questionnaire 9 (PHQ-9) score. We used surveys and focus groups to measure patient and provider satisfaction and analyzed focus groups using qualitative analysis. The intervention was well accepted by providers and patients, based on survey and focus group data. Feasibility was also evidenced by recruitment (87.1%) and retention (92.6%) rates and depression outcomes (64% with >50% improvement in PHQ 9) which were comparable to clinical trials in similar urban populations. Conclusions for practice: DAWN Collaborative Care modified for treatment of perinatal depression in a rural obstetric setting is feasible and acceptable. Behavioral health services integrated into rural obstetric settings could improve care for perinatal depression.

Reducing social inequities in health through settings-related interventions -- a conceptual framework.

PubMed

Shareck, Martine; Frohlich, Katherine L; Poland, Blake

2013-06-01

The creation of supportive environments for health is a basic action principle of health promotion, and equity is a core value. A settings approach offers an opportunity to bridge these two, with its focus on the interplay between individual, environmental and social determinants of health. We conducted a scoping review of the literature on theoretical bases and practical applications of the settings approach. Interventions targeting social inequities in health through action on various settings were analyzed to establish what is done in health equity research and action as it relates to settings. Four elements emerged as central to an equity-focused settings approach: a focus on social determinants of health, addressing the needs of marginalized groups, effecting change in a setting's structure, and involving stakeholders. Each came with related challenges. To offer potential solutions to these challenges we developed a conceptual framework that integrates theoretical and methodological approaches, along with six core guiding principles, into a 'settings praxis'. Reducing social inequities in health through the creation of supportive environments requires the application of the settings approach in an innovative way. The proposed conceptual framework can serve as a guide to do so, and help develop, implement and evaluate equity-focused settings-related interventions.

A brief intervention to improve exercising in patients with schizophrenia: a controlled pilot study with mental contrasting and implementation intentions (MCII).

PubMed

Sailer, Pascal; Wieber, Frank; Pröpster, Karl; Stoewer, Steffen; Nischk, Daniel; Volk, Franz; Odenwald, Michael

2015-09-03

Regular exercise can have positive effects on both the physical and mental health of individuals with schizophrenia. However, deficits in cognition, perception, affect, and volition make it especially difficult for people with schizophrenia to plan and follow through with their exercising intentions, as indicated by poor attendance and high drop-out rates in prior studies. Mental Contrasting and Implementation Intentions (MCII) is a well-established strategy to support the enactment of intended actions. This pilot study tests whether MCII helps people with schizophrenia in highly structured or autonomy-focused clinical hospital settings to translate their exercising intentions into action. Thirty-six inpatients (eleven women) with a mean age of 30.89 years (SD = 11.41) diagnosed with schizophrenia spectrum disorders from specialized highly structured or autonomy-focused wards were randomly assigned to two intervention groups. In the equal contact goal intention control condition, patients read an informative text about physical activity; they then set and wrote down the goal to attend jogging sessions. In the MCII experimental condition, patients read the same informative text and then worked through the MCII strategy. We hypothesized that MCII would increase attendance and persistence relative to the control condition over the course of four weeks and this will be especially be the case when applied in an autonomy-focused setting compared to when applied in a highly structured setting. When applied in autonomy-focused settings, MCII increased attendance and persistence in jogging group sessions relative to the control condition. In the highly structured setting, no differences between conditions were found, most likely due to a ceiling effect. These results remained even when adjusting for group differences in the pre-intervention scores for the control variables depression (BDI), physical activity (IPAQ), weight (BMI), age, and education. Whereas commitment and physical activity apart from the jogging sessions remained stable over the course of the treatment, depression and negative symptoms were reduced. There were no differences in pre-post treatment changes between intervention groups. The intervention in the present study provides initial support for the hypothesis that MCII helps patients to translate their exercising intentions into real-life behavior even in autonomously-focused settings without social control. ClinicalTrials.gov ID; URL: NCT01547026 Registered 3 March 2012.

Development of ACLEEM questionnaire, an instrument measuring residents' educational environment in postgraduate ambulatory setting.

PubMed

Riquelme, Arnoldo; Padilla, Oslando; Herrera, Cristian; Olivos, Trinidad; Román, José Antonio; Sarfatis, Alberto; Solís, Nancy; Pizarro, Margarita; Torres, Patricio; Roff, Sue

2013-01-01

Students' perceptions of their educational environment (EE) have been studied in undergraduate and postgraduate curricula. Postgraduate EE has been measured in hospital settings. However, there are no instruments available to measure the EE in postgraduate ambulatory settings. The aim of this study was to develop the "ambulatory care learning education environment measure" (ACLEEM). A mixed methodology was used including three stages: (1) Grounded theory (focus groups); (2) Delphi technique to identify consensus; and (3) Pilot study. Three quota samples of approximately 60 stakeholders were formed, one as focus groups and two as Delphi panels. Eight focus groups were carried out including 58 residents (Latin-American Spanish speakers). The results were analysed and 173 items were offered to a National Delphi panel (61 residents and teachers). They reduced in two rounds the number of important items to 54. The 54-item questionnaire was then piloted with 63 residents and refined to the final version of the ACLEEM with 50 items and three domains. The 50-item inventory is a valid instrument to measure the EE in postgraduate ambulatory setting in Chile. Large-scale administration of the ACLEEM questionnaire to evaluate its construct validity and reliability are the next steps to test the psychometric properties of the instrument.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 2--the evaluation.

PubMed

Dawber, Chris

2013-06-01

This paper outlines an evaluation of reflective practice groups (RPG) involving nurses and midwives from three clinical nursing specialties at Redcliffe and Caboolture Hospitals, Queensland, Australia. The groups were facilitated by the consultation liaison psychiatry nurse and author using a process-focused, whole-of-group approach to explore clinical narrative in a supportive group setting. This was a preliminary evaluation utilizing a recently-developed tool, the Clinical Supervision Evaluation Questionnaire, along with externally-facilitated focus groups. Nurses and midwives responded favourably to RPG, reporting a positive impact on clinical practice, self-awareness, and resilience. The majority of participants considered RPG had positive implications for team functioning. The focus groups identified the importance of facilitation style and the need to address aspects of workplace culture to enable group development and enhance the capacity for reflection. Evaluation of the data indicates this style of RPG can improve reflective thinking, promote team cohesion, and provide support for nurses and midwives working in clinical settings. Following on from this study, a second phase of research has commenced, providing more detailed, longitudinal evaluation across a larger, more diverse group of nurses. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Qualitative Description of College Students' Dinner Groups

ERIC Educational Resources Information Center

Ball, Brita; Brown, Lora Beth

2012-01-01

Objective: To discover how college students conduct dinner groups and perceptions of the benefits and difficulties of participation. Design: Qualitative study conducted with 7 focus groups. Setting and Participants: A university campus, with 36 students participating in dinner groups, defined as a group of 3 people or more cooking for one another…

The Therapeutic Play Group.

ERIC Educational Resources Information Center

Schiffer, Mortimer

A discussion of group play therapy includes chapters on the school as a setting for treating emotionally disturbed children and focuses on suggestions for group workers. A synopsis of the play group treatment process precedes a description of considerations in organizing groups and methods for working with the children. Recommendations are made…

The Impact of Being Part of an Action Learning Set for New Lecturers: A Reflective Analysis

ERIC Educational Resources Information Center

Haith, Mark P.; Whittingham, Katrina A.

2012-01-01

What is an action learning set (ALS)? An ALS is a regular, action focused peer discussion group, generally facilitated, to address work place issues. Methods of undertaking ALS: methods are flexible within a range of approaches according to the group's developing needs. Benefits of ALS: builds trust, professional development, enables action,…

Factors Considered in Determining Educational Setting for Students with Emotional Disturbance

ERIC Educational Resources Information Center

Hoge, Matthew

2013-01-01

The present study identified factors influencing determination of educational setting for students with Emotional Disturbance (ED). Determination of most appropriate educational setting, a key provision of students' individualized education programs (IEP) continues to be one the most contentious issues in special education. Focus group interviews…

Strategies to Increase Participation in Cooperative Learning Groups

ERIC Educational Resources Information Center

Maher, Laura

2010-01-01

This action research examines how focused organization, group roles, and gender grouping impact student participation when working in a cooperative group setting. Fifty-two sixth graders were studied for a period of nine weeks. Results show when students are organized in their cooperative groups, there will be an increase in student participation.…

Focus-on-form instructional methods promote deaf college students' improvement in English grammar.

PubMed

Berent, Gerald P; Kelly, Ronald R; Aldersley, Stephen; Schmitz, Kathryn L; Khalsa, Baldev Kaur; Panara, John; Keenan, Susan

2007-01-01

Focus-on-form English teaching methods are designed to facilitate second-language learners' noticing of target language input, where "noticing" is an acquisitional prerequisite for the comprehension, processing, and eventual integration of new grammatical knowledge. While primarily designed for teaching hearing second-language learners, many focus-on-form methods lend themselves to visual presentation. This article reports the results of classroom research on the visually based implementation of focus-on-form methods with deaf college students learning English. Two of 3 groups of deaf students received focus-on-form instruction during a 10-week remedial grammar course; a third control group received grammatical instruction that did not involve focus-on-form methods. The 2 experimental groups exhibited significantly greater improvement in English grammatical knowledge relative to the control group. These results validate the efficacy of visually based focus-on-form English instruction for deaf students of English and set the stage for the continual search for innovative and effective English teaching methodologies.

No Natives Here: A Focus Group Study of Student Perceptions of Web 2.0 and the Academic Library

ERIC Educational Resources Information Center

Burhanna, Kenneth J.; Seeholzer, Jamie

2009-01-01

This study explores Web 2.0 technologies in an academic library through focus groups with undergraduates at Kent State University. Results reveal that students, despite being heavy users, are less sophisticated and expressive in their use of Web 2.0 than presumed. Students set clear boundaries between educational and social spaces on the Web, and…

Aspirations, Barriers, and Community Strengths: A Qualitative Survey of Urban Chicano Youth and Families. Occasional Paper No. 38. Latino Studies Series.

ERIC Educational Resources Information Center

Vera, Elizabeth M.

To initiate a primary prevention program in a Midwestern urban community consisting primarily of Chicanos, needs were assessed by conducting focus group meetings with school administrators, teachers, parents, and children in a public school setting. In each student focus group, 8-10 children were selected from a seventh-grade classroom, an…

It's Never Too Late for "Us" to Meet "Them:" Prior Intergroup Friendships Moderate the Impact of Later Intergroup Friendships in Educational Settings

ERIC Educational Resources Information Center

Al Ramiah, Ananthi; Hewstone, Miles; Voci, Alberto; Cairns, Ed; Hughes, Joanne

2013-01-01

Background: In this paper, we focused on mixing in educational settings between members of Catholic and Protestant ethnoreligious groups in Northern Ireland. Aims:. In Study 1, we examined whether opportunities for contact at home and at university were associated with greater actual out-group friendships, and whether this friendship was…

Identifying Multilevel Barriers to Tobacco Intervention in Postdoctoral Dental Education.

PubMed

Albert, David A; Bruzelius, Emilie; Ward, Angela; Gordon, Judith S

2016-04-01

The aims of this mixed-methods study were to assess tobacco treatment behaviors among residents and faculty in dental specialty postdoctoral programs and to explore factors in training and practice related to tobacco treatment education. Surveys and focus groups were conducted with a convenience sample of participants at three postdoctoral residency programs in New York City. Surveys assessed tobacco cessation training and behaviors. Focus groups explored barriers to implementing tobacco cessation treatment in educational settings. Data were collected between May and December 2013. Among the 160 faculty and residents identified as potentially eligible for the study, 60 were invited by program directors to participate, and 50 subsequently completed the survey and participated in a focus group (response rate of 31.3%). Survey results indicated high levels of asking patients about tobacco use and advising patients to quit. In contrast, specific tobacco cessation assistance and follow-up care occurred less frequently. There were statistically significant differences in tobacco cessation intervention across the specialties surveyed, but not between residents and faculty. Focus group comments were grouped into three broad areas: clinician factors, organizational support, and structural and contextual factors. Focus group results indicated that participants experienced significant organizational and structural barriers to learning about and providing tobacco treatment. Participants from each specialty indicated that multi-level barriers impeded their provision of evidence-based tobacco cessation interventions in postdoctoral educational settings. They suggested that didactic education should be reinforced by organizational- and systems-level changes to facilitate comprehensive tobacco education and effective cessation treatment in future dental practice.

Implementing iPads in the Inclusive Classroom Setting

ERIC Educational Resources Information Center

Maich, Kimberly; Hall, Carmen

2016-01-01

This column provides practical suggestions to help guide teachers in utilizing classroom sets of iPads. Following a brief introduction to tablet technology in inclusive classrooms and the origin of these recommendations from a case study focus group, important elements of setting up classroom iPad use, from finding funding to teaching apps, are…

An Analysis of Training Focused on Improving SMART Goal Setting for Specific Employee Groups

ERIC Educational Resources Information Center

Worden, Jeannie M.

2014-01-01

This quantitative study examined the proficiency of employee SMART goal setting following the intervention of employee SMART goal setting training. Current challenges in higher education substantiate the need for employees to align their performance with the mission, vision, and strategic directions of the organization. A performance management…

[Improving the control of food allergy and intolerance risks in school settings: qualitative inputs from focus groups].

PubMed

Londoño, Teresa; Trabado, Verónica; García-Rodríguez, Alejo; Balfagón, Pere; Villalbí, Joan R

2018-04-21

This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Six characteristics of nutrition education videos that support learning and motivation to learn.

PubMed

Ramsay, Samantha A; Holyoke, Laura; Branen, Laurel J; Fletcher, Janice

2012-01-01

To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children. Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus group interview, 3-8 participants (n = 37) viewed video vignettes and participated in a facilitated focus group discussion that was audiorecorded, transcribed, and analyzed. Primary characteristics of video vignettes child care providers perceived as supporting learning and motivation to learn about feeding young children were identified: (1) use real scenarios; (2) provide short segments; (3) present simple, single messages; (4) convey a skill-in-action; (5) develop the videos so participants can relate to the settings; and (6) support participants' ability to conceptualize the information. These 6 characteristics can be used by nutrition educators in selecting and developing videos in nutrition education. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Attitudes and beliefs about exercise among elderly African Americans in an urban community.

PubMed Central

Lavizzo-Mourey, R.; Cox, C.; Strumpf, N.; Edwards, W. F.; Lavizzo-Mourey, R.; Stinemon, M.; Grisso, J. A.

2001-01-01

Older African Americans are less likely to exercise compared with their white counterparts. Few studies have examined the facilitating factors and barriers to exercise among older African Americans living in urban communities. This study represented the first phase of a program to develop an exercise intervention in an urban community. Qualitative research was conducted to identify culturally determined attitudes that could be useful in designing an effective exercise program. Five focus groups involving 38 persons from a variety of settings were facilitated by trained professionals. Transcripts were analyzed to identify themes and contrasts among group participants. Contrary to the expectations of the investigative team, focus-group participants: (1) uniformly preferred group exercises compared with exercising at home, (2) rejected walking as a feasible option because of safety concerns, and (3) expressed limited interest in using weights or Eastern exercises such as Tai Chi. Concepts and goals of exercise differed according to the physical capabilities of the participants. The analysis of these focus-group discussions provided valuable insights with regard to the development of our community-based exercise-intervention protocol. These findings may be important in designing effective exercise programs for older African Americans in urban settings. PMID:11800276

Pretest and refinement of items for alcohol highway safety surveys

DOT National Transportation Integrated Search

1984-05-30

This study summarizes the procedures employed in pre-testing a set of alcohol-highway safety questionnaire items. The procedures included conducting a set of focus groups and a series of telephone interviews on several forms of the questionnaires. Th...

Underreporting Discrimination among Arab American and Muslim American Community College Students: Using Focus Groups to Unravel the Ambiguities within the Survey Data

ERIC Educational Resources Information Center

Shammas, Diane

2017-01-01

Using a mixed methods approach, the researcher gathered a set of narrative responses from focus groups that supported the claim of underreporting campus discrimination on a survey. Multiple studies have shown that underrepresented minority students are likely to bond with same-ethnic peers in a racially tense campus climate. This mixed method is a…

Seeing Students Squirm: Nursing Students' Experiences of Bullying Behaviors During Clinical Rotations.

PubMed

Smith, Carolyn R; Gillespie, Gordon Lee; Brown, Kathryn C; Grubb, Paula L

2016-09-01

Bullying remains a troubling problem in the nursing profession. Nursing students may encounter bullying behavior in clinical settings. However, they may not be adequately prepared to recognize and handle bullying behavior when it occurs. This study's purpose was to gain a greater understanding of nursing students' experiences of bullying behaviors in the clinical setting. Using a descriptive qualitative approach, eight focus groups were held with 56 undergraduate baccalaureate nursing students from four college campuses. Focus group data were coded and analyzed for themes. Four categories were identified: Bullying Behaviors, Rationale for Bullying, Response to Bullying, and Recommendations to Address Bullying. Each category and its corresponding themes are presented. Interventions for nurse educators to address the bullying of nursing students in clinical settings are presented. [J Nurs Educ. 2016;55(9):505-513.]. Copyright 2016, SLACK Incorporated.

Do action learning sets facilitate collaborative, deliberative learning?: A focus group evaluation of Graduate Entry Pre-registration Nursing (GEN) students' experience.

PubMed

Maddison, Charlotte; Strang, Gus

2018-01-01

The aim of this study was to investigate if by participating in action learning sets, Graduate Entry Pre-registration Nursing (GEN) students were able to engage in collaborative and deliberative learning. A single focus group interview involving eleven participants was used to collect data. Data analysis identified five themes; collaborative learning; reflection; learning through case study and problem-solving; communication, and rejection of codified learning. The themes are discussed and further analysed in the context of collaborative and deliberative learning. The evidence from this small scale study suggests that action learning sets do provide an environment where collaborative and deliberative learning can occur. However, students perceived some of them, particularly during year one, to be too 'teacher lead', which stifled learning. Copyright © 2017 Elsevier Ltd. All rights reserved.

Seeing Students Squirm: Nursing Students’ Experiences of Bullying Behaviors During Clinical Rotations

PubMed Central

Smith, Carolyn R.; Gillespie, Gordon Lee; Brown, Kathryn C.; Grubb, Paula L.

2016-01-01

Background Bullying remains a troubling problem in the nursing profession. Nursing students may encounter bullying behavior in clinical settings. However nursing students may not be adequately prepared to recognize and handle bullying behavior when it occurs. The purpose of this study was to gain greater understanding of nursing students’ experiences of bullying behaviors in the clinical setting. Method Using a descriptive qualitative approach, eight focus groups were held with 56 undergraduate baccalaureate nursing students from four college campuses. Focus group data were coded and analyzed for themes. Results Four categories of themes were identified: bullying behaviors, rationale for bullying, response to bullying, and recommendations to address bullying. Each category and its corresponding themes are presented. Conclusion Interventions for nurse educators to address bullying of nursing students in clinical settings are presented. PMID:27560118

Community participation to refine measures of socio-economic status in urban slum settings in Kenya.

PubMed

Ngongo, Carrie Jane; Mathingau, Florence Alice; Burke, Heather; Brieger, William; Frick, Kevin; Chapman, Kimberly; Breiman, Robert

Ownership of household durable assets can be a useful proxy for determining relative socio-economic status in a community, but the assets that should be measured are not always unambiguous. Often the selection of asset variables has been ad hoc or not well explained in the literature. Although the benefits of conducting focus groups to design surveys are widely recognized, the use of focus groups to adapt community-specific asset indices has not previously been reported in Kenya. This article describes how focus group discussions can allow communities to express how residents value assets and distinguish relative wealth. Focus group discussions were conducted within the informal urban settlement of Kibera in Nairobi, Kenya. Participants identified assets that distinguish between the poorest and the least poor in their community. They considered whether they would move away from the slum if they had the opportunity, and many would not, citing reasons ranging from loyalty to the community to greater living expenses on the outside. Local perceptions of relative poverty and mobility provide insight into how quality of life in this setting can be assessed and potentially improved. Moreover, a qualitative approach can lead to the adaptation of a community asset index for use in further research.

Use of focus groups in multi-site, multi-ethnic research projects for women's health: a Study of Women Across the Nation (swan) example.

PubMed

Kagawa-Singer, Marjorie; Adler, Shelley R; Mouton, Charles E; Ory, Marcia; Underwood, Lynne G

2009-01-01

To outline the lessons learned about the use of focus groups for the multisite, multi-ethnic longitudinal Study of Women Across the Nation (SWAN). Focus groups were designed to identify potential cultural differences in the incidence of symptoms and the meaning of transmenopause among women of diverse cultures, and to identify effective recruitment and retention strategies. Inductive and deductive focus groups for a multi-ethnic study. Seven community research sites across the United States conducted focus groups with six ethnic populations: African American, Chinese American, Japanese American, Mexican American, non-Hispanic white, and Puerto Rican. Community women from each ethnic group of color. A set of four/five focus groups in each ethnic group as the formative stage of the deductive, quantitative SWAN survey. Identification of methodological advantages and challenges to the successful implementation of formative focus groups in a multi-ethnic, multi-site population-based epidemiologic study. We provide recommendations from our lessons learned to improve the use of focus groups in future studies with multi-ethnic populations. Mixed methods using inductive and deductive approaches require the scientific integrity of both research paradigms. Adequate resources and time must be budgeted as essential parts of the overall strategy from the outset of study. Inductive cross-cultural researchers should be key team members, beginning with inception through each subsequent design phase to increase the scientific validity, generalizability, and comparability of the results across diverse ethnic groups, to assure the relevance, validity and applicability of the findings to the multicultural population of focus.

Getting (the most) out of the research business: interventions for youth with T1DM.

PubMed

Harris, Michael A; Freeman, Kurt A; Duke, Danny C

2010-12-01

We review research on psychosocial interventions to improve outcomes for youth with type 1 diabetes mellitus. Specifically, we discuss individual- and small group-focused, family-focused, group-focused, and other interventions. After reviewing extant research in each area, we discuss how the current evidence base may be used to inform clinical practice. Finally, we conclude by discussing variations in effects of interventions on different outcomes (eg, glycemic control, family functioning) and how to consider this evidence when selecting treatments to transport into clinical settings.

Perceived effective and feasible strategies to promote healthy eating in young children: focus groups with parents, family child care providers and daycare assistants.

PubMed

Vandeweghe, Laura; Moens, Ellen; Braet, Caroline; Van Lippevelde, Wendy; Vervoort, Leentje; Verbeken, Sandra

2016-10-04

The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children's eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14), family child care providers (n = 9), and daycare assistants (n = 10). The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy). Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.

Group Motivational Interviewing in Schools: Development of a Health Promotion Intervention

ERIC Educational Resources Information Center

Hawkins, Jemma L.; Bravo, Paulina; Gobat, Nina; Rollnick, Stephen; Jerzembek, Gabrielle; Whitehead, Sarah; Chanon, Sue; Kelson, Mark; Adams, Orla; Murphy, Simon

2016-01-01

Objective: In the light of the shortcomings of curriculum-based health promotion in secondary schools, group motivational interviewing provides a potential alternative approach. This two-phase study set out to establish the key components, feasibility and acceptability of a group motivational interviewing intervention, focused on alcohol…

Gestures: Silent Scaffolding within Small Groups

ERIC Educational Resources Information Center

Carter, Glenda; Wiebe, Eric N.; Reid-Griffin, Angela

2006-01-01

This paper describes how gestures are used to enhance scaffolding that occurs in small group settings. Sixth and eighth grade students participated in an elective science course focused on earth science concepts with a substantial spatial visualization component. Gestures that students used in small group discussions were analyzed and four…

Reading Practices in the Juvenile Correctional Facility Setting: Incarcerated Adolescents Speak Out

ERIC Educational Resources Information Center

Wexler, Jade; Reed, Deborah K.; Sturges, Keith

2015-01-01

This multi-phasic, qualitative study explored the perceptions and provision of research-based reading instruction in the juvenile correctional facility setting. In three settings in two states, we interviewed students (n = 17), teachers (n = 5), and administrators (n = 3); and conducted two focus groups (n = 8), student surveys (n = 49), and seven…

Being an outpatient with rheumatoid arthritis--a focus group study on patients' self-efficacy and experiences from participation in a short course and one of three different outpatient settings.

PubMed

Primdahl, Jette; Wagner, Lis; Hørslev-Petersen, Kim

2011-06-01

A Danish study compared three different outpatient settings for persons with rheumatoid arthritis (RA). All participants completed a short course before random allocation to one of three groups. A third of the patients continued with planned medical consultations. A third was allocated to a shared care setting with no planned consultations. The final third was allocated for planned nursing consultations every 3 months. Little knowledge exists of patients' experiences at different outpatient settings. (1) To explore the patients' experiences of participation in the course and one of the three different outpatient settings and (2) to explore whether some of these experiences can explain possible changes in self-efficacy beliefs. In total six focus group interviews were carried out with 33 participants from the three settings. The interviews and the analysis were inspired by phenomenological philosophy. On the short course the participants felt understood, gained new insights and some changed behaviours after attendance. Important themes in experiences from the three outpatient settings were: (1) continuity and relationships with health professionals, (2) a need for others to take control, and (3) contact with health professionals. SPECIFIC FINDINGS: The nursing consultations were experienced as less factual and less authoritarian than the medical consultations. The participants in the shared care setting had a lack of confidence in the GP's competence to manage their RA. However, they felt responsible for taking action in case of a flare up. The study provided opportunities to enhance the participants' self-efficacy beliefs. When planning follow-up care, the focus needs to be on continuity, the interpersonal relationship and easy access to health professionals with thorough knowledge of RA. A short course and consultations with nurses and hospital doctors can enhance patients' self-efficacy and thereby strengthen their confidence to assess and manage their own disease. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

Caregiver Perspectives of Stigma Associated With Sickle Cell Disease in Adolescents.

PubMed

Wesley, Kimberly M; Zhao, Mimi; Carroll, Yvonne; Porter, Jerlym S

2016-01-01

Patients and families affected by various medical conditions report experiencing health-related stigma, which contributes to detrimental physical, psychological, and social outcomes. Sickle cell disease (SCD) is a genetic disorder that affects 89,000 individuals in the United States and is often associated with negative stereotypes and incorrect assumptions. The present study explored the perception of stigma as reported by caregivers of adolescents with SCD. Focus groups were conducted with 20 caregivers of patients with SCD. Focus groups were audio recorded and transcribed. The data were coded independently by two authors, and then reviewed conjointly until consensus was reached. Caregivers reported the perception of stigma in academic, medical, community, and family settings. They also reported internalized stigma including negative feelings toward having a child with SCD, feeling upset with others, and seeing negative emotions in their child due to SCD. Caregivers reported a general lack of knowledge about SCD across settings. These results demonstrated that stigma may affect individuals with SCD across multiple settings. These results also highlighted areas for intervention, with a focus on increasing communication and education toward medical providers, schools, and communities. Interventions can utilize technology, social media, and advertisement campaigns. Additionally, support groups for patients with SCD may help decrease stigma and validate patients' experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding the Knowledge Gap Experienced by U.S. Safety Net Patients in Teleretinal Screening.

PubMed

George, Sheba M; Hayes, Erin Moran; Fish, Allison; Daskivich, Lauren Patty; Ogunyemi, Omolola I

2016-01-01

Safety-net patients' socioeconomic barriers interact with limited digital and health literacies to produce a "knowledge gap" that impacts the delivery of healthcare via telehealth technologies. Six focus groups (2 African- American and 4 Latino) were conducted with patients who received teleretinal screening in a U.S. urban safety-net setting. Focus groups were analyzed using a modified grounded theory methodology. Findings indicate that patients' knowledge gap is primarily produced at three points during the delivery of care: (1) exacerbation of patients' pre-existing personal barriers in the clinical setting; (2) encounters with technology during screening; and (3) lack of follow up after the visit. This knowledge gap produces confusion, potentially limiting patients' perceptions of care and their ability to manage their own care. It may be ameliorated through delivery of patient education focused on both disease pathology and specific role of telehealth technologies in disease management.

Bringing Mathematics To Life.

ERIC Educational Resources Information Center

Castle, Marrietta; Lewis, Cathie

1996-01-01

Describes grade-appropriate weekly activities designed to appeal directly to students by giving them open-ended questions. Activities may be worked on individually, in pairs, or in small groups. This particular set of activities focuses on stories from literature involving measurement, earning money, marketing a product, and setting up a…

Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

PubMed Central

Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Ogahara, Kakuya; Sawada, Tatsunori; Uezu, Sei; Nagatani, Ryutaro; Yamauchi, Keita

2016-01-01

Background Care-home residents are mostly inactive, have little interaction with staff, and are dependent on staff to engage in daily occupations. We recently developed an iPad application called the Aid for Decision-making in Occupation Choice (ADOC) to promote shared decision-making in activities and occupation-based goal setting by choosing from illustrations describing daily activities. This study aimed to evaluate if interventions based on occupation-based goal setting using the ADOC could focus on meaningful activities to improve quality of life and independent activities of daily living, with greater cost-effectiveness than an impairment-based approach as well as to evaluate the feasibility of conducting a large cluster, randomized controlled trial. Method In this single (assessor)-blind pilot cluster randomized controlled trial, the intervention group (ADOC group) received occupational therapy based on occupation-based goal setting using the ADOC, and the interventions were focused on meaningful occupations. The control group underwent an impairment-based approach focused on restoring capacities, without goal setting tools. In both groups, the 20-minute individualized intervention sessions were conducted twice a week for 4 months. Main Outcome Measures Short Form-36 (SF-36) score, SF-6D utility score, quality adjusted life years (QALY), Barthel Index, and total care cost. Results We randomized and analyzed 12 facilities (44 participants, 18.5% drop-out rate), with 6 facilities each allocated to the ADOC (n = 23) and control (n = 21) groups. After the 4-month intervention, the ADOC group had a significantly greater change in the BI score, with improved scores (P = 0.027, 95% CI 0.41 to 6.87, intracluster correlation coefficient = 0.14). No other outcome was significantly different. The incremental cost-effectiveness ratio, calculated using the change in BI score, was $63.1. Conclusion The results suggest that occupational therapy using the ADOC for older residents might be effective and cost-effective. We also found that conducting an RCT in the occupational therapy setting is feasible. Trial Registration UMIN Clinical Trials Registry UMIN000012994 PMID:26930191

Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial.

PubMed

Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Ogahara, Kakuya; Sawada, Tatsunori; Uezu, Sei; Nagatani, Ryutaro; Yamauchi, Keita

2016-01-01

Care-home residents are mostly inactive, have little interaction with staff, and are dependent on staff to engage in daily occupations. We recently developed an iPad application called the Aid for Decision-making in Occupation Choice (ADOC) to promote shared decision-making in activities and occupation-based goal setting by choosing from illustrations describing daily activities. This study aimed to evaluate if interventions based on occupation-based goal setting using the ADOC could focus on meaningful activities to improve quality of life and independent activities of daily living, with greater cost-effectiveness than an impairment-based approach as well as to evaluate the feasibility of conducting a large cluster, randomized controlled trial. In this single (assessor)-blind pilot cluster randomized controlled trial, the intervention group (ADOC group) received occupational therapy based on occupation-based goal setting using the ADOC, and the interventions were focused on meaningful occupations. The control group underwent an impairment-based approach focused on restoring capacities, without goal setting tools. In both groups, the 20-minute individualized intervention sessions were conducted twice a week for 4 months. Short Form-36 (SF-36) score, SF-6D utility score, quality adjusted life years (QALY), Barthel Index, and total care cost. We randomized and analyzed 12 facilities (44 participants, 18.5% drop-out rate), with 6 facilities each allocated to the ADOC (n = 23) and control (n = 21) groups. After the 4-month intervention, the ADOC group had a significantly greater change in the BI score, with improved scores (P = 0.027, 95% CI 0.41 to 6.87, intracluster correlation coefficient = 0.14). No other outcome was significantly different. The incremental cost-effectiveness ratio, calculated using the change in BI score, was $63.1. The results suggest that occupational therapy using the ADOC for older residents might be effective and cost-effective. We also found that conducting an RCT in the occupational therapy setting is feasible. UMIN Clinical Trials Registry UMIN000012994.

How Do Parents and Teachers of Gifted Students Perceive Group Work in Classrooms?

ERIC Educational Resources Information Center

Saunders-Stewart, Katie S.; Walker, Cheryl L.; Shore, Bruce M.

2013-01-01

Although an abundance of information exists concerning advantages and disadvantages of certain grouping arrangements with highly able students in classroom settings, little research has focused on gifted children's parents' and teachers' opinions of group work. The present study explored potential differences between these opinions. Parents (n=…

A Qualitative Assessment of Weight Control among Rural Kansas Women

ERIC Educational Resources Information Center

Ely, Andrea C.; Befort, Christie; Banitt, Angela; Gibson, Cheryl; Sullivan, Debra

2009-01-01

Objective: To explore weight control beliefs, attitudes, knowledge, and practices among rural Kansas women, and to characterize the relationship of these women with their primary-care providers around weight control. Design: Qualitative research using focus groups. Setting: Three separate communities of rural Kansas. Participants: Six focus groups…

Scanning for satisfaction or digging for dismay? Comparing findings from a postal survey with those from a focus group-study.

PubMed

Carlsen, Benedicte; Glenton, Claire

2012-09-03

Despite growing support for mixed methods approaches we still have little systematic knowledge about the consequences of combining surveys and focus groups. While the methodological aspects of questionnaire surveys have been researched extensively, the characteristics of focus group methodology are understudied. We suggest and discuss whether the focus group setting, as compared to questionnaire surveys, encourages participants to exaggerate views in a negative direction. Based on an example from our own research, where we conducted a survey as a follow up of a focus group study, and with reference to theoretical approaches and empirical evidence from the literature concerning survey respondent behaviour and small group dynamics, we discuss the possibility that a discrepancy in findings between the focus groups and the questionnaire reflects characteristics of the two different research methods. In contrast to the survey, the focus group study indicated that doctors were generally negative to clinical guidelines. We were not convinced that this difference in results was due to methodological flaws in either of the studies, and discuss instead how this difference may have been the result of a general methodological phenomenon. Based on studies of how survey questionnaires influence responses, it appears reasonable to claim that surveys are more likely to find exaggerated positive views. Conversely, there are some indications in the literature that focus groups may result in complaints and overly negative attitudes, but this is still an open question. We suggest that while problematic issues tend to be under-communicated in questionnaire surveys, they may be overstated in focus groups.We argue for the importance of increasing our understanding of focus group methodology, for example by reporting interesting discrepancies in mixed methods studies. In addition, more experimental research on focus groups should be conducted to advance the methodology and to test our hypothesis.

Scanning for satisfaction or digging for dismay? Comparing findings from a postal survey with those from a focus group-study

PubMed Central

2012-01-01

Background Despite growing support for mixed methods approaches we still have little systematic knowledge about the consequences of combining surveys and focus groups. While the methodological aspects of questionnaire surveys have been researched extensively, the characteristics of focus group methodology are understudied. We suggest and discuss whether the focus group setting, as compared to questionnaire surveys, encourages participants to exaggerate views in a negative direction. Discussion Based on an example from our own research, where we conducted a survey as a follow up of a focus group study, and with reference to theoretical approaches and empirical evidence from the literature concerning survey respondent behaviour and small group dynamics, we discuss the possibility that a discrepancy in findings between the focus groups and the questionnaire reflects characteristics of the two different research methods. In contrast to the survey, the focus group study indicated that doctors were generally negative to clinical guidelines. We were not convinced that this difference in results was due to methodological flaws in either of the studies, and discuss instead how this difference may have been the result of a general methodological phenomenon. Summary Based on studies of how survey questionnaires influence responses, it appears reasonable to claim that surveys are more likely to find exaggerated positive views. Conversely, there are some indications in the literature that focus groups may result in complaints and overly negative attitudes, but this is still an open question. We suggest that while problematic issues tend to be under-communicated in questionnaire surveys, they may be overstated in focus groups. We argue for the importance of increasing our understanding of focus group methodology, for example by reporting interesting discrepancies in mixed methods studies. In addition, more experimental research on focus groups should be conducted to advance the methodology and to test our hypothesis. PMID:22943658

Identification of relevant functional issues for the care of patients with acute arthritis by health professionals, using the ICF framework and a multi-disciplinary focus group approach.

PubMed

Zochling, J; Grill, E; Alten, R; Ernst, J; Stucki, G; Braun, J

2007-01-01

To identify the most relevant problems to be addressed in the multi-disciplinary care of patients with acute arthritis using focus groups of health professionals followed by a Delphi process. Focus group and Delphi methodology were applied. The focus groups were conducted at three specialist rheumatology hospital clinics in Germany, each group comprising rheumatologists, nurses, physiotherapists, occupational therapists, psychologists and social workers. The participants were asked to decide which categories of the International Classification of Functioning, Disability and Health (ICF) are relevant to the care of patients with acute inflammatory arthritis. The results from the focus groups were then followed by an anonymous Delphi process. Twenty-six health professionals participated in the 3 focus groups. 167 of the second-level ICF categories (63% of all second-level categories) were considered as relevant by the rheumatology health professionals. Items from all four components, Body Functions, Body Structures, Activities and Participation and Environmental Factors were represented. Agreement between focus groups and between different health professional groups was substantial for all components with the exception of Environmental Factors (Cohen's kappa 0.23). The involvement of experts from different health professions is a valuable tool to identify typical patient characteristics, expressed as distinct ICF categories, to aid in patient care in the acute rheumatology setting. Acute patient care cannot and should not be separated from ongoing long-term management.

Use of concurrent mixed methods combining concept mapping and focus groups to adapt a health equity tool in Canada.

PubMed

Guichard, Anne; Tardieu, Émilie; Dagenais, Christian; Nour, Kareen; Lafontaine, Ginette; Ridde, Valéry

2017-04-01

The aim of this project was to identify and prioritize a set of conditions to be considered for incorporating a health equity tool into public health practice. Concept mapping and focus groups were implemented as complementary methods to investigate the conditions of use of a health equity tool by public health organizations in Quebec. Using a hybrid integrated research design is a richer way to address the complexity of questions emerging from intervention and planning settings. This approach provides a deeper, operational, and contextualized understanding of research results involving different professional and organizational cultures, and thereby supports the decision-making process. Concept mapping served to identify and prioritize in a limited timeframe the conditions to be considered for incorporation into a health equity tool into public health practices. Focus groups then provided a more refined understanding of the barriers, issues, and facilitating factors surrounding the tools adoption, helped distinguish among participants' perspectives based on functional roles and organizational contexts, and clarified some apparently contradictory results from the concept map. The combined use of these two techniques brought the strengths of each approach to bear, thereby overcoming some of the respective limitations of concept mapping and focus groups. This design is appropriate for investigating targets with multiple levels of complexity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Architecture for Building Conversational Agents that Support Collaborative Learning

ERIC Educational Resources Information Center

Kumar, R.; Rose, C. P.

2011-01-01

Tutorial Dialog Systems that employ Conversational Agents (CAs) to deliver instructional content to learners in one-on-one tutoring settings have been shown to be effective in multiple learning domains by multiple research groups. Our work focuses on extending this successful learning technology to collaborative learning settings involving two or…

Instructional Utilization of the Internet in Public School Settings.

ERIC Educational Resources Information Center

Milheim, William D.

1997-01-01

Discussion of use of the Internet in educational settings focuses on providing specific information for elementary and secondary school personnel to increase their awareness and utilization of the Internet. Topics include accessing the Internet; school access; origins of the Internet; electronic mail; discussion groups, or listservs; newsgroups;…

Physician assistant students' views regarding interprofessional education: a focus group study.

PubMed

Lie, Désirée; Walsh, Anne; Segal-Gidan, Freddi; Banzali, Yvonne; Lohenry, Kevin

2013-01-01

The purpose of this study was to identify and report physician assistant (PA) student experiences, learning, and opinions regarding interprofessional education (IPE). A series of open-ended questions was constructed and designed to solicit PA students' opinions about the need for IPE, preferred teaching strategies, and implementation methods, using focus group methodology. We used two sets of questions, one for students who had participated in a formal geriatrics IPE experience (n = 12), the other for students who did not have the experience (n = 10). Focus group sessions were audiotaped and transcripts coded. Key themes were identified and ranked. Twenty-two students participated in four focus groups. Theme saturation was reached and six overlapping themes emerged: (1) PA students learned the most about occupational and physical therapist roles; (2) They were surprised at other professions' lack of knowledge about the PA profession; (3) They strongly expressed that IPE should be required early in training; (4) They expressed preference for direct patient care with other health professions students, with trained faculty oversight; (5) They requested diverse clinical settings; and (6) They identified the optimal number of different students in a single IPE experience as four/five. The group exposed to geriatrics IPE noted the critical importance of faculty training for facilitation, while the nonexposed group emphasized the challenge of limited curricular time. PA students recognize the importance of IPE and request early, required clinical experiences led by well-trained interprofessional faculty with the option to choose clinical sites. Student preferences should be considered in IPE curriculum design.

Batch Effect Confounding Leads to Strong Bias in Performance Estimates Obtained by Cross-Validation

PubMed Central

Delorenzi, Mauro

2014-01-01

Background With the large amount of biological data that is currently publicly available, many investigators combine multiple data sets to increase the sample size and potentially also the power of their analyses. However, technical differences (“batch effects”) as well as differences in sample composition between the data sets may significantly affect the ability to draw generalizable conclusions from such studies. Focus The current study focuses on the construction of classifiers, and the use of cross-validation to estimate their performance. In particular, we investigate the impact of batch effects and differences in sample composition between batches on the accuracy of the classification performance estimate obtained via cross-validation. The focus on estimation bias is a main difference compared to previous studies, which have mostly focused on the predictive performance and how it relates to the presence of batch effects. Data We work on simulated data sets. To have realistic intensity distributions, we use real gene expression data as the basis for our simulation. Random samples from this expression matrix are selected and assigned to group 1 (e.g., ‘control’) or group 2 (e.g., ‘treated’). We introduce batch effects and select some features to be differentially expressed between the two groups. We consider several scenarios for our study, most importantly different levels of confounding between groups and batch effects. Methods We focus on well-known classifiers: logistic regression, Support Vector Machines (SVM), k-nearest neighbors (kNN) and Random Forests (RF). Feature selection is performed with the Wilcoxon test or the lasso. Parameter tuning and feature selection, as well as the estimation of the prediction performance of each classifier, is performed within a nested cross-validation scheme. The estimated classification performance is then compared to what is obtained when applying the classifier to independent data. PMID:24967636

Encouraging smoking cessation among disadvantaged groups: a qualitative study of the financial aspects of cessation.

PubMed

Bonevski, Billie; Bryant, Jamie; Paul, Christine

2011-07-01

This study aimed to explore perceptions about financial aspects of smoking cessation among a group of disadvantaged welfare agency clients and their carers. Qualitative focus groups and in-depth interviews were supplemented with participant exit surveys about preferred smoking cessation strategies. Each discussion was audiotaped, transcribed and analysed using a thematic analysis. The setting was six non-government community welfare service organisations operating in New South Wales, Australia. Eleven social services offered by these organisations participated. Thirty two clients participated in six client focus groups, 35 staff participated in six staff focus groups and eight manager telephone interviews were conducted. Clients indicated that the cost of nicotine replacement therapy was a barrier to its use and that financial incentives were acceptable. Of the 16 possible strategies listed in the exit survey, the three selected as the most preferred by clients incorporated financial or non-financial assistance. By contrast, staff and managers selected financial and non-financial incentives as the least preferred and least feasible strategies. The study found high acceptance of incentives as a smoking cessation strategy among a disadvantaged group of non-government welfare service clients. The comparatively low level of desirability and feasibility from the perspective of service staff and managers suggests implementation of such an approach within the community service setting requires careful further testing. © 2010 Australasian Professional Society on Alcohol and other Drugs.

Using qualitative insights to change practice: exploring the culture of antibiotic prescribing and consumption for urinary tract infections

PubMed Central

Duane, Sinead; Domegan, Christine; Callan, Aoife; Galvin, Sandra; Cormican, Martin; Bennett, Kathleen; Murphy, Andrew W

2016-01-01

Objectives The aim of this paper is to explore the culture of antibiotic prescribing and consumption in the community for urinary tract infections (UTI) from the perspective of the general practitioners (GPs) and community member. Design Indepth interviews were conducted with GPs, and focus groups were held with community members. Setting General practice and community setting. Participants 15 GPs practising in rural and urban locations in Ireland participated in the indepth interviews. 6 focus groups (n=42) with participants who had direct or indirect experiences with UTI were also undertaken. Results The decision to prescribe or consume an antibiotic for a UTI is a set of complex processes including need recognition, information search and evaluation processes governed by the relationship and interactions between the GP and the patient. Different GP and patient decision-making profiles emerged emphasising the diversity and variety of general practice in real-life settings. The GP findings showed a requirement for more microbiological information on antibiotic resistance patterns to inform prescribing decisions. Focus group participants wanted a conversation with the GP about their illness and the treatment options available. Conclusions Collectively, this research identified the consultation as a priority intervention environment for stimulating change in relation to antibiotics. This paper demonstrates how qualitative research can identify the interacting processes which are instrumental to the decision to prescribe or consume an antibiotic for a suspected UTI. Qualitative research empowers researchers to investigate the what, how and why of interventions in real-life setting. Qualitative research can play a critical and instrumental role in designing behavioural change strategies with high impact on practice. The results of this research were used to design a complex intervention informed by social marketing. Trial registration number NCT01913860; Pre-results. PMID:26754175

Clarifying the learning experiences of healthcare professionals with in situ and off-site simulation-based medical education: a qualitative study

PubMed Central

Sørensen, Jette Led; Navne, Laura Emdal; Martin, Helle Max; Ottesen, Bent; Albrecthsen, Charlotte Krebs; Pedersen, Berit Woetmann; Kjærgaard, Hanne; van der Vleuten, Cees

2015-01-01

Objective To examine how the setting in in situ simulation (ISS) and off-site simulation (OSS) in simulation-based medical education affects the perceptions and learning experience of healthcare professionals. Design Qualitative study using focus groups and content analysis. Participants Twenty-five healthcare professionals (obstetricians, midwives, auxiliary nurses, anaesthesiologists, a nurse anaesthetist and operating theatre nurse) participated in four focus groups and were recruited due to their exposure to either ISS or OSS in multidisciplinary obstetric emergencies in a randomised trial. Setting Departments of obstetrics and anaesthesia, Rigshospitalet, Copenhagen, Denmark. Results Initially participants preferred ISS, but this changed after the training when the simulation site became of less importance. There was a strong preference for simulation in authentic roles. These perceptions were independent of the ISS or OSS setting. Several positive and negative factors in simulation were identified, but these had no relation to the simulation setting. Participants from ISS and OSS generated a better understanding of and collaboration with the various health professionals. They also provided individual and team reflections on learning. ISS participants described more experiences that would involve organisational changes than the OSS participants did. Conclusions Many psychological and sociological aspects related to the authenticity of the learning experience are important in simulation, but the physical setting of the simulation as an ISS and OSS is the least important. Based on these focus groups OSS can be used provided that all other authenticity elements are taken into consideration and respected. The only difference was that ISS had an organisational impact and ISS participants talked more about issues that would involve practical organisational changes. ISS and OSS participants did, however, go through similar individual and team learning experiences. PMID:26443655

Validation of the Comprehensive ICF Core Set for obstructive pulmonary diseases from the patient's perspective.

PubMed

Marques, Alda; Jácome, Cristina; Gonçalves, Ana; Silva, Sara; Lucas, Carla; Cruz, Joana; Gabriel, Raquel

2014-06-01

This study aimed to validate the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for obstructive pulmonary diseases (OPDs) from the perspective of patients with chronic obstructive pulmonary disease. A cross-sectional qualitative study was carried out with outpatients with chronic obstructive pulmonary disease using focus groups with an ICF-based approach. Qualitative data were analysed using the meaning condensation procedure by two researchers with expertise in the ICF. Thirty-two participants (37.5% women; 63.8 ± 11.3 years old) were included in six focus groups. A total of 61 (86%) ICF categories of the Comprehensive ICF Core Set for OPD were confirmed. Thirty-nine additional second-level categories not included in the Core Set were identified: 15 from the body functions component, four from the body structures, nine from the activities and participation and 11 from the environmental factors. The majority of the categories included in the Comprehensive ICF Core Set for OPD were confirmed from the patients' perspective. However, additional categories, not included in the Core Set, were also reported. The categories included in the Core Set were not confirmed and the additional categories need to be investigated further to develop an instrument tailored to patients' needs. This will promote patient-centred assessments and rehabilitation interventions.

Depression in Aboriginal men in central Australia: adaptation of the Patient Health Questionnaire 9

PubMed Central

2013-01-01

Background While Indigenous Australians are believed to be at a high risk of psychological illness, few screening instruments have been designed to accurately measure this burden. Rather than simply transposing western labels of symptoms, this paper describes the process by which a screening tool for depression was specifically adapted for use across multiple Indigenous Australian communities. Method Potential depression screening instruments were identified and interrogated according to a set of pre-defined criteria. A structured process was then developed which relied on the expertise of five focus groups comprising of members from primary Indigenous language groups in central Australia. First, focus group participants were asked to review and select a screening measure for adaptation. Bi-lingual experts then translated and back translated the language within the selected measure. Focus group participants re-visited the difficult items, explored their meaning and identified potential ways to achieve equivalence of meaning. Results All five focus groups independently selected the Primary Health Questionnaire 9, several key conceptual differences were exposed, largely related to the construction of hopelessness. Together with translated versions of each instrument for each of the five languages, a single, simplified English version for use across heterogeneous settings was negotiated. Importantly, the ‘code’ and specific conceptually equivalent words that could be used for other Indigenous language groups were also developed. Conclusions The extensive process of adaptation used in this study has demonstrated that within the context of Indigenous Australian communities, across multiple language groups, where English is often a third or fourth language, conceptual and linguistic equivalence of psychological constructs can be negotiated. A validation study is now required to assess the adapted instrument’s potential for measuring the burden of disease across all Indigenous Australian populations. PMID:24139186

Patient perspectives on disparities in healthcare from African-American, Asian, Hispanic, and Native American samples including a secondary analysis of the Institute of Medicine focus group data.

PubMed

Gaston-Johansson, Fannie; Hill-Briggs, Felicia; Oguntomilade, Lola; Bradley, Vanessa; Mason, Phyllis

2007-12-01

The existence of racial and ethnic disparities in healthcare in the United States is well recognized. However, often overlooked in the planning and design of initiatives to address those disparities are the patient perspectives regarding the issues of racial and ethnic disparities that directly affect them. The objective of this study was to identify the patient priorities and to provide recommendations for action to improve minority health-care quality. A secondary objective was the qualitative analysis of the Institute of Medicine (IOM) focus group data. Six focus groups were conducted with nine participants in each. These included an African-American focus group in Washington, D.C., an African-American focus group in Los Angeles, an Asian focus group in Los Angeles, an Hispanic focus group in Washington, D.C., an Hispanic focus group in Los Angeles, and a Native American focus group in Albuquerque, NM. The barriers and priorities for action included difficulty in making informed choices when identifying and selecting providers, poor service delivery from medical office staff, the inefficiency of medical visits, provider communication and cultural competence barriers, and stressful treatment settings. Patient recommendations targeted provision of tools to empower patients throughout the process of care, provider and staff training in communication and cultural competence, alternate models of service delivery, and accessible mechanisms for evaluation and oversight. This study concluded that patient-identified priorities and recommendations warranted modification of current explanatory models for minority health-care quality and the provision of greater clarity regarding directions for policy and behavioral initiatives and criteria for performance evaluation be advanced.

An International Collaborative Standardizing a Comprehensive Patient-Centered Outcomes Measurement Set for Colorectal Cancer.

PubMed

Zerillo, Jessica A; Schouwenburg, Maartje G; van Bommel, Annelotte C M; Stowell, Caleb; Lippa, Jacob; Bauer, Donna; Berger, Ann M; Boland, Gilles; Borras, Josep M; Buss, Mary K; Cima, Robert; Van Cutsem, Eric; van Duyn, Eino B; Finlayson, Samuel R G; Hung-Chun Cheng, Skye; Langelotz, Corinna; Lloyd, John; Lynch, Andrew C; Mamon, Harvey J; McAllister, Pamela K; Minsky, Bruce D; Ngeow, Joanne; Abu Hassan, Muhammad R; Ryan, Kim; Shankaran, Veena; Upton, Melissa P; Zalcberg, John; van de Velde, Cornelis J; Tollenaar, Rob

2017-05-01

Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients. The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer. The working group was composed of multidisciplinary oncology specialists in medicine, surgery, radiation therapy, palliative care, nursing, and pathology, along with patient representatives. Through a modified Delphi process during 8 months (July 8, 2015 to February 29, 2016), ICHOM led the working group to a consensus on a final recommended standard set. The process was supported by a systematic PubMed literature review (1042 randomized clinical trials and guidelines from June 3, 2005, to June 3, 2015), a patient focus group (11 patients with early and metastatic colorectal cancer convened during a teleconference in August 2015), and a patient validation survey (among 276 patients with and survivors of colorectal cancer between October 15, 2015, and November 4, 2015). After consolidating findings of the literature review and focus group meeting, a list of 40 outcomes was presented to the WG and underwent voting. The final recommendation includes outcomes in the following categories: survival and disease control, disutility of care, degree of health, and quality of death. Selected case-mix factors were recommended to be collected at baseline to facilitate comparison of results across treatments and health care professionals. A standardized set of patient-centered outcome measures to inform value-based health care in colorectal cancer was developed. Pilot efforts are under way to measure the standard set among members of the working group.

Group Dynamics and Individual Roles: A Differentiated Approach to Social-Emotional Learning

ERIC Educational Resources Information Center

Dugas, Daryl

2017-01-01

Differentiated instruction is a set of strategies to help teachers meet each child where he or she is in order to improve students' engagement, lead them to do their best work, and maximize their success. This article describes a differentiated classroom management approach based in group dynamics which focuses on the development of group norms…

Preference-based measures to obtain health state utility values for use in economic evaluations with child-based populations: a review and UK-based focus group assessment of patient and parent choices.

PubMed

Wolstenholme, Jane L; Bargo, Danielle; Wang, Kay; Harnden, Anthony; Räisänen, Ulla; Abel, Lucy

2018-03-21

No current guidance is available in the UK on the choice of preference-based measure (PBM) that should be used in obtaining health-related quality of life from children. The aim of this study is to review the current usage of PBMs for obtaining health state utility values in child and adolescent populations, and to obtain information on patient and parent-proxy respondent preferences in completing PBMs in the UK. A literature review was conducted to determine which instrument is most frequently used for child-based economic evaluations and whether child or proxy responses are used. Instruments were compared on dimensions, severity levels, elicitation and valuation methods, availability of value sets and validation studies, and the range of utility values generated. Additionally, a series of focus groups of parents and young people (11-20 years) were convened to determine patient and proxy preferences. Five PBMs suitable for child populations were identified, although only the Health Utilities Index 2 (HUI2) and Child Heath Utility 9D (CHU-9D) have UK value sets. 45 papers used PBMs in this population, but many used non-child-specific PBMs. Most respondents were parent proxies, even in adolescent populations. Reported missing data ranged from 0.5 to 49.3%. The focus groups reported their experiences with the EQ-5D-Y and CHU-9D. Both the young persons' group and parent/proxy groups felt that the CHU-9D was more comprehensive but may be harder for a proxy to complete. Some younger children had difficulty understanding the CHU-9D questions, but the young persons' group nonetheless preferred responding directly. The use of PBMs in child populations is increasing, but many studies use PBMs that do not have appropriate value sets. Parent proxies are the most common respondents, but the focus group responses suggest it would be preferred, and may be more informative, for older children to self-report or for child-parent dyads to respond.

What Are Schools Looking for in New, Inclusive Teachers?

ERIC Educational Resources Information Center

Sokal, Laura

2012-01-01

Focus groups were conducted in four school divisions in central Canada in order to determine whether inclusive educators in schools could identify the knowledge base, skills set, and attitudes desirable in new inclusive teachers. Participants failed to identify an essential knowledge base for inclusive educators. Findings indicated that a focus on…

Team-Based Learning for Nursing and Medical Students: Focus Group Results From an Interprofessional Education Project.

