Different Backgrounds--Different Priorities? Student Perceptions of a Technology Initiative

ERIC Educational Resources Information Center

Eriksson, Miikka J.; Vuojärvi, Hanna

2014-01-01

A multitude of studies has assessed the success of different technology initiatives but rarely has the focus been on special groups. This paper examines whether university students with children and those without have different perceptions of a technology initiative where students were able to acquire university sponsored laptops and were provided…

Evaluation of the "Foundations in Knowledge Translation" training initiative: preparing end users to practice KT.

PubMed

Park, Jamie S; Moore, Julia E; Sayal, Radha; Holmes, Bev J; Scarrow, Gayle; Graham, Ian D; Jeffs, Lianne; Timmings, Caitlyn; Rashid, Shusmita; Johnson, Alekhya Mascarenhas; Straus, Sharon E

2018-04-25

Current knowledge translation (KT) training initiatives are primarily focused on preparing researchers to conduct KT research rather than on teaching KT practice to end users. Furthermore, training initiatives that focus on KT practice have not been rigorously evaluated and have focused on assessing short-term outcomes and participant satisfaction only. Thus, there is a need for longitudinal training evaluations that assess the sustainability of training outcomes and contextual factors that may influence outcomes. We evaluated the KT training initiative "Foundations in KT" using a mixed-methods longitudinal design. "Foundations in KT" provided training in KT practice and included three tailored in-person workshops, coaching, and an online platform for training materials and knowledge exchange. Two cohorts were included in the study (62 participants, including 46 "Foundations in KT" participants from 16 project teams and 16 decision-maker partners). Participants completed self-report questionnaires, focus groups, and interviews at baseline and at 6, 12, 18, and 24 months after the first workshop. Participant-level outcomes include survey results which indicated that participants' self-efficacy in evidence-based practice (F(1,8.9) = 23.7, p = 0.001, n = 45), KT activities (F(1,23.9) = 43.2, p < 0.001, n = 45), and using evidence to inform practice increased over time (F(1,11.0) = 6.0, p = 0.03, n = 45). Interviews and focus groups illustrated that participants' understanding of and confidence in using KT increased from baseline to 24 months after the workshop. Interviews and focus groups suggested that the training initiative helped participants achieve their KT project objectives, plan their projects, and solve problems over time. Contextual factors include teams with high self-reported organizational capacity and commitment to implement at the start of their project had buy-in from upper management that resulted in secured funding and resources for their project. Training initiative outcomes include participants who applied the KT knowledge and skills they learned to other projects by sharing their knowledge informally with coworkers. Sustained spread of KT practice was observed with five teams at 24 months. We completed a longitudinal evaluation of a KT training initiative. Positive participant outcomes were sustained until 24 months after the initial workshop. Given the emphasis on implementing evidence and the need to train implementers, these findings are promising for future KT training.

School Health Promotion to Increase Empowerment, Gender Equality and Pupil Participation: A Focus Group Study of a Swedish Elementary School Initiative

ERIC Educational Resources Information Center

Gadin, Katja Gillander; Weiner, Gaby; Ahlgren, Christina

2013-01-01

A school health promotion project was carried out in an elementary school in Sweden where active participation, gender equality, and empowerment were leading principles. The objective of the study was to understand challenges and to identify social processes of importance for such a project. Focus group interviews were conducted with 6 single-sex…

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…

Divorce transition differences of midlife women.

PubMed

Sakraida, Teresa J

2005-01-01

Divorce transition experienced by and its influence upon midlife women's health is not fully understood. Interviews were conducted with 24 divorced women who self-classified into decider status groups: initiator (who first decided to end marriage), non-initiator (recipient of end of marriage decision), and mutual decider (shared decision to end marriage). Interpretive content analysis involving pattern coding was conducted. The divorce transition by initiators (n=8) included self-focused growth, optimism, and social support losses and opportunities, while the divorce transition by non-initiators (n=8) included being left, ruminating, vulnerability, and spiritual comfort. No profile emerged for the mutual-decider group (n=8). This study supports that differences in divorce transition exist for initiators and non-initiators.

American Society of Clinical Oncology Obesity Initiative: Rationale, Progress, and Future Directions.

PubMed

Ligibel, Jennifer A; Wollins, Dana

2016-12-10

Obesity is increasingly being linked to the risk of developing and dying from cancer. In recognition of the growing contribution of obesity to cancer risk and outcomes, ASCO made obesity and cancer one of its core initiatives in 2014. The goals of this initiative included raising awareness of the relationship between obesity and cancer, providing tools and resources to oncology providers and patients to help encourage conversations regarding weight management in cancer survivors, fostering a robust research agenda, and advocating for access to evidence-based weight management programs for cancer survivors. Efforts to date have included developing patient and provider toolkits focused on weight management and physical activity, publishing a policy statement outlining ASCO's initiatives in this area, and hosting a summit focused on obesity research in cancer populations. As ASCO has defined its priorities in the area of obesity and cancer, it has become increasingly clear that obesity is a problem that extends far beyond its impact on cancer risk and outcomes. Many groups, including those focused on heart disease, diabetes, and endocrinology, have been developing, testing, and implementing obesity prevention and treatment strategies for years. As ASCO moves forward with its obesity initiative, the next steps will focus on forging collaboration with groups working on obesity-related initiatives both within and outside of the field of cancer to learn from their efforts and to partner with them on efforts to increase the education of medical professionals; raising awareness in lay populations regarding the negative health consequences of obesity and effective strategies to foster weight loss; developing collaborative research initiatives; and working together to advocate for the societal changes that will be needed to combat the obesity epidemic in the United States and beyond.

Initiating and sustaining breastfeeding in african american women.

PubMed

Lewallen, Lynne Porter; Street, Darlene J

2010-01-01

To explore issues related to initiating and sustaining breastfeeding in African American women. Qualitative design using focus groups, guided by Leininger's theory of culture care diversity and universality. Three different regions of a southeastern state in the United States. Fifteen self-identified African American women who had recently breastfed were recruited by lactation consultants and by word of mouth. Three focus groups were conducted with initial guiding questions. New ideas that emerged were fully explored in the group and included as a guiding question for the next group. Categories identified from the data were reasons to start and stop breastfeeding, advice about breastfeeding that was useful or not useful, and cultural issues related to breastfeeding that were perceived to be unique among African Americans. Three overall themes were identified that cut across categories: perceived lack of information about benefits and management of breastfeeding, difficulties breastfeeding in public, and lack of a support system for continued breastfeeding. Women need to be taught early in their pregnancies about the benefits of breastfeeding and offered continuing support and teaching once breastfeeding is established. Peer support groups for breastfeeding African American women should be established. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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.

Own Group Bias: Determining the Minimal Conditions.

ERIC Educational Resources Information Center

Bowie, Joseph A., Jr.; Kahn, Arnold

Group members tend to like other members of their own group more than members of groups to which they do not belong. This paper focuses on some of the initial determinants of this own-group preference and on the isolation of factors which increase or decrease it. The major finding appears to be that the mere anticipation of cooperation or…

Young women as smokers and nonsmokers: a qualitative social identity approach.

PubMed

Lennon, Alexia; Gallois, Cindy; Owen, Neville; McDermott, Liane

2005-12-01

The authors used a social identity perspective to explore young women's perceptions of smoking. They carried out 13 focus groups and 6 intercept interviews with women aged 16 to 28 years in regards to the social identities that might influence young women's smoking behavior. Three identities emerged: the cool smoker applied to the initiation of smoking; considerate smokers, who were older addicted smokers; and the actual and anticipated good mother identity, which applied to young women who quit smoking during pregnancy. These identities add to our understanding of the meaning of smoking within the lives of young women and might allow more focused initiatives with this group to prevent the progression to regular addicted smoking.

Building a taxonomy of integrated palliative care initiatives: results from a focus group

PubMed Central

Ewert, Benjamin; Hodiamont, Farina; van Wijngaarden, Jeroen; Payne, Sheila; Groot, Marieke; Hasselaar, Jeroen; Menten, Johann; Radbruch, Lukas

2016-01-01

Background Empirical evidence suggests that integrated palliative care (IPC) increases the quality of care for palliative patients and supports professional caregivers. Existing IPC initiatives in Europe vary in their design and are hardly comparable. InSuP-C, a European Union research project, aimed to build a taxonomy of IPC initiatives applicable across diseases, healthcare sectors and systems. Methods The taxonomy of IPC initiatives was developed in cooperation with an international and multidisciplinary focus group of 18 experts. Subsequently, a consensus meeting of 10 experts revised a preliminary taxonomy and adopted the final classification system. Results Consisting of eight categories, with two to four items each, the taxonomy covers the process and structure of IPC initiatives. If two items in at least one category apply to an initiative, a minimum level of integration is assumed to have been reached. Categories range from the type of initiative (items: pathway, model or guideline) to patients’ key contact (items: non-pc specialist, pc specialist, general practitioner). Experts recommended the inclusion of two new categories: level of care (items: primary, secondary or tertiary) indicating at which stage palliative care is integrated and primary focus of intervention describing IPC givers’ different roles (items: treating function, advising/consulting or training) in the care process. Conclusions Empirical studies are required to investigate how the taxonomy is used in practice and whether it covers the reality of patients in need of palliative care. The InSuP-C project will test this taxonomy empirically in selected initiatives using IPC. PMID:26647043

Role of Landlords in Creating Healthy Homes: Section 8 Landlord Perspectives on Healthy Housing Practices.

PubMed

Polletta, Valerie L; Reid, Margaret; Barros, Eugene; Duarte, Catherine; Donaher, Kevin; Wensley, Howard; Wolff, Lisa

2017-11-01

This article presents qualitative research findings of Section 8 landlord perceptions regarding healthy housing practices to inform landlord-focused initiatives. Approach or Design: Five focus groups were conducted with landlords. Boston, Massachusetts. Section 8 landlords participated in focus groups (n = 39). Focus group transcripts were coded for key themes using a grounded theory approach. Landlords' primary challenges to creating a healthy housing environment included tenant behavior, financial burden, and policy enforcement; tenant safety and cost savings were seen as primary benefits. Landlords play a critical role in implementing healthy housing practices. Several opportunities exist to reduce barriers and capitalize on perceived benefits of implementing these practices, including increasing access to educational and financial resources.

Strategic Retirement Reform: Identifying the Broader Strategic Effects from Changes in Human Capital

DTIC Science & Technology

2012-12-01

service and what factors influence their decisions?  What are the potential implications from adopting a defined contribution military retirement system...that best accommodated their personal schedules. After initial sign up , the focus groups were organized and conducted. Focus groups were scheduled to...positive or negative shock, or some other factor , compels a person to “evaluate against (a) a preexisting plan of action; (b) the individual’s values

Program Evaluation of a School District's Multisensory Reading Initiative

ERIC Educational Resources Information Center

Asip, Michael Patrick

2012-01-01

The purpose of this study was to conduct a formative program evaluation of a school district's multisensory reading initiative. The mixed methods study involved semi-structured interviews, online survey, focus groups, document review, and analysis of extant special education student reading achievement data. Participants included elementary…

Initiative Overview & Summary of Research

ERIC Educational Resources Information Center

Education Funders Research Initiative, 2013

2013-01-01

Education Funders Research Initiative (EdFunders), a project of Philanthropy New York, is supported by a group of diverse funding organizations that have pursued an array of education reform strategies. EdFunders have come together to engage New Yorkers and focus leaders on new research into how to best prepare students for college and…

Scaling up Professional Learning: Technical Expectations and Adaptive Challenges

ERIC Educational Resources Information Center

Dobbs, Christina L.; Ippolito, Jacy; Charner-Laird, Megin

2017-01-01

In order to be effective, professional development efforts are most promising if they are context specific and focus on supporting collaboration. Increasingly, schools initiate professional development with small groups of teachers, with the intention that the effects of the initiatives will spill over to other school personnel. This study follows…

Educational interventions for intimate partner violence: guidance from survivors.

PubMed

Randell, Kimberly A; Bledsoe, Linda K; Shroff, Purvi L; Pierce, Mary Clyde

2012-11-01

Previous research suggests that health care providers' assumptions about the content and marketing of intimate partner violence (IPV) materials are not always correct and may do harm. This study sought to determine what mothers with histories of IPV identify as important information to communicate about IPV and how it should be presented in a pediatric emergency department. This qualitative study used English- and Spanish-speaking focus groups for data collection and a grounded theory approach for data analysis. Initial focus groups elicited opinions on content, appearance, and location of IPV material. After data analysis, IPV posters were developed. Follow-up focus groups provided feedback on the posters. Ninety-nine mothers with histories of IPV participated in 8 initial and 4 follow-up focus groups. Women felt information should be presented in a positive, hopeful manner. Key information desired was signs of IPV, effects of childhood IPV exposure, and available resources. Spanish-speaking groups desired that information that helps was available regardless of immigration status. Women cautioned that information regarding the effects of childhood IPV exposure should be presented in a nonjudgmental manner to minimize feelings of anger and guilt in mothers. Participants endorsed the distribution of IPV materials in many formats and locations but also worried that women might suffer retribution if perpetrators see IPV material. Passive educational interventions for IPV should present information about the signs of IPV, resources, and effects on children in a positive, hopeful manner. Materials directed toward Spanish-speaking victims should address the issue of immigration status.

Visual Culture Learning Communities: How and What Students Come to Know in Informal Art Groups

ERIC Educational Resources Information Center

Freedman, Kerry; Heijnen, Emiel; Kallio-Tavin, Mira; Karpati, Andrea; Papp, Laszlo

2013-01-01

This article is the report of a large-scale, international research project involving focus group interviews of adolescent and young adult members of a variety of self-initiated visual culture groups in five urban areas (Amsterdam, Budapest, Chicago, Helsinki, and Hong Kong). Each group was established by young people around their interests in the…

Patient engagement and attrition in pediatric obesity clinics and programs: results and recommendations.

PubMed

Hampl, Sarah; Paves, Heather; Laubscher, Katie; Eneli, Ihuoma

2011-09-01

Pediatric tertiary care institutions are well positioned to provide multidisciplinary, intensive interventions for pediatric obesity known as stage 3 treatment. One contributor to the difficulty in administering this treatment is the high rate of patient attrition. Little is known about the practices used by pediatric weight-management clinics and group-based programs to minimize attrition. Hospital members and nonmembers of FOCUS on a Fitter Future were surveyed on the methods used to engage and retain obese children in their clinics and programs. Shortly thereafter, a benchmarking activity that centered on rates of patient nonattendance at initial and follow-up clinic visits was initiated among FOCUS-group-participating hospitals. Clinic- and group-based program results were contrasted. Staff from group-based programs reported that the majority of patients did not complete even 50% of program follow-up visits. Multiple patient/family- and clinic/program-level barriers to retention were identified. Attention to successful techniques should be paid during planning for new programs and improvement of established ones.

Walking the Talk in Initial Teacher Education: Making Teacher Educator Modeling Effective

ERIC Educational Resources Information Center

Hogg, Linda; Yates, Anne

2013-01-01

This self-study investigated student teachers' perceptions of teacher educators modeling practices within a large lecture class in an initial teacher education program. It also studied factors that affected student teachers' developing ideas and practice. Phase 1 collected data from student teachers through focus group interviews and…

Course Structure Matters in Initial Teacher Education: Student Teachers' Perceptions of Impacts on Their Learning

ERIC Educational Resources Information Center

Hogg, Linda; Yates, Anne

2013-01-01

This formative evaluation within a graduate initial teacher education program sought to identify student teachers' perceptions of lecturer practice and its influence on their developing practice. Data collected from course and teaching evaluations and focus group interviews suggested that microstructural course elements--lectures, tutorials, and…

Paradise nearly Gained. Volume 1: Developing the Frontline Management Initiative.

ERIC Educational Resources Information Center

Barratt-Pugh, Llandis; Soutar, Geoffrey N.

The Frontline Management Initiative (FMI) provides a framework for competency-based development of frontline managers in Australian enterprises. The FMI's impact on businesses was examined in a national study that included the following activities: focus groups; a national survey of management development and targeted national survey of FMI users;…

State Initiatives on Industry-Based Skill Standards and Credentials.

ERIC Educational Resources Information Center

Ganzglass, Evelyn; Simon, Martin

A study examined state initiatives for industry-based skill standards and credentials. Officials in 19 states were interviewed, case studies of programs in 3 states (Georgia, Pennsylvania, and Texas) were conducted, and focus group discussions were held with 25 individuals. State skill standards were generally found to be tied to broader efforts…

Men's Perceptions of Women's Participation in Development Initiatives in Rural Bangladesh.

PubMed

Karim, Rabiul; Lindberg, Lene; Wamala, Sarah; Emmelin, Maria

2018-03-01

Without taking masculine issues into account, women's participation in development initiatives does not always guarantee their empowerment, health, and welfare in a male-dominated society. This study aimed to explore men's perceptions of women's participation in development (WPD) in rural Bangladesh. In adopting a qualitative approach, the study examined 48 purposively selected married and unmarried men aged 20-76 years in three northwest villages. Data collection was accomplished through four focus group discussions (FGDs) with 43 men clustered into four groups and through individual interviews with five other men. A qualitative content analysis of the data revealed an overall theme of "feeling challenged by fears and hopes," indicating variations in men's views on women's participation in development initiatives as represented by three main categories: (a) fearing the loss of male authority, (b) recognizing women's roles in enhancing family welfare, and (c) valuing women's independence. In the context of dominant patriarchal traditions in Bangladesh, these findings provide new insight into dynamics and variations of men's views, suggesting a need to better engage men during different stages of women-focused development initiatives.

Treating alcoholism as a chronic disease: approaches to long-term continuing care.

PubMed

McKay, James R; Hiller-Sturmhofel, Susanne

2011-01-01

For many patients, alcohol and other drug (AOD) use disorders are chronic, recurring conditions involving multiple cycles of treatment, abstinence, and relapse. To disrupt this cycle, treatment can include continuing care to reduce the risk of relapse. The most commonly used treatment approach is initial intensive inpatient or outpatient care based on 12-step principles, followed by continuing care involving self-help groups, 12-step group counseling, or individual therapy. Although these programs can be effective, many patients drop out of initial treatment or do not complete continuing care. Thus, researchers and clinicians have begun to develop alternative approaches to enhance treatment retention in both initial and continuing care. One focus of these efforts has been the design of extended treatment models. These approaches increasingly blur the distinction between initial and continuing care and aim to prolong treatment participation by providing a continuum of care. Other researchers have focused on developing alternative treatment strategies (e.g., telephone-based interventions) that go beyond traditional settings and adaptive treatment algorithms that may improve outcomes for clients who do not respond well to traditional approaches.

Influence of age on clinical outcomes of three-dimensional transfer of the tibial tuberosity for patellar instability with patella alta.

PubMed

Otsuki, Shuhei; Nakajima, Mikio; Fujiwara, Kenta; Okamoto, Yoshinori; Iida, Go; Murakami, Tomohiko; Neo, Masashi

2017-08-01

To evaluate the clinical outcomes of three-dimensional (3D) transfer of the tibial tuberosity for patellar instability with patella alta, with a focus on the influence of age at initial surgery. Three-dimensional surgery was performed on 28 knees with a mean follow-up of 46 months. Patients were separated into three groups based on the age at initial surgery: group A, 10 knees and an average age of 16.3 ± 1.8 (14-19) years; group B, 10 knees and an average age of 22.1 ± 2.5 (20-28) years; and group C, eight knees and an average age of 44.0 ± 2.2 (40-46) years. Patellofemoral geometry improvement focused on patella alta by determining the Insall-Salvati ratio and Caton-Deschamps index, rotational malalignment by measuring the tibial tubercle-trochlear groove (TT-TG) distance, and lateral patellar subluxation by measuring the patellar tilt. Clinical outcomes were evaluated by the Lysholm and Kujala scores, which were compared before and after surgery. Cartilage degeneration was evaluated by the International Cartilage Repair Society grading system at initial arthroscopy. The patellar height, TT-TG, and patellar tilt significantly improved in all groups postoperatively (p < 0.05). The Lysholm and Kujala scores also significantly improved postoperatively; however, both scores were lower in group C than in the other groups (p < 0.05). Particularly, pain scores were more severe in group C than in the other groups, and the severity of cartilage degeneration correlated with the pain scores (p < 0.05). Cartilage damage differed significantly between the groups at initial arthroscopy; particularly, group C included grades III and IV cartilage degeneration (p < 0.05). Age at initial surgery may be the predicting factor for poor clinical outcomes of 3D transfer surgery. The clinical outcome may depend on the age at surgery, which correlated with cartilage damage; thus, surgeons should be given this information when patients are considered undergoing patella surgery. Therapeutic case series, Level IV.

Academic-correctional health partnerships: preparing the correctional health workforce for the changing landscape-focus group research results.

PubMed

Hale, Janet Fraser; Haley, Heather-Lyn; Jones, Judy L; Brennan, Allyson; Brewer, Arthur

2015-01-01

Providing health care in corrections is challenging. Attracting clinicians can be equally challenging. The future holds a shortage of nurses and primary care physicians. We have a unique opportunity, now, to develop and stabilize our workforce, create a positive image, and enhance quality before the health care landscape changes even more dramatically. Focus groups were conducted with 22 correctional health care professionals divided into three groups: physicians (6), nurses (4), and nurse practitioners/physician assistants (12). Content focused on curricular themes, but additional themes emerged related to recruitment and retention. This article describes recruitment challenges, strategic themes identified, and the proposed initiatives to support a stable, high-quality correctional health workforce. © The Author(s) 2014.

Economic empowerment and AIDS-related stigma in rural Kenya: a double-edged sword?

PubMed

Gnauck, Katherine; Ruiz, Jamie; Kellett, Nicole; Sussman, Andrew; Sullivan, Mary Ann; Montoya, Maria; Levin, Nick; Tomedi, Angelo; Mwanthi, Mutuku A

2013-01-01

Economic empowerment, HIV risk and AIDS-related stigma appear intricately intertwined for women in Kenya. Their interaction must be understood in order to implement effective economic interventions that also decrease HIV risk and stigma. We conducted a qualitative study amongst women in a rural Kamba-speaking community of southeastern Kenya to pursue whether engagement in an economic empowerment initiative (a basket weaving cooperative) influences women's perspectives and experiences with HIV risk and AIDS-related stigma. We conducted seven women's focus groups: participants in the local basket-weaving cooperative comprised four focus groups and non-participants comprised the remaining three groups. The HIV status of the women was not known. Three dominant themes emerged from the focus groups: empowerment, pervasive vulnerability and unanticipated social paradoxes. Contradictions found in these themes suggest that economic empowerment can become a double-edged sword. Economic empowerment enhanced perceived individual, domestic and social community status. However, this enhancement was not protective of domestic violence and perceived HIV risk. Social perceptions may have paradoxically contributed barriers to HIV testing and treatment putting women at greater HIV risk. In conclusion, economic empowerment initiatives for women in developing countries in the context of the HIV epidemic should be coupled with peer mediated support and HIV-risk education.

Views of parents, teachers and children on health promotion in kindergarten--first results from formative focus groups and observations.

PubMed

Sansolios, Sanne; Mikkelsen, Bent Egberg

2011-10-01

The aim of the study was to capture the views of children, parents and teachers on the topic of physical activity in kindergarten through observation and focus group interviews. The study was conducted in the kindergartens from the sampling group in the Danish part of PERISCOPE. 1(st) methodology: Children interviewed inside by the researcher on preferable movements and settings and then observed outside during their playtime. 2(nd) methodology: Children asked to draw themselves playing their most preferred physical activity. Parents and kindergarten teachers interviewed in two different groups, using an identical guide. Children are skilled in taking advantage of the space and facilities available for physical activity; girls need more support than boys to initiate physical activity; children are happy with the facilities and the toys available in the kindergarten. Teachers feel an increasing pressure to take more responsibility and initiatives for the children's health habits. Parents state that if more physical activity is initiated in the kindergarten, it could make children request domestic activity. Physical activity and movement concept are too abstract for children of this age to talk about: they quickly lose their focus and concentration. The new methodology of videotaping gives the researcher the chance to interpret facial expressions to capture movement, talk and actions, and to make a distinction among children, as they tend to interrupt each other. However, this method contains a weakness, if used alone, by the fact that the shooting is only a reflection of what the video camera has recorded.

Asthma Prevention and Management for Aboriginal People: Lessons From Mi’kmaq Communities, Unama’ki, Canada, 2012

PubMed Central

Watson, Robert; Bennett, Ella; Masuda, Jeffrey; King, Malcolm; Stewart, Miriam

2016-01-01

Background Asthma affects at least 10% of Aboriginal children (aged 11 or younger) in Canada, making it the second most common chronic disease suffered by this demographic group; yet asthma support strategies specific to Aboriginal peoples have only begun to be identified. Community Context This research builds on earlier phases of a recent study focused on identifying the support needs and intervention preferences of Aboriginal children with asthma and their parents or caregivers. Here, we seek to identify the implications of our initial findings for asthma programs, policies, and practices in an Aboriginal context and to determine strategies for implementing prevention programs in Aboriginal communities. Methods Five focus groups were conducted with 22 recruited community health care professionals and school personnel in 5 Mi’kmaq communities in Unama’ki (Cape Breton), Nova Scotia, Canada, through a community-based participatory research design. Each focus group was first introduced to findings from a local “social support for asthma” intervention, and then the groups explored issues associated with implementing social support from their respective professional positions. Outcome Thematic analysis revealed 3 key areas of opportunity and challenges for implementing asthma prevention and management initiatives in Mi’kmaq communities in terms of 1) professional awareness, 2) local school issues, and 3) community health centers. Interpretation Culturally relevant support initiatives are feasible and effective community-driven ways of improving asthma support in Mi’kmaq communities; however, ongoing assistance from the local leadership (ie, chief and council), community health directors, and school administrators, in addition to partnerships with respiratory health service organizations, is needed. PMID:26766847

Student perception of initial transition into a nursing program: A mixed methods research study.

PubMed

McDonald, Meghan; Brown, Janine; Knihnitski, Crystal

2018-05-01

Transition into undergraduate education programs is stressful and impacts students' well-being and academic achievement. Previous research indicates nursing students experience stress, depression, anxiety, and poor lifestyle habits which interfere with learning. However, nursing students' experience of transition into nursing programs has not been well studied. Incongruence exists between this lack of research and the desire to foster student success. This study analyzed students' experiences of initial transition into a nursing program. An embedded mixed method design. A single site of a direct-entry, four year baccalaureate Canadian nursing program. All first year nursing students enrolled in the fall term of 2016. This study combined the Student Adaptation to College Questionnaire (SACQ) with a subset of participants participating in qualitative focus groups. Quantitative data was analyzed using descriptive statistics to identify statistically significant differences in full-scale and subscale scores. Qualitative data was analyzed utilizing thematic analysis. Significant differences were seen between those who moved to attend university and those who did not, with those who moved scoring lower on the Academic Adjustment subscale. Focus group thematic analysis highlighted how students experienced initial transition into a baccalaureate nursing program. Identified themes included reframing supports, splitting focus/finding focus, negotiating own expectations, negotiating others' expectations, and forming identity. These findings form the Undergraduate Nursing Initial Transition (UNIT) Framework. Significance of this research includes applications in faculty development and program supports to increase student success in the first year of nursing and to provide foundational success for ongoing nursing practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

An Oasis in This Desert: Parents Talk about the New York City Beacons.

ERIC Educational Resources Information Center

Nevarez, Nancy

This report presents the findings of focus groups convened to determine what the parents of youth participants in the New York City Beacons think about the program. The Beacons initiative is a comprehensive model of school-community-family partnerships undertaken by New York City in 1991. The initiative originally enabled 10 community-based…

Enabling Initiative and Enterprise: Faculty-Led Course Redesign in a STEM Discipline

ERIC Educational Resources Information Center

Dee, Jay R.; Henkin, Alan B.; Hearne, Jennifer L.

2011-01-01

This study focuses on processes and outcomes associated with a faculty grassroots initiative to reform teaching and learning in an introductory chemistry course at a research university. The purpose of this study is threefold. First, the study considers faculty groups and teams as sites and sources of pedagogical change in an effort to improve…

Translation Sociology and Social Capital in Rural Development Initiatives. A Case Study from the Italian Alps

ERIC Educational Resources Information Center

Magnani, Natalia; Struffi, Lauro

2009-01-01

This article analyses the results of a European "research and demonstration" project promoting multifunctional and sustainable agriculture in Alpine regions through a participatory approach. It focuses in particular on initiatives undertaken by a local farmers group in the Italian Alpine area of Val di Sole, the purpose being to draw…

Factors That Advance and Restrict Programme Change and Professional Development in Dental Education

ERIC Educational Resources Information Center

Behar-Horenstein, Linda S.; Roberts, Kellie W.; Zafar, Mueen A.

2013-01-01

The aim of this study was to explore the effectiveness of a professional development initiative using organisational change research studies to frame the inquiry. Two faculty groups and two student groups participated in a total of four focus group interviews to ascertain their perceptions of a new model of pre-clinical dental education. Using a…

Barriers to nurse entrepreneurship: a study of the process model of entrepreneurship.

PubMed

Elango, B; Hunter, Gary L; Winchell, Mike

2007-04-01

The potential for nurse entrepreneurship to contribute to the effectiveness of healthcare delivery is well acknowledged, yet it has not been fully realized. Using the process model of entrepreneurship, we attempted to glean information from nursing professionals through focus groups on the barriers to starting a business. Two focus groups were used and expert moderators conducted these exercises. The first focus group included two hospital administrators, a nurse entrepreneur, an ophthalmology entrepreneur, and a dean of the nursing school familiar with nurse entrepreneurship. The second focus group used 20 students in a nurse practitioner program. The study findings indicate nurse practitioners and other nursing professionals do recognize the potential of nurse entrepreneurship. However, several barriers prevent them from exploiting the identified opportunity. While the barriers are significant, we believe they can be overcome with coordinated action by individual nurses, professional associations, and public policy initiatives. Several suggestions are offered to nurses seeking to become nurse entrepreneurs.

E-learning for Critical Thinking: Using Nominal Focus Group Method to Inform Software Content and Design.

PubMed

Parker, Steve; Mayner, Lidia; Michael Gillham, David

2015-12-01

Undergraduate nursing students are often confused by multiple understandings of critical thinking. In response to this situation, the Critiique for critical thinking (CCT) project was implemented to provide consistent structured guidance about critical thinking. This paper introduces Critiique software, describes initial validation of the content of this critical thinking tool and explores wider applications of the Critiique software. Critiique is flexible, authorable software that guides students step-by-step through critical appraisal of research papers. The spelling of Critiique was deliberate, so as to acquire a unique web domain name and associated logo. The CCT project involved implementation of a modified nominal focus group process with academic staff working together to establish common understandings of critical thinking. Previous work established a consensus about critical thinking in nursing and provided a starting point for the focus groups. The study was conducted at an Australian university campus with the focus group guided by open ended questions. Focus group data established categories of content that academic staff identified as important for teaching critical thinking. This emerging focus group data was then used to inform modification of Critiique software so that students had access to consistent and structured guidance in relation to critical thinking and critical appraisal. The project succeeded in using focus group data from academics to inform software development while at the same time retaining the benefits of broader philosophical dimensions of critical thinking.

E-learning for Critical Thinking: Using Nominal Focus Group Method to Inform Software Content and Design

PubMed Central

Parker, Steve; Mayner, Lidia; Michael Gillham, David

2015-01-01

Background: Undergraduate nursing students are often confused by multiple understandings of critical thinking. In response to this situation, the Critiique for critical thinking (CCT) project was implemented to provide consistent structured guidance about critical thinking. Objectives: This paper introduces Critiique software, describes initial validation of the content of this critical thinking tool and explores wider applications of the Critiique software. Materials and Methods: Critiique is flexible, authorable software that guides students step-by-step through critical appraisal of research papers. The spelling of Critiique was deliberate, so as to acquire a unique web domain name and associated logo. The CCT project involved implementation of a modified nominal focus group process with academic staff working together to establish common understandings of critical thinking. Previous work established a consensus about critical thinking in nursing and provided a starting point for the focus groups. The study was conducted at an Australian university campus with the focus group guided by open ended questions. Results: Focus group data established categories of content that academic staff identified as important for teaching critical thinking. This emerging focus group data was then used to inform modification of Critiique software so that students had access to consistent and structured guidance in relation to critical thinking and critical appraisal. Conclusions: The project succeeded in using focus group data from academics to inform software development while at the same time retaining the benefits of broader philosophical dimensions of critical thinking. PMID:26835469

[Professionalization of Legal Dental Experts in Germany: Results of Studies on Structured Focus Groups].