PubMed

Feather, Rebecca A; Carr, Doug E; Reising, Deanna L; Garletts, Derrick M

2016-01-01

Past research indicates that inadequacies in health care delivery create substantial preventable quality issues that can be addressed through improving relationships among clinicians to decrease the negative effects on patient outcomes. The purpose of this article is to describe the implementation of an interprofessional education project with senior nursing and third-year medical students working in teams in a clinical setting. Results include data from focus groups conducted at the conclusion of the project.

Resilience Among Naval Recruits: A Quantitative and Qualitative Analysis of Interventions at Recruit Training Command and Implications on Fleet Readiness

DTIC Science & Technology

2016-03-01

associated with higher levels of resilience (Connor & Davidson, 2003). The CD-RISC offers a validated quantitative scale to researchers , allowing for the...a total of 35 recruits and 12 RDCs were interviewed. Four focus groups and 30 personal interviews were conducted. The interviews included recruits...two to four individuals. The interviews and focus groups were semi-structured. A set of questions were identified prior to the interviews as a

Staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in quality improvement: a focus group discussion study at two hospital settings in Sweden.

PubMed

Hvitfeldt-Forsberg, Helena; Mazzocato, Pamela; Glaser, Daniel; Keller, Christina; Unbeck, Maria

2017-06-06

To explore healthcare staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in improvement efforts. Two focus group discussions were performed. Two settings were included: a rheumatology department and an orthopaedic section both situated in Sweden. Healthcare staff and managers (n=13) from the two settings. Two workshops were performed, one at each setting. Workshops were initiated by a short introduction to simulation modelling. Results from the respective simulation model were then presented and discussed in the following focus group discussion. Categories from the content analysis are presented according to the following research questions: how and when simulation modelling can assist healthcare improvement? Regarding how, the participants mentioned that simulation modelling could act as a tool for support and a way to visualise problems, potential solutions and their effects. Regarding when, simulation modelling could be used both locally and by management, as well as a pedagogical tool to develop and test innovative ideas and to involve everyone in the improvement work. Its potential as an information and communication tool and as an instrument for pedagogic work within healthcare improvement render a broader application and value of simulation modelling than previously reported. © 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.

Outdoor Biology Instructional Strategies Trial Edition, Set IV.

ERIC Educational Resources Information Center

Throgmorton, Larry, Ed.; And Others

Eight games are included in the 24 activities in the Outdoor Biology Instructional Strategies (OBIS) Trial Edition Set IV. There are also simulations, crafts, biological techniques, and organism investigations focusing on animal and plant life in the forest, desert, and snow. Designed for small groups of children ages 10 to 15 from schools and…

Need States Based on Eating Occasions Experienced by Midlife Women

ERIC Educational Resources Information Center

Vue, Houa; Degeneffe, Dennis; Reicks, Marla

2008-01-01

Objective: To identify a comprehensive set of distinct "need states" based on the eating occasions experienced by midlife women. Design: Series of 7 focus group interviews. Setting: Meeting room on a university campus. Participants: A convenience sample of 34 multi-ethnic women (mean age = 46 years). Phenomenon of Interest: Descriptions of eating…

Female Students' Experiences of Computer Technology in Single- versus Mixed-Gender School Settings

ERIC Educational Resources Information Center

Burke, Lee-Ann; Murphy, Elizabeth

2006-01-01

This study explores how female students compare learning computer technology in a single- versus a mixed- gender school setting. Twelve females participated, all of whom were enrolled in a grade 12 course in Communications' Technology. Data collection included a questionnaire, a semi-structured interview and focus groups. Participants described…

Management of Communication Channels for Health Information in the Community

ERIC Educational Resources Information Center

Tanvatanakul, Vasuton; Amado, Joao; Saowakontha, Sastri

2007-01-01

Object: To investigate channels for communication of health information to various groups in the community. Design: An exploratory cross sectional design was used, followed by focus groups of selected participants to confirm and clarify the findings. Setting: Five levels of sub-district administration organizations were selected from different…

Use of Adult Patient Focus Groups to Develop the Initial Item Bank for a Cochlear Implant Quality-of-Life Instrument.

PubMed

McRackan, Theodore R; Velozo, Craig A; Holcomb, Meredith A; Camposeo, Elizabeth L; Hatch, Jonathan L; Meyer, Ted A; Lambert, Paul R; Melvin, Cathy L; Dubno, Judy R

2017-10-01

No instrument exists to assess quality of life (QOL) in adult cochlear implant (CI) users that has been developed and validated using accepted scientific standards. To develop a CI-specific QOL instrument for adults in accordance with the Patient Reported Outcomes Measurement Information System (PROMIS) guidelines. As required in the PROMIS guidelines, patient focus groups participated in creation of the initial item bank. Twenty-three adult CI users were divided into 1 of 3 focus groups stratified by word recognition ability. Three moderator-led focus groups were conducted based on grounded theory on December 3, 2016. Two reviewers independently analyzed focus group recordings and transcripts, with a third reviewer available to resolve discrepancies. All data were reviewed and reported according to the Consolidated Criteria for Reporting Qualitative Research. The setting was a tertiary referral center. Coded focus group data. The 23 focus group participants (10 [43%] female; mean [range] age, 68.1 [46.2-84.2] years) represented a wide range of income levels, education levels, listening modalities, CI device manufacturers, duration of CI use, and age at implantation. Data saturation was determined to be reached before the conclusion of each of the focus groups. After analysis of the transcripts, the central themes identified were communication, emotion, environmental sounds, independence and work function, listening effort, social isolation and ability to socialize, and sound clarity. Cognitive interviews were carried out on 20 adult CI patients who did not participate in the focus groups to ensure item clarity. Based on these results, the initial QOL item bank and prototype were developed. Patient focus groups drawn from the target population are the preferred method of identifying content areas and domains for developing the item bank for a CI-specific QOL instrument. Compared with previously used methods, the use of patient-centered item development for a CI-specific QOL instrument will more accurately reflect patient experience and increase our understanding of how CI use affects QOL.

Faculty development: a need in time for educators in healthcare.

PubMed

Abid, Kauser

2013-04-01

To appraise learning behaviour among participants of faculty development programme in a diverse group setting. The qualitative study was conducted at the Capacity Building Centre of the National Institute of Health and Social Sciences, Islamabad, in March-April 2010. From all the participants who planned to be healthcare educators, 27 were selected for the study. Methodology used was focus group. Coding for focus group interview was done as E1, E2, E3 and E4 for educators from basic sciences, clinical/pre-clinical discipline, nursing and midwifery, and social sciences and information technology profession respectively. For gap analysis, need assessment of focus groups was done with a pre-tested questionnaire. Change in attitude and behaviour as educators was observed in the experience phase during the three modules of the programme. A post-test questionnaire was used to evaluate the effectiveness of the programme. The response rate of the participants was 100%. Gap analysis of focus groups came up with the same challenges that are faced by faculty: insufficient knowledge in the five domains of professional development. In institutional settings, no planned faculty development programmes were reported. By the end of the third module, the participants admitted their step-wise skill development and considered it to be a value addition in their professional career. Talent is not sparse in today's educators of health profession. But professional development to improve their skills is the need of the hour. Capacity-building at workplace is the best solution as it can be managed within the available timeframe and resources.

Identification of Differential Item Functioning in Multiple-Group Settings: A Multivariate Outlier Detection Approach

ERIC Educational Resources Information Center

Magis, David; De Boeck, Paul

2011-01-01

We focus on the identification of differential item functioning (DIF) when more than two groups of examinees are considered. We propose to consider items as elements of a multivariate space, where DIF items are outlying elements. Following this approach, the situation of multiple groups is a quite natural case. A robust statistics technique is…

Initiatives (Part 1): Keystone; Cycle Time Puzzle, A Full-Scale Challenge; Foot to Foot, Face to Face; Change Management; Multi-Element Team Challenge.

ERIC Educational Resources Information Center

Schoel, Jim; Butler, Steve; Murray, Mark; Gass, Mike; Carrick, Moe

2001-01-01

Presents five group problem-solving initiatives for use in adventure and experiential settings, focusing on conflict resolution, corporate workplace issues, or adjustment to change. Includes target group, group size, time and space needs, activity level, overview, goals, props, instructions, and suggestions for framing and debriefing the…

The MAGnet Newsletter on Mixed-Age Grouping in Preschool and Elementary Settings, 1992-1997.

ERIC Educational Resources Information Center

McClellan, Diane, Ed.

1997-01-01

These 11 newsletter issues provide a forum for discussion and exchange of ideas regarding mixed-age grouping in preschool and elementary schools. The October 1992 issue focuses on the mixed-age approach as an educational innovation, defines relevant terms, and presents advice from Oregon teachers on teaching mixed-age groups. The March 1993 issue…

Competing for the same value segments? Insight into the volatile Dutch political landscape.

PubMed

van Herk, Hester; Schoonees, Pieter C; Groenen, Patrick J F; van Rosmalen, Joost

2018-01-01

Values are central to public debates today. Human values convey broad goals that serve as guiding principles in a person's life and value priorities differ across people in society. Groups in society holding opposing values (e.g., universalism versus security) will make different choices when voting in an election. Whereas over time, values are relatively stable, the number and type of political parties as well as the political values they communicate and disseminate have been changing. Groups of people holding the same human values may therefore vote for another (new) party in a later election. We focus on analyzing the relationship between human values and voting in elections, introducing a new methodology to analyze how value profiles relate to political support over time. We investigate the Dutch multi-party political system over five waves of the European Social Survey, spanning 2002 until 2010. Whilst previous research has focused on individual values separately and focused on voters only, we (1) distinguish groups holding a similar set of opposing and compatible values (value profile) instead of focusing on single values in the the entire population; (2) incorporate a correction for differences in scale use in our model; (3) compare voting over time; (4) include non-voters, a growing group in Dutch society. We find evidence that specific value profiles are related to voting for a specific set of political parties. We also find that specific value profiles distinguish non-voters from voters and that voters for populist parties resemble non-voters.

Beyond Rational Choice: How Teacher Engagement with Technology Is Mediated by Culture and Emotions

ERIC Educational Resources Information Center

Perrotta, Carlo

2017-01-01

This paper focuses on the relationship between rational beliefs, culture and agency in formal school settings. This relationship is analysed in the context of the adoption of technological innovations. Interviews and focus groups with 39 secondary teachers from England and other European countries were carried out. The analysis highlights a number…

Action learning sets in a nursing and midwifery practice learning context: a realistic evaluation.

PubMed

Machin, Alison I; Pearson, Pauline

2014-08-01

Action learning sets (ALS) are used widely for organisational and workforce development, including in nursing (Anderson and Thorpe, 2004; Pounder, 2009; Young et al., 2010). In the United Kingdom, a multi-faceted educational Pilot programme for new nurses and midwives was implemented to accelerate their clinical practice and leadership development (NHS Education Scotland, 2010). Action Learning Sets were provided for peer support and personal development. The Realistic Evaluation study reported in this paper explored issues of context, mechanism and outcome (Pawson and Tilley, 1997) influencing the action learning experiences of: programme participants (recently qualified nurses and midwives, from different practice settings); and programme supporters. A range of data were collected via: online questionnaires from 66 participants and 29 supporters; three focus groups, each comprising between eight and 10 programme participants; and one focus group with three action learning facilitators. The qualitative data pertaining to the ALS are presented in this paper. Thematic data analysis of context, mechanism and outcome configurations, generated five themes: creating and sustaining a collective learning environment; challenging constructively; collective support; the role of feedback; and effectiveness of ALS. Study outcomes suggest nursing and midwifery action learning should (a) be facilitated positively to improve participants' experience; (b) be renamed to avoid learning methodology confusion; and (c) be outcome focused to evidence impact on practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

How should doctors disclose conflicts of interest to patients? A focus group investigation.

PubMed

Oakes, J Michael; Whitham, Hilary K; Spaulding, Alicen Burns; Zentner, Lynn A; Beccard, Seth R

2015-01-01

Disclosure is often proposed as a strategy for handling financial conflicts of interest in medicine. Yet there has been no guidance on how clinicians should disclose potential conflicts of interest to patients. To discern patients' attitudes toward conflicts of interest in medicine and their opinions about how physicians should disclose possible conflicts in the clinical setting, we conducted six focus groups with patients recruited from three clinics in the Twin Cities area. Investigators reviewed audio recordings of the focus group discussions independently and identified themes. Maintaining patient-doctor trust was critical to all study participants. Most wanted to know only about conflicts of interest that were directly relevant to their care. In addition, most participants said physicians and other health care providers should offer patients an easy-to-read document about any conflict of interest during clinic check-ins and bring up the subject when discussing specific treatment plans for which the conflict of interest is relevant. Our study offers the first insights into patient attitudes toward and opinions about disclosure practices in clinical settings. More research into the practical aspects of managing conflicts of interest is needed as ineffective disclosure may undermine patients' trust in their doctors.

The doctor as focus group moderator--shifting roles and negotiating positions in health research.

PubMed

Reventlow, S; Tulinius, C

2005-06-01

Any research is inextricably entwined with the researcher's positions adopted while collecting data. This represents an important challenge to focus group moderators whose positions within the group influence data collection. This situation is particularly important in health research where moderators are doctors. This study explores the moderator's social interaction with the group, in particular the moderator's position and how it affects data collection, the research process and knowledge production. A qualitative study exploring group dynamics and the moderator's positions in focus group discussions, in particular the interaction between the moderator's position and her role as a doctor. The social construction and negotiation of the doctor's position depended both on the participants' view of the moderator and on the moderator's situational response. The moderator dealt with the participants' expectations and alternated between different positions: those she chose for herself and those chosen for her by the participants. Adoption of an active strategy outlining the moderator's position clarified the framework of data collection. Doctors using focus groups as research tool to gain insight into people's ideas about illness must be conscious about how their medical background influences their positions during data collection. The focus group moderator must balance between letting participants discuss the topics without being disturbed and actively intervening in the discussion to clarify the process. The researcher has to set the boundaries and guidelines as to how the research is conducted.

Prehospital Trauma Triage Decision-making: A Model of What Happens between the 9-1-1 Call and the Hospital.

PubMed

Jones, Courtney Marie Cora; Cushman, Jeremy T; Lerner, E Brooke; Fisher, Susan G; Seplaki, Christopher L; Veazie, Peter J; Wasserman, Erin B; Dozier, Ann; Shah, Manish N

2016-01-01

We describe the decision-making process used by emergency medical services (EMS) providers in order to understand how 1) injured patients are evaluated in the prehospital setting; 2) field triage criteria are applied in-practice; and 3) selection of a destination hospital is determined. We conducted separate focus groups with advanced and basic life support providers from rural and urban/suburban regions. Four exploratory focus groups were conducted to identify overarching themes and five additional confirmatory focus groups were conducted to verify initial focus group findings and provide additional detail regarding trauma triage decision-making and application of field triage criteria. All focus groups were conducted by a public health researcher with formal training in qualitative research. A standardized question guide was used to facilitate discussion at all focus groups. All focus groups were audio-recorded and transcribed. Responses were coded and categorized into larger domains to describe how EMS providers approach trauma triage and apply the Field Triage Decision Scheme. We conducted 9 focus groups with 50 EMS providers. Participants highlighted that trauma triage is complex and there is often limited time to make destination decisions. Four overarching domains were identified within the context of trauma triage decision-making: 1) initial assessment; 2) importance of speed versus accuracy; 3) usability of current field triage criteria; and 4) consideration of patient and emergency care system-level factors. Field triage is a complex decision-making process which involves consideration of many patient and system-level factors. The decision model presented in this study suggests that EMS providers place significant emphasis on speed of decisions, relying on initial impressions and immediately observable information, rather than precise measurement of vital signs or systematic application of field triage criteria.

Student Recognition of Visual Affordances: Supporting Use of Physics Simulations in Whole Class and Small Group Settings

ERIC Educational Resources Information Center

Stephens, A. Lynn

2012-01-01

The purpose of this study is to investigate student interactions with simulations, and teacher support of those interactions, within naturalistic high school physics classroom settings. This study focuses on data from two lesson sequences that were conducted in several physics classrooms. The lesson sequences were conducted in a whole class…

Influences on Students' Views on Religions and Education in England and Estonia

ERIC Educational Resources Information Center

Neill, Sean; Schihalejev, Olga

2011-01-01

Structural modelling offers an overall pattern of relationships; this paper looks at differences in students' attitude structures between England and Estonia. Where different coherent sets of beliefs exist in a national sample, factor analysis, which focuses on sets of responses which differ between groups, should be able to separate them out.…

How Participants Envision Community Music in Welsh Men's Choirs

ERIC Educational Resources Information Center

Rohwer, Debbie; Rohwer, Mark

2012-01-01

The purpose of this study was to describe choristers' perceptions of Welsh men's choir participation. Four choirs were observed in concert and rehearsal settings across Wales. Focus group interviews were conducted with between 4 and 10 members in each of the 4 choral settings for a total of 24 total interview respondents. The interviewees had a…

Literature-Based Workshops for Mathematics: Ideas for Active Learning Grades K-2.

ERIC Educational Resources Information Center

Morrison, Kathy; Dittrich, Tina; Claridge, Jill

This book presents ways to use high quality children's literature to plan small group workshops in mathematics for K-2 instruction. Each of the six sets of workshops is built around storybooks children love and focuses on a specific aspect of numeracy: shapes, counting, seriation, addition, money, and measurement. Each set is designed for a…

What is agenda setting in the clinical encounter? Consensus from literature review and expert consultation.

PubMed

Gobat, Nina; Kinnersley, Paul; Gregory, John W; Robling, Michael

2015-07-01

To establish consensus on the core domains of agenda setting in consultations. We reviewed the healthcare literature and, using a modified Delphi technique to embrace both patient and clinician perspectives, conducted an iterative online survey, with 30 experts in health communication. Participants described agenda setting and rated the importance of proposed domains. Consensus was determined where the group median was ≥5 on a 7-point Likert-like response scale, and the interquartile range fell to within one point on this scale. Relevant publications were identified in three overlapping bodies of healthcare literature. Survey respondents considered that agenda setting involved a process whereby patients and clinicians establish a joint focus for both their conversation and their working relationship. Consensus was obtained on six core domains: identifying patient talk topics, identifying clinician talk topics, agreement of shared priorities, establishing conversational focus, collaboration and engagement. New terminology--agenda mapping and agenda navigation--is proposed. We identified core agenda setting domains that embraced patient and clinician perspectives. An integrated conceptualization of agenda setting may now be used by researchers and educators in both clinician and patient focused interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

PubMed Central

2013-01-01

Background Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. Objective To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Methods Five focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter. Results All physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients’ lack of Internet access or low computer literacy, and potential impediments to the clinics’ daily workflow. Expanding patients’ use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients’ screening preferences. Participants described that a system to link the online decision aid to a computerized reminder system could promote a better understanding of patients’ screening preferences, though some expressed concern that such a system could be difficult to keep up and running. Conclusions Community practice clinicians and staff perceived the Web-based decision aid technology as promising but raised questions as to how the technology and resultant information would be integrated into their daily practice workflow. Additional research investigating how to best implement online decision aids should be conducted prior to the widespread adoption of such technology so as to maximize the benefits of the technology while minimizing workflow disruptions. PMID:24351420

First-Person Perspectives on Dual Diagnosis Anonymous (DDA): A Qualitative Study.

PubMed

Roush, Sean; Monica, Corbett; Carpenter-Song, Elizabeth; Drake, Robert E

2015-01-01

People with dually diagnosed substance abuse and mental illnesses often feel alienated at traditional 12-step meetings, yet they need the peer support provided by such groups. Dual Diagnosis Anonymous (DDA) is a peer-support program specifically for people with co-occurring disorders, which addresses many of the factors that members find alienating about traditional 12-step groups. This study aimed to elicit first-person perspectives on DDA. Occupational therapy students conducted 13 focus groups with 106 DDA members in three settings: the community (6 groups, n = 36), correctional facilities (5 groups, n = 53), and the state psychiatric hospital (2 groups, n = 17). Researchers inductively analyzed focus group transcripts to identify prominent themes. The vast majority of participants were between the ages of 18 and 49 (n = 87, 82.1%) and were non-Hispanic/White (n = 82, 77.4%). Most participants had been using substances for more than 10 years and had a diagnosed mental illness for more than 10 years. The most common substance of choice among those in the community and corrections setting was multiple substances, while those in the state hospital identified alcohol most often. Bipolar disorder was the most common mental illness diagnosis among participants in the state hospital, but depression and anxiety were the two most common diagnoses in the community and corrections participants. Four primary themes emerged from the qualitative analysis: (1) feeling accepted by others in the group, (2) understanding the interactive nature of dual disorders, (3) the open discussions in DDA meetings, and (4) a focus on hope and recovery from both illnesses. DDA provides a helpful alternative for individuals who do not feel comfortable at traditional 12-step groups due to their mental illness. Members value the acceptance, understanding, discussion, and hope in DDA meetings.

"More Writing than Welding": Learning in Worker Writer Groups

ERIC Educational Resources Information Center

Woodin, Tom

2005-01-01

The Federation of Worker Writers and Community Publishers was set up in 1976 by a number of independent writing and publishing groups to support and develop the writing of working class and other marginalized people. Focusing on the development of individuals within a collective organization over the previous three decades provides important…

Data Curation: A Study of Researcher Practices and Needs

ERIC Educational Resources Information Center

McLure, Merinda; Level, Allison V.; Cranston, Catherine L.; Oehlerts, Beth; Culbertson, Mike

2014-01-01

Colorado State University librarians conducted five focus groups with thirty-one faculty, research scientists, and research associates. The groups explored: (1) The nature of data sets that these researchers create or maintain; (2) How participants manage their data; (3) Needs for support that the participants identify in relation to sharing,…

School-Based Mutual Support Groups for Parents: An Intervention Guidebook.

ERIC Educational Resources Information Center

Simoni, Jane M.

This handbook focuses on steps and tasks related to establishing mutual support groups for parents in a school setting. A sequential approach is described that involves: working within the school to get started; recruiting members; training parents how to run their own meetings; and offering off-site consultation as requested. The first section…

A Group Contingency Program to Improve the Behavior of Elementary School Students in a Cafeteria

ERIC Educational Resources Information Center

Fabiano, Gregory A.; Pelham, William E., Jr.; Karmazin, Karen; Kreher, Joanne; Panahon, Carlos J.; Carlson, Carl

2008-01-01

Studies of behavior modification interventions for disruptive behavior in schools have generally focused on classroom behavior with less research directed toward child behavior in other school settings (e.g., cafeterias). The present report documents the effect of a group contingency intervention with a random reward component, targeting…

Leaders Behaving Badly: Using Power to Generate Undiscussables in Action Learning Sets

ERIC Educational Resources Information Center

Donovan, Paul Jeffrey

2014-01-01

"Undiscussables" are topics associated with threat or embarrassment that are avoided by groups, where that avoidance is also not discussed. Their deleterious effect on executive groups has been a point of discussion for several decades. More recently critical action learning (AL) has brought a welcome focus to power relations within AL…

A phenomenological evaluation: using storytelling as a primary teaching method.

PubMed

Davidson, Michele R

2004-09-01

This phenomenological study examines the experiences of students who had been enrolled in an undergraduate women's health issues course where storytelling served as one of the primary teaching and learning tools. Using hermeneutic phenomenology, the investigator explored the perceptions of participants at the conclusion of the course. A purposive sample of 10 students made up the focus group. Themes were explicated and analyzed from interviews until data saturation was reached. Content analysis from focus groups revealed three themes: personalizing learning, participatory learning, and group trust/safe environment. Storytelling provided students with an opportunity to become more actively involved, provided a forum to relate real life examples to concrete didactic data, served as a trigger for information recollection, and made material seem more realistic. The increased discussion and interaction within the classroom setting enabled students to probe alternative views and perspectives in the class room. The use of more diverse teaching tools can enhance the students' experiences in the classroom setting.

The effects of wilderness settings on organized groups: a state-of-knowledge paper

Treesearch

Alan Ewert; Leo H. McAvoy

2000-01-01

Organized groups present a major use of wilderness resources. The focus of this paper is on the research findings that have emerged over the past 12 years concerning the benefits and effects of participation by groups in wilderness and wilderness-like areas. In general, the majority of research in this area has provided evidence of the beneficial and positive effects...

Focus groups inform a web-based program to increase fruit and vegetable intake.

PubMed

Rolnick, Sharon J; Calvi, Josephine; Heimendinger, Jerianne; McClure, Jennifer B; Kelley, Mary; Johnson, Christine; Alexander, Gwen L

2009-11-01

To use focus groups to inform a web-based educational intervention for increased fruit and vegetable (FV) consumption. Twelve groups (participants=137, aged 21-65) were recruited from four geographically diverse health systems. Four groups were stratified by gender and eight by race (white and African American) and gender. Questions included perceptions of healthy eating, factors that encourage or serve as barriers to FV consumption and features preferred for a web-based educational intervention. Though knowledgeable about healthy eating, participants did not know how to achieve or always care about healthy nutritional choices. Motivators for FV consumption included being role models and health concerns. Barriers included: lack of time, expense and FV availability. Website preferences included: visuals, links, tailored materials, menu suggestions, goal setting assistance, printable summaries and built in motivation. The developers incorporated nearly all suggestions. Focus groups provided needs-based tactical strategies for an online, education intervention targeting factors to improve FV consumption. Focus groups can provide valuable input to inform interventions. Further, web-based programs' abilities to offer information without time or geographic constraints, with capacity for tailoring and tracking progress makes them a valuable addition in the arsenal of efforts to promote healthy behaviors.

Overdose Education and Naloxone for Patients Prescribed Opioids in Primary Care: A Qualitative Study of Primary Care Staff.

PubMed

Binswanger, Ingrid A; Koester, Stephen; Mueller, Shane R; Gardner, Edward M; Goddard, Kristin; Glanz, Jason M

2015-12-01

The rate of fatal unintentional pharmaceutical opioid poisonings has increased substantially since the late 1990s. Naloxone is an effective opioid antidote that can be prescribed to patients for bystander use in the event of an overdose. Primary care clinics represent settings in which large populations of patients prescribed opioids could be reached for overdose education and naloxone prescription. Our aim was to investigate the knowledge, attitudes and beliefs about overdose education and naloxone prescription among clinical staff in primary care. This was a qualitative study using focus groups to elucidate both clinic-level and provider-level barriers and facilitators. Ten primary care internal medicine, family medicine and infectious disease/HIV practices in three large Colorado health systems. A focus group guide was developed based on behavioral theory. Focus group transcripts were coded for manifest and latent meaning, and analyzed for themes using a recursive approach that included inductive and deductive analysis. Themes emerged in four content areas related to overdose education and naloxone prescription: knowledge, barriers, benefits and facilitators. Clinical staff (N = 56) demonstrated substantial knowledge gaps about naloxone and its use in outpatient settings. They expressed uncertainty about who to prescribe naloxone to, and identified a range of logistical barriers to its use in practice. Staff also described fears about offending patients and concerns about increased risk behaviors in patients prescribed naloxone. When considering naloxone, some providers reflected critically and with discomfort on their own opioid prescribing. These barriers were balanced by beliefs that prescribing naloxone could prevent death and result in safer opioid use behaviors. Findings from these qualitative focus groups may not be generalizable to other settings. In addition to evidence gaps, logistical and attitudinal barriers will need to be addressed to enhance uptake of overdose education and naloxone prescription for patients prescribed opioids for pain.

Use of Appreciative Inquiry To Engage Parents as Codesigners of a Weight Management Intervention for Adolescents

PubMed Central

Killion, Cheryl M.; Andrisin, Sharon; Lissemore, Frances; Primm, Tonia; Olayinka, Oluwatomisin; Borawski, Elaine A.

2017-01-01

Abstract Background: Focus groups are often used to involve families as codesigners of weight management interventions. Focus groups, however, are seldom designed to elicit families' strengths and positive experiences. The purpose of this study was to describe the use of the Appreciative Inquiry process in the conduct of focus groups to engage families in the design of a weight management intervention for adolescents. Methods: A convenience sample of 44 parents (84% female; 82% minority) of adolescent children with a BMI ≥ 85th percentile, who were in the 6th–8th grade in a large urban school, participated in focus groups designed to elicit family-positive experiences and strengths regarding healthy living. A structured set of questions based on the Appreciative Inquiry process was used in the focus groups. Analyses consisted of the constant comparative method to generate themes. Results: Parent-positive perceptions regarding their family's healthy living habits were reflected in five themes: (1) Having healthy children is a joy; (2) Becoming healthy is a process; (3) Engaging in healthy habits is a family affair; (4) Good health habits can be achieved despite obstacles; and (5) School, community, and social factors contribute to their family's health habits. Parents generated ideas to improve their families' health. Conclusions: Focus groups based on the Appreciative Inquiry process were found to be a useful approach to discover features that are important to low-income, urban-living parents to include in an adolescent weight management program. Recommendations for designing and conducting focus groups based on the Appreciative Inquiry process are provided. PMID:28187267

Changing Thoughts, Changing Practice: Examining the Delivery of a Group CBT-Based Intervention in a School Setting

ERIC Educational Resources Information Center

Weeks, Caoimhe; Hill, Vivian; Owen, Charlie

2017-01-01

Promoting mental health and well-being for children and young people in the UK has attracted increasing prominence in recent years and has been a focus for government strategy within health and education. Training and practice in educational psychology has increasingly focused on developing skills and expertise to provide therapeutic support…

Clinical effort against secondhand smoke exposure: development of framework and intervention.

PubMed

Winickoff, Jonathan P; Park, Elyse R; Hipple, Bethany J; Berkowitz, Anna; Vieira, Cecilia; Friebely, Joan; Healey, Erica A; Rigotti, Nancy A

2008-08-01

The purpose of this work was to describe a novel process and present results of formative research to develop a pediatric office intervention that uses available systems of care for addressing parental smoking. The scientific development of the intervention occurred in 3 stages. In stage 1, we designed an office system for parental tobacco control in the pediatric outpatient setting on the basis of complementary conceptual frameworks of preventive services delivery, conceptualized for the child health care setting through a process of key interviews with leaders in the field of implementing practice change; existing Public Health Service guidelines that had been shown effective in adult practices; and adaptation of an evidence-based adult office system for tobacco control. This was an iterative process that yielded a theoretically framed intervention prototype. In stage 2, we performed focus-group testing in pediatric practices with pediatricians, nurses, clinical assistants, and key office staff. Using qualitative methods, we adapted the intervention prototype on the basis of this feedback to include 5 key implementation steps for the child health care setting. In stage 3, we presented the intervention to breakout groups at 2 national meetings of pediatric practitioners for additional refinements. The main result was a theoretically grounded intervention that was responsive to the barriers and suggestions raised in the focus groups and at the national meetings. The Clinical Effort Against Secondhand Smoke Exposure intervention was designed to be flexible and adaptable to the particular practices' staffing, resources, and physical configuration. Practice staff can choose materials relevant to their own particular systems of care (www.ceasetobacco.org). Conceptually grounded and focus-group-tested strategies for parental tobacco control are now available for implementation in the pediatric outpatient setting. The tobacco-control intervention-development process might have particular relevance for other chronic pediatric conditions that have a strong evidence base and have available treatments or resources that are underused.

Fostering interprofessional learning in a rehabilitation setting: development of an interprofessional clinical learning unit.

PubMed

Vanderzalm, Jeanne; Hall, Mark D; McFarlane, Lu-Anne; Rutherford, Laurie; Patterson, Steven K

2013-01-01

The development and implementation of interprofessional (IP) clinical learning units as a method to enhance IP clinical education and improve patient care in a rehabilitation setting are described. Using a community-based participatory research approach, academia and healthcare delivery agencies formed a partnership to create an IP clinical learning unit in a rehabilitation setting. Preimplementation data from surveys and focus group data identified areas for improvement to enhance IP understanding and collaboration. A working group developed and implemented initiatives to enhance IP practice. Preimplementation, eight themes emerged from which the working group identified goals and implemented strategies to strengthen IP learning. Goals included Creation of an IP Learning Environment, Increased Awareness of IP Practice, Role Clarification, Enhanced IP Communication, and Reflection and Evaluation. Postimplementation data revealed six themes: Communication, Informal IP Learning, Role Awareness, Positive Learning Environment, Logistics, and Challenges. The development of the IP clinical learning unit was successful and rewarding, but not without its challenges. Formal IP education was necessary to enhance collaborative practice, even in a multidisciplinary environment. Commitment and support from all participants, particularly managers and administrators from the healthcare agency, were critical to success. The focus of this unit was on a stroke rehabilitation unit; however, the development and implementation principles identified may be applicable to any team-based clinical setting. © 2013 Association of Rehabilitation Nurses.

Creating psychological connections between intervention recipients: development and focus group evaluation of a group singing session for people with aphasia

PubMed Central

Tarrant, Mark; Warmoth, Krystal; Code, Chris; Dean, Sarah; Goodwin, Victoria A; Stein, Ken; Sugavanam, Thavapriya

2016-01-01

Objectives The study sought to identify key design features that could be used to create a new framework for group-based health interventions. We designed and tested the first session of a group intervention for stroke survivors with aphasia which was aimed at nurturing new psychological connections between group members. Setting The intervention session, a participant focus group and interviews with intervention facilitators were held in a local community music centre in the South West of England. Participants A convenience sample of 10 community-dwelling people with poststroke aphasia participated in the session. Severity of aphasia was not considered for inclusion. Intervention Participants took part in a 90-min group singing session which involved singing songs from a specially prepared song book. Musical accompaniment was provided by the facilitators. Primary and secondary outcome measures Participants and group facilitators reported their experiences of participating in the session, with a focus on activities within the session related to the intervention aims. Researcher observations of the session were also made. Results Two themes emerged from the analysis, concerning experiences of the session (‘developing a sense of group belonging’) and perceptions of its design and delivery (‘creating the conditions for engagement’). Participants described an emerging sense of shared social identity as a member of the intervention group and identified fixed (eg, group size, session breaks) and flexible (eg, facilitator responsiveness) features of the session which contributed to this emergence. Facilitator interviews and researcher observations corroborated and expanded participant reports. Conclusions Engagement with health intervention content may be enhanced in group settings when intervention participants begin to establish positive and meaningful psychological connections with other group members. Understanding and actively nurturing these connections should be a core feature of a general framework for the design and delivery of group interventions. PMID:26908519

Setting goals, not just roles: Improving teamwork through goal-focused debriefing.

PubMed

Gardner, Aimee K; Kosemund, Matthew; Hogg, Deborah; Heymann, Abraham; Martinez, Joseph

2017-02-01

The role of goal setting within post-simulation debriefing is not well known. This study sought to examine how inclusion of group-level goals, individual-level goals, or no goals in the debriefing process impacts teamwork. Students participated in two high-fidelity team training scenarios. Between scenarios, teams were assigned to one of three debriefing groups: jointly creating five teamwork goals for the group to achieve (group-level goals); independently creating five teamwork goals for each individual to attain (individual-level goals); or no goals. Paired-samples t tests and one-way ANOVA with post-hoc Tukey tests were used to examine performance improvements and differences between groups. 86 MS3s participated in the training program across 22 groups. Percentage of items achieved on the teamwork tool from first to second scenario were 61.7±20.4 to 60.2±8.8 (no goals; ns), 59.8±14.0 to 76.8±7.0 (individual goals; p<0.01), and 62.5±9.5 to 67.0±10.0 (group goals; ns). Performance improvement in the individual goals group was significantly higher than the no goals group (p<0.05). Debriefing facilitators should encourage learners to focus on creating and achieving personal goals contributing to teamwork. Copyright © 2016 Elsevier Inc. All rights reserved.

A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program.

PubMed

Brazil, Kevin; Cloutier, Michelle M; Tennen, Howard; Bailit, Howard; Higgins, Pamela S

2008-04-01

The purpose of this study was to examine the challenges of integrating an asthma disease management (DM) program into a primary care setting from the perspective of primary care practitioners. A second goal was to examine whether barriers differed between urban-based and nonurban-based practices. Using a qualitative design, data were gathered using focus groups in primary care pediatric practices. A purposeful sample included an equal number of urban and nonurban practices. Participants represented all levels in the practice setting. Important themes that emerged from the data were coded and categorized. A total of 151 individuals, including physicians, advanced practice clinicians, registered nurses, other medical staff, and nonmedical staff participated in 16 focus groups that included 8 urban and 8 nonurban practices. Content analyses identified 4 primary factors influencing the implementation of a DM program in a primary care setting. They were related to providers, the organization, patients, and characteristics of the DM program. This study illustrates the complexity of the primary care environment and the challenge of changing practice in these settings. The results of this study identified areas in a primary care setting that influence the adoption of a DM program. These findings can assist in identifying effective strategies to change clinical behavior in primary care practices.

Comprehensive Aspectual UML approach to support AspectJ.

PubMed

Magableh, Aws; Shukur, Zarina; Ali, Noorazean Mohd

2014-01-01

Unified Modeling Language is the most popular and widely used Object-Oriented modelling language in the IT industry. This study focuses on investigating the ability to expand UML to some extent to model crosscutting concerns (Aspects) to support AspectJ. Through a comprehensive literature review, we identify and extensively examine all the available Aspect-Oriented UML modelling approaches and find that the existing Aspect-Oriented Design Modelling approaches using UML cannot be considered to provide a framework for a comprehensive Aspectual UML modelling approach and also that there is a lack of adequate Aspect-Oriented tool support. This study also proposes a set of Aspectual UML semantic rules and attempts to generate AspectJ pseudocode from UML diagrams. The proposed Aspectual UML modelling approach is formally evaluated using a focus group to test six hypotheses regarding performance; a "good design" criteria-based evaluation to assess the quality of the design; and an AspectJ-based evaluation as a reference measurement-based evaluation. The results of the focus group evaluation confirm all the hypotheses put forward regarding the proposed approach. The proposed approach provides a comprehensive set of Aspectual UML structural and behavioral diagrams, which are designed and implemented based on a comprehensive and detailed set of AspectJ programming constructs.

Comprehensive Aspectual UML Approach to Support AspectJ

PubMed Central

Magableh, Aws; Shukur, Zarina; Mohd. Ali, Noorazean

2014-01-01

Unified Modeling Language is the most popular and widely used Object-Oriented modelling language in the IT industry. This study focuses on investigating the ability to expand UML to some extent to model crosscutting concerns (Aspects) to support AspectJ. Through a comprehensive literature review, we identify and extensively examine all the available Aspect-Oriented UML modelling approaches and find that the existing Aspect-Oriented Design Modelling approaches using UML cannot be considered to provide a framework for a comprehensive Aspectual UML modelling approach and also that there is a lack of adequate Aspect-Oriented tool support. This study also proposes a set of Aspectual UML semantic rules and attempts to generate AspectJ pseudocode from UML diagrams. The proposed Aspectual UML modelling approach is formally evaluated using a focus group to test six hypotheses regarding performance; a “good design” criteria-based evaluation to assess the quality of the design; and an AspectJ-based evaluation as a reference measurement-based evaluation. The results of the focus group evaluation confirm all the hypotheses put forward regarding the proposed approach. The proposed approach provides a comprehensive set of Aspectual UML structural and behavioral diagrams, which are designed and implemented based on a comprehensive and detailed set of AspectJ programming constructs. PMID:25136656

Implementation of Lifestyle Modification Program Focusing on Physical Activity and Dietary Habits in a Large Group, Community-Based Setting

ERIC Educational Resources Information Center

Stoutenberg, Mark; Falcon, Ashley; Arheart, Kris; Stasi, Selina; Portacio, Francia; Stepanenko, Bryan; Lan, Mary L.; Castruccio-Prince, Catarina; Nackenson, Joshua

2017-01-01

Background: Lifestyle modification programs improve several health-related behaviors, including physical activity (PA) and nutrition. However, few of these programs have been expanded to impact a large number of individuals in one setting at one time. Therefore, the purpose of this study was to determine whether a PA- and nutrition-based lifestyle…

Set shifting deficits in melancholic vs. non-melancholic depression: preliminary findings.

PubMed

Michopoulos, I; Zervas, I M; Papakosta, V M; Tsaltas, E; Papageorgiou, C; Manessi, T; Papakostas, Y G; Lykouras, L; Soldatos, C R

2006-09-01

Twenty-two patients with major depressive disorder, 11 of them with melancholic features, and 11 controls were investigated with CANTAB subtests focusing in visual memory/learning and executive functions. Melancholic patients performed worse than the other groups in all tasks and manifested a significant impairment in set shifting. The results are discussed in association with prefrontal dysfunction.

Investigation of the 3D temperature distribution patterns above the Antarctic Peninsula using remote sensing data - A contribution for polar climate monitoring

NASA Astrophysics Data System (ADS)

Wachter, Paul; Höppner, Kathrin; Jacobeit, Jucundus; Diedrich, Erhard

2015-04-01

West Antarctica and the Antarctic Peninsula are in the focus of current studies on a changing environment and climate of the polar regions. A recently founded Junior Researchers Group at the German Aerospace Center (DLR) is studying changing processes in cryosphere and atmosphere above the Antarctic Peninsula. It is the aim of the group to make use of long-term remote sensing data sets of the land and ice surfaces and the atmosphere in order to characterize environmental changes in this highly sensitive region. One of the PhD projects focuses on the investigation of the 3D temperature distribution patterns above the Antarctic Peninsula. Temperature data sets ranging from MODIS land surface temperatures up to middle atmosphere data of AURA/MLS will be evaluated over the last approx. 12 years. This 3-dimensional view allows comprehensive investigations of the thermal structure and spatio-temporal characteristics of the southern polar atmosphere. Tropospheric data sets will be analyzed by multivariate statistical methods and will allow the identification of dominant atmospheric circulation patterns as well as their temporal variability. An overview of the data sets and first results will be presented.

Parents' views on engaging families of middle school students in obesity prevention and control in a multiethnic population.

PubMed

Cowgill, Burton O; Chung, Paul J; Thompson, Lindsey R; Elijah, Jacinta; Lamb, Sheila; Garcia, Vanessa P; Bastani, Roshan

2014-04-04

Overweight and obesity remain significant public health risks for youth in the United States, particularly among racial/ethnic minority groups. Efforts at obesity prevention and control have targeted youth and family members in diverse settings. Although involving parents in obesity prevention programs for youth may improve the potential of these programs, less is known about parents' preferred methods of engagement, especially among racial/ethnic minority parents and parents whose primary language is not English. In this qualitative study, parents of middle-school-aged children were asked how best to engage their children in obesity prevention and control efforts. We recruited 38 parents whose children attended Los Angeles middle schools to participate in focus groups. Two English-language focus groups with 14 parents of different racial/ethnic backgrounds and 2 Spanish language groups with 24 Latino parents were conducted from 2010 through 2011. We analyzed focus group transcripts by using content analysis using inductive and deductive techniques. Findings from focus groups confirmed that parents want to help their children avoid obesity but feel constrained in their ability to take action. Participants identified an overarching desire to become better parents as a potential incentive to engage in obesity prevention efforts. Parents advocated for family-focused approaches in obesity prevention programs, including family sports leagues and cooking classes. Most findings were consistent between language groups, but parents in the Spanish language groups cited language-related barriers. The development and testing of simple programs that are sustainable, community-based, and family-focused may empower families to address obesity prevention and control.

Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions

PubMed Central

Reeve, Joanne; Dowrick, Christopher F; Freeman, George K; Gunn, Jane; Mair, Frances; May, Carl; Mercer, Stewart; Palmer, Victoria; Howe, Amanda; Irving, Greg; Shiner, Alice; Watson, Jessica

2013-01-01

Objectives Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists. Yet GPs fulfil multiple roles and the pressures of delivering these roles along with wider contextual changes create real challenges to generalist practice. Our study aimed to explore GP perceptions of enablers and constraints for expert generalist care, in order to identify what is needed to ensure health systems are designed to support the generalist role. Design Qualitative study in General Practice. Setting UK primary care. Main outcome measures A qualitative study – interviews, surveys and focus groups with GPs and GP trainees. Data collection and analysis was informed by Normalisation Process Theory. Design and setting Qualitative study in General Practice. We conducted interviews, surveys and focus groups with GPs and GP trainees based mainly, but not exclusively, in the UK. Data collection and analysis were informed by Normalization Process Theory. Participants UK based GPs (interview and surveys); European GP trainees (focus groups). Results Our findings highlight key gaps in current training and service design which may limit development and implementation of expert generalist practice (EGP). These include the lack of a consistent and universal understanding of the distinct expertise of EGP, competing priorities inhibiting the delivery of EGP, lack of the consistent development of skills in interpretive practice and a lack of resources for monitoring EGP. Conclusions We describe four areas for change: Translating EGP, Priority setting for EGP, Trusting EGP and Identifying the impact of EGP. We outline proposals for work needed in each area to help enhance the expert generalist role. PMID:24475347

Agarra el momento/seize the moment: Developing communication activities for a drug prevention intervention with and for Latino families in the US Southwest

PubMed Central

Ayón, Cecilia; Baldwin, Adrienne; Umaña-Taylor, Adriana J; Marsiglia, Flavio F; Harthun, Mary

2015-01-01

This article presents the development of parent–child communication activities by applying Community-Based Participatory Research and focus group methodology. Three parent–child communication activities were developed to enhance an already efficacious parenting intervention: (1) agarra el momento or seize the moment uses everyday situations to initiate conversations about substance use, (2) hay que adelantarnos or better sooner than later stresses being proactive about addressing critical issues with youth, and (3) setting rules and expectations engages parents in establishing rules and expectations for healthy and effective conversations with youth. Focus group data are presented to illustrate how thematic content from the focus groups was used to inform the development of the activities and, furthermore, how such methods supported the development of a culturally grounded intervention. PMID:26924943

Focus Groups and Exit Interviews Are Components of Chemistry Department Program Assessment

NASA Astrophysics Data System (ADS)

Dreisbach, Joseph H.; Hogan, Thomas P.; Stamford, Anne Marie; Greggo, John W.

1998-10-01

The Chemistry Department, in conjunction with the Assessment and Institutional Research Office (AIRO) and the Department of Counseling and Human Services developed an assessment plan which incorporates use of focus groups and exit interviews. As part of the five-year departmental review, a number of student focus groups were facilitated to evaluate (a) the freshman and sophomore organic chemistry programs which also service other departments and (b) the upper division lecture and laboratory program for majors. Use of direct conversation in program assessment yields less ambiguous results compared with other methods because responses can be clarified with careful follow up questions. Success of this project gave rise to use of annual exit interviews with graduating seniors from the chemistry department. The approach described can easily be modified to meet the needs of any academic setting.

Best Practices for Use of Blended Learning

PubMed Central

Porter, Andrea L.; Pitterle, Michael E.

2017-01-01

Objective. To determine instructional best practice recommendations for use of blended learning from the students’ perspective. Methods. Three focus groups were created, one for each of the first three years at a school of pharmacy. The focus group discussions were audio recorded and transcribed for content analysis. Results. Ten instructional best practices were identified from the focus groups: setting the stage, consistency when team teaching, timeliness in posting materials, time on task, accountability for online activities, use of structured active learning, instructor use of feedback on student preparation, incorporation of student feedback into the course, short reviews of online material during class, and ensuring technologies are user friendly. Conclusion. Instructors using blended learning should consider incorporating these best practices into their course design and management. More evaluation is needed to see if implementation of these practices affects student performance. PMID:28496269

Best Practices for Use of Blended Learning.

PubMed

Margolis, Amanda R; Porter, Andrea L; Pitterle, Michael E

2017-04-01

Objective. To determine instructional best practice recommendations for use of blended learning from the students' perspective. Methods. Three focus groups were created, one for each of the first three years at a school of pharmacy. The focus group discussions were audio recorded and transcribed for content analysis. Results. Ten instructional best practices were identified from the focus groups: setting the stage, consistency when team teaching, timeliness in posting materials, time on task, accountability for online activities, use of structured active learning, instructor use of feedback on student preparation, incorporation of student feedback into the course, short reviews of online material during class, and ensuring technologies are user friendly. Conclusion. Instructors using blended learning should consider incorporating these best practices into their course design and management. More evaluation is needed to see if implementation of these practices affects student performance.

Competing for the same value segments? Insight into the volatile Dutch political landscape

PubMed Central

Groenen, Patrick J. F.; van Rosmalen, Joost

2018-01-01

Values are central to public debates today. Human values convey broad goals that serve as guiding principles in a person’s life and value priorities differ across people in society. Groups in society holding opposing values (e.g., universalism versus security) will make different choices when voting in an election. Whereas over time, values are relatively stable, the number and type of political parties as well as the political values they communicate and disseminate have been changing. Groups of people holding the same human values may therefore vote for another (new) party in a later election. We focus on analyzing the relationship between human values and voting in elections, introducing a new methodology to analyze how value profiles relate to political support over time. We investigate the Dutch multi-party political system over five waves of the European Social Survey, spanning 2002 until 2010. Whilst previous research has focused on individual values separately and focused on voters only, we (1) distinguish groups holding a similar set of opposing and compatible values (value profile) instead of focusing on single values in the the entire population; (2) incorporate a correction for differences in scale use in our model; (3) compare voting over time; (4) include non-voters, a growing group in Dutch society. We find evidence that specific value profiles are related to voting for a specific set of political parties. We also find that specific value profiles distinguish non-voters from voters and that voters for populist parties resemble non-voters. PMID:29324764

Healthcare experiences of women with visual impairment.

PubMed

Sharts-Hopko, Nancy C; Smeltzer, Suzanne; Ott, Barbara B; Zimmerman, Vanessa; Duffin, Janice

2010-01-01

This investigation was a secondary analysis of focus group transcripts to address the question of how women with low vision or blindness have experienced healthcare. Secondary analysis of qualitative data was performed on transcripts from 2 focus groups. These focus groups were conducted at an agency serving visually impaired people in Philadelphia. The 2 focus groups included 7 and 11 women, respectively, having low-vision or who are blind who had been part of an original study of reaching hard-to-reach women with disabilities. Content analysis for the identification of thematic clusters was performed on transcriptions of the focus group data. Findings are consistent with existing research on the health needs of women with disabilities but add specific understanding related to visual impairment. Six thematic categories were identified: health professionals' awareness, information access, healthcare access, isolation, the need for self-advocacy, and perception by others. Secondary analysis of qualitative data affords in-depth understanding of a particular subset of participants within a larger study. Clinical nurse specialists and other health professionals need to increase their sensitivity to the challenges faced by women with visual impairment, and plan and provide care accordingly. Health professions students need to be prepared to interact with people who are visually impaired and healthcare settings need to respond to their needs.

Using Multidisciplinary Focus Groups to Inform the Development of mI SMART: A Nurse-Led Technology Intervention for Multiple Chronic Conditions

PubMed Central

Theeke, Laurie A.; Theeke, Elliott; Mallow, Brian K.

2016-01-01

Used as integrated tools, technology may improve the ability of healthcare providers to improve access and outcomes of care. Little is known about healthcare teams' preferences in using such technology. This paper reports the findings from focus groups aimed at evaluating a newly developed primary care technology platform. Focus groups were completed in academic, outpatient, and community settings. Focus groups were attended by 37 individuals. The participants included professionals from multiple disciplines. Both prescribing (N = 8) and nonprescribing healthcare team members (n = 21) completed the focus groups and survey. The majority were practicing for more than 20 years (44.8%) in an outpatient clinic (62%) for 20–40 hours per week (37.9%). Providers identified perceived obstacles of patient use as ability, willingness, and time. System obstacles were identified as lack of integration, lack of reimbursement, and cost. The positive attributes of the developed system were capability for virtual visits, readability, connectivity, user-friendliness, ability to capture biophysical measures, enhanced patient access, and incorporation of multiple technologies. Providers suggested increasing capability for biophysical and symptom monitoring for more common chronic conditions. Technology interventions have the potential to improve access and outcomes but will not be successful without the input of users. PMID:27504199

[Development of a set of nursing-sensitive indicators for Swiss practice].

PubMed

Kleinknecht-Dolf, Michael; Baumberger, Dieter; Jucker, Thomas; Kliem, Uwe; Zimmermann, Natalie; Spirig, Rebecca

2016-02-01

The SwissDRG prospective payment system is known to inadequately account for nursing intensity due to the DRG group criteria insufficiently describing the variability of nursing intensity within individual diagnosis-related groups. In order to allow for appropriate reimbursement and resource allocation, nursing intensity must be able to be explicitly quantified and accounted for. The aim of this project was to develop a set of nursing-sensitive indicators intended to reduce the variation within individual diagnosis-related groups, supplementary to existing SwissDRG group criteria. The approach comprised a variety of methods. A systematic literature review, input from an advisory board and an expert panel, as well as three focus group interviews with nurses and nurse managers formed the basis for the synthesis of data and information gathered from these sources. A set of 14 nursing-sensitive indicators was developed. The indicators are intended to improve the homogeneity of nursing intensity within SwissDRG diagnosis-related groups. Before these nursing indicators can be adopted as group criteria, they must be formulated to conform with SwissDRG and tested empirically. This set of indicators can be seen at as a first step towards nursing intensity being adequately represented in SwissDRG diagnosis-related groups. The next challenge to be met is operationalising the indicators in codable form.

Challenges and Dilemmas Expressed by Teachers Working in Toddler Groups in the Nordic Countries

ERIC Educational Resources Information Center

Alvestad, Torgeir; Bergem, Helen; Eide, Brit; Johansson, Jan-Erik; Os, Ellen; Pálmadóttir, Hrönn; Samuelsson, Ingrid Pramling; Winger, Nina

2014-01-01

This article is based on a collaborative study in Iceland, Sweden and Norway of the youngest children in institutional settings, such as preschools. At the present time, preschool curricula and frameworks are changing to include increased learning. However, preschool teacher education lacks sufficient focus on this age group. New preschool…

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

ERIC Educational Resources Information Center

McKay, Mary M.; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Chacko, Anil; Jackson, Jerrold M.; Fuss, Ashley

2011-01-01

This article presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within 13 urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this article focuses on parent…

Problem-Based Learning in Tertiary Education: Teaching Old "Dogs" New Tricks?

ERIC Educational Resources Information Center

Yeo, Roland K.

2005-01-01

Purpose--The paper sets out to explore the challenges of problem-based learning (PBL) in tertiary education and to propose a framework with implications for practice and learning. Design/Methodology/Approach--A total of 18 tertiary students divided into three groups participated in the focus group discussions. A quantitative instrument was used as…

The Efficacy of Contingency Models of Reinforcement on Group Expectations and Reading Achievement

ERIC Educational Resources Information Center

Wilder, Valerie Kristine

2011-01-01

Social learning theory contends that group contingent reinforcement can be used as a means of shaping problematic behavior in both academic and nonacademic settings. Prior research has focused on contingent management of academic behaviors with older populations at the college level and younger students both with and without disabilities in the…

Addressing Point of Need in Interactive Multimedia Instruction: A Conceptual Review and Evaluation

DTIC Science & Technology

2013-11-01

classroom setting, ability grouping refers to the practice of putting students into groups on the basis of individual group members’ ability levels...presentation of elaborated/basic vs. advanced material, color cuing, pretesting and modifying learning presentation based on performance) ...learners’ points of need. The point of need concept is focused both on the accessibility of information to support the learning process as well as

Hope for successful implementation of psychosocial/psychiatric rehabilitation in the forensic mental health setting.

PubMed

Brown, Stephanie A; Lewis, Kent

2015-12-01

To explore staff perceptions of the successes and barriers to implementation of the psychosocial/psychiatric rehabilitation (PSR) model in the forensic mental health setting and identify staff supports needed for greater implementation. A qualitative descriptive design was used and staff focus group data was analyzed using the constant comparative method. All aspects of PSR are being implemented in the forensic setting. Barriers limiting comprehensive implementation include hospital processes and functions, legal components, client clinical presentation, staff attributes and interactions, and lack of resources. To foster greater implementation, employees require support to improve interprofessional interactions and acquire additional resources and education. Strengthening existing successes and addressing barriers identified will foster greater PSR implementation in the forensic setting. Adjusting the physical environment, streamlining documentation, shifting focus from security to rehabilitation goals, and adapting PSR principles to various levels of illness acuity and stages of treatment would enhance PSR implementation. A management focus on improving staff morale, self-care, peer support, team cohesion, and communication would limit burnout and increase successful implementation of PSR. Additional educational opportunities and ongoing training are suggested to support a unified understanding and sustained approach to PSR implementation in the forensic setting. (c) 2015 APA, all rights reserved).

Leadership support for ward managers in acute mental health inpatient settings.

PubMed

Bonner, Gwen; McLaughlin, Sue

2014-05-01

This article shares findings of work undertaken with a group of mental health ward managers to consider their roles through workshops using an action learning approach. The tensions between the need to balance the burden of administrative tasks and act as clinical role models, leaders and managers are considered in the context of providing recovery-focused services. The group reviewed their leadership styles, broke down the administrative elements of their roles using activity logs, reviewed their working environments and considered how recovery focused they believed their wards to be. Findings support the notion that the ward manager role in acute inpatient settings is at times unmanageable. Administration is one aspect of the role for which ward managers feel unprepared and the high number of administrative tasks take them away from front line clinical care, leading to frustration. Absence from clinical areas reduces opportunities for role modeling good clinical practice to other staff. Despite the frustrations of administrative tasks, overall the managers thought they were supportive to their staff and that their wards were recovery focused.

High performance low cost interconnections for flip chip attachment with electrically conductive adhesive. Final report

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

NONE

1998-05-01

This final report is a compilation of final reports from each of the groups participating in the program. The main three groups involved in this effort are the Thomas J. Watson Research Center of IBM Corporation in Yorktown Heights, New York, Assembly Process Design of IBM Corporation in Endicott, New York, and SMT Laboratory of Universal Instruments Corporation in Binghamton, New York. The group at the research center focused on the conductive adhesive materials development and characterization. The group in process development focused on processing of the Polymer-Metal-Solvent Paste (PMSP) to form conductive adhesive bumps, formation of the Polymer-Metal Compositemore » (PMC) on semiconductor devices and study of the bonding process to circuitized organic carriers, and the long term durability and reliability of joints formed using the process. The group at Universal Instruments focused on development of an equipment set and bonding parameters for the equipment to produce bond assembly tooling. Reports of each of these individual groups are presented here reviewing their technical efforts and achievements.« less

Conflict resolution styles: a comparison of assisted living and nursing home facilities.

PubMed

Small, Jeff A; Montoro-Rodriguez, Julian

2006-01-01

In this exploratory study, the authors investigated how interpersonal conflict is resolved in assisted living and nursing home facilities. In particular, the authors examined whether conflict resolution styles differed between type of facility and between residents and staff in each type of facility. Four focus groups were conducted--two with residents and two with staff from each type of facility. The focus groups centered on discussing the occurrence of conflict and how each participant handled it. Discourse analysis was employed to identify participants' use of three styles of conflict resolution: controlling, solution-oriented, and non-confrontational. The results indicate that staff in each care context showed a preference for the solution-oriented approach. Residents in each setting reported equal use of the non-confrontational and solution-oriented styles. The findings suggest that preferred conflict resolution styles may vary more as a function of the role of each communicator than the context of the care setting.

Randomized Clinical Trial of Cognitive Behavioral Social Skills Training for Schizophrenia: Improvement in Functioning and Experiential Negative Symptoms

PubMed Central

Granholm, Eric; Holden, Jason; Link, Peter C.; McQuaid, John R.

2014-01-01

Objective Identifying treatments to improve functioning and reduce negative symptoms in consumers with schizophrenia is of high public health significance. Method In this randomized clinical trial, participants with schizophrenia or schizoaffective disorder (N=149) were randomly assigned to cognitive behavioral social skills training (CBSST) or an active goal-focused supportive contact (GFSC) control condition. CBSST combined cognitive behavior therapy with social skills training and problem solving training to improve functioning and negative symptoms. GFSC was weekly supportive group therapy focused on setting and achieving functioning goals. Blind raters assessed functioning (primary outcome: Independent Living Skills Survey (ILSS)), CBSST skill knowledge, positive and negative symptoms, depression, and defeatist performance attitudes. Results In mixed-effects regression models in intent-to-treat analyses, CBSST skill knowledge, functioning, amotivation/asociality negative symptoms and defeatist performance attitudes improved significantly more in CBSST relative to GFSC. In both treatment groups, comparable improvements were also found for positive symptoms and a performance-based measure of social competence. Conclusions The results suggest CBSST is an effective treatment to improve functioning and experiential negative symptoms in consumers with schizophrenia, and both CBSST and supportive group therapy that is actively focused on setting and achieving functioning goals can improve social competence and reduce positive symptoms. PMID:24911420

Barriers to Implementing Person-Centered Recovery Planning in Public Mental Health Organizations in Texas: Results from Nine Focus Groups.

PubMed

Lodge, Amy C; Kaufman, Laura; Stevens Manser, Stacey

2017-05-01

Despite being an established practice in the disabilities service systems, person-centered planning is a relatively new practice in the behavioral health system. As a result, little is known about the barriers that mental health organizations face in implementing person-centered recovery planning (PCRP). To fill this gap, results are presented from a qualitative analysis of nine focus groups at three public mental health organizations in Texas that have been implementing PCRP for at least 2 years. Findings suggest that organizations experienced 12 distinct barriers to PCRP implementation which were categorized into the Consolidated Framework for Implementation Research domains of intervention characteristics, the outer setting, the inner setting, characteristics of individuals, and the implementation process. Half of these 12 barriers fell within the inner setting domain, suggesting that implementation efforts should be flexible and adaptable to organizational culture and context. One-quarter of the barriers fell into the domain of characteristics of individuals involved in the intervention, which further suggests implementation efforts should assess the impact that both staff and consumers have on implementation success.

Students' Perceptions on an Interprofessional Ward Round Training - A Qualitative Pilot Study.

PubMed

Nikendei, C; Huhn, D; Pittius, G; Trost, Y; Bugaj, T J; Koechel, A; Schultz, J-H

2016-01-01

Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students', nurses' as well as physiotherapists' views on a simulation-based interprofessional ward round training. In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second) volunteered to participate in two standardized patient ward round scenarios: (1) patient with myocardial infarction, and (2) patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups. Focus group based feedback contained two main categories (A) ward round training benefits and (B) difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups. The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian Action Summit 2011.

PubMed

Patel, P P; Russell, J; Allden, K; Betancourt, T S; Bolton, P; Galappatti, A; Hijazi, Z; Johnson, K; Jones, L; Kadis, L; Leary, K; Weissbecker, I; Nakku, J

2011-12-01

The Working Group (WG) on Mental Health and Psychosocial Support participated in its second Humanitarian Action Summit in 2011. This year, the WG chose to focus on a new goal: reviewing practice related to transitioning mental health and psychosocial support programs from the emergency phase to long-term development. The Working Group's findings draw on a review of relevant literature as well as case examples. The objective of the Working Group was to identify factors that promote or hinder the long term sustainability of emergency mental health and psychosocial interventions in crisis and conflict, and to provide recommendations for transitioning such programs from relief to development. The Working Group (WG) conducted a review of relevant literature and collected case examples based on experiences and observations of working group members in implementing mental and psychosocial programming in the field. The WG focused on reviewing literature on mental health and psychosocial programs and interventions that were established in conflict, disaster, protracted crisis settings, or transition from acute phase to development phase. The WG utilized case examples from programs in Lebanon, the Gaza Strip, Sierra Leone, Aceh (Indonesia), Sri Lanka, and New Orleans (United States). The WG identified five key thematic areas that should be addressed in order to successfully transition lasting and effective mental health and psychosocial programs from emergency settings to the development phase. The five areas identified were as follows: Government and Policy, Human Resources and Training, Programming and Services, Research and Monitoring, and Finance. The group identified several recommendations for each thematic area, which were generated from key lessons learned by working group members through implementing mental health and psychosocial support programs in a variety of settings, some successfully sustained and some that were not.

Phenotype definition and development--contributions from Group 7.

PubMed

Wilcox, Marsha A; Paterson, Andrew D

2009-01-01

The papers in Genetic Analysis Workshop 16 Group 7 covered a wide range of topics. The effects of confounder misclassification and selection bias on association results were examined by one group. Another focused on bias introduced by various methods of accounting for treatment effects. Two groups used related methods to derive phenotypic traits. They used different analytic strategies for genetic associations with non-overlapping results (but because they used different sets of single-nucleotide polymorphisms (SNPs) and significance criteria, this is not surprising). Another group relied on the well-characterized definition of type 2 diabetes to show benefits of a novel predictive test. Transmission-ratio distortion was the focus of another paper. The results were extended to show a potential secondary benefit of the test to identify potentially mis-called SNPs. (c) 2009 Wiley-Liss, Inc.

Public views on the donation and use of human biological samples in biomedical research: a mixed methods study

PubMed Central

Lewis, Celine; Clotworthy, Margaret; Hilton, Shona; Magee, Caroline; Robertson, Mark J; Stubbins, Lesley J; Corfield, Julie

2013-01-01

Objective A mixed methods study exploring the UK general public's willingness to donate human biosamples (HBSs) for biomedical research. Setting Cross-sectional focus groups followed by an online survey. Participants Twelve focus groups (81 participants) selectively sampled to reflect a range of demographic groups; 1110 survey responders recruited through a stratified sampling method with quotas set on sex, age, geographical location, socioeconomic group and ethnicity. Main outcome measures (1) Identify participants’ willingness to donate HBSs for biomedical research, (2) explore acceptability towards donating different types of HBSs in various settings and (3) explore preferences regarding use and access to HBSs. Results 87% of survey participants thought donation of HBSs was important and 75% wanted to be asked to donate in general. Responders who self-reported having some or good knowledge of the medical research process were significantly more likely to want to donate (p<0.001). Reasons why focus group participants saw donation as important included: it was a good way of reciprocating for the medical treatment received; it was an important way of developing drugs and treatments; residual tissue would otherwise go to waste and they or their family members might benefit. The most controversial types of HBSs to donate included: brain post mortem (29% would donate), eyes post mortem (35%), embryos (44%), spare eggs (48%) and sperm (58%). Regarding the use of samples, there were concerns over animal research (34%), research conducted outside the UK (35%), and research conducted by pharmaceutical companies (56%), although education and discussion were found to alleviate such concerns. Conclusions There is a high level of public support and willingness to donate HBSs for biomedical research. Underlying concerns exist regarding the use of certain types of HBSs and conditions under which they are used. Improved education and more controlled forms of consent for sensitive samples may mitigate such concerns. PMID:23929915

Consumers’ Perceptions of Preconception Health

PubMed Central

Squiers, Linda; Mitchell, Elizabeth W.; Levis, Denise M.; Lynch, Molly; Dolina, Suzanne; Margolis, Marjorie; Scales, Monica; Kish-Doto, Julia

2015-01-01

Purpose To inform the development of a preconception health (PCH) social marketing plan, we conducted qualitative research with prospective consumers. Approach We present formative findings based on the four Ps of social marketing: product, price, promotion, and place. Setting We conducted focus groups with 10 groups of women in Atlanta, Georgia, in fall 2010. Participants We classified women aged 18 to 44 into five groups based on their pregnancy plans, and then further segmented the groups based on socioeconomic status for a total of 10 groups. Method The focus group guide was designed to elicit participants’ responses about the product, price, promotion, and placement of PCH. We used NVivo 9 software to analyze focus group data. Results Women planning a pregnancy in the future had different perspectives on PCH as a product than women not planning a pregnancy. Barriers to PCH included lack of social support, addiction, and lack of awareness about PCH. Participants preferred to think of PCH behaviors as “promoting” a healthy baby rather than preventing an unhealthy birth outcome. Many women in the focus groups preferred to hear PCH messages from a health care provider, among other channels. Conclusion The results from this research will inform the development of a social marketing plan for PCH and the development of concepts that will be tested with consumers to determine their viability for use in a national campaign. PMID:23286658

The Animadora Project: Identifying factors related to the promotion of physical activity among Mexican Americans with diabetes

PubMed Central

Ingram, Maia; Ruis, Maricruz; Mayorga, Maria Theresa; Rosales, Cecilia

2015-01-01

Purpose There is a dearth of information about factors related to physical activity among Mexican Americans with diabetes. Self efficacy and social support are associated with physical activity, however little is known about their role within different cultural groups. Design Focus groups were used to identify factors that motivate walking. Setting Two Mexican American communities located in Tucson, Arizona. Subjects Individuals who attended diabetes education. Intervention A community-based provider organized walking groups with people who previously attended diabetes classes. Walkers participated in focus groups exploring themes related to their experience. Measures Self efficacy, social support, and collective efficacy. Grounded theory was used to analyze focus group results using two rounds of analysis; the first identifying references to self efficacy and social support and the second adding collective efficacy as a theoretical basis for walking. Results Among 43 eligible participants, 20 participated in focus groups. Social support was expressed as commitment and companionship. Walkers demonstrated a high level of self efficacy for walking. Development of group identity/social cohesion was also a motivator to walk. Collective efficacy emerged as an applicable theoretical model encompassing these themes and their interrelationship. Conclusion Collective efficacy, or the belief that the group can improve their lives through collective effort, is a viable theoretical construct in the development of physical activity interventions targeting Mexican Americans with diabetes. PMID:19601479

Contextualizing the findings of a systematic review on patient and carer experiences of dementia diagnosis and treatment: a qualitative study.

PubMed

Bunn, Frances; Sworn, Katie; Brayne, Carol; Iliffe, Steve; Robinson, Louise; Goodman, Claire

2015-10-01

Involving service users in the systematic review process is seen as increasingly important. As systematic reviews often include studies from diverse settings and covering a time span of several decades, involving service users in consideration of applicability to specific populations or settings might make reviews more useful to practitioners and policymakers. To test and contextualize the findings of a systematic review of qualitative studies looking at patient and carer experiences of diagnosis and treatment of dementia. Results from the systematic review were discussed in focus groups and semi-structured interviews with patient, public and professional participants in the South East of England. Analysis was guided by coding frameworks developed from the results of the systematic review. We recruited 27 participants, including three people with dementia, 12 carers, six service providers and five older people without dementia. Findings from the focus groups and interviews were consistent with those from the systematic review and suggest that our review findings were applicable to the local setting. We found some evidence that access to information and diagnostic services had improved but, as in the systematic review, post-diagnosis support was still often experienced as inadequate. Focus groups and interviews with service users and their representatives can provide useful contextual information. However, such strategies can require considerable investment of the part of the researcher in terms of time and resources, and more work is needed to refine strategies and establish the benefits for patients and the organization of services. © 2013 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Investigating the experiences in a school-based occupational therapy program to inform community-based paediatric occupational therapy practice.

PubMed

Rens, Lezahn; Joosten, Annette

2014-06-01

A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.

Development of questionnaires to measure patient preferences for intranasal corticosteroids in patients with allergic rhinitis.

PubMed

Meltzer, Eli O; Hadley, James; Blaiss, Michael; Benninger, Michael; Kimel, Miriam; Kleinman, Leah; Dupclay, Leon; Garcia, Jorge; Leahy, Michael; Georges, George

2005-02-01

To develop a questionnaire to evaluate preferences for attributes of intranasal corticosteroids (INSs) in clinical trials with allergic rhinitis (AR) patients. Established questionnaire development practices were used, including performance of a literature review and use of patient and physician focus groups, cognitive debriefing interviews, and pilot testing before validation. Findings from patient and physician focus groups suggest that sensory attributes are relevant to AR patients when choosing INSs. Physician focus groups identified the need for 2 distinct preference instruments, a clinical trial patient preference questionnaire (CTPPQ) and a clinical practice preference questionnaire (CPPPQ). A pilot study suggests that the CTPPQ is capable of discriminating between 2 INSs in the clinical trial setting. Initial findings suggest that items in the CTPPQ and CPPPQ are easy to understand and relevant to patients. Further validation studies with larger sample sizes are needed to assess the psychometric properties of both questionnaires. B-20.

Acceptability of the Fetzer/NIA Multidimensional Measure of Religiousness and Spirituality in a sample of community-dwelling Black adults.

PubMed

Mokel, Melissa J; Shellman, Juliette M

2014-01-01

To examine the acceptability of the National Institute on Aging/Fetzer Multidimensional Measure of Religiousness and Spirituality in a sample of Black, community-dwelling, older adults using focus group inquiry (N =15). Focus group methodology was used for data collection and analysis. Three focus groups (N = 15) were conducted in two different urban settings in the northeastern part of the United States. Key findings were that (a) self-rating on religiousness was uncomfortable for many participants, (b) selfless was a word many participants confused with selfish, and (c) spirituality was an important concept. Overall, the Measure was found to be culturally acceptable and required little modification. Religious health beliefs such as "rebuking" or "not claiming" medical diagnoses are important considerations to bear in mind in seeking to understand the impact of religiousness on health in this population.

Accounting for the move to ambulatory patient groups.

PubMed

Boyagian, H R; Dessingue, R F

1998-07-01

This article focuses on the cost accounting challenge an ambulatory patient group (APG)-like-based prospective payment system presents to providers and the issues associated with that challenge. In particular, how can costs be identified, how can the differences in costs be associated with alternative settings, and how do costs identified through a detailed resource costing methodology compare to estimates using alternative measures? The results presented suggest that decisions made based on current measures of ambulatory cost (i.e., charge-based measures) need to be reexamined. These decisions could include which services to provide, what setting is appropriate, and where marketshare opportunities exist.

Knowledge of Food Production Methods Informs Attitudes toward Food but Not Food Choice in Adults Residing in Socioeconomically Deprived Rural Areas within the United Kingdom

ERIC Educational Resources Information Center

Barton, Maria; Kearney, John; Stewart-Knox, Barbara J.

2011-01-01

Objective: Understand food choice, from the perspective of people residing in socioeconomically deprived rural neighborhoods. Methods: Focus groups (n = 7) were undertaken within a community setting involving 42 adults (2 males and 40 females) recruited through voluntary action groups. Data were recorded, transcribed verbatim, and content…

Examining the Mediation of Power in a Collaborative Community: Engaging in Informal Science as Authentic Practice

ERIC Educational Resources Information Center

Puvirajah, Anton; Verma, Geeta; Webb, Horace

2012-01-01

Focusing on the interplay of context and language, this study examined a group of high school students and their mentors' use of language during a robotics competition. This informal setting allowed us to gain insights into the mediation and manifestation of power within the group. Using critical discourse analysis of competition transcripts and…

The Development of a Small-World Network of Higher Education Students, Using a Large-Group Problem-Solving Method

ERIC Educational Resources Information Center

Sousa, Fernando Cardoso; Monteiro, Ileana Pardal; Pellissier, René

2014-01-01

This article presents the development of a small-world network using an adapted version of the large-group problem-solving method "Future Search." Two management classes in a higher education setting were selected and required to plan a project. The students completed a survey focused on the frequency of communications before and after…

Comparison of Two Small-Group Learning Methods in 12th-Grade Physics Classes Focusing on Intrinsic Motivation and Academic Performance

ERIC Educational Resources Information Center

Berger, Roland; Hanze, Martin

2009-01-01

Twelfth-grade physics classes with 344 students participated in a quasi-experimental study comparing two small-group learning settings. In the jigsaw classroom, in contrast to the cyclical rotation method, teaching expectancy as well as resource interdependence is established. The study is based on the self-determination theory of motivation,…

Parents’ Views on Engaging Families of Middle School Students in Obesity Prevention and Control in a Multiethnic Population

PubMed Central

Chung, Paul. J.; Thompson, Lindsey R.; Elijah, Jacinta; Lamb, Sheila; Garcia, Vanessa P.; Bastani, Roshan

2014-01-01

Introduction Overweight and obesity remain significant public health risks for youth in the United States, particularly among racial/ethnic minority groups. Efforts at obesity prevention and control have targeted youth and family members in diverse settings. Although involving parents in obesity prevention programs for youth may improve the potential of these programs, less is known about parents’ preferred methods of engagement, especially among racial/ethnic minority parents and parents whose primary language is not English. In this qualitative study, parents of middle-school–aged children were asked how best to engage their children in obesity prevention and control efforts. Methods We recruited 38 parents whose children attended Los Angeles middle schools to participate in focus groups. Two English-language focus groups with 14 parents of different racial/ethnic backgrounds and 2 Spanish language groups with 24 Latino parents were conducted from 2010 through 2011. We analyzed focus group transcripts by using content analysis using inductive and deductive techniques. Results Findings from focus groups confirmed that parents want to help their children avoid obesity but feel constrained in their ability to take action. Participants identified an overarching desire to become better parents as a potential incentive to engage in obesity prevention efforts. Parents advocated for family-focused approaches in obesity prevention programs, including family sports leagues and cooking classes. Most findings were consistent between language groups, but parents in the Spanish language groups cited language-related barriers. Conclusion The development and testing of simple programs that are sustainable, community-based, and family-focused may empower families to address obesity prevention and control. PMID:24698532

An Observational Study of Group Waterpipe Use in a Natural Environment

PubMed Central

2014-01-01

Introduction: To date research on tobacco smoking with a waterpipe (hookah, narghile, and shisha) has focused primarily on the individual user in a laboratory setting. Yet, waterpipe tobacco smoking is often a social practice that occurs in cafés, homes, and other natural settings. This observational study examined the behavior of waterpipe tobacco smokers and the social and contextual features of waterpipe use among groups in their natural environment. Methods: Trained observers visited urban waterpipe cafés on multiple occasions during an 8-month period. Observations of 241 individual users in naturally formed groups were made on smoking topography (puff frequency, duration, and interpuff interval [IPI]) and engagement in other activities (e.g., food and drink consumption, other tobacco use, and media viewing). Results: Most users were male in group sizes of 3–4 persons, on average, and each table had 1 waterpipe, on average. The predominant social features during observational periods were conversation and nonalcoholic drinking. Greater puff number was associated with smaller group sizes and more waterpipes per group, while longer IPIs were associated with larger group sizes and fewer waterpipes per group. Additionally, greater puff frequency was observed during media viewing and in the absence of other tobacco use. Conclusions: Overall, the results suggest that waterpipe smoking behavior is affected by group size and by certain social activities. Discussion focuses on how these findings enhance our understanding of factors that may influence exposure to waterpipe tobacco smoke toxicants in naturalistic environments. PMID:23943842

Impact of Blood Pressure Dysregulation on Health-Related Quality of Life in Persons With Spinal Cord Injury: Development of a Conceptual Model

PubMed Central

Carlozzi, Noelle E.; Fyffe, Denise; Morin, Kel G.; Byrne, Rachel; Tulsky, David S.; Victorson, David; Lai, Jin-Shei; Wecht, Jill M.

2015-01-01

Objectives To identify medically relevant aspects of blood pressure dysregulation (BPD) related to quality of life in individuals with spinal cord injury (SCI), and to propose an integrated conceptual framework based on input from both individuals with SCI and their clinical providers. This framework will serve as a guide for the development of a patient-reported outcome (PRO) measure specifically related to BPD. Design Three focus groups with individuals with SCI and 3 groups with SCI providers were analyzed using grounded-theory based qualitative analysis to ascertain how blood pressure impacts health-related quality of life (HRQOL) in individuals with SCI. Setting Focus groups were conducted at 2 Veterans Affairs medical centers and a research center. Participants Individuals with SCI (n=27) in 3 focus groups and clinical providers (n=25) in 3 focus groups. Interventions Not applicable. Main Outcome Measures Not applicable. Results Qualitative analysis indicated that all focus groups spent the highest percentage of time discussing symptoms of BPD (39%), followed by precipitators/causes of BPD (16%), preventative actions (15%), corrective actions (12%), and the impact that BPD has on social or emotional functioning (8%). While patient/consumer focus groups and provider focus groups raised similar issues, providers spent more time discussing precipitators/causes of BPD and preventative actions (38%) than patient/consumer groups (24%). Conclusions These results suggest that BPD uniquely and adversely impacts HRQOL in persons with SCI. While both individuals with SCI and their providers highlighted the relevant symptoms of BPD, the SCI providers offered additional detailed information regarding the precipitators/causes and what can be done to prevent/treat BPD. Further, the results suggest that persons with SCI are aware of how BPD impacts their HRQOL and are able to distinguish between subtle signs and symptoms. These findings exemplify the need for a validated and sensitive clinical measurement tool that can assess the extent to which BPD impacts HRQOL in patients with SCI. PMID:23499779

Social and place-focused communities in location-based online social networks

NASA Astrophysics Data System (ADS)

Brown, Chloë; Nicosia, Vincenzo; Scellato, Salvatore; Noulas, Anastasios; Mascolo, Cecilia

2013-06-01

Thanks to widely available, cheap Internet access and the ubiquity of smartphones, millions of people around the world now use online location-based social networking services. Understanding the structural properties of these systems and their dependence upon users' habits and mobility has many potential applications, including resource recommendation and link prediction. Here, we construct and characterise social and place-focused graphs by using longitudinal information about declared social relationships and about users' visits to physical places collected from a popular online location-based social service. We show that although the social and place-focused graphs are constructed from the same data set, they have quite different structural properties. We find that the social and location-focused graphs have different global and meso-scale structure, and in particular that social and place-focused communities have negligible overlap. Consequently, group inference based on community detection performed on the social graph alone fails to isolate place-focused groups, even though these do exist in the network. By studying the evolution of tie structure within communities, we show that the time period over which location data are aggregated has a substantial impact on the stability of place-focused communities, and that information about place-based groups may be more useful for user-centric applications than that obtained from the analysis of social communities alone.

Ovarian Cancer Survivors’ Experiences of Self-Advocacy: A Focus Group Study

PubMed Central

Hagan, Teresa L.; Donovan, Heidi S.

2014-01-01

Purpose/Objectives To explore ovarian cancer survivors’ experiences of self-advocacy in symptom management. Research Approach Descriptive, qualitative. Setting A public café in an urban setting. Participants 13 ovarian cancer survivors aged 26–69 years with a mean age of 51.31. Methodologic Approach Five focus groups were formed. Focus group discussions were audio recorded and transcribed verbatim. The content was analyzed using the constant comparison method with axial coding. In-depth interviews with 5 of the 13 participants occurred via telephone one to five months after each focus group meeting to clarify and expand on identified themes. Preliminary findings were shared with all participants for validation. Findings Two major themes emerged from the data: (a) knowing who I am and keeping my psyche intact, and (b) knowing what I need and fighting for it. Exemplar quotations illustrate the diverse dimensions of self-advocacy. In addition, a working female-centric definition of self-advocacy was attained. Conclusions Women have varying experiences with cancer- and treatment-related symptoms, but share a common process for recognizing and meeting their needs. Self-advocacy was defined as a process of learning one’s needs and priorities as a cancer survivor and negotiating with healthcare teams, social supports, and other survivors to meet these needs. Interpretation This phenomenologic process identified key dimensions and a preliminary definition of self-advocacy that nurses can recognize and support when patients seek and receive care consistent with their own needs and preferences. Knowledge Translation Self-advocacy among female cancer survivors is a process of recognizing one’s needs and priorities and fighting for them within their cancer care and life. Practitioners can support female cancer survivors through the process of self-advocacy by providing them with skills and resources in making informed choices for themselves. PMID:23454476

Health care provider communication: an empirical model of therapeutic effectiveness.

PubMed

Chochinov, Harvey M; McClement, Susan E; Hack, Thomas F; McKeen, Nancy A; Rach, Amanda M; Gagnon, Pierre; Sinclair, Shane; Taylor-Brown, Jill

2013-05-01

Patients who are facing life-threatening and life-limiting cancer almost invariably experience psychological distress. Responding effectively requires therapeutic sensitivity and skill. In this study, we examined therapeutic effectiveness within the setting of cancer-related distress with the objective of understanding its constituent parts. Seventy-eight experienced psychosocial oncology clinicians from 24 health care centers across Canada were invited to participate in 3 focus groups each. In total, 29 focus groups were held over 2 years, during which clinicians articulated the therapeutic factors deemed most helpful in mitigating patient psychosocial distress. The content of each focus group was summarized into major themes and was reviewed with participants to confirm their accuracy. Upon completion of the focus groups, workshops were held in various centers, eliciting participant feedback on an empirical model of therapeutic effectiveness based on the qualitative analysis of focus group data. Three primary, interrelated therapeutic domains emerged from the data, forming a model of optimal therapeutic effectiveness: 1) personal growth and self-care (domain A), 2) therapeutic approaches (domain B), and 3) creation of a safe space (domain C). Areas of domain overlap were identified and labeled accordingly: domain AB, therapeutic humility; domain BC, therapeutic pacing; and domain AC, therapeutic presence. This empirical model provides detailed insights regarding the elements and pedagogy of effective communication and psychosocial care for patients who are experiencing cancer-related distress. Copyright © 2012 American Cancer Society.

Volunteer Stroke Service (VSS) groups for patients with communication difficulties after stroke: a qualitative analysis of the value of groups to their users.

PubMed

Legg, Lynn; Stott, David; Ellis, Graham; Sellars, Cameron

2007-09-01

To identify the functions that Volunteer Stroke Service (VSS) groups fulfil for their members. Qualitative focus group study. Mixed urban and rural community settings in Scotland. Seven focus groups comprising a total of 24 men and 14 women, with dysarthria or aphasia following stroke, who were members of VSS groups funded by Chest Heart and Stroke Scotland. We identified eight main themes. VSS groups (1) include members in an interpersonal network, (2) provide members with the opportunity to develop interpersonal relations, (3) provide members with support, (4) provide opportunities for personal growth and development, (5) supply members with a purpose, structure and routine, (6) help members establish and confirm their identify, beliefs and values, (7) help members accomplish individual and shared goals, and (8) provide members with the opportunity to influence others and be influenced. VSS groups appear to provide a range of functions that meet members' personal, interpersonal and psychological needs.

A Cross-Sectional Study of Shared Attention by Children with Autism and Typically Developing Children in an Inclusive Preschool Setting

ERIC Educational Resources Information Center

Rice, Catherine E.; Adamson, Lauren B.; Winner, Ellen; McGee, Gail G.

2016-01-01

This study examined the ways in which young children with autism and typical children focus their engagement with objects and people (peers and adults) in an inclusive preschool setting. A cross-sectional analysis was conducted of 30 typical children and 30 children with autism, with 10 different children from each group at 3 different ages (2, 3,…

Developing Intervention Strategies to Optimise Body Composition in Early Childhood in South Africa

PubMed Central

Tomaz, Simone A.; Stone, Matthew; Hinkley, Trina; Jones, Rachel A.; Louw, Johann; Twine, Rhian; Kahn, Kathleen; Norris, Shane A.

2017-01-01

Purpose. The purpose of this research was to collect data to inform intervention strategies to optimise body composition in South African preschool children. Methods. Data were collected in urban and rural settings. Weight status, physical activity, and gross motor skill assessments were conducted with 341 3–6-year-old children, and 55 teachers and parents/caregivers participated in focus groups. Results. Overweight and obesity were a concern in low-income urban settings (14%), but levels of physical activity and gross motor skills were adequate across all settings. Focus group findings from urban and rural settings indicated that teachers would welcome input on leading activities to promote physical activity and gross motor skill development. Teachers and parents/caregivers were also positive about young children being physically active. Recommendations for potential intervention strategies include a teacher-training component, parent/child activity mornings, and a home-based component for parents/caregivers. Conclusion. The findings suggest that an intervention focussed on increasing physical activity and improving gross motor skills per se is largely not required but that contextually relevant physical activity and gross motor skills may still be useful for promoting healthy weight and a vehicle for engaging with teachers and parents/caregivers for promoting other child outcomes, such as cognitive development. PMID:28194417

Emotional effects of continuity of care on family physicians and the therapeutic relationship

PubMed Central

Schultz, Karen; Delva, Dianne; Kerr, Jonathan

2012-01-01

Abstract Objective To explore conceptions of continuity of care among family physicians in traditional practices, family medicine–trained physicians working in episodic care, and family medicine residents to better understand the emotional effects on physicians of establishing long-term relationships with patients as a starting point for developing a tool to measure the qualitative connections between physicians and their patients. Design Qualitative descriptive study using focus groups. Setting Traditional family practice, family medicine residency training, and episodic-care settings in Kingston, Ont. Participants Three groups of first-year family medicine residents (n = 18), 2 groups of family physicians in established traditional practice (n = 9), and 2 groups of family physicians working in episodic-care settings (n = 10). Methods Using focus groups, a semistructured discussion guide, and a phenomenologic approach, we explored residents’ and practising physicians’ conceptions about continuity of care, predominantly exploring the emotional effects on physicians of providing care for a group of patients over time. Main findings Providing care for patients over time and developing a deep knowledge of, and often a deep connection to, patients affected physicians in various ways. Most of these effects were rewarding: feelings of connection, trust, curiosity, enhanced professional competence (diagnostically and therapeutically), personal growth, and being cared for and respected. Some, however, were distressing: anxiety, grief, frustration, boundary issues, and negative effects on personal life. Conclusion Family physicians experience myriad emotions connected with providing care to patients. Knowledge of what physicians find rewarding from their long-term connections with patients, and of the difficulties that arise, might be useful in further understanding interpersonal continuity of care and the therapeutic relationship, and in informing resident education about developing therapeutic relationships, evaluating resident educational experiences with continuity of care, and addressing physician burnout. PMID:22337743

Age-related differences in goals: testing predictions from selection, optimization, and compensation theory and socioemotional selectivity theory.

PubMed

Penningroth, Suzanna L; Scott, Walter D

2012-01-01

Two prominent theories of lifespan development, socioemotional selectivity theory and selection, optimization, and compensation theory, make similar predictions for differences in the goal representations of younger and older adults. Our purpose was to test whether the goals of younger and older adults differed in ways predicted by these two theories. Older adults and two groups of younger adults (college students and non-students) listed their current goals, which were then coded by independent raters. Observed age group differences in goals generally supported both theories. Specifically, when compared to younger adults, older adults reported more goals focused on maintenance/loss prevention, the present, emotion-focus and generativity, and social selection, and less goals focused on knowledge acquisition and the future. However, contrary to prediction, older adults also showed less goal focusing than younger adults, reporting goals from a broader set of life domains (e.g., health, property/possessions, friendship).

Development and Evaluation of a Career Continuance Model for Company Grade Officers in the United States Army

DTIC Science & Technology

2011-03-01

causal inference (e.g., longitudinal designs , training designs that include matched control groups ). Given the importance of time in our model... quantitative results. We did, of course, do qualitative research as part of this project in the form of focus groups and interviews. There are a... nonequivalent group designs . In T. D. Cook & D. T. Campbell, D. T. Quasi-experimentation: Design and Analysis Issues for Field Settings. (pp. 147-205

Decision rules for GHB (γ-hydroxybutyric acid) detoxification: a vignette study.

PubMed

Kamal, Rama M; van Iwaarden, Sjacco; Dijkstra, Boukje A G; de Jong, Cornelis A J

2014-02-01

GHB dependent patients can suffer from a severe and sometimes life-threatening withdrawal syndrome. Therefore, most of the patients are treated within inpatient settings. However, some prefers an outpatient approach to treatment. The aim of this study was to develop decision rules for addiction physicians to determine whether an outpatient or inpatient setting should be chosen for a safe GHB detoxification. A prospective vignette study was performed. Forty addiction medicine specialists from various treatment settings and residents of the Addiction Medicine postgraduate Master training were asked to contribute vignettes of GHB dependent patients. A focus group of 15 psychiatrists and addiction medicine specialists was asked to recommend an outpatient or inpatient setting for GHB detoxification treatment per vignette. Finally, five addiction medicine specialists, experts in GHB dependence treatment in the Netherlands, assessed the bio-psychosocial reasons for the choices of the focus group and formulated the recommended criteria. Based on the bio-psychosocial state of twenty vignette patients, addiction physicians and psychiatrists established the criteria and conditions recommended for the indication of an outpatient GHB detoxification. Intensity of addiction (GHB dose ≤32 g/d and frequency of abuse ≤2 h) was stated as the primary criterion in determining the setting as well as the complexity of the psychiatric comorbid disorders. The importance of a stable support system was emphasised. The vignette study resulted in a set of criteria with which addiction medicine specialists can make a weighted decision as to an outpatient or inpatient setting for GHB detoxification. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Exploring the efficacy of electronic response devices in ninth-grade science classrooms

NASA Astrophysics Data System (ADS)

Dey, John A., Jr.

Student use of electronic response technology has been prevalent in postsecondary institutions and is beginning to penetrate K--12 classroom settings. Despite these trends, research exploring the impact of this technology in these settings has been limited. The extant research has relied heavily on survey methodologies and largely has focused on student/teacher perception or implementation practices while remaining silent on learning outcomes. The purpose of this study was to broaden the scope of research models used to explore electronic response technology and its impact on student learning. The study took place in a ninth-grade science classroom at a large high school with a comprehensive curriculum. Study participants were first-year high school students enrolled in one of two sections of the freshman science sequence focusing on Physical Science content. One section, serving as the Treatment group, used electronic response devices on a daily basis to respond to preplanned teacher questions. The other section, serving as the Comparison group, relied on traditional methods of interaction such as raising hands to respond to questions. They responded to the same set of preplanned questions and differed only in the manner of response, with the teacher asking the class and then calling on one of the students to answer. The study focused on academic achievement, as measured by student performance on a pre- and posttest, as well as student engagement, measured by momentary time sample data taken throughout the entire class with focused attention on periods of teacher questioning. The analysis of academic achievement employed an ANOVA, and no statistically significant difference was found between the groups. Engagement data were analyzed using an independent samples t test, and statistically significant differences were found between the two groups. Findings from this study indicated that, when using electronic response technology in their science classes, students demonstrated significantly higher levels of engagement across an entire class period as well as during teacher questioning. Implications of the study have been framed around the promise of electronic response technology for engaging and motivating students.

Understanding weight stigmatization: a focus group study.

PubMed

Cossrow, N H; Jeffery, R W; McGuire, M T

2001-01-01

The purpose of this research was to investigate, in a nonclinical sample of adults, thoughts on and experiences with weight stigmatization. Focus groups were used to collect information. Participants were recruited through a newspaper advertisement and flyers posted in public places in Minneapolis and St. Paul. During the focus groups, participants were led in a discussion about their thoughts on weight stigmatization and personal experiences of being treated differently or poorly because of their weight. Six gender-specific focus groups consisted of 31 adult volunteers (17 women and 14 men). Perceptions of weight-based stereotypes and weight stigmatization and personal reports of having been treated differently or poorly owing to weight were measured. Participants reported a variety of experiences of being treated differently or poorly because of their weight. These included teasing, harassment, slurs and insults, negative judgments and assumptions, and perceived discrimination. Participants reported that such experiences occurred at home, among friends and strangers, at work, and in health care settings. Women reported a greater number and a greater variety of negative experiences than men. The results indicated that participants experienced weight-based stigmatization in many aspects of their lives. Awareness of these experiences may assist in the development of treatments for overweight individuals.

Refusal of Medical Blood Transfusions Among Jehovah's Witnesses: Emotion Regulation of the Dissonance of Saving and Sacrificing Life.

PubMed

Ringnes, Hege Kristin; Hegstad, Harald

2016-10-01

This study focuses on the requirement of JWs to refuse medical blood transfusions. We identified a life-death cognitive dissonance among JWs, with the opposing cognitions of being willing to sacrifice life by religious standards, while being unwilling to do so. Using a theory that connects cognitive dissonance with the need to regulate difficult emotions to analyze our qualitative data material, we identified two sets of dissonance reduction strategies among the JWs. Set 1 was tied to the individual-group: selective focus on eternal life, a non-blood support and control system, and increased individualization of treatment choices. Set 2 was in the religion versus medicine intersection: denial of risk combined with optimism, perception of blood as dangerous, and use of medical language to underscore religious doctrine.

What Should Dental Services for People with Disabilities in Ireland Be Like? Agreed Priorities from a Focus Group of People with Learning Disabilities

ERIC Educational Resources Information Center

Mac Giolla Phadraig, Caoimhin; Dougall, Alison; Stapleton, Siobhan; McGeown, Danielle; Nunn, June; Guerin, Suzanne

2016-01-01

Background: In Ireland, people with learning disabilities have poor oral health. This is in part due to inappropriate oral health services. Recognising the value of inclusive approaches to research and healthcare planning, this study sought to include a group of people with learning disabilities in priority setting for oral health services in…

Reaching Agreement in Uncertain Circumstances: The Practice of Evidence-Based Policy in the Case of the Swedish National Guidelines for Heart Diseases

ERIC Educational Resources Information Center

Eckard, Nathalie; Nedlund, Ann-Charlotte; Janzon, Magnus; Levin, Lars-Åke

2017-01-01

This paper explores the practice of evidence-based policy in a Swedish healthcare context. The study focused on how policymakers in the specific working group, the Priority-Setting Group (PSG), handled the various forms of evidence and values and their competing rationalities, when producing the Swedish National Guidelines for heart diseases that…

Integrating security in a group oriented distributed system

NASA Technical Reports Server (NTRS)

Reiter, Michael; Birman, Kenneth; Gong, LI

1992-01-01

A distributed security architecture is proposed for incorporation into group oriented distributed systems, and in particular, into the Isis distributed programming toolkit. The primary goal of the architecture is to make common group oriented abstractions robust in hostile settings, in order to facilitate the construction of high performance distributed applications that can tolerate both component failures and malicious attacks. These abstractions include process groups and causal group multicast. Moreover, a delegation and access control scheme is proposed for use in group oriented systems. The focus is the security architecture; particular cryptosystems and key exchange protocols are not emphasized.

"Is It Worth Knowing?" Focus Group Participants' Perceived Utility of Genomic Preconception Carrier Screening.

PubMed

Schneider, Jennifer L; Goddard, Katrina A B; Davis, James; Wilfond, Benjamin; Kauffman, Tia L; Reiss, Jacob A; Gilmore, Marian; Himes, Patricia; Lynch, Frances L; Leo, Michael C; McMullen, Carmit

2016-02-01

As genome sequencing technology advances, research is needed to guide decision-making about what results can or should be offered to patients in different clinical settings. We conducted three focus groups with individuals who had prior preconception genetic testing experience to explore perceived advantages and disadvantages of genome sequencing for preconception carrier screening, compared to usual care. Using a discussion guide, a trained qualitative moderator facilitated the audio-recorded focus groups. Sixteen individuals participated. Thematic analysis of transcripts started with a grounded approach and subsequently focused on participants' perceptions of the value of genetic information. Analysis uncovered two orientations toward genomic preconception carrier screening: "certain" individuals desiring all possible screening information; and "hesitant" individuals who were more cautious about its value. Participants revealed valuable information about barriers to screening: fear/anxiety about results; concerns about the method of returning results; concerns about screening necessity; and concerns about partner participation. All participants recommended offering choice to patients to enhance the value of screening and reduce barriers. Overall, two groups of likely users of genome sequencing for preconception carrier screening demonstrated different perceptions of the advantages or disadvantages of screening, suggesting tailored approaches to education, consent, and counseling may be warranted with each group.

Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors

PubMed Central

Greenwood, Nan; Holley, Jess; Ellmers, Theresa; Mein, Gill; Cloud, Geoffrey

2016-01-01

Objectives Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge. Design This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups. Setting Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. Participants 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. Results Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups. Conclusions Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers’ part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face. PMID:26826148

Identifying Differences Between Off-Highway Vehicle (OHV) and Non-OHV User Groups for Recreation Resource Planning

NASA Astrophysics Data System (ADS)

Kil, Namyun; Holland, Stephen M.; Stein, Taylor V.

2012-09-01

Off-highway vehicle (OHV) riding is among the fastest growing recreational activities in the United States. However, little research exists about the central components of outcomes-focused management (OFM) as it relates to motorized recreation. Utilizing a two-activity dichotomy, OHV and non-OHV centric user groups were compared on several key concepts associated with OFM, including desired experiences, perceived and desired recreation opportunity spectrum-type settings, and intentional behaviors (i.e., place-protective behavior, spending-time intentions) toward potential changes in settings. Results indicated that the two groups were different in terms of intensity and relative rankings of their perceived experiences and settings. Although both groups preferred social bonding, stress relief, nostalgia and learning experiences, the OHV user group ranked using equipment and achieving physical fitness experiences as more important than the non-OHV group. The non-OHV user group preferred enjoying nature and solitude/tranquility experiences more strongly than the OHV user group. Further analysis found that both groups perceived settings that they recreated in to be pristine and preferred such conditions, and both groups preferred moderate levels of rules and regulations. Finally, the OHV user group was more reactive to rules and regulations, while the non-OHV user group expressed stronger intentions to protect the environmental quality of recreation areas. The results suggest that planners and managers who understand OHV user's perceptions and behaviors could provide enhanced recreation opportunities potentially providing additional beneficial outcomes for motorized and non-motorized groups in spatially different zones. Additional implications for planners and managers and future studies are discussed.

Stressors influencing Middle Eastern women's perceptions of the risk of cardiovascular disease: a focus group study.

PubMed

Gholizadeh, Leila; Digiacomo, Michelle; Salamonson, Yenna; Davidson, Patricia M

2011-08-01

To better understand Australia-dwelling Middle Eastern women's lack of service utilization in cardiovascular health, we undertook a study to investigate their understandings and meanings of cardiovascular disease (CVD) and its risk factors. Eight focus groups were conducted in community settings with Turkish, Persian, and Arab women. We found that the women understated their risk of CVD, faced many barriers in reducing their risks, and perceived stress as the most significant contributor to CVD. Women described their stress as primarily emanating from issues surrounding migration and acculturation. Implications for development and delivery of tailored health interventions for Middle Eastern women are discussed.

Residents' perceived needs in communication skills training across in- and outpatient clinical settings.

PubMed

Junod Perron, Noelle; Sommer, Johanna; Hudelson, Patricia; Demaurex, Florence; Luthy, Christophe; Louis-Simonet, Martine; Nendaz, Mathieu; De Grave, Willem; Dolmans, Diana; Van der Vleuten, Cees

2009-05-01

Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics and amount of prior training in communication skills. In focus groups, outpatient residents felt that communication skills were especially useful in addressing chronic diseases and social issues. In contrast, inpatient residents emphasized the importance of good communication skills for dealing with family conflicts and end-of-life issues. Felt needs reflected residents' differing service priorities: outpatient residents saw the need for skills to structure the consultation and explore patients' perspectives in order to build therapeutic alliances, whereas inpatient residents wanted techniques to help them break bad news, provide information and increase their own well-being. The survey's overall response rate was 56%. Its data showed that outpatient residents received more training in communication skills and more of them than inpatient residents considered communication skills training to be useful (100% vs 74%). Outpatient residents' perceived needs in communication skills were more patient-centered than the needs perceived by inpatient residents. Residents' perceived needs for communication skills may differ not only because of their differing service priorities but also because of differences in their previous experiences with communication skills training. These factors should be taken into account when designing a training programme in communication skills.

Focused breastfeeding counselling improves short- and long-term success in an early-discharge setting: A cluster-randomized study.

PubMed

Nilsson, Ingrid M S; Strandberg-Larsen, Katrine; Knight, Christopher H; Hansen, Anne Vinkel; Kronborg, Hanne

2017-10-01

Length of postnatal hospitalization has decreased and has been shown to be associated with infant nutritional problems and increase in readmissions. We aimed to evaluate if guidelines for breastfeeding counselling in an early discharge hospital setting had an effect on maternal breastfeeding self-efficacy, infant readmission and breastfeeding duration. A cluster randomized trial was conducted and assigned nine maternity settings in Denmark to intervention or usual care. Women were eligible if they expected a single infant, intended to breastfeed, were able to read Danish, and expected to be discharged within 50 hr postnatally. Between April 2013 and August 2014, 2,065 mothers were recruited at intervention and 1,476 at reference settings. Results show that the intervention did not affect maternal breastfeeding self-efficacy (primary outcome). However, less infants were readmitted 1 week postnatally in the intervention compared to the reference group (adjusted OR 0.55, 95% CI 0.37, -0.81), and 6 months following birth, more infants were exclusively breastfed in the intervention group (adjusted OR 1.36, 95% CI 1.02, -1.81). Moreover, mothers in the intervention compared to the reference group were breastfeeding more frequently (p < .001), and spend more hours skin to skin with their infants (p < .001). The infants were less often treated for jaundice (p = 0.003) and there was more paternal involvement (p = .037). In an early discharge hospital setting, a focused breastfeeding programme concentrating on increased skin to skin contact, frequent breastfeeding, good positioning of the mother infant dyad, and enhanced involvement of the father improved short-term and long-term breastfeeding success. © 2017 John Wiley & Sons Ltd.

Paediatric nurses' understanding of the process and procedure of double-checking medications.

PubMed

Dickinson, Annette; McCall, Elaine; Twomey, Bernadette; James, Natalie

2010-03-01

To understand paediatric nurses' understanding and practice regarding double-checking medication and identify facilitators and barriers to the process of independent double-checking (IDC). A system of double-checking medications has been proposed as a way of minimising medication error particularly in situations involving high-risk medications, complex processes such as calculating doses, or high-risk patient populations such as infants and children. While recommendations have been made in support of IDC in paediatric settings little is known about nursing practice and the facilitators and barriers to this process. A descriptive qualitative design was used. Data were collected via three focus group interviews. Six to seven paediatric nurses participated in homogenous groups based on level of practice. Data were analysed using thematic analysis. This study demonstrates that, while IDC is accepted and promoted as best practice in a paediatric setting, there is a lack of clarity as to what this means. This study supports other studies in relation to the influence of workload, distraction and environmental factors on the administration process but highlights the need for more research in relation to the impact of the power dynamic between junior and senior nurses. The issue of automaticity has been unexplored in relation to nursing practice but this study indicates that this may have an important influence on how care is delivered to patients. While the focus of this study was in the paediatric setting, the findings have relevance to other settings and population groups. The adoption of IDC in health care settings must have in place: policy and guidelines that clearly define the process of checking, educational support, an environment that supports peer critique and review, well-designed medication areas and accessible resources to support drug administration.

Key Elements of Clinical Physician Leadership at an Academic Medical Center

PubMed Central

Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

2011-01-01

Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

A survey-based cross-sectional study of doctors’ expectations and experiences of non-technical skills for Out of Hours work

PubMed Central

Brown, Michael; Shaw, Dominick; Sharples, Sarah; Jeune, Ivan Le; Blakey, John

2015-01-01

Objectives The skill set required for junior doctors to work efficiently and safely Out of Hours (OoH) in hospitals has not been established. This is despite the OoH period representing 75% of the year and it being the time of highest mortality. We set out to explore the expectations of medical students and experiences of junior doctors of the non-technical skills needed to work OoH. Design Survey-based cross-sectional study informed by focus groups. Setting Online survey with participants from five large teaching hospitals across the UK. Participants 300 Medical Students and Doctors Outcome measure Participants ranked the importance of non-technical skills, as identified by literature review and focus groups, needed for OoH care. Results The focus groups revealed a total of eight non-technical skills deemed to be important. In the survey ‘Task Prioritisation’ (mean rank 1.617) was consistently identified as the most important non-technical skill. Stage of training affected the ranking of skills, with significant differences for ‘Communication with Senior Doctors’, ‘Dealing with Clinical Isolation’, ‘Task Prioritisation’ and ‘Communication with Patients’. Importantly, there was a significant discrepancy between the medical student expectations and experiences of doctors undertaking work. Conclusions Our findings suggest that medical staff particularly value task prioritisation skills; however, these are not routinely taught in medical schools. The discrepancy between expectations of students and experience of doctors reinforces the idea that there is a gap in training. Doctors of different grades place different importance on specific non-technical skills with implications for postgraduate training. There is a pressing need for medical schools and deaneries to review non-technical training to include more than communication skills. PMID:25687899

Developing cessation interventions for the social and community service setting: a qualitative study of barriers to quitting among disadvantaged Australian smokers.

PubMed

Bryant, Jamie; Bonevski, Billie; Paul, Christine; O'Brien, Jon; Oakes, Wendy

2011-06-24

Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appropriate to the social and community service setting. Semi-structured focus groups were conducted with clients attending five community welfare organisations located in New South Wales, Australia. Thirty-two clients participated in six focus groups. A discussion guide was used to explore the barriers and facilitators to smoking and smoking cessation including: current smoking behaviour, motivation to quit, past quit attempts, barriers to quitting and preferences for cessation support. Focus groups were audio-taped, transcribed and analysed using thematic analysis techniques. Participants were current smokers and most expressed a desire to quit. Factors predisposing continued smoking included perceived benefits of smoking for stress relief, doubting of ability to quit, fear of gaining weight, and poor knowledge and scepticism about available quit support. The high cost of nicotine replacement therapy was a barrier to its use. Continual exposure to smoking in personal relationships and in the community reinforced smoking. Participants expressed a strong preference for personalised quit support. Disadvantaged smokers in Australia express a desire to quit smoking, but find quitting difficult for a number of reasons. SCSOs may have a role in providing information about the availability of quit support, engaging disadvantaged smokers with available quit support, and providing personalised, ongoing support.

Fast and robust group-wise eQTL mapping using sparse graphical models.

PubMed

Cheng, Wei; Shi, Yu; Zhang, Xiang; Wang, Wei

2015-01-16

Genome-wide expression quantitative trait loci (eQTL) studies have emerged as a powerful tool to understand the genetic basis of gene expression and complex traits. The traditional eQTL methods focus on testing the associations between individual single-nucleotide polymorphisms (SNPs) and gene expression traits. A major drawback of this approach is that it cannot model the joint effect of a set of SNPs on a set of genes, which may correspond to hidden biological pathways. We introduce a new approach to identify novel group-wise associations between sets of SNPs and sets of genes. Such associations are captured by hidden variables connecting SNPs and genes. Our model is a linear-Gaussian model and uses two types of hidden variables. One captures the set associations between SNPs and genes, and the other captures confounders. We develop an efficient optimization procedure which makes this approach suitable for large scale studies. Extensive experimental evaluations on both simulated and real datasets demonstrate that the proposed methods can effectively capture both individual and group-wise signals that cannot be identified by the state-of-the-art eQTL mapping methods. Considering group-wise associations significantly improves the accuracy of eQTL mapping, and the successful multi-layer regression model opens a new approach to understand how multiple SNPs interact with each other to jointly affect the expression level of a group of genes.

Value of a regional family practice residency training program site

PubMed Central

Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

2014-01-01

Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693

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

Incorporating electronic-based and computer-based strategies: graduate nursing courses in administration.

PubMed

Graveley, E; Fullerton, J T

1998-04-01

The use of electronic technology allows faculty to improve their course offerings. Four graduate courses in nursing administration were contemporized to incorporate fundamental computer-based skills that would be expected of graduates in the work setting. Principles of adult learning offered a philosophical foundation that guided course development and revision. Course delivery strategies included computer-assisted instructional modules, e-mail interactive discussion groups, and use of the electronic classroom. Classroom seminar discussions and two-way interactive video conferencing focused on group resolution of problems derived from employment settings and assigned readings. Using these electronic technologies, a variety of courses can be revised to accommodate the learners' needs.

"Come on Guys, What Are We Really Trying to Say Here?" Using Google Docs to Develop Year 9 Pupils' Essay-Writing Skills

ERIC Educational Resources Information Center

Moonen, Lucy

2015-01-01

Lucy Moonen set out to explore whether collaborative writing in small groups, facilitated by the use of Google Docs, would help to sustain students' focus on essay writing as the development of an historical argument. She explains how she set up an essay on the League of Nationals as a collaborative task and demonstrates how the technology enabled…

Stakeholders' Voices: Defining Needs of Students with Emotional and Behavioral Disorders Transitioning between School Settings.

PubMed

Buchanan, Rohanna; Nese, Rhonda N T; Clark, Miriam

2016-05-01

Students with emotional and behavioral disorders (EBD) too often do not receive adequate services or care in their school settings, particularly during transitions in educational placements. In addition, school support teams often struggle with creating transition plans that honor the needs of students with input from key stakeholders responsible for supporting student success. This article presents findings from the information-gathering phase of an iterative project that aims to develop a support program for students with EBD transitioning from day-treatment schools to district schools. We conducted 5 semistructured, qualitative focus groups with parents and teachers to explore needs during students' transitions between school settings. Five themes emerged from the focus groups: (a) consistent, behavior-specific feedback and positive reinforcement are vital to sustaining learned prosocial skills; (b) students benefit from regular opportunities to learn and practice social skills; (c) transition programming should emphasize communication between school and home; (d) routines at home and school should be coordinated; and (e) parents need support at school meetings. We will use findings from this study to develop a multifaceted intervention that aims to support students, their caregivers, and their teachers during transitions between the aforementioned types of schools.