PubMed

Brauer, H U; Walther, W; Dick, M

2018-04-01

Legal expert opinions are a crucial instrument of professional self-control in medicine. To give impulses for further development, focus groups were initiated to reflect upon the perspective of legal dental experts. 5 focus group discussions on the topic "Professionalization of legal dental experts" were conducted. A total of 32 experienced legal dental experts participated in the discussions. The results were evaluated by qualitative content analysis. A catalogue of 68 ideas was generated for improvement and divided into 15 categories. Among these were periodic quality circles, interprofessional exchange, supervision of novices and periodic feedback for legal dental experts and dentists. Self-reflection can be included as an instrument for quality improvement of legal dental expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

How Laptops Digitize and Transform Learning

ERIC Educational Resources Information Center

Corn, Jenifer; Tingen, Jennifer; Argueta, Rodolfo; Patel, Ruchi; Stanhope, Daniel

2010-01-01

Laptops have been shown to improve 21st century skills such as life and career skills, learning and innovation skills, and group collaboration, but how does this ever-present technology affect the thinking of today's "screenager"? Through an analysis of focus groups and surveys with students in 1:1 initiatives across North Carolina,…

Formative research exploring acceptability, utilization, and promotion in order to develop a micronutrient powder (Sprinkles) intervention among Luo families in western Kenya.

PubMed

Jefferds, Maria Elena D; Ogange, Lorraine; Owuor, Mercy; Cruz, Kari; Person, Bobbie; Obure, Alfredo; Suchdev, Parminder S; Ruth, Laird J

2010-06-01

There is a lack of peer-reviewed literature describing in detail the formative research to develop Sprinkles interventions. To describe community members' reactions to and experiences using Sprinkles, with an emphasis on acceptability, utilization, and promotion. Fourteen initial focus group discussions on Sprinkles and a 25-family home study were conducted. For the home study, each child 6 to 59 months of age in the household received 30 sachets (1 per day). The initial 14 focus group discussions included mothers, grandmothers, vendors, women who purchased from vendors, and adults in the general population. Home study families were recruited from participants in the initial 14 focus group discussions who had at least one child 6 to 59 months of age. Sprinkles were highly acceptable to adults and most children; some children thought Sprinkles were sugar. Most home study families prepared and used Sprinkles correctly. All families reported positive effects, particularly increased appetite, and recommended Sprinkles; none experienced major problems. Potential barriers identified were lack of knowledge of and experience with Sprinkles, availability of Sprinkles, and cost. Promotional messages targeted to mothers, fathers, all child-care providers, and doctors focused on the positive health effects of Sprinkles. Issues related to Sprinkles preparation, use, and barriers required attention before implementation. Locally appropriate visual and written instructions were developed for dissemination. Intervention training sessions and promotions were tailored to answer frequently asked questions, increase knowledge of Sprinkles, and provide tangible evidence of health benefits. Information needs and perceptions changed quickly after use of Sprinkles. Existing levels of Sprinkles awareness and knowledge should be considered when designing interventions.

Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

PubMed

Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

2018-03-01

Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

The Women's Recovery Group Study: a Stage I trial of women-focused group therapy for substance use disorders versus mixed-gender group drug counseling.

PubMed

Greenfield, Shelly F; Trucco, Elisa M; McHugh, R Kathryn; Lincoln, Melissa; Gallop, Robert J

2007-09-06

The aim of this Stage I Behavioral Development Trial was to develop a manual-based 12-session Women's Recovery Group (WRG) and to pilot test this new treatment in a randomized controlled trial against a mixed-gender Group Drug Counseling (GDC), an effective manual-based treatment for substance use disorders. After initial manual development, two pre-pilot groups of WRG were conducted to determine feasibility and initial acceptability of the treatment among subjects and therapists. In the pilot stage, women were randomized to either WRG or GDC. No significant differences in substance use outcomes were found between WRG and GDC during the 12-week group treatment. However, during the 6-month post-treatment follow-up, WRG members demonstrated a pattern of continued reductions in substance use while GDC women did not. In addition, pilot WRG women with alcohol dependence had significantly greater reductions in average drinks/drinking day than GDC women 6 months post-treatment (p<.03, effect size=0.81). While satisfaction with both groups was high, women were significantly more satisfied with WRG than GDC (p<.009, effect size=1.11). In this study, the newly developed 12-session women-focused WRG was feasible with high satisfaction among participants. It was equally effective as mixed-gender GDC in reducing substance use during the 12-week in-treatment phase, but demonstrated significantly greater improvement in reductions in drug and alcohol use over the post-treatment follow-up phase compared with GDC. A women-focused single-gender group treatment may enhance longer-term clinical outcomes among women with substance use disorders.

Language of motivation and emotion in an internet support group for smoking cessation: explorative use of automated content analysis to measure regulatory focus.

PubMed

Johnsen, Jan-Are K; Vambheim, Sara M; Wynn, Rolf; Wangberg, Silje C

2014-01-01

The present study describes a novel approach to the identification of the motivational processes in text data extracted from an Internet support group (ISG) for smoking cessation. Based on the previous findings that a "prevention" focus might be more relevant for maintaining behavior change, it was hypothesized that 1) language use (ie, the use of emotional words) signaling a "promotion" focus would be dominant in the initiating stages of the ISG, and 2) that the proportion of words signaling a prevention focus would increase over time. The data were collected from the ISG site, spanning 4 years of forum activity. The data were analyzed using the Linguistic Inquiry and Word Count application. The first hypothesis - of promotion focus dominance in the initiating stages - was not supported during year 1. However, for all the other years measured, the data showed that a prevention failure was more dominant compared with a promotion failure. The results indicate that content analysis could be used to investigate motivational and language-driven processes in ISGs. Understanding the interplay between self-regulation, lifestyle change, and modern communication channels could be of vital importance in providing the public with better health care services and interventions.

Peer support groups boost use of female condom.

PubMed

1997-09-01

Preliminary research findings from Brazil and Kenya indicate that, when women are provided with female condoms and peer group support, traditional obstacles to safe sex practices can be overcome. In these countries, as well as many others, women face cultural barriers to negotiating condom use with male partners. The study, conducted by the Women's Health Initiative of Family Health International's AIDS Control and Prevention Project, involved 106 Kenyan and 103 Brazilian women. A female focus group was held at the beginning of the study, followed by two peer support group meetings, with another focus group at the end of the study. Group support was an essential element in the acceptance process. Women who were afraid or unsuccessful with initial use were encouraged by other group members to try different, non-threatening approaches to the negotiation of female condom use and given suggestions for overcoming difficulties with insertion and lubrication. Some of these strategies included laying the female condom on the bed so the male partner raises the subject of its use and telling the partner the doctor had recommended the method to avoid the negative side effects associated with the pill. When female condom use is presented as a form of pregnancy prevention, the association of condoms with infidelity is overcome.

Six ways not to improve patient flow: a qualitative study.

PubMed

Kreindler, Sara Adi

2017-05-01

Although well-established principles exist for improving the timeliness and efficiency of care, many organisations struggle to achieve more than small-scale, localised gains. Where care processes are complex and include segments under different groups' control, the elegant solutions promised by improvement methodologies remain elusive. This study sought to identify common design flaws that limit the impact of flow initiatives. This qualitative study was conducted within an explanatory case study of a Canadian regional health system in which multitudinous flow initiatives had yielded no overall improvement in system performance. Interviews with 62 senior, middle and departmental managers, supplemented by ∼700 documents on flow initiatives, were analysed using the constant comparative method. Findings suggested that smooth flow depends on linking a defined population to appropriate capacity by means of an efficient process ; flawed initiatives reflected failure to consider one or more of these essential elements. Many initiatives focused narrowly on process, failing to consider that the intended population was poorly defined or the needed capacity inaccessible; some introduced capacity for an intended population, but offered no process to link the two. Moreover, interveners were unable to respond effectively when a bottleneck moved to another part of the system. Errors of population, capacity and process, in different combinations, generated six 'formulae for failure'. Typically, flawed initiatives focused on too small a segment of the patient journey to properly address the impediments to flow. The proliferation of narrowly focused initiatives, in turn, reflected a decentralised system in which responsibility for flow improvement was fragmented. Thus, initiatives' specific design flaws may have their roots in a deeper problem: the lack of a coherent system-level strategy. 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/.

"It's about Us": Marital Adjustment and Marital Adaptation in Couples Who Adopt Children from the Child Welfare System

ERIC Educational Resources Information Center

Mooradian, John K.; Timm, Tina M.; Hock, Robert M.; Jackson, Rosemary

2011-01-01

This article examines, using grounded theory methodology, the marital relationships of couples who adopted children from the child welfare system. Twenty-two spouses in four focus groups reported initial marital adjustment that featured husbands' support of their wives' initiation of adoption and management of child needs. About one half of these…

Men’s Perceptions of Women’s Participation in Development Initiatives in Rural Bangladesh

PubMed Central

Karim, Rabiul; Lindberg, Lene; Wamala, Sarah; Emmelin, Maria

2017-01-01

Without taking masculine issues into account, women’s participation in development initiatives does not always guarantee their empowerment, health, and welfare in a male-dominated society. This study aimed to explore men’s perceptions of women’s participation in development (WPD) in rural Bangladesh. In adopting a qualitative approach, the study examined 48 purposively selected married and unmarried men aged 20–76 years in three northwest villages. Data collection was accomplished through four focus group discussions (FGDs) with 43 men clustered into four groups and through individual interviews with five other men. A qualitative content analysis of the data revealed an overall theme of “feeling challenged by fears and hopes,” indicating variations in men’s views on women’s participation in development initiatives as represented by three main categories: (a) fearing the loss of male authority, (b) recognizing women’s roles in enhancing family welfare, and (c) valuing women’s independence. In the context of dominant patriarchal traditions in Bangladesh, these findings provide new insight into dynamics and variations of men’s views, suggesting a need to better engage men during different stages of women-focused development initiatives. PMID:29025358

Evaluating Evidence-Based Intervention to Prevent Fall and Pressure Ulcers

DTIC Science & Technology

2011-12-20

Group 1 and 2 attended EBP ED. Out of this group , 205 completed a pretest and 213 completed a posttest for CPG knowledge uptake. In group 1, ninety...various times and locations while supporting the staffing needs of the nursing care unit. This adjustment extended the timeline by one month. Group ...structured EBP education focusing on translation of research into practice for all nurses involved in this initiative to include clinicians, managers, and

Recruitment of racial/ethnic minority older adults through community sites for focus group discussions.

PubMed

Northridge, Mary E; Shedlin, Michele; Schrimshaw, Eric W; Estrada, Ivette; De La Cruz, Leydis; Peralta, Rogelina; Birdsall, Stacia; Metcalf, Sara S; Chakraborty, Bibhas; Kunzel, Carol

2017-06-09

Despite a body of evidence on racial/ethnic minority enrollment and retention in research, literature specifically focused on recruiting racially/ethnically diverse older adults for social science studies is limited. There is a need for more rigorous research on methodological issues and the efficacy of recruitment methods. Cultural obstacles to recruitment of racial/ethnic minority older adults include language barriers, lack of cultural sensitivity of target communities on the part of researchers, and culturally inappropriate assessment tools. Guided by the Consolidated Framework for Implementation Research (CFIR), this study critically appraised the recruitment of racial/ethnic minority older adults for focus groups. The initial approach involved using the physical and social infrastructure of the ElderSmile network, a community-based initiative to promote oral and general health and conduct health screenings in places where older adults gather, to recruit racial/ethnic minority adults for a social science component of an interdisciplinary initiative. The process involved planning a recruitment strategy, engaging the individuals involved in its implementation (opinion leaders in senior centers, program staff as implementation leaders, senior community-based colleagues as champions, and motivated center directors as change agents), executing the recruitment plan, and reflecting on the process of implementation. While the recruitment phase of the study was delayed by 6 months to allow for ongoing recruitment and filling of focus group slots, the flexibility of the recruitment plan, the expertise of the research team members, the perseverance of the recruitment staff, and the cultivation of change agents ultimately resulted in meeting the study targets for enrollment in terms of both numbers of focus group discussions (n = 24) and numbers of participants (n = 194). This study adds to the literature in two important ways. First, we leveraged the social and physical infrastructure of an existing program to recruit participants through community sites where older adults gather. Second, we used the CFIR to guide the appraisal of the recruitment process, which underscored important considerations for both reaching and engaging this underserved population. This was especially true in terms of understanding the disparate roles of the individuals involved in implementing and facilitating the recruitment plan.

A motivation-focused weight loss maintenance program is an effective alternative to a skill-based approach.

PubMed

West, D S; Gorin, A A; Subak, L L; Foster, G; Bragg, C; Hecht, J; Schembri, M; Wing, R R

2011-02-01

Maintaining weight loss is a major challenge in obesity treatment. Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors. Therefore, a novel weight loss maintenance program that specifically targets motivational factors was evaluated. Overweight women (N=338; 19% African American) with urinary incontinence were randomized to lifestyle obesity treatment or control and followed for 18 months. All participants in lifestyle (N=226) received the same initial 6-month group behavioral obesity treatment and were then randomized to (1) a novel motivation-focused maintenance program (N=113) or (2) a standard skill-based maintenance approach (N=113). Weight assessed at baseline, 6 and 18 months. Both treatment groups (motivation-focused and skill-based) achieved comparable 18-month weight losses (-5.48% for motivation-focused vs -5.55% in skill-based, P=0.98), and both groups lost significantly more than controls (-1.51%; P=0.0012 in motivation-focused and P=0.0021 in skill-based). A motivation-focused maintenance program offers an alternative, effective approach to weight maintenance expanding available evidence-based interventions beyond traditional skill-based programs.

Effective heart disease prevention: lessons from a qualitative study of user perspectives in Bangladeshi, Indian and Pakistani communities.

PubMed

Netto, G; McCloughan, L; Bhatnagar, A

2007-03-01

Coronary heart disease (CHD) has a high mortality, incidence and prevalence among Indian, Pakistani and Bangladeshi communities in the UK, indicating the need for effective heart disease prevention initiatives for these communities. This paper considers how service user perspectives can be used to develop effective, culturally focused CHD prevention interventions for these target groups by addressing identified barriers, including deeply held cultural beliefs. A qualitative research study, using a longitudinal action research approach. This was a community-based study in Edinburgh. Six focus group discussions--two for each community--were organized with participants from these communities at the beginning of the project. A further six focus group discussions for the same communities were organized six months later. Over the period examined, participants reported varying changes in levels of knowledge relating to the nature, causes and symptoms of CHD. Some participants reported taking slight to significant steps to reduce or prevent heart disease, while others did not. The project was viewed as helpful in increasing knowledge about CHD and preventive measures and encouraging healthier lifestyles. However, persistent barriers to change were also identified, requiring changes to the project that involved not only matching intervention materials and messages to observable, superficial characteristics of the target population, but more fundamental changes that address the cultural, social, historical, environmental and psychological forces that influence health behaviour. CHD prevention initiatives need to identify and respond to deep-rooted influences on health-behaviour in 'at-risk' groups, in addition to superficial characteristics of the target populations. It is important for specific prevention initiatives to be linked into wider CHD frameworks to ensure transferability of learning and integration within wider service provision.

Engaging adolescents in tuberculosis and clinical trial research through drama.

PubMed

Schmidt, Bey-Marrié; Abrams, Amber; Tameris, Michele

2016-04-06

The South African Tuberculosis Vaccine Initiative is based in Worcester where tuberculosis (TB) is endemic, and incidence rates are amongst the highest nationally. In high TB burden settings after an early childhood peak, incidence rates start to rise again in adolescents, therefore they are an important target group for tuberculosis vaccine research. In 2012, learners from a local school developed a one-off theatrical production out of an educational comic book Carina's Choice, developed by the South African Tuberculosis Vaccine Initiative in 2010. A Wellcome Trust International Engagement grant allowed for this one-off production to be further developed, with input from university students and staff, and rolled out to schools in the Worcester area as an engagement and education intervention. Focus group feedback was used to identify key messages and to develop the play's script. Qualitative methods were used to collect and analyse relevant data. Interviews were conducted with learner-actors, pre- and post-focus group feedback was obtained from a sample of school-going adolescents, and pre- and post-questionnaires were administered to adolescent audience members. From the pre-drama focus group discussions, topics such as TB symptoms, stigma and transmission were identified as areas that needed attention. After the performances, adolescents showed improved knowledge on the identified topics and they discussed TB prevention measures. They highlighted transmission of TB during pregnancy as a further topic to be addressed in future iterations of the drama. Although stigma is a difficult phenomenon to interpret, post-drama participants understood that TB transmission could occur in all individuals. Learner-actors agreed with focus group participants that the play could impact the wider community if it were rolled out. Feedback from the South African Tuberculosis Vaccine Initiative staff verified that recruitment for an upcoming trial was facilitated by the preparedness that the play provided in recruitment areas. The study showed that before and after evaluations provide data on the usefulness of the play as an education tool. Theatre, presented and motivated by adolescent peers, can raise awareness of TB, and assist clinical trial preparedness and further engagement between trial staff and their trial community.

The development of an educational video to motivate teens with asthma to be more involved during medical visits and to improve medication adherence.

PubMed

Sleath, Betsy; Carpenter, Delesha M; Lee, Charles; Loughlin, Ceila E; Etheridge, Dana; Rivera-Duchesne, Laura; Reuland, Daniel S; Batey, Karolyne; Duchesne, Cristina I; Garcia, Nacire; Tudor, Gail

2016-09-01

Our objective was to develop a series of short educational videos for teens and parents to watch before pediatric visits to motivate teens to be more actively involved during their visits. The development of the short educational videos was theoretically guided by Social Cognitive Theory. First we conducted four focus groups with teens (ages 11 to 17) with asthma, four focus groups with the teens' parents, and seven focus groups with pediatric providers from four clinics. The research team, which included two teens with asthma and their parents, analyzed the focus group transcripts for themes and then developed the initial video script. Next, a visual storyboard was reviewed by focus groups with parents and four with teens to identify areas of the script for improvement. The English videos were then produced. Focus groups with Hispanic parents and teens were then conducted for advice on how to modify the videos to make a more culturally appropriate Spanish version. Based on focus group results, teen newscasters narrate six one- to two-minute videos with different themes: (a) how to get mom off your back, (b) asthma triggers, (c) staying active with asthma, (d) tracking asthma symptoms, (e) how to talk to your doctor and (f) having confidence with asthma. Each video clip has three key messages and emphasizes how teens should discuss these messages with their providers. Teens, parents, and providers gave us excellent insight into developing videos to increase teen involvement during medical visits.

Differentiation of Self, Personal Adjustment, Problem Solving, and Ethnic Group Belonging among Persons of Color.

ERIC Educational Resources Information Center

Skowron, Elizabeth A.

2004-01-01

This study focused on examining the cross-cultural validity of Bowen family systems theory (M. Bowen, 1978), namely differentiation of self for individuals of color. Ethnic minority men and women completed measures of differentiation of self, ethnic group belonging, and 3 indices of personal adjustment. Initial support for the cross-cultural…

Communication and Decision-Making About End-of-Life Care in the Intensive Care Unit.

PubMed

Brooks, Laura Anne; Manias, Elizabeth; Nicholson, Patricia

2017-07-01

Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. The study was conducted in a 24-bed intensive care unit in Melbourne, Australia. An interpretative, qualitative inquiry was used, with focus groups as the data collection method. Intensive care nurses and physicians were recruited to participate in a discipline-specific focus group. Focus group discussions were audio-recorded, transcribed, and subjected to thematic data analysis. Five focus groups were conducted; 17 nurses and 11 physicians participated. The key aspects discussed included communication and shared decision-making. Themes related to communication included the timing of end-of-life care discussions and conducting difficult conversations. Implementation and multidisciplinary acceptance of end-of-life care plans and collaborative decisions involving patients and families were themes related to shared decision-making. Effective communication and decision-making practices regarding initiating end-of-life care in the intensive care unit are important. Multidisciplinary implementation and acceptance of end-of-life care plans in the intensive care unit need improvement. Clear organizational processes that support the introduction of nurse and physician end-of-life care leaders are essential to optimize outcomes for patients, family members, and clinicians. ©2017 American Association of Critical-Care Nurses.

Clinical user experiences of observation and response charts: focus group findings of using a new format chart incorporating a track and trigger system.

PubMed

Elliott, Doug; Allen, Emily; Perry, Lin; Fry, Margaret; Duffield, Christine; Gallagher, Robyn; Iedema, Rick; McKinley, Sharon; Roche, Michael

2015-01-01

Optimising clinical responses to deteriorating patients is an international indicator of acute healthcare quality. Observation charts incorporating track and trigger systems are an initiative to improve early identification and response to clinical deterioration. A suite of track and trigger 'Observation and Response Charts' were designed in Australia and initially tested in simulated environments. This paper reports initial clinical user experiences and views following implementation of these charts in adult general medical-surgical wards. Across eight trial sites, 44 focus groups were conducted with 218 clinical ward staff, mostly nurses, who received training and had used the charts in routine clinical practice for the preceding 2-6 weeks. Transcripts of audio recordings were analysed for emergent themes using an inductive approach. In this exploration of initial user experiences, key emergent themes were: tensions between vital sign 'ranges versus precision' to support decision making; using a standardised 'generalist chart in a range of specialist practice' areas; issues of 'clinical credibility', 'professional autonomy' and 'influences of doctors' when communicating abnormal signs; and 'permission and autonomy' when escalating care according to the protocol. Across themes, participants presented a range of positive, negative or mixed views. Benefits were identified despite charts not always being used up to their optimal design function. Participants reported tensions between chart objectives and clinical practices, revealing mismatches between design characteristics and human staff experiences. Overall, an initial view of 'increased activity/uncertain benefit' was uncovered. Findings particularly reinforced the significant influences of organisational work-based cultures, disciplinary boundaries and interdisciplinary communication on implementation of this new practice chart. Optimal use of all chart design characteristics will be possible when these broader cultural issues are addressed. 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.

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

Diethylnitrosamine initiation does not alter clofibric acid-induced hepatocarcinogenesis in the rat.

PubMed

Michel, Cecile; Desdouets, Chantal; Slaoui, Mohamed; Isaacs, Kevin Robert; Roberts, Ruth Angela; Boitier, Eric

2007-09-01

Clofibric acid (CLO) is a nongenotoxic hepatocarcinogen in rodents that causes altered hepatocellular foci and/or neoplasms. Initiation by DNA-damaging agents such as diethylnitrosamine (DEN) accelerates focus and tumor appearance and could therefore significantly contribute to shortening of the regulatory 2-year rodent carcinogenicity bioassays. However, it is crucial to evaluate the histological and molecular impact of initiation with DEN on hepatocarcinogenesis promoted by CLO. Male F344 rats were given a single nonnecrogenic injection of DEN (0 or 30 mg/kg) followed by Control diet or CLO (5000 ppm) in diet for up to 20 months. Histopathology and gene expression profiling were performed in liver tumors and surrounding nontumoral liver tissues. The molecular signature of DEN was characterized and its histopathological and immunohistopathological effects on focus and tumor types were also determined. Although foci and tumors appeared earlier in the DEN+CLO-treated group compared to the group treated with CLO alone, DEN had little impact on gene expression in nontumoral tissues since the gene expression profiles were highly similar between Control and DEN-treated rats, and DEN+CLO- and CLO-treated rats. Finally, tumors obtained from DEN+CLO and CLO-treated groups displayed highly correlated gene expression profiles (r>0.83, independently of the time-point). The pathways involved in tumor development revealed by Gene Ontology functional analysis are similar when driven either by spontaneous initiation or by a chemically induced initiation step. Our work described here may contribute to the design optimization of shorter preclinical tests for the evaluation of the nongenotoxic hepatocarcinogenic potential of drugs under development.

Promoting pre-conceptional use of folic acid to Hispanic women: a social marketing approach.

PubMed

Quinn, Gwendolyn P; Hauser, Kimberlea; Bell-Ellison, Bethany A; Rodriguez, Nydia Y; Frías, Jaime L

2006-09-01

To develop a culturally appropriate communication initiative in an effort to promote the use of pre-conceptional folic acid among Hispanic women of childbearing age. The materials were designed to communicate information about the risks of neural tube defects and the value of folic acid supplementation before conception. The initiative was developed using a social marketing approach. A series of focus groups were conducted with Hispanic women, particularly Mexican and Mexican-American women, to gain an understanding of their knowledge, attitudes, and behaviors regarding birth defects and folic acid. Additionally focus groups assessed women's preferences for existing folic acid education materials. Qualitative analysis of coded transcripts revealed key themes which were incorporated into a multi-media initiative. Critical themes of the research highlighted the need to include the role of partners and a sense of family in the promotions aimed at these groups. Another key component was the need to dispel myths which act as barriers to pre-conceptional folic acid use. Other important elements included in the media products were the need for Spanish and English versions, an explanation of neural tube defects, and a reference to the cost of the supplements. The final products of the initiative included Spanish and English versions of a brochure, photo-novella, and radio public service announcement. Pre-testing results showed women understood the message, thought the message was for women like them, and expected to begin taking a folic acid supplement. Results of the overall evaluation of the initiative are on-going.

10th Annual Small Business Conference

DTIC Science & Technology

2006-11-02

has extensive process knowledge in military, space and commercial. Steve worked many corporate initiatives, and led a leveraging group that made a...2001, Mr. Loehrl served as Chief of the Chemical Demilitarization program, a $ 12 billion mission that was new to the Command. His - 1 - - 1... Trivia Question Apple Trivia Question Focus Right Product Right Time Right Place Right Price Rapid Fielding Initiative Equipment Items Fielded to All

The Impact of a School Board's One-To-One iPad Initiative on Equity and Inclusion

ERIC Educational Resources Information Center

Kirkpatrick, Lori C.; Brown, Heather M.; Searle, Michelle J.; Sauder, Adrienne E.; Smiley, Eric

2017-01-01

This paper examines the impact of a school board's one-to-one iPad initiative on equity and inclusion. Data include: questionnaires from Grade 7-9 students, teachers, and administrators; focus groups with inclusion coaches; and interviews with classroom teachers. The results show that the iPads have supported equity among students in the district;…

Prevention of the Post traumatic Fibrotic Response in Joints

DTIC Science & Technology

2016-12-01

researchers focusing on research associated with post -traumatic joint stiffness. This team has grown from a group of three initial Principal Investigators...The formation of the Translational Research Partnership ensured reaching the stated objective. Two Specific Aims were defined to test the...body weight of rabbits during the initial 8 weeks of the experimental study. During this time the rabbits were treated with tested and control

EPA Solar Utilization in Higher Education Networking and Information Sharing Group

EPA Pesticide Factsheets

EPA's Green Power Partnership has a number of initiatives that focus on the collective green power efforts within specific sectors and renewable energy procurement strategies, which provide recognition opportunities for Partners and increase awareness.

Child-Level Predictors of Responsiveness to Evidence-Based Mathematics Intervention.

PubMed

Powell, Sarah R; Cirino, Paul T; Malone, Amelia S

2017-07-01

We identified child-level predictors of responsiveness to 2 types of mathematics (calculation and word-problem) intervention among 2nd-grade children with mathematics difficulty. Participants were 250 children in 107 classrooms in 23 schools pretested on mathematics and general cognitive measures and posttested on mathematics measures. We assigned classrooms randomly assigned to calculation intervention, word-problem intervention, or business-as-usual control. Intervention lasted 17 weeks. Path analyses indicated that scores on working memory and language comprehension assessments moderated responsiveness to calculation intervention. No moderators were identified for responsiveness to word-problem intervention. Across both intervention groups and the control group, attentive behavior predicted both outcomes. Initial calculation skill predicted the calculation outcome, and initial language comprehension predicted word-problem outcomes. These results indicate that screening for calculation intervention should include a focus on working memory, language comprehension, attentive behavior, and calculations. Screening for word-problem intervention should focus on attentive behavior and word problems.

How do children with attention deficit hyperactivity disorder interact in a clinical dental examination? A video analysis.

PubMed

Blomqvist, My; Augustsson, Mikael; Bertlin, Christine; Holmberg, Kirsten; Fernell, Elisabeth; Dahllöf, Göran; Ek, Ulla

2005-06-01

Attention deficit hyperactivity disorder (ADHD) is currently the most common behavioural disorder in school-age children. The aim of this study was to perform a detailed analysis of behavioural interactions between the dentist and the child patient with ADHD. All children born in 1991 (n = 555) in one Swedish municipality were screened for attention and learning problems, and assessed for ADHD. Twenty-two children with ADHD, and a control group of 47 children without attention and learning problems, were included in the study. The dental recall visit was recorded on video. The interaction between the dentist and the child was analysed in detail and scored as verbal and non-verbal initiatives and responses. Compared to the children in the control group, the children with ADHD made significantly more initiatives, especially initiatives that did not focus on the examination or the dentist. The children with ADHD had fewer verbal responses and more missing responses. In conclusion, the problems in communication resulted in less two-way communication between the dentist and the children with ADHD than the interaction between the dentist and the children in the control group. The children with ADHD had particular difficulties staying focused on the examination. (c) Eur J Oral Sci, 2005

Learning from Marketing: Rapid Development of Medication Messages that Engage Patients

PubMed Central

Yank, Veronica; Tribett, Erika; Green, Lydia; Pettis, Jasmine

2015-01-01

Objective To adapt marketing approaches in a health services environment. Methods Researchers and advertising professionals partnered in developing advertising-style messages designed to activate patients pre-identified as having chronic kidney disease to ask providers about recommended medications. We assessed feasibility of the development process by evaluating partnership structure, costs, and timeframe. We tested messages with patients and providers using preliminary surveys to refine initial messages and subsequent focus groups to identify the most persuasive ones. Results The partnership achieved an efficient structure, $14,550 total costs, and 4-month timeframe. The advertising team developed 11 initial messages. The research team conducted surveys and focus groups with a total of 13 patients and 8 providers to identify three messages as most activating. Focus group themes suggested the general approach of using advertising-style messages was acceptable if it supported patient-provider relationships and had a credible evidence base. Individual messages were more motivating if they elicited personal identification with imagery, particular emotions, active patient role, and message clarity. Conclusion We demonstrated feasibility of a research-advertising partnership and acceptability and likely impact of advertising-style messages on patient medication-seeking behavior. Practice Implications Healthcare systems may want to replicate our adaptation of marketing approaches to patients with chronic conditions. PMID:25913245

An anthropomorphic design for a minimally invasive surgical system based on a survey of surgical technologies, techniques and training.

PubMed

Tzemanaki, Antonia; Walters, Peter; Pipe, Anthony Graham; Melhuish, Chris; Dogramadzi, Sanja

2014-09-01

Over the past century, abdominal surgery has seen a rapid transition from open procedures to less invasive methods, such as robot-assisted minimally invasive surgery (MIS). This study aimed to investigate and discuss the needs of MIS in terms of instrumentation and to inform the design of a novel instrument. A survey was conducted among surgeons regarding their opinions on surgical training, surgical systems, how satisfied they were with them and how easy they were to use. A concept for MIS robotic instrumentation was then developed and a series of focus groups with surgeons were run to discuss it. The initial prototype of the robotic instruments, herein demonstrated, comprises modular rigid links with soft joints actuated by shape memory alloy helix actuators; these instruments are controlled using a sensory hand exoskeleton. The results of the survey, as well as those of the focus groups, are presented here. A first prototype of the system was built and initial laboratory tests have been conducted in order to evaluate this approach. The analysed data from both the survey and the focus groups justify the chosen concept of an anthropomorphic MIS robotic system which imitates the natural motion of the hands. Copyright © 2013 John Wiley & Sons, Ltd.

Learning from marketing: Rapid development of medication messages that engage patients.