Stakeholders’ Voices: Defining Needs of Students with Emotional and Behavioral Disorders Transitioning between School Settings

PubMed Central

Buchanan, Rohanna; Nese, Rhonda N. T.; Clark, Miriam

2017-01-01

Students with emotional and behavioral disorders (EBD) too often do not receive adequate services or care in their school settings, particularly during transitions in educational placements. In addition, school support teams often struggle with creating transition plans that honor the needs of students with input from key stakeholders responsible for supporting student success. This article presents findings from the information-gathering phase of an iterative project that aims to develop a support program for students with EBD transitioning from day-treatment schools to district schools. We conducted 5 semistructured, qualitative focus groups with parents and teachers to explore needs during students’ transitions between school settings. Five themes emerged from the focus groups: (a) consistent, behavior-specific feedback and positive reinforcement are vital to sustaining learned prosocial skills; (b) students benefit from regular opportunities to learn and practice social skills; (c) transition programming should emphasize communication between school and home; (d) routines at home and school should be coordinated; and (e) parents need support at school meetings. We will use findings from this study to develop a multifaceted intervention that aims to support students, their caregivers, and their teachers during transitions between the aforementioned types of schools. PMID:29706679

The use of nutritional labels by college students in a food-court setting.

PubMed

Kolodinsky, Jane; Green, Jennifer; Michahelles, Marina; Harvey-Berino, Jean R

2008-01-01

Between January and September 2006, the authors examined when, why, if, and how nutrition labels impact food purchase decisions of college students. Participants were 16 college-aged students at a large northeastern university. As part of a larger study undertaken at a large northeastern university on the effect of nutrition labels in restaurant settings on food purchases, the authors held a focus group to look more deeply at when and why nutrition labeling impacted college student food purchases. Although results of the large study are still being discerned, the focus group results reveal that college women and men were interested in the provision of nutrition labels in the food court-like setting found at the university, and that those exposed to labels over the course of the study noticed these labels and often referred to them when making purchase decisions. Additional findings reveal that price and convenience also play a role in food purchases and that, of those items listed on each label, calories and fat were most important to the study population. Although more research is needed, this qualitative study finds that students want nutrition labels and would use them to make food purchasing decisions.

Provider perceptions of reproductive health service quality in jordanian public community health centers.

PubMed

Al-Qutob, Raeda; Nasir, Laeth S

2008-05-01

Enhancing the quality of reproductive health care delivery in developing countries is a key prerequisite to increased utilization and sustainability of these services in the target population. Our objective was to assess the perception of quality of reproductive health (RH) care services provided by Jordanian Ministry of Health community-based centers from the perspective of service providers in these settings. A purposeful nationwide sample of 50 primary health care providers took part in five focus group discussions with the purpose of exploring their perceptions of the quality of care provided by their centers and perceived barriers to the provision of quality RH care. Health care providers felt that the quality of RH care provided by their centers was suboptimal. Focus group participants reported numerous barriers to the provision of high quality-care in the clinical setting. These included issues related to patient overload, patient and physician characteristics, as well as problems inherent to supervisory and administrative functions. Exploring and aligning goals and expectations of RH care providers and administrators may result in improvements in the quality of RH care service delivery and morale in public health settings in Jordan, which is a requirement for public sector reform.

Reflective teaching practices: an approach to teaching communication skills in a small-group setting.

PubMed

Fryer-Edwards, Kelly; Arnold, Robert M; Baile, Walter; Tulsky, James A; Petracca, Frances; Back, Anthony

2006-07-01

Small-group teaching is particularly suited for complex skills such as communication. Existing work has identified the basic elements of small-group teaching, but few descriptions of higher-order teaching practices exist in the medical literature. Thus the authors developed an empirically driven and theoretically grounded model for small-group communication-skills teaching. Between 2002 and 2005, teaching observations were collected over 100 hours of direct contact time between four expert facilitators and 120 medical oncology fellows participating in Oncotalk, a semiannual, four-day retreat focused on end-of-life communication skills. The authors conducted small-group teaching observations, semistructured interviews with faculty participants, video or audio recording with transcript review, and evaluation of results by faculty participants. Teaching skills observed during the retreats included a linked set of reflective, process-oriented teaching practices: identifying a learning edge, proposing and testing hypotheses, and calibrating learner self-assessments. Based on observations and debriefings with facilitators, the authors developed a conceptual model of teaching that illustrates an iterative loop of teaching practices aimed at enhancing learners' engagement and self-efficacy. Through longitudinal, empirical observations, this project identified a set of specific teaching skills for small-group settings with applicability to other clinical teaching settings. This study extends current theory and teaching practice prescriptions by describing specific teaching practices required for effective teaching. These reflective teaching practices, while developed for communication skills training, may be useful for teaching other challenging topics such as ethics and professionalism.

Increasing the qualitative understanding of optimal functionality in older adults: a focus group based study.

PubMed

Algilani, Samal; Östlund-Lagerström, Lina; Schoultz, Ida; Brummer, Robert J; Kihlgren, Annica

2016-03-23

Decreased independence and loss of functional ability are issues regarded as inevitably connected to old age. This ageism may have negative influences on older adults' beliefs about aging, making it difficult for them to focus on their current ability to maintain a good health. It is therefore important to change focus towards promoting Optimal Functionality (OF). OF is a concept putting the older adult's perspective on health and function in focus, however, the concept is still under development. Hence, the aim was to extend the concept of optimal functionality in various groups of older adults. A qualitative study was conducted based on focus group discussions (FGD). In total 6 FGDs were performed, including 37 older adults from three different groups: group 1) senior athletes, group 2) free living older adults, group 3) older adults living in senior living homes. All data was transcribed verbatim and analyzed following the process of deductive content analysis. The principal outcome of the analysis was "to function as optimally as you possibly can", which was perceived as the core of the concept. Further, the concept of OF was described as multifactorial and several new factors could be added to the original model of OF. Additionally the findings of the study support that all three cornerstones comprising OF have to occur simultaneously in order for the older adult to function as optimal as possible. OF is a multifaceted and subjective concept, which should be individually defined by the older adult. This study further makes evident that older adults as a group are heterogeneous in terms of their preferences and views on health and should thus be approached as such in the health care setting. Therefore it is important to promote an individualized approach as a base when caring for older adults.

International patient and physician consensus on a psoriatic arthritis core outcome set for clinical trials.

PubMed

Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip; Shea, Judy A; Gossec, Laure; Leung, Ying Ying; Tillett, William; Elmamoun, Musaab; Callis Duffin, Kristina; Campbell, Willemina; Christensen, Robin; Coates, Laura; Dures, Emma; Eder, Lihi; FitzGerald, Oliver; Gladman, Dafna; Goel, Niti; Grieb, Suzanne Dolwick; Hewlett, Sarah; Hoejgaard, Pil; Kalyoncu, Umut; Lindsay, Chris; McHugh, Neil; Shea, Bev; Steinkoenig, Ingrid; Strand, Vibeke; Ogdie, Alexis

2017-04-01

To identify a core set of domains (outcomes) to be measured in psoriatic arthritis (PsA) clinical trials that represent both patients' and physicians' priorities. We conducted (1) a systematic literature review (SLR) of domains assessed in PsA; (2) international focus groups to identify domains important to people with PsA; (3) two international surveys with patients and physicians to prioritise domains; (4) an international face-to-face meeting with patients and physicians using the nominal group technique method to agree on the most important domains; and (5) presentation and votes at the Outcome Measures in Rheumatology (OMERACT) conference in May 2016. All phases were performed in collaboration with patient research partners. We identified 39 unique domains through the SLR (24 domains) and international focus groups (34 domains). 50 patients and 75 physicians rated domain importance. During the March 2016 consensus meeting, 12 patients and 12 physicians agreed on 10 candidate domains. Then, 49 patients and 71 physicians rated these domains' importance. Five were important to >70% of both groups: musculoskeletal disease activity, skin disease activity, structural damage, pain and physical function. Fatigue and participation were important to >70% of patients. Patient global and systemic inflammation were important to >70% of physicians. The updated PsA core domain set endorsed by 90% of OMERACT 2016 participants includes musculoskeletal disease activity, skin disease activity, pain, patient global, physical function, health-related quality of life, fatigue and systemic inflammation. The updated PsA core domain set incorporates patients' and physicians' priorities and evolving PsA research. Next steps include identifying outcome measures that adequately assess these domains. 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/.

Nutrition Beliefs of Disadvantaged Parents of Overweight Children

ERIC Educational Resources Information Center

Pescud, Melanie; Pettigrew, Simone; Henley, Nadine

2014-01-01

Objective: To explore low socioeconomic parents' beliefs in relation to children's nutrition. Design: A qualitative, longitudinal study over 12 months involving 37 low socioeconomic parents. Setting: Perth, Western Australia. Method: Parents' nutrition-related beliefs were explored via interviews, focus groups and…

A group therapy approach to treating combat posttraumatic stress disorder: interpersonal reconnection through letter writing.

PubMed

Keenan, Melinda J; Lumley, Vicki A; Schneider, Robert B

2014-12-01

Many who have served in a war zone carry deep emotional wounds that go beyond the typical symptom clusters of reexperiencing, avoidance/numbing, and hyperarousal that comprise a diagnosis of posttraumatic stress disorder (PTSD). Specifically, many combatants experience unresolved grief, guilt, and shame caused by losses and traumatic experiences suffered in war, called "moral injury" by some clinicians and researchers (e.g., Litz et al., 2009; Shay, 1994). We describe the aspects of human attachment that set the stage for grief, guilt, and shame, and outline the 3-phase group therapy model we have implemented in a clinical setting to foster the reconnection of severed human bonds. Special attention is paid to killing and related phenomena that are unique to combat PTSD. The program phases include psychoeducation, trauma-focused therapy, and aftercare, which focuses on assisting the veterans in reconnecting with their families and communities. The use of letter writing as an intervention is illustrated through case examples, and clinical outcomes are anecdotally described.

Exploring staff perceptions on the role of physical environment in dementia care setting.

PubMed

Lee, Sook Y; Chaudhury, Habib; Hung, Lillian

2016-07-01

This study explored staff perceptions of the role of physical environment in dementia care facilities in affecting resident's behaviors and staff care practice. We conducted focus groups with staff (n = 15) in two purposely selected care facilities in Vancouver, Canada. Focus group participants included nurses, care aides, recreation staff, administrative staff, and family. Data analysis revealed two themes: (a) a supportive physical environment contributes positively to both quality of staff care interaction and residents' quality of life and (b) an unsupportive physical environment contributes negatively to residents' quality of life and thereby makes the work of staff more challenging. The staff participants collectively viewed that comfort, familiarity, and an organized space were important therapeutic resources for supporting the well-being of residents. Certain behaviors of residents were influenced by poor environmental factors, including stimulation overload, safety risks, wayfinding challenge, and rushed care This study demonstrates the complex interrelationships among the dementia care setting's physical environment, staff experiences, and residents' quality of life. © The Author(s) 2014.

The Effectiveness of Adapted Versions of an Evidence-based Prevention Program in Reducing Alcohol Use among Alternative School Students

PubMed Central

Hopson, Laura M.; Holleran Steiker, Lori K.

2010-01-01

Although there is a strong evidence base for effective substance abuse prevention programs for youth, there is a need to facilitate the implementation and evaluation of these programs in real world settings. This study evaluates the effectiveness of adapted versions of an evidence-based prevention program, keepin’ it REAL (kiR), with alternative school students. Programs are often adapted when used in schools and other community settings for a variety of reasons. The kiR adaptations, developed during an earlier phase of this study, were created to make the curriculum more appropriate for alternative high school youth. The adaptations were evaluated using a quasi-experimental design in which questionnaires were administered at pretest, posttest, and follow-up, and focus groups were conducted at posttest. MANOVA analyses indicate significantly reduced intentions to accept alcohol and, for younger participants, reduced alcohol use. Focus group data support the need for age appropriate prevention content. The authors discuss implications for practitioners implementing prevention programs in schools. PMID:20622971

Examining hospital pharmacists' goals for medication counseling within the communication accommodation theoretical framework.

PubMed

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2016-01-01

Medication counseling opportunities are key times for pharmacists to speak to patients about their medications and any changes made during their hospital stay. Communication Accommodation Theory (CAT) posits that an individual's goals drive their communication behavior. The way in which pharmacists communicate with patients may be determined by the goals they set for these medication counseling sessions. To examine hospital pharmacists' goals in patient medication counseling within the CAT framework. Hospital pharmacist focus groups were held in two teaching hospitals. Interested pharmacists attended a focus group designed to elicit their goals in patient medication counseling. Focus groups were audio recorded and transcribed verbatim. NVivo(®) software was used to assist in coding and organization. The codes were reviewed for reliability by pharmacists independent of the focus groups. An inductive thematic analysis was applied to the data. Six 1 h focus groups were conducted with a total of 24 pharmacists participating. Saturation of information was achieved after four focus groups. Greater than 80% consensus was achieved for reliability of the identified codes. Patient-centered themes constructed from these codes were to build rapport, to empower patients and to improve patients' experience, health and safety. Exemplars provided by pharmacists for the goals of building rapport and empowering patients were aligned with five CAT communication behaviors (approximation, interpretability, discourse management, emotional expression and interpersonal control). Patient-centered goals described by hospital pharmacists for medication counseling aligned well with CAT behaviors necessary for effective communication. Further research using the CAT framework to examine the effectiveness of hospital pharmacist-patient exchanges that include both participants' perspectives is required to better understand how well pharmacists communicate with patients. Copyright © 2015 Elsevier Inc. All rights reserved.

In our country tortilla doesn't make us fat: cultural factors influencing lifestyle goal-setting for overweight and obese Urban, Latina patients.

PubMed

Jay, Melanie; Gutnick, Damara; Squires, Allison; Tagliaferro, Barbara; Gerchow, Lauren; Savarimuthu, Stella; Chintapalli, Sumana; Shedlin, Michele G; Kalet, Adina

2014-11-01

Obesity disproportionately affects Latina adults, and goal-setting is a technique often used to promote lifestyle behavior change and weight loss. To explore the meanings and dimensions of goal-setting in immigrant Latinas, we conducted four focus groups arranged by language ability and country of origin in an urban, public, primary care clinic. We used a narrative analytic approach to identify the following themes: the immigrant experience, family dynamics, and health care. Support was a common sub-theme that threaded throughout, with participants relying on the immigrant community, family, and the health care system to support their goals. Participants derived satisfaction from setting and achieving goals and emphasized personal willpower as crucial for success. These findings should inform future research on how goal-setting can be used to foster lifestyle behavior change and illustrate the importance of exploring the needs of Latino sub-groups in order to improve lifestyle behaviors in diverse Latino populations.

Evaluating the influence of goal setting on intravenous catheterization skill acquisition and transfer in a hybrid simulation training context.

PubMed

Brydges, Ryan; Mallette, Claire; Pollex, Heather; Carnahan, Heather; Dubrowski, Adam

2012-08-01

Educators often simplify complex tasks by setting learning objectives that focus trainees on isolated skills rather than the holistic task. We designed 2 sets of learning objectives for intravenous catheterization using goal setting theory. We hypothesized that setting holistic goals related to technical, cognitive, and communication skills would result in superior holistic performance, whereas setting isolated goals related to technical skills would result in superior technical performance. We randomly assigned practicing health care professionals to set holistic (n = 14) or isolated (n = 15) goals. All watched an instructional video and studied a list of 9 goals specific to their group. Participants practiced independently in a hybrid simulation (standardized patient combined with an arm simulator). The first and the last practice trials were videotaped for analysis. One-week later, participants completed a transfer test in another hybrid simulation scenario. Blinded experts evaluated performance on all 3 trials using the Direct Observation of Procedural Skills tool. The holistic group scored higher than the isolated group on the holistic Direct Observation of Procedural Skills score for all 3 trials [mean (SD), 45.0 (9.16) vs. 38.4 (9.17); P = 0.01]. The isolated group did not perform better than the holistic group on the technical skills score [10.3 (2.73) vs. 11.6 (3.01); P = 0.11]. Our results suggest that asking learners to set holistic goals did not interfere with their attaining competent holistic and technical skills during hybrid simulation training. This exploratory trial provides preliminary evidence for how to consider integrating hybrid simulation into medical curricula and for the design of learning goals in simulation-based education.

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review1234

PubMed Central

Brimblecombe, Julie; Wycherley, Thomas Philip

2017-01-01

Smartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings. PMID:28298274

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review.

PubMed

Tonkin, Emma; Brimblecombe, Julie; Wycherley, Thomas Philip

2017-03-01

Smartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings. © 2017 American Society for Nutrition.

Patients' experiences of an intervention to support tuberculosis treatment adherence in South Africa.

PubMed

Atkins, Salla; Biles, David; Lewin, Simon; Ringsberg, Karin; Thorson, Anna

2010-07-01

Tuberculosis (TB) infects over 9 million people annually and, in high prevalence settings, is closely related to HIV/AIDS. Despite this, the two diseases are often treated using contrasting approaches: one focused on patient control, the other focused on empowerment. This article reports on patient experiences of a TB treatment programme in South Africa modelled on the empowerment-oriented antiretroviral treatment (ART) programme. Patients' perceptions of the programme and its impacts on their lives were investigated through six focus groups with patients from intervention clinics; two focus groups with patients from a comparison clinic; and interviews with two patients who had failed to adhere to the intervention treatment. The data were analysed using content analysis. The main themes that emerged were: the tension between agency and coercion in treatment taking; treatment as a lifestyle change; and the role of the lay treatment supporter as either constraining or facilitating empowerment. Patients reported having made lifestyle changes and discussed issues of treatment control and responsibility. However, it seemed that treatment supporters maintained a monitoring role regarding patients' treatment, limiting patients' opportunities to exercise control over their illness and their drug regimen. The study suggests that differences remain between the ART approach and the new TB treatment model. While the new programme seems to have succeeded in providing additional information, it is not clear that it substantially changed patient agency over their treatment taking in this setting.

The FIGS (Focused Identification of Germplasm Strategy) Approach Identifies Traits Related to Drought Adaptation in Vicia faba Genetic Resources

PubMed Central

Khazaei, Hamid; Street, Kenneth; Bari, Abdallah; Mackay, Michael; Stoddard, Frederick L.

2013-01-01

Efficient methods to explore plant agro-biodiversity for climate change adaptive traits are urgently required. The focused identification of germplasm strategy (FIGS) is one such approach. FIGS works on the premise that germplasm is likely to reflect the selection pressures of the environment in which it developed. Environmental parameters describing plant germplasm collection sites are used as selection criteria to improve the probability of uncovering useful variation. This study was designed to test the effectiveness of FIGS to search a large faba bean (Vicia faba L.) collection for traits related to drought adaptation. Two sets of faba bean accessions were created, one from moisture-limited environments, and the other from wetter sites. The two sets were grown under well watered conditions and leaf morpho-physiological traits related to plant water use were measured. Machine-learning algorithms split the accessions into two groups based on the evaluation data and the groups created by this process were compared to the original climate-based FIGS sets. The sets defined by trait data were in almost perfect agreement to the FIGS sets, demonstrating that ecotypic differentiation driven by moisture availability has occurred within the faba bean genepool. Leaflet and canopy temperature as well as relative water content contributed more than other traits to the discrimination between sets, indicating that their utility as drought-tolerance selection criteria for faba bean germplasm. This study supports the assertion that FIGS could be an effective tool to enhance the discovery of new genes for abiotic stress adaptation. PMID:23667581

Health Care Provider Communication

PubMed Central

Chochinov, Harvey M; McClement, Susan E; Hack, Thomas F; McKeen, Nancy A; Rach, Amanda M; Gagnon, Pierre; Sinclair, Shane; Taylor-Brown, Jill

2013-01-01

BACKGROUND Patients who are facing life-threatening and life-limiting cancer almost invariably experience psychological distress. Responding effectively requires therapeutic sensitivity and skill. In this study, we examined therapeutic effectiveness within the setting of cancer-related distress with the objective of understanding its constituent parts. METHODS Seventy-eight experienced psychosocial oncology clinicians from 24 health care centers across Canada were invited to participate in 3 focus groups each. In total, 29 focus groups were held over 2 years, during which clinicians articulated the therapeutic factors deemed most helpful in mitigating patient psychosocial distress. The content of each focus group was summarized into major themes and was reviewed with participants to confirm their accuracy. Upon completion of the focus groups, workshops were held in various centers, eliciting participant feedback on an empirical model of therapeutic effectiveness based on the qualitative analysis of focus group data. RESULTS Three primary, interrelated therapeutic domains emerged from the data, forming a model of optimal therapeutic effectiveness: 1) personal growth and self-care (domain A), 2) therapeutic approaches (domain B), and 3) creation of a safe space (domain C). Areas of domain overlap were identified and labeled accordingly: domain AB, therapeutic humility; domain BC, therapeutic pacing; and domain AC, therapeutic presence. CONCLUSIONS This empirical model provides detailed insights regarding the elements and pedagogy of effective communication and psychosocial care for patients who are experiencing cancer-related distress. [See editorial on pages 000–000, this issue.] Cancer 2013. © 2013 American Cancer Society. PMID:23341092

Council of International Neonatal Nurses (COINN) Global Neonatal Provider Database Initiative (CGNPD): Results From an Implementation Focus Group.

PubMed

Eklund, Wakako; Kenner, Carole

2015-12-01

The neonatal nurses are the key component of the essential workforce necessary to address the healthcare needs of the infants globally. The paucity of the data regarding the availability and training of the neonatal workforce challenges the stakeholders at the regional, national, and global levels. The lack of these data makes strategic planning for initiatives especially in low-resourced countries difficult. Up-to-date data are critically needed to describe the role neonatal nurses play in global newborn health outcomes. The purpose of the COINN Global Neonatal Provider Database Initiative (CGNPD) was to develop a workforce database by developing survey questions, conducting a focus group to determine the key reasons such a database was needed and how best to implement it, and incorporating these comments into the workforce survey and launch. Pilot testing of the draft survey instrument was done. This article reports on the findings from the focus group and the development of the survey. A qualitative design using the focus group method was used. The focus group discussions were guided by semi-structured interview questions that had been developed prior to the focus group by neonatal experts. A convenience sample of 14 members from the international delegates and project advisory members who attended the COINN 2013 in Belfast, Northern Ireland, participated. These participants represented 10 countries. Thematic analysis was conducted using verbatim transcripts of the focus group data. Four main themes emerged: (1) the invisibility of neonatal nurses, (2) benchmarking needs for quality and standards, (3) need for partnership to implement the database, and (4) setting priorities for variables needed for the most salient database. The questionnaire examined participants' perceptions of the significance of and the future utilization of the workforce database and elements that should be included in the survey. The global neonatal workforce database is needed to describe who the neonatal nurses are in each country, what they do, how they are trained, and where they work. The data from the focus group aided in the development of the workforce survey that has been pilot tested and provides critical information to guide COINN's global implementation of the database project.

The subjective experience of using Ignatian meditation by male and female South African university students: an exploratory study.

PubMed

Efthimiadis-Keith, Helen; Lindegger, Graham

2014-10-01

This study is set out to examine the subjective experience of using the Ignatian method of meditation to reflect on and pray through Ruth 2. A group of male and female Theology students from the University of KwaZulu-Natal were invited to reflect upon/pray through Ruth 2 using Ignatian meditation. Following this exercise, participants were invited to participate in a focus group in which they shared their experience of this exercise, focusing particularly on some of the gendered aspects of the experience. The transcribed focus group material was subjected to a critical thematic analysis, in order to identify which core aspects of the experience of using this method of meditation and reflection were responsible for the reported subjective experiences. The analysis also included a comparison of the experience for men and women participating in this exercise, and the differential effect of various aspects of the exercise on men and women.

Focus groups with working parents of school-aged children: what's needed to improve family meals?

PubMed

Fulkerson, Jayne A; Kubik, Martha Y; Rydell, Sarah; Boutelle, Kerri N; Garwick, Ann; Story, Mary; Neumark-Sztainer, Dianne; Dudovitz, Bonnie

2011-01-01

To conduct focus groups to identify parents' perceptions of barriers to family meals and elucidate ideas to guide the development of interventions to overcome barriers. Focus groups were conducted with a convenience sample of 27 working parents in urban community settings. Parents reported enjoying the sharing/bonding at meals, but they reported limited time for meal preparation and frequent multi-tasking at mealtime. They wanted their children's help with meal preparation, but they were concerned about the time and "mess" involved. They were frustrated with the limited range of food items their children would eat. Preferred program ideas included feeding tips/recipes, meal planning/preparation, and changing food offerings. Findings indicate a need for creative programs and professional nutrition guidance to facilitate family engagement in planning and cooking quick, healthful meals; development of skill building; and increasing healthful food consumption. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Evaluating patient care communication in integrated care settings: application of a mixed method approach in cerebral palsy programs.

PubMed

Gulmans, J; Vollenbroek-Hutten, M M R; Van Gemert-Pijnen, J E W C; Van Harten, W H

2009-02-01

In this study, we evaluated patient care communication in the integrated care setting of children with cerebral palsy in three Dutch regions in order to identify relevant communication gaps experienced by both parents and involved professionals. A three-step mixed method approach was used starting with a questionnaire to identify communication links in which parents experienced gaps. In subsequent in-depth interviews with parents and focus group meetings with professionals underlying factors were evaluated. In total, 197 parents completed the questionnaire (response 67%); 6% scored negative on parent-professional communication, whereas 17% scored negative on inter-professional communication, especially between the rehabilitation physician and primary care physiotherapy (16%) and (special) education/day care (15%). In-depth interviews among a subset of 20 parents revealed various sources of dissatisfaction such as lack of cooperation and patient centeredness, inappropriate amount of information exchange and professional use of parents as messenger of information. Focus group meetings revealed that professionals recognized these gaps. They attributed them to capacity problems, lack of interdisciplinary guidelines and clear definition of roles, but also a certain hesitance for contact due to unfamiliarity with involved professionals in the care network. Parents particularly identified gaps in inter-professional communication between (rehabilitation) hospitals and primary care settings. Involved professionals recognized these gaps and primarily attributed them to organizational factors. Improvement initiatives should focus on these factors as well as facilitation of low-threshold contact across the patient's care network.

Identifying important life stages for monitoring and assessing risks from exposures to environmental contaminants: results of a World Health Organization review.

PubMed

Cohen Hubal, Elaine A; de Wet, Thea; Du Toit, Lilo; Firestone, Michael P; Ruchirawat, Mathuros; van Engelen, Jacqueline; Vickers, Carolyn

2014-06-01

In this paper, we summarize exposure-related issues to consider in determining the most appropriate age ranges and life stages for risk assessment. We then propose a harmonized set of age bins for monitoring and assessing risks from exposures to chemicals for global use. The focus is on preconception through adolescence, though the approach should be applicable to additional life stages. A two-tiered set of early life age groups is recommended. The first tier involves the adoption of guidance similar to the childhood age groups recommended by the U.S. Environmental Protection Agency, whereas the second tier consolidates some of those age groups to reduce the burden of developing age-specific exposure factors for different regions. While there is no single "correct" means of choosing a common set of age groups to use internationally in assessing early life exposure and risk, use of a set of defined age groups is recommended to facilitate comparisons of potential exposures and risks around the globe, the collection of data and analyses of aggregate exposure and cumulative risk. Application of these age groups for robust assessment of exposure and risk for specific populations will require region-specific exposure factors as well as local environmental monitoring data. Copyright © 2013 World Health Organization. Published by Elsevier Inc. All rights reserved.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model.

PubMed

Dawber, Chris

2013-04-01

In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Microaggressions within Families: Experiences of Multiracial People

ERIC Educational Resources Information Center

Nadal, Kevin L.; Sriken, Julie; Davidoff, Kristin C.; Wong, Yinglee; McLean, Kathryn

2013-01-01

This study illustrates the types of multiracial microaggressions, or subtle forms of discrimination toward multiracial people, that transpire in family settings. Utilizing a Consensual Qualitative Research (CQR) Method and a Qualitative Secondary Analysis (QSA), multiracial participants ("N" = 9) were interviewed in three focus groups to describe…

Ways Animals Communicate

ERIC Educational Resources Information Center

Curry, Kristen; Sumrall, William J.; Moore, Jerilou; Daniels, Anniece

2008-01-01

The authors describe a set of upper-elementary activities that focuses on how animals communicate. The activities describe procedures that students working in groups can use to investigate the topic of animal communication. An initial information sheet, resource list, and grading rubric are provided. The lesson plan was field-tested in an…

UNISIST II: Special Report.

ERIC Educational Resources Information Center

Hattery, Lowell H., Ed.

1979-01-01

The major part of this report of the Intergovernmental Conference on Scientific and Technical Information (UNISIST II), held in Paris May 28-June 1, 1979, focuses on three sets of recommendations which were unanimously approved after combining the recommendations proposed by various groups and blocs: (1) recommendations to the United Nations…

Analysis to Inform CA Grid Integration Rules for PV: Final Report on Inverter Settings for Transmission and Distribution System Performance

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

Smith, Jeff; Rylander, Matthew; Boemer, Jens

The fourth solicitation of the California Solar Initiative (CSI) Research, Development, Demonstration and Deployment (RD&D) Program established by the California Public Utilities Commission (CPUC) supported the Electric Power Research Institute (EPRI), National Renewable Energy Laboratory (NREL), and Sandia National Laboratories (SNL) with data provided from Pacific Gas and Electric (PG&E), Southern California Edison (SCE), and San Diego Gas and Electric (SDG&E) conducted research to determine optimal default settings for distributed energy resource advanced inverter controls. The inverter functions studied are aligned with those developed by the California Smart Inverter Working Group (SIWG) and those being considered by the IEEE 1547more » Working Group. The advanced inverter controls examined to improve the distribution system response included power factor, volt-var, and volt-watt. The advanced inverter controls examined to improve the transmission system response included frequency and voltage ride-through as well as Dynamic Voltage Support. This CSI RD&D project accomplished the task of developing methods to derive distribution focused advanced inverter control settings, selecting a diverse set of feeders to evaluate the methods through detailed analysis, and evaluating the effectiveness of each method developed. Inverter settings focused on the transmission system performance were also evaluated and verified. Based on the findings of this work, the suggested advanced inverter settings and methods to determine settings can be used to improve the accommodation of distributed energy resources (PV specifically). The voltage impact from PV can be mitigated using power factor, volt-var, or volt-watt control, while the bulk system impact can be improved with frequency/voltage ride-through.« less

Development of a Core Set of Outcome Measures for Large-vessel Vasculitis: Report from OMERACT 2016.

PubMed

Sreih, Antoine G; Alibaz-Oner, Fatma; Kermani, Tanaz A; Aydin, Sibel Z; Cronholm, Peter F; Davis, Trocon; Easley, Ebony; Gul, Ahmet; Mahr, Alfred; McAlear, Carol A; Milman, Nataliya; Robson, Joanna C; Tomasson, Gunnar; Direskeneli, Haner; Merkel, Peter A

2017-12-01

Among the challenges in conducting clinical trials in large-vessel vasculitis (LVV), including both giant cell arteritis (GCA) and Takayasu arteritis (TA), is the lack of standardized and meaningful outcome measures. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group initiated an international effort to develop and validate data-driven outcome tools for clinical investigation in LVV. An international Delphi exercise was completed to gather opinions from clinical experts on LVV-related domains considered important to measure in trials. Patient interviews and focus groups were completed to identify outcomes of importance to patients. The results of these activities were presented and discussed in a "Virtual Special Interest Group" using telephone- and Internet-based conferences, discussions through electronic mail, and an in-person session at the 2016 OMERACT meeting. A preliminary core set of domains common for all forms of LVV with disease-specific elements was proposed. The majority of experts agree with using common outcome measures for GCA and TA, with the option of supplementation with disease-specific items. Following interviews and focus groups, pain, fatigue, and emotional effect emerged as health-related quality of life domains important to patients. Current disease assessment tools, including the Birmingham Vasculitis Activity Score, were found to be inadequate to assess disease activity in GCA and standardized assessment of imaging tests were felt crucial to study LVV, especially TA. Initial data from a clinician Delphi exercise and structured patient interviews have provided themes toward an OMERACT-endorsed core set of domains and outcome measures.

Expressive body movement responses to music are coherent, consistent, and low dimensional.

PubMed

Amelynck, Denis; Maes, Pieter-Jan; Martens, Jean Pierre; Leman, Marc

2014-12-01

Embodied music cognition stresses the role of the human body as mediator for the encoding and decoding of musical expression. In this paper, we set up a low dimensional functional model that accounts for 70% of the variability in the expressive body movement responses to music. With the functional principal component analysis, we modeled individual body movements as a linear combination of a group average and a number of eigenfunctions. The group average and the eigenfunctions are common to all subjects and make up what we call the commonalities. An individual performance is then characterized by a set of scores (the individualities), one score per eigenfunction. The model is based on experimental data which finds high levels of coherence/consistency between participants when grouped according to musical education. This shows an ontogenetic effect. Participants without formal musical education focus on the torso for the expression of basic musical structure (tempo). Musically trained participants decode additional structural elements in the music and focus on body parts having more degrees of freedom (such as the hands). Our results confirm earlier studies that different body parts move differently along with the music.

Feasibility of implementing oral health guidelines in residential care settings: views of nursing staff and residential care workers.

PubMed

Hilton, Shaylee; Sheppard, Justine Joan; Hemsley, Bronwyn

2016-05-01

To determine the views of nurses and on the feasibility of implementing current evidence-based guidelines for oral care, examining barriers and facilitators to implementation. This mixed-methods study involved an online survey of 35 nurses and residential care workers, verified and expanded upon by one focus group of six residential care workers. Results reflected that nurses and residential care workers (a) have little or no training in recommended oral care techniques, and (b) lack access to the equipment and professional supports needed to provide adequate oral care. Basic oral care might be performed less than once per day in some settings and patients with problematic behaviours, dysphagia, or sensitivities associated with poor oral health might be less likely to receive oral care. While lack of time was highlighted as a barrier in the survey findings, focus group members considered that time should not be a barrier to prioritising oral care practices on a daily basis in residential care settings. There are several important discrepancies between the recommendations made in evidence-based guidelines for oral care and the implementation of such practices in residential care settings. Nursing and residential care staff considered adequate oral care to be feasible if access, funding and training barriers are removed and facilitators enhanced. Copyright © 2015 Elsevier Inc. All rights reserved.

Patients' Conceptions of Terms Related to Sexual Interest, Desire, and Arousal.

PubMed

DeLamater, John D; Weinfurt, Kevin P; Flynn, Kathryn E

2017-11-01

Measurement of sexual function typically uses self-report, which, to work as intended, must use language that is understood consistently by diverse respondents. Commonly used measures employ multiple terms, primarily (sexual) interest, desire, and arousal, that might not be understood in the same way by laypeople and professionals. To inform self-reported measurement efforts for research and clinical settings by examining how US men and women recruited from a health care setting understand and interpret different terms. We conducted 10 focus groups in Durham, NC (N = 57). Discussions were audio-recorded and transcribed, and the content of the discussions was systematically analyzed in 2 phases of coding by the research team, facilitated by Nvivo qualitative analysis software (QSR International, Doncaster, VIC, Australia). Patient focus group discussions about the meanings and connotations of multiple terms related to sexual function, especially interest, desire, and arousal. 5 groups included male participants and 5 included female participants. Participants characterized (sexual) interest as a cognitive phenomenon and a situational response to a specific person. Similarly, they characterized (sexual) desire as a situational person-specific experience with some support for it as a cognitive phenomenon but more support for it as a physical phenomenon. In contrast, participants characterized sexual arousal as a physical phenomenon occurring in response to physical or visual stimulation and not related to a specific person. These results can help us understand how laypeople are using and responding to these terms when they are used in clinical and research settings. Patient participants in these groups were diverse in age, gender, sexual orientation, and health, with the potential to voice diverse perspectives on sexual functioning; however, the sample was limited to a single city in the southeastern United States. The meanings of interest, desire, and arousal were defined, compared, and contrasted in the context of patient focus groups. Qualitative coding showed that interest was considered the most "cognitive," arousal the most "physical," and desire somewhere in between. DeLamater JD, Weinfurt KP, Flynn KE. Patients' Conceptions of Terms Related to Sexual Interest, Desire, and Arousal. J Sex Med 2017;14:1327-1335. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Uruguayan secondary school students speak up about tobacco: results from focus group discussions in and around Montevideo.

PubMed

Peterson, Erin; Harrell, Melissa; Springer, Andrew; Medina, José; Martinez, Lucía; Perry, Cheryl; Estol, Diego

2017-07-01

This qualitative research study investigated intrapersonal, interpersonal, and environmental factors that shape young adolescent tobacco use behaviors in Uruguay. Focus groups were conducted in the summer of 2012 and fall of 2013 in four secondary schools in Montevideo, Uruguay, including two private schools and two public schools. A total of four focus groups were led in each school, composed of 4-6 students each, 16 focus groups in total. Data analysis utilized NVivo software and included deductive and inductive content analysis. Overwhelmingly, students reported that the onset of smoking occurred in the second year of secondary school. The primary intrapersonal factors that were found to be universal among respondents identified that smoking was a performance in groups, to garner attention from their peers. Students interviewed most often stated that the greatest interpersonal factors for smoking were to look older, as a rite of passage, and for group membership. Environmental factors cited most often indicate that they smoked during unsupervised time, either at night or around the short Uruguayan school day. Focus group interviews revealed that adolescents had easy access to cigarettes for purchase through small family owned grocery stores, even though laws exist preventing the sale of cigarettes to minors. Few differences were cited between strata related to cigarette use in adolescents. The differences that do exist are most apparent across gender, though there were a few observed differences when stratified by public and private school. Findings from this study indicate that key factors across ecological levels (intrapersonal, interpersonal, and environmental) should be taken into consideration when designing tobacco prevention programs for youth in Uruguay. A multiple-component approach which addresses risk factors at all of these levels, implemented in schools, may be particularly well-suited to this setting.

Needs and Preferences for Receiving Mental Health Information in an African American Focus Group Sample

PubMed Central

Mishra, Shiraz I.; Lucksted, Alicia; Gioia, Deborah; Barnet, Beth; Baquet, Claudia R.

2013-01-01

The purpose of this study is to better understand the mental health/illness information and service delivery preferences among African American residents of Baltimore. We conducted four focus groups (n=42) among African American adults currently unconnected with the mental health system. Participants expressed fear of stigma and perceptions of racism as major barriers to seeking information and/or services and discussed some normalizing strategies to address these barriers. African Americans harbor cultural and traditional beliefs regarding mental illness which could also act as barriers. Findings have implications for imparting acceptable and culturally-sensitive mental health education and service delivery programs in community settings. PMID:18633704

Which activities threaten independent living of elderly when becoming problematic: inspiration for meaningful service robot functionality.

PubMed

Bedaf, Sandra; Gelderblom, Gert Jan; Syrdal, Dag Sverre; Lehmann, Hagen; Michel, Hervé; Hewson, David; Amirabdollahian, Farshid; Dautenhahn, Kerstin; de Witte, Luc

2014-11-01

In light of the increasing elderly population and the growing demand for home care, the potential of robot support is given increasing attention. In this paper, an inventory of activities was made that threaten independent living of elderly when becoming problematic. Results will guide the further development of an existing service robot, the Care-O-bot®. A systematic literature search of PubMed was performed, focused on the risk factors for institutionalization. Additionally, focus group sessions were conducted in the Netherlands, United Kingdom and France. In these focus group sessions, problematic activities threatening the independence of elderly people were discussed. Three separate target groups were included in the focus group sessions: (1) elderly persons (n = 41), (2) formal caregivers (n = 40) and (3) informal caregivers (n = 32). Activities within the International Classification of Functioning domains mobility, self-care, and interpersonal interaction and relationships were found to be the most problematic. A distinct set of daily activities was identified that may threaten independent living, but no single activity could be selected as the main activity causing a loss of independence as it is often a combination of problematic activities that is person-specific. Supporting the problematic activities need not involve a robotic solution.

Spiraling between qualitative and quantitative data on women's health behaviors: a double helix model for mixed methods.

PubMed

Mendlinger, Sheryl; Cwikel, Julie

2008-02-01

A double helix spiral model is presented which demonstrates how to combine qualitative and quantitative methods of inquiry in an interactive fashion over time. Using findings on women's health behaviors (e.g., menstruation, breast-feeding, coping strategies), we show how qualitative and quantitative methods highlight the theory of knowledge acquisition in women's health decisions. A rich data set of 48 semistructured, in-depth ethnographic interviews with mother-daughter dyads from six ethnic groups (Israeli, European, North African, Former Soviet Union [FSU], American/Canadian, and Ethiopian), plus seven focus groups, provided the qualitative sources for analysis. This data set formed the basis of research questions used in a quantitative telephone survey of 302 Israeli women from the ages of 25 to 42 from four ethnic groups. We employed multiple cycles of data analysis from both data sets to produce a more detailed and multidimensional picture of women's health behavior decisions through a spiraling process.

Workgroup report: developing environmental health indicators for European children: World Health Organization Working Group.

PubMed

Pond, Kathy; Kim, Rokho; Carroquino, Maria-Jose; Pirard, Philippe; Gore, Fiona; Cucu, Alexandra; Nemer, Leda; MacKay, Morag; Smedje, Greta; Georgellis, Antonis; Dalbokova, Dafina; Krzyzanowski, Michal

2007-09-01

A working group coordinated by the World Health Organization developed a set of indicators to protect children's health from environmental risks and to support current and future European policy needs. On the basis of identified policy needs, the group developed a core set of 29 indicators for implementation plus an extended set of eight additional indicators for future development, focusing on exposure, health effects, and action. As far as possible, the indicators were designed to use existing information and are flexible enough to be developed further to meet the needs of policy makers and changing health priorities. These indicators cover most of the priority topic areas specified in the Children's Environment and Health Action Plan for Europe (CEHAPE) as adopted in the Fourth Ministerial Conference on Health and Environment in 2004, and will be used to monitor the implementation of CEHAPE. This effort can be viewed as an integral part of the Global Initiative on Children's Environmental Health Indicators, launched at the World Summit on Sustainable Development in 2002.

Two Models for Implementing Senior Mentor Programs in Academic Medical Settings

ERIC Educational Resources Information Center

Corwin, Sara J.; Bates, Tovah; Cohan, Mary; Bragg, Dawn S.; Roberts, Ellen

2007-01-01

This paper compares two models of undergraduate geriatric medical education utilizing senior mentoring programs. Descriptive, comparative multiple-case study was employed analyzing program documents, archival records, and focus group data. Themes were compared for similarities and differences between the two program models. Findings indicate that…

Does Peer Group Identity Influence Absenteeism in High School Students?

ERIC Educational Resources Information Center

Hartnett, Sharon

2008-01-01

The focus of this piece is on exploring questions regarding school organizational structures and cultures and their unintentional encouragement of teenage absenteeism. The organizational structure and culture of a school setting contributes to how students experience the system. School characteristics and culture can influence student absenteeism…

Mid-America Group: A Foundation for Renewal.

ERIC Educational Resources Information Center

Lorenzo, Albert L.; Blanzy, James J.

Drawing from a review of the literature and on-site observations, this paper sets forth a comprehensive framework for organizational renewal within the community college. Part 1 focuses on the adaptation of organizational life cycle theory to community colleges. Building upon a broadened definition of human development and the related hierarchy of…

Health Promotion in University: What Do Students Want?

ERIC Educational Resources Information Center

Dunne, Cathy; Somerset, Maggie

2004-01-01

This qualitative research was designed to investigate students' health needs and their views on health promotion in a University. A total of 31 students participated in focus group discussions. Inductive analysis revealed two central themes: student health concerns and health promotion in a University setting. The former included issues associated…

Food Security in Older Australians from Different Cultural Backgrounds

ERIC Educational Resources Information Center

Radermacher, Harriet; Feldman, Susan; Bird, Stephen

2010-01-01

Objective: To investigate the experiences and barriers to food security of community-dwelling older people. Design: Quantitative questionnaire and 5 focus group discussions using purposive sampling. Setting: Shire of Melton, Victoria, Australia. Participants: Thirty-seven people (13 male and 24 female), between 58 and 85 years of age, from…

The National Health Educator Job Analysis 2010: Process and Outcomes

ERIC Educational Resources Information Center

Doyle, Eva I.; Caro, Carla M.; Lysoby, Linda; Auld, M. Elaine; Smith, Becky J.; Muenzen, Patricia M.

2012-01-01

The National Health Educator Job Analysis 2010 was conducted to update the competencies model for entry- and advanced-level health educators. Qualitative and quantitative methods were used. Structured interviews, focus groups, and a modified Delphi technique were implemented to engage 59 health educators from diverse work settings and experience…

Understanding Barriers to Continence Care in Institutions

ERIC Educational Resources Information Center

Tannenbaum, Cara; Labrecque, Danielle; Lepage, Christiane

2005-01-01

This work seeks to identify factors that facilitate or diminish care-providers' propensity to improve continence care in long-term care (LTC) settings. We conducted a cross-sectional qualitative study using focus group methodology in four long-term care institutions in Montreal, QC. Forty-two nurses, nursing assistants, and orderlies caring for…

The Reflexive Imperative among High-Achieving Adolescents: A Flemish Case Study

ERIC Educational Resources Information Center

Van Lancker, Inge

2016-01-01

The socio-cultural conditions of late modernity induce a "reflexive imperative" amongst young people, which also results in metapragmatic and metalinguistic behaviour, as has been demonstrated by linguistic ethnographers (LE). However, recent LE studies on reflexivity in Western European settings have mainly focused on how groups of…

76 FR 12979 - Submission for OMB Review: Comment Request; Questionnaire Cognitive Interviewing and Pretesting...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-09

... cognitive interviews, focus groups, Pilot household interviews, and experimental research in laboratory and field settings, both for applied questionnaire evaluation and more basic research on response errors in surveys. The most common evaluation method is the cognitive interview, in which a questionnaire design...

XML Schema Languages: Beyond DTD.

ERIC Educational Resources Information Center

Ioannides, Demetrios

2000-01-01

Discussion of XML (extensible markup language) and the traditional DTD (document type definition) format focuses on efforts of the World Wide Web Consortium's XML schema working group to develop a schema language to replace DTD that will be capable of defining the set of constraints of any possible data resource. (Contains 14 references.) (LRW)

Aflatoxin control measures: A basis for improved health in developing countries

USDA-ARS?s Scientific Manuscript database

The goal of this IARC Working Group Report is to produce a document, based on expertly evaluated scientific evidence, which provides a set of clear, concise and focused messages to inform policymakers, international organizations and funders in their decision-making with regards to appropriate aflat...

Updating the Psoriatic Arthritis (PsA) Core Domain Set: A Report from the PsA Workshop at OMERACT 2016.

PubMed

Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip J; Callis Duffin, Kristina; Elmamoun, Musaab; Tillett, William; Campbell, Willemina; FitzGerald, Oliver; Gladman, Dafna D; Goel, Niti; Gossec, Laure; Hoejgaard, Pil; Leung, Ying Ying; Lindsay, Chris; Strand, Vibeke; van der Heijde, Désirée M; Shea, Bev; Christensen, Robin; Coates, Laura; Eder, Lihi; McHugh, Neil; Kalyoncu, Umut; Steinkoenig, Ingrid; Ogdie, Alexis

2017-10-01

To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). At OMERACT 2016, research conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants. We conducted a systematic literature review of domains measured in PsA RCT and LOS, and identified 24 domains. We conducted 24 focus groups with 130 patients from 7 countries representing 5 continents to identify patient domains. We achieved consensus through 2 rounds of separate surveys with 50 patients and 75 physicians, and a nominal group technique meeting with 12 patients and 12 physicians. We conducted a workshop and breakout groups at OMERACT 2016 in which findings were presented and discussed. The updated PsA Core Domain Set endorsed with 90% agreement by OMERACT 2016 participants included musculoskeletal disease activity, skin disease activity, fatigue, pain, patient's global assessment, physical function, health-related quality of life, and systemic inflammation, which were recommended for all RCT and LOS. These were important, but not required in all RCT and LOS: economic cost, emotional well-being, participation, and structural damage. Independence, sleep, stiffness, and treatment burden were on the research agenda. The updated PsA Core Domain Set was endorsed at OMERACT 2016. Next steps for the PsA working group include evaluation of PsA outcome measures and development of a PsA Core Outcome Measurement Set.

A core outcome set for clinical trials in acute diarrhoea.

PubMed

Karas, Jacek; Ashkenazi, Shai; Guarino, Alfredo; Lo Vecchio, Andrea; Shamir, Raanan; Vandenplas, Yvan; Szajewska, Hania

2015-04-01

Core outcome sets are the baseline for what should be measured in clinical research and, thus, should serve as a guide for what should be collected and reported. The Consensus Group on Outcome Measures Made in Pediatric Enteral Nutrition Clinical Trials, established in 2012, agreed that consensus on a core set of outcomes with agreed-upon definitions that should be measured and reported in clinical trials was needed. To achieve this goal, six working groups (WGs) were setup, including WG on acute diarrhoea, whose main goal was to develop a core outcome set for trials in acute diarrhoea. The first step identified how published outcomes related to acute diarrhoea were reported. The second focused on the methodology for determining which outcomes to measure in clinical trials. The third employed a two-phase questionnaire study using the Delphi technique to define clinically important outcomes to clinicians and parents. For therapeutic studies, the five most important outcome measures were diarrhoea duration, degree of dehydration, need for hospitalisation (or duration of hospitalisation for inpatients), the proportion of patients recovered by 48 h and adverse effects. The prophylactic core outcome set included prevention of diarrhoea, prevention of dehydration, prevention of hospitalisation and adverse effects. The outcome sets for therapy and prevention can be recommended for use in future trials of patients with gastroenteritis. Their envisioned goal is to decrease study heterogeneity and to ease the comparability of studies. WG's next step is to determine how to measure the outcomes included in the core set. 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.

Core outcome sets in dermatology: report from the second meeting of the International Cochrane Skin Group Core Outcome Set Initiative.

PubMed

Kottner, J; Jacobi, L; Hahnel, E; Alam, M; Balzer, K; Beeckman, D; Busard, C; Chalmers, J; Deckert, S; Eleftheriadou, V; Furlan, K; Horbach, S E R; Kirkham, J; Nast, A; Spuls, P; Thiboutot, D; Thorlacius, L; Weller, K; Williams, H C; Schmitt, J

2018-04-01

Results of clinical trials are the most important information source for generating external clinical evidence. The use of different outcomes across trials, which investigate similar interventions for similar patient groups, significantly limits the interpretation, comparability and clinical application of trial results. Core outcome sets (COSs) aim to overcome this limitation. A COS is an agreed standardized collection of outcomes that should be measured and reported in all clinical trials for a specific clinical condition. The Core Outcome Set Initiative within the Cochrane Skin Group (CSG-COUSIN) supports the development of core outcomes in dermatology. In the second CSG-COUSIN meeting held in 2017, 11 COS development groups working on skin diseases presented their current work. The presentations and discussions identified the following overarching methodological challenges for COS development in dermatology: it is not always easy to define the disease focus of a COS; the optimal method for outcome domain identification and level of detail needed to specify such domains is challenging to many; decision rules within Delphi surveys need to be improved; appropriate ways of patient involvement are not always clear. In addition, there appear to be outcome domains that may be relevant as potential core outcome domains for the majority of skin diseases. The close collaboration between methodologists in the Core Outcome Set Initiative and the international Cochrane Skin Group has major advantages for trialists, systematic reviewers and COS developers. © 2018 British Association of Dermatologists.

Difficulties Experienced in Setting and Achieving Goals by Participants of a Falls Prevention Programme: A Mixed-Methods Evaluation

PubMed Central

Mason, Wendy; Haines, Terry P.

2014-01-01

ABSTRACT Purpose: To evaluate the ability of participants of a falls prevention programme to set and achieve goals. Methods: The study used a prospective longitudinal design and a mixed-methods approach to data collection. Study participants were (1) 220 older adults participating in a 15-week combined exercise and education falls prevention programme and (2) 9 practitioners (3 home-care nurses, 5 community workers, and an exercise physiologist) involved in delivering the programme. Data from goal-setting forms were analyzed, and descriptive statistics were used to determine the number of appropriate goals set and achieved. Data were analyzed according to programme setting (home- or group-based) and whether or not participants were classified as being from a Culturally and Linguistically Diverse (CALD) background in the Australian context. Semi-structured interviews with programme practitioners were thematically analyzed. Results: A total of 144 respondents (n=75 CALD group, n=41 non-CALD group, n=6 CALD home, n=22 non-CALD home) set 178 goals. Only 101 (57%) goals could be evaluated according to achievement, because participants set goals that focused on health state instead of behaviour, set goals not relevant to falls prevention, used inappropriate constructs to measure goal achievement, and either did not review their goals or dropped out of the programme before goal review. Of these 101 goals, 64 were achieved. Practitioners described their own difficulties in understanding the process of setting health behaviour goals along with communication, cultural, and logistic difficulties. Conclusions: Both CALD and non-CALD participants and those participating in both group- and home-based programmes experienced difficulty in setting and achieving goals to facilitate behaviour change for falls prevention. Data suggest that home-based participants had more difficulty in setting goals than their group-based counterparts and, to a lesser extent, that CALD participants experienced more difficulty in setting goals than their non-CALD counterparts. The use of a guided approach to goal setting and the need for more specific practitioner training and follow-up support regarding goal setting in the context of a falls prevention programme should be considered. PMID:25922563

Difficulties experienced in setting and achieving goals by participants of a falls prevention programme: a mixed-methods evaluation.

PubMed

Haas, Romi; Mason, Wendy; Haines, Terry P

2014-01-01

To evaluate the ability of participants of a falls prevention programme to set and achieve goals. The study used a prospective longitudinal design and a mixed-methods approach to data collection. Study participants were (1) 220 older adults participating in a 15-week combined exercise and education falls prevention programme and (2) 9 practitioners (3 home-care nurses, 5 community workers, and an exercise physiologist) involved in delivering the programme. Data from goal-setting forms were analyzed, and descriptive statistics were used to determine the number of appropriate goals set and achieved. Data were analyzed according to programme setting (home- or group-based) and whether or not participants were classified as being from a Culturally and Linguistically Diverse (CALD) background in the Australian context. Semi-structured interviews with programme practitioners were thematically analyzed. A total of 144 respondents (n=75 CALD group, n=41 non-CALD group, n=6 CALD home, n=22 non-CALD home) set 178 goals. Only 101 (57%) goals could be evaluated according to achievement, because participants set goals that focused on health state instead of behaviour, set goals not relevant to falls prevention, used inappropriate constructs to measure goal achievement, and either did not review their goals or dropped out of the programme before goal review. Of these 101 goals, 64 were achieved. Practitioners described their own difficulties in understanding the process of setting health behaviour goals along with communication, cultural, and logistic difficulties. Both CALD and non-CALD participants and those participating in both group- and home-based programmes experienced difficulty in setting and achieving goals to facilitate behaviour change for falls prevention. Data suggest that home-based participants had more difficulty in setting goals than their group-based counterparts and, to a lesser extent, that CALD participants experienced more difficulty in setting goals than their non-CALD counterparts. The use of a guided approach to goal setting and the need for more specific practitioner training and follow-up support regarding goal setting in the context of a falls prevention programme should be considered.

Medication errors in home care: a qualitative focus group study.

PubMed

Berland, Astrid; Bentsen, Signe Berit

2017-11-01

To explore registered nurses' experiences of medication errors and patient safety in home care. The focus of care for older patients has shifted from institutional care towards a model of home care. Medication errors are common in this situation and can result in patient morbidity and mortality. An exploratory qualitative design with focus group interviews was used. Four focus group interviews were conducted with 20 registered nurses in home care. The data were analysed using content analysis. Five categories were identified as follows: lack of information, lack of competence, reporting medication errors, trade name products vs. generic name products, and improving routines. Medication errors occur frequently in home care and can threaten the safety of patients. Insufficient exchange of information and poor communication between the specialist and home-care health services, and between general practitioners and healthcare workers can lead to medication errors. A lack of competence in healthcare workers can also lead to medication errors. To prevent these, it is important that there should be up-to-date information and communication between healthcare workers during the transfer of patients from specialist to home care. Ensuring competence among healthcare workers with regard to medication is also important. In addition, there should be openness and accurate reporting of medication errors, as well as in setting routines for the preparation, alteration and administration of medicines. To prevent medication errors in home care, up-to-date information and communication between healthcare workers is important when patients are transferred from specialist to home care. It is also important to ensure adequate competence with regard to medication, and that there should be openness when medication errors occur, as well as in setting routines for the preparation, alteration and administration of medications. © 2017 John Wiley & Sons Ltd.

A qualitative evaluation of owner and worker health and safety beliefs in small auto collision repair shops.

PubMed

Parker, David L; Bejan, Anca; Brosseau, Lisa M

2012-05-01

About 223,000 people are employed in approximately 34,500 auto collision repair businesses. In general, employees and owners in these establishments lack knowledge of health and safety practices and do not have the technical expertise to make their place of work safer. Three employee and three owner focus groups were conducted. The goal of these focus groups was to characterize health and safety beliefs of owners and employees and to determine the best methods for motivating safety improvements in collision repair shops. A total of 11 owners and 19 workers participated in these focus groups. Employees and owners were aware of a wide range of hazards. Both groups noted difficulty in staying informed. Employers were hesitant to set and enforce safety and health rules. Employees perceive owners to be unwilling to dedicate the resources to make the workplace safer and provide personal protective equipment. Both groups felt insurance reimbursement practices placed undue pressure on employees. Focus groups provide important insights into intervention development in very small enterprises in general and auto collision shops in specific. Employers were conflicted about allowing employees a certain level of independence while also maintaining a safe workplace. From the employee perspective, owners frequently fail to provide adequate personal protective equipment and make improvements needed to ensure safe work. The unique managerial needs of very small enterprises must be accounted for if health and safety programs are to be implemented in these establishments. Copyright © 2012 Wiley Periodicals, Inc.

A focus group study of chiropractic students following international service learning experiences

PubMed Central

Boysen, James C.; Salsbury, Stacie A.; Derby, Dustin; Lawrence, Dana J.

2016-01-01

Objective: One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Methods: Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. Results: The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor–patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Conclusion: Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices. PMID:27258817

Dignity and deferral narratives as strategies in facilitated technology-based support groups for people with advanced cancer.

PubMed

Street, Annette F; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

Lesbianas Unidas: Shaping nation through community activist rhetorics.

PubMed

Gil-Gómez, Ellen M

2016-01-01

Latina Queer activisms emerged in response to the ethnic-based Chicano movement and the White-focused women's movement. Latina lesbians found that foregrounding nationhood based on ethnic origin was in absolute opposition to sexual and gendered liberation. Specifically, Latina feminist groups of the 1970s emphasized their compliant straightness to maintain their citizenship within the Chicano/Latino nation. In addition, from a Chicano perspective, feminism itself was considered a "White disease" and part of destructive White "gabacho" influence. While White lesbian groups were many times allied with lesbians of color their racist blinders were evident. The founders of Lesbianas Unidas in Los Angeles walked a fine line of rejection and alienation from their families and home culture of ethnicity and authenticity while redefining "queer" as coherent within the Chicano/Latino nation. My study focuses on their creation of rhetorical strategies of sex, gender, and nationality that set Lesbianas Unidas apart first, from masculinist Chicano civil rights groups, then from early feminist Chicana groups, and finally through dialogue with gay Latino groups.

Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

PubMed Central

Street, Annette F.; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated. PMID:22530115

Psychotherapy with schizophrenics in team groups: a systems model.

PubMed

Beeber, A R

1991-01-01

This paper focuses on the treatment of patients with schizophrenic disorders employing the Team Group model. The advantages and disadvantages of the Team Group are presented. Systems theory and principles of group development are applied as a basis for understanding the dynamics of the group in the context at the acute psychiatric unit. Particular problems encountered in treating patients with schizophrenic disorders in this setting are presented. These include: (1) issues of therapist style and technique, (2) basic psychopathology of the schizophrenic disorders, and (3) phase-specific problems associated with the dynamics of the group. Recommendations for therapist interventions are made that may better integrate these patients into the Team Group.

The case for exploring the usage of employee wellness programs for pediatric asthma control.

PubMed

Jassal, Mandeep S; Butz, Arlene

2018-01-18

The multiple socioecological determinants of asthma mandate that pediatricians develop a treatment strategy beyond the practice-based setting. To expand to a more impactful community-based role, pediatricians must look to form partnerships with groups that are capable of promoting social and environmental change. Traditionally, these groups have included schools, governmental agencies, and child care establishments. One group that is not actively being availed of are employers who have shown success in improving adult-based outcomes through wellness programs. Employers are stakeholders in pediatric asthma care through its impact on reduced worker productivity and higher health insurance premiums. An employer's focus on pediatric asthma will be a collective win for the employer and employee. The article herein describes the rationale for the focus of employers on pediatric asthma care and potential incorporation within employer-based wellness strategies.

Doctors' use of mobile devices in the clinical setting: a mixed methods study.

PubMed

Nerminathan, Arany; Harrison, Amanda; Phelps, Megan; Alexander, Shirley; Scott, Karen M

2017-03-01

Mobile device use has become almost ubiquitous in daily life and therefore includes use by doctors in clinical settings. There has been little study as to the patterns of use and impact this has on doctors in the workplace and how negatively or positively it impacts at the point of care. To explore how doctors use mobile devices in the clinical setting and understand drivers for use. A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper-based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting. Trainees were more likely than consultants to use their mobile devices for learning and accessing information related to patient care, as well as for personal communication unrelated to work. Focus group data highlighted a range of factors that influenced doctors to use personal mobile devices in the clinical setting, including convenience for medical photography, and factors that limited use. Distraction in the clinical setting due to use of mobile devices was a key issue. Personal experience and confidence in using mobile devices affected their use, and was guided by role modelling and expectations within a medical team. Doctors use mobile devices to enhance efficiency in the workplace. In the current environment, doctors are making their own decisions based on balancing the risks and benefits of using mobile devices in the clinical setting. There is a need for guidelines around acceptable and ethical use that is patient-centred and that respects patient privacy. © 2016 Royal Australasian College of Physicians.

Family physicians’ perspectives on care of dementia patients and family caregivers

PubMed Central

Yaffe, Mark J.; Orzeck, Pam; Barylak, Lucy

2008-01-01

ABSTRACT OBJECTIVE To identify factors that facilitate or impede family physicians in ambulatory care of patients with dementia and the family caregivers of such patients. DESIGN Explanatory qualitative analyses of focus group discussions. SETTING Large, medium, and small urban; suburban; and rural family practices from various regions of the province of Quebec. PARTICIPANTS Twenty-five family doctors whose practices had at least 75% ambulatory patients; of these patients, an estimated minimum of 20% were 65 years old or older and at least 2% suffered from dementia. METHOD Physicians were recruited by telephone to be paid participants in their regions in focus groups studying aspects of dementia care in ambulatory settings. Grounded theory and constant comparative methods were used to explore data from 3 French-speaking focus groups and 1 English-speaking focus group. MAIN FINDINGS Physicians were 72% male, had a mean of 21.3 years in practice, and spent about 87% of their professional time in office practice. An estimated 38.7% of their patients were 65 years old or older, and 5.6% of these patients had Alzheimer disease or related dementias. Physicians were comfortable caring for these patients and their family caregivers but thought much of this care should come from support services offered elsewhere. Physicians admitted they had little knowledge of these services and had little interest in acquiring information about them. Government-run, community-based health and social service centres were the “black boxes” to which they referred patients and their caregivers for any form of help. Inconsistencies in the services offered by these centres were noted. CONCLUSION While family doctors are seeking a more seamless form of interdisciplinary dementia care, a large amount of that care comes from support services about which physicians are not well informed and are not interested in learning. PMID:18625826

What does it mean to be a family physician?

PubMed Central

Beaulieu, Marie-Dominique; Dory, Valérie; Pestiaux, Dominique; Pouchain, Denis; Rioux, Marc; Rocher, Guy; Gay, Bernard; Boucher, Laurier

2009-01-01

Abstract OBJECTIVE To explore the conceptions that family medicine residents from 3 countries have of the roles and responsibilities of family physicians in order to gain a better understanding of challenges that might transcend the specific contexts of different health care systems. DESIGN Qualitative study using focus groups. SETTING Resident training programs in France, Belgium, and Canada. PARTICIPANTS A total of 57 residents in the last year of training. METHOD Ten focus groups were conducted in 3 countries: 2 in France, 3 in Belgium, and 5 in Canada. All focus groups were held in different cities, with residents registered in different universities in France and Canada and with residents from the same university in Belgium. The study was informed by Abbott’s conceptual framework on the system of professions. Each 90-minute focus group was moderated by the same researchers. The transcripts were analyzed according to the immersion-crystallization method. MAIN FINDINGS Respondents shared common conceptions of the family physician’s role: continuity of care and patient advocacy were seen as the foundations of the discipline. Respondents also shared a sense of discomfort about how accessible they were expected to be for patients and about the scope of family practice. They saw family medicine as flexible and reported that they strove for balance between their professional and personal life goals. All respondents strongly believed that their profession was undervalued by the medical schools where they trained. CONCLUSION This exploratory study suggests that there are more similarities than differences in the understanding that future family physicians from different countries have of their discipline and of their careers. We observed a tension between a desire to develop a “new general practice” and the more traditional vision of the discipline. The culture in academic settings appears to contribute to the persistent low appeal of being a primary care physician. PMID:19675252

The enquiry-based learning experience: An evaluation project.

PubMed

Ashby, Jayne; Hubbert, Vanessa; Cotrel-Gibbons, Liz; Cox, Karen; Digan, John; Lewis, Kerry; Langmack, Gill; Matiti, Milika; McCormick, Damion; Roberts, Lorraine; Taylor, Derek; Thom, Natasha; Wiggs, Mary; Wilson, Linda

2006-01-01

A research and nursing development initiative group consisting of health lecturers and lecturer practitioners set out to evaluate how learners and teachers felt about the introduction of an enquiry based learning (EBL) approach to education. Five focus groups, teachers (1 group) post-registration students (1 group) and pre-registration diploma students (3 groups) were interviewed. Discussions were tape recorded, transcribed, and analysed. The results revealed that students and teachers held disparative views on the efficiency of EBL. Teachers, surprisingly, felt more doubtful and discouraged than learners. Several concerns were raised over the ability of EBL to establish a foothold in a curriculum more noted for a pedagogical stance on learning.

Effects of form-focused training on running biomechanics: A pilot randomized trial in untrained individuals

PubMed Central

Kumar, Deepak; McDermott, Kelly; Feng, Haojun; Goldman, Veronica; Luke, Anthony; Souza, Richard B; Hecht, Frederick M

2015-01-01

Objective To investigate the changes in running biomechanics after training in Form-Focused running using ChiRunning vs. Not-Form focused training and Self-Directed training in untrained individuals. Design Pilot study - Randomized controlled trial. Setting Research Institution with Tertiary Care Medical Center. Participants Seventeen subjects (9 males, 8 females) with pre-hypertension. Methods Twenty-two participants were randomized to three study arms but 17 completed the study. The study arms were: 1) group-based Form-Focused running using ChiRunning (enrolled, n =10; completed, n=7); 2) group-based conventional running (enrolled, n=6; completed, n=4); 3) self-directed training with educational materials (enrolled, n =6; completed, n=6). The training schedule was prescribed for 8 weeks with 4 weeks of follow-up. All subjects completed overground running motion analyses before and after training. Outcomes Ankle, knee, hip joint peak moments and powers; Average vertical loading rate (AVLR), impact peak, cadence, stride length, strike index, and stride reach. Paired T-tests were used to compare differences with-in groups over-time. Results Form-Focused group reduced their Stride Reach (P = .047) after the training but not the other groups. Form-Focused group showed a close to significant reduction in knee adduction moment (P = .051) and a reduction in the peak ankle eversion moment (P = .027). Self-Directed group showed an increase in the running speed, (P =.056) and increases in ankle and knee joint powers and moments. Conclusions There are differences in the changes in running biomechanics between individuals trained in running form that emphazies mid-foot strike, higher cadence, and shorter stride compared to those not trained in the thise technique. These differences may be associated with reduced lower extremity stress in individuals trained in this running form but future studies are needed to confirm these findings in larger samples. PMID:25633634

Influencing factors of sedentary behavior in European preschool settings: an exploration through focus groups with teachers.

PubMed

De Decker, Ellen; De Craemer, Marieke; De Bourdeaudhuij, Ilse; Wijndaele, Katrien; Duvinage, Kristin; Androutsos, Odysseas; Iotova, Violeta; Lateva, Mina; Alvira, Juan Miguel Fernández; Zych, Kamila; Manios, Yannis; Cardon, Greet

2013-09-01

Sedentary behavior refers to activities involving sitting down and reclining (eg, watching TV, using the computer) and has been associated with different health outcomes. In preschool, children are sedentary for 50% to 80% of the time, in the classroom as well as during recess. Because of the absence of qualitative studies examining influencing factors of preschoolers' sedentary behavior in preschool settings, this study explored teachers' opinions on potentially influencing factors of this behavior. Eighty-seven teachers of 4- to 6-year-old preschoolers from 6 European countries participated in a total of 18 focus groups between October 2010 and January 2011. Key findings were reported separately by country, and were independently analyzed by 2 researchers using qualitative content analysis. Teachers perceive the lack of play space and small classroom size as being influential factors on preschoolers' sedentary behavior; increasing play equipment and using teachers' prompts are mentioned as ways to stimulate children to be less sedentary on the playground. Computer use is reported to be more common in preschool than watching TV. Interventions should focus on increasing teachers' awareness of how sedentary preschoolers are during the preschool day. Teachers also should be informed about strategies to decrease sedentariness in the classroom and on the playground. © 2013, American School Health Association.

What do practitioners think? A qualitative study of a shared care mental health and nutrition primary care program

PubMed Central

Paquette-Warren, Jann; Vingilis, Evelyn; Greenslade, Jaimi; Newnam, Sharon

2006-01-01

Abstract Objective To develop an in-depth understanding of a shared care model from primary mental health and nutrition care practitioners with a focus on program goals, strengths, challenges and target population benefits. Design Qualitative method of focus groups. Setting/Participants The study involved fifty-three practitioners from the Hamilton Health Service Organization Mental Health and Nutrition Program located in Hamilton, Ontario, Canada. Method Six focus groups were conducted to obtain the perspective of practitioners belonging to various disciplines or health care teams. A qualitative approach using both an editing and template organization styles was taken followed by a basic content analysis. Main findings Themes revealed accessibility, interdisciplinary care, and complex care as the main goals of the program. Major program strengths included flexibility, communication/collaboration, educational opportunities, access to patient information, continuity of care, and maintenance of practitioner and patient satisfaction. Shared care was described as highly dependent on communication style, skill and expertise, availability, and attitudes toward shared care. Time constraint with respect to collaboration was noted as the main challenge. Conclusion Despite some challenges and variability among practices, the program was perceived as providing better patient care by the most appropriate practitioner in an accessible and comfortable setting. PMID:17041680

Quality of Health Care: The Views of Homeless Youth

PubMed Central

Ensign, Josephine

2004-01-01

Objective To develop homeless-youth-identified process and outcome measures of quality of health care. Data Sources/Study Setting Primary data collection with homeless youth from both street and clinic settings in Seattle, Washington, for calendar year 2002. Study Design The research was a focused ethnography, using key informant and in-depth individual interviews as well as focus groups with a purposeful sample of 47 homeless youth aged 12–23 years. Data Collection/Extraction Methods All interviews and focus groups were tape-recorded, transcribed, and preliminarily coded, with final coding cross-checked and verified with a second researcher. Principal Findings Homeless youth most often stated that cultural and interpersonal aspects of quality of care were important to them. Physical aspects of quality of care reported by the youth were health care sites separate from those for homeless adults, andsites that offered a choice of allopathic and complementary medicine. Outcomes of health care included survival of homelessness, functional and disease-state improvement, and having increased trust and connections with adults and with the wider community. Conclusions Homeless youth identified components of quality of care as well as how quality of care should be measured. Their perspectives will be included in a larger follow-up study to develop quality of care indicators for homeless youth. PMID:15230923

Construction of a novel multi-gene assay (42-gene classifier) for prediction of late recurrence in ER-positive breast cancer patients.

PubMed

Tsunashima, Ryo; Naoi, Yasuto; Shimazu, Kenzo; Kagara, Naofumi; Shimoda, Masashi; Tanei, Tomonori; Miyake, Tomohiro; Kim, Seung Jin; Noguchi, Shinzaburo

2018-05-04

Prediction models for late (> 5 years) recurrence in ER-positive breast cancer need to be developed for the accurate selection of patients for extended hormonal therapy. We attempted to develop such a prediction model focusing on the differences in gene expression between breast cancers with early and late recurrence. For the training set, 779 ER-positive breast cancers treated with tamoxifen alone for 5 years were selected from the databases (GSE6532, GSE12093, GSE17705, and GSE26971). For the validation set, 221 ER-positive breast cancers treated with adjuvant hormonal therapy for 5 years with or without chemotherapy at our hospital were included. Gene expression was assayed by DNA microarray analysis (Affymetrix U133 plus 2.0). With the 42 genes differentially expressed in early and late recurrence breast cancers in the training set, a prediction model (42GC) for late recurrence was constructed. The patients classified by 42GC into the late recurrence-like group showed a significantly (P = 0.006) higher late recurrence rate as expected but a significantly (P = 1.62 × E-13) lower rate for early recurrence than non-late recurrence-like group. These observations were confirmed for the validation set, i.e., P = 0.020 for late recurrence and P = 5.70 × E-5 for early recurrence. We developed a unique prediction model (42GC) for late recurrence by focusing on the biological differences between breast cancers with early and late recurrence. Interestingly, patients in the late recurrence-like group by 42GC were at low risk for early recurrence.

Educating Mental Health Clinicians About Sensory Modulation to Enhance Clinical Practice in a Youth Acute Inpatient Mental Health Unit: A Feasibility Study.

PubMed

Blackburn, Julie; McKenna, Brian; Jackson, Brian; Hitch, Danielle; Benitez, Jessica; McLennan, Cathy; Furness, Trentham

2016-07-01

There is an emergence of literature describing effective sensory modulation (SM) interventions to de-escalate violence and aggression among mental health inpatients. However, the evidence is limited to adult settings, with the effect of SM in youth acute settings unknown. Yet, before SM may be used as a de-escalation intervention in youth acute settings, multidisciplinary staff need to be educated about and supported in the clinical application of SM. In the current study, an online SM education package was developed to assist mental health staff understand SM. This was blended with action learning sets (ALS), small group experiential opportunities consisting staff and consumers to learn about SM resources, and the support of SM trained nurses. The aims of the study were to evaluate the effectiveness of this SM education intervention in (a) transferring knowledge of SM to staff, and (b) translating this knowledge into practice in a youth acute inpatient mental health unit. A mixed methods research design with an 11-item pre- and post-education questionnaire was used along with three-month follow-up focus groups. The SM education improved understanding about SM (all 11-items p ≤ 0.004, r ≥ 0.47). Three-months after SM education, four themes evident in the focus group data emerged about the practice and process of SM; (1) translating of learning into practice, (2) SM in practice, (3) perceptions of SM benefits, and (4) limitations of SM. A blended SM education process enhanced clinical practice in the unit, yet participants were mindful of limitations of SM in situations of distress or escalating agitation.

A survey-based cross-sectional study of doctors' expectations and experiences of non-technical skills for Out of Hours work.

PubMed

Brown, Michael; Shaw, Dominick; Sharples, Sarah; Jeune, Ivan Le; Blakey, John

2015-02-16

The skill set required for junior doctors to work efficiently and safely Out of Hours (OoH) in hospitals has not been established. This is despite the OoH period representing 75% of the year and it being the time of highest mortality. We set out to explore the expectations of medical students and experiences of junior doctors of the non-technical skills needed to work OoH. Survey-based cross-sectional study informed by focus groups. Online survey with participants from five large teaching hospitals across the UK. 300 Medical Students and Doctors Participants ranked the importance of non-technical skills, as identified by literature review and focus groups, needed for OoH care. The focus groups revealed a total of eight non-technical skills deemed to be important. In the survey 'Task Prioritisation' (mean rank 1.617) was consistently identified as the most important non-technical skill. Stage of training affected the ranking of skills, with significant differences for 'Communication with Senior Doctors', 'Dealing with Clinical Isolation', 'Task Prioritisation' and 'Communication with Patients'. Importantly, there was a significant discrepancy between the medical student expectations and experiences of doctors undertaking work. Our findings suggest that medical staff particularly value task prioritisation skills; however, these are not routinely taught in medical schools. The discrepancy between expectations of students and experience of doctors reinforces the idea that there is a gap in training. Doctors of different grades place different importance on specific non-technical skills with implications for postgraduate training. There is a pressing need for medical schools and deaneries to review non-technical training to include more than communication skills. 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.

Healthy Aging in Community for Older Lesbians.

PubMed

Bradford, Judith B; Putney, Jennifer M; Shepard, Bonnie L; Sass, Samantha E; Rudicel, Sally; Ladd, Holly; Cahill, Sean

2016-04-01

In Boston and Outer Cape, Massachusetts, we explored the expectations of lesbians 60 years and older regarding healthy aging and community importance. Focus groups were conducted with participants after completing an anonymous demographic questionnaire. Thematic analysis was used to generate themes and identify how they varied by urban versus rural settings. Group discussions focused on community, finances, housing, and healthcare. Primary concerns included continued access to supportive and lesbian communities as a source of resilience during aging. Concerns about discrimination and isolation mirror themes found in national research. The study findings suggest a need for more research into the housing and transportation needs of lesbians approaching later life, with a focus on how those needs relate to affordability, accessibility, and proximity to social support and healthcare. These findings also suggest the need for substantial investments in strengthening the LGBT-related cultural competence of providers of services for the elderly.

Igniting interest in prevention: using firefighter focus groups to inform implementation and enhancement of an urban canvassing program.

PubMed

Frattaroli, Shannon; McDonald, Eileen M; Tran, Nhan T; Trump, Alison R; OʼBrocki, Raymond C; Gielen, Andrea C

2012-01-01

Smoke alarm canvassing is recognized as an empirically based, effective intervention for increasing access to and the presence of smoke alarms in homes. We sought to inform the implementation of an intervention designed to enhance an existing fire department smoke alarm canvassing program through an empirically grounded, participatory process. We conducted a series of focus groups with fire union leaders and firefighters involved with the canvassing program in 1 US city, shared the results with the participants, and presented the resulting recommendations to fire department leadership. This research occurred in Baltimore, Maryland. Focus group participants included firefighters who participate in the Fire Department's smoke alarm canvassing program and representatives from the local firefighters' union. The focus groups sought to capture firefighters' experiences with and opinions about the canvassing program and how to improve it as well as challenges to canvassing work. We conducted 10 focus groups with 65 participants. Firefighters' perspectives on the canvassing program and their recommendations for improving it were expressed through 3 categories of themes concerning program management, canvassing challenges, and attitudes about the program and the community. We also discuss the process of presenting these findings and recommendations to the participants and the fire department leadership, and describe how implementation of some of the recommendations has progressed. Both the process and outcomes of this formative work inform how to develop and implement community-based public health interventions in real-world settings through academic-community partnerships. The findings also have implications for how canvassing programs are being implemented.

Identification of unique food handling practices that could represent food safety risks for minority consumers.

PubMed

Henley, Shauna C; Stein, Susan E; Quinlan, Jennifer J

2012-11-01

Foodborne illness caused by Salmonella and Campylobacter is a concern for consumers, and there is evidence that minority racial-ethnic populations experience greater rates of illness because of these pathogens. The limited body of research concerning food safety knowledge and practices among minority consumers has focused more on general food safety knowledge than on culturally specific food handling practices. The purpose of the research reported here was to explore food handling behaviors of minority racial-ethnic consumers through in-depth discussions in focus group settings. In this way, we hoped to identify potential unique, previously unidentified food handling practices among these consumers. Nine focus groups were held in Philadelphia, PA. Three focus groups were conducted with African American consumers, three with Hispanic consumers, and three with Asian consumers. In all, 56 consumers participated. Data were recorded, transcribed, and analyzed for unique and potentially unsafe food handling behaviors. Potentially unsafe food handling practices identified among all three groups included extended time to transport food from retail to home and washing of raw poultry. Culturally unique behaviors within groups included (i) using hot water (Asian, Hispanic) or acidic solutions (African American, Hispanic) to clean raw poultry, (ii) purchasing live poultry (Asian, Hispanic), (iii) cooking poultry overnight (African American), and (iv) preparing bite-size pieces of meat prior to cooking (Asian, Hispanic). To have focus groups include a limited number of participants and nonrandom sampling means that these themes and trends cannot be extrapolated to represent food mishandling among these populations in general. Results presented here allow modification of an existing food safety survey to identify the prevalence of these food handling practices among consumers of different demographics.

Canadian family doctors' roles and responsibilities toward outbound medical tourists: "Our true role is ... within the confines of our system".

PubMed

Johnston, Rory; Crooks, Valorie A; Snyder, Jeremy; Dharamsi, Shafik

2013-12-01

To explore how Canadian family doctors understand their roles and responsibilities toward patients who seek health care abroad. Six focus groups were held with family doctors across British Columbia to explore their experiences with and perspectives on outbound medical tourism. Focus groups were digitally recorded, transcribed, and subsequently thematically coded to discover common issues and themes across the entire data set. Focus groups were held with family doctors in 6 cities in British Columbia that provided representation from all provincial health authorities and a range of urban contexts. A total of 22 currently practising family doctors participated across the 6 focus groups, with groups ranging in size from 2 to 6 participants (average 4 participants). Thematic analysis of the transcripts identified cross-cutting themes that emerged across the 6 focus groups. Participants reported that medical tourism threatened patients' continuity of care. Informational continuity is disrupted before patients go abroad because patients regularly omit family doctors from preoperative planning and upon return home when patients lack complete or translated medical reports. Participants believed that their responsibilities to patients resumed once the patients had returned home from care abroad, but were worried about not being able to provide adequate follow-up care. Participants were also concerned about bearing legal liability toward patients should they be asked to clinically support treatments started abroad. Medical tourism poses challenges to Canadian family doctors when trying to reconcile their traditional roles and responsibilities with the novel demands of private out-of-country care pursued by their patients. Guidance from professional bodies regarding physicians' responsibilities to Canadian medical tourists is currently lacking. Developing these supports would help address challenges faced in clinical practice.

A stakeholder co-design approach for developing a community pharmacy service to enhance screening and management of atrial fibrillation.

PubMed

Sabater-Hernández, Daniel; Tudball, Jacqueline; Ferguson, Caleb; Franco-Trigo, Lucía; Hossain, Lutfun N; Benrimoj, Shalom I

2018-02-27

Community pharmacies provide a suitable setting to promote self-screening programs aimed at enhancing the early detection of atrial fibrillation (AF). Developing and implementing novel community pharmacy services (CPSs) is a complex and acknowledged challenge, which requires comprehensive planning and the participation of relevant stakeholders. Co-design processes are participatory research approaches that can enhance the development, evaluation and implementation of health services. The aim of this study was to co-design a pharmacist-led CPS aimed at enhancing self-monitoring/screening of AF. A 3-step co-design process was conducted using qualitative methods: (1) interviews and focus group with potential service users (n = 8) to identify key needs and concerns; (2) focus group with a mixed group of stakeholders (n = 8) to generate a preliminary model of the service; and (3) focus group with community pharmacy owners and managers (n = 4) to explore the feasibility and appropriateness of the model. Data were analysed qualitatively to identify themes and intersections between themes. The JeMa2 model to conceptualize pharmacy-based health programs was used to build a theoretical model of the service. Stakeholders delineated: a clear target population (i.e., individuals ≥65 years old, with hypertension, with or without previous AF or stroke); the components of the service (i.e., patient education; self-monitoring at home; results evaluation, referral and follow-up); and a set of circumstances that may influence the implementation of the service (e.g., quality of the service, competency of the pharmacist, inter-professional relationships, etc.). A number of strategies were recommended to enable implementation (e.g.,. endorsement by leading cardiovascular organizations, appropriate communication methods and channels between the pharmacy and the general medical practice settings, etc.). A novel and preliminary model of a CPS aimed at enhancing the management of AF was generated from this participatory process. This model can be used to inform decision making processes aimed at adopting and piloting of the service. It is expected the co-designed service has been adapted to suit existing needs of patients and current care practices, which, in turn, may increase the feasibility and acceptance of the service when it is implemented into a real setting.

Perceived climate in physical activity settings.

PubMed

Gill, Diane L; Morrow, Ronald G; Collins, Karen E; Lucey, Allison B; Schultz, Allison M

2010-01-01

This study focused on the perceived climate for LGBT youth and other minority groups in physical activity settings. A large sample of undergraduates and a selected sample including student teachers/interns and a campus Pride group completed a school climate survey and rated the climate in three physical activity settings (physical education, organized sport, exercise). Overall, school climate survey results paralleled the results with national samples revealing high levels of homophobic remarks and low levels of intervention. Physical activity climate ratings were mid-range, but multivariate analysis of variation test (MANOVA) revealed clear differences with all settings rated more inclusive for racial/ethnic minorities and most exclusive for gays/lesbians and people with disabilities. The results are in line with national surveys and research suggesting sexual orientation and physical characteristics are often the basis for harassment and exclusion in sport and physical activity. The current results also indicate that future physical activity professionals recognize exclusion, suggesting they could benefit from programs that move beyond awareness to skills and strategies for creating more inclusive programs.

Adolescents and young adults with cancer: aspects of adherence - a questionnaire study.

PubMed

Kleinke, Anne Marie; Classen, Carl Friedrich

2018-01-01

For adolescents and young adults (AYAs), a cancer diagnosis represents an extraordinary strike in a vulnerable phase of life. They have special needs that the medical system has to take into consideration, and they exhibit a lower degree of therapy adherence than both older and younger patients. The purpose of this study was first to analyze the adherence of AYAs with cancer compared to a group of older patients and, second, to determine correlated parameters, with focus on the psychosocial interaction between physicians and patients. In 2012, a complete 1 year cohort of patients reported, by use of a questionnaire, to the Rostock clinical cancer registry, and a group of older patients were invited to answer a multi-item set of questionnaires on a volunteer basis, leading to a population-based cross-sectional analysis. This included a bias due to non-answering which is unavoidable in such a setting. The questionnaire consisted of well-established standard questionnaires, a questionnaire on adherence that has just recently been published, and a self-written questionnaire focusing on patient-physician relationship. The responses were analyzed for our current study. Gender, religion, education, age, anxiety, family atmosphere, or physician-patient relationship were not significantly correlated to adherence in AYAs. However, markedly more AYAs, as compared to the older patients group, considered breaking off therapy and reported suboptimal communication with the physicians. Only the perceived physical illness could be identified as a factor related to adherence among the AYA group. Our findings confirm the need for more focused approaches to serve the special needs of AYAs, with particular attention on specific items that showed up discriminating AYAs from older patients, that is, Internet use and communication with physicians. Here, further research is needed to examine adherence to specific treatment protocols.

Continuing professional development: issues raised by nurses and allied health professionals working in musculoskeletal settings.

PubMed

Haywood, Hannah; Pain, Helen; Ryan, Sarah; Adams, Jo

2013-09-01

Nurses and allied health professionals (AHPs) are required to evidence their engagement in continuing professional development (CPD) in order to retain their professional registration. Many challenges to CPD are reported, but little literature has explored pertinent CPD issues for clinicians with specialist roles or working in specialist services. No literature to date has explored the perceptions of CPD held by patients who receive these specialist services. Three focus groups and two conference calls were conducted with nurses, physiotherapists, podiatrists and occupational therapists who work in musculoskeletal (MSK) services; managers of these services; and people who use MSK services. These focus groups aimed: to explore the CPD needs and issues for this group of clinicians; to explore the perceptions of CPD held by people who have MSK conditions; and to compare the above with current literature to discern any factors specific to MSK settings. The focus groups and conference calls were audio-recorded. The recordings were coded by the researchers using a priori and inductive coding. The main issues discussed were: funding and time for CPD, providing examples of ways to provide CPD in spite of the challenges faced; that CPD needs changed with level of experience; initiatives by clinical specialists to reduce professional isolation; and future trends in CPD, including concerns about succession planning. The views of people with MSK conditions demonstrated an emphasis on communication skills that was seldom raised by managers and clinicians. Sufficient time, funding and provision of study leave were key to facilitating CPD activity for nurses and AHPs working in MSK services. People with MSK conditions particularly valued health professionals who combined good listening and communication skills with an attempt to understand what it was like to live with their condition. Copyright © 2012 John Wiley & Sons, Ltd.

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.

The language of change? Characterizations of in-group social position, threat, and the deployment of distinctive group attributes.

PubMed

Livingstone, Andrew G; Spears, Russell; Manstead, Antony S R

2009-06-01

A considerable body of research has shown that group members establish and emphasize characteristics or attributes that define their in-group in relation to comparison out-groups. We extend this research by exploring the range of ways in which members of the same social category (Welsh people) deploy a particular attribute (the Welsh language) as a flexible identity management resource. Through a thematic analysis of data from interviews and two public speeches, we examine how the deployment of the Welsh language is bound up with characterizations of the in-group's wider intergroup position (in terms of power relations and their legitimacy and stability), and one's position within the in-group. We focus in particular on the rhetorical and strategic value of such characterizations for policing in-group boundaries on the one hand, and for the in-group's intergroup position on the other. We conclude by emphasizing the need to (1) locate analyses of the uses and importance of group-defining attributes within the social setting that gives them meaning and (2) to appreciate such characterizations as attempts to influence, rather than simply reflect that setting.

Tinnitus retraining therapy: mixing point and total masking are equally effective.

PubMed

Tyler, Richard S; Noble, William; Coelho, Claudia Barros; Ji, Haihong

2012-01-01

Habituation to tinnitus cannot occur with total masking, an argument made by proponents of "tinnitus retraining therapy." We also compared the effectiveness of retraining therapy with mixing-point masking, total masking, and with counseling alone. Forty-eight tinnitus patients were randomly assigned to one of three groups: counseling, counseling plus bilateral noise generators set to completely mask the tinnitus, or counseling plus bilateral noise generators with a focus on the mixing point (partial masking just below total masking). A picture-based counseling protocol was used to assist in providing similar counseling among all three groups. The Tinnitus Handicap Questionnaire was administered before and after about 12 months of treatment. After 12 months, in the counseling group, three of 18 patients benefited significantly, in the mixing-point group, six of 19 patients benefited, and in the total masking group, four of 11 patients benefited from the treatment. The average decrease in the questionnaire was 16.7% for the counseling group, 31.6% for the retraining group, and 36.4% for the total masking group. No significant average differences among groups were observed. One premise of retraining therapy is incorrect; a focus on mixing-point masking is not required for habituation.

A Proposal for an Austrian Nursing Minimum Data Set (NMDS)

PubMed Central

Hackl, W.O.; Ammenwerth, E.

2014-01-01

Summary Objective Nursing Minimum Data Sets can be used to compare nursing care across clinical populations, settings, geographical areas, and time. NMDS can support nursing research, nursing management, and nursing politics. However, in contrast to other countries, Austria does not have a unified NMDS. The objective of this study is to identify possible data elements for an Austrian NMDS. Methods A two-round Delphi survey was conducted, based on a review of available NMDS, 22 expert interviews, and a focus group discussion. Results After reaching consensus, the experts proposed the following 56 data elements for an NMDS: six data elements concerning patient demographics, four data elements concerning data of the healthcare institution, four data elements concerning patient’s medical condition, 20 data elements concerning patient problems (nursing assessment, nursing diagnoses, risk assessment), eight data elements concerning nursing outcomes, 14 data elements concerning nursing interventions, and no additional data elements concerning nursing intensity. Conclusion The proposed NMDS focuses on the long-term and acute care setting. It must now be implemented and tested in the nursing practice. PMID:25024767

Understanding the digital divide in the clinical setting: the technology knowledge gap experienced by US safety net patients during teleretinal screening.

PubMed

George, Sheba; Moran, Erin; Fish, Allison; Ogunyemi, Lola

2013-01-01

Differential access to everyday technology and healthcare amongst safety net patients is associated with low technological and health literacies, respectively. These low rates of literacy produce a complex patient "knowledge gap" that influences the effectiveness of telehealth technologies. To understand this "knowledge gap", six focus groups (2 African-American and 4 Latino) were conducted with patients who received teleretinal screenings in U.S. urban safety-net settings. Findings indicate that patients' "knowledge gap" is primarily produced at three points: (1) when patients' preexisting personal barriers to care became exacerbated in the clinical setting; (2) through encounters with technology during screening; and (3) in doctor-patient follow-up. This "knowledge gap" can produce confusion and fear, potentially affecting patients' confidence in quality of care and limiting their disease management ability. In rethinking the digital divide to include the consequences of this knowledge gap faced by patients in the clinical setting, we suggest that patient education focus on both their disease and specific telehealth technologies deployed in care delivery.

Narrowing the creativity gap: the moderating effects of perceived support for creativity.

PubMed

DiLiello, Trudy C; Houghton, Jeffery D; Dawley, David

2011-01-01

This article examines the role of 3 types of perceived support for creativity in moderating the relation between creative self-efficacy and self-perceived creativity. The findings suggest significant interaction effects for perceived work-group support and supervisor support, but not for perceived organizational support. This study is among the first to (a) examine the importance of perceived support for creativity in unlocking creative potential and increasing creativity in organizations and (b) use interaction terms in structural equation modeling (SEM) to investigate moderator effects in an applied research setting. These results imply that organizational interventions focused on training supervisors and work-group members to support creativity in the workplace may be more effective than broader and less focused interventions at the organizational level.

Recruiting adolescents into qualitative tobacco research studies: experiences and lessons learned.

PubMed

McCormick, L K; Crawford, M; Anderson, R H; Gittelsohn, J; Kingsley, B; Upson, D

1999-03-01

An increasing barrier to the development and implementation of effective youth smoking prevention and cessation programs involves recruiting adolescents into research studies. Even for non-intervention studies, issues of consent, confidentiality, and motivation to participate are important considerations. In 1996, 11 Prevention Research Center sites across the country conducted qualitative research using focus groups to explore ethnic differences in smoking among adolescents. The diversity in strategies used to interest, motivate, and retain potential focus group subjects provided a rich data set for information about effective strategies and challenges to recruitment. This article presents an overview of recruitment methods used in a multi-site qualitative study on adolescent tobacco use, reports on successful and less successful strategies, and provides recommendations for future recruitment.

Telling Their Stories: Primary Care Practitioners' Experience Evaluating and Reporting Injuries Caused by Child Abuse

ERIC Educational Resources Information Center

Flaherty, Emalee G.; Jones, Rise; Sege, Robert

2004-01-01

Objective: To learn about primary care physicians' experiences in identifying and reporting injuries caused by physical abuse. Method: Two qualitative analysts facilitated a focus group of six Chicago area, primary care physicians. Physicians representing diverse practice settings were selected to participate in the discussion. The analysts…

Students' Perceptions of Effective EFL Teachers in University Settings in Cyprus

ERIC Educational Resources Information Center

Kourieos, Stella; Evripidou, Dimitris

2013-01-01

This study sought to identify what characteristics and teaching behaviours describe effective EFL University teachers as perceived by Cypriot students. Data were collected by means of a questionnaire and focus group interviews. Findings have provided evidence that effective language teaching seems to be related to a more learner-centred approach…

Integrating mHealth Mobile Applications to Reduce High Risk Drinking among Underage Students

ERIC Educational Resources Information Center

Kazemi, Donna M.; Cochran, Allyson R.; Kelly, John F.; Cornelius, Judith B.; Belk, Catherine

2014-01-01

Objective: College students embrace mobile cell phones (MCPs) as a primary communication and entertainment device. The aim of this study was to investigate college students' perceptions toward using mHealth technology to deliver interventions to prevent high-risk drinking and associated consequences. Design/setting: Four focus group interviews…

Asking to Listen: Towards a Youth Perspective on Sexual Health Education and Needs

ERIC Educational Resources Information Center

MacDonald, Jo-Ann; Gagnon, Anita J.; Mitchell, Claudia; Di Meglio, Giuseppina; Rennick, Janet E.; Cox, Joseph

2011-01-01

In this three-phase exploratory study, we used participatory approaches with youth in a small Canadian province. Through iterative focus groups in school settings, we examined young men and women's perspectives regarding factors important to taking control of their sexual health behaviour. Youth aged 15-17 discussed sexual health through…

Using Marketing Research Techniques To Improve Quality and Service.

ERIC Educational Resources Information Center

Rahilly, Tony

Marketing in the business world has long used focus group interviews and survey techniques to explore the attitudes, behaviors, and perceptions of their customers. In the college setting, these same techniques are now being used to improve program quality, assess the effectiveness of publications, and explore the image of the college. At Durham…

What Is the Difference between a Calorie and a Carbohydrate?--Exploring Nutrition Education Opportunities in Alternative School Settings

ERIC Educational Resources Information Center

Norquest, Michele; Phelps, Josh; Hermann, Janice; Kennedy, Tay

2015-01-01

Extension-based nutrition educators have indicated current curricula do not engage alternative school students' interests. The study reported here explored nutrition education opportunities at alternative schools in Oklahoma. Data collection involved focus groups gathering student perspectives regarding preferred teaching and learning styles, and…

Evaluation of a Numeracy Intervention Program Focusing on Basic Numerical Knowledge and Conceptual Knowledge: A Pilot Study.

ERIC Educational Resources Information Center

Kaufmann, Liane; Handl, Pia; Thony, Brigitte

2003-01-01

In this study, six elementary grade children with developmental dyscalculia were trained individually and in small group settings with a one-semester program stressing basic numerical knowledge and conceptual knowledge. All the children showed considerable and partly significant performance increases on all calculation components. Results suggest…

Tikkun Olam: A Model for Healing the World.

ERIC Educational Resources Information Center

Berman, Dene S.; Davis-Berman, Jennifer

1999-01-01

Discusses Tikkun Olam--the Jewish tenet of healing the world through individual good deeds--and its applicability to the practice of adventure therapy. Focuses on the therapeutic relationship, as it develops in group settings, and the role of adventure leaders and therapists in nourishing such relationships to provide a vehicle for healing or…

Students' Experiences of Attending an Innovative Occupational Therapy Professional Practice Placement in a Childcare Setting

ERIC Educational Resources Information Center

Yu, Mong-lin; Brown, Ted; Etherington, Jamie

2018-01-01

This study investigated occupational therapy students' experiences of their alternative fieldwork placement at one childcare center where there was no established occupational therapy service. A semi-structured focus group interview explored four students' placement experiences. The interview was audio-recorded, transcribed verbatim, and content…

When Social Identities Collide: Commentary on "Gender in the Management Education Classroom"

ERIC Educational Resources Information Center

Patton, Eric

2010-01-01

This commentary to "Gender in the Management Education Classroom" (Bilimoria, O'Neil, Hopkins, & Murphy, 2010) employs social identity and self-categorization theory to analyze the incident described in the article. In any MBA classroom, students are dealing with multiple group memberships. Similar to workplace settings, when the focus is on…

Infant Feeding Practices: Perceptions of Native American Mothers and Health Paraprofessionals

ERIC Educational Resources Information Center

Horodynski, Mildred A; Calcatera, Mary; Carpenter, Amanda

2012-01-01

Objective: To ascertain infant feeding practices and to explore the feasibility of an in-home feeding intervention with Native American Indian (NAI) mothers in six Native American communities in the United States (US). Design: Qualitative focus group study. Setting: Six Native American communities in the Midwest region of the United States.…

Reframing School Violence: Listening to Voices of Students.

ERIC Educational Resources Information Center

Haselswerdt, Michael V.; Lenhardt, Ann Marie C.

2003-01-01

Focus groups with 82 middle and high school students from diverse school settings elicited four themes: (1) definitions of school violence must be expanded beyond physical assault; (2) teachers should be more involved in establishing a safe environment; (3) respect is the key to effective communication; and (4) connections with school and adults…

Six Characteristics of Nutrition Education Videos That Support Learning and Motivation to Learn

ERIC Educational Resources Information Center

Ramsay, Samantha A.; Holyoke, Laura; Branen, Laurel J.; Fletcher, Janice

2012-01-01

Objective: To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children. Methods: Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus…

School Wellness Policy Implementation: Attitudes of School Professionals and Parents in Elementary Schools

ERIC Educational Resources Information Center

Molaison, Elaine Fontenot; Carr, Deborah H.; Federico, Holly A.

2008-01-01

Purpose/Objectives: The purpose of this research was to explore the attitudes and barriers related to the implementation of the local wellness policy (LWP) in the elementary school setting. Methods: Researchers used a two-phase approach. Phase I included focus group interviews with school nutrition directors, principals, teachers, parents, and…

The CIQG International Quality Principles: Toward a Shared Understanding of Quality. CIQG Publication Series

ERIC Educational Resources Information Center

Uvalic-Trumbic, Stamenka

2016-01-01

The idea of developing International Quality Principles emerged from a dialogue and debate among colleagues from many countries at the Council for Higher Education Accreditation (CHEA) International Quality Group (CIQG) 2014 Annual Meeting. The discussion focused on whether a single set of international standards for academic quality in higher…

Introduction to Population Modeling.

ERIC Educational Resources Information Center

Frauenthal, James C.

The focus is on the formulation and solution of mathematical models with the idea of a population employed mainly as a pedogogical tool. If the biological setting is stripped away, the material can be interpreted as topics or the qualitative behavior of differential and difference equations. The first group of models investigate the dynamics of a…

American Indians' Construction of Cultural Identity.

ERIC Educational Resources Information Center

Glatzmaier, Luann; Myers, Monique; Bordogna, Melissa A.

This paper examines how American Indians construct and describe their own cultural identities. In particular, it focuses on cultural group identity from the perspective of three American Indians living in an urban setting, and on the ways that cultural identity can be communicated and enacted. Two American Indian women and one American Indian man,…

Developing Inquiry-as-Stance and Repertoires of Practice: Teacher Learning across Two Settings

ERIC Educational Resources Information Center

Braaten, Melissa L.

2011-01-01

Sixteen science educators joined a science teacher video club for one school year to collaboratively inquire into each other's classroom practice through the use of records of practice including classroom video clips and samples of student work. This group was focused on developing ambitious, equitable science teaching that capitalizes on…

Students' Needs Analysis in an EFL Program for University Professors

ERIC Educational Resources Information Center

Bedoya, Paula Andrea; Valencia, Luz María; Montoya, Juan Carlos

2016-01-01

This study sets out to investigate professors' needs from an English as a foreign language program in a public university regarding demands, interests, and lacks based on the methodology of needs analysis. Data collected through a survey, focus groups, and individual interviews showed that professors need to meet the institutional language policy…

An Anthropological Paradigm for the Study of Youth and Drugs

ERIC Educational Resources Information Center

Soloway, Irving H.; And Others

1977-01-01

Authors note that the focus of their current research is substantive. They have begun to analyze and explicate the native defined views of an age-stratified set of peer groups with respect to numerous variables such as their concepts of health and sickness and their definitions of drugs. (Author/AM)

Gifted Hispanic Identity: Exploring Relationships among Resilience, Goals and Academic Orientation

ERIC Educational Resources Information Center

Forrester, Matthew Mitchell

2012-01-01

The purpose of this phenomenological analysis was to explore the identity development of gifted Hispanic male students in the middle school setting. The study used a survey, multiple interviews and observations, along with focus group data to acquire data in four principle areas: academic orientation, ethnic identity, resilience and goals. Results…

Reforming the Environment: The Influence of the Roundtable Classroom Design on Interactive Learning

ERIC Educational Resources Information Center

Parsons, Caroline S.

2017-01-01

This study investigated the influence of physical and virtual learning spaces on interactive learning in a college and university setting. Qualitative analysis of an undergraduate liberal arts program that employs the use of roundtable classrooms was conducted. Interview and focus group data from students and faculty, along with classroom…

School Mission Statements and School Performance: A Mixed Research Investigation

ERIC Educational Resources Information Center

Slate, John R.; Jones, Craig H.; Wiesman, Karen; Alexander, Jeanie; Saenz, Tracy

2008-01-01

Background: Schools in K-12 have generated mission statements as ways of focusing their efforts and energies in specific areas. These mission statements vary by institutional setting as a function of the stakeholders and constituent groups who facilitate their development. To date, no studies were located in which the mission statements of…

Image Making of Arab Americans: Implications for Teachers in Diverse Settings.

ERIC Educational Resources Information Center

Suleiman, Mahmoud F.

Arab Americans are a very diverse group. Misinformation about Arab culture plays a significant role in American perceptions and understandings of Arab American students. Whenever major events occur in the Middle East, Arab Americans become the focus of investigation. However, the Arab American community has remained relatively silent. The media…

Getting in Touch with Paramedic Student Career Intentions

ERIC Educational Resources Information Center

O'Meara, Peter; Tourle, Vianne; Madigan, Veronica; Lighton, David

2012-01-01

Objective: This study of paramedic and nursing/paramedic students aimed to determine the initial career intentions of full-time paramedic students and to identify the key factors that influence their career choices. Design: A longitudinal study design, utilizing surveys and a focus group, was employed. Setting: The study was conducted in an…

Exploring and Leveraging Chinese International Students' Strengths for Success

ERIC Educational Resources Information Center

He, Ye; Hutson, Bryant

2018-01-01

This study used an Appreciative Education framework to explore the strengths of Chinese international students and to identify areas where support is needed during their transition to U.S. higher education settings. Using a convergent mixed methods design with data collected from surveys, interviews and focus groups, the complex nature of the…

Social Interaction and Stereotypic Responses to Homosexuals.

ERIC Educational Resources Information Center

Farrell, Ronald A.; Morrione, Thomas J.

This work focuses on the variations in societal responses perceived by male homosexuals in various group settings of interaction and on the relationship of these responses to their social status and related behavioral characteristics. Conclusions were based on the analysis of data collected from a sampling of 148 male homosexuals in and around a…

Criticality's Affective Entanglements: Rethinking Emotion and Critical Thinking in Higher Education

ERIC Educational Resources Information Center

Danvers, Emily Clair

2016-01-01

Critical thinking is often understood as a set of tangible, transferrable and measurable skills and competencies. Yet, it is also an intensely affective experience that is complex, contingent and contextualised. Using interview, focus group and observation data conducted with 15 first-year undergraduate social science students at a UK…

Teacher-Parent Cooperation: Strategies to Engage Parents in Their Children's School Lives

ERIC Educational Resources Information Center

Symeou, Loizos

2006-01-01

This article examines the collaboration of 2 teachers with the families of their pupils. The data were collected during an ethnographic study conducted in a rural school in Cyprus. The data set includes individual interviews, focus groups, observations, and the researcher's journal. These 2 teachers, with different perspectives on parental…

Mexican American Parents' Perceptions of Childhood Risk Factors for Type 2 Diabetes

ERIC Educational Resources Information Center

Head, Barbara J.; Barr, Kathleen L.; Baker, Sharon K.

2011-01-01

A study was conducted to identify the norms, values, and perceptions of urban immigrant Mexican American (MA) parents of school children relative to physical activity, healthy eating, and child risk factors for type 2 diabetes. Investigators facilitated five focus groups in an urban elementary school setting and analyzed data using qualitative…

Use of Qualitative Research to Inform Development of Nutrition Messages for Low-Income Mothers of Preschool Children

ERIC Educational Resources Information Center

White, Alicie H.; Wilson, Judy F.; Burns, Adam; Blum-Kemelor, Donna; Singh, Anita; Race, Patricia O.; Soto, Valery; Lockett, Alice F.

2011-01-01

Objective: To develop and test nutrition messages and supporting content with low-income mothers for use with theory-based interventions addressing fruit and vegetable consumption and child-feeding practices. Design: Six formative and 6 evaluative focus groups explored message concepts and tested messages, respectively. Setting: Research…

Exploring Student Engagement in STEM Education: An Examination of STEM Schools, STEM Programs, and Traditional Schools

ERIC Educational Resources Information Center

Franco, M. Suzanne; Patel, Nimisha H.

2017-01-01

High school students' perceptions and experiences regarding student engagement were investigated using 32 focus group sessions across 4 different types of STEM education settings in 2 metropolitan areas in the Midwest. Students' understandings and experiences related to student engagement were reflected via 5 categories: students' thinking of…

High School Students' Perceptions of Alcohol Prevention Programs

ERIC Educational Resources Information Center

Ogenchuk, Marcella

2012-01-01

The purpose of this study was to explore Grade 11 students' perceptions of programs related to the prevention of alcohol use in high school settings through an analysis of quantitative and qualitative data elicited from student questionnaires (n=452) and focus groups. It was found that students felt a need for increased information on alcohol…

Reconceptualising Relational Aggression as Strategic Communication: Girls, Goals, and Their Peer Groups

ERIC Educational Resources Information Center

Page, Angela; Charteris, Jennifer

2017-01-01

Since its inception, relational aggression has been conceptualised as a set of destructive attempts by young girls to get their own way, and these aggressive acts have been demonised in public and media debate. This article challenges the prevailing developmental psychopathologisation literature to centre the focus on functionality, positioning…

Guidelines for a cancer prevention smartphone application: A mixed-methods study.

PubMed

Ribeiro, Nuno; Moreira, Luís; Barros, Ana; Almeida, Ana Margarida; Santos-Silva, Filipe

2016-10-01

This study sought to explore the views and experiences of healthy young adults concerning the fundamental features of a cancer prevention smartphone app that seeks behaviour change. Three focus groups were conducted with 16 healthy young adults that explored prior experiences, points of view and opinions about currently available health-related smartphone apps. Then, an online questionnaire was designed and applied to a larger sample of healthy young adults. Focus group and online questionnaire data were analysed and confronted. Study results identified behaviour tracking, goal setting, tailored information and use of reminders as the most desired features in a cancer prevention app. Participants highlighted the importance of privacy and were reluctant to share personal health information with other users. The results also point out important dimensions to be considered for long-term use of health promotion apps related with usability and perceived usefulness. Participants didn't consider gamification features as important dimensions for long-term use of apps. This study allowed the definition of a guideline set for the development of a cancer prevention app. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

PubMed

Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

2018-01-01

Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

Perceptions of quality in primary health care: perspectives of patients and professionals based on focus group discussions

PubMed Central

2014-01-01

Background The EUprimecare project-team assessed the perception of primary health care (PHC) professionals and patients on quality of organization of PHC systems in the participating countries: Estonia, Finland, Germany, Hungary, Italy, Lithuania and Spain. This article presents the aggregated opinions, expectations and priorities of patients and professionals along some main dimensions of quality in primary health care, such as access, equity, appropriateness and patient- centeredness. Methods The focus group technique was applied in the study as a qualitative research method for exploration of attitudes regarding the health care system and health service. Discussions were addressing the topics of: general aspects of quality in primary health care; possibilities to receive/provide PHC services based on both parties needs; determinant factors of accessibility to PHC services; patient centeredness. The data sets collected during the focus group discussions were evaluated using the method of thematic analysis. Results There were 14 focus groups in total: a professional and a patient group in each of the seven partner countries. Findings of the thematic analysis were summarized along the following dimensions: access and equity, appropriateness (coordination, continuity, competency and comprehensiveness) and patient centeredness. Conclusions This study shows perceptions and views of patients in interaction with PHC and opinion of professionals working in PHC. It serves as source of criteria with relevance to everyday practice and experience. The criteria mentioned by patients and by health care professionals which were considered determining factors of the quality in primary care were quite similar among the investigated countries. However, the perception and the level of tolerance regarding some of the criteria differed among EUprimecare countries. Among these dissimilar criteria we especially note the gate-keeping role of GPs, the importance of nurses' competency and the acceptance of waiting times. The impact of waiting time on patient satisfaction is obvious; the influence of equity and access to PHC services are more dependent on the equal distribution of settings and doctors in urban and rural area. Foreseen shortage of doctors is expected to have a substantial influence on patient satisfaction in the near future. PMID:24974196

Lessons learned from a lateral violence and team-building intervention.