PubMed

Yank, Veronica; Tribett, Erika; Green, Lydia; Pettis, Jasmine

2015-08-01

To adapt marketing approaches in a health services environment. Researchers and advertising professionals partnered in developing advertising-style messages designed to activate patients pre-identified as having chronic kidney disease to ask providers about recommended medications. We assessed feasibility of the development process by evaluating partnership structure, costs, and timeframe. We tested messages with patients and providers using preliminary surveys to refine initial messages and subsequent focus groups to identify the most persuasive ones. The partnership achieved an efficient structure, $14,550 total costs, and 4-month timeframe. The advertising team developed 11 initial messages. The research team conducted surveys and focus groups with a total of 13 patients and 8 providers to identify three messages as most activating. Focus group themes suggested the general approach of using advertising-style messages was acceptable if it supported patient-provider relationships and had a credible evidence base. Individual messages were more motivating if they elicited personal identification with imagery, particular emotions, active patient role, and message clarity. We demonstrated feasibility of a research-advertising partnership and acceptability and likely impact of advertising-style messages on patient medication-seeking behavior. Healthcare systems may want to replicate our adaptation of marketing approaches to patients with chronic conditions. Copyright © 2015. Published by Elsevier Ireland Ltd.

Family forest landowners' interest in forest carbon offset programs: focus group findings from the lake States, USA.

PubMed

Miller, Kristell A; Snyder, Stephanie A; Kilgore, Mike A; Davenport, Mae A

2014-12-01

In 2012, focus groups were organized with individuals owning 20+ acres in the Lake States region of the United States (Michigan, Minnesota, and Wisconsin) to discuss various issues related to forest carbon offsetting. Focus group participants consisted of landowners who had responded to an earlier mail-back survey (2010) on forest carbon offsets. Two focus groups were held per state with an average of eight participants each (49 total). While landowner participant types varied, overall convergence was reached on several key issues. In general, discussion results found that the current payment amounts offered for carbon credits are not likely, on their own, to encourage participation in carbon markets. Landowners are most interested in other benefits they can attain through carbon management (e.g., improved stand species mix, wildlife, and trails). Interestingly, landowner perceptions about the condition of their own forest land were most indicative of prospective interest in carbon management. Landowners who felt that their forest was currently in poor condition, or did not meet their forest ownership objectives, were most interested in participating. While the initial survey sought landowner opinions about carbon markets, a majority of focus group participants expressed interest in general carbon management as a means to achieve reduced property taxes.

Family Forest Landowners' Interest in Forest Carbon Offset Programs: Focus Group Findings from the Lake States, USA

NASA Astrophysics Data System (ADS)

Miller, Kristell A.; Snyder, Stephanie A.; Kilgore, Mike A.; Davenport, Mae A.

2014-12-01

In 2012, focus groups were organized with individuals owning 20+ acres in the Lake States region of the United States (Michigan, Minnesota, and Wisconsin) to discuss various issues related to forest carbon offsetting. Focus group participants consisted of landowners who had responded to an earlier mail-back survey (2010) on forest carbon offsets. Two focus groups were held per state with an average of eight participants each (49 total). While landowner participant types varied, overall convergence was reached on several key issues. In general, discussion results found that the current payment amounts offered for carbon credits are not likely, on their own, to encourage participation in carbon markets. Landowners are most interested in other benefits they can attain through carbon management (e.g., improved stand species mix, wildlife, and trails). Interestingly, landowner perceptions about the condition of their own forest land were most indicative of prospective interest in carbon management. Landowners who felt that their forest was currently in poor condition, or did not meet their forest ownership objectives, were most interested in participating. While the initial survey sought landowner opinions about carbon markets, a majority of focus group participants expressed interest in general carbon management as a means to achieve reduced property taxes.

Support needs of breast-feeding women: views of Australian midwives and health nurses.

PubMed

McLelland, Gayle; Hall, Helen; Gilmour, Carole; Cant, Robyn

2015-01-01

to explore the views of midwives and maternal-child health nurses regarding factors that influence breast feeding initiation and continuation, focusing on how support for women could be improved to increase breast feeding duration. a focus group study. hospital or domiciliary (home-visiting) midwives and community-based maternal and child health (MCH) nurses in one region of Victoria, Australia. twelve MCH nurses and five midwives who provided supportive services to women in the immediate postnatal period attended one of three audio-recorded focus groups. Thematic findings were identified. four key themes were: 'Guiding women over breast-feeding hurdles', 'Timing, and time to care'; 'Continuity of women's care' and 'Imparting professional knowledge'. Given the a pattern of hospital discharge of mother and infant on day one or day two after birth, participants thought the timing of immediate postnatal breast-feeding support was critical to enable women to initiate and continue breast feeding. Community-based MCH nurses reported time gaps in uptake of new mother referrals and time-pressured face-to-face consultations. Both groups perceived barriers to continuity of women's care. health services subscribe to the Baby Friendly Health Initiative and government policies which support breast feeding, however providers described time pressures and a lack of continuity of women's care, including during transition from hospital to community services. there is a need to examine administration of service delivery and how domiciliary and community nurses can collaborate to establish and maintain supportive relationships with breast feeding women. Copyright © 2014 Elsevier Ltd. All rights reserved.

Development and field testing of a smartphone "App" for tinnitus management.

PubMed

Henry, James A; Thielman, Emily; Zaugg, Tara; Kaelin, Christine; Choma, Christie; Chang, Bill; Hahn, Shira; Fuller, Bret

2017-10-01

This study's objective was to develop and test a smartphone app that supports learning and using coping skills for managing tinnitus. The app's content was based on coping skills that are taught as a part of progressive tinnitus management (PTM). The study involved three phases: (1) develop a prototype app and conduct usability testing; (2) conduct two focus groups to obtain initial feedback from individuals representing potential users; and (3) conduct a field study to evaluate the app, with three successive groups of participants. Participants were adults with bothersome tinnitus. For Phase 2, two focus groups were attended by a total of 17 participants. Phase 3 involved three consecutive rounds of participants: five from the focus groups followed by two rounds with 10 participants each who had not seen the app previously. In both the focus groups and field studies, participants responded favourably to the content. Certain features, however, were deemed too complex. Completion of this project resulted in the development and testing of the delivery of PTM coping skills via a smartphone app. This new approach has the potential to improve access to coping skills for those with bothersome tinnitus.

"Don't Be Uneasy, My Children": Finding Strength in Stories of the Enslaved

ERIC Educational Resources Information Center

Gilbert, Lisa

2014-01-01

Tackling challenging topics in history can be difficult, and sometimes teachers struggle to find age-appropriate ways to help students confront painful stories from the past. About four years ago, this author spearheaded a focus group with the purpose of taking on such a challenge. In the initial meetings, members of the group (four educators from…

Enacting Key Skills-Based Curricula in Secondary Education: Lessons from a Technology-Mediated, Group-Based Learning Initiative

ERIC Educational Resources Information Center

Johnston, Keith; Conneely, Claire; Murchan, Damian; Tangney, Brendan

2015-01-01

Bridge21 is an innovative approach to learning for secondary education that was originally conceptualised as part of a social outreach intervention in the authors' third-level institution whereby participants attended workshops at a dedicated learning space on campus focusing on a particular model of technology-mediated group-based learning. This…

Women-focused treatment agencies and process improvement: Strategies to increase client engagement

PubMed Central

Wisdom, Jennifer P.; Hoffman, Kim; Rechberger, Elke; Seim, Kay; Owens, Betta

2009-01-01

Behavioral health treatment agencies often struggle to keep clients engaged in treatment. Women clients often have additional factors such as family responsibilities, financial difficulties, or abuse histories that provide extra challenges to remaining in care. As part of a national initiative, four women-focused drug treatment agencies used process improvement to address treatment engagement. Interviews and focus groups with staff assessed the nature and extent of interventions. Women-focused drug treatment agencies selected relational-based interventions to engage clients in treatment and improved four-week treatment retention from 66% to 76%. Process improvement interventions in women-focused treatment may be useful to improve engagement. PMID:20046914

Accepting transitions: African Americans discuss end of life.

PubMed

Yancu, Cecile N; Farmer, Deborah F; Graves, Mara J; Rhinehardt, April; Leahman, Dee

2015-06-01

African Americans typically underuse hospice care; this study explores their end of life attitudes. An iterative focus group strategy generated qualitative data using 4 baseline groups and 1 confirmatory focus group recruited from predominantly African American churches. Each group consisted of 8 to 14 adults. Investigators analyzed data for dominant themes, representatives from baseline groups returned to discuss the results. A total of 43 African Americans (male: 8 [18.6]; female: 35 [81.4]) participated in initial discussions, with 10 returning for follow-up. The prevailing theme was transitions; with life to death dominating discourse; other themes included curative to palliative care and acceptance of death as inevitable. Among African Americans, outreach efforts may be strengthened by reframing the dying process as the product of many transitions and reaching out to faith-based communities. © The Author(s) 2014.

Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women's perspectives.

PubMed

Katirayi, Leila; Chadambuka, Addmore; Muchedzi, Auxilia; Ahimbisibwe, Allan; Musarandega, Reuben; Woelk, Godfrey; Tylleskar, Thorkild; Moland, Karen Marie

2017-10-05

With the introduction of 2016 World Health Organization guidelines recommending universal antiretroviral therapy (ART), there has been increased recognition of the lack of men engaging in HIV testing and treatment. Studies in sub-Saharan Africa indicate there have been challenges engaging men in HIV testing and HIV-positive men into treatment. This qualitative study explored women's perspective of their male partner's attitudes towards HIV and ART and how it shapes woman's experience with ART. Data were collected through in-depth interviews and focus group discussions with HIV-positive pregnant and postpartum women on Option B+ and health care workers in Malawi and Zimbabwe. In Malawi, 19 in-depth interviews and 12 focus group discussions were conducted from September-December 2013. In Zimbabwe, 15 in-depth interviews and 21 focus-group discussions were conducted from July 2014-March 2014. The findings highlighted that many men discourage their partners from initiating or adhering to ART. One of the main findings indicated that despite the many advancements in HIV care and ART regimens, there are still many lingering negative beliefs about HIV and ART from the earlier days of the epidemic. In addition to existing theories explaining men's resistance to/absence in HIV testing and treatment as a threat to their masculinity or because of female-focused health facilities, this paper argues that men's aversion to HIV may be a result of old beliefs about HIV and ART which have not been addressed. Due to lack of accurate and up to date information about HIV and ART, many men discourage their female partners from initiating and adhering to ART. The effect of lingering and outdated beliefs about HIV and ART needs to be addressed through strengthened communication about developments in HIV care and treatment. Universal ART offers a unique opportunity to curb the epidemic, but successful implementation of these new guidelines is dependent on ART initiation and adherence by both women and men. Strengthening men's understanding about HIV and ART will greatly enhance women's ability to initiate and adhere to ART and improve men's health.

Psychotherapy of Bereavement After Homicide

PubMed Central

RYNEARSON, TED

1994-01-01

The author presents guidelines for the assessment and initial treatment of bereavement after a homicide. Early interventions include nonverbal techniques applied in individual and group therapy. Because patients are over-whelmed and reactive, initial treatment strategy is supportive and focuses on reestablishing resiliency rather than on preexisting vulnerabilities (ambivalence, guilt, repression, denial). Adjustment to homicidal dying is lifelong, and therapist and patient should acknowledge that change may be limited. PMID:22700202

Minimising compassion fatigue in obstetrics/gynaecology doctors: exploring an intervention for an occupational hazard.

PubMed

Allen, Rosemary; Watt, Felice; Jansen, Brendan; Coghlan, Edwina; Nathan, Elizabeth A

2017-08-01

To explore the indicators of occupational stress in a group of obstetrics and gynaecology doctors and to investigate the impact of work-focused discussion groups over a 6 month period. The ProQOL questionnaire was used to measure the efficacy of monthly psychiatrist-led Balint style discussion groups on minimising Compassion Fatigue (consisting of Secondary Traumatic Stress and Burnout). The 25 doctors were given the given the ProQOL questionnaire to complete: (a) at the initiation of the intervention in July 2015, (b) in October 2015, and (c) in December 2015. Significantly decreased levels of Secondary Traumatic Stress ( p=0.008), Burnout ( p=0.010), as well as significantly increased rates of Compassion Satisfaction ( p=0.035) were recorded. Participants requested that the groups be continued. Psychiatrist-led work focused discussion groups were associated with improved rates of Secondary Traumatic Stress, Burnout, and Compassion Satisfaction in this sample group.

Special action groups for policy change and infrastructure support to foster healthier communities on the Arizona-Mexico border.

PubMed Central

Cohen, Stuart J.; Meister, Joel S.; deZapien, Jill G.

2004-01-01

As part of efforts to help stem the rising tide of diabetes among Hispanic Americans living in Arizona-Mexico border communities, the Border Health Strategic Initiative was launched to foster community-based approaches to diabetes prevention and control. A major thrust of the initiative was establishment of special community action groups (SAGs) to help stimulate policy change and sustain interventions designed to reduce the risk of diabetes and its complications. The SAGs met regularly for more than two years, focusing primarily on policies that encourage development of an infrastructure to support physical activity and healthier nutrition. Through involvement with planning commissions, parks and recreation, and private companies, two community development block grants were obtained to support new walking trails. The SAGs also encouraged elementary schools to improve physical education and change vending machine products, and grocery store owners and managers to allow the demonstration and promotion of healthier foods. These groups, focused on policy and infrastructure change within their communities, may be the glue needed to hold comprehensive community health promotion efforts together. PMID:15147648

Workplace exposures and protective practices of Hispanic warehouse workers.

PubMed

Livaudais, Jennifer C; Thompson, Beti; Islas, Ilda; Ibarra, Genoveva; Anderson, Jennifer; Coronado, Gloria D

2009-04-01

This study was undertaken to assess workplace hazards and protective practices among Hispanic men and women working post-harvest in asparagus, apple and pear packaging warehouses. Three focus groups were conducted in July 2003 with 25 workers (20 women, 5 men) recruited from communities in the Yakima Valley, Washington. Focus group content informed the design of an in-person structured interview administered to 50 additional warehouse workers from August to November 2006. Focus group participants reported difficult working conditions, exposure to chemicals, adverse health effects and use of work and home protective practices to minimize exposures for themselves and their families. Structured interview participants reported few workplace exposures to chemicals although many reported engaging in workplace and home protective practices. Findings from this research can direct initial efforts to determine if and how interventions for warehouse workers may be designed to protect against hazardous workplace exposures.

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.

Transportation research synthesis : effects of major traffic generators on local highway systems.

DOT National Transportation Integrated Search

2010-01-01

The Minnesota Department of Transportation initiated a study focused on the effects of major traffic generators on : local highway systems. Minnesota State University and SRF Consulting Group, Inc. will conduct a major research : study on the topic. ...

Community Consultation and Communication for a Population-Based DNA Biobank: the Marshfield Clinic Personalized Medicine Research Project

PubMed Central

McCarty, Catherine A.; Chapman-Stone, Donna; Derfus, Teresa; Giampietro, Philip F.; Fost, Norman

2008-01-01

The purpose of this paper is to describe community consultation and communication efforts for the Personalized Medicine Research Project (PMRP), a population-based biobank. A series of focus group discussions was held in the year preceding initial recruitment efforts with potentially eligible community residents and slightly less than a year after initial recruitment with eligible residents who had declined participation in PMRP. A Community Advisory Group, with 19 members reflecting the demographics of the eligible community, was formed and meets twice yearly to provide advice and feedback to the PMRP Principal Investigator and the local IRB. Ongoing communication with study subjects, who consent on the condition that personal genetic results will not be disclosed, takes place through a newsletter that is distributed twice yearly, community talks and media coverage. Most focus group participants were concerned about the confidentiality of both their medical and genetic data. Focus group discussions with eligible residents who elected not to participate in PMRP revealed that many knew very little about the project, but thought that too much information had been provided, leading them to believe that it would take too long for them to understand and enroll in the study. In conclusion, an engaged community advisory group can provide a sounding board to study investigators for many study issues and can provide guidance for broader communication activities. Researchers need to balance the provision of information for potential subjects to make informed decisions about study participation, with respect for individuals’ time to read and interpret study materials. PMID:19006210

What lessons can operational planners infer from the NATO Partnership for Peace Program for the execution of contemporary US Regionally Aligned Force and UK Adaptable Force Security Cooperation missions

DTIC Science & Technology

2016-05-26

research questions consist of three groups . The first group addresses an analysis of PfP. The second group determines contemporary US and UK strategy...The second group of research questions focuses upon current US, UK security cooperation initiatives and the specific policy objectives they...Ambition, Austerity and the Case for Rethinking UK Military Spending.” Oxford Research Group . Last modified May 13, 2015. Accessed September 17, 2015

The Effect of Changes in Health Beliefs Among African-American and Rural White Church Congregants Enrolled in an Obesity Intervention: A Qualitative Evaluation.

PubMed

Martinez, Diane J; Turner, Monique M; Pratt-Chapman, Mandi; Kashima, Kanako; Hargreaves, Margaret K; Dignan, Mark B; Hébert, James R

2016-06-01

Church interventions can reduce obesity disparities by empowering participants with knowledge and skills within an established community. The purpose of this study was to evaluate the Biomedical/Obesity Reduction Trial (BMORe) and investigate changes in health beliefs among obese adult participants. Ten pre-/post-intervention focus groups applying the Health Belief Model conducted in two African-American churches in Tennessee (n = 20) and South Carolina (n = 20), and one rural Appalachian church in Kentucky (n = 21). Two independent coders using NVivo analyzed transcribed audio data and notes. Participants' health status of being overweight/obese and having comorbidities of diabetes and high blood pressure motivated enrollment in BMORe. Initially participants voiced low self-efficacy in cooking healthy and reading food labels. BMORe made participants feel "empowered" after 12 weeks compared to initially feeling "out of control" with their weight. Participants reported improvements in emotional health, quality of life, and fewer medications. During post-intervention focus groups, participants reported increased self-efficacy through family support, sharing healthy eating strategies, and having accountability partners. Solidarity and common understanding among BMORe participants led focus group attendees to comment how their peers motivated them to stay in the program for 12 weeks. Long-term barriers include keeping the weight off by maintaining habits of exercise and healthy eating. Implementation of pre-/post-intervention focus groups is an innovative approach to evaluate an obesity intervention and track how changes in health beliefs facilitated behavior change. This novel approach shows promise for behavioral interventions that rely on participant engagement for sustained effectiveness.

Support for At-Risk Girls: A School-Based Mental Health Nursing Initiative.

PubMed

Adamshick, Pamela

2015-09-01

Mental health problems often go undiagnosed or unaddressed until a crisis or extreme event brings the problem to the forefront. Youth are particularly at risk for lack of identification and treatment in regard to mental health issues. This article describes an advanced nursing practice mental health initiative for at-risk teenage girls based on Hildegard Peplau's nursing theory, group process, and healing through holistic health approaches. A support group, RICHES, was developed with focus on core components of relationships, identity, communication, health, esteem, and support. The acronym RICHES was chosen as the name of the support group. Selected themes and issues addressed in this school-based support group are illustrated in case vignettes. Through a collaborative approach with the community and school, this practice initiative presents a unique healing process that extends knowledge in the realm of intervention with at-risk teenage girls. Further research is needed on the efficacy of support groups to modify risk factors and to address goals for primary prevention in at-risk teenage girls. © The Author(s) 2014.

Differences in children's thinking and learning during attentional focus instruction.

PubMed

Perreault, Melanie E; French, Karen E

2016-02-01

Considerable evidence supports the motor learning advantage associated with an external focus of attention; however, very few studies have investigated attentional focus effects with children despite individual functional constraints that have the potential to impact use of instructional content. Thus, the purpose of this study was to determine the effect of attentional focus instruction on motor learning in children. Participants (n=42) aged 9-11years were randomly assigned to one of three gender-stratified groups: (1) control, (2) internal focus, or (3) external focus. Following initial instructions and task demonstration, participants performed 100 modified free throws over two days while receiving additional cues respective to their attentional focus condition and returned approximately 48h later to perform 20 additional free throws. Results revealed no significant learning differences between groups. However, responses to retrospective verbal reports suggest that the use of external focus content during practice may have contributed to some participants' superior performance in retention. Future research should continue to examine attentional focus effects across a variety of ages and incorporate retrospective verbal reports in order to examine children's thoughts during attentional focus instruction. Copyright © 2015 Elsevier B.V. All rights reserved.

An Initiative Toward Reliable Long-Duration Operation of Diode Lasers in Space

NASA Technical Reports Server (NTRS)

Tratt, David M.; Amzajerdian, Farzin; Stephen, Mark A.; Shapiro, Andrew A.

2006-01-01

This viewgraph presentation reviews the workings of the Laser Diode Arrays (LDA) working group. The group facilitates focused interaction between the LDA user and provider communities and it will author standards document for the specification and qualification of LDA's for operation in the space environment. It also reviews the NASA test and evaluation facilities that are available to the community.

Develop and test messages to deter drinking and driving

DOT National Transportation Integrated Search

1998-04-01

This document summarizes the results of a study which developed pilot media messages to support and/or encourage anti-DWI norms. The target audience for these messages was individuals 18-25 years of age. Initially, focus groups were held in the Bosto...

Impact of local/short haul operations on driver fatigue : focus group summary and analysis

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Institutional and Organizational Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstrati...

The National Strategic Plan and Action Agenda for Agricultural Education: Reinventing Agricultural Education for the Year 2020. Creating the Preferred Future for Agricultural Education.

ERIC Educational Resources Information Center

National Council for Agricultural Education, Alexandria, VA.

The Reinventing Agricultural Education for the Year 2020 initiative, a project conducted during 1996-1999 with a diverse group of more than 10,000 people from across the United States, resulted in this strategic plan designed to achieve the mission set by the initiative. That mission has a two-part focus: preparing students for career success in…

Patient Privacy, Consent, and Identity Management in Health Information Exchange: Issues for the Military Health System

DTIC Science & Technology

2013-01-01

JPC-1b Joint Program Committee-1b on Health Information Technology and Medical Informatics MAeHC Massachusetts eHealth Collaborative MHS Military...efficiency of care. The second study, by the eHealth Initiative (2011), surveyed communities across the United States with initiatives to share health...Simon et al. (2009) conducted focus groups involving 64 participants in several rural towns participating in the Massachusetts eHealth Collaborative

Understanding the impact of interprofessional collaboration on the quality of care: a case report from a small-scale resource limited health care environment.

PubMed

Busari, Jamiu O; Moll, Franka M; Duits, Ashley J

2017-01-01

A critical assessment of current health care practices, as well as the training needs of various health care providers, is crucial for improving patient care. Several approaches have been proposed for defining these needs with attention on communication as a key competency for effective collaboration. Taking our cultural context, resource limitations, and small-scale setting into account, we researched the applicability of a mixed focus group approach for analysis of the communication between doctors and nurses, as well as the measures for improvement. Assessment of nurse-physician communication perception in patient care in a Caribbean setting. Focus group sessions consisting of nurses, interns, and medical specialists were conducted using an ethnographic approach, paying attention to existing communication, risk evaluation, and recommendations for improvement. Data derived from the focus group sessions were analyzed by thematic synthesis method with descriptive themes and development of analytic themes. The initial focus group sessions produced an extensive list of key recommendations which could be clustered into three domains (standardization, sustainment, and collaboration). Further discussion of these domains in focus groups showed nurses' and physicians' domain perspectives and effects on patient care to be broadly similar. Risks related to lack of information, knowledge sharing, and professional respect were clearly described by the participants. The described mixed focus group session approach for effectively determining current interprofessional communication and key improvement areas seems suitable for our small-scale, limited resource setting. The impact of the cultural context should be further evaluated by a similar study in a different cultural context.

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.

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.

Drum-Assisted Recovery Therapy for Native Americans (DARTNA): results from a pretest and focus groups.

PubMed

Dickerson, Daniel L; Venner, Kamilla L; Duran, Bonnie; Annon, Jeffrey J; Hale, Benjamin; Funmaker, George

2014-01-01

Drum-Assisted Recovery Therapy for Native Americans (DARTNA) is a substance abuse treatment intervention for American Indians/Alaska Natives (AI/ANs). This article provides results from 1) an initial pretest of DARTNA provided to 10 AI/AN patients with histories of substance use disorders, and 2) three subsequent focus groups conducted among AI/AN DARTNA pretest participants, substance abuse treatment providers, and the DARTNA Community Advisory Board. These research activities were conducted to finalize the DARTNA treatment manual; participants also provided helpful feedback which will assist toward this goal. Results suggest that DARTNA may be beneficial for AI/ANs with substance use problems.

Collaborative leadership and the implementation of community-based fall prevention initiatives: a multiple case study of public health practice within community groups.

PubMed

Markle-Reid, Maureen; Dykeman, Cathy; Ploeg, Jenny; Kelly Stradiotto, Caralyn; Andrews, Angela; Bonomo, Susan; Orr-Shaw, Sarah; Salker, Niyati

2017-02-16

Falls among community-dwelling older adults are a serious public health concern. While evidence-based fall prevention strategies are available, their effective implementation requires broad cross-sector coordination that is beyond the capacity of any single institution or organization. Community groups comprised of diverse stakeholders that include public health, care providers from the public and private sectors and citizen volunteers are working to deliver locally-based fall prevention. These groups are examples of collective impact and are important venues for public health professionals (PHPs) to deliver their mandate to work collaboratively towards achieving improved health outcomes. This study explores the process of community-based group work directed towards fall prevention, and it focuses particular attention on the collaborative leadership practices of PHPs, in order to advance understanding of the competencies required for collective impact. Four community groups, located in Ontario, Canada, were studied using an exploratory, retrospective, multiple case study design. The criteria for inclusion were presence of a PHP, a diverse membership and the completion of an initiative that fit within the scope of the World Health Organization Fall Prevention Model. Data were collected using interviews (n = 26), focus groups (n = 4), and documents. Cross-case synthesis was conducted by a collaborative team of researchers. The community groups differed by membership, the role of the PHP and the type of fall prevention initiatives. Seven practice themes emerged: (1) tailoring to address context; (2) making connections; (3) enabling communication; (4) shaping a vision; (5) skill-building to mobilize and take action; (6) orchestrating people and projects; and (7) contributing information and experience. The value of recognized leadership competencies was underscored and the vital role of institutional supports was highlighted. To align stakeholders working towards fall prevention for community-dwelling older adults and establish a foundation for collective impact, public health professionals employed practices that reflected a collaborative leadership style. Looking ahead, public health professionals will want to shift their focus to evaluating the effectiveness of their group work within communities. They will also need to assess outcomes and evaluate whether the anticipated reductions in fall rates among community-dwelling older adults is being achieved.

Exploring why girls smoke in Malaysia--a qualitative approach.

PubMed

Al-Sadat, Nabilla; Binns, Colin W

2008-10-01

The fast increase in the rate of uptake of smoking amongst adolescent girls in Malaysia is a public health concern. The objective of this study was to investigate factors that influenced the initiation of smoking and the effects of advertisement on consolidating the smoking habit among teenage girls in the urban city of Kuala Lumpur. Qualitative research was conducted using both interviews and focus group discussions with groups of adolescent girls. Data collected was analysed using grounded thematic theory methodology and validated using methodological triangulation. The reasons for initiating smoking elicited from the study can be grouped into 4 general themes; influence by peers, influence of seeing parents smoking, misguided belief that it could alleviate stress and finally that it would impress others. Smoking imageries in media and advertisements were not primary influencing factors in the initiation of smoking but it encouraged them to progress to become regulars. Ways should be sought to empower girls to feel more confident about resisting pressures to initiate smoking. This could be done through activities such as positive peer sports, education on how to alleviate stress and curbing of smoking imageries in the media.

A Qualitative Analysis of Physician Perspectives on Missed and Delayed Outpatient Diagnosis: The Focus on System-Related Factors.

PubMed

Sarkar, Urmimala; Simchowitz, Brett; Bonacum, Doug; Strull, William; Lopez, Andrea; Rotteau, Leahora; Shojania, Kaveh G

2014-10-01

Delayed and missed diagnoses lead to significant patient harm. Because physician actions are fundamental to the outpatient diagnostic process, a study was conducted to explore physician perspectives on diagnosis. As part of a quality improvement initiative, an integrated health system conducted six physician focus groups in 2004 and 2005. The focus groups included questions about the process of diagnosis, specific factors contributing to missed diagnosis, use of guidelines, atypical vs. typical presentations of disease, diagnostic tools, and follow-up, all with regard to delays in the diagnostic process. The interviews were analyzed (1) deductively, with application of the Systems Engineering Initiative for Patient Safety (SEIPS) model, which addresses systems design, quality management, job design, and technology implementations that affect safety-related patient and organizational and/or staff outcomes, and (2) inductively, with identification of novel themes using content analysis. A total of 25 physicians participated in the six focus groups, which yielded 12 hours of discussion. Providers identified multiple barriers to timely and accurate diagnosis, including organizational culture, information availability, and communication factors. Multiple themes relating to each of the participants in the diagnostic process-health system, provider, and patient-emerged. Concerns about health system structure and providers' interactions with one another and with patients far exceeded discussion of the cognitive factors that might affect the diagnostic process. The results suggest that, at least in physicians' views, improving the diagnostic process requires attention to the organization of the health system in addition to the cognitive aspects of diagnosis.

EPA Scientific Knowledge Management Assessment and Needs

EPA Science Inventory

A series of activities have been conducted by a core group of EPA scientists from across the Agency. The activities were initiated in 2012 and the focus was to increase the reuse and interoperability of science software at EPA. The need for increased reuse and interoperability ...

Initiation of farm safety programs in the Arkansas Delta: a case study of participatory methods.

PubMed

Richter, Jan S; Hall, Becky G; Deere, G David

2007-01-01

Outreach to high-risk communities is one of the goals of Area Health Education Centers. One such population is the farm community, which is known to suffer high rates of traumatic events. To describe a participatory methods initiative by the Arkansas Delta Area Health Education Center and other agencies to address farm-related health hazards in a 7-county region. Regional injury and fatality data were gathered from sources including Arkansas Farm Bureau Federation insurance claims, the Arkansas Statistical Service Phone Survey, the National Agricultural Statistics Service, and the Cooperative Extension Service Division of Agriculture at the University of Arkansas. Focus groups were held to assess farmer perceptions and recommendations. Accidents involving tractors accounted for 42% of deaths, and accidents with crop-spraying aircraft accounted for 36%. Focus group participants agreed that planting and harvesting seasons were particularly dangerous. Recommendations included educating motorists to be more cautious on agricultural area roads, using local farmers to provide farm safety training, and making safety equipment more available.

Beliefs and social norms about sildenafil citrate (Viagra) misuse and perceived consequences among Houstonian teenage males.

PubMed

Peters, Ronald J; Johnson, Regina J; Kelder, Steve; Meshack, Angela F; Jefferson, Troy

2007-09-01

In the current study, a qualitative approach was used to investigate relevant beliefs and norms associated with sildenafil citrate (Viagra) consumption, initiation, and perceived consequences. Focus groups were conducted with 43 young men aged 18 and 19 years who identified themselves as lifetime sildenafil citrate users. The majority of focus group participants believed that "curiosity" and "peer pressure" contributed to their initial use. Most revealed that they first heard about sildenafil citrate from television advertisements, family members, friends, or sporting events, and they were able to obtain the drug from their friends and family members or they stole it from their father or grandfather. These findings may highlight the relative importance of exposure to prescription drug messages among those to whom the message is not specifically targeted, that is, young men. It is possible that the sildenafil citrate television messages are recalled by not only older male audiences but also by teenagers and younger men, producing similar cognitive processing and curiosity in both age cohorts.

Formative research to identify community partnerships and foster relationships for health promotion research in South Mississippi.

PubMed

Lemacks, J; Landry, A; Wenzler, P

2018-06-01

The purpose of this short communication is to describe the trust building and collaboration, fostering phases of a community-academic partnership between churches and academic researchers using a community-based participatory research approach. An academic-community partnership with church leaders was initiated using survey administration and was further developed using focus groups. A coalition was developed, and it guided a subsequent focus group with church members. Most churches surveyed did not have a health ministry in place but were agreeable that a variety of health topics were appropriate for the church setting. Church leaders felt that church members were key to engage in health programs in the church, whereas church members viewed pastoral support as important. Church leaders felt that working with a university brings credibility to their own health programs. This early work provides a valuable example of how community collaborations may be initiated and developed using formative research methods, serving both community and research agendas. Published by Elsevier Ltd.

Forming first impressions of children: the role of attention-deficit/hyperactivity disorder symptoms and emotion dysregulation.