PubMed

Barrett, Ann; Piatek, Carolyn; Korber, Susan; Padula, Cynthia

2009-01-01

Lateral violence is likely to exist in settings characterized by poor leadership and lack of clearly articulated roles, expectations, and processes that guide behavior. The purposes of this process improvement project were to (1) identify and improve baseline levels of nurse satisfaction and group cohesion through planned unit-based interventions, (2) determine the effect of a team-building intervention on factors that impact cohesive team functioning, and (3) determine the effect of lateral violence training and communication style differences in improving team cohesion. The sample consisted of registered nurses (RNs) from 4 diverse patient care areas, chosen on the basis of low scores on the National Database of Nursing Quality Indicators (NDNQI) RN-RN interaction subscale. A quasi-experimental pre-post intervention design without a control group was employed. The intervention focused on lateral violence and team building. A qualitative component focused on the impact of the intervention on overall group dynamics and processes. RN scores on the Group Cohesion Scale (P = .037) and the RN-RN interaction scores improved postintervention. Group sessions focused on building trust, identifying and clarifying roles, engaging staff in decision making, role-modeling positive interactions, and holding each other accountable. Key to a cohesive environment is an effective nurse manager able to drive and sustain change.

[Statistical Process Control (SPC) can help prevent treatment errors without increasing costs in radiotherapy].

PubMed

Govindarajan, R; Llueguera, E; Melero, A; Molero, J; Soler, N; Rueda, C; Paradinas, C

2010-01-01

Statistical Process Control (SPC) was applied to monitor patient set-up in radiotherapy and, when the measured set-up error values indicated a loss of process stability, its root cause was identified and eliminated to prevent set-up errors. Set up errors were measured for medial-lateral (ml), cranial-caudal (cc) and anterior-posterior (ap) dimensions and then the upper control limits were calculated. Once the control limits were known and the range variability was acceptable, treatment set-up errors were monitored using sub-groups of 3 patients, three times each shift. These values were plotted on a control chart in real time. Control limit values showed that the existing variation was acceptable. Set-up errors, measured and plotted on a X chart, helped monitor the set-up process stability and, if and when the stability was lost, treatment was interrupted, the particular cause responsible for the non-random pattern was identified and corrective action was taken before proceeding with the treatment. SPC protocol focuses on controlling the variability due to assignable cause instead of focusing on patient-to-patient variability which normally does not exist. Compared to weekly sampling of set-up error in each and every patient, which may only ensure that just those sampled sessions were set-up correctly, the SPC method enables set-up error prevention in all treatment sessions for all patients and, at the same time, reduces the control costs. Copyright © 2009 SECA. Published by Elsevier Espana. All rights reserved.

What does it take to set goals for self-management in primary care? A qualitative study.

PubMed

Lenzen, Stephanie Anna; van Dongen, Jerôme Jean Jacques; Daniëls, Ramon; van Bokhoven, Marloes Amantia; van der Weijden, Trudy; Beurskens, Anna

2016-12-01

There is an increasing number of patients with a chronic illness demanding primary care services. This demands for effective self-management support, including collaborative goal setting. Despite the fact that primary care professionals seem to have difficulties implementing goal setting, little information is available about the factors influencing the complexity of this process in primary care. The aim of this study was to contribute to an understanding of the complexity of self-management goal setting in primary care by exploring experts' and primary care professionals' experiences with self-management goal setting and viewpoints regarding influencing factors. A descriptive qualitative research methodology was adopted. Two focus groups and three individual interviews were conducted (total participants n = 17). Thematic content analysis was used to analyse the data. The findings were categorized into four main themes with subordinated subthemes. The themes focus around the complexity of setting non-medical goals and around professionals' skills and attitudes to negotiate and decide about goals with patients. Furthermore, patients' skills and attitudes for goal setting and the integration of goal setting in the time available were formulated as themes. Setting self-management goals in primary care, especially in family medicine, might require a shift from a medical perspective to a biopsychosocial perspective, with an increasing role set aside for the professional to coach the patient in expressing his self-management goals and to take responsibility for these goals. © The Author 2016. Published by Oxford University Press.

Pile sorting innovations: exploring gender norms, power and equity in sub-Saharan Africa.

PubMed

Bourey, Christine; Stephenson, Rob; Bartel, Doris; Rubardt, Marcie

2012-01-01

Understanding gender norms, power and equity is important for developing successful sexual and reproductive health interventions. However, little attention has been given to how to capture the gender ideals and imbalances that inform these relationships in low resource settings. Pile sorting exercises were conducted in four gender-segregated focus groups in Ethiopia and Kenya. Each group received cards illustrated with a man, woman and man and woman together and cards labelled with duties and decisions. Participants discussed and decided together whether men, women or both performed each duty and decision and assigned the cards accordingly. Participants then reflected on and physically manipulated the piles to challenge gender norms, investigate role flexibility and identify agents of social change. Data collected included photographs of the pile sorts and recordings of the discussions. Conducting pile sorting within focus group discussions enabled comparative analyses of gender norms, while enriching data by focusing discussions and encouraging consensus building. Innovative applications facilitated participants' abilities to engage abstract concepts, reflecting on issues of gender norms, power and equity.

What HIV-Positive Young Women Want from Behavioral Interventions: A Qualitative Approach

PubMed Central

Brothers, Jennifer; Lemos, Diana

2012-01-01

Abstract Young women living with HIV in the United States face many social and psychological challenges, including involvement in health care and secondary prevention efforts. The factors that put these young women at risk for HIV acquisition initially, such as poverty, gender roles, cultural norms, and limited perceived control over sexual relationships, continue to place them at risk for both adverse mental and physical health outcomes that impact their daily lives and secondary prevention efforts. This study utilized focus groups with young HIV-positive women in order to better understand their perceived problems and pressures and to inform a developmentally appropriate secondary prevention intervention for young HIV-positive women that could be implemented in clinical care settings. Focus groups with young HIV-positive women were convened in three U.S. cities: Baltimore, Chicago, and Tampa. A total of 17 young, HIV-positive women, age range 17–24 (mean age=21), participated in the focus groups. This article describes the psychological and social challenges these young women face as well as their suggestions regarding secondary HIV prevention intervention components. PMID:22675725

Comparing young people's experience of technology-delivered v. face-to-face mindfulness and relaxation: two-armed qualitative focus group study.

PubMed

Tunney, Conall; Cooney, Patricia; Coyle, David; O'Reilly, Gary

2017-04-01

Background The current popularity of mindfulness-based practices has coincided with the increase in access to mobile technology. This has led to many mindfulness apps and programs becoming available, some specifically for children. However, little is known about the experience of engaging with mindfulness through these mediums. Aims To explore children's experience of mindfulness delivered both face-to-face and through a computer game to highlight any differences or similarities. Method A two-armed qualitative focus groups design was used to explore children's experiences. The first arm offered mindfulness exercises in a traditional face-to-face setting with guided meditations. The second arm offered mindfulness exercises through a computer game avatar. Results Themes of relaxation, engagement, awareness, thinking, practice and directing attention emerged from both arms of focus groups. Subthematic codes highlight key differences as well as similarities in the experience of mindfulness. Conclusions These results indicate that mindfulness delivered via technology can offer a rich experience. © The Royal College of Psychiatrists 2017.

Barriers to disclosing and reporting violence among women in Pakistan: findings from a national household survey and focus group discussions.

PubMed

Andersson, Neil; Cockcroft, Anne; Ansari, Umaira; Omer, Khalid; Ansari, Noor M; Khan, Amir; Chaudhry, Ubaid Ullah

2010-11-01

Worldwide, many women who experience domestic violence keep their experience secret. Few report to official bodies. In a national survey of abuse against women in Pakistan, we examined factors related to disclosure: women who had experienced physical violence telling someone about it. In focus groups, we explored why women do not report domestic violence. Nearly one third of the 23,430 women interviewed had experienced physical violence. Only 35% of them had told anyone about it, almost always someone within their own family. Several personal and family factors were associated with disclosure. Having discussed the issue and feeling empowered to discuss violence were consistent associations. Of the 7,895 women who had suffered physical violence, only 14 had reported the matter to the police. Female focus groups said women who report violence risk their reputation and bring dishonor to the family; women fear reporting violence because it may exacerbate the problem and may lead to separation or divorce and loss of their children. Focus groups of men and women were skeptical about community leaders, councilors, and religious leaders supporting reporting of violence. They suggested setting up local groups where abused women could seek help and advice. There are strong disincentives to reporting violence in Pakistan, which are well known to women. Until better systems for reporting and dealing with reported cases are in place, domestic violence will continue to be a hidden scourge here and elsewhere.

Stuck in the catch 22: attitudes towards smoking cessation among populations vulnerable to social disadvantage.

PubMed

Pateman, Kelsey; Ford, Pauline; Fizgerald, Lisa; Mutch, Allyson; Yuke, Kym; Bonevski, Billie; Gartner, Coral

2016-06-01

To explore how smoking and smoking cessation is perceived within the context of disadvantage, across a broad cross-section of defined populations vulnerable to social disadvantage. Qualitative focus groups with participants recruited through community service organizations (CSO). Metropolitan and regional settings in Queensland, Australia. Focus groups were held at the respective CSO facilities. Fifty-six participants across nine focus groups, including people living with mental illness, people experiencing or at risk of homelessness (adult and youth populations), people living with HIV, people living in a low-income area and Indigenous Australians. Thematic, in-depth analysis of focus group discussions. Participant demographic information and smoking history was recorded. Smoking behaviour, smoking identity and feelings about smoking were reflective of individual circumstances and social and environmental context. Participants felt 'trapped' in smoking because they felt unable to control the stressful life circumstances that triggered and sustained their smoking. Smoking cessation was viewed as an individual's responsibility, which was at odds with participants' statements about the broader factors outside of their own control that were responsible for their smoking. Highly disadvantaged smokers' views on smoking involve contradictions between feeling that smoking cessation involves personal responsibility, while at the same time feeling trapped by stressful life circumstances. Tobacco control programmes aiming to reduce smoking among disadvantaged groups are unlikely to be successful unless the complex interplay of social factors is carefully considered. © 2015 Society for the Study of Addiction.

Two vignettes of adolescent sexual disclosure: guidance for HIV clinical practice

PubMed Central

Lichtenstein, Bronwen; Rodgers, Cynthia; Marefka, Lauren EB; Hinson, Marla D; Cook-Heard, Dayna; Rygiel, Stephen D; Sturdevant, Marsha S

2016-01-01

HIV-positive adolescents are required by law to notify sexual partners, but can find it difficult to achieve this goal. This article offers practice guidance for counselling HIV-positive adolescents about sexual disclosure in clinical settings and for building confidence in managing sexual lives with HIV. We use two vignettes to illustrate key differences between perinatally and sexually infected adolescents in terms of readiness to disclose, and include a set of strategies for both groups that can be tailored to individual circumstances and contexts. The toolbox of strategies we describe include pre-counselling, focused counselling, social support groups and technical support. Pre-counselling helps to identify barriers and motivations to sexual disclosure and is followed by counselling sessions in which the focus is on role playing and sexual scripts for disclosure. Peer-led support groups are designed to boost adolescent confidence, and pre-paid cell phones, text messaging, ready-dial phone numbers and a private Facebook page provide back-up support and out-of-hours contact. Since sexual disclosure can be a risky proposition, safety plans, such as having an emergency contact person, should always be in place. These strategies are designed to empower vulnerable adolescents, foster trust between patient and provider, and reduce HIV transmission to sexual partners. PMID:28989498

Two vignettes of adolescent sexual disclosure: guidance for HIV clinical practice.

PubMed

Lichtenstein, Bronwen; Rodgers, Cynthia; Marefka, Lauren Eb; Hinson, Marla D; Cook-Heard, Dayna; Rygiel, Stephen D; Sturdevant, Marsha S

2017-01-01

HIV-positive adolescents are required by law to notify sexual partners, but can find it difficult to achieve this goal. This article offers practice guidance for counselling HIV-positive adolescents about sexual disclosure in clinical settings and for building confidence in managing sexual lives with HIV. We use two vignettes to illustrate key differences between perinatally and sexually infected adolescents in terms of readiness to disclose, and include a set of strategies for both groups that can be tailored to individual circumstances and contexts. The toolbox of strategies we describe include pre-counselling, focused counselling, social support groups and technical support. Pre-counselling helps to identify barriers and motivations to sexual disclosure and is followed by counselling sessions in which the focus is on role playing and sexual scripts for disclosure. Peer-led support groups are designed to boost adolescent confidence, and pre-paid cell phones, text messaging, ready-dial phone numbers and a private Facebook page provide back-up support and out-of-hours contact. Since sexual disclosure can be a risky proposition, safety plans, such as having an emergency contact person, should always be in place. These strategies are designed to empower vulnerable adolescents, foster trust between patient and provider, and reduce HIV transmission to sexual partners.

Using Community Partnerships to Better Understand the Barriers to Using an Evidence-Based, Parent-Mediated Intervention for Autism Spectrum Disorder in a Medicaid System.

PubMed

Pickard, Katherine E; Kilgore, Amanda N; Ingersoll, Brooke R

2016-06-01

Service use disparities have been noted to impede under-resourced families' ability to access high-quality services for their child with autism spectrum disorder (ASD). These disparities are particularly relevant for parent-mediated interventions and may suggest a lack of fit between these interventions and the needs of under-resourced community settings. This study used Roger's Diffusion of Innovations theory to guide community partnerships aimed at understanding the perceived compatibility, complexity, and relative advantage of using an evidence-based, parent-mediated intervention (Project ImPACT) within a Medicaid system. Three focus groups were conducted with 16 Medicaid-eligible parents, and three focus groups were conducted with 16 ASD providers operating within a Medicaid system. Across all groups, parents and providers reported general interest in using Project ImPACT. However, primary themes emerged regarding the need to (a) reduce the complexity of written materials; (b) allow for a more flexible program delivery; (c) ensure a strong parent-therapist alliance; (d) involve the extended family; and (e) help families practice the intervention within their preexisting routines. Results are discussed as they relate to the design and fit of evidence-based, parent-mediated interventions for under-resourced community settings. © Society for Community Research and Action 2016.

Relevant patient perceptions and experiences for evaluating quality of interaction with physiotherapists during outpatient rehabilitation: a qualitative study.

PubMed

Del Baño-Aledo, M Elena; Medina-Mirapeix, Francesc; Escolar-Reina, Pilar; Montilla-Herrador, Joaquina; Collins, Sean M

2014-03-01

To identify elements of the physiotherapist-patient interaction considered by patients when they evaluate the quality of care in outpatient rehabilitation settings. A qualitative study with nine focus groups, Two researchers conducted the focus groups, and a topic guide with predetermined questions was used. Each group discussion was audiotaped,, transcribed verbatim and analyzed thematically according to a modified grounded theory approach. Three postacute ambulatory centers in Barcelona, Madrid and Seville (Spain). Fifty-seven adults undergoing outpatient rehabilitation for musculoskeletal conditions/injuries. Patients based their evaluations of quality of care on their assessment of physiotherapists' willingness to provide information and education, technical expertise and interpersonal manners (eg. respect, emotional support and sensitivity changes in the patient's status). Both positive and negative aspects of the physiotherapist-patient interaction emerged under all these themes, except for friendly and respectful communication. This study identified which elements of the physiotherapist-patient interaction are considered by patients when evaluating the quality of care in rehabilitation outpatient settings. Further research should work to develop self-report questionnaires about patients' experiences of the physiotherapist-patient interaction in rehabilitation services to provide empirical and quantitative evidence. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Barriers and enabling factors for work-site physical activity programs: a qualitative examination.

PubMed

Fletcher, Gena M; Behrens, Timothyh K; Domina, Lorie

2008-05-01

Work sites offer a productive setting for physical activity (PA) promoting interventions. Still, PA participation remains low. Thus, the purpose of this study was to examine the reasoning behind commonly reported barriers and enabling factors to participation in PA programs in a work-site setting. Employees from a large city government were recruited to participate in focus groups, stratified by white- and blue-collar occupations. Responses from open-ended questions about factors influencing participation in PA programs were audio recorded and transcribed verbatim. Resulting data were analyzed with open and axial coding. The sample consisted of 60 employees composing 9 focus groups. Although time was the most common barrier between both groups, white-collars workers responded that scheduling and work conflicts were the most common barrier concerning time. Blue-collar workers indicated shift work as their most common barrier. In addition, health was a significant enabling factor for both occupational categories. White-collar workers were much more concerned with appearances and were more highly motivated by weight loss and the hopefulness of quick results than were blue-collar workers. These findings are important in the understanding of PA as it relates to the reasoning behind participation in work-site programs in regard to occupational status.

Consumer Attitudes and Perceptions on mHealth Privacy and Security: Findings From a Mixed-Methods Study.

PubMed

Atienza, Audie A; Zarcadoolas, Christina; Vaughon, Wendy; Hughes, Penelope; Patel, Vaishali; Chou, Wen-Ying Sylvia; Pritts, Joy

2015-01-01

This study examined consumers' attitudes and perceptions regarding mobile health (mHealth) technology use in health care. Twenty-four focus groups with 256 participants were conducted in 5 geographically diverse locations. Participants were also diverse in age, education, race/ethnicity, gender, and rural versus urban settings. Several key themes emerged from the focus groups. Findings suggest that consumer attitudes regarding mHealth privacy/security are highly contextualized, with concerns depending on the type of information being communicated, where and when the information is being accessed, who is accessing or seeing the information, and for what reasons. Consumers frequently considered the tradeoffs between the privacy/security of using mHealth technologies and the potential benefits. Having control over mHealth privacy/security features and trust in providers were important issues for consumers. Overall, this study found significant diversity in attitudes regarding mHealth privacy/security both within and between traditional demographic groups. Thus, to address consumers' concerns regarding mHealth privacy and security, a one-size-fits-all approach may not be adequate. Health care providers and technology developers should consider tailoring mHealth technology according to how various types of information are communicated in the health care setting, as well as according to the comfort, skills, and concerns individuals may have with mHealth technology.

Granularity refined by knowledge: contingency tables and rough sets as tools of discovery

NASA Astrophysics Data System (ADS)

Zytkow, Jan M.

2000-04-01

Contingency tables represent data in a granular way and are a well-established tool for inductive generalization of knowledge from data. We show that the basic concepts of rough sets, such as concept approximation, indiscernibility, and reduct can be expressed in the language of contingency tables. We further demonstrate the relevance to rough sets theory of additional probabilistic information available in contingency tables and in particular of statistical tests of significance and predictive strength applied to contingency tables. Tests of both type can help the evaluation mechanisms used in inductive generalization based on rough sets. Granularity of attributes can be improved in feedback with knowledge discovered in data. We demonstrate how 49er's facilities for (1) contingency table refinement, for (2) column and row grouping based on correspondence analysis, and (3) the search for equivalence relations between attributes improve both granularization of attributes and the quality of knowledge. Finally we demonstrate the limitations of knowledge viewed as concept approximation, which is the focus of rough sets. Transcending that focus and reorienting towards the predictive knowledge and towards the related distinction between possible and impossible (or statistically improbable) situations will be very useful in expanding the rough sets approach to more expressive forms of knowledge.

Radiologic-Pathologic Correlation of Solid Portions on Thin-section CT Images in Lung Adenocarcinoma: A Multicenter Study.

PubMed

Yanagawa, Masahiro; Kusumoto, Masahiko; Johkoh, Takeshi; Noguchi, Masayuki; Minami, Yuko; Sakai, Fumikazu; Asamura, Hisao; Tomiyama, Noriyuki

2018-05-01

Measuring the size of invasiveness on computed tomography (CT) for the T descriptor size was deemed important in the 8th edition of the TNM lung cancer classification. We aimed to correlate the maximal dimensions of the solid portions using both lung and mediastinal window settings on CT imaging with the pathologic invasiveness (> 0.5 cm) in lung adenocarcinoma patients. The study population consisted of 378 patients with a histologic diagnosis of adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), invasive adenocarcinoma (IVA)-lepidic, IVA-acinar and/or IVA-papillary, and IVA-micropapillary and/or solid adenocarcinoma. A panel of 15 radiologists was divided into 2 groups (group A, 9 radiologists; and group B, 6 radiologists). The 2 groups independently measured the maximal and perpendicular dimensions of the solid components and entire tumors on the lung and mediastinal window settings. The solid proportion of nodule was calculated by dividing the solid portion size (lung and mediastinal window settings) by the nodule size (lung window setting). The maximal dimensions of the invasive focus were measured on the corresponding pathologic specimens by 2 pathologists. The solid proportion was larger in the following descending order: IVA-micropapillary and/or solid, IVA-acinar and/or papillary, IVA-lepidic, MIA, and AIS. For both groups A and B, a solid portion > 0.8 cm in the lung window setting or > 0.6 cm in the mediastinal window setting on CT was a significant indicator of pathologic invasiveness > 0.5 cm (P < .001; receiver operating characteristic analysis using Youden's index). A solid portion > 0.8 cm on the lung window setting or solid portion > 0.6 cm on the mediastinal window setting on CT predicts for histopathologic invasiveness to differentiate IVA from MIA and AIS. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Comparing safety climate for nurses working in operating theatres, critical care and ward areas in the UK: a mixed methods study

PubMed Central

Tarling, Maggie; Jones, Anne; Murrells, Trevor; McCutcheon, Helen

2017-01-01

Objectives The main aim of the study was to explore the potential sources of variation and understand the meaning of safety climate for nursing practice in acute hospital settings in the UK. Design A sequential mixed methods design included a cross-sectional survey using the Safety Climate Questionnaire (SCQ) and thematic analysis of focus group discussions. Confirmatory factor analysis (CFA) was used to validate the factor structure of the SCQ. Factor scores were compared between nurses working in operating theatres, critical care and ward areas. Results from the survey and the thematic analysis were then compared and synthesised. Setting A London University. Participants 319 registered nurses working in acute hospital settings completed the SCQ and a further 23 nurses participated in focus groups. Results CFA indicated that there was a good model fit on some criteria (χ2=1683.699, df=824, p<0.001; χ2/df=2.04; root mean square error of approximation=0.058) but a less acceptable fit on comparative fit index which is 0.804. There was a statistically significant difference between clinical specialisms in management commitment (F (4,266)=4.66, p=0.001). Nurses working in operating theatres had lower scores compared with ward areas and they also reported negative perceptions about management in their focus group. There was significant variation in scores for communication across clinical specialism (F (4,266)=2.62, p=0.035) but none of the pairwise comparisons achieved statistical significance. Thematic analysis identified themes of human factors, clinical management and protecting patients. The system and the human side of caring was identified as a meta-theme. Conclusions The results suggest that the SCQ has some utility but requires further exploration. The findings indicate that safety in nursing practice is a complex interaction between safety systems and the social and interpersonal aspects of clinical practice. PMID:29084793

Examining the Hospital Elder Life Program in a rehabilitation setting: a pilot feasibility study.

PubMed

Huson, Kelsey; Stolee, Paul; Pearce, Nancy; Bradfield, Corrie; Heckman, George A

2016-07-18

The Hospital Elder Life Program (HELP) has been shown to effectively prevent delirium and functional decline in older patients in acute care, but has not been examined in a rehabilitation setting. This pilot study examined potential successes and implementation factors of the HELP in a post-acute rehabilitation hospital setting. A mixed methods (quantitative and qualitative) evaluation, incorporating a repeated measures design, was used. A total of 100 patients were enrolled; 58 on the pilot intervention unit and 42 on a usual care unit. Group comparisons were made using change scores (pre-post intervention) on outcome measures between pilot unit patients and usual care patients (separate analyses compared usual care patients with pilot unit patients who did or did not receive the HELP). Qualitative data were collected using focus group and individual interviews, and analyzed using emergent coding procedures. Delirium prevalence reduced from 10.9 % (n = 6) to 2.5 % (n = 1) in the intervention group, while remaining the same in the usual care group (2.5 % at both measurement points). Those who received the HELP showed greater improvement on cognitive and functional outcomes, particularly short-term memory and recall, and a shorter average length of stay than patients who did not. Participant groups discussed perceived barriers, benefits, and recommendations for further implementation of the HELP in a rehabilitation setting. This study adds to the limited research on delirium and the effectiveness of the HELP in post-acute rehabilitation settings. The HELP was found to be feasible and have potential benefits for reduced delirium and improved outcomes among rehabilitation patients.

Validating the measurement of social capital in Bangladesh: a cognitive approach.

PubMed

Story, William T; Taleb, Fahmida; Ahasan, S M Monirul; Ali, Nabeel A

2015-06-01

Despite the growing evidence linking social capital to improvements in health and health behaviors, reliable measures of social capital are lacking in low-income countries. To accurately measure social capital in new contexts, there is a need to validate social capital survey questions in each new cultural setting. In this article, we examine the content validity of the measurement of social capital in Bangladesh using qualitative methods. In December 2012, we conducted four focus group discussions and 32 cognitive interviews in one rural subdistrict (Durgapur) and one urban slum (Mirpur). We used the findings from the focus groups and cognitive interviews to create a new social capital survey instrument that can be used by health and development organizations in Bangladesh. Furthermore, in this article, we provide insight into social capital survey research in general, including suggestions for the measurement of group membership, social support, collective action, and social trust. © The Author(s) 2015.

Validating the Measurement of Social Capital in Bangladesh: A Cognitive Approach

PubMed Central

Story, William T.; Taleb, Fahmida; Ahasan, S.M. Monirul; Ali, Nabeel A.

2015-01-01

Despite the growing evidence linking social capital to improvements in health and health behaviors, reliable measures of social capital are lacking in low-income countries. To accurately measure social capital in new contexts, there is a need to validate social capital survey questions in each new cultural setting. In this article we examine the content validity of the measurement of social capital in Bangladesh using qualitative methods. In December 2012, we conducted four focus group discussions and 32 cognitive interviews in one rural subdistrict (Durgapur) and one urban slum (Mirpur). We used the findings from the focus groups and cognitive interviews to create a new social capital survey instrument that can be used by health and development organizations in Bangladesh. Furthermore, in this article we provide insight into social capital survey research in general, including suggestions for the measurement of group membership, social support, collective action, and social trust. PMID:25857652

Informing Patients

PubMed Central

Tang, Paul C.; Newcomb, Carol

1998-01-01

Abstract Objective: To understand and address patients' need for information surrounding ambulatory-care visits. Design: The authors conducted two patient focus groups regarding patient education. The first covered general information needs of patients and the second explored their reactions to a computer-generated patient handout that was developed in response to the results of the first focus group and implemented in a clinic. Results: Participants sought information about their health—generally after the encounter with their caregiver. They wanted a permanent record of personal health data and relevant educational information. Participants recommended that the information be concise, clear, and illustrated with graphics if appropriate. Receiving health-related information from their providers favorably affected the participants' trust in, relationship with, and confidence in their physicians. When given printouts with graphic trends depicting their responses to therapy, participants reported that they were more motivated to adhere to a treatment plan and were more satisfied with their care. Based on the results of the focus groups, we developed a set of attributes (P.A.T.I.E.N.T.) to guide the development of patient and consumer health information. Conclusions: Patients participating in our focus groups felt that providing printed summary information to patients at the end of a clinic visit improves their understanding of their care, enhances their relationships with providers, improves their satisfaction with care, and motivates them to adhere to treatment plans. Further empirical studies are necessary to test their perceptions. PMID:9824803

What drives technology-based distractions? A structural equation model on social-psychological factors of technology-based driver distraction engagement.

PubMed

Chen, Huei-Yen Winnie; Donmez, Birsen

2016-06-01

With the proliferation of new mobile and in-vehicle technologies, understanding the motivations behind a driver's voluntary engagement with such technologies is crucial from a safety perspective, yet is complex. Previous literature either surveyed a large number of distractions that may be diverse, or too focuses on one particular activity, such as cell phone use. Further, earlier studies about social-psychological factors underlying driver distraction tend to focus on one or two factors in-depth, and those that examine a more comprehensive set of factors are often limited in their analyses methods. The present work considers a wide array of social-psychological factors within a structural equation model to predict their influence on a focused set of technology-based distractions. A better understanding of these facilitators can enhance the design of distraction mitigation strategies. We analysed survey responses about three technology-based driver distractions: holding phone conversations, manually interacting with cell phones, and adjusting the settings of in-vehicle technology, as well as responses on five social-psychological factors: attitude, descriptive norm, injunctive norm, technology inclination, and a risk/sensation seeking personality. Using data collected from 525 drivers (ages: 18-80), a structural equation model was built to analyse these social-psychological factors as latent variables influencing self-reported engagement in these three technology-based distractions. Self-reported engagement in technology-based distractions was found to be largely influenced by attitudes about the distractions. Personality and social norms also played a significant role, but technology inclination did not. A closer look at two age groups (18-30 and 30+) showed that the effect of social norms, especially of injunctive norm (i.e., perceived approvals), was less prominent in the 30+ age group, while personality remained a significant predictor for the 30+ age group but marginally significant for the younger group. Findings from this work provide insights into the social-psychological factors behind intentional engagement in technology-based distractions and in particular suggesting that these factors may be sensitive to demographic differences. Copyright © 2016. Published by Elsevier Ltd.

Critical Care Interprofessional Education: Exploring Conflict and Power-Lessons Learned.

PubMed

Friend, Mary Louanne; Friend, Richard D; Ford, Cassandra; Ewell, Patrick J

2016-12-01

The purpose of this mixed-methods study was to evaluate the effects of an innovative critical care interprofessional education intervention on prelicensure nursing and medical students at a large public university. The class provided opportunities for students to (a) explore stereotypes about each respective profession, (b) examine the occurrence and effects of interprofessional conflict in high-acuity areas, and (c) explore conflict resolution techniques while learning how to perform critical care procedures as a team. A nonequivalent control group design with pretest, posttest, and focus group interviews were used. Data analyses indicated no subscales and total scores were significantly different across time or between groups. However, focus group analyses indicated that changes did occur. The findings suggest that students experience interprofessional conflict in clinical settings, yet lack the confidence and skills to effectively mitigate these behaviors. Ongoing studies to measure student empowerment and their intentions to practice collaboratively before and after graduation are recommended. [J Nurs Educ. 2016;55(12):696-700.]. Copyright 2016, SLACK Incorporated.

A focus-group study on spirituality and substance-abuse treatment

PubMed Central

Heinz, Adrienne J.; Disney, Elizabeth R.; Epstein, David H.; Glezen, Louise A.; Clark, Pamela I.; Preston, Kenzie L.

2010-01-01

Individuals recovering from addictions frequently cite spirituality as a helpful influence. However, little is known about whether or how spirituality could be incorporated into formal treatment in a manner that is sensitive to individual differences. In the present study, focus groups were conducted with 25 methadone-maintained outpatients (primarily high-school educated, African-American males) to examine beliefs about the role of spirituality in recovery and its appropriateness in formal treatment. Groups also discussed the relationship between spirituality and behavior during active addiction. Thematic analyses suggested that spirituality and religious practices suffered in complex ways during active addiction, but went “hand in hand” with recovery. Nearly all participants agreed that integration of a voluntary spiritual discussion group into formal treatment would be preferable to currently available alternatives. One limitation was that all participants identified as strongly spiritual. Studies of more diverse samples will help guide the development and evaluation of spiritually based interventions in formal treatment settings. PMID:20025443

Social and economic causes of deforestation in the Peruvian Amazon basin: Natives and colonists. Working paper

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

Garland, E.B.

1991-03-01

The people in the Peruvian Amazon directly engaged in agriculture are the leading cause of deforestation; and can be divided into two groups, colonists and indigenous groups. The factors affecting the rate at which each group causes deforestation differ. The paper explores these differences in Peru's Upper Huallaga Valley (the principal coca producing region in the world), focusing on the interrelationships between land availability, land tenure laws, and market forces on one hand, and agricultural intensification and deforestation on the other. The study concludes that the technological decisions of the two groups are guided by diverse sets of socioeconomic factors.

Meta-Cognitions in Tourette Syndrome, Tic Disorders, and Body-Focused Repetitive Disorder

PubMed Central

O’Connor, Kieron; St-Pierre-Delorme, Marie-Ève; Leclerc, Julie; Lavoie, Marc; Blais, Mélodie T

2014-01-01

Objective To explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB (n = 36). Method: The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54. Results: The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test–retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment. Conclusions: Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group. PMID:25161066

‘It's leaflet, leaflet, leaflet then, “see you later”’: black Caribbean women's perceptions of perinatal mental health care

PubMed Central

Edge, Dawn

2011-01-01

Background Despite high levels of psychosocial risks, black women of Caribbean origin rarely consult health professionals regarding symptoms of perinatal depression. Reasons for this are unclear as there has been little perinatal mental health research among this ethnic group. Aim To examine stakeholder perspectives on what might account for low levels of consultation for perinatal depression among a group of women who are, theoretically, vulnerable. Design of study A qualitative study using focus group interviews. Setting Community settings in the northwest of England. Method A purposive sample of black Caribbean women (n = 42) was split into focus groups and interviewed. This sample was drawn from a larger study. Interviews were digitally recorded and transcribed verbatim. Framework analysis was used to generate themes. Results Perceptions of practitioners' lack of compassion in delivering physical care and women's inability to develop confiding relationships with professionals during pregnancy and childbirth were significant barriers to consulting for depressive symptoms in particular, and health needs more generally. Advocating a ‘stepped-care’ approach, black Caribbean women suggested that new care pathways are required to address the full spectrum of perinatal mental health need. Apparently eschewing mono-ethnic, ‘culturally sensitive’ models, women suggested there was much to be gained from receiving care and support in mixed ethnic groups. Conclusion Black Caribbean women's suggestions for more collaborative, community-based models of care are in line with policy, practice, and the views of members of other ethnic groups. Adopting such approaches might provide more sustainable mechanisms for improving access and engagement both among so-called hard-to-reach groups and more generally, thereby potentially improving maternal and child outcomes. PMID:21439184

Meta-cognitions in tourette syndrome, tic disorders, and body-focused repetitive disorder.

PubMed

O'Connor, Kieron; St-Pierre-Delorme, Marie-Ève; Leclerc, Julie; Lavoie, Marc; Blais, Mélodie T

2014-08-01

To explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB (n = 36). The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54. The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test-retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment. Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group.

Complex network construction based on user group attention sequence

NASA Astrophysics Data System (ADS)

Zhang, Gaowei; Xu, Lingyu; Wang, Lei

2018-04-01

In the traditional complex network construction, it is often to use the similarity between nodes, build the weight of the network, and finally build the network. However, this approach tends to focus only on the coupling between nodes, while ignoring the information transfer between nodes and the transfer of directionality. In the network public opinion space, based on the set of stock series that the network groups pay attention to within a certain period of time, we vectorize the different stocks and build a complex network.

Perceptions on the risk communication strategy during the 2013 avian influenza A/H7N9 outbreak in humans in China: a focus group study.

PubMed

Li, Richun; Xie, Ruiqian; Yang, Chong; Frost, Melinda

2016-01-01

To identify the general public's perceptions of the overall risk communication strategy carried out by Chinese public health agencies during the first wave of avian influenza A(H7N9) outbreak in humans in 2013. Participants were recruited from communities in Beijing, Lanzhou and Hangzhou, China in May and June 2013 by convenience sampling. Demographics and other relevant information were collected using a self-administered questionnaire. Focus group interviews were conducted using a set of nine pre-developed questions and a tested moderator guide. The interviews were audio recorded and were transcribed verbatim. The constant comparative method was used to identify trends and themes. A total of nine focus group interviews, with 94 participants recruited from nine communities, were conducted. Most participants received H7N9 information via television and the Internet. Most the participants appreciated the transparency and timeliness of the information released by the government. They expressed a sense of trust in the recommended public health advice and followed most of them. The participants suggested that the government release more information about clinical treatment outcomes, have more specific health recommendations that are practical to their settings and expand the use of new media channels for risk communication. The public perceived the overall risk communication strategy by the Chinese public health agencies as effective, though the moderator had a governmental agency title that might have biased the results. There is a need to expand the use of social media for risk communication in the future.

Communication and Quality of Care on Palliative Care Units: A Qualitative Study.

PubMed

Seccareccia, Dori; Wentlandt, Kirsten; Kevork, Nanor; Workentin, Kevin; Blacker, Susan; Gagliese, Lucia; Grossman, Daphna; Zimmermann, Camilla

2015-09-01

Clinician-patient communication is central in palliative care, but it has not been described qualitatively which specific elements of communication are important for high-quality palliative care, particularly in the inpatient setting. Our aim was to identify elements of communication that are central to quality of care and satisfaction with care on palliative care units (PCUs), as described by inpatients, family caregivers, and health care providers. Qualitative interviews with patients/caregivers and focus groups with staff were conducted on four PCUs. Semi-structured interviews and focus groups elicited thoughts about the characteristics of satisfaction with care and quality of care for PCU inpatients and their family caregivers. Data were analyzed using a grounded theory method with an inductive, constant comparison approach; themes were coded to saturation. There were 46 interviews and eight focus groups. Communication was the most prevalent theme regarding satisfaction and quality of care, with five subthemes describing elements important to patients, caregivers, and staff. These included: 1) building rapport with patients and families to build trust and kinship; 2) addressing expectations and explaining goals of care; 3) keeping patients and families informed about the patient's condition; 4) listening actively to validate patients' concerns and individual needs; and 5) providing a safe space for conversations about death and dying. Patients, family caregivers, and health care providers affirmed that communication is a central element of quality of care and family satisfaction on PCUs. The five subthemes identified may serve as a structure for education and for quality improvement tools in palliative care inpatient settings.

Workgroup Report: Developing Environmental Health Indicators for European Children: World Health Organization Working Group

PubMed Central

Pond, Kathy; Kim, Rokho; Carroquino, Maria-Jose; Pirard, Philippe; Gore, Fiona; Cucu, Alexandra; Nemer, Leda; MacKay, Morag; Smedje, Greta; Georgellis, Antonis; Dalbokova, Dafina; Krzyzanowski, Michal

2007-01-01

A working group coordinated by the World Health Organization developed a set of indicators to protect children’s health from environmental risks and to support current and future European policy needs. On the basis of identified policy needs, the group developed a core set of 29 indicators for implementation plus an extended set of eight additional indicators for future development, focusing on exposure, health effects, and action. As far as possible, the indicators were designed to use existing information and are flexible enough to be developed further to meet the needs of policy makers and changing health priorities. These indicators cover most of the priority topic areas specified in the Children’s Environment and Health Action Plan for Europe (CEHAPE) as adopted in the Fourth Ministerial Conference on Health and Environment in 2004, and will be used to monitor the implementation of CEHAPE. This effort can be viewed as an integral part of the Global Initiative on Children’s Environmental Health Indicators, launched at the World Summit on Sustainable Development in 2002. PMID:17805431

Genetic educational needs and the role of genetics in primary care: a focus group study with multiple perspectives

PubMed Central

2011-01-01

Background Available evidence suggests that improvements in genetics education are needed to prepare primary care providers for the impact of ongoing rapid advances in genomics. Postgraduate (physician training) and master (midwifery training) programmes in primary care and public health are failing to meet these perceived educational needs. The aim of this study was to explore the role of genetics in primary care (i.e. family medicine and midwifery care) and the need for education in this area as perceived by primary care providers, patient advocacy groups and clinical genetics professionals. Methods Forty-four participants took part in three types of focus groups: mono-disciplinary groups of general practitioners and midwives, respectively and multidisciplinary groups composed of a diverse set of experts. The focus group sessions were audio-taped, transcribed verbatim and analysed using content analysis. Recurrent themes were identified. Results Four themes emerged regarding the educational needs and the role of genetics in primary care: (1) genetics knowledge, (2) family history, (3) ethical dilemmas and psychosocial effects in relation to genetics and (4) insight into the organisation and role of clinical genetics services. These themes reflect a shift in the role of genetics in primary care with implications for education. Although all focus group participants acknowledged the importance of genetics education, general practitioners felt this need more urgently than midwives and more strongly emphasized their perceived knowledge deficiencies. Conclusion The responsibilities of primary care providers with regard to genetics require further study. The results of this study will help to develop effective genetics education strategies to improve primary care providers' competencies in this area. More research into the educational priorities in genetics is needed to design courses that are suitable for postgraduate and master programmes for general practitioners and midwives. PMID:21329524

Capturing Public Opinion on Public Health Topics: A Comparison of Experiences from a Systematic Review, Focus Group Study, and Analysis of Online, User-Generated Content.

PubMed

Giles, Emma Louise; Adams, Jean M

2015-01-01

Capturing public opinion toward public health topics is important to ensure that services, policy, and research are aligned with the beliefs and priorities of the general public. A number of approaches can be used to capture public opinion. We are conducting a program of work on the effectiveness and acceptability of health promoting financial incentive interventions. We have captured public opinion on financial incentive interventions using three methods: a systematic review, focus group study, and analysis of online user-generated comments to news media reports. In this short editorial-style piece, we compare and contrast our experiences with these three methods. Each of these methods had their advantages and disadvantages. Advantages include tailoring of the research question for systematic reviews, probing of answers during focus groups, and the ability to aggregate a large data set using online user-generated content. However, disadvantages include needing to update systematic reviews, participants conforming to a dominant perspective in focus groups, and being unable to collect respondent characteristics during analysis of user-generated online content. That said, analysis of user-generated online content offers additional time and resource advantages, and we found it elicited similar findings to those obtained via more traditional methods, such as systematic reviews and focus groups. A number of methods for capturing public opinions on public health topics are available. Public health researchers, policy makers, and practitioners should choose methods appropriate to their aims. Analysis of user-generated online content, especially in the context of news media reports, may be a quicker and cheaper alternative to more traditional methods, without compromising on the breadth of opinions captured.

Influences on students’ career decisions concerning general practice: a focus group study

PubMed Central

Nicholson, Sandra; Hastings, Adrian Michael; McKinley, Robert Kee

2016-01-01

Background Despite concerns about recruitment to UK general practice, there has been no concerted educational intervention to address them. Aim To better understand how medical students’ perceptions of their experiences of their undergraduate curriculum may affect choosing general practice as a career. Design and setting Qualitative study comprising focus groups of a total of 58 students from a range of medical schools across the UK. Method A range of UK medical schools students were invited by email to participate in focus groups and return a questionnaire detailing their current career choice to facilitate sampling students with varied career preferences. Students late in their studies were sampled as they were likely to be considering future careers. Focus group discussions were audiotaped, transcribed, and anonymised for both school and participant, then thematically analysed. Perceived differences in medical school culture, curriculum philosophy, design, and intent were explored. Results Six focus groups (58 students) were convened. Some student participants’ career aspirations were strongly shaped by family and home, but clinical placements remained important in confirming or refuting these choices. High-quality general practice attachments are a powerful attractor to general practice and, when they reflect authentic clinical practice, promote general practice careers. GP tutors can be powerful, positive role models. Students’ comments revealed conflicting understandings about general practice. Conclusion Attracting rather than coercing students to general practice is likely to be more effective at changing their career choices. Early, high-quality, ongoing and, authentic clinical exposure promotes general practice and combats negative stereotyping. It is recommended that increasing opportunities to help students understand what it means to be a ‘good GP’ and how this can be achieved are created. PMID:27578812

Cultural perceptions and clinical experiences of nursing students in Eastern Turkey.

PubMed

Karatay, G; Bowers, B; Karadağ, E B; Demir, M C

2016-12-01

This study explored Turkish nursing students' perceptions of providing care to patients culturally different from themselves. Increasing migration will increase the need for nurses to provide care across cultural groups. Twenty one students in the second year of a 4-year nursing programme participated in 3 focus groups. Data were analysed using directed content analysis. Research questions were based on Campinha-Bacote's model. Three themes were identified: perceived cultural barriers, perceived cultural facilitators and identifying culturally sensitive actions. Generally, students were able to define culture but were unable to say how culture would affect nursing practice. Students were unprepared to practice in a multicultural setting. Cultural awareness is insufficient for determining how to respond to cultural differences. The study is limited by its restriction to a single school of nursing and a single curriculum. The multiple, ongoing political, religious and ethnic conflicts will require nurses to provide care to patients from other cultural groups, in some instances to people identified as adversaries to the group the nurse may represent. Understanding cultural differences is insufficient to do this effectively. Learning culturally competent care requires opportunities to provide, be guided through and reflect on care to individuals from different cultural groups. Standards for culturally competent care should be adopted by all care delivery settings. Public and organizational policies openly declaring healthcare settings as cultural safe zones, and explicit organizational commitment to culturally safe care, would set clear expectations for providers and help ensure a positive patient experience. © 2016 International Council of Nurses.

Why We Belong - Exploring Membership of Healthcare Professionals in an Intensive Care Virtual Community Via Online Focus Groups: Rationale and Protocol.

PubMed

Rolls, Kaye; Hansen, Margaret; Jackson, Debra; Elliott, Doug

2016-06-13

Many current challenges of evidence-based practice are related to ineffective social networks among health care professionals. Opportunities exist for multidisciplinary virtual communities to transcend professional and organizational boundaries and facilitate important knowledge transfer. Although health care professionals have been using the Internet to form virtual communities for many years, little is known regarding "why" they join, as most research has focused on the perspective of "posters," who form a minority of members. Our aim was to develop a comprehensive understanding of why health care professionals belong to a virtual community (VC). A qualitative approach will be used to explore why health care professionals belong to an intensive care practice-based VC, established since 2003. Three asynchronous online focus groups will be convened using a closed secure discussion forum. Participants will be recruited directly by sending emails to the VC and a Google form used to collect consent and participant demographics. Participants will be stratified by their online posting behaviors between September 1, 2012, and August 31, 2014: (1) more than 5 posts, (2) 1-5 posts, or (3) no posts. A question guide will be used to guide participant discussion. A moderation approach based on the principles of focus group method and e-moderation has been developed. The main source of data will be discussion threads, supported by a research diary and field notes. Data analysis will be undertaken using a thematic approach and framed by the Diffusion of Innovation theory. NVivo software will be used to support analyses. At the time of writing, 29 participants agreed to participate (Focus Group 1: n=4; Focus Group 2: n=16; Focus Group 3: n=9) and data collection was complete. This study will contribute to a growing body of research on the use of social media in professional health care settings. Specifically, we hope results will demonstrate an enhancement of health care professionals' social networks and how VCs may improve knowledge distribution and patient care outcomes. Additionally, the study will contribute to research methods development in this area by detailing approaches to understand the effectiveness of online focus groups as a data collection method for qualitative research methods.

Why We Belong - Exploring Membership of Healthcare Professionals in an Intensive Care Virtual Community Via Online Focus Groups: Rationale and Protocol

PubMed Central

Hansen, Margaret; Jackson, Debra; Elliott, Doug

2016-01-01

Background Many current challenges of evidence-based practice are related to ineffective social networks among health care professionals. Opportunities exist for multidisciplinary virtual communities to transcend professional and organizational boundaries and facilitate important knowledge transfer. Although health care professionals have been using the Internet to form virtual communities for many years, little is known regarding “why” they join, as most research has focused on the perspective of “posters,” who form a minority of members. Objective Our aim was to develop a comprehensive understanding of why health care professionals belong to a virtual community (VC). Methods A qualitative approach will be used to explore why health care professionals belong to an intensive care practice-based VC, established since 2003. Three asynchronous online focus groups will be convened using a closed secure discussion forum. Participants will be recruited directly by sending emails to the VC and a Google form used to collect consent and participant demographics. Participants will be stratified by their online posting behaviors between September 1, 2012, and August 31, 2014: (1) more than 5 posts, (2) 1-5 posts, or (3) no posts. A question guide will be used to guide participant discussion. A moderation approach based on the principles of focus group method and e-moderation has been developed. The main source of data will be discussion threads, supported by a research diary and field notes. Data analysis will be undertaken using a thematic approach and framed by the Diffusion of Innovation theory. NVivo software will be used to support analyses. Results At the time of writing, 29 participants agreed to participate (Focus Group 1: n=4; Focus Group 2: n=16; Focus Group 3: n=9) and data collection was complete. Conclusions This study will contribute to a growing body of research on the use of social media in professional health care settings. Specifically, we hope results will demonstrate an enhancement of health care professionals’ social networks and how VCs may improve knowledge distribution and patient care outcomes. Additionally, the study will contribute to research methods development in this area by detailing approaches to understand the effectiveness of online focus groups as a data collection method for qualitative research methods. PMID:27296929

Barriers to Care of Inner-City Children with Asthma: School Nurse Perspective

ERIC Educational Resources Information Center

Forbis, Shalini; Rammel, Jennifer; Huffman, Belinda; Taylor, Roberta

2006-01-01

School nurses spend considerable time caring for the needs of children with asthma and thus can offer valuable insights into barriers to asthma care within the school setting. Investigators conducted focus groups with school nurses in Dayton Public Schools to evaluate barriers to asthma care for children in an urban school system. The school…

Changes in Intergenerational Eating Patterns and the Impact on Childhood Obesity

ERIC Educational Resources Information Center

Kime, Nicky

2012-01-01

The objective of this study was to examine intergenerational eating patterns within two sets of families, those with an obese child and those with a normal weight child, and to assess the impact of intergenerational influences on children's eating. A qualitative study design was used, incorporating focus groups and semi-structured interviews.…

Conducting Design Experiments to Support Teachers' Learning: A Reflection from the Field

ERIC Educational Resources Information Center

Cobb, Paul; Zhao, Qing; Dean, Chrystal

2009-01-01

This article focuses on 3 conceptual challenges that we sought to address while conducting a design experiment in which we supported the learning of a group of middle school mathematics teachers. These challenges involved (a) situating teachers' activity in the institutional setting of the schools and district in which they worked, (b) developing…

Double-Edged Sword: Social Media Use in the Classroom

ERIC Educational Resources Information Center

Chromey, Kelli J.; Duchsherer, Amy; Pruett, Jennifer; Vareberg, Kyle

2016-01-01

The purpose of this research is to identify the students' perceptions of social media use in a classroom setting. Knowing students' perceptions of social media can help the instructor build a course that both student and teacher can find effective. Using focus groups this study found a model to determine if social media is an appropriate or…

Engaging Young Readers with Text through Shared Reading Experiences

ERIC Educational Resources Information Center

Honchell, Barbara; Schulz, Melissa

2012-01-01

This article explores Shared Reading as an instructional approach that mimics home reading experiences in a group setting for young children. The article includes information about how to use enlarged text as the teacher provides experiences with books that first focus on the meaning and enjoyment of the story and then shifts to how print works…

Appraising the Dimensionality of the Medical College Admission Test. MCAT Monograph.

ERIC Educational Resources Information Center

Meara, Kevin; Sireci, Stephen G.

To provide a better understanding of the structure of the Medical College Admission Test (MCAT) and to determine if there are structural differences across selected groups of MCAT examinees, several dimensionality analyses were conducted on data from recent administrations of the MCAT. The first set of analyses focused on the global structure of…

Adolescent and Parent Perceptions of Media Influence on Adolescent Sexuality

ERIC Educational Resources Information Center

Werner-Wilson, Ronald Jay; Fitzharris, Jennifer Lynn; Morrissey, Kathleen M.

2004-01-01

Empirical evidence suggests that television and other media influence adolescents' attitudes and behaviors. Much of the research in this area is based on surveys in which adolescents are asked to rank the relative importance of a fixed set of factors such as parents, peers, and media. We reviewed data from focus groups conducted with adolescents…

Re:Membering Fatherhood: Evaluating the Impact of a Group Intervention on Fathering

ERIC Educational Resources Information Center

Gearing, Robin Edward; Colvin, Geordie; Popova, Svetlana; Regehr, Cheryl

2008-01-01

The Re:Membering Fatherhood Program is designed for men wanting to address and improve their fathering experience. The primary focus is to enhance the personal parenting capacity of each individual, not to develop or inculcate a specific set of parenting skills. This exploratory study evaluated the efficacy of an eight-week, manualized…

Toddler Feeding: Expectations and Experiences of Low-Income African American Mothers

ERIC Educational Resources Information Center

Horodynski, Mildred A.; Brophy-Herb, Holly; Henry, Michelle; Smith, Katharine A.; Weatherspoon, Lorraine

2009-01-01

Objective: To ascertain maternal expectations and experiences with mealtimes and feeding of toddlers among low-income African American mothers in two mid- to large-size cities in the United States. Design: Qualitative focus group study. Setting: Two Early Head Start programme sites in a Midwestern state which serve low income families. Method:…

Food Safety Is a Key Determinant of Fruit and Vegetable Consumption in Urban Beninese Adolescents

ERIC Educational Resources Information Center

Nago, Eunice S.; Verstraeten, Roosmarijn; Lachat, Carl K.; Dossa, Romain A.; Kolsteren, Patrick W.

2012-01-01

Objective: To identify the determinants of fruit and vegetable consumption in urban Beninese adolescents and elements to develop a school-based fruit and vegetable program. Design: Sixteen focus groups conducted with a key word guide. Setting and Participants: Two private and 2 public secondary schools in Cotonou, Benin. One hundred fifty-three…

Documentary Photography: Cognitive Dimensionality of Selected Photographs and Community Perceptions in a Coorientation Model.

ERIC Educational Resources Information Center

Brown, James W.; Foushee, Richard E.

This paper discusses a proposed term project for a course in documentary photography that centered on photographically documenting a rural community and measuring its symbolic sociodramas. The paper describes the focus of the project, which was to determine how various community groups interpreted a given set of photographs designed to express a…

Religious Differences in Modernization of the Family: Family Demographics Trends in Ghana

ERIC Educational Resources Information Center

Heaton, Tim B.; Darkwah, Akosua

2011-01-01

This research examines trends in a broad set of reproductive and marital behaviors in Ghana, focusing on religious group differences. These comparisons provide evidence of how family trends are constrained by religious identity in a less developed country. Three waves of the Ghana Demographic and Health Surveys are used to track trends in the age…

The Internet Initiative: Libraries Providing Internet Services and How They Plan, Pay, and Manage.

ERIC Educational Resources Information Center

Valauskas, Edward J., Ed.; John, Nancy R., Ed.

This book examines real-life projects involving Internet access, use, and financing in libraries. It focuses on how becoming an Internet provider has improved many libraries' public visibility, level of service, and communication with other educational or community institutions. Chapters include: (1) "Setting Up an Internet Users Group in the…

Shopping Behaviors of Low-income Families during a 1-Month Period of Time

ERIC Educational Resources Information Center

Darko, Janice; Eggett, Dennis L.; Richards, Rickelle

2013-01-01

Objective: To explore food shopping behaviors among low-income families over the course of the month. Design: Two researchers conducted 13 90-minute focus groups. Setting: Two community organizations serving low-income populations and a university campus. Participants: Low-income adults (n = 72) who were the primary household food shoppers and who…

Problem Based Learning in School of Engineering Science, Osaka University

NASA Astrophysics Data System (ADS)

Sato, Kosuke; Kosakada, Kozo; Kuboi, Ryoichi

Problem Based Leaning in School of Engineering Science, Osaka University is being achieved mainly focusing on the spontaneous setting of the project theme. The PBL program aims to promote students' wide variety of abilities ; communication skill, group discussion, presentation skill, mutual assessment of the students, and also especially research skill 3P (Plan-Perform-Publish) .

The Outdoor Recess Activities of Children at an Urban School: Longitudinal and Intraperiod Patterns

ERIC Educational Resources Information Center

Holmes, Robyn M.

2012-01-01

Based on a study of 149 parochial-school students enrolled in kindergarten through eighth grade, this article explores children's outdoor recess activities in an urban setting--with a focus on how age, gender, and size of play group influence their outdoor play preferences--and examines changes in children's activity preferences over a single…

Disrupting Communities of Practice? How "Reluctant" Practitioners View Early Years Workforce Reform in England

ERIC Educational Resources Information Center

Payler, Jane K.; Locke, Rachel

2013-01-01

This article reports on the views of early years practitioners in England from settings that were identified as "reluctant to engage" with one of the government's key policies, the introduction of Early Years Professional Status (EYPS), to drive forwards workforce reform. Focus groups, interviews and a survey were undertaken in 2009 with…

The Meaning of Social Inclusion for People with Disabilities in South Korea

ERIC Educational Resources Information Center

Kim, Kyung Mee; Shin, Yu Ri; Yu, Dong Chul; Kim, Dong Ki

2017-01-01

This study sets out to examine and understand the meaning of social inclusion for people with disabilities, as constructed by people with disabilities themselves. Focus group interviews with 34 people who have physical impairments, cerebral palsy, or hearing or visual impairments were conducted for the study. Using the data obtained from these…

Developmentally Disabled Persons in Family Settings: Report No. 3.