PubMed

Lee, Christine A; Milich, Richard; Lorch, Elizabeth P; Flory, Kate; Owens, Julie Sarno; Lamont, Andrea E; Evans, Steven W

2018-05-01

Previous research on peer status of children with attention-deficit/hyperactivity disorder (ADHD) has focused on already-established peer groups, rendering the specific social behaviors that influence peers' initial impressions largely unknown. Recently, theorists have argued that emotion dysregulation is a key aspect of ADHD, with empirical work finding relations between emotion dysregulation and social outcomes. Therefore, the current study focuses on the initial interactions among children varying in ADHD symptoms duringh a novel playgroup, proposing that emotion dysregulation displayed during the playgroup may serve as a possible pathway between ADHD symptoms and peers' initial negative impressions. Participants were 233 elementary-age children ranging from 8 to 10 years old (M = 8.83, 70% male). Parents and teachers rated children's ADHD symptoms and related impairment; 51% of the children met criteria for an ADHD diagnosis. Then, children participated with unfamiliar peers in a three-hour playgroup that included three structured and two unstructured tasks. After the tasks, children and staff rated each child on social outcomes. Coders unaware of child's diagnostic status watched videos of the groups and rated each child's global emotion dysregulation during each task. Using multiple raters and methods, ADHD severity was associated with more negative peer ratings, through observed emotion dysregulation. Results were consistent for both parent and teacher ratings of ADHD severity as well as for both peer ratings of likeability and staff ratings of perceived peer likeability. When focusing on improving peers' initial impressions of children with ADHD symptoms, emotion dysregulation may be a valuable target for intervention. © 2017 Association for Child and Adolescent Mental Health.

[How to design workshops to promote health in community groups].

PubMed

Hernández-Díaz, Josefina; Paredes-Carbonell, Joan J; Marín Torrens, Rosa

2014-01-01

One of the strategies of health promotion is to develop life skills people considering themselves as the main health resource. A workshop has to get its participants become «asset» to make decisions and create health, focusing on the development and acquisition of skills in a motivating group and in order to achieve health objectives. The concepts behind the design of a workshop are: participatory planning, training, meaningful learning, group learning and participatory techniques. The steps to follow to design a workshop and facilitate their application are: Stage 0, founding; initial stage, host and initial evaluation; central or construction stage based learning in the acquisition of knowledge, attitudes and skills, and final stage or evaluation. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Nurses' perspectives on how operational leaders influence function-focused care for hospitalised older people.

PubMed

Fox, Mary T; Butler, Jeffrey I

2016-11-01

To explore nurses' perspectives on how leaders influence function-focused care, defined as care that preserves and restores older people's functional abilities. Hospitalised older people are at risk of functional decline. Although leaders have the potential to influence function-focused care, few studies have explored nurses' perspectives on how leaders influence function-focused care. Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses' perspectives, needs and strategies to meet their needs. Data were thematically analysed. Three themes were identified: (1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; (2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people's functioning and nurses' provisioning of function-focused care; and (3) leadership strategies to better support nurses in providing function-focused care to older people in the context of system efficiency. Leaders should connect with practice to devise age-sensitive efficiency initiatives that support function-focused care. Nurses need support from leaders in four areas to provide function-focused care to older people in the current hospital context. The findings provide direction on how leaders can facilitate function-focused care in the current health-care environment emphasising system efficiency. © 2016 John Wiley & Sons Ltd.

American Indian Breast Cancer Project: Educational Development and Implementation.

ERIC Educational Resources Information Center

Hodge, Felicia Schanche; Casken, John

1999-01-01

Describes the development, implementation, and evaluation of Pathways to Health, a breast cancer education program targeting American Indian women in California. Discusses initial focus group results concerning belief in breast cancer risk, barriers to cancer screening and treatment, culturally sensitive issues, and illness beliefs. Describes…

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

ERIC Educational Resources Information Center

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

2015-01-01

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

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…

DOE Big Idea Summit III: Solving the Information Technology Challenge Beyond Moore's Law: A New Path to Scaling.

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

McCormick, Frederick B.; Shalf, John; Mitchell, Alan

This report captures the initial conclusions of the DOE seven National Lab team collaborating on the “Solving the Information Technology Energy Challenge Beyond Moore’s Law” initiative from the DOE Big Idea Summit III held in April of 2016. The seven Labs held a workshop in Albuquerque, NM in late July 2016 and gathered 40 researchers into 5 working groups: 4 groups spanning the levels of the co-design framework shown below, and a 5th working group focused on extending and advancing manufacturing approaches and coupling their constraints to all of the framework levels. These working groups have identified unique capabilities withinmore » the Labs to support the key challenges of this Beyond Moore’s Law Computing (BMC) vision, as well as example first steps and potential roadmaps for technology development.« less

The use of focus groups to examine pubertal concerns in preteen girls: initial findings and implications for practice and research.

PubMed

Doswell, W M; Vandestienne, G

1996-01-01

This article presents the findings of four focus groups aimed at discovering the concerns a group of 9- to 12-year-old African American and Hispanic girls (N = 38) had about puberty, the transition to adolescence, and growing up. Among the factors these girls liked about growing up were increasing independence from parents, widening social relations with same- and opposite-sex friends, and an increase in decision making regarding clothes and activities. What they reported as not liking about growing up were an increase in peer pressure, high parental expectations, and more responsibility for their actions in home, school, and recreational activities. Health care for this group must include systematic monitoring of pubertal development and concerns in order to aggressively educate preadolescents to negotiate this period smoothly and to avoid high-risk behaviors that could have negative health and social sequelae during adolescence and adulthood.

Inter-disciplinary focus groups on telephone medicine: a quality improvement initiative.

PubMed

Whitson, Heather E; Hastings, S Nicole; McConnell, Eleanor S; Lekan-Rutledge, Deborah A

2006-09-01

To identify opportunities for quality improvement in long-term care telephone medicine using a model of interdisciplinary focus groups. Descriptive pilot project. Extended Care and Rehabilitation Center (ECRC), Durham VA Medical Center, Durham, North Carolina. Eight of 20 registered or licensed practical nurses and 4 of 6 geriatric medicine fellows voluntarily participated in this quality improvement project. In two 45-minute focus groups, participants were asked to discuss 3 open-ended questions related to telephone medicine. Comments were recorded during the discussions; topical themes were identified by the authors. Participant comments could be categorized into 4 domains describing the characteristics of nurses and physicians who practice the best telephone medicine: (1) provides the appropriate medical component of patient care; (2) appreciates contextual issues; (3) respects the other party's time and resources; and (4) possesses a collaborative attitude. The focus groups identified 5 quality improvement goals: (1) better nursing assessment and provision of patient information; (2) minimization of non-urgent calls after hours; (3) more decisive physician action (or explanation of inaction); (4) better physician familiarity with facility policies/logistics; and (5) better communication/paging system. The discussion format allowed nurses and physicians to identify and respond to potential barriers to improving quality in each area. Nurses and physicians appreciate unique aspects of long-term care telephone medicine and identify distinct barriers to improving practice. Interdisciplinary focus groups were a productive step toward understanding the telephone medicine experience in our facility and developing quality improvement interventions for both nurses and physicians.

Development and evaluation of a Chinese-language newborn feeding hotline: a prospective cohort study.

PubMed

Janssen, Patricia A; Livingstone, Verity H; Chang, Bruce; Klein, Michael C

2009-01-29

Preference for formula versus breast feeding among women of Chinese descent remains a concern in North America. The goal of this study was to develop an intervention targeting Chinese immigrant mothers to increase their rates of exclusive breastfeeding. We convened a focus group of immigrant women of Chinese descent in Vancouver, British Columbia to explore preferences for method of infant feeding. We subsequently surveyed 250 women of Chinese descent to validate focus group findings. Using a participatory approach, our focus group participants reviewed survey findings and developed a priority list for attributes of a community-based intervention to support exclusive breastfeeding in the Chinese community. The authors and focus group participants worked as a team to plan, implement and evaluate a Chinese language newborn feeding information telephone service staffed by registered nurses fluent in Chinese languages. Participants in the focus group reported a strong preference for formula feeding. Telephone survey results revealed that while pregnant Chinese women understood the benefits of breastfeeding, only 20.8% planned to breastfeed exclusively. Only 15.6% were breastfeeding exclusively at two months postpartum. After implementation of the feeding hotline, 20% of new Chinese mothers in Vancouver indicated that they had used the hotline. Among these women, the rate of exclusive breastfeeding was 44.1%; OR 3.02, (95% CI 1.78-5.09) compared to women in our survey. Initiation of a language-specific newborn feeding telephone hotline reached a previously underserved population and may have contributed to improved rates of exclusive breastfeeding.

A case study: the initiative to improve RN scheduling at Hamilton Health Sciences.

PubMed

Wallace, Laurel-Anne; Pierson, Sharon

2008-01-01

In 2003, Hamilton Health Sciences embarked on an initiative to improve and standardize nursing schedules and scheduling practices. The scheduling project was one of several initiatives undertaken by a corporate-wide Nursing Resource Group established to enhance the work environment and patient care and to ensure appropriate utilization of nursing resources across the organization's five hospitals. This article focuses on major activities undertaken in the scheduling initiative. The step-by-step approach described, plus examples of the scheduling resources developed and samples of extended-tour schedules, will all provide insight, potential strategies and practical help for nursing administrators, human resources (HR) personnel and others interested in improving nurse scheduling.

"Y Nosotros, Que?": Moving beyond the Margins in a Community Change Initiative

ERIC Educational Resources Information Center

Quinones, Sandra; Ares, Nancy; Padela, Maryam Razvi; Hopper, Mindy; Webster, Stephanie

2011-01-01

Our ethnography focuses on an urban community change organization within a predominantly African American and Latino population. Latino Critical Race Theory and Critical Race Theory help us understand the Spanish speakers' positioning and how particularities of Latinas/os' experience challenged power relations and group cohesion. Our findings…

Psychometric Evaluation of the Child-Adolescent Teasing Scale

ERIC Educational Resources Information Center

Vessey, Judith A.; Horowitz, June A.; Carlson, Karen L.; Duffy, Mary

2008-01-01

Background: This article presents the psychometric evaluation of the Child-Adolescent Teasing Scale (CATS), an instrument to be used as a screening measure with middle school students. Methods: A 70-item scale was initially derived from qualitative data obtained from focus groups comprised of middle school students. A diverse sample of…

Rural Indiana Profile: Alcohol, Tobacco & Other Drugs.

ERIC Educational Resources Information Center

Drug Strategies, Washington, DC.

This report examines alcohol, tobacco, and other drug use in rural parts of Indiana, as well as public and private initiatives to reduce these problems. The report is based on epidemiological, health, and criminal justice indicators; focus groups; and in-depth interviews with local officials, researchers, service providers, and civic leaders.…

Professional Learning Communities: Keeping the Focus on Instructional Practice

ERIC Educational Resources Information Center

Spencer, Elizabeth J.

2016-01-01

The inclusion of professional learning community (PLC) groups is now a common initiative in many districts across the country. While this step supports the professional development of teachers, an effective PLC program must go beyond just bringing colleagues together during a common time. The author recommends organizational structures for schools…

Teaching Highs and Lows: Exploring University Teaching Assistants' Experiences

ERIC Educational Resources Information Center

Green, Jennifer L.

2010-01-01

Recent reforms in statistics education have initiated the need to prepare graduate teaching assistants (TAs) for these changes. A focus group study explored the experiences and perceptions of University of Nebraska-Lincoln TAs. The results reinforced the idea that content, pedagogy, and technology are central aspects for teaching an introductory…

Smoking Attitudes and Practices among Low-Income African Americans: Qualitative Assessment of Contributing Factors.

ERIC Educational Resources Information Center

Beech, Bettina M.; Scarinci, Isabel C.

2003-01-01

Qualitatively examined sociocultural factors associated with smoking attitudes and practices among low-income, African American young adults smokers and nonsmokers. Focus group data indicated that specific contextual and familial factors contributed to smoking initiation, maintenance, and cessation (e.g., strong parental discipline, limited…

Urban Men's Knowledge and Perceptions regarding Sexually Transmitted Infections in Pakistan

ERIC Educational Resources Information Center

Mohammad Mir, Ali; Reichenbach, Laura; Wajid, Abdul

2009-01-01

In a pioneering study undertaken in Pakistan, urban men's sexual behaviors, perceptions and knowledge regarding sexually transmitted infections including HIV/AIDS were determined by employing both qualitative and quantitative research methods. Focus group discussions were carried out initially and followed by a structured cross sectional survey…

Composing Alternatives to a National Security Language Policy

ERIC Educational Resources Information Center

Wible, Scott

2009-01-01

President Bush's National Security Language Initiative focuses narrowly on gearing language education to security and military needs. English educators should work with their counterparts in foreign language departments to promote a broader view, one that encourages study of the multiple language groups that currently exist within the United…

Improving Participation and Success in VET for Disadvantaged Learners. Research Report

ERIC Educational Resources Information Center

Lamb, Stephen; Maire, Quentin; Walstab, Anne; Newman, Graeme; Doecke, Esther; Davies, Merryn

2018-01-01

Improving the educational outcomes of the various disadvantaged groups, such as Indigenous Australians, people with a disability, learners with low prior educational attainment and individuals from non-English speaking backgrounds, is a focus of many government policy initiatives centred on social inclusion. This research takes a regional approach…

Knowledge Collisions: Perspectives from CED Practitioners Working with Women. NALL Working Paper.

ERIC Educational Resources Information Center

Stratton, Mary; Jackson, Ted

A study explored the ways that front-line community development workers across Canada gained information needed to work with women participants in community economic development initiatives. Data were gathered through focus groups, a preliminary study with 15 key informants employed in community development organizations, and structured telephone…

Research Staff and Public Engagement: A UK Study

ERIC Educational Resources Information Center

Davies, Sarah R.

2013-01-01

Public engagement plays an important role in the contemporary UK academy, and is promoted through initiatives such as Beacons of Public Engagement and research grant "Pathways to Impact". Relatively little is known, however, about academic experiences of such engagement activities. This study focuses on one staff group, contract…

Operating a Distance Learning Module within an Undergraduate Work Placement: Some Reflections.

ERIC Educational Resources Information Center

Gammie, Elizabeth; Gammie, Bob; Duncan, Fiona

2002-01-01

A distance learning module on auditing was implemented for accounting students on a 1-year full-time work placement. Review of stakeholder focus groups showed that they considered the module innovative; there were concerns about standards and equity. Initial groundwork with stakeholders, especially professional organizations and external…

Assessment Options in Higher Education

ERIC Educational Resources Information Center

Craddock, Deborah; Mathias, Haydn

2009-01-01

This article evaluates an initiative to introduce assessment choice within a taught unit on an undergraduate healthcare programme as a means of addressing poor performance, especially for those students diagnosed with dyslexia. Students' perceptions of the assessment experience were sought via the use of two focus group interviews (n = 16). The…

Project success: A methodological and evaluative case study of the early alert program interventions

NASA Astrophysics Data System (ADS)

Larkins, Randy James

The purpose of this study was twofold. First, to methodologically examine the use of three types of focus groups 1), traditional face-to face, 2), online video and audio, and 3) online text only. Second, to examine the impact of academic intervention attempts offered by university and department support services. Methodologically, the three types of focus groups were compared in terms of ease of use, comfort, richness of data and ethical considerations. Contextually, support services for a general chemistry course taken primarily by new students were examined using an evaluation method involving effort, monitoring, process, component and treatment specification types of implementation. For this research, fourteen students enrolled in the general chemistry course at Rocky Mountain University in fall term 2014 participated in one of the three types of focus groups to discuss support services for the course. Since the increase of technological advances in the late twentieth century, the use of electronic focus groups has been viewed as a viable alternative to traditional in-person meetings. However, different methods within a methodology might produce different results for both students and researchers. This study inspected differences in ease of use for participants and the researcher, comfort in terms of using technology and in discussing academic issues and support services, richness of the data, and ethical issues surrounding privacy and confidentiality. For this case study, methodological findings were that in-person groups still had relevance in this age of advanced technology. Audio-video groups were more limited than in-person groups in terms of interaction and administration, while text-only groups were easiest to transcribe, but seemed to be the most limited in terms of all other aspects of the research. Finally, ethical concerns were not considered important by members in any group; therefore, it is incumbent on the researcher to provide the best ethical environment possible in whatever form the focus group takes place. Suggestions for future research include recruiting participants from online classes and attempting to engage more disenfranchised students in other studies. Similar to new types of focus group methods due to technological advances, academic interventions for students facing failing grades are also increasing due to the internet and new methods of service delivery. The contextual aspect of this research involved asking students to participate in an initial focus group session, four weeks of email updates, and a final focus group session in which students participated in the same group as the initial session. The purpose of the focus groups was to evaluate whether or not the universities' attempts to help students succeed in a course known in the past for high failure rates through a program known as the Early Alert Project was succeeding. Interview data were analyzed using thematic coding to evaluate available support services using a comprehensive implementation evaluation model which included effort, monitoring, process, components; and treatment specification. The primary findings were although students believed the university was trying to help them succeed, Early Alert Project efforts were adversely received. In addition, participants felt that although there were enough support services to help them succeed in the course, the components of the support system were confusing and not organized in any systematic manner. Suggestions for further research included researching delivery of this type of communication that might be more amenable to the students who received it and applying this research to other courses to examine whether the same results occur. Finally, implications of the use of traditional methods and academic support services are discussed in addition to the effect of the research itself upon its participants.

Investigation of the Causes of Breast Cancer at the Cellular Level: Isolation of In Vivo Binding Sites of the Human Origin Recognition Complex

DTIC Science & Technology

2002-08-01

We study the process of DNA replication in proliferating human cells. Our efforts are directed to the identification and characterization of proteins...that promote DNA replication (initiators) as well as the DNA sequences recognized by them (replicators) . We have focused in a group of initiator...to be a critical factor for the coordination of DNA replication with the cell division cycle. hOrclp levels are higher between the exit of mitosis and

Challenges and Changes: Developing Teachers' and Initial Teacher Education Students' Understandings of the Nature of Science

NASA Astrophysics Data System (ADS)

Ward, Gillian; Haigh, Mavis

2017-12-01

Teachers need an understanding of the nature of science (NOS) to enable them to incorporate NOS into their teaching of science. The current study examines the usefulness of a strategy for challenging or changing teachers' understandings of NOS. The teachers who participated in this study were 10 initial teacher education chemistry students and six experienced teachers from secondary and primary schools who were introduced to an explicit and reflective activity, a dramatic reading about a historical scientific development. Concept maps were used before and after the activity to assess teachers' knowledge of NOS. The participants also took part in a focus group interview to establish whether they perceived the activity as useful in developing their own understanding of NOS. Initial analysis led us to ask another group, comprising seven initial teacher education chemistry students, to take part in a modified study. These participants not only completed the same tasks as the previous participants but also completed a written reflection commenting on whether the activity and focus group discussion enhanced their understanding of NOS. Both Lederman et al.'s (Journal of Research in Science Teaching, 39(6), 497-521, 2002) concepts of NOS and notions of "naive" and "informed" understandings of NOS and Hay's (Studies in Higher Education, 32(1), 39-57, 2007) notions of "surface" and "deep" learning were used as frameworks to examine the participants' specific understandings of NOS and the depth of their learning. The ways in which participants' understandings of NOS were broadened or changed by taking part in the dramatic reading are presented. The impact of the data-gathering tools on the participants' professional learning is also discussed.

Worklife Improvement and Leadership Development study: a learning experience in leadership development and "planned" organizational change.

PubMed

Cummings, Greta G; Spiers, Judith A; Sharlow, Janice; Germann, Paula; Yurtseven, Ozden; Bhatti, Aslam

2013-01-01

In response to increasing recognition of the importance of quality health care work environments, the Alberta Cancer Board initiated a province-wide leadership development program to plan for organizational change through a series of stages. In 2004, the Leadership Development Initiative (LDI) was implemented to facilitate organizational learning using a cohort-based leadership intervention based on a communities of practice framework. The aim of the Worklife Improvement and Leadership Development study was to examine both the outcomes and experiences of participants of the LDI program to better understand leadership development, implementation, and its impact on worklife quality among 5 cohorts of health care managers and staff at the Alberta Cancer Board. This study used both structured survey and interview methods, using a pretest-intervention-posttest quasi-experiment without a control group design, to assess the effects of LDI on worklife of leaders and staff. Surveys included the Leadership Practices Inventory and Areas of Worklife Scale, which looked at meaningfulness of work and organizational engagement. Interviews and focus group data provided a more detailed description of the experience of leadership development and perceptions of organizational worklife. The study revealed layers of information about the complexity of individual and collective leadership in a cohort-based design, perceptions of leadership initiatives, organizational worklife, and planned organizational change. Our findings suggest that early changes in how leaders reflected on their own skills and practices (Leading Self) were positive; however, growing disengagement as the LDI continued was evident in the focus group data, particularly when change in behavior of others was not perceived to be evident. To support the effectiveness and success of a leadership initiative, managers and administrators need to implement strategies designed to help leaders grow and cope with ongoing flux of organizational change and stagnation.

Factors that facilitate or constrain the use of continuous sedation at the end of life by physicians and nurses in Belgium: results from a focus group study.

PubMed

Raus, Kasper; Anquinet, Livia; Rietjens, Judith; Deliens, Luc; Mortier, Freddy; Sterckx, Sigrid

2014-04-01

Continuous sedation at the end of life (CS) is the practice whereby a physician uses sedatives to reduce or take away a patient's consciousness until death. Although the incidence of CS is rising, as of yet little research has been conducted on how the administration of CS is experienced by medical practitioners. Existing research shows that many differences exist between medical practitioners regarding how and how often they perform CS. We conducted a focus group study to find out which factors may facilitate or constrain the use of continuous sedation by physicians and nurses. The participants often had clear ideas on what could affect the likelihood that sedation would be used. The physicians and nurses in the focus groups testified that the use of continuous sedation was facilitated in cases where a patient has a very limited life expectancy, suffers intensely, makes an explicit request and has family members who can cope with the stress that accompanies sedation. However, this 'paradigm case' was considered to occur only rarely. Furthermore, deviations from the paradigm case were said to be sometimes due to physicians initiating the discussion on CS too late or not initiating it at all for fear of inducing the patient. Deviations from the paradigm case may also occur when sedation proves to be too difficult for family members who are said to sometimes pressure the medical practitioners to increase dosages and speed up the sedation.

Mapping the Barriers and Facilitators of HCV Treatment Initiation in Methadone Maintenance Therapy Patients: Implications for Intervention Development.

PubMed

Bass, Sarah Bauerle; Jessop, Amy; Maurer, Laurie; Gashat, Muhamed; Al Hajji, Mohammed; Gutierrez, Mercedes

2018-01-01

An estimated 70-90% of current methadone users have Hepatitis C (HCV). Current treatments have few side effects and can cure infection in 8-12 weeks, but less than 10% of methadone patients initiate treatment. Engaging this group in treatment is an important strategy to lower both morbidity and mortality from liver disease and eliminate a significant reservoir of HCV in communities. To understand how to address this treatment gap we used commercial marketing techniques called perceptual mapping and vector message modeling to analyze survey data from 100 HCV+ methadone patients from four centers in Philadelphia. Results were used to understand barriers and facilitators to treatment initiation and to devise targeted message strategies to adapt to a mobile health communication intervention. Results indicate that focusing on how treatment can make one feel "in charge", positive interactions with healthcare providers, the positive attributes of the new vs. old HCV treatments, and providing strategies to address tangible barriers to getting treatment, would be important to address in a communication intervention. These marketing methods allow for focusing on specific variables to "move" the group toward a treatment decision, making them an innovative technique to use in developing highly targeted health communication messages.

The enactment of knowledge translation: a study of the Collaborations for Leadership in Applied Health Research and Care initiative within the English National Health Service.

PubMed

D'Andreta, Daniela; Scarbrough, Harry; Evans, Sarah

2013-10-01

We contribute to existing knowledge translation (KT) literature by developing the notion of 'enactment' and illustrate this through an interpretative, comparative case-study analysis of three Collaborations for Leadership in Applied Health Research and Care (CLAHRC) initiatives. We argue for a focus on the way in which the CLAHRC model has been 'enacted' as central to the different KT challenges and capabilities encountered. A comparative, mixed method study created a typology of enactments (Classical, Home-grown and Imported) using qualitative analysis and social network analysis. We identify systematic differences in the enactment of the CLAHRC model. The sources of these different enactments are subsequently related to variation in formative interpretations and leadership styles, the implementation of different governance structures, and the relative epistemic differences between the professional groups involved. Enactment concerns the creative agency of individuals and groups in constituting a particular context for their work through their local interpretation of a particular KT model. Our theory of enactment goes beyond highlighting variation between CLAHRCs, to explore the mechanisms that influence the way a particular model is interpreted and acted upon. We thus encourage less focus on conceptual models and more on the formative role played by leaders of KT initiatives.

The Starr County Border Health Initiative: Focus Groups on Diabetes Prevention in Mexican Americans.

PubMed

Brown, Sharon A; Perkison, William B; García, Alexandra A; Cuevas, Heather E; Velasquez, Mary M; Winter, Mary A; Hanis, Craig L

2018-06-01

Purpose The purpose of the study was to conduct focus groups with Mexican Americans in an impoverished rural community on the Texas-Mexico border to identify current barriers to adopting healthier lifestyles and to obtain recommendations for diabetes prevention. Methods Three separate 2-hour focus groups were led by an experienced bilingual Mexican American moderator. Interviews included questions about cultural factors and barriers that influence lifestyle behaviors, aspects of previous diabetes self-management interventions that were helpful for motivating behavioral change, and recommendations for diabetes prevention. Results Twenty-seven participants attended a focus group session; each session involved 7 to 12 informants. Individuals were diagnosed with prediabetes or type 2 diabetes mellitus; most were female, foreign born, and Spanish speaking. Interviews documented the cultural importance of food. Informants raised priority issues for diabetes prevention, including the need to learn how to prepare healthier foods and track caloric intake. Major barriers to healthier lifestyles included high costs of healthy foods, fatigue from busy schedules and working multiple jobs, a cultural view that exercise is a waste of valuable time, and fear of deportation. Conclusions Cultural influences and barriers to implementing healthy lifestyles should be assessed regularly and strategies implemented to overcome them. Such factors may change as environmental, sociocultural, and political environments change.

Using global health initiatives to strengthen health systems: a civil society perspective.

PubMed

Cohn, Jennifer; Russell, Asia; Baker, Brook; Kayongo, Alice; Wanjiku, Esther; Davis, Paul

2011-01-01

Research into the effects of global health initiatives (GHIs) on health systems has largely left out the viewpoints and contributions of civil society. This study details civil society's perspective regarding the effects of two GHIs, the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), on country health systems and the added value of civil society interacting with GHIs to strengthen health systems. The study employed qualitative data collection methods using semi-structured interviews administered during focus groups and key informant interviews. A range of health system stakeholders were interviewed in Kenya, Malawi, Uganda and Zambia. Data were coded and analysed for themes and sub-themes. In total, 2910 civil society participants provided information individually or in focus groups. Respondents reported that GHIs have contributed to dramatic health benefits within and outside of a disease-specific focus, including health systems strengthening efforts. However, opportunities for synergy between GHIs and health systems have been missed, and GHIs have not worked sufficiently to close capacity gaps of grassroots civil society organisations. Despite some governance innovations, civil society's opportunities to participate meaningfully in GHI priority setting efforts are limited. Recommendations are included on how to best use GHIs to strengthen health systems by partnering with civil society.

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.

[An overview of telehealth initiatives in Latin America].

PubMed

dos Santos, Alaneir de Fátima; D'Agostino, Marcelo; Bouskela, Maurício Simon; Fernandéz, Andrés; Messina, Luiz Ary; Alves, Humberto José

2014-01-01

This article aimed to systematize the views on telehealth in Latin America and to present the experience of building an instrument for monitoring the development of telehealth initiatives based on the reality of this region. A group was structured to coordinate telehealth efforts in Latin America, with members appointed by the ministries of health of 16 countries. Five thematic groups were also set up. Based on international experiences and focusing on the reality of telehealth in the continent, an instrument was created to monitor the development of telehealth in Latin America. Several countries have national telehealth projects: Brazil, Colombia, Ecuador, Mexico, Panama. Others are in the process of development and early deployment: Bolivia, Costa Rica, Cuba, El Salvador, Guatemala, Peru, Venezuela. The instrument described in the article, which is still being tested, proposes a characterization of countries according to their telehealth development stage: nonexistent, nascent, intermediate, advanced, and exemplary. Currently, important telehealth initiatives are already underway in Latin America.

The increased cost of ventral hernia recurrence: a cost analysis.

PubMed

Davila, D G; Parikh, N; Frelich, M J; Goldblatt, M I

2016-12-01

Over 300,000 ventral hernia repairs (VHRs) are performed each year in the US. We sought to assess the economic burden related to ventral hernia recurrences with a focused comparison of those with the initial open versus laparoscopic surgery. The Premier Alliance database from 2009 to 2014 was utilized to obtain patient demographics and comorbid indices, including the Charlson comorbidity index (CCI). Total hospital cost and resource expenses during index laparoscopic and open VHRs and subsequent recurrent repairs were also obtained. The sample was separated into laparoscopic and open repair groups from the initial operation. Adjusted and propensity score matched cost outcome data were then compared amongst groups. One thousand and seventy-seven patients were used for the analysis with a recurrence rate of 3.78 %. For the combined sample, costs were significantly higher during recurrent hernia repair hospitalization ($21,726 versus $19,484, p < 0.0001). However, for index laparoscopic repairs, both the adjusted total hospital cost and department level costs were similar during the index and the recurrent visit. The costs and resource utilization did not go up due to recurrence, even though these patients had greater severity during the recurrent visit (CCI score 0.92 versus 1.06; p = 0.0092). Using a matched sample, the total hospital recurrence cost was higher for the initial open group compared to laparoscopic group ($14,520 versus $12,649; p = 0.0454). Based on our analysis, need for recurrent VHR adds substantially to total hospital costs and resource utilization. Following initial laparoscopic repair, however, the total cost of recurrent repair is not significantly increased, as it is following initial open repair. When comparing the initial laparoscopic repair versus open, the cost of recurrence was higher for the prior open repair group.

"It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study.

PubMed

Passey, Megan E; Gale, Jennifer T; Sanson-Fisher, Robert W

2011-12-09

Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge Aboriginal identity and culture as a source of empowerment; and to recognise the role of persistent marginalization in contributing to the high prevalence and initiation of smoking.

"It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study

PubMed Central

2011-01-01

Background Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. Methods We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Results Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. Conclusions The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge Aboriginal identity and culture as a source of empowerment; and to recognise the role of persistent marginalization in contributing to the high prevalence and initiation of smoking. PMID:22152218

Pregnancy discovery and acceptance among low-income primiparous women: a multicultural exploration.

PubMed

Peacock, N R; Kelley, M A; Carpenter, C; Davis, M; Burnett, G; Chavez, N; Aranda, V

2001-06-01

As part of a larger study exploring psychosocial factors that influence self-care and use of health care services during pregnancy, we investigated the process of pregnancy discovery and acceptance among a culturally diverse group of women who had given birth to their first child in the year preceding data collection. Eighty-seven low-income women from four cultural groups (African American, Mexican, Puerto Rican, and white) participated in eight focus groups held in their communities. The focus groups were ethnically homogenous and stratified by early and late entry into prenatal care. A social influence model guided the development of focus group questions, and the study followed a participatory action research model, with community members involved in all phases of the research. Issues that emerged from the focus groups as possible influences on timing of pregnancy recognition include the role of pregnancy signs and symptoms and pregnancy risk perception in the discovery process, the role of social network members in labeling and affirming the pregnancy, concerns about disclosure, "planning" status of the pregnancy, and perceived availability of choices for resolving an unintended pregnancy. The pregnancy discovery process is complex, and when protracted, can potentially result in delayed initiation of both prenatal care and healthful pregnancy behaviors. Enhancing our understanding of pregnancy discovery and acceptance has clear implications for primary and secondary prevention. Future research is needed to further explain the trajectory of pregnancy discovery and acceptance and its influence on health behaviors and pregnancy outcome.

Understanding Genomic Knowledge in Rural Appalachia: The West Virginia Genome Community Project.