ERIC Educational Resources Information Center

Cox, Wendy M.; Wilson, Wendell L.

The final part of a three part study of developmentally disabled persons in Washington State, this document focuses on clients of the Division of Developmental Disabilities (DDD), ages 19 through 26, who appeared to be eligible for DDD services but were not enrolled with the DDD (group C). Telephone interviews were conducted with parents of 55…

Perceptions of Slimming and Healthiness among Norwegian Adolescent Girls

ERIC Educational Resources Information Center

Hjelkrem, Kristiane; Lien, Nanna; Wandel, Margareta

2013-01-01

Objective: To explore what adolescent girls mean when they talk about healthiness and slimming, as well as the distinction between the 2 concepts. Design: Data was collected by the use of 8 focus groups, each with 5-9 adolescent girls. Setting: Four different schools in Oslo and 2 other municipalities in Norway in 2006-2007. Participants:…

Reflecting on the Think-Aloud Method for Evaluating E-Learning

ERIC Educational Resources Information Center

Cotton, Deborah; Gresty, Karen

2006-01-01

E-learning is increasingly being used in higher education settings, yet research examining how students use e-resources is frequently limited. Some previous studies have used the think-aloud method (an approach with origins in cognitive psychology) as an alternative to the more usual questionnaire or focus groups, but there is little discussion in…

Accessing the Food Systems in Urban and Rural Minnesotan Communities

ERIC Educational Resources Information Center

Smith, Chery; Miller, Hannah

2011-01-01

Objective: Explore how urban and rural Minnesotans access the food system and to investigate whether community infrastructure supports a healthful food system. Design: Eight (4 urban and 4 rural) focus groups were conducted. Setting and Participants: Eight counties with urban influence codes of 1, 2, 4, 5, 8, and 10. Fifty-nine (urban, n = 27;…

Student Perceptions on the Impact of Career and Technical Education Programs: A Mixed-Methods Study

ERIC Educational Resources Information Center

Eimers, Kimberly

2017-01-01

This mixed-methods study analyzed student perceptions regarding the impact of career and technical education (CTE) programs on student engagement, mind-set, support of teachers, and school climate. The Tripod 7C instrument was utilized to gather quantitative data, while focus groups were utilized for gathering qualitative data. Survey results…

Pediatric Healthcare Professionals' Views on Autism Spectrum Disorder Screening at 12-18 Months

ERIC Educational Resources Information Center

Crais, Elizabeth R.; McComish, Cara S.; Humphreys, Betsy P.; Watson, Linda R.; Baranek, Grace T.; Reznick, J. Steven; Christian, Rob B.; Earls, Marian

2014-01-01

This study explored North Carolina pediatric healthcare professional's (PHP) perceptions of screening 12-18 month old infants for Autism Spectrum Disorder (ASD). Eight focus groups (66 PHPs) were conducted across practice settings. The purpose was to explore PHP's perspectives to: inform development of ASD screening tools and ultimately impact…

Future HIV Vaccine Acceptability among Young Adults in South Africa

ERIC Educational Resources Information Center

Sayles, Jennifer N.; Macphail, Catherine L.; Newman, Peter A.; Cunningham, William E.

2010-01-01

Developing and disseminating a preventive HIV vaccine is a primary scientific and public health objective. However, little is known about HIV vaccine acceptability in the high-prevalence setting of South Africa--where young adults are likely to be targeted in early dissemination efforts. This study reports on six focus groups (n = 42) conducted in…

Information Systems for Subject Specialists: A Multi-Modal Approach to Indexing and Classification.

ERIC Educational Resources Information Center

Swift, D.F.; And Others

A fundamental problem in the two broad approaches to indexing in the social sciences--providing structure using preferred terms, cross references, and groupings of sets of materials, or compiling a concordance of an author's terms based on occurrence, leaving users free to impose their own structure--is that different indexers and users focus on…

A Second Chance: Meanings of Body Weight, Diet, and Physical Activity to Women Who Have Experienced Cancer

ERIC Educational Resources Information Center

Maley, Mary; Warren, Barbour S.; Devine, Carol M.

2013-01-01

Objective: To understand the meanings of diet, physical activity, and body weight in the context of women's cancer experiences. Design: Grounded theory using 15 qualitative interviews and 3 focus groups. Setting: Grassroots community cancer organizations in the northeastern United States. Participants: Thirty-six white women cancer survivors; 86%…

An Initial Examination of Facebook as a Source of Memorable Messages for First-Year College Students

ERIC Educational Resources Information Center

Russell, Jessica; Nazione, Samantha; Smith, Sandi

2012-01-01

This study investigated a set of messages on a university group's Facebook page intended as advice for first-year college students. Investigators coded 108 different units of advice into three overarching categories focused on academics, the transition to college life, and comprehension of the college campus. Messages transmitted were similar in…

Impacting Readiness: Nature and Nurture

ERIC Educational Resources Information Center

Healy, Jane M.

2011-01-01

Whereas some four year olds could draw a person with five fingers on each hand and a full set of facial features, others could barely hold a pencil. Some sat quietly in a small group, intently listening to and understanding a story, while others wiggled, fidgeted, and couldn't focus their attention. In those days, before the explosion of…

Talking Shop: Authentic Conversation and Teacher Learning.

ERIC Educational Resources Information Center

Clark, Christopher M., Ed.

This book presents a set of stories that focus on what teachers learn from talking to one another about their practice, presenting a case for how the ordinary talk among teachers is a potent medium for teacher learning and professional development. Drawing from the work of eight groups of teachers in the United States and Israel who met in…

Sustained Shared Thinking in an Early Childhood Setting: An Exploration of Practitioners' Perspectives

ERIC Educational Resources Information Center

Purdon, Anne

2016-01-01

Sustained shared thinking (SST) has been identified in the Teachers Standards (Early Years) (2013) as contributing to good progress and outcomes by children. In this paper, I define SST and discuss the outcomes of a study of practitioners' understandings of SST, its challenges and benefits. Writing frames, questionnaires and focus group interviews…

Young People's Perceptions of the Objective Physical Activity Monitoring Process: A Qualitative Exploration

ERIC Educational Resources Information Center

Scott, Joseph J.; Hansen, Vibeke; Morgan, Philip J.; Plotnikoff, Ronald C.; Lubans, David R.

2018-01-01

Objective: To explore young people's perceptions of pedometers and investigate behaviours exhibited while being monitored. Design: Qualitative design using six focus groups with participants (mean age 14.7 years). Setting: Study participants (n = 24) were randomly selected from a previous study of 123 young people aged 14-15 years from three…

Contradictions, Dialectical Oppositions and Shifts in Teaching Mathematics

ERIC Educational Resources Information Center

Stouraitis, Konstantinos; Potari, Despina; Skott, Jeppe

2017-01-01

The study reported in this paper concerns the tensions and conflicts that teachers experience while they enact a new set of reform-oriented curricular materials into their classrooms. Our focus is ?n the interactions developed in two groups of teachers in two schools for a period of a school year. We use Activity Theory to study emerging…

Error Patterns with Fraction Calculations at Fourth Grade as a Function of Students' Mathematics Achievement Status.

PubMed

Schumacher, Robin F; Malone, Amelia S

2017-09-01

The goal of the present study was to describe fraction-calculation errors among 4 th -grade students and determine whether error patterns differed as a function of problem type (addition vs. subtraction; like vs. unlike denominators), orientation (horizontal vs. vertical), or mathematics-achievement status (low- vs. average- vs. high-achieving). We specifically addressed whether mathematics-achievement status was related to students' tendency to operate with whole number bias. We extended this focus by comparing low-performing students' errors in two instructional settings that focused on two different types of fraction understandings: core instruction that focused on part-whole understanding vs. small-group tutoring that focused on magnitude understanding. Results showed students across the sample were more likely to operate with whole number bias on problems with unlike denominators. Students with low or average achievement (who only participated in core instruction) were more likely to operate with whole number bias than students with low achievement who participated in small-group tutoring. We suggest instruction should emphasize magnitude understanding to sufficiently increase fraction understanding for all students in the upper elementary grades.

Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records.

PubMed

Bardach, Shoshana H; Real, Kevin; Bardach, David R

2017-05-01

Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners' experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one's notes. Limitations in technology-including limited computer availability, documentation complexity, and sluggish sign-in processes-also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care.

Legal risk management and injury in the fitness industry: the outcomes of focus group research and a national survey of fitness professionals.

PubMed

Keyzer, Patrick; Coyle, Ian R; Dietrich, Joachim; Norton, Kevin; Sekendiz, Betul; Jones, Veronica; Finch, Caroline F

2014-06-01

The Australian Fitness Industry Risk Management (AFIRM) Project was set up to explore the operation of rules and regulations for the delivery of safe fitness services. This article summarises the results of recent focus group research and a national survey of risk management practices by the AFIRM Project. Our focus group research in four States identified the following most important concerns: (1) the competency of fitness professionals; (2) the effectiveness of pre-exercise screening and the management of de-conditioned clients; (3) poor supervision of fitness service users and incorrect use of equipment; (4) fitness trainers failing to remain within their scope of practice; (5) equipment misuse (as distinct from incorrect use); and (6) poor fitness training environments. This information was then used to develop 45 specific items for a questionnaire that was disseminated throughout the fitness industry. The survey, which is the largest ever conducted in the Australian fitness industry (n = 1,178), identified similar concerns. Our research indicates that efforts to improve risk management in the fitness industry should focus, first and foremost, on the development and monitoring of safety policy, and improvements in the education and training of fitness instructors to ensure that they can incorporate risk management practices.

Identifying the needs of critical and acute cardiac care nurses within the first two years of practice in Egypt using a nominal group technique.

PubMed

Gorman, Linda L; McDowell, Joan R S

2018-01-01

Nursing in Egypt faces many challenges and working conditions in health care settings are generally poor. Little is known about the needs of new nurses transitioning in Egypt. The literature focuses on the first year of practice and only a small body of research has explored the transition needs within acute care speciality settings. This paper reports on the important professional needs of new graduate nurses working in an acute cardiac setting in Egypt during the first two years of practice and differences between their perceived most important needs. The total population participated and two group interviews were conducted (n = 5; n = 6) using the nominal group technique. Needs were identified and prioritised using both rankings and ratings to attain consensus. Content analysis was conducted to produce themes and enable cross-group comparison. Rating scores were standardised for comparison within and between groups. Both groups ranked and rated items as important: 1) education, training and continued professional development; 2) professional standards; 3) supportive clinical practice environment; 4) manageable work patterns, and 5) organisational structure. It is important that health care organisations are responsive to these needs to ensure support strategies reflect the priorities of new nurses transitioning in acute care hospitals within Egypt. Copyright © 2017 Elsevier Ltd. All rights reserved.

Use of iPhones by Nurses in an Acute Care Setting to Improve Communication and Decision-Making Processes: Qualitative Analysis of Nurses’ Perspectives on iPhone Use

PubMed Central

2016-01-01

Background Smartphones and other mobile devices are having and will continue to have an impact on health care delivery in acute settings in Australia and overseas. Nurses, unlike physicians, have been slow to adopt these technologies and the reasons for this may relate to the status of both these professions within the hospital setting. Objective To explore nurses’ perspectives on iPhone use within an acute care unit. We examined their experiences and views on how this device may improve communication and decision-making processes at the point of care. Methods Two focus group discussions, using a semistructured interview, were conducted over the trial period. The discussions focused on the nurses’ experiences regarding ease of use, features, and capabilities of the device. The focus groups were recorded, transcribed, and analyzed using semistructured interview questions as a guide. Results The positive findings indicated that the iPhones were accessible and portable at point of care with patients, enhanced communication in the workplace, particularly among the nurses, and that this technology would evolve and be embraced by all nurses in the future. The negatives were the small screen size when undertaking bedside education for the patient and the invasive nature of the device. Another issue was the perception of being viewed as unprofessional when using the device in real time with the patients and their family. Conclusions The use of iPhones by nurses in acute care settings has the potential to enhance patient care, especially through more effective communication among nurses, and other health care professionals. To ensure that the benefits of this technology is woven into the everyday practice of the nurse, it is important that leaders in these organizations develop the agenda or policy to ensure that this occurs. PMID:27246197

Use of iPhones by Nurses in an Acute Care Setting to Improve Communication and Decision-Making Processes: Qualitative Analysis of Nurses' Perspectives on iPhone Use.

PubMed

Farrell, Maureen

2016-05-31

Smartphones and other mobile devices are having and will continue to have an impact on health care delivery in acute settings in Australia and overseas. Nurses, unlike physicians, have been slow to adopt these technologies and the reasons for this may relate to the status of both these professions within the hospital setting. To explore nurses' perspectives on iPhone use within an acute care unit. We examined their experiences and views on how this device may improve communication and decision-making processes at the point of care. Two focus group discussions, using a semistructured interview, were conducted over the trial period. The discussions focused on the nurses' experiences regarding ease of use, features, and capabilities of the device. The focus groups were recorded, transcribed, and analyzed using semistructured interview questions as a guide. The positive findings indicated that the iPhones were accessible and portable at point of care with patients, enhanced communication in the workplace, particularly among the nurses, and that this technology would evolve and be embraced by all nurses in the future. The negatives were the small screen size when undertaking bedside education for the patient and the invasive nature of the device. Another issue was the perception of being viewed as unprofessional when using the device in real time with the patients and their family. The use of iPhones by nurses in acute care settings has the potential to enhance patient care, especially through more effective communication among nurses, and other health care professionals. To ensure that the benefits of this technology is woven into the everyday practice of the nurse, it is important that leaders in these organizations develop the agenda or policy to ensure that this occurs.

Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group.

PubMed

Allden, K; Jones, L; Weissbecker, I; Wessells, M; Bolton, P; Betancourt, T S; Hijazi, Z; Galappatti, A; Yamout, R; Patel, P; Sumathipala, A

2009-01-01

The Working Group on Mental Health and Psychosocial Support was convened as part of the 2009 Harvard Humanitarian Action Summit. The Working Group chose to focus on ethical issues in mental health and psychosocial research and programming in humanitarian settings. The Working Group built on previous work and recommendations, such as the Inter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings. The objective of this working group was to address one of the factors contributing to the deficiency of research and the need to develop the evidence base on mental health and psychosocial support interventions during complex emergencies by proposing ethical research guidelines. Outcomes research is vital for effective program development in emergency settings, but to date, no comprehensive ethical guidelines exist for guiding such research efforts. Working Group members conducted literature reviews which included peer-reviewed publications, agency reports, and relevant guidelines on the following topics: general ethical principles in research, cross-cultural issues, research in resource-poor countries, and specific populations such as trauma and torture survivors, refugees, minorities, children and youth, and the mentally ill. Working Group members also shared key points regarding ethical issues encountered in their own research and fieldwork. The group adapted a broad definition of the term "research", which encompasses needs assessments and data gathering, as well as monitoring and evaluation. The guidelines are conceptualized as applying to formal and informal processes of assessment and evaluation in which researchers as well as most service providers engage. The group reached consensus that it would be unethical not to conduct research and evaluate outcomes of mental health and psychosocial interventions in emergency settings, given that there currently is very little good evidence base for such interventions. Overarching themes and issues generated by the group for further study and articulation included: purpose and benefits of research, issues of validity, neutrality, risk, subject selection and participation, confidentiality, consent, and dissemination of results. The group outlined several key topics and recommendations that address ethical issues in conducting mental health and psychosocial research in humanitarian settings. The group views this set of recommendations as a living document to be further developed and refined based on input from colleagues representing different regions of the globe with an emphasis on input from colleagues from low-resource countries.

ORCID Uptake in the Astronomical Community

NASA Astrophysics Data System (ADS)

Holmquist, Jane

2015-08-01

The IAU General Assembly provides librarians with a unique opportunity to interact with astronomers from all over the world. From the perspective of an ORCID Ambassador, the Focus Group Meeting on "Scholarly Publication in Astronomy" also provides an opportunity to demonstrate the cooperation and collaboration needed by individual astronomers, societies, librarians, publishers and bibliographic database providers to achieve universal adoption of ORCID, a standard unique identifier for authors, just as the DOI (digital object identifier) has been adopted for each journal article published.I propose to 1) present at the Focus Group Meeting an update on the uptake of ORCID by members of the astronomical community and 2) set up a small station (TBA) near the IAU registration area where librarians can show researchers how to register for an ORCID in 30 seconds.

Risk of future cardiovascular disease in women with prior preeclampsia: a focus group study.

PubMed

Seely, Ellen W; Rich-Edwards, Janet; Lui, Janet; Nicklas, Jacinda M; Saxena, Aditi; Tsigas, Eleni; Levkoff, Sue E

2013-12-21

A history of preeclampsia is a risk factor for the future development of hypertension and cardiovascular disease (CVD). The objective of this study was to assess, in women with prior preeclampsia, the level of knowledge regarding the link between preeclampsia and CVD, motivators for and barriers to lifestyle change and interest in a lifestyle modification program to decrease CVD risk following a pregnancy complicated by preeclampsia. Twenty women with a history of preeclampsia participated in 5 phone-based focus groups. Focus groups were recorded, transcribed, and analyzed. Qualitative content analysis was used to identify common themes across focus groups. Consensus was reached on a representative set of themes describing the data. Women with prior preeclampsia were in general unaware of the link between preeclampsia and future CVD but eager to learn about this link and motivated to achieve a healthy lifestyle. Major perceived barriers to lifestyle change were lack of time, cost of healthy foods and family responsibilities. Perceived facilitators included knowledge of the link between preeclampsia and CVD, a desire to stay healthy, and creating a healthy home for their children. Women with prior preeclampsia were interested in the idea of a web-based program focused on lifestyle strategies to decrease CVD risk in women. Women with prior preeclampsia were eager to learn about the link between preeclampsia and CVD and to take steps to reduce CVD risk. A web-based program to help women with prior preeclampsia adopt a healthy lifestyle may be an appropriate strategy for this population.

'Better than nothing' is not good enough: challenges to introducing evidence-based approaches for traumatized populations.

PubMed

Clark, James J; Sprang, Ginny; Freer, Benjamin; Whitt-Woosley, Adrienne

2012-04-01

Focus group data were generated by a larger, mixed-methods investigation on treatment practices among therapists working with significantly traumatized populations in a primarily rural, underdeveloped region of the USA. This paper explores reasons behind low utilization of evidence-based practices (EBPs) that putatively would benefit poor communities where these behavioural health care providers serve. Eight focus groups of 45 licensed and certified behavioural health professionals were conducted over a 6-month period of time in 2006. Sites were selected based on Beale code designations with representation from urban, rural, and rural with urban influence providers. Potential respondents were selected from licensing board membership rosters and invited to participate in the study. Focus groups were facilitated by trained interviewers using a semi-structured interview schedule that focused on how participants defined, assessed, and understood trauma, as well as the information therapists utilized to determine interventions for clients with trauma histories. Focus group transcripts were analysed using qualitative data reduction methods and six major themes emerged regarding the limited use of EBPs: complexity of trauma identification, issues with manualized assessment, role of treatment settings, conditions for innovation success and failure, untangling cultural effects, and defining successful treatment outcomes. These findings shed light on the endurance of insufficient behavioural health infrastructures despite therapists' access to scientifically validated treatments for trauma spectrum and co-morbid mental disorders suffered by children and adults. Such insights have implications for the success of global dissemination of validated behavioural health interventions. © 2010 Blackwell Publishing Ltd.

Identifying the Barriers and Enablers to Nutrition Care in Head and Neck and Esophageal Cancers: An International Qualitative Study.

PubMed

Martin, Lisa; de van der Schueren, Marian A E; Blauwhoff-Buskermolen, Susanne; Baracos, Vickie; Gramlich, Leah

2016-03-01

The goal of this work was to identify barriers and enablers to the implementation of nutrition care in head and neck and esophageal (HNE) cancers and to prioritize barriers to help improve the nutrition care process. This study used a multimethod qualitative study design (including semistructured interviews, focus group). Interviews (n = 29) were conducted at 5 European sites providing care and treatment to patients with HNE cancers. A focus group (n = 21) reviewed and corroborated interview findings and identified priorities for nutrition care. Participants were healthcare providers and researchers with direct experience in the field of HNE cancer. Five themes with accompanying barriers and enablers were identified related to nutrition care: (1) evidence for the benefit of nutrition interventions, (2) implementation of nutrition care processes (assessment, intervention, and follow-up), (3) characteristics of healthcare providers, (4) site factors, and (5) patient characteristics. Focus group discussions identified 2 priorities that must be acted on to improve nutrition care: (1) improve the evidence base and (2) develop standardized nutrition care pathways. Themes related to nutrition care in HNE cancers were similar between sites, but barriers and enablers differed. Interview and focus group participants agreed the following actions will result in improvements in nutrition care: (1) enhance the evidence base to test the benefit of nutrition interventions, with a focus on resolving specific controversies regarding nutrition therapy, and (2) establish a minimum data set with a goal to create standardized nutrition care pathways where roles and responsibilities for care are clearly defined. © 2014 American Society for Parenteral and Enteral Nutrition.

Patient-reported outcomes and adult patients' disease experience in the idiopathic inflammatory myopathies. report from the OMERACT 11 Myositis Special Interest Group.

PubMed

Alexanderson, Helene; Del Grande, Maria; Bingham, Clifton O; Orbai, Ana-Maria; Sarver, Catherine; Clegg-Smith, Katherine; Lundberg, Ingrid E; Song, Yeong Wook; Christopher-Stine, Lisa

2014-03-01

The newly formed Outcome Measures in Rheumatology (OMERACT) Myositis Special Interest Group (SIG) was established to examine patient-reported outcome measures (PROM) in myositis. At OMERACT 11, a literature review of PROM used in the idiopathic inflammatory myopathies (IIM) and other neuromuscular conditions was presented. The group examined in more detail 2 PROM more extensively evaluated in patients with IIM, the Myositis Activities Profile, and the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire, through the OMERACT filter of truth, discrimination, and feasibility. Preliminary results from a qualitative study of patients with myositis regarding their symptoms were discussed that emphasized the range of symptoms experienced: pain, physical tightness/stiffness, fatigue, disease effect on emotional life and relationships, and treatment-related side effects. Following discussion of these results and following additional discussions since OMERACT 11, a research agenda was developed. The next step in evaluating PROM in IIM will require additional focus groups with a spectrum of patients with different myositis disease phenotypes and manifestations across a range of disease activity, and from multiple international settings. The group will initially focus on dermatomyositis and polymyositis in adults. Qualitative analysis will facilitate the identification of commonalities and divergent patient-relevant aspects of disease, insights that are critical given the heterogeneous manifestations of these diseases. Based on these qualitative studies, existing myositis PROM can be examined to more thoroughly assess content validity, and will be important to identify gaps in domain measurement that will be required to develop a preliminary core set of patient-relevant domains for IIM.

Defining competencies for education in health care value: recommendations from the University of California, San Francisco Center for Healthcare Value Training Initiative.

PubMed

Moriates, Christopher; Dohan, Daniel; Spetz, Joanne; Sawaya, George F

2015-04-01

Leaders in medical education have increasingly called for the incorporation of cost awareness and health care value into health professions curricula. Emerging efforts have thus far focused on physicians, but foundational competencies need to be defined related to health care value that span all health professions and stages of training. The University of California, San Francisco (UCSF) Center for Healthcare Value launched an initiative in 2012 that engaged a group of educators from all four health professions schools at UCSF: Dentistry, Medicine, Nursing, and Pharmacy. This group created and agreed on a multidisciplinary set of comprehensive competencies related to health care value. The term "competency" was used to describe components within the larger domain of providing high-value care. The group then classified the competencies as beginner, proficient, or expert level through an iterative process and group consensus. The group articulated 21 competencies. The beginner competencies include basic principles of health policy, health care delivery, health costs, and insurance. Proficient competencies include real-world applications of concepts to clinical situations, primarily related to the care of individual patients. The expert competencies focus primarily on systems-level design, advocacy, mentorship, and policy. These competencies aim to identify a standard that may help inform the development of curricula across health professions training. These competencies could be translated into the learning objectives and evaluation methods of resources to teach health care value, and they should be considered in educational settings for health care professionals at all levels of training and across a variety of specialties.

Building professional competence in dental hygiene students through a community-based practicum.

PubMed

Yoon, M N; Compton, S M

2017-11-01

As Canadians age, there is an increased need for oral health professionals specializing in services for this unique population. Dental hygiene students require exposure to this population to develop professional competencies. This study investigated the dimensions of professional competence that were developed through a practicum for dental hygiene students in long-term care settings while working with older adults. Nine dental hygiene students were recruited across two cohorts. All students completed reflective journals describing their practicum experiences. Five students also participated in an audio-recorded focus group and completed a pre-focus group questionnaire. Additionally, the practicum course coordinator completed an audio-recorded interview. Transcripts and journals were coded using a constant comparative approach and themes were identified. Students described developing client-focused skills, such as effective verbal and non-verbal communication with older adults with dementia. Context-based learning was also a large part of the competency development for the practicum students. Understanding the care environment within which these residents lived helped students to understand and empathize why oral health may not be prioritized. Students also developed an understanding of the work of other health professionals in the settings and improved their abilities to communicate with other healthcare providers. However, students recognized that the utility of those interprofessional skills in private practice may be limited. Dental hygiene students developed personal and ethical competencies during practicum that are highly transferrable across professional settings. Exposure of students to older adult populations in long-term care may increase the likelihood of dental hygienists working in this area. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Counseling to Prevent Obesity Among Preschool Children: Acceptability of a Pilot Urban Primary Care Intervention

PubMed Central

McKee, M. Diane; Maher, Stacia; Deen, Darwin; Blank, Arthur E.

2010-01-01

PURPOSE To help design effective primary care-based interventions, we explored urban parents’ reactions to a pilot and feasibility study designed to address risk behaviors for obesity among preschool children. METHODS We conducted 3 focus groups (2 in English, 1 in Spanish) to evaluate the pilot intervention. Focus group participants explored the acceptability of the pilot intervention components (completion of a new screening tool for risk assessment, discussion of risk behaviors and behavior change goal setting by physicians, and follow-up contacts with a lifestyle counselor) and the fidelity of the pilot intervention delivery. RESULTS Parents expressed a desire to change behaviors to achieve healthier families. They believed that doctors should increase their focus on healthy habits during visits. Parents were more accepting of nutrition discussions than increasing activity (citing a lack of safe outdoor space) or decreasing sedentary behaviors (citing many benefits of television viewing). Contacts with the lifestyle counselor were described as empowering, with parents noting her focus on strategies to achieve change for the whole family while recognizing that many food behaviors relate to cultural heritage. Parents expressed frustration with physicians for offering advice about changing behavior but not how to achieve it, for dismissing concerns about picky eating or undereating, and in some cases for labels of overweight that they believed were inappropriately applied. CONCLUSIONS Parents welcomed efforts to address family lifestyle change in pediatric visits. The model of physician goal setting with referral for behavior change counseling is highly acceptable to families. Future interventions should acknowledge parental concerns about undereating and perceived benefits of television viewing. PMID:20458109

Motivational Interviewing to Promote Long-Acting Reversible Contraception in Postpartum Teenagers.

PubMed

Tomlin, Kristl; Bambulas, Tammalynn; Sutton, Maureen; Pazdernik, Vanessa; Coonrod, Dean V

2017-06-01

To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group. Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care. Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014. Motivational interviewing within the context of adolescent-focused prenatal care. Rates of uptake of LARC within 13 postpartum weeks. The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks postpartum was 38% (95% confidence interval [CI], 29%-47%) compared with 18% (95% CI, 11%-28%) for standard care participants, with an adjusted odds ratio of LARC use of 2.8 (95% CI, 1.5-5.2). Among patients who received adolescent-focused prenatal care, most (27% vs 12.7%) were using an intrauterine device as opposed to an implantable contraceptive device. Participation in an adolescent-focused antepartum setting using motivational interviewing to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake compared with standard prenatal care. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

An integrated model for adolescent inpatient group therapy.

PubMed

Garrick, D; Ewashen, C

2001-04-01

This paper proposes an integrated group therapy model to be utilized by psychiatric and mental health nurses; one innovatively designed to meet the therapeutic needs of adolescents admitted to inpatient psychiatric programs. The writers suggest a model of group therapy primarily comprised of interpersonal approaches within a feminist perspective. The proposed group focus is on active therapeutic engagement with adolescents to further interpersonal learning and to critically examine their contextualized lived experiences. Specific client and setting factors relevant to the selection of therapeutic techniques are reviewed. Selected theoretical models of group therapy are critiqued in relation to group therapy with adolescents. This integrated model of group therapy provides a safe and therapeutic forum that enriches clients' personal and interpersonal experiences as well as promotes healthy exploration, change, and empowerment.

Facility with the English language and problem-based learning group interaction: findings from an Arabic setting.

PubMed

Mpofu, D J; Lanphear, J; Stewart, T; Das, M; Ridding, P; Dunn, E

1998-09-01

The Faculty of Medicine and Health Sciences (FMHS), United Arab Emirates (UAE) University is in a unique position to explore issues related to English language proficiency and medical student performance. All students entering the FMHS have English as a second language. This study focused on the issues of students' proficiency in English as measured by the TOEFL test, student background factors and interaction in problem-based learning (PBL) groups. Using a modification of Bales Interaction Process Analysis, four problem-based learning groups were observed over four thematic units, to measure the degree of student interaction within PBL groups and to compare this to individual TOEFL scores and key background variables. The students' contributions correlated highly with TOEFL test results in the giving of information (range r = 0.67-0.74). The female students adhered to interacting in English during group sessions, whereas the male students were more likely to revert to using Arabic in elaborating unclear phenomena (p < 0.01). The educational level of the student's mother was highly predictive of TOEFL scores for the male students, but not for female students. Multivariate analysis was undertaken to analyse the relative contribution of the TOEFL, parental education and years of studying in English. The best predictor of students' contributions in PBL groups was identified as TOEFL scores. The study demonstrates the importance of facilitating a locally acceptable level of English proficiency prior to admission to the FMHS. However, it also highlights the importance of not focusing only on English proficiency but paying attention to additional factors in facilitating medical students in maximizing benefits from interactions in PBL settings.

Emotional effects of continuity of care on family physicians and the therapeutic relationship.

PubMed

Schultz, Karen; Delva, Dianne; Kerr, Jonathan

2012-02-01

To explore conceptions of continuity of care among family physicians in traditional practices, family medicine-trained physicians working in episodic care, and family medicine residents to better understand the emotional effects on physicians of establishing long-term relationships with patients as a starting point for developing a tool to measure the qualitative connections between physicians and their patients. Qualitative descriptive study using focus groups. Traditional family practice, family medicine residency training, and episodic-care settings in Kingston, Ont. Three groups of first-year family medicine residents (n = 18), 2 groups of family physicians in established traditional practice (n = 9), and 2 groups of family physicians working in episodic-care settings (n = 10). Using focus groups, a semistructured discussion guide, and a phenomenologic approach, we explored residents' and practising physicians' conceptions about continuity of care, predominantly exploring the emotional effects on physicians of providing care for a group of patients over time. Providing care for patients over time and developing a deep knowledge of, and often a deep connection to, patients affected physicians in various ways. Most of these effects were rewarding: feelings of connection, trust, curiosity, enhanced professional competence (diagnostically and therapeutically), personal growth, and being cared for and respected. Some, however, were distressing: anxiety, grief, frustration, boundary issues, and negative effects on personal life. Family physicians experience myriad emotions connected with providing care to patients. Knowledge of what physicians find rewarding from their long-term connections with patients, and of the difficulties that arise, might be useful in further understanding interpersonal continuity of care and the therapeutic relationship, and in informing resident education about developing therapeutic relationships, evaluating resident educational experiences with continuity of care, and addressing physician burnout.

The effects of spaced retrieval training in improving hyperphagia of people living with dementia in residential settings.

PubMed

Hsu, Chia-Ning; Lin, Li-Chan; Wu, Shiao-Chi

2017-10-01

To investigate the effectiveness of spaced retrieval for improving hyperphagia in patients with dementia in residential care settings. Although 10-30% of patients with dementia have hyperphagia, most studies have focused on eating difficulties. Only a few studies have focused on hyperphagia. Various memory problems cause hyperphagia in patients with dementia. Spaced retrieval, a cognitive technique for information learning, can be used as a training method to improve memory loss. Recent studies showed that patients who received the training successfully memorised information learned in the training and correctly applied it to their daily lives. Single-blind experiments were performed. The 97 subjects with dementia were recruited from seven institutions. All research participants were stratified into three groups according to cognitive impairment severity and Hyperphagic Behavior Scale scores and then randomly assigned to the experimental and control groups. The experimental group received a six-week one-by-one spaced retrieval training for hyperphagia behaviour. The control group received routine care. After the intervention, the frequency and severity of hyperphagia in the patients with dementia, and food intake were significantly lower in the experimental group than in the control group. However, body mass index did not significantly differ. Our results suggest that the spaced retrieval training could decrease the frequency and severity of hyperphagia in patients with dementia. The content of this training programme is consistent with the normal manner of eating in daily life and is easy for patients to understand and perform. Therefore, it can be applied in residents' daily lives. This study confirms the efficacy of the spaced retrieval training protocol for hyperphagia in patients with dementia. In future studies, the follow-up duration can be increased to determine the long-term effectiveness of the intervention. © 2016 John Wiley & Sons Ltd.

Supporting university students with autism spectrum disorder.

PubMed

Hillier, Ashleigh; Goldstein, Jody; Murphy, Deirdra; Trietsch, Rhoda; Keeves, Jacqueline; Mendes, Eva; Queenan, Alexa

2018-01-01

Increasing numbers of students with autism spectrum disorder are entering higher education. Their success can be jeopardized by organizational, social/emotional, and academic challenges if appropriate supports are not in place. Our objective was to evaluate the effectiveness of a support group model for university students with autism spectrum disorder in improving psychological and functional outcomes. A curriculum guided the weekly discussions and consisted of topics such as time and stress management, managing group work, and social communication. Efficacy was assessed through pre- and post self-report measures focused on self-esteem, loneliness, anxiety, and depression. Functional changes in academic and social skills were examined through qualitative analysis of focus groups. Findings from the self-report measures indicated significant reductions in feelings of loneliness and general anxiety, and a significant increase in self-esteem at the end of the program compared to the beginning. Five prominent themes were identified in the focus-group analysis and reflected how the program had positively impacted participants' skills and coping: executive functioning; goal setting; academics and resources; stress and anxiety; and social. Given the cost effectiveness of "in-house" interventions and the potential for improving academic outcomes and retention of students with autism spectrum disorder, further research examining similar program models is warranted.

Collaborative diagramming during problem based learning in medical education: Do computerized diagrams support basic science knowledge construction?

PubMed

De Leng, Bas; Gijlers, Hannie

2015-05-01

To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning. Opinions and perceptions of students (n = 70) and tutors (n = 4) who used collaborative diagramming in tutorial groups were collected with a questionnaire and focus group discussions. A framework derived from the analysis of discourse in computer-supported collaborative leaning was used to construct the questionnaire. Video observations were used during the focus group discussions. Both students and tutors felt that collaborative diagramming positively affected discussion and knowledge construction. Students particularly appreciated that diagrams helped them to structure knowledge, to develop an overview of topics, and stimulated them to find relationships between topics. Tutors emphasized that diagramming increased interaction and enhanced the focus and detail of the discussion. Favourable conditions were the following: working with a shared whiteboard, using a diagram format that facilitated distribution, and applying half filled-in diagrams for non-content expert tutors and\\or for heterogeneous groups with low achieving students. The empirical findings in this study support the findings of earlier more descriptive studies that diagramming in a collaborative setting is valuable for learning complex knowledge in medicine.

General practitioners’ experiences using cognitive behavioural therapy in general practice: A qualitative study

PubMed Central

Aschim, Bente; Lundevall, Sverre; Martinsen, Egil W.; Frich, Jan C.

2011-01-01

Objective To explore GPs’ experiences using cognitive behavioural therapy (CBT), with a focus on factors that promote or limit the use of CBT in general practice. Design Qualitative study using data from written evaluation reports and focus-group interviews. Setting Norwegian general practice. Subjects GPs who participated in a longitudinal CBT course in the continuous medical education (CME) programme for GPs in Norway, of whom 19 filled in evaluation forms and 15 participated in focus-group interviews. Main outcome measures Experiences with the use of CBT in general practice. Results GPs used CBT mainly in the treatment of patients with anxiety disorders and depression. Factors that promoted the use of CBT in general practice were structured supervision and group counselling, receiving feedback on individual video-recorded consultations, and experiencing that one mastered the therapeutic techniques. Limiting factors were that it took some time before one mastered the techniques, lack of eligible patients, constraints related to attending group supervision during office hours, and the lack of financial incentives to use CBT in general practice. Conclusion Tailored training programmes in CBT for GPs may contribute to more frequent use of CBT in general practice. A formal recognition of CBT in the reimbursement scheme for GPs might counter limiting factors to an increased use of CBT in general practice. PMID:21861599

Flemish adolescents’ perceptions of cigarette plain packaging: a qualitative study with focus group discussions

PubMed Central

Van Hal, Guido; Van Roosbroeck, Sofie; Vriesacker, Bart; Arts, Matheus; Hoeck, Sarah; Fraeyman, Jessica

2012-01-01

Objectives To find out whether there is a potential impact of the appearance of a plain cigarette package on the smoking perceptions and behavioural intentions of Flemish adolescents. Design We performed a cross-sectional study using the qualitative method of focus group discussions. Setting Flemish adolescents. Participants We performed eight focus group discussions, in which 55 adolescents took part, 32 female and 23 male. Inclusion criteria were: Flemish male and female 15-year-olds to 16-year-olds and 17-year-olds to 18-year-olds attending regular high-school education or vocational training who were current or had ever been smokers. Outcome measure (planned as well as measured) The opinions and perceptions of young Flemish smokers regarding the impact of cigarette packaging on their smoking behaviour. Results Plain packages are perceived as less attractive, cheap and unreliable for young people. Because of the unattractiveness of the plain packaging, the health warnings catch the eye much more strongly. Conclusions In this first scientific study in Flanders on this topic, it emerged that plain packaging could be a strong policy tool to reduce the number of adolescents starting smoking. Validation of these findings by conducting a quantitative survey in the same target group is recommended. PMID:23242481

Team effectiveness in academic medical libraries: a multiple case study*

PubMed Central

Russo Martin, Elaine

2006-01-01

Objectives: The objective of this study is to apply J. Richard Hackman's framework on team effectiveness to academic medical library settings. Methods: The study uses a qualitative, multiple case study design, employing interviews and focus groups to examine team effectiveness in three academic medical libraries. Another site was selected as a pilot to validate the research design, field procedures, and methods to be used with the cases. In all, three interviews and twelve focus groups, with approximately seventy-five participants, were conducted at the case study libraries. Findings: Hackman identified five conditions leading to team effectiveness and three outcomes dimensions that defined effectiveness. The participants in this study identified additional characteristics of effectiveness that focused on enhanced communication, leadership personality and behavior, and relationship building. The study also revealed an additional outcome dimension related to the evolution of teams. Conclusions: Introducing teams into an organization is not a trivial matter. Hackman's model of effectiveness has implications for designing successful library teams. PMID:16888659

Black Men's Perceptions and Knowledge of Diabetes: A Church-Affiliated Barbershop Focus Group Study.

PubMed

Balls-Berry, Joyce; Watson, Christopher; Kadimpati, Sandeep; Crockett, Andre; Mohamed, Essa A; Brown, Italo; Soto, Miguel Valdez; Sanford, Becky; Halyard, Michele; Khubchandani, Jagdish; Dacy, Lea; Davis, Olga Idriss

2015-12-01

Diabetes is the seventh leading cause of death in the United States and disproportionately affects racial and ethnic minorities. These disparities persist despite educational efforts to reduce the prevalence of diabetes. Receptiveness of educational efforts for Black men needs to be studied. This study assesses Black men's receptiveness to a barbershop-based program focused on diabetes prevention and awareness in a church-affiliated barbershop in Rochester, Minnesota. The pastor and barber of a church-affiliated barbershop and academic medical researchers designed a community-engaged research study to determine Black men's perception of diabetes. Recruitment for the 90-minute focus group included flyers (n=60), email, and in-person. Units of analysis included focus-group audio recording, transcripts, and field notes. Using traditional content analysis, we categorized data into themes and sub-themes. Thirteen Black men participated (Group 1, n=6; Group 2, n=7) having a mean age of 40.3 years (range 19 to 65), and employed full-time (77%). Themes included diabetes prevention, treatment, prevalence, risks, and health education. Participants identified diet and exercise as essential components of diabetes prevention. Additionally, participants mentioned that family history contributes to diabetes. Participants agreed that barbershops are an appropriate setting for data collection and health education on diabetes for Black men. Findings indicate that Black men are generally aware of diabetes. The community-engaged research process allowed for development of a culturally appropriate research study on diabetes. This study is the foundation for developing a culturally appropriate health education program on diabetes for Black men.

Knowledge, perceptions, and decision-making about human papillomavirus vaccination among Korean American women: A focus group study

PubMed Central

Kim, Kyounghae; Kim, Boyoung; Choi, Eunsuk; Song, Youngshin; Han, Hae-Ra

2014-01-01

Objective As one of the fastest growing ethnic minority groups in the United States, Korean American (KA) women experience a heightened cervical cancer burden. The advent of the human papillomavirus (HPV) vaccine offers an unprecedented opportunity to eliminate cervical cancer disparities in KA women. Yet, the uptake of HPV vaccine among KA adolescents remains suboptimal. Hence, we set out to explore knowledge, perceptions, and decision-making about HPV vaccination among KA women. Methods We conducted four focus groups of 26 KA women who participated in a community-based randomized controlled trial to promote breast and cervical cancer screening. Focus group data were analyzed using qualitative content analysis. Results Four main themes emerged from the focus groups: (1) limited awareness and knowledge of HPV vaccine, (2) perceptions and beliefs about HPV vaccination (acceptance, negative perceptions, ambivalence), (3) patterns of decision-making about HPV vaccination (hierarchical, peer-influenced, autonomous, and collaborative), and (4) promoting HPV education and information-sharing in the Korean community. Conclusion KA women are generally favorable toward HPV vaccination but lack awareness and knowledge about HPV. Culturally tailored HPV education programs based on KA women’s decision-making patterns and effective information-sharing by trustworthy sources in comfortable environments are suggested strategies to promote HPV vaccination in the KA community. The findings point to the need for a multi-level approach to addressing linguistic, cultural, and system barriers that the recent immigrant community faces in promoting HPV vaccinations. In the development of targeted interventions for KA women, educational strategies and patterns of decision-making need to be considered. PMID:25747518

Interaction of cadmium with phosphate on goethite

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

Venema, P.; Hiemstra, T.; Riemsdijk, W.H. van

1997-08-01

Interactions between different ions are of importance in understanding chemical processes in natural systems. In this study simultaneous adsorption of phosphate and cadmium on goethite is studied in detail. The charge distribution (CD)-multisite complexation (MUSIC) model has been successful in describing extended data sets of cadmium adsorption and phosphate adsorption on goethite. In this study, the parameters of this model for these two data sets were combined to describe a new data set of simultaneous adsorption of cadmium and phosphate on goethite. Attention is focused on the surface speciation of cadmium. With the extra information that can be obtained frommore » the interaction experiments, the cadmium adsorption model is refined. For a perfect description of the data, the singly coordinated surface groups at the 110 face of goethite were assumed to form both monodentate and bidentate surface species with cadmium. The CD-MUSIC model is able to describe data sets of both simultaneous and single adsorption of cadmium and phosphate with the same parameters. The model calculations confirmed the idea that only singly coordinated surface groups are reactive for specific ion binding.« less

Seasonal changes in household food insecurity and symptoms of anxiety and depression.

PubMed

Hadley, Craig; Patil, Crystal L

2008-02-01

There is growing awareness that common mental health disorders are key contributors to the burden of disease in developing countries. Studies examining the correlates of mental health have primarily been carried out in urban settings and focused on the burden rapid economic change places on individuals. In these settings, poverty and low education are consistent predictors of anxiety and depressive symptoms. We argue here that these variables are proxies for insecurity, and that a more general model of symptoms of depression and anxiety should focus on locally salient forms of insecurity. Building on previous work in a seasonal subsistence setting, we identify food insecurity as a potent source of insecurity in a rural African setting, and then test whether seasonal changes in food insecurity are correlated with concomitant changes in a measure of symptoms of anxiety and depression among 173 caretakers. Results indicate that food insecurity is a strong predictor of symptoms of anxiety and depression (P < 0.0001), that changes in food insecurity across the seasons predict changes in symptoms of anxiety and depression (P < 0.0001), and that this is robust to the inclusion of covariates for material assets and household production. These results hold for individuals in both ethnic groups studied (Pimbwe and Sukuma); however, at the group level the burden falls disproportionately on Pimbwe. The results add to the growing literature on the causes of population level differences in mental health disorders and suggest new research avenues and strategies to link mental health disorders with variation in physical and biosocial outcomes. Copyright 2007 Wiley-Liss, Inc.

Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders.

PubMed

Coenen, Michaela; Cabello, Maria; Umlauf, Silvia; Ayuso-Mateos, José Luis; Anczewska, Marta; Tourunen, Jouni; Leonardi, Matilde; Cieza, Alarcos

2016-01-01

The objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews. The study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework. Sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders. This study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses. Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patient's daily life should be considered in all the neuropsychiatric conditions.

Educators' insights in using chronicle diabetes: a data management system for diabetes education.

PubMed

Wang, Jing; Siminerio, Linda M

2013-01-01

Diabetes educators lack data systems to monitor diabetes self-management education processes and programs. The purpose of the study is to explore diabetes educator's insights in using a diabetes education data management program: the Chronicle Diabetes system. We conducted 1 focus group with 8 diabetes educators who use the Chronicle system in western Pennsylvania. The focus group was audiotaped and transcribed verbatim. Themes were categorized according to system facilitators and barriers in using Chronicle. Educators report 4 system facilitators and 4 barrier features. System facilitators include (1) ability to extract data from Chronicle for education program recognition, (2) central location for collecting and documenting all patient and education data, (3) capability to monitor behavioral goal setting and clinical outcomes, and (4) use of a patient snapshot report that automatically summarizes behavioral goal setting and an education plan. Barriers reported are (1) initially time-consuming for data entry, (2) Health Insurance Portability and Accountability Act privacy concerns for e-mailing or downloading report, (3) need for special features (e.g., ability to attach a food diary), and (4) need to enhance existing features to standardize goal-setting process and incorporate psychosocial content. Educators favor capabilities for documenting program requirements, goal setting, and patient summaries. Barriers that need to be overcome are the amount of time needed for data entry, privacy, and special features. Diabetes educators conclude that a data management system such as Chronicle facilitates the education process and affords ease in documentation of meeting diabetes self-management education standards and recognition requirements.

An understanding of Japanese children's perceptions of fun, barriers, and facilitators of active free play.

PubMed

Lee, YingHua; Takenaka, Koji; Kanosue, Kazuyuki

2015-09-01

Physical activity contributes to children's physical and mental well-being. Research suggests that active free play helps to maintain and increase physical activity in children and also contributes to social and emotional well-being. To date, these studies have focused on Western countries. Thus, this study was conducted to gain insights into the factors of perceptions of fun, barriers, and facilitators affecting active free play from the perspective of Japanese children using focus group interviews. In Japan, 12 focus groups were conducted with 60 children aged 9-11 years. Children's perceptions of fun in active free play were categorized into socializing, achievement, emotions, and freedom. Additionally, active boys' groups were interested in free play and adventure play; girls' groups were interested in free play with less physical movement and challenges; inactive boys' groups were interested in relaxing and competitive play with bodily contact. However, children mentioned that busy schedules, weather, and health-related factors acted as main barriers. Lastly, children noted facilitators include setting schedules, having access to equipment and playgrounds, and holding special events. The findings provide insights into active free play-related factors for active and inactive Japanese children and also clarify the differences between Japanese and Western children. Such findings will contribute to designing interventions to increase active free play. © The Author(s) 2013.

Using participatory action research in a community-based initiative addressing complex mental health needs.

PubMed

Knightbridge, Stephen M; King, Robert; Rolfe, Timothy J

2006-04-01

This paper describes the first phase of a larger project that utilizes participatory action research to examine complex mental health needs across an extensive group of stakeholders in the community. Within an objective qualitative analysis of focus group discussions the social ecological model is utilized to explore how integrative activities can be informed, planned and implemented across multiple elements and levels of a system. Seventy-one primary care workers, managers, policy-makers, consumers and carers from across the southern metropolitan and Gippsland regions of Victoria, Australia took part in seven focus groups. All groups responded to an identical set of focusing questions. Participants produced an explanatory model describing the service system, as it relates to people with complex needs, across the levels of social ecological analysis. Qualitative themes analysis identified four priority areas to be addressed in order to improve the system's capacity for working with complexity. These included: (i) system fragmentation; (ii) integrative case management practices; (iii) community attitudes; and (iv) money and resources. The emergent themes provide clues as to how complexity is constructed and interpreted across the system of involved agencies and interest groups. The implications these findings have for the development and evaluation of this community capacity-building project were examined from the perspective of constructing interventions that address both top-down and bottom-up processes.

Community Priorities for Healthy Eating in Older Adults.

PubMed

Jiang, Qianzhi; Cohen, Nancy L; Marra, Melissa Ventura; Woolf, Kathleen; Gilbride, Judith; Francis, Sarah L

2017-01-01

Community planners such as policymakers and health care and nutrition service providers can create an "age-friendly" environment to support healthy eating in older residents by addressing the highest priorities that enable older adults to improve their dietary intake through different food-related community settings. To identify and prioritize these factors that facilitate behavioral change (enablers) and behavioral settings important for older adult nutrition based on the social ecological model, nutrition and aging professionals (n = 30) from two rural (West Virginia, Iowa) and two urban (Massachusetts, New York) city/county regions (communities) participated in an online or live focus group discussion and completed an analytic hierarchy process survey online. Overall, the most important perceived enablers were accessibility and cost, followed by transportation and social support, but their relative importance varied by community. Participants from all communities considered congregate meal sites and food banks among the most important behavioral settings. Participants from most communities considered food stores to be important and also highlighted other settings unique to the area, such as senior housing, neighborhood, and farmers' markets. By targeting interventions to address the most notable enablers and behavioral settings specific to their community, planning groups can enhance their older residents' ability to achieve optimal nutritional health.

Identifying preferences for mobile health applications for self-monitoring and self-management: focus group findings from HIV-positive persons and young mothers.

PubMed

Ramanathan, Nithya; Swendeman, Dallas; Comulada, W Scott; Estrin, Deborah; Rotheram-Borus, Mary Jane

2013-04-01

Self-management of risk behaviors is a cornerstone of future population health interventions. Using mobile phones for routine self-monitoring and feedback is a cost-efficient strategy for self-management and ecological momentary interventions (EMI). However, mobile health applications need to be designed to be highly attractive and acceptable to a broad range of user groups. To inform the design of an adaptable mobile health application we aimed to identify the dimensions and range of user preferences for application features by different user groups. Five focus group interviews were conducted: two (n=9; n=20) with people living with HIV (PLH) and three with young mothers (n=6; n=8; n=10). Thematic analyses were conducted on the focus group sessions' notes and transcripts. Both groups considered customization of reminders and prompts as necessary, and goal setting, motivational messaging, problem solving, and feedback as attractive. For PLH, automated and location-based reminders for medication adherence and sharing data with healthcare providers were both acceptable and attractive features. Privacy protection and invasiveness were the primary concerns, particularly around location tracking, illegal drug use, and sexual partner information. Concerns were ameliorated by use scenario or purpose, monetary incentives, and password protection. Privacy was not a major concern to mothers who considered passwords burdensome. Mothers' preferences focused on customization that supports mood, exercise and eating patterns, and especially using the mobile phone camera to photograph food to increase self-accountability. Individualization emerged as the key feature and design principle to reduce user burden and increase attractiveness and acceptability. Mobile phone EMI uniquely enables individualization, context-aware and real-time feedback, and tailored intervention delivery. Published by Elsevier Ireland Ltd.

Health education in the Libyan Arab Jamahiriya: assessment of future needs.

PubMed

Elfituri, A A; Elmahaishi, M S; MacDonald, T H; Sherif, F M

2006-01-01

The aim of this study was to determine priority health issues, target groups and education media for future health education programmes in the Libyan Arab Jamahiriya. A questionnaire was addressed to 2 groups: health officials (n=60) and the general public (n=300). In their lists of health issues to focus on, 7 were the same although prioritization differed. Children and youth were considered the most important target groups and the school setting the most appropriate medium for them. Broadcast media were acknowledged as valuable for health education for the general public. We recommend systematic consultation across official and lay groups as a preliminary requisite for health education initiatives.

Short-term effects of goal-setting focusing on the life goal concept on subjective well-being and treatment engagement in subacute inpatients: a quasi-randomized controlled trial

PubMed Central

Ogawa, Tatsuya; Omon, Kyohei; Yuda, Tomohisa; Ishigaki, Tomoya; Imai, Ryota; Ohmatsu, Satoko; Morioka, Shu

2016-01-01

Objective: To investigate the short-term effects of the life goal concept on subjective well-being and treatment engagement, and to determine the sample size required for a larger trial. Design: A quasi-randomized controlled trial that was not blinded. Setting: A subacute rehabilitation ward. Subjects: A total of 66 patients were randomized to a goal-setting intervention group with the life goal concept (Life Goal), a standard rehabilitation group with no goal-setting intervention (Control 1), or a goal-setting intervention group without the life goal concept (Control 2). Interventions: The goal-setting intervention in the Life Goal and Control 2 was Goal Attainment Scaling. The Life Goal patients were assessed in terms of their life goals, and the hierarchy of goals was explained. The intervention duration was four weeks. Main measures: Patients were assessed pre- and post-intervention. The outcome measures were the Hospital Anxiety and Depression Scale, 12-item General Health Questionnaire, Pittsburgh Rehabilitation Participation Scale, and Functional Independence Measure. Results: Of the 296 potential participants, 66 were enrolled; Life Goal (n = 22), Control 1 (n = 22) and Control 2 (n = 22). Anxiety was significantly lower in the Life Goal (4.1 ±3.0) than in Control 1 (6.7 ±3.4), but treatment engagement was significantly higher in the Life Goal (5.3 ±0.4) compared with both the Control 1 (4.8 ±0.6) and Control 2 (4.9 ±0.5). Conclusions: The life goal concept had a short-term effect on treatment engagement. A sample of 31 patients per group would be required for a fully powered clinical trial. PMID:27496700

How Pregnant African-American Women View Pregnancy Weight Gain

PubMed Central

Groth, Susan W.; Morrison-Beedy, Dianne; Meng, Ying

2012-01-01

Objective To gain insight into how low-income, pregnant African-American women viewed their weight gain while pregnant and how they managed their weight during pregnancy. Design Descriptive study using three focus groups. Setting Women were recruited from urban prenatal care sites and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) services in a medium-sized urban Northeastern city. Participants Twenty-six adult, low-income, pregnant African-American women, aged 18–39; the majority were within the first 20 weeks of pregnancy. Methods Three focus groups were conducted utilizing open-ended questions related to pregnancy weight gain. Content analysis was used to analyze the verbatim transcripts. Analysis focused on meaning, intention and context. Groups were compared and contrasted at the within and between group levels to identify themes. Results Four themes were identified that provided insight into how women viewed their pregnancy weight gain and managed weight gain during pregnancy: (a) pregnancy weight gain: no matter how much means a healthy baby; (b) weight retention: it happens; (c) there is a limit: weight gain impact on appearance; and (d) watching and waiting: plans for controlling weight. Conclusion Low-income African-American women, though cognizant of the likelihood of retention of weight following pregnancy, are not focused on limiting their gestational weight gain. The cultural acceptance of a larger body size along with the belief that gaining more weight is indicative of a healthy infant present challenges for interventions to limit excessive gestational weight gain. PMID:22789036

Development of a multi-behavioral mHealth app for women smokers

PubMed Central

Armin, Julie; Johnson, Thienne; Hingle, Melanie; Giacobbi, Peter; Gordon, Judith S.