PubMed

Mallow, Jennifer A; Theeke, Laurie A; Crawford, Patricia; Prendergast, Elizabeth; Conner, Chuck; Richards, Tony; McKown, Barbara; Bush, Donna; Reed, Donald; Stabler, Meagan E; Zhang, Jianjun; Dino, Geri; Barr, Taura L

Rural communities have limited knowledge about genetics and genomics and are also underrepresented in genomic education initiatives. The purpose of this project was to assess genomic and epigenetic knowledge and beliefs in rural West Virginia. A total of 93 participants from three communities participated in focus groups and 68 participants completed a demographic survey. The age of the respondents ranged from 21 to 81 years. Most respondents had a household income of less than $40,000, were female and most were married, completed at least a HS/GED or some college education working either part-time or full-time. A Community Based Participatory Research process with focus groups and demographic questionnaires was used. Most participants had a basic understanding of genetics and epigenetics, but not genomics. Participants reported not knowing much of their family history and that their elders did not discuss such information. If the conversations occurred, it was only during times of crisis or an illness event. Mental health and substance abuse are topics that are not discussed with family in this rural population. Most of the efforts surrounding genetic/genomic understanding have focused on urban populations. This project is the first of its kind in West Virginia and has begun to lay the much needed infrastructure for developing educational initiatives and extending genomic research projects into our rural Appalachian communities. By empowering the public with education, regarding the influential role genetics, genomics, and epigenetics have on their health, we can begin to tackle the complex task of initiating behavior changes that will promote the health and well-being of individuals, families and communities.

Isolated low initial differential renal function in patients with primary non-refluxing megaureter should not be considered an indication for early surgery: A multicentric study.

PubMed

Drlík, Marcel; Flogelová, Hana; Martin, Kubát; Jan, Tomášek; Pavel, Zerhau; Oldřich, Šmakal; Ivo, Novák; Martin, Komarc; Radim, Kočvara

2016-08-01

Low initial differential renal function (DRF) in patients with primary non-refluxing megaureter (PNRM) is considered an indication for surgery as are an increase of dilatation and symptoms. We hypothesized that low DRF is not necessarily a result of obstruction, but may be due to impaired development of the upper urinary tract. Thus, in the absence of symptoms, there is a low risk for further loss of renal function. This study aimed to assess whether initially low DRF is a reliable indicator of obstruction. We reviewed data from four university centers between 1995 and 2010. Patients under 12 months of age with unilateral primary non-refluxing megaureter (PNMR) and a DRF between 10% and 40%, and followed minimally 24 months, were included. Patients were placed in two groups based on management: group A, surgical; group B, conservative. The dynamics of DRF in relation to age and type of treatment was studied. In each patient we recorded the earliest (initial) DRF, the last known (final) DRF, the age when MAG-3 scans were performed and the type of treatment. From 25 patients, 16 were treated surgically (group A) and 9 followed conservatively (group B). The initial mean DRF in group A was 33.1% and in group B 34.5%, at a mean age 3.0 and 3.6 months, respectively. The final mean DRF in group A was 40.1% and in group B 43%, at a mean age 59.9 and 46.3 months, respectively. Using two-way repeated ANOVA (age [initial DRF, final DRF] vs. group [group A, group B]), we found non-significant difference between the groups in the DRF, F (1, 21) = 0.96, p = 0.338, while we observed statistically significant and similar increase from the initial to final DRF in both groups, F (1, 21) = 16.66, p = 0.001 (Figure). This is the first study focusing on the evolution of renal function in patients with PNRM and low initial DRF. Results suggest that the diagnosis of obstruction is inaccurate in most infants with unilateral PNRM if it is based on low initial DRF only. Renal deterioration rarely occurs in asymptomatic patients, and even profoundly impaired kidneys have potential for improvement. Limitations of our study include retrospective design and lack of standardization of treatment among the four centers. Low DRF in asymptomatic and anatomically stable patients with PNMR should not be considered an indication for early surgery. These findings challenge current practice and should be confirmed by a prospective study. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Update on Outcome Measure Development for Large Vessel Vasculitis: Report from OMERACT 12

PubMed Central

Aydin, Sibel Zehra; Direskeneli, Haner; Sreih, Antoine; Alibaz-Oner, Fatma; Gul, Ahmet; Kamali, Sevil; Hatemi, Gulen; Kermani, Tanaz; Mackie, Sarah L.; Mahr, Alfred; Meara, Alexa; Milman, Nataliya; Nugent, Heidi; Robson, Joanna; Tomasson, Gunnar; Merkel, Peter A.

2015-01-01

Objective The rarity of large vessel vasculitis (LVV) is a major factor limiting randomized controlled trials in LVV, resulting in treatment choices in these diseases that are guided mainly by observational studies and expert opinion. Further complicating trials in LVV is the absence of validated and meaningful outcome measures. The Outcome Measures in Rheumatology (OMERACT) vasculitis working group initiated the Large Vessel Vasculitis task force in 2009 to develop data-driven, validated outcome tools for clinical investigation in LVV. This report summarizes the progress that has been made on a disease activity assessment tool and patient-reported outcomes in LVV as well as the group’s research agenda. Methods The OMERACT LVV task force brought an international group of investigators and patient research partners together to work collaboratively on developing outcome tools. The group initially focused on disease activity assessment tools in LVV. Following a systematic literature review, an international Delphi exercise was conducted to obtain expert opinion on principles and domains for disease assessment. The OMERACT vasculitis working group’s LVV task force is also conducting qualitative research with patients, including interviews, focus groups, and engaging patients as research partners, all to ensure that the approach to disease assessment includes measures of patients’ perspectives and that patients have input into the research agenda and process. Results The preliminary results of both the Delphi exercise and the qualitative interviews were discussed at the OMERACT 12 (2014) meeting and the completion of the analyses will produce an initial set of domains and instruments to form the basis of next steps in the research agenda. Conclusion The research agenda continues to evolve, with the ultimate goal of developing an OMERACT-endorsed core set of outcome measures for use in clinical trials of LVV. PMID:26077399

Development of an interface-focused educational complex intervention.

PubMed

Sampson, Rod; MacVicar, Ronald; Wilson, Philip

2017-09-01

In many countries, the medical primary-secondary care interface is central to the delivery of quality patient care. There is prevailing interest in developing initiatives to improve interface working for the benefit of health care professionals and their patients. To describe the development of an educational intervention designed to improve working at the primary-secondary care interface in NHS Scotland (United Kingdom) within the context of the Medical Research Council framework for the development and evaluation of complex interventions. A primary-secondary care interface focused Practice-based Small Group Learning (PBSGL) module was developed building upon qualitative synthesis and original research. A 'meeting of experts' shaped the module, which was subsequently piloted with a group of interface clinicians. Reflections on the module were sought from clinicians across NHS Scotland to provide contextual information from other areas. The PBSGL approach can be usefully applied to the development of a primary-secondary care interface-focused medical educational intervention.

Attitudes to the public release of comparative information on the quality of general practice care: qualitative study.

PubMed

Marshall, Martin N; Hiscock, Julia; Sibbald, Bonnie

2002-11-30

To examine the attitudes of service users, general practitioners, and clinical governance leads based in primary care trusts to the public dissemination of comparative reports on quality of care in general practice, to guide the policy and practice of public disclosure of information in primary care. Qualitative focus group study using mock quality report cards as prompts for discussion. 12 focus groups held in an urban area in north west England and a semirural area in the south of England. 35 service users, 24 general practitioners, and 18 clinical governance leads. There was general support for the principle of publishing comparative information, but all three stakeholder groups expressed concerns about the practical implications. Attitudes were strongly influenced by experience of comparative reports from other sectors-for example, school league tables. Service users distrusted what they saw as the political motivation driving the initiative, expressed a desire to "protect" their practices from political and managerial interference, and were uneasy about practices being encouraged to compete against each other. General practitioners focused on the unfairness of drawing comparisons from current data and the risks of "gaming" the results. Clinical governance leads thought that public disclosure would damage their developmental approach to implementing clinical governance. The initial negative response to the quality reports seemed to diminish on reflection. Despite support for the principle of greater openness, the planned publication of information about quality of care in general practice is likely to face considerable opposition, not only from professional groups but also from the public. A greater understanding of the practical implications of public reporting is required before the potential benefits can be realised.

Undergraduate Reflective Journaling in Work Integrated Learning: Is It Relevant to Professional Practice?

ERIC Educational Resources Information Center

Edgar, Susan; Francis-Coad, Jacqueline; Connaughton, Joanne

2013-01-01

This paper presents the research findings from a study reviewing graduates' opinions on completing online reflective journaling tasks during work integrated learning as an undergraduate. The study was divided into two parts with an initial focus group conducted with six physiotherapy graduates seven months following graduation. Findings from the…

Advocating for Ethnographic Work in Early Childhood Federal Policy: Problems and Possibilities

ERIC Educational Resources Information Center

Adair, Jennifer Keys

2011-01-01

Initiated as part of the Council on Anthropology and Education's Policy Engagement Working Group, the policy brief "Ethnographic Knowledge For Early Childhood" focused on making the case for ethnography as evidence within early childhood federal policy. This article describes the creation and distribution of the policy brief as well as the…

Soft Assembling Project-Based Learning and Leadership in Japan

ERIC Educational Resources Information Center

Knight, Kevin; Murphey, Tim

2017-01-01

In this article, we initially focus on how the conceptualization of leadership by Knight (2013a) in his leadership seminars became the basis for choosing a project-based learning (PBL) approach. We then consider how soft assembling can enhance the leadership project activities of student teams and group-work in general classes. Soft assembling…

Higher Education, Globalization and Economic Development in Virginia

ERIC Educational Resources Information Center

State Council of Higher Education for Virginia, 2010

2010-01-01

In early 2009, the State Council of Higher Education for Virginia (SCHEV) initiated an effort to assess the status of the Commonwealth's international education programs. A survey was distributed to the public and private institutions, focusing on critical aspects of contemporary international education programs as identified by an ad hoc group of…

Experiences of Latino Couples in Relationship Education: A Critical Analysis

ERIC Educational Resources Information Center

Perez, Carlos; Brown, Matthew D.; Whiting, Jason B.; Harris, Steven M.

2013-01-01

There exists a need to better understand the applicability of Marriage and Relationship Education (MRE) initiatives with diverse populations. This study presents findings from focus groups with Latino men and women (N = 16) who participated in MRE classes. A critical theory approach guided the researchers who used grounded theory methodology to…

Women's Lives, Mothers' Health. Children in the Tropics No. 159.

ERIC Educational Resources Information Center

Chauliac, M.; Masse-Raimbault, A. M.

1985-01-01

Part of a program of publications concerning the status and advancement of women coordinated in four journals by the Group for Initiatives on Women and Development, this issue of "Children in the Tropics" focuses on mothers' health. Section I describes factors conditioning the health and nutritional status of women and girls. Discussion…

Eating and Scraping Away at Practice with Two-Year-Olds

ERIC Educational Resources Information Center

Barron, Ian; Taylor, Lisa

2017-01-01

This paper examines how early childhood policy initiatives in the United Kingdom and internationally currently reflect neoliberal concerns with school readiness in the development of human capital and what diverse theoretical perspectives might offer. The focus is a project involving a group of early childhood academics from one university and a…

A Mixed Methods Portrait of Urban Instrumental Music Teaching

ERIC Educational Resources Information Center

Fitzpatrick, Kate R.

2011-01-01

The purpose of this mixed methods study was to learn about the ways that instrumental music teachers in Chicago navigated the urban landscape. The design of the study most closely resembles Creswell and Plano Clark's (2007) two-part Triangulation Convergence Mixed Methods Design, with the addition of an initial exploratory focus group component.…

Psychological Predictors of Mortality: Evidence from a 41-Year Prospective Study.

ERIC Educational Resources Information Center

Graves, Pirkko L.; And Others

The Precursors Study, initiated in 1946, has focused on searching for links between psychological patterns and future disease and death. Gathering a broad spectrum of psychobiological characteristics from a large group of medical students, this study has continued year after year. This study examined the role of psychological factors on mortality,…

Who Benefits From Your AGU Donation?

NASA Astrophysics Data System (ADS)

Howard, Claire

2014-09-01

When you give to AGU, you are giving to programs and initiatives that affect you, your fellow scientists, and the entire world. From section and focus group newsletters to student scholarships to struggling communities, there is an opportunity for you to engage and make a difference. Visit http://giving.agu.org to make your impact.

The Behaviors of Parents of Children with Autism Predict the Subsequent Development of Their Children's Communication.

ERIC Educational Resources Information Center

Siller, Michael; Sigman, Marian

2002-01-01

Comparison of caregiver behaviors of children with either autism, developmental delay, or typical development found no difference between groups in caregiver synchronization with the child's focus of attention. Also, caregivers of children with autism who showed higher levels of synchronization during initial play interactions led to superior…

A Norwegian Out-of-School Mathematics Project's Influence on Secondary Students' STEM Motivation

ERIC Educational Resources Information Center

Jensen, Fredrik; Sjaastad, Jørgen

2013-01-01

Considerable resources are spent on initiatives aiming to increase achievement and participation in science, technology, engineering, and mathematics (STEM). Drawing on focus group interviews and a questionnaire study with participants in ENT3R, a Norwegian out-of-school mathematics program, we investigated why participants attended and stayed in…

Models of Influence on Mathematics Instructional Coaches

ERIC Educational Resources Information Center

Brown, Sue; Harrell, Scott; Browning, Sandra

2017-01-01

In our study, we examine the factors influencing the implementation of a mathematics coaching initiative at four high schools including the assets an instructional coach brings to the position and the challenges unique to each school. In our case study we include data collected in individual interviews with instructional coaches, focus groups with…

Do Video Games Promote Positive Youth Development?

ERIC Educational Resources Information Center

Adachi, Paul J. C.; Willoughby, Teena

2013-01-01

We argue that video game play may meet Larson's (2000) criteria for fostering initiative in youth, and thus, may be related to positive outcomes such as flow, cooperation, problem solving, and reduced in-group bias. However, developmental and social psychologists examining adolescent video game use have focused heavily on how video games are…

What Limits the Effectiveness of Antibullying Programs? A Thematic Analysis of the Perspective of Teachers

ERIC Educational Resources Information Center

Cunningham, Charles E.; Rimas, Heather; Mielko, Stephanie; Mapp, Cailin; Cunningham, Lesley; Buchanan, Don; Vaillancourt, Tracy; Chen, Yvonne; Deal, Ken; Marcus, Madalyn

2016-01-01

Prevention programs yield modest reductions in bullying in North American schools. This study explored the perspective of educators regarding factors limiting the impact of these initiatives. Transcripts from nineteen 90-min focus groups with 103 educators were coded thematically. Educators felt that off-site incidents, cyberbullying, and the…

Teacher Education in Bhutan: Highlights and Challenges for Reform

ERIC Educational Resources Information Center

VanBalkom, W. Duffie; Sherman, Ann

2010-01-01

Bhutan is embarking on a comprehensive education reform process, with teachers and teacher education at the centre of a number of initiatives. This study describes the current state of affairs based on interviews with key informants and semi-structured focus groups in Bhutan. Several major themes emerged, including issues of quality of students…

Mall Schools: A New Era for Cutting Edge Alternative Education

ERIC Educational Resources Information Center

Chalker, Christopher Scott; Stelsel, Kirk

2008-01-01

Education Resource Centers (ERCs) were established by the Simon Youth Foundation (SYF) as a means of providing economic opportunities and life choices for youth considered at risk through focused programs and initiatives with public school partners. In the current academic year there are 21 ERCs operating primarily in Simon Property Group (SPG)…

HRD Challenges Faced in the Post-Global Financial Crisis Period--Insights from the UK

ERIC Educational Resources Information Center

Keeble-Ramsay, Diane Rose; Armitage, Andrew

2015-01-01

Purpose: The paper aims to report initial empirical research that examines UK employees' perceptions of the changing nature of work since the Global Financial Crisis (GFC) to consider how the financial context may have constrained HRD practice and more sustainable approaches. Design/methodology/approach: Focus group research was facilitated…

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…

A Mental Health Training Format for Adult Education Teachers

ERIC Educational Resources Information Center

Meek, Fiona; Specht, Jacqueline; Rodger, Susan

2017-01-01

The present study investigated the needs of adult education staff pertaining to adult students' mental health issues within a local school board. The study utilized mixed-methods design and was divided into progression of three separate studies. An initial focus group was conducted to identify the 12 participants' concerns and provide a direction…

Accountability for the Education of Disadvantaged Groups through the Disadvantaged Schools Program.

ERIC Educational Resources Information Center

Randell, Shirley K.

Financial, educational, and political accountability issues involved in the Disadvantaged Schools Program, initiated by the Schools Commission to improve the learning outcomes of children from educationally disadvantaged backgrounds in Australia, are the focus of this paper. Consideration is given to the views of the Commission in its published…

Getting Norway to eat healthier: what are the opportunities?

PubMed

Oostindjer, Marije; Amdam, Gro V; Egelandsdal, Bjørg

2015-02-01

Increased food consumption and the related problem of obesity have spurred initiatives to motivate consumers to eat healthier. Some strategies have shown positive but only short-term effects, as consumers or other stakeholders do not accept them sufficiently in the long term. The aim of this study was to investigate opportunities for healthier eating in Norway according to both consumers and other stakeholders. Five focus-group sessions were conducted with individuals working in the food industry, retail, public health, research and various non-governmental organisations related to food consumption. Topics that were discussed in the focus groups were transformed into a consumer survey, which was conducted with 1178 respondents. The focus groups often indicated a specific responsibility for the food industry to get people to eat healthier. Survey respondents indicated that all actors in the food chain had responsibility for healthier eating in the population, but agreed that the food industry, as well as the health authority, have major responsibilities. Food education was regarded as a favourable strategy in the focus groups and by survey respondents to help people to eat healthier, as were less advertising of unhealthy food and developing new healthy food products. Such strategies should be focused on parents, families, schools and children according to both focus group and survey participants. Implementation challenges include consumers wanting freedom to choose what they eat and consumers wanting food information that is easier to understand. this study showed that consumers and other stakeholders see opportunities for healthier eating in Norway by providing more food education and clearer food information, targeted towards children, families and parents. © 2014 the Nordic Societies of Public Health.

Key principles of community-based natural resource management: a synthesis and interpretation of identified effective approaches for managing the commons.

PubMed

Gruber, James S

2010-01-01

This article examines recent research on approaches to community-based environmental and natural resource management and reviews the commonalities and differences between these interdisciplinary and multistakeholder initiatives. To identify the most effective characteristics of Community-based natural resource management (CBNRM), I collected a multiplicity of perspectives from research teams and then grouped findings into a matrix of organizational principles and key characteristics. The matrix was initially vetted (or "field tested") by applying numerous case studies that were previously submitted to the World Bank International Workshop on CBNRM. These practitioner case studies were then compared and contrasted with the findings of the research teams. It is hoped that the developed matrix may be useful to researchers in further focusing research, understanding core characteristics of effective and sustainable CBNRM, providing practitioners with a framework for developing new CBNRM initiatives for managing the commons, and providing a potential resource for academic institutions during their evaluation of their practitioner-focused environmental management and leadership curriculum.

Development and evaluation of a Chinese-language newborn feeding hotline: A prospective cohort study

PubMed Central

Janssen, Patricia A; Livingstone, Verity H; Chang, Bruce; Klein, Michael C

2009-01-01

Background Preference for formula versus breast feeding among women of Chinese descent remains a concern in North America. The goal of this study was to develop an intervention targeting Chinese immigrant mothers to increase their rates of exclusive breastfeeding. Methods We convened a focus group of immigrant women of Chinese descent in Vancouver, British Columbia to explore preferences for method of infant feeding. We subsequently surveyed 250 women of Chinese descent to validate focus group findings. Using a participatory approach, our focus group participants reviewed survey findings and developed a priority list for attributes of a community-based intervention to support exclusive breastfeeding in the Chinese community. The authors and focus group participants worked as a team to plan, implement and evaluate a Chinese language newborn feeding information telephone service staffed by registered nurses fluent in Chinese languages. Results Participants in the focus group reported a strong preference for formula feeding. Telephone survey results revealed that while pregnant Chinese women understood the benefits of breastfeeding, only 20.8% planned to breastfeed exclusively. Only 15.6% were breastfeeding exclusively at two months postpartum. After implementation of the feeding hotline, 20% of new Chinese mothers in Vancouver indicated that they had used the hotline. Among these women, the rate of exclusive breastfeeding was 44.1%; OR 3.02, (95% CI 1.78–5.09) compared to women in our survey. Conclusion Initiation of a language-specific newborn feeding telephone hotline reached a previously underserved population and may have contributed to improved rates of exclusive breastfeeding. PMID:19178746

Altered visual focus on sensorimotor control in people with chronic ankle instability.

PubMed

Terada, Masafumi; Ball, Lindsay M; Pietrosimone, Brian G; Gribble, Phillip A

2016-01-01

The purpose of this investigation was to examine the effects of the combination of chronic ankle instability (CAI) and altered visual focus on strategies for dynamic stability during a drop-jump task. Nineteen participants with self-reported CAI and 19 healthy participants performed a drop-jump task in looking-up and looking-down conditions. For the looking-up condition, participants looked up and read a random number that flashed on a computer monitor. For the looking-down condition, participants focused their vision on the force plate. Sagittal- and frontal-plane kinematics in the hip, knee and ankle were calculated at the time points of 100 ms pre-initial foot contact to ground and at IC. The resultant vector time to stabilisation was calculated with ground reaction force data. The CAI group demonstrated less hip flexion at the point of 100 ms pre-initial contact (P < 0.01), and less hip flexion (P = 0.03) and knee flexion at initial contact (P = 0.047) compared to controls. No differences in kinematics or dynamic stability were observed in either looking-up or looking-down conditions (P > 0.05). Altered visual focus did not influence movement patterns during the drop-jump task, but the presence of CAI did. The current data suggests that centrally mediated changes associated with CAI may lead to global alterations in the sensorimotor control.

Parent perspectives on the decision to initiate medication treatment of attention-deficit/hyperactivity disorder.

PubMed

Coletti, Daniel J; Pappadopulos, Elizabeth; Katsiotas, Nikki J; Berest, Alison; Jensen, Peter S; Kafantaris, Vivian

2012-06-01

Despite substantial evidence supporting the efficacy of stimulant medication for children with attention-deficit/hyperactivity disorder (ADHD), adherence to stimulant treatment is often suboptimal. Applying social/cognitive theories to understanding and assessing parent attitudes toward initiating medication may provide insight into factors influencing parent decisions to follow ADHD treatment recommendations. This report describes results from formative research that used focus groups to obtain parent input to guide development of a provider-delivered intervention to improve adherence to stimulants. Participants were caregivers of children with ADHD who were given a stimulant treatment recommendation. Focus groups were recorded and transcribed verbatim. Data were analyzed by inductive, grounded theory methods as well as a deductive analytic strategy using an adapted version of the Unified Theory of Behavior Change to organize and understand parent accounts. Five groups were conducted with 27 parents (mean child age=9.35 years; standard deviation [SD]=2.00), mean time since diagnosis=3.33 years (SD=2.47). Most parents (81.5%) had pursued stimulant treatment. Inductive analysis revealed 17 attitudes facilitating adherence and 25 barriers. Facilitators included parent beliefs that medication treatment resulted in multiple functional gains and that treatment was imperative for their children's safety. Barriers included fears of personality changes and medication side effects. Complex patterns of parent adherence to medication regimens were also identified, as well as preferences for psychiatrists who were diagnostically expert, gave psychoeducation using multiple modalities, and used a chronic illness metaphor to explain ADHD. Theory-based analyses revealed conflicting expectancies about treatment risks and benefits, significant family pressures to avoid medication, guilt and concern that their children required medication, and distorted ideas about treatment risks. Parents, however, took pride in successfully pursuing efforts to manage their child behaviorally and to avoid medication when possible. Focus group data identified social, cognitive, and affective influences on treatment decision making. Results support prior research comparing family/social functioning, physician characteristics, and adherence. Findings suggest that parent attitudes to psychiatric care need to be assessed comprehensively at initial evaluation to aid the development of psychoeducational messages, and a more careful consideration about how parents interpret and respond to adherence-related questioning.

A Good Idea May Not Be Good Enough: Stakeholder Buy In to QuitConnect, a National Smokers' Registry.

PubMed

Macauda, Mark M; Thrasher, James F; Saul, Jessie E; Celestino, Paula; Cummings, K Michael; Strayer, Scott M

2017-01-01

To examine interest and concerns among those who fund and operate state-run smoking cessation helplines (quitlines) about the concept of creating a centralized smokers' registry that could be used to reengage smokers after they receive initial quitline support services. We conducted 3, hour-long focus groups with stakeholders, covering the perceived benefits and barriers to creating a smokers' registry. The focus groups were conducted via telephone. Three groups participated: quitline service providers (n = 14), quitline funders (n = 9), and national quitline partners (n = 8). Data collection: Focus groups were recorded, transcribed, and coded for major relevant themes. Analysis Strategies: We used a grounded theory approach. Stakeholders were generally positive about the concept of a centralized smokers' registry (ie, QuitConnect), especially with its potential to link relapsed smokers to ongoing research studies designed to help smokers achieve abstinence from tobacco. However, stakeholders expressed concern about QuitConnect duplicating services already offered by state quitlines. Despite a common goal, many state quitline stakeholders had strong reservations about the creation of a centralized smokers' registry unless they could see clear evidence that the registry added value and was not duplicative of their existing services.

An analysis of health promotion materials for Dutch truck drivers: Off target and too complex?

PubMed

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2017-01-01

Despite various health promotion initiatives, unfavorable figures regarding Dutch truck drivers' eating behaviors, exercise behaviors, and absenteeism have not improved. The aim was to obtain a better understanding of the low level of effectiveness of current health interventions for Dutch truck drivers by examining to what extent these are tailored to the target group's particular mindset (focus of content) and health literacy skills (presentation of content). The article analyzes 21 health promotion materials for Dutch truck drivers using a two-step approach: (a) an analysis of the materials' focus, guided by the Health Action Process Approach; and (b) an argumentation analysis, guided by pragma-dialectics. The corpus analysis revealed: (a) a predominant focus on the motivation phase; and (b) in line with the aim of motivating the target group, a consistent use of pragmatic arguments, which were typically presented in an implicit way. The results indicate that existing health promotion materials for Dutch truck drivers are not sufficiently tailored to the target group's mindset and health literacy skills. Recommendations are offered to develop more tailored/effective health interventions targeting this high-risk, underserved occupational group.

Impact of Advocacy Initiatives on Nurses' Motivation to Sustain Momentum in Public Policy Advocacy.

PubMed

Taylor, Melissa R S

2016-01-01

The purpose of this study is to elicit insight from the public policy leaders of 2 regional professional nursing organizations on key qualities of their current advocacy initiatives that motivate nurses to sustain momentum in public policy advocacy beyond a single episode. The goal is to inform quality improvement in the development of future advocacy initiatives to increase sustained engagement of nurses. Social cognitive theory was used as the rationale for this qualitative, descriptive study. A purposive convenience sample of executive leadership and board committee members from 2 regional professional nursing organizations were recruited to complete an initial Web-based electronic survey, followed by separate semistructured interview focus groups. One organization was composed primarily of advanced practice registered nurses, and the other group composed of diverse, multispecialty nursing members with varied educational levels. Nine themes emerged, categorized as facilitators or challenges to the positive impact of advocacy initiatives on nurses' motivation. Highlighting and marketing facilitators to the positive impact of advocacy initiatives on nurses' motivation to sustain momentum in public policy advocacy, while designing and testing new initiatives that address the challenges, may increase the number of nurses who sustain engagement in the policy advocacy process. Copyright © 2016 Elsevier Inc. All rights reserved.

Georgia's breastfeeding promotion program for low-income women.

PubMed

Ahluwalia, I B; Tessaro, I; Grummer-Strawn, L M; MacGowan, C; Benton-Davis, S

2000-06-01

Beginning in 1990, Georgia's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) initiated 5 new strategies to promote breastfeeding among its pregnant and postpartum clients. These strategies were implemented in 1991, each to be provided as an addition to its standard program of counseling on breastfeeding and distributing appropriate literature: 1) enhanced breastfeeding education, 2) breast pump loans, 3) hospital-based programs, 4) peer counseling, and 5) community coalitions. The enhanced breastfeeding education strategy provides access to a hotline as well as periodic training of staff, and the breast pump loan provides free breast pumps to mothers who want to use them. The hospital-based strategy provides bedside support and counseling to women who have just given birth and includes staff training, as well as a hotline number for women to call after they leave the hospital. The peer-counseling strategy focuses on identifying former WIC participants who have successfully breastfed their infants; these women are recruited to provide support and encouragement to current WIC participants. Finally, the community coalitions approach is designed to identify existing community attitudes about breastfeeding, establish plans to address gaps in breastfeeding services, to develop resource guides on breastfeeding for the community, and to advocate at the community level to support breastfeeding women. The objective of our research was to evaluate the impact of breastfeeding promotion strategies on breastfeeding initiation among WIC participants in Georgia. Using data from the Pregnancy Nutrition Surveillance System (PNSS) for 1992-1996, we examined breastfeeding initiation rate during this period and compared rates among 6 different intervention strategies. Also, we used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to assess breastfeeding initiation and duration among WIC enrollees. We conducted 13 focus groups to understand the experiences of program participants. Ten focus groups were conducted with women who were breastfeeding their infants, 3 each with women from the community coalitions, hospital-based programs, and standard education programs, and 1 with women from the breast pump loan program. Three focus groups were conducted with women who were feeding their infants formula. PNSS data show that breastfeeding initiation increased in the Georgia WIC program from 31.6% in 1992 to 39.5% in 1996. PRAMS data confirmed the increase in breastfeeding initiation from 33.6% (standard error [SE]: 2.2) in 1993 to 42.1% (SE: 2.4) in 1996 among WIC participants. Both datasets (PRAMS and PNSS) showed breastfeeding initiation to be well below the year 2000 goal of 75%. Overall, PRAMS data show a high breastfeeding initiation among non-WIC participants (range: 64.7% [SE: 2.2]) for 1994 to 70.1% (SE: 2.2) in 1996. The percent change between 1993 and 1996 was 8% for non-WIC participants, and it was 25% for the WIC participants among those responding to the PRAMS questionnaire. Data from PRAMS indicated no statistical change in the percentage of WIC enrollees who breastfed their infants for 8 weeks or more; this estimate was 18.3% (95% confidence interval (CI): 14.9-21.8) in 1993 and 19.4% (95% CI: 15.7-23.2) in 1996, well below the Healthy People 2000 objective of 50% at 6 months. According to PNSS data, the largest increases in breastfeeding initiation for 1992 to 1996 were among younger women (

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

Postdoctoral Fellow | Center for Cancer Research

Cancer.gov

Highly motivated postdoctoral fellows sought to work on tumor immunology with a strong background in biology preferentially cellular immunology. The tumor immunology group in the laboratory is exploring mechanisms of improving vaccines and immunotherapy for cancer, especially by discovering new principles to enhance and steer T cell immune responses. The group is focusing on negative immunoregulatory mechanisms used for immune evasion by cancer cells. The postdoctoral fellow will work on a project to understand the negative regulatory mechanisms of tumor immunity especially the mechanisms initiated by NKT cells. Group members also have an opportunity to gain knowledge of HIV/mucosal immunology by interacting with the HIV research group in the lab.

Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.

PubMed

Voils, Corrine I; Gierisch, Jennifer M; Olsen, Maren K; Maciejewski, Matthew L; Grubber, Janet; McVay, Megan A; Strauss, Jennifer L; Bolton, Jamiyla; Gaillard, Leslie; Strawbridge, Elizabeth; Yancy, William S

2014-09-01

Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. Previously, we created a conceptual model that distinguishes behavior initiation from maintenance. This model was used to generate Maintenance After Initiation of Nutrition TrAINing (MAINTAIN), an intervention to enhance weight loss maintenance following initiation. The effectiveness of MAINTAIN is being evaluated in an ongoing trial, the rationale and procedures of which are reported herein. Veterans aged ≤ 75 with body mass index ≥ 30 kg/m(2) participate in a 16-week, group-based weight loss program. Participants who lose ≥ 4 kg by the end of 16 weeks (target n = 230) are randomized 1:1 to receive (a) usual care for 56 weeks or (b) MAINTAIN, a theoretically-informed weight loss maintenance intervention for 40 weeks, followed by 16 weeks of no intervention contact. MAINTAIN involves 3 in-person group visits that transition to 8 individualized telephone calls with decreasing contact frequency. MAINTAIN focuses on satisfaction with outcomes, weight self-monitoring, relapse prevention, and social support. We hypothesize that, compared to usual care, MAINTAIN will result in at least 3.5 kg less regain and better relative levels of caloric intake and physical activity over 56 weeks, and that it will be cost-effective. If effective, MAINTAIN could serve as a model for redesigning existing weight loss programs. NCT01357551. Published by Elsevier Inc.

General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

PubMed

Appleby, N J; Dunt, D; Southern, D M; Young, D

1999-08-01

To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

L2 Word Recognition: Influence of L1 Orthography on Multi-syllabic Word Recognition.

PubMed

Hamada, Megumi

2017-10-01

L2 reading research suggests that L1 orthographic experience influences L2 word recognition. Nevertheless, the findings on multi-syllabic words in English are still limited despite the fact that a vast majority of words are multi-syllabic. The study investigated whether L1 orthography influences the recognition of multi-syllabic words, focusing on the position of an embedded word. The participants were Arabic ESL learners, Chinese ESL learners, and native speakers of English. The task was a word search task, in which the participants identified a target word embedded in a pseudoword at the initial, middle, or final position. The search accuracy and speed indicated that all groups showed a strong preference for the initial position. The accuracy data further indicated group differences. The Arabic group showed higher accuracy in the final than middle, while the Chinese group showed the opposite and the native speakers showed no difference between the two positions. The findings suggest that L2 multi-syllabic word recognition involves unique processes.

End-of-Life Care for Blood Cancers: A Series of Focus Groups With Hematologic Oncologists

PubMed Central

Odejide, Oreofe O.; Salas Coronado, Diana Y.; Watts, Corey D.; Wright, Alexi A.; Abel, Gregory A.

2014-01-01

Purpose: Hematologic cancers are associated with aggressive cancer-directed care near death and underuse of hospice and palliative care services. We sought to explore hematologic oncologists' perspectives and decision-making processes regarding end-of-life (EOL) care. Methods: Between September 2013 and January 2014, 20 hematologic oncologists from the Dana-Farber/Harvard Cancer Center participated in four focus groups regarding EOL care for leukemia, lymphoma, multiple myeloma, and hematopoietic stem-cell transplantation. Focus groups employed a semistructured format with case vignettes and open-ended questions and were followed by thematic analysis. Results: Many participants felt that identifying the EOL phase for patients with hematologic cancers was challenging as a result of the continuing potential for cure with advanced disease and the often rapid pace of decline near death. This difficulty was reported to result in later initiation of EOL care. Barriers to high-quality EOL care were also reported to be multifactorial, including unrealistic expectations from both physicians and patients, long-term patient-physician relationships resulting in difficulty conducting EOL discussions, and inadequacy of existing home-based EOL services. Participants also expressed concern that some EOL quality measures developed for solid tumors may be unacceptable for patients with blood cancers given their unique needs at the EOL (eg, palliative transfusions). Conclusion: Our analysis suggests that hematologic oncologists need better clinical markers for when to initiate EOL care. In addition, current quality measures may be inappropriate for identifying overly aggressive care for patients with blood cancers. Further research is needed to develop effective interventions to improve EOL care for this patient population. PMID:25294393

Barriers to and acceptability of provider-initiated HIV testing and counselling and adopting HIV-prevention behaviours in rural Uganda: a qualitative study.

PubMed

Kiene, Susan M; Sileo, Katelyn; Wanyenze, Rhoda K; Lule, Haruna; Bateganya, Moses H; Jasperse, Joseph; Nantaba, Harriet; Jayaratne, Kia

2015-02-01

In Uganda, a nationwide scale-up of provider-initiated HIV testing and counselling presents an opportunity to deliver HIV-prevention services to large numbers of people. In a rural Ugandan hospital, focus group discussions and key informant interviews were conducted with outpatients receiving provider-initiated HIV testing and counselling and staff to explore the HIV-prevention information, motivation and behavioural skills strengths and weaknesses, and community-level and structural barriers to provider-initiated HIV testing and counselling acceptability and HIV prevention among this population. Strengths and weakness occurred at all levels, and results suggest brief client-centred interventions during provider-initiated HIV testing and counselling may be an effective approach to increase prevention behaviours in outpatient settings. © The Author(s) 2013.

A qualitative focus group study to identify the needs of survivors of stage II and III colorectal cancer.

PubMed

Ho, Maria Y; McBride, Mary L; Gotay, Carolyn; Grunfeld, Eva; Earle, Craig C; Relova, Sharon; Tsonis, Miranda; Ruan, Jenny Y; Chang, Jennifer T; Cheung, Winson Y

2016-12-01

Prior survivorship research has largely focused on issues faced by survivors of childhood tumors, breast cancers, or hematologic malignancies. Relatively little is known about the needs of other prevalent survivor groups. Our aim was to identify the specific concerns of colorectal cancer (CRC) survivors in the key domains of physical functioning, psychological wellbeing, and social relationships. We conducted focus groups with stage II and III CRC survivors who had completed their primary active anti-cancer treatments. Patients were asked to describe how their diagnosis and treatment impacted their lives, to outline deficiencies in the care that they received, and to suggest ways of addressing any unmet needs. A content analysis was subsequently conducted to identify major themes. Thirty CRC survivors participated in six focus groups. Individuals reported some degree of dissatisfaction with the amount and type of diagnostic and treatment information they received at their initial clinic visit. Distress from toxicities, such as peripheral neuropathy, was also common among the survivors. Similarly, the majority faced challenges adjusting to their lives and daily activities, especially in caring for their colostomy. Having survived CRC, many survivors expressed an interest in advocacy and health promotion of CRC. CRC survivors face many barriers after their cancer treatment. Issues with colostomy are unique to this survivor group. Interventions to improve CRC survivorship care should also incorporate opportunities for patient advocacy. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Gross and fine motor function in fibromyalgia and chronic fatigue syndrome.

PubMed

Rasouli, Omid; Fors, Egil A; Borchgrevink, Petter Chr; Öhberg, Fredrik; Stensdotter, Ann-Katrin

2017-01-01

This paper aimed to investigate motor proficiency in fine and gross motor function, with a focus on reaction time (RT) and movement skill, in patients with fibromyalgia (FM) and chronic fatigue syndrome (CFS) compared to healthy controls (HC). A total of 60 individuals (20 CFS, 20 FM, and 20 HC), age 19-49 years, participated in this study. Gross motor function in the lower extremity was assessed using a RT task during gait initiation in response to an auditory trigger. Fine motor function in the upper extremity was measured during a precision task (the Purdue Pegboard test) where the number of pins inserted within 30 s was counted. No significant differences were found between FM and CFS in any parameters. FM and CFS groups had significantly longer RT than HC in the gait initiation ( p =0.001, and p =0.004 respectively). In the Purdue Pegboard test, 20% in the FM group, 15% in the CFS groups, and 0% of HC group, scored below the threshold of the accepted performance. However, there were no significant differences between FM, CFS, and HC in this task ( p =0.12). Compared to controls, both CFS and FM groups displayed significantly longer RT in the gait initiation task. Generally, FM patients showed the worst results in both tests, although no group differences were found in fine motor control, according to the Purdue Pegboard test.

Is Object-Based Attention Mandatory? Strategic Control over Mode of Attention

ERIC Educational Resources Information Center

Yeari, Menahem; Goldsmith, Morris

2010-01-01

Is object-based attention mandatory or under strategic control? In an adapted spatial cuing paradigm, participants focused initially on a central arrow cue that was part of a perceptual group (Experiment 1) or a uniformly connected object (Experiment 2), encompassing one of the potential target locations. The cue always pointed to an opposite,…

Strengthening Pennsylvania's Charter School Reform: Findings From the Statewide Evaluation and Discussion of Relevant Policy Issues. Year Five Report.

ERIC Educational Resources Information Center

Miron, Gary; Nelson, Christopher; Risley, John

In 2001, the Pennsylvania Department of Education contracted with Western Michigan University to evaluate Pennsylvania's charter schools and charter school initiative over two years. The study used site visits, work sample review, document review, focus groups, portfolios and surveys to gather data regarding the movement's effectiveness, progress,…

Effective Change: A Case Study of Implementation of A Standards Based Grading Initiative

ERIC Educational Resources Information Center

MacCrindle, Amy N.

2017-01-01

This study followed mindset changes in elementary teachers as they transitioned from traditional grading to standards based grading during the earliest stages of the change process. A pre- and post-survey of mindsets of participants, individual interviews, and a focus group interview were conducted. While the results of the pre- and post-survey…

Rhythmic Instruction from Square One: A Constructivist Teacher and Her Metronome

ERIC Educational Resources Information Center

Miller, Beth Ann

2012-01-01

Adhering to a constructivist approach, this teacher focused on problem solving and group discussion as she initiated a study of traditional notation. She began with the metronome to make the steady beat less abstract for those students who still learn best through concrete operations. The students were challenged to match magnets of various…

Assessing College Student-Athletes' Life Stress: Initial Measurement Development and Validation

ERIC Educational Resources Information Center

Lu, Frank Jing-Horng; Hsu, Ya-Wen; Chan, Yuan-Shuo; Cheen, Jang-Rong; Kao, Kuei-Tsu

2012-01-01

College student-athletes have unique life stress that warrants close attention. The purpose of this study was to develop a reliable and valid measurement assessing college student-athletes' life stress. In Study 1, a focus group discussion and Delphi method produced a questionnaire draft, termed the College Student-Athletes' Life Stress Scale. In…

Supporting the Emotional Labour Associated with Teaching: Considering a Pluralistic Approach to Group Supervision

ERIC Educational Resources Information Center

Hanley, Terry

2017-01-01

This paper puts forward a framework for supervising teaching staff whose roles involve supporting the emotional well-being of young people and young adults. Initially, the increasing focus upon the interface between education and health is outlined and the potential for this "emotional labour" to cause distress to those in helping roles…

International trends in health science librarianship part 20: Russia.

PubMed

Murphy, Jeannette; Jargin, Serge

2017-03-01

This is the last in a series of articles exploring international trends in health science librarianship in the 21st century. The focus of the present issue is Russia. The next feature column will initiate a new series entitled New Directions in Health Science Librarianship. The first contribution will be from Australia. JM. © 2017 Health Libraries Group.

Parents' and Sons' Perspectives on Video Game Play: A Qualitative Study

ERIC Educational Resources Information Center

Kutner, Lawrence A.; Olson, Cheryl K.; Warner, Dorothy E.; Hertzog, Sarah M.

2008-01-01

Public policy efforts to restrict children's access to electronic games with violent or sexual content are often predicated on assumptions about parental concerns. As an initial step in determining whether those assumptions are accurate, the authors conduct focus groups of 21 adolescent boys and 21 of their parents or guardians to explore parents'…

Research on Children & Adolescents with Mental, Behavioral & Developmental Disorders. Mobilizing a National Initiative. Report of a Study.

ERIC Educational Resources Information Center

Institute of Medicine (NAS), Washington, DC. Div. of Mental Health and Behavioral Medicine.

This report focuses on the 7.5 million children in the United States with diagnosable mental illnesses, examining developmental, behavioral and emotional disorders in this group. Progress being made toward understanding, preventing, and treating these disorders is documented, future directions for research are put forth, and critical resource…

Employee Participation in Non-Mandatory Professional Development--The Role of Core Proactive Motivation Processes

ERIC Educational Resources Information Center

Sankey, Kim S.; Machin, M. Anthony

2014-01-01

With a focus on the self-initiated efforts of employees, this study examined a model of core proactive motivation processes for participation in non-mandatory professional development (PD) within a proactive motivation framework using the Self-Determination Theory perspective. A multi-group SEM analysis conducted across 439 academic and general…

Does First Sex Really "Just Happen?" A Retrospective Exploratory Study of Sexual Debut among American Adolescents

ERIC Educational Resources Information Center

Lieberman, Lisa D.; Goldfarb, Eva S.; Kwiatkowski, Samantha; Santos, Paul

2017-01-01

First sex marks a significant transition for most adolescents, yet teens often report that it was unplanned. Seventy-four college students participated in exploratory focus groups about their first sex. Although initially asked whether their first sex was spontaneous or planned, many participants revealed evidence of forethought or anticipation,…

A Study of Attitudes Associated with Retraining. Part II. Work Resource and Retraining Initiative.

ERIC Educational Resources Information Center

Miskovic, Darlene

A study was conducted to gain insight into how to persuade those in fields where job opportunities are declining to take advantage of existing retraining programs in order to avoid future displacement. Research was conducted through a series of focus groups in Chicago, Louisville, and Davenport. Participants in these sessions included men and…

Library Involvement in State Government Information Policy Development in the United States.

ERIC Educational Resources Information Center

Weaver, Barbara F.

This paper focuses on efforts by library groups and individuals to influence the development of state government information policy in various states in the United States, and emphasizes the need for librarians to make sure they either initiate such development or insert themselves into any existing policy development processes. Emphasis is given…

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…

You Just Feed Them with a Long-Handled Spoon: Families Evaluate Their Experiences in a Class Size Reduction Reform

ERIC Educational Resources Information Center

Graue, M. Elizabeth; Oen, Denise

2009-01-01

Emerging from an evaluation of Wisconsin's Student Achievement Guarantee in Education program (SAGE), a multidimensional program popularly known for its class size reduction component, this article examines SAGE's "lighted schoolhouse" initiative aimed to strengthen links between home and school. Drawing on family focus groups held at…

Using Communities of Practice to Foster Faculty Development in Higher Education

ERIC Educational Resources Information Center

Teeter, Christopher; Fenton, Nancy; Nicholson, Karen; Flynn, Terry; Kim, Joseph; McKay, Muriel; O'Shaughnessy, Bridget; Vajoczki, Sue

2011-01-01

Communities of practice are becoming more widespread within higher education, yet little research has explored how these social learning networks can enhance faculty development. The focus of this paper is to describe the first-year experience of a community of practice initiative at McMaster University that was designed to engage groups of…

Correlating Aptitude with Oral Proficiency: A Quantitative Study of DLAB and OPI Scores across Four Language Categories

ERIC Educational Resources Information Center

Santizo, Isabelle Poupard

2017-01-01

This quantitative study focuses on the relationship between foreign language learners' aptitude and proficiency test scores. Four groups of 136 beginning students received six months of Initial Acquisition Training (IAT) in four different language categories, according to the level of complexity for an English speaker: French (Category I),…

Competing Philosophies in the Classroom: A Challenge to Hong Kong Teachers

ERIC Educational Resources Information Center

Wong, Donna Kam Pun; Pearson, Veronica; Lo, Eva Mei Kuen

2004-01-01

The present paper examines the experiences of teachers in teaching children with special needs in mainstream schools and how they see and evaluate the feasibility of the new integration initiatives in Hong Kong. The data are based on individual and focus group interviews with general class teachers, resource class teachers and principals of…

Phonetic Aspects of Children's Elicited Word Revisions.

ERIC Educational Resources Information Center

Paul-Brown, Diane; Yeni-Komshian, Grace H.

A study of the phonetic changes occurring when a speaker attempts to revise an unclear word for a listener focuses on changes made in the sound segment duration to maximize differences between phonemes. In the study, five-year-olds were asked by adults to revise words differing in voicing of initial and final stop consonants; a control group of…

Tuning in to Kids: An Emotion-Focused Parenting Program--Initial Findings from a Community Trial

ERIC Educational Resources Information Center

Havighurst, Sophie S.; Wilson, Katherine R.; Harley, Ann E.; Prior, Margot R.

2009-01-01

This study evaluated a new group parenting program, Tuning in to Kids, which taught emotion coaching skills to parents of preschool children. In a randomized control trial, 218 primary caregiver parents of children aged 4.0-5.11 years completed questionnaires assessing parent emotion socialization (emotion coaching vs. emotion dismissing), parent…

Leading and Supporting the Implementation of the Norwegian Network of Health Promoting Schools

ERIC Educational Resources Information Center

Viig, Nina Grieg; Fosse, Elisabeth; Samdal, Oddrun; Wold, Bente

2012-01-01

The aim of this study was to examine how program leaders in the Norwegian Network of Health Promoting Schools managed, facilitated, and supported the development and implementation of the health promotion initiatives at their school. Two focus group interviews were conducted with 10 program leaders. The findings suggest that the implementation of…

Barriers to Adjustment: Needs of International Students within a Semi-Urban Campus Community

ERIC Educational Resources Information Center

Poyrazli, Senel; Grahame, Kamini Maraj

2007-01-01

Following an ecological framework, the primary purpose of this study was to examine the adjustment needs of international students within their academic and social communities. Focus group interviews revealed that students are more in need during their initial transition after arrival to the U.S. and that they experience a number of barriers in…

A Qualitative Study of Smokers' Responses to Messages Discouraging Dual Tobacco Product Use

ERIC Educational Resources Information Center

Popova, Lucy; Kostygina, Ganna; Sheon, Nicolas M.; Ling, Pamela M.

2014-01-01

Cigarette companies increasingly promote novel smokeless tobacco products to smokers, encouraging them to use smokeless tobacco in smoke-free environments. New messages may counteract this promotion. We developed 12 initial anti-smokeless message ideas and tested them in eight online focus groups with 75 US smokers. Those smokers who never tried…

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…

Sharing the Dream: How Faculty, Families and Community Leaders Respond to Community College Reform

ERIC Educational Resources Information Center

Immerwahr, John; Friedman, Will

2005-01-01

In an effort to gauge receptiveness to Achieving the Dream, a major initiative to close achievement gaps at the nation's community colleges, the authors chose three participating colleges for an exploratory study. In each of the three communities, they conducted focus groups with relatively understudied stakeholders: full-time and adjunct faculty…

Three Key Conditions to Revitialise an ePortfolio Program in Response to Increasing Regulation of Teacher Education

ERIC Educational Resources Information Center

Kertesz, John Leslie

2016-01-01

This paper describes a study undertaken within the education faculty of a mid-sized university in response to the recommendations of the Teacher Education Ministerial Advisory Group (TEMAG) (2014) that initial teacher education (ITE) graduates emerge with an evidence-based professional standards-focused portfolio of teaching competency. In…

The enactment of knowledge translation: a study of the Collaborations for Leadership in Applied Health Research and Care initiative within the English National Health Service

PubMed Central

D’Andreta, Daniela; Scarbrough, Harry; Evans, Sarah

2014-01-01

Objectives We contribute to existing knowledge translation (KT) literature by developing the notion of ‘enactment’ and illustrate this through an interpretative, comparative case-study analysis of three Collaborations for Leadership in Applied Health Research and Care (CLAHRC) initiatives. We argue for a focus on the way in which the CLAHRC model has been ‘enacted’ as central to the different KT challenges and capabilities encountered. Methods A comparative, mixed method study created a typology of enactments (Classical, Home-grown and Imported) using qualitative analysis and social network analysis. Results We identify systematic differences in the enactment of the CLAHRC model. The sources of these different enactments are subsequently related to variation in formative interpretations and leadership styles, the implementation of different governance structures, and the relative epistemic differences between the professional groups involved. Conclusions Enactment concerns the creative agency of individuals and groups in constituting a particular context for their work through their local interpretation of a particular KT model. Our theory of enactment goes beyond highlighting variation between CLAHRCs, to explore the mechanisms that influence the way a particular model is interpreted and acted upon. We thus encourage less focus on conceptual models and more on the formative role played by leaders of KT initiatives. PMID:24048695

Towards an understanding of British public attitudes concerning human cloning.

PubMed

Shepherd, Richard; Barnett, Julie; Cooper, Helen; Coyle, Adrian; Moran-Ellis, Jo; Senior, Victoria; Walton, Chris

2007-07-01

The ability of scientists to apply cloning technology to humans has provoked public discussion and media coverage. The present paper reports on a series of studies examining public attitudes to human cloning in the UK, bringing together a range of quantitative and qualitative methods to address this question. These included a nationally representative survey, an experimental vignette study, focus groups and analyses of media coverage. Overall the research presents a complex picture of attitude to and constructions of human cloning. In all of the analyses, therapeutic cloning was viewed more favourably than reproductive cloning. However, while participants in the focus groups were generally negative about both forms of cloning, and this was also reflected in the media analyses, quantitative results showed more positive responses. In the quantitative research, therapeutic cloning was generally accepted when the benefits of such procedures were clear, and although reproductive cloning was less accepted there was still substantial support. Participants in the focus groups only differentiated between therapeutic and reproductive cloning after the issue of therapeutic cloning was explicitly raised; initially they saw cloning as being reproductive cloning and saw no real benefits. Attitudes were shown to be associated with underlying values associated with scientific progress rather than with age, gender or education, and although there were a few differences in the quantitative data based on religious affiliation, these tended to be small effects. Likewise in the focus groups there was little direct appeal to religion, but the main themes were 'interfering with nature' and the 'status of the embryo', with the latter being used more effectively to try to close down further discussion. In general there was a close correspondence between the media analysis and focus group responses, possibly demonstrating the importance of media as a resource, or that the media reflect public discourse accurately. However, focus group responses did not simply reflect media coverage.

Scientists' perspectives on the ethical issues of stem cell research.

PubMed

Longstaff, Holly; Schuppli, Catherine A; Preto, Nina; Lafrenière, Darquise; McDonald, Michael

2009-06-01

This paper describes findings from an ethics education project funded by the Canadian Stem Cell Network (SCN). The project is part of a larger research initiative entitled "The Stem Cell Research Environment: Drawing the Evidence and Experience Together". The ethics education study began with a series of focus groups with SCN researchers and trainees as part of a "needs assessment" effort. The purpose of these discussions was to identify the main ethical issues associated with stem cell (SC) research from the perspective of the stem cell community. This paper will focus on five prominent themes that emerged from the focus group data including: (1) the source of stem cells; (2) the power of stem cells; (3) working within a charged research environment; (4) the regulatory context; and (5) ethics training for scientists. Additional discussions are planned with others involved in Canadian stem cell research (e.g., research ethics board members, policy makers) to supplement initial findings. These assessment results combined with existing bioethics literature will ultimately inform a web-based ethics education module for the SCN. We believe that our efforts are important for those analyzing the ethical, legal, and social issues (ELSI) in this area because our in depth understanding of stem cell researcher perspectives will enable us to develop more relevant and effective education material, which in turn should help SC researchers address the important ethical challenges in their area.

Correlates of HPV vaccine initiation and provider recommendation among male adolescents, 2014 NIS-Teen.

PubMed

Landis, Kathryn; Bednarczyk, Robert A; Gaydos, Laura M

2018-05-08

Vaccination is a safe and effective way to prevent Human Papillomavirus (HPV) infection and related cancers; however, HPV vaccine uptake remains low in the US. After the 2011 Advisory Committee on Immunization Practices (ACIP) recommendation for routine HPV vaccination of adolescent males, several studies have examined predictors for initiating the vaccine series in this population of interest, particularly with regard to provider recommendations. This study examined racial and ethnic differences for HPV vaccine initiation and provider recommendation in male adolescents. Based on prior HPV vaccine uptake estimates and healthcare utilization data, we hypothesized that minority adolescents would be more likely to initiate HPV vaccines, but less likely to receive a provider recommendation compared to white counterparts. We analyzed the 2014 National Immunization Survey-Teen (NIS-Teen), which included 10,753 male adolescents with provider-verified vaccination data in 50 US states, using multivariate logistic regression models to evaluate racial/ethnic differences in HPV vaccine initiation and provider recommendation. The odds of HPV vaccine initiation were 76 percent higher for Hispanic adolescents and 43 percent higher for non-Hispanic Other or Multiple race adolescents compared to white adolescents. Approximately half of parents reported receiving a provider recommendation for vaccination, with no significant difference in the odds of receiving a provider recommendation across racial/ethnic groups. Despite similar frequency of recommendations across racial and ethnic groups, male adolescents who are racial/ethnic minorities are more likely to initiate vaccination. Future research should focus on developing tailored interventions to increase HPV vaccine receipt among males of all racial/ethnic groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

NASA industry education initiative. Education programs report, 1991

NASA Technical Reports Server (NTRS)

1991-01-01

Findings from the initial inventory of education programs show that support for the NASA-Industry Education Initiative (NIEI) appears to be strong among the organizations surveyed. In addition, the range, depth and historical baselines of NIEI education programs are encouraging. It is also apparent that there is a significant level of cooperation between NIEI members and other organizations. Heavily focused towards science, engineering, mathematics and technology achievement, NIEI activities appear to be aligned with national education goals. Three criticisms are revealed: (1) the majority of programs are targeted fairly late in the education cycle; (2) the number of initiatives geared towards adult literacy and adult skills-enhancement appears to be relatively low; (3) the majority of NIEI activities involve traditional education-assistance programs, but the number of critical assessment and systematic reform initiatives is low. Four Working Group recommendations resulted from this activity: (1) NIEI Working Group operations should continue for an indefinite period, with participation open to other like-minded private-sector organization; (2) the report should be periodically updated; (3) an analysis of ongoing education programs should be conducted; (4) American corporations should continue to support education and evaluate in-house programs periodically.

Building and expanding interprofessional teaching teams.

PubMed

Darlow, Ben; McKinlay, Eileen; Gallagher, Peter; Beckingsale, Louise; Coleman, Karen; Perry, Meredith; Pullon, Sue

2017-03-01

INTRODUCTION Interprofessional education (IPE) aims to prepare learners to work in collaborative health-care teams. The University of Otago, Wellington has piloted, developed and expanded an IPE programme since 2011. An interprofessional teaching team has developed alongside this programme. AIMS This study aimed to understand the development of a university-based interprofessional teaching team over a 4-year period and generate insights to aid the development of such teams elsewhere. METHODS Two semi-structured audio-recorded educator focus groups were conducted at key times in the development of the IPE programme in 2011 and 2014. The programme focused on long-term condition management and involved students from dietetics, medicine, physiotherapy and radiation therapy. Focus group transcripts were independently analysed by two researchers using Thematic Analysis to identify broad themes. Initial themes were compared, discussed and combined to form a thematic framework. The thematic framework was verified by the education team and subsequently updated and reorganised. RESULTS Three key themes emerged: (i) development as an interprofessional educator; (ii) developing a team; and (iii) risk and reward. Teaching in an interprofessional environment was initially daunting but confidence increased with experience. Team teaching highlighted educators' disciplinary roles and skill sets and exposed educators to different teaching approaches. Educators perceived they modelled team development processes to students through their own development as a team. Interprofessional teaching was challenging to organise but participation was rewarding. Programme expansion increased the risks and complexity, but also acted as a stimulus for development and energised the teaching team. DISCUSSION Interprofessional teaching is initially challenging but ultimately enriching. Interprofessional teaching skills take time to develop and perspectives of role change over time. Educator team development is aided by commitment, understanding, enthusiasm, leadership and trust.

Understanding Genomic Knowledge in Rural Appalachia: The West Virginia Genome Community Project

PubMed Central

Mallow, Jennifer A.; Theeke, Laurie A.; Crawford, Patricia; Prendergast, Elizabeth; Conner, Chuck; Richards, Tony; McKown, Barbara; Bush, Donna; Reed, Donald; Stabler, Meagan E.; Zhang, Jianjun; Dino, Geri; Barr, Taura L.

2016-01-01

Purpose Rural communities have limited knowledge about genetics and genomics and are also underrepresented in genomic education initiatives. The purpose of this project was to assess genomic and epigenetic knowledge and beliefs in rural West Virginia. Sample A total of 93 participants from three communities participated in focus groups and 68 participants completed a demographic survey. The age of the respondents ranged from 21 to 81 years. Most respondents had a household income of less than $40,000, were female and most were married, completed at least a HS/GED or some college education working either part-time or full-time. Method A Community Based Participatory Research process with focus groups and demographic questionnaires was used. Findings Most participants had a basic understanding of genetics and epigenetics, but not genomics. Participants reported not knowing much of their family history and that their elders did not discuss such information. If the conversations occurred, it was only during times of crisis or an illness event. Mental health and substance abuse are topics that are not discussed with family in this rural population. Conclusions Most of the efforts surrounding genetic/genomic understanding have focused on urban populations. This project is the first of its kind in West Virginia and has begun to lay the much needed infrastructure for developing educational initiatives and extending genomic research projects into our rural Appalachian communities. By empowering the public with education, regarding the influential role genetics, genomics, and epigenetics have on their health, we can begin to tackle the complex task of initiating behavior changes that will promote the health and well-being of individuals, families and communities. PMID:27212895

Impact of Simulation Training on Time to Initiation of Cardiopulmonary Resuscitation for First-Year Pediatrics Residents

PubMed Central

Ross, Joshua C.; Trainor, Jennifer L.; Eppich, Walter J.; Adler, Mark D.

2013-01-01

Background Pediatrics residents have few opportunities to perform cardiopulmonary resuscitation (CPR). Enhancing the quality of CPR is a key factor to improving outcomes for cardiopulmonary arrest in children and requires effective training strategies. Objective To evaluate the effectiveness of a simulation-based intervention to reduce first-year pediatrics residents' time for 3 critical actions in CPR: (1) call for help, (2) initiate bag-mask ventilation, and (3) initiate chest compressions. Methods A prospective study involving 31 first-year pediatrics residents at a children's hospital assigned to an early or late (control) intervention group. Residents underwent baseline assessment followed by repeat evaluations at 3 and 6 months. Time to critical actions was scored by video review. A 90-minute educational intervention focused on skill practice was conducted following baseline evaluation for the early-intervention group and following 3-month evaluation for the late-intervention group. Primary outcome was change in time to initiating the 3 critical actions. Change in time was analyzed by comparison of Kaplan-Meier curves, using the log-rank test. A 10% sample was timed by a second rater. Agreement was assessed using intraclass correlation (ICC). Results There was a statistically significant reduction in time for all 3 critical actions between baseline and 3-month evaluation in the early intervention group; this was not observed in the late (control) group. Rater agreement was excellent (ICC ≥ 0.99). Conclusions A simulation-based educational intervention significantly reduced time to initiation of CPR for first-year pediatrics residents. Simulation training facilitated acquisition of critical CPR skills that have the potential to impact patient outcome. PMID:24455010

Building the field of population health intervention research: The development and use of an initial set of competencies.

PubMed

Riley, Barbara; Harvey, Jean; Di Ruggiero, Erica; Potvin, Louise

2015-01-01

Population health intervention research (PHIR) is a relatively new research field that studies interventions that can improve health and health equity at a population level. Competencies are one way to give legitimacy and definition to a field. An initial set of PHIR competencies was developed with leadership from a multi-sector group in Canada. This paper describes the development process for these competencies and their possible uses. Methods to develop the competencies included key informant interviews; a targeted review of scientific and gray literature; a 2-round, online adapted Delphi study with a 24-member panel; and a focus group with 9 international PHIR experts. The resulting competencies consist of 25 items grouped into 6 categories. They include principles of good science applicable though not exclusive to PHIR, and more suitable for PHIR teams rather than individuals. This initial set of competencies, released in 2013, may be used to develop graduate student curriculum, recruit trainees and faculty to academic institutions, plan non-degree professional development, and develop job descriptions for PHIR-related research and professional positions. The competencies provide some initial guideposts for the field and will need to be adapted as the PHIR field matures and to meet unique needs of different jurisdictions.

Building the field of population health intervention research: The development and use of an initial set of competencies

PubMed Central

Riley, Barbara; Harvey, Jean; Di Ruggiero, Erica; Potvin, Louise

2015-01-01

Population health intervention research (PHIR) is a relatively new research field that studies interventions that can improve health and health equity at a population level. Competencies are one way to give legitimacy and definition to a field. An initial set of PHIR competencies was developed with leadership from a multi-sector group in Canada. This paper describes the development process for these competencies and their possible uses. Methods to develop the competencies included key informant interviews; a targeted review of scientific and gray literature; a 2-round, online adapted Delphi study with a 24-member panel; and a focus group with 9 international PHIR experts. The resulting competencies consist of 25 items grouped into 6 categories. They include principles of good science applicable though not exclusive to PHIR, and more suitable for PHIR teams rather than individuals. This initial set of competencies, released in 2013, may be used to develop graduate student curriculum, recruit trainees and faculty to academic institutions, plan non-degree professional development, and develop job descriptions for PHIR-related research and professional positions. The competencies provide some initial guideposts for the field and will need to be adapted as the PHIR field matures and to meet unique needs of different jurisdictions. PMID:26844160

Residents as health advocates: The development, implementation and evaluation of a child advocacy initiative at the University of Toronto (Toronto, Ontario).