2017-01-01

Objective This paper describes the development of the See Me Smoke-Free™ (SMSF) mobile health application, which uses guided imagery to support women in smoking cessation, eating a healthy diet, and increasing physical activity. Materials and Methods Focus group discussions, with member checks, were conducted to refine the intervention content and app user interface. Data related to the context of app deployment were collected via user testing sessions and internal quality control testing, which identified and addressed functionality issues, content problems, and bugs. Results Interactive app features include playback of guided imagery audio files, notification pop-ups, award-sharing on social media, a tracking calendar, content resources, and direct call to the local tobacco quitline. Focus groups helped design the user interface, and identified several themes for incorporation into app content, including positivity, the rewards of smoking cessation, and the integrated benefits maintaining a healthy lifestyle. User testing improved app functionality and usability on many Android phone models. Discussion Changes to the app content and function were made iteratively by the development team as a result of focus group and user testing. Despite extensive internal and user testing, unanticipated data collection and reporting issues emerged during deployment due to the variety of Android software and hardware, but also due to individual phone settings and use. Conclusion Focus group interviews helped thematically frame the intervention and maximize user engagement. Testing caught many bugs and usability concerns, but missed some of the data transmission problems encountered during deployment. PMID:28121240

Empirically Derived Lessons Learned about What Makes Peer-Led Exercise Groups Flourish.

PubMed

Fletcher, Kathlyn E; Ertl, Kristyn; Ruffalo, Leslie; Harris, LaTamba; Whittle, Jeff

2017-01-01

Physical exercise confers many health benefits, but it is difficult to motivate people to exercise. Although community exercise groups may facilitate initiation and persistence in an exercise program, reports regarding factors that allow such groups to flourish are limited. We performed a prospective qualitative evaluation of our experience starting a program of community-based, peer-led exercise groups for military veterans to identify important lessons learned. We synthesized data from structured observations, post-observation debriefings, and focus groups. Our participants were trained peer leaders and exercise group members. Our main outcomes consisted of empirically derived lessons learned during the implementation of a peer-led group exercise program for veterans at multiple community sites. We collected and analyzed data from 40 observation visits (covering 14 sites), 7 transcribed debriefings, and 5 focus groups. We identified five lessons learned. (1) The camaraderie and social aspect of the exercise groups provided motivation for people to stay involved. (2) Shared responsibility and commitment to each other by the group members was instrumental to success. (3) Regular meeting times encouraged participation. (4) Variety, especially getting outdoors, was very popular for some groups. (5) Modest involvement of professionals encouraged ongoing engagement with the program. Both social and programmatic issues influence implementation of group exercise programs for older, predominantly male, veterans. These results should be confirmed in other settings.

Learning Achievement and Motivation in an Out-of-School Setting—Visiting Amphibians and Reptiles in a Zoo Is More Effective than a Lesson at School

NASA Astrophysics Data System (ADS)

Wünschmann, Stephanie; Wüst-Ackermann, Peter; Randler, Christoph; Vollmer, Christian; Itzek-Greulich, Heike

2017-06-01

Interventions in out-of-school settings have been shown in previous studies to be effectively increase students' science knowledge and motivation, with mixed results on whether they are more effective than teaching at school. In this study, we compared an out-of-school setting in a reptile and amphibian zoo (Landau, Germany) with a sequence of classroom teaching and a control group without teaching on the topic. We compared learning at school (School) and out-of-school learning (Reptilium), which were tested in a randomized field setting with a focus on knowledge and motivation. Sixty-five elementary students participated in either the School group, Reptilium group or control group. We measured knowledge on the topics reptiles and amphibians with a newly developed two-factorial test, calibrated with item response theory, before the intervention, immediately afterwards (posttest) and 2 weeks later (follow-up). Motivation was measured immediately after the intervention. Data analyses were performed using SPSS and Mplus. We conclude that the two interventions appeared highly superior to the control group and that the out-of-school setting in the Reptilium was more effective than the school-only program. Concerning motivation, perception of choice was higher in the Reptilium than in the School group. There were gender-by-treatment interaction effects for knowledge in the posttest and follow-up, for perceived competence and for pressure/tension. Concerning knowledge, boys performed better in the School group than girls but this gender gap was not significant in the Reptilium group. Boys perceived themselves as more competent in the School group while girls reported less pressure/tension in the Reptilium group. In conclusion, encountering living animals in a formal zoo learning arrangement is encouraged in primary school since it supports self-determination (free choice), leads to higher achievement and closes gender disparities in achievement.

The Effects of Group Leader Learning Style on Student Knowledge Gain in a Leadership Camp Setting: A Repeated-Measures Experiment

ERIC Educational Resources Information Center

Brown, Nicholas R.; Terry, Robert, Jr.

2013-01-01

Many state FFA associations conduct summer camps focusing on leadership and personal development for FFA members. Interestingly, little research has been conducted on the impact or outcomes of these common activities. The purpose of this split-plot factorial repeated-measures experiment was to assess the level of campers' learning of the…

A Corpus-Based Investigation of Critical Reflective Practice and Context in Early Career Teacher Settings

ERIC Educational Resources Information Center

Murphy, Bróna

2015-01-01

Reflective practice is at the core of teacher education programmes and is highly regarded as an essential component in the education of new and experienced teachers. Given the recent interest in language use and the role of discourse in articulating knowledge of one's practice, this paper focuses on how two groups of early career teachers from…

Quality from a Toddler's Perspective: A Bottom-Up Examination of Classroom Experiences

ERIC Educational Resources Information Center

Hallam, Rena; Fouts, Hillary; Bargreen, Kaitlin; Caudle, Lori

2009-01-01

Defining and measuring quality in group care settings has become a central issue in the field of early care and education in the United States, particularly as states develop systems to improve child care quality. Most research and policy definitions of quality rely on a top-down perspective focusing on structural and environmental features of the…

Catapulting Shifts in Images, Understandings, and Actions for Family Members through Research-Based Drama

ERIC Educational Resources Information Center

Dupuis, Sherry L.; Gillies, Jennifer; Mitchell, Gail J.; Jonas-Simpson, Christine; Whyte, Colleen; Carson, Jennifer

2011-01-01

This article examined how images, understandings, and actions change for family members of persons with dementia after the introduction of a research-based drama called I'm Still Here. Guided by interpretivist phenomenology, a set of seven pre- and post-performance focus groups were conducted with family members (n = 48) in four cities. Findings…

Eliciting Students' Understanding of a Local Socioscientific Issue through the Use of Critical Response Pedagogies

ERIC Educational Resources Information Center

Karahan, Engin; Andzenge, Senenge T.; Roehrig, Gillian

2017-01-01

This study introduces a critical response pedagogy (CRP), an arts-based critical technique to facilitate meaningful dialogue in focus group settings, to secondary school science education students to engage them in discussion about sediment and chemical load in their local river basin community. Using a holistic single case design, twenty-two 11th…

Concept Paper on the Effects of the Physical Environment on Day Care.

ERIC Educational Resources Information Center

Prescott, Elizabeth; David, Thomas G.

This paper presents a discussion of the effect of the physical environment on children receiving day care services. Various dimensions of the physical environment which may affect the well-being of infants, preschool and school age children in group or family day care settings are examined. The focus is on the overall well-being and development of…

Pediatric nursing in the context of the HIV/AIDS epidemic in resource-poor settings--balancing the "art and the science".

PubMed

Govender, Linda; Rochat, Tamsen; Richter, Linda; Rollins, Nigel

2006-01-01

Pediatric wards in South Africa are largely occupied by children with AIDS-related illnesses. This study uses qualitative inquiry involving focus groups with nurses into the needs of children, caregivers, and healthcare providers. The findings indicate changes to the nature of nursing practice, knowledge of nursing, and ethics of nursing care.

A Qualitative Study of Early Childhood Educators' Beliefs about Key Preschool Classroom Experiences

ERIC Educational Resources Information Center

Lara-Cinisomo, Sandraluz; Fuligni, Allison Sidle; Daugherty, Lindsay; Howes, Carollee; Karoly, Lynn

2009-01-01

The aim of the study was to uncover early childhood educators' beliefs about how to best work with children getting ready for kindergarten. The study involved 11 focus groups with providers from three types of early education settings located in Los Angeles County: (1) public center-based programs, (2) private center-based programs, and (3) family…

Documentary Photography: Cognitive Dimensionality of Selected Photographs and Community Perceptions in a Coorientation Model.

ERIC Educational Resources Information Center

Brown, James W.; Foushee, Richard E.

A term project for a journalism course in documentary photography (the proposal for which is cited in ED 177 560) centered on photographically documenting a rural community and measuring its symbolic sociodramas. The focus of the project was to determine how various community groups interpreted a given set of photographs selected to represent a…

The Impact of SIM on FCAT Reading Scores of Special Education and At-Risk Students

ERIC Educational Resources Information Center

Matyo-Cepero, Jude

2013-01-01

The purpose of this study was to determine if special education and at-risk students educated exclusively in a school-within-a-school setting showed improved high-stakes standardized reading test scores after learning the strategic instruction model (SIM) inference strategy. This study was focused on four groups of eighth-grade students attending…

The Feasibility of Using Nature-Based Settings for Physical Activity Programming: Views from Urban Youth and Program Providers

ERIC Educational Resources Information Center

Blanton, Jedediah E.; Oregon, Evelyn M.; Flett, M. Ryan; Gould, Daniel R.; Pfeiffer, Karin A.

2013-01-01

Background and Purpose: Given the urgency to design programs to increase physical activity, especially to combat obesity in children, the primary purpose of this study was to investigate perceptions and opinions of a nature-based physical activity intervention designed for low-income urban adolescents. Methods: Four focus groups of adolescents,…

Forest conditions and trends in the northern United States

Treesearch

Stephen R. Shifley; Francisco X. Aguilar; Nianfu Song; Susan I. Stewart; David J. Nowak; Dale D. Gormanson; W. Keith Moser; Sherri Wormstead; Eric J. Greenfield

2012-01-01

This section describes current conditions and trends for the 20 Northern States by focusing on selected characteristics associated with forest sustainability. Its format is based upon a set of 64 indicators within 7 broad criteria that the United States and 11 other countries have adopted under the auspices of the Montréal Process Working Group on Criteria and...

Factors that Influence Physical Activity in Long-Term Care: Perspectives of Residents, Staff, and Significant Others

ERIC Educational Resources Information Center

Benjamin, Kathleen; Edwards, Nancy; Guitard, Paulette; Murray, Mary Ann; Caswell, Wenda; Perrier, Marie Josee

2011-01-01

Physical activity has been linked to positive health outcomes for frail seniors. However, our understanding of factors that influence the physical activity of residents in the long-term care (LTC) setting is limited. This article describes our work with focus groups, one component of a multi-component study that examined factors influencing the…

The Effects of Using a Combination of Story Frames and Retelling Strategies with Learning Disabled Students To Build Their Comprehension Ability.

ERIC Educational Resources Information Center

Kuldanek, Kelly

Reading is the foundation for literacy and comprehension is the foundation for education. Many learning disabled students struggle to understand what they have read and many instructional approaches in small group settings focus on decoding rather than on comprehension. Employing a dual strategic approach to facilitate comprehension enables…

A Collaborative Writing Project Using the Worldwide Web.

ERIC Educational Resources Information Center

Sylvester, Allen; Essex, Christopher

A student in a distance education course, as part of a midterm project, set out to build a Web site that had written communication as its main focus. The Web site, "The Global Campfire," was modeled on the old Appalachian tradition of the "Story Tree," where a storyteller begins a story and allows group members to add to it.…

Infusing Human Rights into the Curriculum: The Case of the South African Revised National Curriculum Statement

ERIC Educational Resources Information Center

Carrim, Nazir; Keet, Andre

2005-01-01

This article reflects on experiences of attempting to infuse human rights in the South African Revised National Curriculum Statement (RNCS). Using our experiences as members of Human Rights and Inclusivity Group (HRIWG), one of the curriculum development structures set up for the RNCS, and focusing particularly on the Learning Area of Mathematics,…

Identifying Structural Changes from Within: Emancipatory Narratives Exploring Community Constraints to Women's Education and Empowerment in Rural India

ERIC Educational Resources Information Center

Baily, Supriya

2015-01-01

Using a critical theory framework, the article explores emancipatory narratives obtained through a case study of women in rural India. In-depth interviews, focus group conversations, observations, and document analysis highlight the complexity of the subsequent set of challenges facing women as it relates to both the education and empowerment for…

Comparison of Time-Distance Local Helioseismology on GONG and MDI Data Sets

NASA Technical Reports Server (NTRS)

Duvall, T. L., Jr.; Zhao, J.; Rajaguru, S. P.; Toner, C. G.; Kosovichev, A. G.; Thompson, M. J.; Hughes, S. J.

2003-01-01

We show first results derived from one rotation of GONG++ and MDI data analyzed independently by different groups with time-distance techniques. We focus on observations obtained during spring 2002 and especially on Carrington rotation 1988 (2002/3/30 - 2002/4/26) and measure flow components and wave speed inhomogeneities over a range of depths for different active regions.

Older People's Views of Advice about Falls Prevention: A Qualitative Study

ERIC Educational Resources Information Center

Yardley, L.; Donovan-Hall, M.; Francis, K.; Todd, C.

2006-01-01

The aim of this study was to gain an understanding of older people's perceptions of falls prevention advice, and how best to design communications that will encourage older people to take action to prevent falls. Focus groups and interviews were carried out with 66 people aged 61-94 years recruited from a variety of settings, using falls…

Parental Voice and Involvement in Cultural Context: Understanding Rationales, Values, and Motivational Constructs in a Dual Immersion Setting

ERIC Educational Resources Information Center

Gerena, Linda

2011-01-01

In an attempt to operationalize an equitable educational program, a dual immersion program was established. After 2 years of field observations, a series of focus group interviews was conducted to examine the perceptions and viewpoints of parents whose children had participated in the program for 2 years. These interviews offered parents an…

The Socio-Emotional Needs of Children with Dyslexia in Different Educational Settings in Ireland

ERIC Educational Resources Information Center

Casserly, Ann Marie

2013-01-01

This paper reports on a four-year research project examining the experiences of children with dyslexia in mainstream schools and reading schools/classes. The focus of this paper is on the socio-emotional effects of dyslexia on a group of children attending a reading school/class for a specific duration before returning to mainstream. The findings…

Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual [and] Participant Workbook.

ERIC Educational Resources Information Center

Reilly, Patrick M.; Shopshire, Michael S.; Durazzo, Timothy C.; Campbell, Torri A.

This manual and workbook set focuses on anger management. The manual was designed for use by qualified substance abuse and mental health clinicians who work with substance abuse and mental health clients with concurrent anger programs. The manual describes a 12-week cognitive behavioral anger management group treatment. Each of the 12 90-minute…

Adolescent Development and the Biology of Puberty: Summary of a Workshop on New Research.

ERIC Educational Resources Information Center

Kipke, Michele D., Ed.

On March 23 and 24, 1998, the Forum on Adolescence gathered an interdisciplinary group of researchers and practitioners to review the state of knowledge about adolescent development at a workshop entitled "New Research on the Biology of Puberty and Adolescent Development." This workshop focused both on puberty, a set of physical changes rooted in…

Sharing My Music with You: The Musical Presentation as a Tool for Exploring, Examining and Enhancing Self-Awareness in a Group Setting

ERIC Educational Resources Information Center

Bensimon, Moshe; Amir, Dorit

2010-01-01

Musical presentation (MP) is a diagnostic and therapeutic music therapy tool which focuses on the participant's emotional exploration and awareness-insight development. Using this tool people present themselves through music of their choice and subsequently receive feedback from their peers. This study investigates MP as a tool for enhancing…

A Coding System for Qualitative Studies of the Information-Seeking Process in Computer Science Research

ERIC Educational Resources Information Center

Moral, Cristian; de Antonio, Angelica; Ferre, Xavier; Lara, Graciela

2015-01-01

Introduction: In this article we propose a qualitative analysis tool--a coding system--that can support the formalisation of the information-seeking process in a specific field: research in computer science. Method: In order to elaborate the coding system, we have conducted a set of qualitative studies, more specifically a focus group and some…

Service impact of a national clinical leadership development programme: findings from a qualitative study.

PubMed

Fealy, Gerard M; McNamara, Martin S; Casey, Mary; O'Connor, Tom; Patton, Declan; Doyle, Louise; Quinlan, Christina

2015-04-01

The study reported here was part of a larger study, which evaluated a national clinical leadership development programme with reference to resources, participant experiences, participant outcomes and service impact. The aim of the present study was to evaluate the programme's service impact. Clinical leadership development develops competencies that are expressed in context. The outcomes of clinical leadership development occur at individual, departmental and organisational levels. The methods used to evaluate the service impact were focus groups, group interviews and individual interviews. Seventy participants provided data in 18 separate qualitative data collection events. The data contained numerous accounts of service development activities, initiated by programme participants, which improved service and/or improved the culture of the work setting. Clinical leadership development programmes that incorporate a deliberate service impact element can result in identifiable positive service outcomes. The nuanced relationship between leader development and service development warrants further investigation. This study demonstrates that clinical leadership development can impact on service in distinct and identifiable ways. Clinical leadership development programmes should focus on the setting in which the leadership competencies will be demonstrated. © 2013 John Wiley & Sons Ltd.

Promoting interprofessional learning with medical students in home care settings.

PubMed

Solomon, Patricia; Risdon, Cathy

2011-01-01

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

Power Up for Health-Participants' Perspectives on an Adaptation of the National Diabetes Prevention Program to Engage Men.

PubMed

Realmuto, Lindsey; Kamler, Alexandra; Weiss, Linda; Gary-Webb, Tiffany L; Hodge, Michael E; Pagán, José A; Walker, Elizabeth A

2018-07-01

The National Diabetes Prevention Program (NDPP) has been effectively translated to various community and clinical settings; however, regardless of setting, enrollment among men and lower-income populations is low. This study presents participant perspectives on Power Up for Health, a novel NDPP pilot adaption for men residing in low-income communities in New York City. We conducted nine interviews and one focus group with seven participants after the program ended. Interview and focus group participants had positive perceptions of the program and described the all-male aspect of the program and its reliance on male coaches as major strengths. Men felt the all-male adaptation allowed for more open, in-depth conversations on eating habits, weight loss, body image, and masculinity. Participants also reported increased knowledge and changes to their dietary and physical activity habits. Recommendations for improving the program included making the sessions more interactive by, for example, adding exercise or healthy cooking demonstrations. Overall, findings from the pilot suggest this NDPP adaptation was acceptable to men and facilitated behavior change and unique discussions that would likely not have occurred in a mixed-gender NDPP implementation.

Youth Mental Health, Family Practice, and Knowledge Translation Video Games about Psychosis: Family Physicians' Perspectives.

PubMed

Ferrari, Manuela; Suzanne, Archie

2017-01-01

Family practitioners face many challenges providing mental healthcare to youth. Digital technology may offer solutions, but the products often need to be adapted for primary care. This study reports on family physicians' perspectives on the relevance and feasibility of a digital knowledge translation (KT) tool, a set of video games, designed to raise awareness about psychosis, marijuana use, and facilitate access to mental health services among youth. As part of an integrated knowledge translation project, five family physicians from a family health team participated in a focus group. The focus group delved into their perspectives on treating youth with mental health concerns while exploring their views on implementing the digital KT tool in their practice. Qualitative data was analyzed using thematic analysis to identify patterns, concepts, and themes in the transcripts. Three themes were identified: (a) challenges in assessing youth with mental health concerns related to training, time constraints, and navigating the system; (b) feedback on the KT tool; and, (c) ideas on how to integrate it into a primary care practice. Family practitioners felt that the proposed video game KT tool could be used to address youth's mental health and addictions issues in primary care settings.

Providers' perceptions of spinal cord injury pressure ulcer guidelines.

PubMed

Thomason, Susan S; Evitt, Celinda P; Harrow, Jeffrey J; Love, Linda; Moore, D Helen; Mullins, Maria A; Powell-Cope, Gail; Nelson, Audrey L

2007-01-01

Pressure ulcers are a serious complication for people with spinal cord injury (SCI). The Consortium for Spinal Cord Medicine (CSCM) published clinical practice guidelines (CPGs) that provided guidance for pressure ulcer prevention and treatment after SCI. The aim of this study was to assess providers' perceptions for each of the 32 CPG recommendations regarding their agreement with CPGs, degree of CPG implementation, and CPG implementation barriers and facilitators. This descriptive mixed-methods study included both qualitative (focus groups) and quantitative (survey) data collection approaches. The sample (n = 60) included 24 physicians and 36 nurses who attended the 2004 annual national conferences of the American Paraplegia Society or American Association of Spinal Cord Injury Nurses. This sample drew from two sources: a purposive sample from a list of preregistered participants and a convenience sample of conference attendee volunteers. We analyzed quantitative data using descriptive statistics and qualitative data using a coding scheme to capture barriers and facilitators. The focus groups agreed unanimously on the substance of 6 of the 32 recommendations. Nurse and physician focus groups disagreed on the degree of CGP implementation at their sites, with nurses as a group perceiving less progress in implementation of the guideline recommendations. The focus groups identified only one recommendation, complications of surgery, as being fully implemented at their sites. Categories of barriers and facilitators for implementation of CPGs that emerged from the qualitative analysis included (a) characteristics of CPGs: need for research/evidence, (b) characteristics of CPGs: complexity of design and wording, (c) organizational factors, (d) lack of knowledge, and (e) lack of resources. Although generally SCI physicians and nurses agreed with the CPG recommendations as written, they did not feel these recommendations were fully implemented in their respective clinical settings. The focus groups identified multiple barriers to the implementation of the CPGs and suggested several facilitators/solutions to improve implementation of these guidelines in SCI. Participants identified organizational factors and the lack of knowledge as the most substantial systems/issues that created barriers to CPG implementation.

Attitudes Toward Smoking Cessation Among Sheltered Homeless Parents.

PubMed

Stewart, Holly C; Stevenson, Terrell N; Bruce, Janine S; Greenberg, Brian; Chamberlain, Lisa J

2015-12-01

The prevalence of smoking among homeless adults is approximately 70 %. Cessation programs designed for family shelters should be a high priority given the dangers cigarette smoke poses to children. However, the unique nature of smoking in the family shelter setting remains unstudied. We aimed to assess attitudes toward smoking cessation, and unique barriers and motivators among homeless parents living in family shelters in Northern California. Six focus groups and one interview were conducted (N = 33, ages 23-54). The focus groups and interviews were audiorecorded, transcribed verbatim, and a representative team performed qualitative theme analysis. Eight males and 25 females participated. The following major themes emerged: (1) Most participants intended to quit eventually, citing concern for their children as their primary motivation. (2) Significant barriers to quitting included the ubiquity of cigarette smoking, its central role in social interactions in the family shelter setting, and its importance as a coping mechanism. (3) Participants expressed interest in quitting "cold turkey" and in e-cigarettes, but were skeptical of the patch and pharmacotherapy. (4) Feelings were mixed regarding whether individual, group or family counseling would be most effective. Homeless parents may be uniquely motivated to quit because of their children, but still face significant shelter-based social and environmental barriers to quitting. Successful cessation programs in family shelters must be designed with the unique motivations and barriers of this population in mind.

Student attitudes towards clinical teaching resources in complementary medicine: a focus group examination of Australian naturopathic medicine students.

PubMed

Wardle, Jonathan Lee; Sarris, Jerome

2014-06-01

Complementary medicine is forming an increasingly large part of health care in developed countries and is increasingly being formally taught in tertiary academic settings. An exploratory study of naturopathic student perceptions of, use of and attitudes towards teaching resources in naturopathic clinical training and education. Focus groups were conducted with current and recent students of 4-year naturopathic degree programmes in Brisbane and Sydney to ascertain how they interact with clinical teaching materials, and their perceptions and attitudes towards teaching materials in naturopathic education. Naturopathic students have a complex and critical relationship with their learning materials. Although naturopathic practice is often defined by traditional evidence, students want information that both supports and is critical of traditional naturopathic practices, and focuses heavily on evidence-based medicine. Students remain largely ambivalent about new teaching technologies and would prefer that these develop organically as an evolution from printed materials, rather than depart from dramatically and radically from these previously established materials. Findings from this study will assist publishers, librarians and academics develop clinical information sources that appropriately meet student expectations and support their learning requirements. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

New rules meet established sickness certification practice: A focus-group study on the introduction of functional assessments in Norwegian primary care

PubMed Central

Krohne, Kariann; Brage, Søren

2007-01-01

Objective To explore how general practitioners view and handle new standards for functional assessments in sickness certification practice. Design Qualitative study using focus group interviews. Data were analysed according to Giorgi's phenomenological approach and supported by theories on knowledge. Setting General practitioners from three neighbouring counties in Norway. Subjects Four focus groups with a total of 23 participants were recruited through the Norwegian Medical Association and its Continuous Medical Education system. Results The participants reported difficulties and reluctance to act in accordance with new functional assessment demands on both a practical and a conceptual level. In established sickness certification practice functional assessment was described as an unspoken part of the medical examination. After the introduction of formal, written functional assessments they identified problems of terminology, communication, and trust. Strategies were developed to circumvent these problems. Conclusions A gap was noticeable between the participants’ established practice and the new standards’ demand for a more theoretical and communicative functional assessment. The general lack of training, being confronted with new terminology, and increasingly high pressure to reduce sickness absences create an atmosphere of insecurity when assessing function. PMID:17846936

Social and Economic Costs of Food Allergies in Europe: Development of a Questionnaire to Measure Costs and Health Utility

PubMed Central

Fox, Margaret; Voordouw, Jantine; Mugford, Miranda; Cornelisse, Judith; Antonides, Gerrit; Frewer, Lynn

2009-01-01

Objectives To develop a questionnaire to measure the additional social costs of food allergies (FAs). Data Source and Study Setting People with FAs and sampled members of the general population (with and without FAs) in the Netherlands and the United Kingdom in 2006. Study Design (1) Literature review. (2) Focus group to identify key costs of FAs and seek views on the questionnaires. (3) Pilot survey to test the questionnaires in cases and controls. Data Collection Twenty-eight participants in the United Kingdom and the Netherlands with clinically or self-diagnosed FAs took part in one of five focus groups. A case–control postal survey was conducted in the United Kingdom and the Netherlands (with 125 FA cases and 62 controls). Principal Findings Methods exist to measure social costs in chronic illness, but not FAs. Focus groups found features of FAs likely to impact costs of living. Pilot results suggest higher costs of living and health care costs, and well-being in FAs. Conclusion The questionnaire is proposed for use in wider European and other comparative studies of FAs. PMID:19619251

A qualitative study of the aspirations and challenges of low-income mothers in feeding their preschool-aged children

PubMed Central

2012-01-01

Background The prevalence of obesity among preschool-aged children has increased, especially among those in low-income households. Two promising behavioral targets for preventing obesity include limiting children’s portion sizes and their intake of foods high in solid fats and/or added sugars, but these approaches have not been studied in low-income preschoolers in the home setting. The purpose of this study was to understand the contextual factors that might influence how low-income mothers felt about addressing these behavioral targets and mothers’ aspirations in feeding their children. Methods We recruited 32 English-speaking women in Philadelphia, Pennsylvania who were eligible for the Supplemental Nutrition Assistance Program and who were the biologic mothers of children 36 to 66 months of age. Each mother participated in 1 of 7 focus groups and completed a brief socio-demographic questionnaire. Focus group questions centered on eating occasions, foods and drinks consumed in the home, and portion sizes. Each focus group lasted 90 minutes and was digitally recorded and transcribed verbatim. Three authors independently identified key themes and supporting quotations. Themes were condensed and modified through discussion among all authors. Results Thirty-one mothers identified themselves as black, 15 had a high school education or less, and 22 lived with another adult. Six themes emerged, with three about aspirations mothers held in feeding their children and three about challenges to achieving these aspirations. Mothers’ aspirations were to: 1) prevent hyperactivity and tooth decay by limiting children’s sugar intake, 2) use feeding to teach their children life lessons about limit setting and structure, and 3) be responsive to children during mealtimes to guide decisions about portions. Especially around setting limits with sweets and snacks, mothers faced the challenges of: 1) being nagged by children’s food requests, 2) being undermined by other adults in the family, and 3) having bad memories from childhood that made it hard to deny children’s food requests. Conclusions Although the primary aspirations of low-income mothers in feeding their preschool-aged children were not focused on children’s weight, these aspirations were compatible with obesity prevention strategies to limit children’s portion sizes and their intake of solid fats and/or added sugars. PMID:23157723

Leadership development programs for physicians: a systematic review.

PubMed

Frich, Jan C; Brewster, Amanda L; Cherlin, Emily J; Bradley, Elizabeth H

2015-05-01

Physician leadership development programs typically aim to strengthen physicians' leadership competencies and improve organizational performance. We conducted a systematic review of medical literature on physician leadership development programs in order to characterize the setting, educational content, teaching methods, and learning outcomes achieved. Articles were identified through a search in Ovid MEDLINE from 1950 through November 2013. We included articles that described programs designed to expose physicians to leadership concepts, outlined teaching methods, and reported evaluation outcomes. A thematic analysis was conducted using a structured data entry form with categories for setting/target group, educational content, format, type of evaluation and outcomes. We identified 45 studies that met eligibility criteria, of which 35 reported on programs exclusively targeting physicians. The majority of programs focused on skills training and technical and conceptual knowledge, while fewer programs focused on personal growth and awareness. Half of the studies used pre/post intervention designs, and four studies used a comparison group. Positive outcomes were reported in all studies, although the majority of studies relied on learner satisfaction scores and self-assessed knowledge or behavioral change. Only six studies documented favorable organizational outcomes, such as improvement in quality indicators for disease management. The leadership programs examined in these studies were characterized by the use of multiple learning methods, including lectures, seminars, group work, and action learning projects in multidisciplinary teams. Physician leadership development programs are associated with increased self-assessed knowledge and expertise; however, few studies have examined outcomes at a system level. Our synthesis of the literature suggests important gaps, including a lack of programs that integrate non-physician and physician professionals, limited use of more interactive learning and feedback to develop greater self-awareness, and an overly narrow focus on individual-level rather than system-level outcomes.

A Novel Implementation Strategy in Residential Care Settings to Promote EBP: Direct Care Provider Perceptions and Development of a Conceptual Framework.

PubMed

Slaughter, Susan E; Bampton, Erin; Erin, Daniel F; Ickert, Carla; Jones, C Allyson; Estabrooks, Carole A

2017-06-01

Innovative approaches are required to facilitate the adoption and sustainability of evidence-based care practices. We propose a novel implementation strategy, a peer reminder role, which involves offering a brief formal reminder to peers during structured unit meetings. This study aims to (a) identify healthcare aide (HCA) perceptions of a peer reminder role for HCAs, and (b) develop a conceptual framework for the role based on these perceptions. In 2013, a qualitative focus group study was conducted in five purposively sampled residential care facilities in western Canada. A convenience sample of 24 HCAs agreed to participate in five focus groups. Concurrent with data collection, two researchers coded the transcripts and identified themes by consensus. They jointly determined when saturation was achieved and took steps to optimize the trustworthiness of the findings. Five HCAs from the original focus groups commented on the resulting conceptual framework. HCAs were cautious about accepting a role that might alienate them from their co-workers. They emphasized feeling comfortable with the peer reminder role and identified circumstances that would optimize their comfort including: effective implementation strategies, perceptions of the role, role credibility and a supportive context. These intersecting themes formed a peer reminder conceptual framework. We identified HCAs' perspectives of a new peer reminder role designed specifically for them. Based on their perceptions, a conceptual framework was developed to guide the implementation of a peer reminder role for HCAs. This role may be a strategic implementation strategy to optimize the sustainability of new practices in residential care settings, and the related framework could offer guidance on how to implement this role. © 2017 Sigma Theta Tau International.

Perceptions on the risk communication strategy during the 2013 avian influenza A/H7N9 outbreak in humans in China: a focus group study

PubMed Central

Li, Richun; Xie, Ruiqian; Yang, Chong

2016-01-01

Objective To identify the general public’s perceptions of the overall risk communication strategy carried out by Chinese public health agencies during the first wave of avian influenza A(H7N9) outbreak in humans in 2013. Methods Participants were recruited from communities in Beijing, Lanzhou and Hangzhou, China in May and June 2013 by convenience sampling. Demographics and other relevant information were collected using a self-administered questionnaire. Focus group interviews were conducted using a set of nine pre-developed questions and a tested moderator guide. The interviews were audio recorded and were transcribed verbatim. The constant comparative method was used to identify trends and themes. Results A total of nine focus group interviews, with 94 participants recruited from nine communities, were conducted. Most participants received H7N9 information via television and the Internet. Most the participants appreciated the transparency and timeliness of the information released by the government. They expressed a sense of trust in the recommended public health advice and followed most of them. The participants suggested that the government release more information about clinical treatment outcomes, have more specific health recommendations that are practical to their settings and expand the use of new media channels for risk communication. Conclusion The public perceived the overall risk communication strategy by the Chinese public health agencies as effective, though the moderator had a governmental agency title that might have biased the results. There is a need to expand the use of social media for risk communication in the future. PMID:27757257

Understanding the challenges to facilitating active learning in the resident conferences: a qualitative study of internal medicine faculty and resident perspectives.

PubMed

Sawatsky, Adam P; Zickmund, Susan L; Berlacher, Kathryn; Lesky, Dan; Granieri, Rosanne

2015-01-01

In the Next Accreditation System, the Accreditation Council for Graduate Medical Education outlines milestones for medical knowledge and requires regular didactic sessions in residency training. There are many challenges to facilitating active learning in resident conferences, and we need to better understand resident learning preferences and faculty perspectives on facilitating active learning. The goal of this study was to identify challenges to facilitating active learning in resident conferences, both through identifying specific implementation barriers and identifying differences in perspective between faculty and residents on effective teaching and learning strategies. The investigators invited core residency faculty to participate in focus groups. The investigators used a semistructured guide to facilitate discussion about learning preferences and teaching perspectives in the conference setting and used an 'editing approach' within a grounded theory framework to qualitative analysis to code the transcripts and analyze the results. Data were compared to previously collected data from seven resident focus groups. Three focus groups with 20 core faculty were conducted. We identified three domains pertaining to facilitating active learning in resident conferences: barriers to facilitating active learning formats, similarities and differences in faculty and resident learning preferences, and divergence between faculty and resident opinions about effective teaching strategies. Faculty identified several setting, faculty, and resident barriers to facilitating active learning in resident conferences. When compared to residents, faculty expressed similar learning preferences; the main differences were in motivations for conference attendance and type of content. Resident preferences and faculty perspectives differed on the amount of information appropriate for lecture and the role of active participation in resident conferences. This study highlights several challenges to facilitating active learning in resident conferences and provides insights for residency faculty who seek to transform the conference learning environment within their residency program.

Unmet Communication and Information Needs for Patients with IBD: Implications for Mobile Health Technology.

PubMed

Khan, Sameer; Dasrath, Florence; Farghaly, Sara; Otobo, Emamuzo; Riaz, Muhammad Safwan; Rogers, Jason; Castillo, Anabella; Atreja, Ashish

2016-01-01

In order to develop an application that addresses the most significant challenges facing IBD patients, this qualitative study explored the major hurdles of living with IBD, the information needs of IBD patients, and how application technology may be used to improve quality of life. 15 IBD patients participated in two focus groups of 120 minutes each. Data collection was achieved by combining focus groups with surveys and direct observation of patients looking at a patient-engaged app (HealthPROMISE) screenshots. The survey elicited information on demographics, health literacy and quality of life through the Short IBD Questionnaire (SIBDQ). The needs of IBD patients center around communication as it relates to both patient information needs and navigating the social impacts of IBD on patients' lives: Communication Challenges regarding Information Needs: Patients cited a doctor-patient communication divide where there is a continued lack of goal setting when discussing treatments and a lack of objectivity in disease control. When objectively compared with the SIBDQ, nearly half of the patients in the focus groups wrongly estimated their IBD control.Communication Challenges regarding Social Impacts of IBD: Patients strongly felt that while IBD disrupts routines, adds significant stress, and contributes to a sense of isolation, the impact of these issues would be significantly alleviated through more conversation and better support.Implication for Mobile Health Solutions: Patients want a tool that improves tracking of symptoms, medication adherence and provides education. Physician feedback to patient input on an application is required for long-term sustainability. IBD patients need mobile health technologies that evaluate disease control and the goals of care. Patients feel an objective assessment of their disease control, goal setting and physician feedback will greatly enhance utilization of all mobile health applications.

Prosthetists' and Orthotists' experience of their work and workspace - characterising the physical and organisational environment: Focus group findings.

PubMed

Anderson, Sarah; Stuckey, Rwth; Oakman, Jodi R

2016-12-01

Little research has been undertaken into occupational health and safety in the Prosthetics and Orthotics profession. To identify physical, psychosocial and environmental workplace experiences of Prosthetists and Orthotists in organisational settings. Qualitative methodology, cross-sectional design, using thematically analysed data collected from focus groups. Focus groups explored workplace and work experiences across varied Prosthetic and Orthotic settings. Data were thematically analysed to identify physical, psychosocial and environmental workplace experiences. Three major themes, Demands of Work Practice, Impacts on the Individual and Job Design, were identified as problematic. A latent theme Perceptions of Others of P&O highlighted a lack of understanding of the Prosthetics and Orthotics job role outside the profession. This first study of occupational health and safety in the Prosthetics and Orthotics profession identifies a number of important physical and psychosocial issues, including characteristics that have been previously identified as risk factors for work-related musculoskeletal disorders. Findings from the study indicate that some Australian organisations lack understanding of the Prosthetics and Orthotics job role, which results in inappropriate expectations of Prosthetics and Orthotics professionals. Preventing injuries and retaining experienced Prosthetists and Orthotists in the workplace is vital for the profession, and as a result, issues raised in this study require further exploration and then development of appropriate management strategies. This is the first study characterising the experiences of work and risk of injuries in Prosthetists and Orthotists. Preventing injuries and retaining experienced Prosthetists and Orthotists in the workplace is vital for the international profession. Issues raised in this study require further exploration and then development of appropriate management strategies. © The International Society for Prosthetics and Orthotics 2015.

Development and quality analysis of the Work Experience Measurement Scale (WEMS).

PubMed

Nilsson, Petra; Bringsén, Asa; Andersson, H Ingemar; Ejlertsson, Göran

2010-01-01

Instruments related to work are commonly illuminated from an ill-health perspective. The need for a concise and useable instrument in workplace health promotion governed the aim of this paper which is to present the development process and quality assessment of the Work Experience Measurement Scale (WEMS). A survey, using a questionnaire based on established theories regarding work and health, and a focus group study were performed in hospital settings in 2005 and 2006 respectively. A Principal Component Analysis (PCA) was used to statistically develop a model, and focus group interviews were made to compare quantitative and qualitative results for convergence and corroboration. The PCA resulted in a six factor model of dimensions containing items regarding management, reorganization, internal work experience, pressure of time, autonomy and supportive working conditions. In the analysis of the focus group study three themes appeared and their underlying content was compared to, and matched, with the dimensions of the PCA. The reliability, shown by weighted kappa values, ranged from 0.36 to 0.71, and adequate Cronbach's Alpha values of the dimensions were all above 0.7. The study validity, indicated by discriminant validity, with correlation values that ranged from 0.10 to 0.39, in relation to the content validity appeared to be good when the theoretical content of the WEMS was compared to the content of similar instruments. The WEMS presents a multidimensional picture of work experience. Its theoretical base and the psychometric properties give support for applicability and offer a possibility to measure trends in the work experience over time in health care settings. One intention of the WEMS is to stimulate the ability of organizations and the employees themselves to take action on improving their work experience. The conciseness of the instrument is intended to increase its usability.

Initiating a Standardized Regional Referral and Counter-Referral System in Guatemala: A Mixed-Methods Study.

PubMed

Kapoor, Rupa; Avendaño, Leslie; Sandoval, Maria Antonieta; Cruz, Andrea T; Sampayo, Esther M; Soto, Miguel A; Camp, Elizabeth A; Crouse, Heather L

2017-01-01

Background: Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods : PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system. Referred patient records were reviewed to evaluate system effectiveness. Results : A total of 111 initial focus group participants included 96 (86.5%) from PHCs and 15 from the hospital. Of these participants, 53 PHC physicians and nurses and 15 hospital physicians initially completed written surveys. Convenience samples participated in follow-up. Eighteen focus groups achieved thematic saturation. Four themes emerged: effective communication; provision of timely, quality patient care with adequate resources; educational opportunities; and development of empowerment and relationships. Pre- and post-implementation surveys demonstrated significant improvement at the PHCs ( P < .001) and the hospital ( P = .02). Chart review included 435 referrals, 98 (22.5%) pre-implementation and 337 (77.5%) post-implementation. There was a trend toward an increased percentage of appropriately referred patients requiring medical intervention (30% vs 40%, P = .08) and of patients requiring intervention who received it prior to transport (55% vs 73%, P = .06). Conclusions : Standardizing a referral/counter-referral system improved communication, education, and trust across different levels of pediatric health care delivery. This model may be used for extension throughout Guatemala or be modified for use in other countries. Mixed-methods research design can evaluate complex systems in resource-limited settings.

EC FP6 Siberia-focused Enviro-RISKS Project and its Outcomes

NASA Astrophysics Data System (ADS)

Baklanov, A. A.; Gordov, E. P.

2009-04-01

The FP6 Project "Man-induced Environmental Risks: Monitoring, Management and Remediation of Man-made Changes in Siberia" (Enviro-RISKS) strategic objective is to facilitate elaboration of solid scientific background and understanding of man-made associated environmental risks, their influence on all aspects of regional environment and optimal ways for it remediation by means of coordinated initiatives of a range of relevant RTD projects as well as to achieve their improved integration thus giving the projects additional synergy in current activities and potential for practical applications. List of Partners includes 3 leading European research organizations, 6 leading Russian research organizations (5 - located in Siberia) and 1 organization from Kazakhstan. Additionally several Russian and European research organizations joined to the Project as Associated Partners. Scientific background and foundation for the project performance is formed by a number of different levels RTD projects carried out by Partners and devoted to near all aspects of the theme. The set comprise coordinated/performed by partners EC funded thematic international projects, Russian national projects and other projects performed by NIS partners. Project outcomes include, in particular, development and support of the bilingual Enviro-RISKS web portal (http://risks.scert.ru/) as the major tool for disseminations of environmental information and project results; achieved level of development of Siberia Integrated Regional Study (SIRS, http://sirs.scert.ru/), which is the Siberia-focused NEESPI Environmental Mega-Project ongoing under the auspices of the Siberian Branch of the Russian Academy of Sciences. The main Project outcome are Memorandum on the state of the art of environmental RTD activity in Siberia and Recommendations on future environmental RTD activity in Siberia elaborated by four Working Experts Groups working in most important for Siberia Thematic Focuses. Three Thematic Focuses/Groups consider major risks inherent to Siberia environment, while the forth Focus has a generic nature. These groups analyzed numerous RTD projects devoted Siberia environment and prepared Reports summarizing their findings. Focus groups Reports are published as a DMI Scientific Report: Atmospheric Pollution and Risks (www.dmi.dk/dmi/sr08-05-1.pdf), Climate/Global Change and Risks (www.dmi.dk/dmi/sr08-05-2.pdf), and Terrestrial Ecosystems and Hydrology and Risks (www.dmi.dk/dmi/sr08-05-3.pdf). Information Systems, Integration and Synthesis (www.dmi.dk/dmi/sr08-05-4.pdf). The results obtained form a solid basis for organization of a coordinated set of the new projects on Siberia environment.

How diverse is the asteroid belt?

NASA Technical Reports Server (NTRS)

Burbine, Thomas H.; Bell, Jeffrey F.

1993-01-01

For approximately twenty years, many different asteroid taxonomies, which used many different observational data sets, have been developed to try to group asteroids into classes that contain members with similar spectral characteristics. However, to understand the structure of the asteroid belt, the resulting classes are only useful if they are grouping together asteroids with somewhat similar mineralogies and thermal histories. Until recently, these taxonomies have focused on spectral reflectance data from 0.3 to 1.1 microns and visual albedo. But in the last five years, observational data sets (e.g., 0.8 to 2.5 microns spectra, CCD spectra, 3 microns spectra, and radar albedos) for a small number of asteroids were compiled that can give a better mineralogical interpretation, but whose use in asteroid taxonomy was relatively limited. Analyses of these 'supplementary' data sets show that most asteroid classes contain members with different compositions and/or thermal histories. To understand the diversity of the asteroid belt, the number of objects with these observations must be expanded and used in the next generation of taxonomies.

Translating teamwork behaviours from aviation to healthcare: development of behavioural markers for neonatal resuscitation

PubMed Central

Thomas, E; Sexton, J; Helmreich, R

2004-01-01

Improving teamwork in healthcare may help reduce and manage errors. This paper takes a step toward that goal by (1) proposing a set of teamwork behaviours, or behavioural markers, for neonatal resuscitation; (2) presenting a data form for recording observations about these markers; and (3) comparing and contrasting different sets of teamwork behaviours that have been developed for healthcare. Data from focus groups of neonatal providers, surveys, and video recordings of neonatal resuscitations were used to identify some new teamwork behaviours, to translate existing aviation team behaviours to this setting, and to develop a data collection form. This behavioural marker audit form for neonatal resuscitation lists and defines 10 markers that describe specific, observable behaviours seen during the resuscitation of newborn infants. These markers are compared with those developed by other groups. Future research should determine the relations among these behaviours and errors, and test their usefulness in measuring the impact of team training interventions. PMID:15465957

Problematizing the concept of the "borderline" group in performance assessments.

PubMed

Homer, Matt; Pell, Godfrey; Fuller, Richard

2017-05-01

Many standard setting procedures focus on the performance of the "borderline" group, defined through expert judgments by assessors. In performance assessments such as Objective Structured Clinical Examinations (OSCEs), these judgments usually apply at the station level. Using largely descriptive approaches, we analyze the assessment profile of OSCE candidates at the end of a five year undergraduate medical degree program to investigate the consistency of the borderline group across stations. We look specifically at those candidates who are borderline in individual stations, and in the overall assessment. While the borderline group can be clearly defined at the individual station level, our key finding is that the membership of this group varies considerably across stations. These findings pose challenges for some standard setting methods, particularly the borderline group and objective borderline methods. They also suggest that institutions should ensure appropriate conjunctive rules to limit compensation in performance between stations to maximize "diagnostic accuracy". In addition, this work highlights a key benefit of sequential testing formats in OSCEs. In comparison with a traditional, single-test format, sequential models allow assessment of "borderline" candidates across a wider range of content areas with concomitant improvements in pass/fail decision-making.

Rel8: demonstrating the feasibility of delivering an 8-week social skills program in a public mental health setting.

PubMed

Wauchope, Bronwyn; Terlich, Alissa; Lee, Stuart

2016-06-01

As community mental health services integrate recovery-oriented practices, treatments that focus on skills development and social integration are desirable. This study aimed to examine the feasibility of implementing "Rel8", an 8-week social skills training group adapted to suit a public community mental health setting. A retrospective audit was conducted of quantitative and qualitative data from four groups run between 2011 and 2013. Pre- and post-group measures were collected, assessing self-rated friendships and confidence with social skills and clinician-rated social skill performance. Qualitative feedback about group participation was also collected through use of a developed questionnaire. Analysis revealed significant improvements in participants' confidence with their social skills following group participation, with a trend also found for improved social skill performance. "Rel8", an adapted 8-week social skills training group, is a feasible program in the context of community mental health services. The program added to the recovery-centred practice of the community mental health service while also adding to the diversity of clinician skills for psychosocial-oriented practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

A Road Less Traveled By: Exploring a Decade of Ellman Chemistry

PubMed Central

Shelat, Anang A.; Guy, R. Kiplin

2009-01-01

The Ellman group has been one of the most influential in the development and widespread adoption of combinatorial chemistry techniques for biomedical research. Their work has included substantial methodological development for library synthesis with a particular focus on new scaffolds rationally targeted to biomolecules of interest and biologically relevant natural products. Herein we analyze a representative set of libraries from this group with respect to their biological and biomedical relevance in comparison to existing drugs and probe compounds. This analysis reveals that the Ellman group has not only provided new methodologies to the community but also provided libraries with unique potential for further biological study. PMID:18343129

3D splint prototype system for applications in muscular rehab by transcutaneous electrical nerve stimulation (TENS)

NASA Astrophysics Data System (ADS)

Saldaña-Martínez, M. I.; Guzmán-González, J. V.; Barajas-González, O. G.; Guzman-Ramos, V.; García-Garza, A. K.; González-García, R. B.; García-Ramírez, M. A.

2017-03-01

It is quite common that patients with ligamentous ruptures, tendonitis, tenosynovitis or sprains are foreseen the use of ad hoc splints for a swift recovery. In this paper, we propose a rehabilitation split that is focused on upper-limb injuries. By considering that upper-limb patient shows a set of different characteristics, our proposal personalizes and prints the splint custom made though a digital model that is generated by a 3D commercial scanner. To fabricate the 3D scanned model the Stereolithography material (SLA) is considered due to the properties that this material offers. In order to complement the recovery process, an electronic system is implemented within the splint design. This system generates a set of pulses for a fix period of time that focuses mainly on a certain group of muscles to allow a fast recovery process known as Transcutaneous Electrical Nerve Stimulation Principle (TENS).

Implementation and adoption of mechanical patient lift equipment in the hospital setting: The importance of organizational and cultural factors.

PubMed

Schoenfisch, Ashley L; Myers, Douglas J; Pompeii, Lisa A; Lipscomb, Hester J

2011-12-01

Work focused on understanding implementation and adoption of interventions designed to prevent patient-handling injuries in the hospital setting is lacking in the injury literature and may be more insightful than more traditional evaluation measures. Data from focus groups with health care workers were used to describe barriers and promoters of the adoption of patient lift equipment and a shift to a "minimal-manual lift environment" at two affiliated hospitals. Several factors influencing the adoption of the lift equipment and patient-handling policy were noted: time, knowledge/ability, staffing, patient characteristics, and organizational and cultural aspects of work. The adoption process was complex, and considerable variability by hospital and across units was observed. The use of qualitative data can enhance the understanding of factors that influence implementation and adoption of interventions designed to prevent patient-handling injuries among health care workers. Copyright © 2011 Wiley Periodicals, Inc.

The group-as-a-whole-object relations model of group psychotherapy.

PubMed

Rosen, D; Stukenberg, K W; Saeks, S

2001-01-01

The authors review the theoretical basis of group psychotherapy performed at The Menninger Clinic and demonstrate how the theory has been put into practice on two different types of inpatient units. The fundamental elements of the theory and practice used can be traced to object relations theory as originally proposed by Melanie Klein. Her work with individuals was directly applied to working with groups by Ezriel and Bion, who focused on interpreting group tension. More modern approaches have reintegrated working with individual concerns while also attending to the group-as-a-whole. Historically, these principles have been applied to long-term group treatment. The authors apply the concepts from the group-as-a-whole literature to short- and medium-length inpatient groups with open membership. They offer clinical examples of the application of these principles in short-term inpatient settings in groups with open membership.

Acute care patient portals: a qualitative study of stakeholder perspectives on current practices.

PubMed

Collins, Sarah A; Rozenblum, Ronen; Leung, Wai Yin; Morrison, Constance Rc; Stade, Diana L; McNally, Kelly; Bourie, Patricia Q; Massaro, Anthony; Bokser, Seth; Dwyer, Cindy; Greysen, Ryan S; Agarwal, Priyanka; Thornton, Kevin; Dalal, Anuj K

2017-04-01

To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation. Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations. Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus. Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest. Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Impact and management of dual relationships in metropolitan, regional and rural mental health practice.

PubMed

Endacott, Ruth; Wood, Anita; Judd, Fiona; Hulbert, Carol; Thomas, Ben; Grigg, Margaret

2006-01-01

To explore the extent and impact of professional boundary crossings in metropolitan, regional and rural mental health practice in Victoria and identify strategies mental health clinicians use to manage dual relationships. Nine geographically located focus groups consisting of mental health clinicians: four focus groups in rural settings; three in a regional city and two in a metropolitan mental health service. A total of 52 participants were interviewed. Data revealed that professional boundaries were frequently breached in regional and rural settings and on occasions these breaches had a significantly negative impact. Factors influencing the impact were: longevity of the clinician's relationship with the community, expectations of the community, exposure to community 'gossip' and size of the community. Participants reported greater stress when the boundary crossing affected their partner and/or children. Clinicians used a range of proactive and reactive strategies, such as private telephone number, avoidance of social community activities, when faced with a potential boundary crossing. The feasibility of reactive strategies depended on the service configuration: availability of an alternative case manager, requirement for either patient or clinician to travel. The greater challenges faced by rural and regional clinicians were validated by metropolitan participants with rural experience and rural participants with metropolitan experience. No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.

The use of computer simulations in whole-class versus small-group settings

NASA Astrophysics Data System (ADS)

Smetana, Lara Kathleen

This study explored the use of computer simulations in a whole-class as compared to small-group setting. Specific consideration was given to the nature and impact of classroom conversations and interactions when computer simulations were incorporated into a high school chemistry course. This investigation fills a need for qualitative research that focuses on the social dimensions of actual classrooms. Participants included a novice chemistry teacher experienced in the use of educational technologies and two honors chemistry classes. The study was conducted in a rural school in the south-Atlantic United States at the end of the fall 2007 semester. The study took place during one instructional unit on atomic structure. Data collection allowed for triangulation of evidence from a variety of sources approximately 24 hours of video- and audio-taped classroom observations, supplemented with the researcher's field notes and analytic journal; miscellaneous classroom artifacts such as class notes, worksheets, and assignments; open-ended pre- and post-assessments; student exit interviews; teacher entrance, exit and informal interviews. Four web-based simulations were used, three of which were from the ExploreLearning collection. Assessments were analyzed using descriptive statistics and classroom observations, artifacts and interviews were analyzed using Erickson's (1986) guidelines for analytic induction. Conversational analysis was guided by methods outlined by Erickson (1982). Findings indicated (a) the teacher effectively incorporated simulations in both settings (b) students in both groups significantly improved their understanding of the chemistry concepts (c) there was no statistically significant difference between groups' achievement (d) there was more frequent exploratory talk in the whole-class group (e) there were more frequent and meaningful teacher-student interactions in the whole-class group (f) additional learning experiences not measured on the assessment resulted from conversations and interactions in the whole-class setting (g) the potential benefits of exploratory talk in the whole-class setting were not fully realized. These findings suggest that both whole-class and small-group settings are appropriate for using computer simulations in science. The effective incorporation of simulations into whole-class instruction may provide a solution to the dilemma of technology penetration versus integration in today's classrooms.

When does power disparity help or hurt group performance?

PubMed

Tarakci, Murat; Greer, Lindred L; Groenen, Patrick J F

2016-03-01

Power differences are ubiquitous in social settings. However, the question of whether groups with higher or lower power disparity achieve better performance has thus far received conflicting answers. To address this issue, we identify 3 underlying assumptions in the literature that may have led to these divergent findings, including a myopic focus on static hierarchies, an assumption that those at the top of hierarchies are competent at group tasks, and an assumption that equality is not possible. We employ a multimethod set of studies to examine these assumptions and to understand when power disparity will help or harm group performance. First, our agent-based simulation analyses show that by unpacking these common implicit assumptions in power research, we can explain earlier disparate findings--power disparity benefits group performance when it is dynamically aligned with the power holder's task competence, and harms group performance when held constant and/or is not aligned with task competence. Second, our empirical findings in both a field study of fraud investigation groups and a multiround laboratory study corroborate the simulation results. We thereby contribute to research on power by highlighting a dynamic understanding of power in groups and explaining how current implicit assumptions may lead to opposing findings. (c) 2016 APA, all rights reserved).