PubMed

Au, Hosanna; Harrison, Megan; Ahmet, Alexandra; Orsino, Angela; Beck, Carolyn E; Tallett, Susan; Gans, Marvin; Birken, Catherine S

2007-09-01

Advocacy is an integral part of a paediatrician's role. The Royal College of Physicians and Surgeons of Canada has identified advocacy as one of the essential Canadian Medical Education Directives for Specialists competencies, and participation in child advocacy work as an important component of paediatric residency training. The objective of the present paper was to describe the development, implementation and evaluation of the first four years of the child advocacy initiative at the University of Toronto (Toronto, Ontario). Ideas for community child advocacy projects were generated through a literature review, and a link to a local elementary school was identified. Teacher and parent focus groups were conducted to identify areas for resident involvement. Workshops were then developed, implemented and evaluated by paediatric residents. Six child advocacy projects between 2001 and 2004 were conducted based on results from the focus groups. These included annual clothing drives, as well as workshops for parents and children about nutrition, safety, parenting, illness management and basic first aid. More than 95% of parents reported that the workshops were useful or very useful, more than 92% felt that they learned something new and more than 83% wanted the residents to return for further workshops. Teachers and residents gave positive informal feedback. Through the child advocacy initiative, paediatric residents had the opportunity to develop skills in advocacy, learn about the determinants of child health and become community partners in advocating for children. Such an initiative can be incorporated into the residency curriculum to help residents develop competency in advocacy.

Inter-lab proteomics: data mining in collaborative projects on the basis of the HUPO brain proteome project's pilot studies.

PubMed

Hamacher, Michael; Gröttrup, Bernd; Eisenacher, Martin; Marcus, Katrin; Park, Young Mok; Meyer, Helmut E; Kwon, Kyung-Hoon; Stephan, Christian

2011-01-01

Several projects were initiated by the Human Proteome Organisation (HUPO) focusing on the proteome analysis of distinct human organs. The initiative dedicated to the brain, its development and correlated diseases is the HUPO Brain Proteome Project (HUPO BPP). An objective data submission, storage, and reprocessing strategy have been established with the help of the results gained in a pilot study phase and within subsequent studies. The bioinformatic relevance of the data is drawn from the inter-laboratory comparisons as well as from the recalculation of all data sets submitted by the different groups. In the following, results of the single groups as well as the centralised reprocessing effort are summarised, demonstrating the added-value of this concerted work.

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.

Development of the behaviorally focused fruits & Veggies--More Matters public health initiative.

PubMed

Pivonka, Elizabeth; Seymour, Jennifer; McKenna, Jeff; Baxter, Suzanne Domel; Williams, Simon

2011-10-01

Due to changing recommendations for fruit and vegetable (F/V) intake, public health and private organizations recognized the need to revise communications and programs that promote F/V consumption. This article describes formative research conducted in 2005 to develop a new identity for the 5 A Day Program, updated to the Fruits & Veggies--More Matters program. The objective was to re-brand the 5 A Day Program's campaign message to be adaptable, sustainable, and compelling, while leveraging the program's existing message dissemination infrastructure. Formative research included interviews with representatives from government, nonprofit organizations, and industry, and consumer perspectives from interviews, focus groups, and an online survey. Public health and private organizations agreed that a compelling emotional benefit was needed to motivate consumers to eat more F/V and that messaging needed to be used consistently among national, state, and local programs. Interviews and focus groups targeted mothers who believed they and their families were getting enough F/V, knew they could eat more, but needed to be convinced why they should do so. The most effective messages appealed to mothers' emotional needs to be responsible, leveraged functional intrinsic values of F/V, did not try to quantify "enough," and focused on small steps. When the Fruits & Veggies-More Matters slogan and graphic were viewed together, the majority (62%) said it increased their interest in eating more F/V. The Fruits & Veggies-More Matters brand offers numerous opportunities for promoting F/V consumption through this public health initiative. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

“They talk like that, but we keep working”: Sexual harassment and sexual assault experiences among Mexican Indigenous farmworker women in Oregon

PubMed Central

Murphy, Jeanne; Samples, Julie; Morales, Mavel; Shadbeh, Nargess

2014-01-01

In order to examine the experiences of sexual harassment and sexual assault among indigenous and non-indigenous Mexican immigrant farmworkers in Oregon's Willamette Valley, a community-academic participatory research partnership initiated a study, which included focus groups, conducted and analyzed by skilled practitioners and researchers. The themes that emerged from the focus groups included direct and indirect effects of sexual harassment and sexual assault on women and risk factors associated with the farmworker workplace environment, and the increased vulnerability of non-Spanish-speaking indigenous women due to low social status, poverty, cultural and linguistic issues, and isolation. Recommendations for prevention and improved services for vulnerable women will be discussed as well as limitations and future research directions. PMID:24514945

Purulent pericarditis and pneumonia caused by Streptococcus equi subsp. zooepidemicus.

PubMed

Held, Jürgen; Schmitz, Roland; van der Linden, Mark; Nührenberg, Thomas; Häcker, Georg; Neumann, Franz-Josef

2014-02-01

Purulent pericarditis is a life-threatening disease that usually manifests following bacteraemia or through spreading from an intrathoracic focus. Only a few cases of this disease have been reported with Lancefield group C streptococci as aetiological agents, and the primary focus in these infections remains unknown. We report a case of purulent pericarditis with septic and cardiogenic shock, caused by Streptococcus equi subsp. zooepidemicus (group C) in a 51-year-old patient. The pathogen was possibly contracted through contact with horses. Most probably, it caused initially pneumonia before spreading to the pericardium, either directly or via the bloodstream. A combined therapeutic approach, consisting of antibiotic therapy and repeated pericardial drainage, was necessary to ensure a clinical cure. After discharge, long-term follow-up for development of constrictive pericarditis is considered mandatory.

"They Talk Like That, But We Keep Working": Sexual Harassment and Sexual Assault Experiences Among Mexican Indigenous Farmworker Women in Oregon.

PubMed

Murphy, Jeanne; Samples, Julie; Morales, Mavel; Shadbeh, Nargess

2015-12-01

In order to examine the experiences of sexual harassment and sexual assault among indigenous and non-indigenous Mexican immigrant farmworkers in Oregon's Willamette Valley, a community-academic participatory research partnership initiated a study, which included focus groups, conducted and analyzed by skilled practitioners and researchers. The themes that emerged from the focus groups included direct and indirect effects of sexual harassment and sexual assault on women and risk factors associated with the farmworker workplace environment, and the increased vulnerability of non-Spanish-speaking indigenous women due to low social status, poverty, cultural and linguistic issues, and isolation. Recommendations for prevention and improved services for vulnerable women will be discussed as well as limitations and future research directions.

Nutrition in medical education: reflections from an initiative at the University of Cambridge

PubMed Central

Ball, Lauren; Crowley, Jennifer; Laur, Celia; Rajput-Ray, Minha; Gillam, Stephen; Ray, Sumantra

2014-01-01

Landmark reports have confirmed that it is within the core responsibilities of doctors to address nutrition in patient care. There are ongoing concerns that doctors receive insufficient nutrition education during medical training. This paper provides an overview of a medical nutrition education initiative at the University of Cambridge, School of Clinical Medicine, including 1) the approach to medical nutrition education, 2) evaluation of the medical nutrition education initiative, and 3) areas identified for future improvement. The initiative utilizes a vertical, spiral approach during the clinically focused years of the Cambridge undergraduate and graduate medical degrees. It is facilitated by the Nutrition Education Review Group, a group associated with the UK Need for Nutrition Education/Innovation Programme, and informed by the experiences of their previous nutrition education interventions. Three factors were identified as contributing to the success of the nutrition education initiative including the leadership and advocacy skills of the nutrition academic team, the variety of teaching modes, and the multidisciplinary approach to teaching. Opportunities for continuing improvement to the medical nutrition education initiative included a review of evaluation tools, inclusion of nutrition in assessment items, and further alignment of the Cambridge curriculum with the recommended UK medical nutrition education curriculum. This paper is intended to inform other institutions in ongoing efforts in medical nutrition education. PMID:24899813

Developing Policy for Integrating Biomedicine and Traditional Chinese Medical Practice Using Focus Groups and the Delphi Technique

PubMed Central

Chung, Vincent C. H.; Ma, Polly H. X.; Lau, Chun Hong; Griffiths, Sian M.

2012-01-01

In Hong Kong, statutory regulation for traditional Chinese medicine (TCM) practitioners has been implemented in the past decade. Increasing use of TCM on top of biomedicine (BM) services by the population has been followed; but corresponding policy development to integrate their practices has not yet been discussed. Using focus group methodology, we explore policy ideas for integration by collating views from frontline BM (n = 50) and TCM clinicians (n = 50). Qualitative data were analyzed under the guidance of structuration model of collaboration, a theoretical model for understanding interprofessional collaboration. From focus group findings we generated 28 possible approaches, and subsequently their acceptability was assessed by a two round Delphi survey amongst BM and TCM policy stakeholders (n = 12). Consensus was reached only on 13 statements. Stakeholders agreed that clinicians from both paradigms should share common goals of providing patient-centered care, promoting the development of protocols for shared care and information exchange, as well as strengthening interprofessional connectivity and leadership for integration. On the other hand, attitudes amongst policy stakeholders were split on the possibility of fostering trust and mutual learning, as well as on enhancing innovation and governmental support. Future policy initiatives should focus on these controversial areas. PMID:22649469

Retrospective qualitative analysis of ecological networks under environmental perturbation: a copper-polluted intertidal community as a case study.

PubMed

Ramos-Jiliberto, Rodrigo; Garay-Narváez, Leslie; Medina, Matías H

2012-01-01

The coast of Chañaral Bay in northern Chile has been affected by copper mine wastes for decades. This sustained perturbation has disrupted the intertidal community in several ways, but the mechanisms behind the observed shifts in local biodiversity remain poorly understood. Our main goal was to identify the species (lumped into trophic groups) belonging to the Chañaral intertidal community that, being directly affected by copper pollution, contributed primarily to the generation of the observed changes in community structure. These groups of species were called initiators. We applied a qualitative modelling approach based only on the sign and direction of effects among species, and present a formula for predicting changes in equilibrium abundances considering stress on multiple variables simultaneously. We then applied this technique retrospectively to identify the most likely set of initiators. Our analyses allowed identification of a unique set of four initiators in the studied intertidal system (a group of algae, sessile invertebrates, a group of herbivores and starfish), which were hypothesized to be the primary drivers of the observed changes in community structure. In addition, a hypothesis was derived about how the perturbation affected these initiators. The hypothesis is that pollution affected negatively the population growth rate of both algae and sessile invertebrates and suppressed the interaction between herbivores and starfish. Our analytic approach, focused on identifying initiators, constitutes an advance towards understanding the mechanisms underlying human-driven ecosystem disruption and permits identifying species that may serve as a focal point for community management and restoration.

Health information exchange policy and evaluation.

PubMed

Marchibroda, Janet M

2007-12-01

Concerns about the quality, safety, and cost of healthcare have driven the nation to increase its focus on this issue. A number of states are moving forward-in parallel with federal efforts-to develop and adopt policies for improving health and healthcare through health information technology and electronic health information exchange. Based on the eHealth Initiative's experience providing technical assistance to more than 20 states, and its work related to its coalition of more than 250 state, regional and community-based health information exchange initiatives and organizations, the most difficult challenges facing these initiatives and organizations today is that related to assessing the value of services that emerge from the health information exchange to various stakeholders groups such as providers, payers, and employers, and converting those value assessments to business plans that promote and assure sustainability for these initiatives. The combination of increased federal and state focus and funding and the pace at which regional and community-based health information networks are developing, along with the identification of value and sustainability as some of the most difficult challenges experienced by these efforts, all point to the significant need for evaluation. The most critical evaluation questions focus on the impact of health information technology and health information exchange on quality, safety, efficiency, the value of such efforts for various stakeholders, and assessment of how grant programs can be designed to support positive impact, value, and a sustainable business model, so that efforts continue when the grant funds are fully expended.

The Role for Community-Based Participatory Research in Formulating Policy Initiatives: Promoting Safety and Health for In-Home Care Workers and Their Consumers

PubMed Central

Gong, Fang; Ayala, Linda; Stock, Laura; McDevitt, Susannah; Heaney, Cathy

2009-01-01

Although community-based participatory research (CBPR) can be effective in influencing policy, the process of formulating policy initiatives through CBPR is understudied. We describe a case study to illustrate how alliances among various community partners could be united to formulate policy directions. In collaboration with partners, the National Institute for Occupational Safety and Health initiated a project aimed at improving health and safety for low-income elderly and disabled persons and their in-home care workers. Community partners and stakeholders participated in focus groups, stakeholder interviews, and meetings; they played multiple roles including identifying organizational policy changes the partners could initiate immediately, as well as broader public policy goals. Results indicated that a strong community partnership, participation, and shared values contributed to successful formulation of policy initiatives. PMID:19890153

Generation Ys' Employment Expectations: UK Undergraduates' Opinions on Enjoyment, Opportunity and Progression

ERIC Educational Resources Information Center

Maxwell, G. A.; Broadbridge, A. M.

2017-01-01

Generation Y can be taken to be the group of people born between 1977 and 2000. The aim of this paper is to investigate the initial career entry and long-term career employment expectations of UK undergraduate Generation Ys, in order to inform employability skills development in higher education. The empirical research comprises 26 focus groups…

Let's Erase the Stigma (LETS): A Quasi-Experimental Evaluation of Adolescent-Led School Groups Intended to Reduce Mental Illness Stigma

ERIC Educational Resources Information Center

Murman, Nicole M.; Buckingham, Kyla C. E.; Fontilea, Philippe; Villanueva, Robert; Leventhal, Bennett; Hinshaw, Stephen P.

2014-01-01

Background: Reducing mental illness stigma in youth is an important societal goal, but much of the existing literature focuses on knowledge enhancement strategies. These alone may not be sufficient to enhance empathy, change fundamental attitudes, or reduce social distance. Objective: To evaluate a youth-initiated, discussion- and empathy-based…

PlainTalk Starter Kit: A Practical Guide to Community-Based Programming To Reduce Teen Pregnancy, STDs and HIV/AIDS.

ERIC Educational Resources Information Center

Douglas, Elaine

Plain Talk is a community-based initiative designed to assist neighborhood groups and residents in creating and implementing locally acceptable and effective strategies to protect sexually active youth from pregnancy. Plain Talk aims to affect individual, neighborhood, and community behavior through a process that focuses on helping adults develop…

Item Banks for Measuring Emotional Distress from the Patient-Reported Outcomes Measurement Information System (PROMIS[R]): Depression, Anxiety, and Anger

ERIC Educational Resources Information Center

Pilkonis, Paul A.; Choi, Seung W.; Reise, Steven P.; Stover, Angela M.; Riley, William T.; Cella, David

2011-01-01

The authors report on the development and calibration of item banks for depression, anxiety, and anger as part of the Patient-Reported Outcomes Measurement Information System (PROMIS[R]). Comprehensive literature searches yielded an initial bank of 1,404 items from 305 instruments. After qualitative item analysis (including focus groups and…

Parents as Co-Researchers: A Participatory Action Research Initiative Involving Parents of People with Intellectual Disabilities in Ireland

ERIC Educational Resources Information Center

Walmsley, Jan; Mannan, Hasheem

2009-01-01

This paper evaluates a participatory action research (PAR) approach to conducting family research in Ireland. Drawing on PAR methodology it describes how parents of people with intellectual disabilities were recruited and trained to facilitate focus groups of parents in Ireland, in order to create an evidence base to support improved dialogue…

Foster Parents Speak: Preferred Characteristics of Foster Children and Experiences in the Role of Foster Parent

ERIC Educational Resources Information Center

Rosenwald, Mitchell; Bronstein, Laura

2008-01-01

Foster parents play a pivotal role in the child welfare system. A study that employed focus groups with foster parents was conducted at a private foster care agency with the initial purpose of understanding the characteristics of foster children that foster parents both preferred and not preferred. In the qualitative research tradition, their…

Student Persistence and Attrition in an Online M. S. Program: Implications for Program Design

ERIC Educational Resources Information Center

Waugh, Michael; Su-Searle, Jian

2014-01-01

This paper describes results from a case study that focuses on the initial implementation of a new, online instructional program, the WebIT M.S. in Instructional Technology, offered at the University of Tennessee at Knoxville during 2008-2010. Survey data were collected from two groups of students: a self-selected sample of those students who…

Development of an Educational Video to Improve Patient Knowledge and Communication with Their Healthcare Providers about Colorectal Cancer Screening

ERIC Educational Resources Information Center

Katz, Mira L.; Heaner, Sarah; Reiter, Paul; van Putten, Julie; Murray, Lee; McDougle, Leon; Cegala, Donald J.; Post, Douglas; David, Prabu; Slater, Michael; Paskett, Electra D.

2009-01-01

Background: Low rates of colorectal cancer (CRC) screening persist due to individual, provider, and system level barriers. Purpose: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. Methods: Focus groups of patients were conducted prior to the development of the CRC…

Water Quality and Fecal-Indicator Detection in Response to an Impaired Urban Watershed: Turkey Creek "Gulf of Mexico Initiative Focus"; and a "Making a Visible Difference" Program

EPA Science Inventory

The historical communities of Turkey Creek originated in 1866, when a group of emancipated African-Americans purchased land in Harrison County, MS, along the Turkey Creek watershed. Many of the current members of this community are descendants from the original settlers. This wa...

Racial Isolation in the Rochester Public Schools: The Problem and What to Do About It. Special Report.

ERIC Educational Resources Information Center

Urban League of Rochester, Inc., NY.

This report focuses on initiatives which might be taken by the Rochester Board of Education to reduce racial isolation within the city. Information is provided about the extent of racial isolation in Rochester, the effects of isolation on student achievement, the forces behind minority group isolation, and current policies and programs undertaken…

PACT Manual: Parent and Community Teams for School Success. ABC Dropout Prevention and Intervention Series.

ERIC Educational Resources Information Center

Larson, Katherine; Rumberger, Russell

This manual describes the PACT (Parent and Community Team) for School Success concept, which was developed from insights and techniques gained from three dropout and intervention projects with high-risk junior high school youth and families. PACT focuses on ways to initiate and maintain a group that meets frequently to create ongoing cohesive…

Expanding Agency: Centering Gender Identity in College and University Student Records Systems

ERIC Educational Resources Information Center

Linley, Jodi L.; Kilgo, Cindy Ann

2018-01-01

This article details the process the authors--a doctoral student at the time, and a faculty member--engaged in to change the ways the University of Iowa (UI) asks for and reports student name, gender pronouns, sex, and gender identity. The UI Inclusive Student Records Initiative raises implications for practice and research. Two focus groups--one…

An Initial Model for Generative Design Research: Bringing Together Generative Focus Group (GFG) and Experience Reflection Modelling (ERM)

ERIC Educational Resources Information Center

Bakirlioglu, Yekta; Ogur, Dilruba; Dogan, Cagla; Turhan, Senem

2016-01-01

Understanding people's experiences and the context of use of a product at the earliest stages of the design process has in the last decade become an important aspect of both the design profession and design education. Generative design research helps designers understand user experiences, while also throwing light on their current needs,…

Initial Assessment of the Acceptability of a Push-Pull Aedes aegypti Control Strategy in Iquitos, Peru and Kanchanaburi, Thailand

PubMed Central

Paz-Soldan, Valerie A.; Plasai, Valaikanya; Morrison, Amy C.; Rios-Lopez, Esther J.; Guedez-Gonzales, Shirly; Grieco, John P.; Mundal, Kirk; Chareonviriyaphap, Theeraphap; Achee, Nicole L.

2011-01-01

As part of a larger research program evaluating chemical threshold levels for a Push-Pull intervention to reduce man-vector (Aedes aegypti) contact, this qualitative study explored local perceptions and strategies associated with mosquito control within dengue-endemic communities in Peru and Thailand. Focus groups were used to provide preliminary information that would identify possible public acceptance issues to the Push-Pull strategy in each site. Nine focus group discussions (total of 102 individuals) conducted between September 2008 and March 2009 examined several themes: 1) current mosquito control practices; 2) perceptions of spatial repellency and contact irritancy versus killing mosquitoes; and 3) initial perceptions toward mosquito host-seeking traps. Results indicate participants use household-level strategies for insect control that reveal familiarity with the concept of spatial repellent and contact irritant actions of chemicals and that placing traps in the peridomestic environment to remove repelled mosquitoes was acceptable. Preliminary evidence suggests a Push-Pull strategy should be well accepted in these locations. These results will be beneficial for developing future large scale push-pull interventions and are currently being used to guide insecticide application strategies in (entomological) proof-of-concept studies using experimental huts. PMID:21292886

Outcome evaluation of a 3-year senior health and wellness initiative.

PubMed

Kuczmarksi, Marie Fanelli; Cotugna, Nancy

2009-02-01

The Wilmington Senior Center developed a 3-year multidisciplinary health and wellness initiative entitled The Time of Your Life to promote healthy aging for participants attending countywide senior centers. The purpose of this paper is to describe the development and implementation of the evaluation methodology and outcomes of this senior health and wellness project that consisted of 11 programs in total. Long-term programming can present several challenges in both implementation and evaluation, but assessing outcomes is critical to documenting program value and accountability. Participant-completed surveys and post-series focus groups were utilized as the evaluation tools. Our findings indicate that the program's objectives of increasing knowledge and motivating adoption or maintenance of a healthy lifestyle were met to varying degrees, while a third objective of assessing the usefulness of resources to inform health-related decisions was unable to be evaluated due to the cross-sectional nature of the data collection. Post-series focus groups indicated that topics of most interest to seniors were money management, medications and staying mentally and physically fit. The evaluations showed that long-term programming, while challenging, can be a successful and sustainable format for senior health education.

Association between anger rumination and autism symptom severity, depression symptoms, aggression, and general dysregulation in adolescents with autism spectrum disorder.

PubMed

Patel, Shivani; Day, Taylor N; Jones, Neil; Mazefsky, Carla A

2017-02-01

Rumination has a large direct effect on psychopathology but has received relatively little attention in autism spectrum disorder despite the propensity to perseverate in this population. This study provided initial evidence that adolescents with autism spectrum disorder self-report more anger-focused rumination than typically developing controls, though there was substantial within-group variability. Anger rumination was positively correlated with autism symptom severity with both groups combined. Future studies that include measures of perseveration on special interests are needed to understand whether anger rumination is a manifestation of a perseverative type of repetitive behavior or a distinct trait. Even when controlling for autism symptom severity, however, anger-focused rumination was associated with poorer functioning, including more depression symptoms and overall emotional and behavioral dysregulation. Therefore, further inquiry regarding anger rumination in autism spectrum disorder is clinically important, and the potential impact of rumination-focused interventions should be explored.

Turning on and turning off: a focus group study of the factors that affect women's sexual arousal.

PubMed

Graham, Cynthia A; Sanders, Stephanie A; Milhausen, Robin R; McBride, Kimberly R

2004-12-01

The aim of this study was to inform the development of a questionnaire to assess a woman's tendency to respond with sexual excitation/inhibition in different situations. Nine focus groups, involving 80 women (M age = 34.3 years; range, 18-84), were conducted. Women described a wide range of physical (genital and nongenital), cognitive/emotional, and behavioral cues to arousal. The relationship between sexual interest (desire) and sexual arousal was complex; sexual interest was reported as sometimes preceding arousal, but at other times following it. Many women did not clearly differentiate between arousal and interest. Qualitative data on the factors that women perceived as "enhancers" and "inhibitors" of sexual arousal are presented, with a focus on the following themes: feelings about one's body; concern about reputation; unwanted pregnancy/contraception; feeling desired versus feeling used by a partner; feeling accepted by a partner; style of approach/initiation; and negative mood. The findings can help inform conceptualizations of sexual arousal in women.

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.

Sexual communication among young adult heterosexual Latinos: a qualitative descriptive study.

PubMed

Alvarez, Carmen Paula; Villarruel, Antonia

2013-01-01

Sexual communication between sexual partners is an important component in prevention efforts against unintended consequences of sex. The purpose of this study was to describe sexual communication among young adult Latinos. Four semistructured, sex-segregated focus groups were used for this study. Participants (N = 20) were 18-30 years old self-identified Latinos who were in heterosexual and sexually active relationships (more than 3 months). Participants revealed that initial sexual communication with their partners was avoided related to a lack of interest in a partner's sexual history, feeling embarrassed about the topic, or concern for offending one's partner or partner's family. As a result of these beliefs and attitudes, initial sexual communication was nonverbal and focused on sexual pleasure. After the initiation of sexual activity, verbal sexual communication expanded to include sexual history. These findings highlight the importance of attitudes and subjective norms toward verbal sexual communication. Attitudes and subjective norms toward sexual communication in the context of a romantic relationship and how it may impact sexual behavior in the relationship should be further explored.

Perceived barriers to initiating and maintaining physical activity among South Asian and White British adults in their 60s living in the United Kingdom: a qualitative study.

PubMed

Horne, Maria; Skelton, Dawn A; Speed, Shaun; Todd, Chris

2013-01-01

To explore the barriers to initiating and maintaining regular physical activity (PA) among UK Indian, Pakistani and White British adults in their 60s. An exploratory qualitative approach was utilised using 15 focus groups and 40 in-depth interviews. Purposive sampling was used to recruit participants with different experiences of participation or non-participation in PA. Misunderstandings about the value of exercise in later life, particularly for those with ongoing healthcare problems, were identified in UK South Asian and White British older adults' accounts of their experience of the barriers to initiating and maintaining regular PA. Both groups and genders said that PA could exacerbate pre-existing health problems and result in physical harm. Although most beliefs were similar to those of the White British, ethnic-specific factors, such as language barriers, religious beliefs and cultural practices could act as additional barriers to undertaking and maintaining PA among UK South Asian older adults. Understanding the multiple levels of influence on older adults' PA behaviour can provide the basis for developing comprehensive approaches to health promotion initiatives aimed at increasing PA levels. Healthcare providers need to understand the characteristics and specific barriers faced by these groups of older adults; work with older people from these groups to develop culturally appropriate PA programmes and address the misunderstandings and misconceptions about the value of exercise in later-life, particularly in those with ongoing health problems.

Initial surgery for benign primary hyperparathyroidism: an analysis of 1,300 patients in a teaching hospital.

PubMed

Karakas, Elias; Schneider, Ralph; Rothmund, Matthias; Bartsch, Detlef K; Schlosser, Katja

2014-08-01

Success rates of initial surgery for primary hyperparathyroidism (pHPT) are greater than 95 % in specialized centers, mostly referring to single-surgeon experiences. The present study was performed to identify changes in clinical manifestations, diagnostic procedures, surgical strategies, and outcome of initial parathyroid interventions in a teaching hospital during the past 25 years with special regard to the surgical expertise. Clinical data of patients who underwent an initial neck exploration for benign pHPT between 1985 and 2010 at the University hospital Marburg were retrospectively evaluated. All data were analyzed particularly with regard to the implementation of additional pre- and intraoperative procedures and to the particular surgical strategy. In addition, operative results were furthermore analyzed with regard to the experience of the responsible surgeons. An initial neck exploration for benign pHPT was performed in 1,300 patients. Of these, 1,035 patients had a bilateral cervical exploration (BCE) and 265 patients had a focused, minimally invasive parathyroidectomy (MIP). Cure rates did not differ between focused surgeries and BCE (98.9 vs. 98.3%, p = 0.596) after a mean follow-up of 33.4 (± 44.3) months. Postoperative transient hypoparathyroidism was significantly lower in the MIP group (11 vs. 47%, p < 0.0001). The rate of permanent recurrent laryngeal nerve palsies (0.4 vs. 2%, p = 0.064) and nonsurgical complications (0 vs. 1.4%, p = 0.0875) tended to be lower in the MIP group. Success and complication rates of chief surgeons (n = 2), attending surgeons (n = 20), and residents (56 < 3 years, 30 > 3 years) were similar, despite a significantly shorter operating time in the chief surgeon group (p < 0.01). Despite the implementation of several diagnostic procedures and significant changes concerning the surgical strategy, high success rates of primary interventions for pHPT did not change over the past three decades. High success rates also can be achieved in a teaching hospital, provided that surgery is supervised by an experienced endocrine surgeon. MIP is the treatment of choice in patients with benign sporadic pHPT and positive preoperative localization studies.

Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups.

PubMed

Grayson, M Lindsay; Macesic, Nenad; Huang, G Khai; Bond, Katherine; Fletcher, Jason; Gilbert, Gwendolyn L; Gordon, David L; Hellsten, Jane F; Iredell, Jonathan; Keighley, Caitlin; Stuart, Rhonda L; Xuereb, Charles S; Cruickshank, Marilyn

2015-01-01

Important culture-change initiatives (e.g. improving hand hygiene compliance) are frequently associated with variable uptake among different healthcare worker (HCW) categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design. We used an innovative personality-profiling tool (ColourGrid®) to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data) to: a) compare the relative accuracy of these two sources; b) identify differences between HCW groups and c) use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence). Results from 34,243 HCWs (HR data) and 1045 survey participants (PS data) suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services) and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting) senior medical officers (SMO, VMO) and junior hospital medical officers (HMO), with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence. Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality profiling based on HR data may represent a useful means of developing a national culture-change "blueprint" for HCW education.

Explaining Physical Activity Maintenance After a Theory-Based Intervention Among Patients With Rheumatoid Arthritis: Process Evaluation of a Randomized Controlled Trial.

PubMed

Knittle, Keegan; De Gucht, Véronique; Hurkmans, Emalie; Vlieland, Thea Vliet; Maes, Stan

2016-02-01

Regular physical activity (PA) benefits patients with rheumatoid arthritis (RA), particularly when maintained over time. Research in this area has largely focused on factors associated with initiating PA, while factors contributing to PA maintenance, particularly after lifestyle interventions, have received less attention. This study examined whether higher levels of autonomous motivation, self-efficacy for PA, and greater use of self-regulation skills mediated PA initiation and maintenance 6 months after a theory-based motivational interviewing and self-regulation coaching intervention. Seventy-eight individuals with RA were randomized to receive either a patient-education session (control group), or the patient-education session plus 1 motivational interview and 2 self-regulation coaching sessions (treatment group). Mediation analyses examined the effects of this intervention on PA initiation and maintenance through the intermediate variables autonomous motivation, self-efficacy for PA, and use of self-regulation skills. Analyses were controlled for age, sex, and previous levels of PA. The treatment group reported significantly higher autonomous motivation and greater use of self-regulation skills than controls at posttreatment. Increases in PA from baseline to posttreatment were not mediated by any intermediate variables. However, maintenance of PA from posttreatment to followup (6 months later) was mediated by greater autonomous motivation and use of self-regulation skills. Greater autonomous motivation and use of self-regulation skills predict maintenance of PA following a motivational interviewing and self-regulation coaching intervention. In promoting PA among patients with RA, supporting patient autonomy and teaching self-regulation skills, which focus attention on achieving PA goals, may improve long-term maintenance of PA. © 2016, American College of Rheumatology.

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.

Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system.

PubMed

Ganz, David A; Yano, Elizabeth M; Saliba, Debra; Shekelle, Paul G

2009-11-16

Implementing quality improvement programs that require behavior change on the part of health care professionals and patients has proven difficult in routine care. Significant randomized trial evidence supports creating fall prevention programs for community-dwelling older adults, but adoption in routine care has been limited. Nationally-collected data indicated that our local facility could improve its performance on fall prevention in community-dwelling older people. We sought to develop a sustainable local fall prevention program, using theory to guide program development. We planned program development to include important stakeholders within our organization. The theory-derived plan consisted of 1) an initial leadership meeting to agree on whether creating a fall prevention program was a priority for the organization, 2) focus groups with patients and health care professionals to develop ideas for the program, 3) monthly workgroup meetings with representatives from key departments to develop a blueprint for the program, 4) a second leadership meeting to confirm that the blueprint developed by the workgroup was satisfactory, and also to solicit feedback on ideas for program refinement. The leadership and workgroup meetings occurred as planned and led to the development of a functional program. The focus groups did not occur as planned, mainly due to the complexity of obtaining research approval for focus groups. The fall prevention program uses an existing telephonic nurse advice line to 1) place outgoing calls to patients at high fall risk, 2) assess these patients' risk factors for falls, and 3) triage these patients to the appropriate services. The workgroup continues to meet monthly to monitor the progress of the program and improve it. A theory-driven program development process has resulted in the successful initial implementation of a fall prevention program.

Development of a group-based self-management programme for individuals with chronic fatigue syndrome: a pilot study.

PubMed

Pinxsterhuis, Irma; Hellum, Live Lange; Aannestad, Hilde Hassum; Sveen, Unni

2015-03-01

The aim of the study was to develop a group-based self-management programme for individuals with chronic fatigue syndrome (CFS) by using the participants' experiences with the initial version of the programme, which intends to promote coping with the illness in a primary healthcare setting. An initial programme was developed, based on self-efficacy theory and the concepts of client-centred practice and empowerment. Subsequently, the programme was tested and further developed by drawing on the participants' experiences with the programme. Focus-group interviews were applied. The interviews were analysed using thematic analysis. The initial programme was found to be feasible, although several modifications regarding the content and practical organization of the programme were proposed. In line with the participants' experiences, the final self-management programme was developed, which includes short presentations of eight topics, exchange of experiences among participants, goal-setting, construction of action plans, and relaxation exercises, in addition to a meeting for relatives. The programme will be provided in eight biweekly sessions and be led by juxtaposed peer counsellors and occupational therapists. The effects of the final programme will be evaluated in a randomized controlled trial.

Perceptions of interprofessional collaboration of general practitioners and community pharmacists - a qualitative study.

PubMed

Löffler, Christin; Koudmani, Carolin; Böhmer, Femke; Paschka, Susanne D; Höck, Jennifer; Drewelow, Eva; Stremme, Martin; Stahlhacke, Bernd; Altiner, Attila

2017-03-21

Despite numerous evidences for the positive effect of community pharmacists on health care, interprofessional collaboration of pharmacists and general practitioners is very often limited. Though highly trained, pharmacists remain an underutilised resource in primary health care in most western countries. This qualitative study aims at investigating pharmacists' and general practitioners' views on barriers to interprofessional collaboration in the German health care system. A total of 13 narrative in-depth interviews, and two focus group discussions with 12 pharmacists and general practitioners in Mecklenburg-Western Pomerania, a predominantly rural region of North-Eastern Germany, were conducted. The interviews aimed at exploring general practitioners' and pharmacists' attitudes, views and experiences of interprofessional collaboration. At a second stage, two focus group discussions were performed. Fieldwork was carried out by a multi-professional team. All interviews and focus group discussions were audio taped and transcribed verbatim. The constant comparative method of analysis from grounded theory was applied to the data. There are three main findings: First, mutual trust and appreciation appear to be important factors influencing the quality of interprofessional collaboration. Second, in light of negative personal experiences, pharmacists call for a predefined, clear and straightforward way to communicate with physicians. Third, given the increasing challenge to treat a rising number of elderly patients with chronic conditions, general practitioners desire competent support of experienced pharmacists. On the ground of methodological triangulation the findings of this study go beyond previous investigations and are able to provide specific recommendations for future interprofessional collaboration. First, interventions and initiatives should focus on increasing trust, e.g. by implementing multi-professional local quality circles. Second, governments and health authorities in most countries have been and still are reluctant in advancing political initiatives that bring together physicians and pharmacists. Proactive lobbying and empowerment of pharmacists are extremely important in this context. In addition, future physician and pharmaceutical training curricula should focus on comprehensive pharmacist-physician interaction at early stages within both professional educations and careers. Developing and fostering a culture of continued professional exchange and appreciation is one major challenge of future policy and research.

Gross and fine motor function in fibromyalgia and chronic fatigue syndrome

PubMed Central

Rasouli, Omid; Fors, Egil A; Borchgrevink, Petter Chr; Öhberg, Fredrik; Stensdotter, Ann-Katrin

2017-01-01

Purpose This paper aimed to investigate motor proficiency in fine and gross motor function, with a focus on reaction time (RT) and movement skill, in patients with fibromyalgia (FM) and chronic fatigue syndrome (CFS) compared to healthy controls (HC). Methods A total of 60 individuals (20 CFS, 20 FM, and 20 HC), age 19–49 years, participated in this study. Gross motor function in the lower extremity was assessed using a RT task during gait initiation in response to an auditory trigger. Fine motor function in the upper extremity was measured during a precision task (the Purdue Pegboard test) where the number of pins inserted within 30 s was counted. Results No significant differences were found between FM and CFS in any parameters. FM and CFS groups had significantly longer RT than HC in the gait initiation (p=0.001, and p=0.004 respectively). In the Purdue Pegboard test, 20% in the FM group, 15% in the CFS groups, and 0% of HC group, scored below the threshold of the accepted performance. However, there were no significant differences between FM, CFS, and HC in this task (p=0.12). Conclusion Compared to controls, both CFS and FM groups displayed significantly longer RT in the gait initiation task. Generally, FM patients showed the worst results in both tests, although no group differences were found in fine motor control, according to the Purdue Pegboard test. PMID:28223840

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.

Communication and Information About "Safer Sex:" Intervention Issues Within Communities of African Migrants Living in Poorer Neighbourhoods in Portugal.

PubMed

de Matos, Margarida Gaspar; Gaspar, Tania; Simons-Morton, Bruce; Reis, Marta; Ramiro, Lúcia

2008-01-01

The aims of this study are to determine the influence of migrant status on sexual behavior and communication about "safer sex" and to identify ethnic-specific prevention issues. Data were obtained from a special administration of the Health Behavior in School-Aged Children Survey in a special sample of Portuguese schools located in low-income Lisbon neighborhoods with large proportions of African migrants.Survey participants included 919 6th, 8th and 10th graders (52.3% female), of whom 19.2% were migrant foreigners from African Portuguese-speaking countries, including Cape Verde (60.8%), Mozambique (1.6%), Angola (16.8%), S. Tomé (8%), and Guinea-Bissau (14.8%). Subsequently, four focus groups were held with adolescent who had participated in the survey (n = 45), three focus group with health and education professionals (n = 25), and one focus group with parents (n = 6).Compared with Portuguese adolescents, African migrant teens reported initial sexual intercourse at earlier ages, less frequent condom use, and less frequent and less comfortable communications with parents about sexual issues.Implications for selective prevention of STD are discussed and recommendations are made.

Cold homes, fuel poverty and energy efficiency improvements: A longitudinal focus group approach.

PubMed

Grey, Charlotte N B; Schmieder-Gaite, Tina; Jiang, Shiyu; Nascimento, Christina; Poortinga, Wouter

2017-08-01

Cold homes and fuel poverty have been identified as factors in health and social inequalities that could be alleviated through energy efficiency interventions. Research on fuel poverty and the health impacts of affordable warmth initiatives have to date primarily been conducted using quantitative and statistical methods, limiting the way how fuel poverty is understood. This study took a longitudinal focus group approach that allowed exploration of lived experiences of fuel poverty before and after an energy efficiency intervention. Focus group discussions were held with residents from three low-income communities before (n = 28) and after (n = 22) they received energy efficiency measures funded through a government-led scheme. The results show that improving the energy efficiency of homes at risk of fuel poverty has a profound impact on wellbeing and quality of life, financial stress, thermal comfort, social interactions and indoor space use. However, the process of receiving the intervention was experienced by some as stressful. There is a need for better community engagement and communication to improve the benefits delivered by fuel poverty programmes, as well as further qualitative exploration to better understand the wider impacts of fuel poverty and policy-led intervention schemes.

Cold homes, fuel poverty and energy efficiency improvements: A longitudinal focus group approach

PubMed Central

Grey, Charlotte N. B.; Schmieder-Gaite, Tina; Jiang, Shiyu; Nascimento, Christina

2017-01-01

Cold homes and fuel poverty have been identified as factors in health and social inequalities that could be alleviated through energy efficiency interventions. Research on fuel poverty and the health impacts of affordable warmth initiatives have to date primarily been conducted using quantitative and statistical methods, limiting the way how fuel poverty is understood. This study took a longitudinal focus group approach that allowed exploration of lived experiences of fuel poverty before and after an energy efficiency intervention. Focus group discussions were held with residents from three low-income communities before (n = 28) and after (n = 22) they received energy efficiency measures funded through a government-led scheme. The results show that improving the energy efficiency of homes at risk of fuel poverty has a profound impact on wellbeing and quality of life, financial stress, thermal comfort, social interactions and indoor space use. However, the process of receiving the intervention was experienced by some as stressful. There is a need for better community engagement and communication to improve the benefits delivered by fuel poverty programmes, as well as further qualitative exploration to better understand the wider impacts of fuel poverty and policy-led intervention schemes. PMID:28890663

Effects of priming self-construals on self-evaluations: Cultural game player perspective.

PubMed

Kim, Jungsik; Song, Eugene; Takemoto, Timothy

2016-12-01

This study examined the validity of situational view on culture-specific behaviours focusing on self-evaluation. Two experiments with American students as samples were conducted to examine whether priming their self-construals would affect individuals' self-evaluation. In Experiment 1, the participants' self-evaluation was compared across different conditions of primed self-contruals. In Experiment 2, the participants were split into 2 groups based on their initial default self-consturals and, the self-evaluations were compared across the 2 groups after priming self-contruals. The results demonstrated that although the participants' self-evaluation was initially in accord with their default self-construal, it changed into accord with the primed self-construals. The findings supported the proposed cultural game player view. Implications on situational view of self-evaluation are also discussed. © 2015 International Union of Psychological Science.

Development of refractive X-ray focusing optics at Diamond Light Source

NASA Astrophysics Data System (ADS)

Alianelli, L.; Sawhney, K. J. S.; Loader, I. M.; Jenkins, D. W. K.; Stevens, R.; Snigirev, A.; Snigireva, I.

2007-09-01

The Diamond Optics & Metrology Group and the collaborators at the STFC Central Microstructure Facility have initiated a program for the design and fabrication of in-line micro- and nano-focusing optics for synchrotron radiation beamlines. The first type of optics fabricated is a kinoform lens in silicon on the same model proposed by K. Evans- Lutterodt et al [Opt. Expr. 11 (2003) 919.]. The fabrication utilised ultra high resolution electron beam lithographic patterning of an electron sensitive SU8 polymer and deep reactive ion etching of silicon. The first test of the focusing properties was performed at the ESRF BM5 optics beamline. In this paper we present details on the design and fabrication, and discuss the test results.

Mobile phone-based asthma self-management aid for adolescents (mASMAA): a feasibility study.

PubMed

Rhee, Hyekyun; Allen, James; Mammen, Jennifer; Swift, Mary

2014-01-01

Adolescents report high asthma-related morbidity that can be prevented by adequate self-management of the disease. Therefore, there is a need for a developmentally appropriate strategy to promote effective asthma self-management. Mobile phone-based technology is portable, commonly accessible, and well received by adolescents. The purpose of this study was to develop and evaluate the feasibility and acceptability of a comprehensive mobile phone-based asthma self-management aid for adolescents (mASMAA) that was designed to facilitate symptom monitoring, treatment adherence, and adolescent-parent partnership. The system used state-of-the-art natural language-understanding technology that allowed teens to use unconstrained English in their texts, and to self-initiate interactions with the system. mASMAA was developed based on an existing natural dialogue system that supports broad coverage of everyday natural conversation in English. Fifteen adolescent-parent dyads participated in a 2-week trial that involved adolescents' daily scheduled and unscheduled interactions with mASMAA and parents responding to daily reports on adolescents' asthma condition automatically generated by mASMAA. Subsequently, four focus groups were conducted to systematically obtain user feedback on the system. Frequency data on the daily usage of mASMAA over the 2-week period were tabulated, and content analysis was conducted for focus group interview data. Response rates for daily text messages were 81%-97% in adolescents. The average number of self-initiated messages to mASMAA was 19 per adolescent. Symptoms were the most common topic of teen-initiated messages. Participants concurred that use of mASMAA improved awareness of symptoms and triggers, promoted treatment adherence and sense of control, and facilitated adolescent-parent partnerships. This study demonstrates the utility and user acceptability of mASMAA as a potential asthma self-management tool in a selective group of adolescents. Further research is needed to replicate the findings in a large group of adolescents from sociodemographically diverse backgrounds to validate the findings.

Providing Consumers with Web-Based Information on the Environmental Effects of Automobiles

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

Saulsbury, J.W.

The Department of Energy (DOE) and the Environmental Protection Agency (EPA) provide consumers with web-based information on the environmental effects of automobiles so that individuals can make informed choices about the vehicles they use or may purchase. DOE and EPA maintain a web site (www.fueleconomy.gov) that provides users with information about fuel economy [as well as greenhouse gas (GHG) emissions and air pollution emissions] for the cars and trucks they use or may consider purchasing. EPA also maintains a separate web site (www.epa.gov/greenvehicles) that offers similar information, with the focus on air pollution emissions rather than fuel economy. The Americanmore » Council for an Energy-Efficient Economy (ACEEE) (www.greenercars.com) and the California Air Resources Board (CARB) (www.arb.ca.gov/msprog/ccbg/ccbg.htm) also maintain web sites that provide consumers with information on the environmental effects of automobiles. Through the National Transportation Research Center (NTRC) at Oak Ridge National Laboratory, DOE has supported some initial qualitative research with people who are interested in purchasing a new or used vehicle and whose actions identify them as at least somewhat concerned about the environment. The purpose of this research was to explore and understand how these people respond to the different ratings and measurements of environmental effects provided by the four web sites. The goal of the research is to optimize the communication of information provided on the DOE/EPA web site (www.fueleconomy.gov). Working with a private marketing research firm (The Looking Glass Group of Knoxville, Tennessee), NTRC staff initiated this research by meeting with two focus groups in Knoxville on February 27, 2001. To obtain information for comparison, staff from the NTRC and the Looking Glass Group also met with two focus groups in Los Angeles, California, on August 13, 2001.« less

Supporting safe driving with arthritis: developing a driving toolkit for clinical practice and consumer use.

PubMed

Vrkljan, Brenda H; Cranney, Ann; Worswick, Julia; O'Donnell, Siobhan; Li, Linda C; Gélinas, Isabelle; Byszewski, Anna; Man-Son-Hing, Malcolm; Marshall, Shawn

2010-01-01

We conducted a series of focus groups to explore the information needs of clinicians and consumers related to arthritis and driving. An open coding analysis identified common themes across both consumer and clinician-based focus groups that underscored the importance of addressing driving-related concerns and the challenges associated with assessing safety. The results revealed that although driving is critical for maintaining independence and community mobility, drivers with arthritis experience several problems that can affect safe operation of a motor vehicle. Findings from this study are part of a broader research initiative that will inform the development of the Arthritis and Driving toolkit. This toolkit outlines strategies to support safe mobility for people with arthritis and will be an important resource in the coming years given the aging population.

Development of satellite remote sensing techniques as an economic tool for forestry industry

NASA Technical Reports Server (NTRS)

Sader, Steven A.; Jadkowski, Mark A.

1989-01-01

A cooperative commercial development project designed to focus on cost-effective and practical applications of satellite remote sensing in forest management is discussed. The project, initiated in September, 1988 is being executed in three phases: (1) development of a forest resource inventory and geographic information system (GIS) updating systems; (2) testing and evaluation of remote-sensing products against forest industry specifications; and (3) integration of remote-sensing services and products in an operational setting. An advisory group represented by eleven major forest-product companies will provide direct involvement of the target market. The advisory group will focus on the following questions: Does the technology work for them? How can it be packaged to provide the needed forest-management information? Can the products and information be provided in a cost-effective manner?

Control of neuronal excitability by Group I metabotropic glutamate receptors.

PubMed

Correa, Ana Maria Bernal; Guimarães, Jennifer Diniz Soares; Dos Santos E Alhadas, Everton; Kushmerick, Christopher

2017-10-01

Metabotropic glutamate (mGlu) receptors couple through G proteins to regulate a large number of cell functions. Eight mGlu receptor isoforms have been cloned and classified into three Groups based on sequence, signal transduction mechanisms and pharmacology. This review will focus on Group I mGlu receptors, comprising the isoforms mGlu 1 and mGlu 5 . Activation of these receptors initiates both G protein-dependent and -independent signal transduction pathways. The G-protein-dependent pathway involves mainly Gα q , which can activate PLCβ, leading initially to the formation of IP 3 and diacylglycerol. IP 3 can release Ca 2+ from cellular stores resulting in activation of Ca 2+ -dependent ion channels. Intracellular Ca 2+ , together with diacylglycerol, activates PKC, which has many protein targets, including ion channels. Thus, activation of the G-protein-dependent pathway affects cellular excitability though several different effectors. In parallel, G protein-independent pathways lead to activation of non-selective cationic currents and metabotropic synaptic currents and potentials. Here, we provide a survey of the membrane transport proteins responsible for these electrical effects of Group I metabotropic glutamate receptors.

A national minority transplant program for increasing donation rates.

PubMed

Callender, C; Burston, B; Yeager, C; Miles, P

1997-01-01

Since 1982, our group efforts demonstrated statistically significant improvements in minority donation rates which have applicability to all minority populations. As we continue to reach out to the various ethnic communities, we must listen to the needs of the community understanding that all ethnic communities have various beliefs and cultural barriers that will need to be addressed. For instance, the African-American population revealed the previously mentioned five obstacles to donation. The Hispanic population has revealed relatively the same fears to donation as the African-American population. In addition, the tribes within the Native-American population each have their own belief systems which will have to be addressed appropriately. The fears and obstacles toward donation within the Asians and Pacific Islanders and the Alaska Native groups are being defined. However, initial research reveals that all of the minority groups have very similar, if not the same, fears that were identified with the initial focus group in 1978. This simple methodology that has been established can ultimately help achieve the overall desired goal--an increase in minority donation rates.

Accelerated forgetting? An evaluation on the use of long-term forgetting rates in patients with memory problems

PubMed Central

Geurts, Sofie; van der Werf, Sieberen P.; Kessels, Roy P. C.

2015-01-01

The main focus of this review was to evaluate whether long-term forgetting rates (delayed tests, days, to weeks, after initial learning) are more sensitive measures than standard delayed recall measures to detect memory problems in various patient groups. It has been suggested that accelerated forgetting might be characteristic for epilepsy patients, but little research has been performed in other populations. Here, we identified eleven studies in a wide range of brain injured patient groups, whose long-term forgetting patterns were compared to those of healthy controls. Signs of accelerated forgetting were found in three studies. The results of eight studies showed normal forgetting over time for the patient groups. However, most of the studies used only a recognition procedure, after optimizing initial learning. Based on these results, we recommend the use of a combined recall and recognition procedure to examine accelerated forgetting and we discuss the relevance of standard and optimized learning procedures in clinical practice. PMID:26106343

Landing strategies focusing on the control of tibial rotation in the initial contact period of one-leg forward hops.

PubMed

Chen, W-L; Chen, Y-T; Huang, S-Y; Yang, C-Y; Wu, C-D; Chang, C-W

2017-08-01

Anterior cruciate ligament (ACL) reconstruction (ACLR) surgeries successfully restore anterior tibial translation but not tibial rotation. This study aimed to explore landing strategies focusing on the control of tibial rotation at landing when the ACL is most vulnerable. Three groups of male subjects (50 ACLRs, 26 basketball players, and 31 controls) participated in one-leg forward hop tests for determining the tibial rotatory landing strategies adopted during the initial landing phase. The differences in knee kinematics and muscle activities between internal and external tibial rotatory (ITR, ETR) landing strategies were examined. A higher proportion of basketball players (34.6%) were found to adopt ITR strategies (controls: 6.5%), exhibiting significantly greater hopping distance and knee strength. After adjusting for hopping distance, subjects adopting ITR strategies were found to hop faster with straighter knees at foot contact and with greater ITR and less knee adduction angular displacement during the initial landing phase. However, significantly greater angular displacement in knee flexion, greater medial hamstring activities, and greater co-contraction index of hamstrings and medial knee muscles were also found during initial landing. Our results support the importance of the recruitments of medial hamstrings or the local co-contraction in assisting the rotatory control of the knee during initial landing for avoiding ACL injuries. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

"I Love Fruit But I Can't Afford It": Using Participatory Action Research to Develop Community-Based Initiatives to Mitigate Challenges to Chronic Disease Management in an African American Community Living in Public Housing.

PubMed

Rogers, Courtney; Johnson, Joy; Nueslein, Brianne; Edmunds, David; Valdez, Rupa S

2018-03-12

As chronic conditions are on the rise in the USA, management initiatives outside of the inpatient setting should be explored to reduce associated cost and access disparities. Chronic conditions disproportionately affect African American public housing residents due to the effects of historical marginalization on the manifestation of economic and social problems exacerbating health disparities and outcomes. Informed by participatory research action tenets, this study focused on identifying the challenges to management of chronic conditions and developing community-envisioned initiatives to address these challenges in a predominantly African American public housing community. Two focus groups were conducted with former and current public housing residents and were analyzed using inductive content analysis. Physical activity, the cost associated with healthy eating, and lack of information were noted as challenges to chronic disease management. Initiatives discussed were the formation of a walking partner's program to promote physical activity, a shopper's club to exchange coupons and learn how to prepare healthy meals, and a natural remedy's book to share information intergenerationally about management tactics. Challenges identified existed predominantly on the individual and the system level, while the initiatives generated target engaging interpersonal and community relationships. These community-envisioned approaches should be explored to facilitate chronic disease management in public housing neighborhoods.

Parent Perspectives on the Decision to Initiate Medication Treatment of Attention-Deficit/Hyperactivity Disorder

PubMed Central

Pappadopulos, Elizabeth; Katsiotas, Nikki J.; Berest, Alison; Jensen, Peter S.; Kafantaris, Vivian

2012-01-01

Abstract Objectives Despite substantial evidence supporting the efficacy of stimulant medication for children with attention-deficit/hyperactivity disorder (ADHD), adherence to stimulant treatment is often suboptimal. Applying social/cognitive theories to understanding and assessing parent attitudes toward initiating medication may provide insight into factors influencing parent decisions to follow ADHD treatment recommendations. This report describes results from formative research that used focus groups to obtain parent input to guide development of a provider-delivered intervention to improve adherence to stimulants. Methods Participants were caregivers of children with ADHD who were given a stimulant treatment recommendation. Focus groups were recorded and transcribed verbatim. Data were analyzed by inductive, grounded theory methods as well as a deductive analytic strategy using an adapted version of the Unified Theory of Behavior Change to organize and understand parent accounts. Results Five groups were conducted with 27 parents (mean child age=9.35 years; standard deviation [SD]=2.00), mean time since diagnosis=3.33 years (SD=2.47). Most parents (81.5%) had pursued stimulant treatment. Inductive analysis revealed 17 attitudes facilitating adherence and 25 barriers. Facilitators included parent beliefs that medication treatment resulted in multiple functional gains and that treatment was imperative for their children's safety. Barriers included fears of personality changes and medication side effects. Complex patterns of parent adherence to medication regimens were also identified, as well as preferences for psychiatrists who were diagnostically expert, gave psychoeducation using multiple modalities, and used a chronic illness metaphor to explain ADHD. Theory-based analyses revealed conflicting expectancies about treatment risks and benefits, significant family pressures to avoid medication, guilt and concern that their children required medication, and distorted ideas about treatment risks. Parents, however, took pride in successfully pursuing efforts to manage their child behaviorally and to avoid medication when possible. Conclusions Focus group data identified social, cognitive, and affective influences on treatment decision making. Results support prior research comparing family/social functioning, physician characteristics, and adherence. Findings suggest that parent attitudes to psychiatric care need to be assessed comprehensively at initial evaluation to aid the development of psychoeducational messages, and a more careful consideration about how parents interpret and respond to adherence-related questioning. PMID:22537185

What Is the Key for Older People to Show Interest in Playing Digital Learning Games? Initial Qualitative Findings from the LEAGE Project on a Multicultural European Sample.

PubMed

Diaz-Orueta, Unai; Facal, David; Nap, Henk Herman; Ranga, Myrto-Maria

2012-04-01

Learning digital games can influence both older adults' health condition and their capacity to carry on activities in their actual environment. The goal of the current study was to explore and define the user requirements for developing digital learning games for older Europeans, focusing on types of learning games, motivational and social aspects, and preferences on game controllers. For this initial stage, a qualitative focus group study was performed in three participating countries (Spain, The Netherlands, and Greece) where both games existing in the market and others developed in other European Commission projects like HERMES were presented to them, both on video presentations and also with the possibility to actually test some of them. Challenge, socialization, fun, providing learning opportunities, and escape from daily routine were extracted as the main keys why older people would be interested in playing digital games. Users described themselves as active and participating in many leisure activities, and this level of activity appeared to be related with the contents proposed for digital games, such as physical activity, culture, arts, and other human sciences (history, geography, traveling, foreign languages, music), and daily life skills (cooking, computer use, first aid). The knowledge gathered from the focus groups will be used as input for the design of a learning game that will be largely compatible with the needs and abilities of a wide range of older Europeans.

Consumer response to a report card comparing healthcare systems.

PubMed

Braun, Barbara L; Kind, Elizabeth A; Fowles, Jinnet B; Suarez, Walter G

2002-06-01

Report cards to date have focused on quality of care in health plans rather than within healthcare delivery systems. The purpose of this study was to evaluate consumer response to the first healthcare system-level report card. Qualitative assessment of consumer response. We conducted 5 focus groups of community members to evaluate consumer response to the report card; 2 included community club members, 3 included community-dwelling retired persons. Discussions were audiotaped and transcribed; comments were categorized by topic area from the script, and common themes identified. Focus group participants, in general, were unaware of the current emphasis on medical quality improvement initiatives. However, they believed that the opinion that the descriptive clinic information and patient survey data contained in the report card would be most useful mainly for choosing a healthcare system if they were dissatisfied with current medical care, if their healthcare options changed, or if they were in poor health. Personal experience was considered a more trustworthy measure of healthcare quality than were patient survey results. Trustworthiness was perceived to be higher if the report card sponsor was not affiliated with the healthcare systems being evaluated. Participants also believed care system administrators should use the data to enact positive clinic-level and physician-level changes. Healthcare consumers appreciated the attention to patient experiences and supported healthcare quality improvement initiatives. Report cards were considered important for choosing a healthcare system in certain circumstances and for guiding quality improvement efforts at all levels.

Parents' Perspectives About Factors Influencing Adherence to Pharmacotherapy for ADHD.

PubMed

Ahmed, Rana; Borst, Jacqueline; Wei, Yong C; Aslani, Parisa

2017-01-01

The aim of the present study was to explore factors influencing parents' decisions to adhere and persist with ADHD pharmacotherapy in children. Focus groups ( n = 3) were conducted with 16 parents recruited from metropolitan Sydney. Group discussions explored factors impacting on treatment initiation, continuation, and cessation. Focus groups were audio-recorded, transcribed verbatim, and thematically content analyzed. Parents commenced and continued pharmacotherapy due to its positive impact on their child's behavior. Improvements in the child's academic performance and social interactions encouraged persistence with therapy. Parents elected to cease therapy after their children experienced side effects including appetite suppression, weight loss, and sleep disturbances. Concerns about long-term effects of ADHD medication use including potential for addiction and growth stunting, in addition to the stigma surrounding ADHD also contributed to parents ceasing treatment. The findings highlight a need for the provision of accurate information about ADHD and its treatments to parents to empower their treatment decisions and promote adherence.

An educative support group for female family caregivers: impact on caregivers psychological distress and patient's neuropsychiatry symptoms.

PubMed

Javadpour, Ali; Ahmadzadeh, Laaya; Bahredar, Mohammad Jafar

2009-05-01

In developing world most patients with dementia live in the community. And female family caregivers are the primary source to delivering care to patients. Educating and supporting the careers may reduce psychological distress and the challenging behavior as well. We run a non pharmacological intervention focusing on education regarding dementia, behavioral problems and interactive self support group. Twenty nine female family caregivers were assigned and divided in two groups of 15 and 14. Two hours weekly sessions were conducted for 8 weeks. Baseline and outcome measures were assessed using neuropsychiatry Inventory (NPI), general health questionnaire and perceived stress scale (PSS). Initial co relational analysis demonstrated a significant correlation between GHQ and total NPI scores but not for PSS. Paired sample test revealed significant change from baseline and at the end in both GHQ score and neuropsychiatry symptoms. This study supports the use of a non-pharmacologic intervention focusing on education in a feasible and cost benefit setting for dementia caregivers. (c) 2008 John Wiley & Sons, Ltd.

Verb Morphology in Catalan and Spanish in Children with Specific Language Impairment: A Developmental Study

ERIC Educational Resources Information Center

Sanz-Torrent, Monica; Serrat, Elisabet; Andreu, Llorenc; Serra, Miquel

2008-01-01

In this article we examine language processing and development in Catalan or Spanish-speaking children with SLI, focusing on the study of the verb. We analyse the key initial phase of its process of acquisition and aim to define common features of the SLI group that distinguish them from children with normal language development. We intend to…

The Formation of a Socioeconomic Health Disparity: The Case of Cocaine Use during the 1980s and 1990s

ERIC Educational Resources Information Center

Miech, Richard

2008-01-01

Despite the substantial and prolonged sociological interest in health disparities, much remains unknown about the processes that initiate them. To investigate this topic, we focus on the case study of cocaine use, for which a socioeconomic disparity emerged across all age groups in a short period of time around 1990. We examine whether the…

Welfare to Wages: Strategies To Assist the Private Sector To Employ Welfare Recipients. Companion Case Studies, Focus Groups & Data Analysis.

ERIC Educational Resources Information Center

Roberts, Brandon; Padden, Jeffrey D.

This report, which is directed toward policymakers at the local, state, and national levels, is based on an extensive nationwide study of welfare-to-work initiatives. It identifies strategies to assist the private sector in employing welfare recipients. The document begins with an executive summary that discusses the following: the research study…

Improving the Reading of Bisyllabic Words That Involve Context-Sensitive Spelling Rules: Focus on Successes or on Failures?

ERIC Educational Resources Information Center

Steenbeek-Planting, Esther G.; van Bon, Wim H. J.; Schreuder, Robert

2013-01-01

The effect of two training procedures on the improvement of reading accuracy in poor readers was examined in relation to their initial reading level. A randomized controlled trial was conducted with 60 poor readers. Poor readers were assigned to a control group that received no training, or one of two training conditions. One training concentrated…

Increasing Opportunities for Older Youth in After-School Programs. A Report on the Experiences of Boys & Girls Clubs in Boston and New York City.

ERIC Educational Resources Information Center

Herrera, Carla; Arbreton, Amy J. A.

Boys & Girls Clubs in New York City and Boston participated in a 3-year initiative to provide and enhance services to underserved teens. Researchers collected data via surveys of club members and staff; cost surveys of club administrators; interviews, focus groups, and observations at each club; and attendance information. Results indicated…

The Winding Valley of Grief: When a Dog Guide Retires or Dies

ERIC Educational Resources Information Center

Schneider, Katherine Standish

2005-01-01

Schools that train dog guides work hard to help their clients bond with their new partners, but during the initial training, little is said about the other end of the process, for example, when it is time to say good-bye. When people return for subsequent dogs, a grief group or individual counseling may be offered, but the focus remains on moving…

Student-Issued One-to-One Laptop Computers on Secondary Campuses in Four Texas School Districts: A Phenomenological Case Study

ERIC Educational Resources Information Center

Hoyer, Randall J.

2011-01-01

The purpose of this phenomenological case study was to investigate the impact of one-to-one student issued laptop computers on secondary campuses in four rural Texas school districts. Data were collected using focus groups which included 27 leaders in four rural Texas school districts that had implemented the one-to-one laptop initiative. The…

The Pedagogical Use of Mobile Speech Synthesis (TTS): Focus on French Liaison

ERIC Educational Resources Information Center

Liakin, Denis; Cardoso, Walcir; Liakina, Natallia

2017-01-01

We examine the impact of the pedagogical use of mobile TTS on the L2 acquisition of French liaison, a process by which a word-final consonant is pronounced at the beginning of the following word if the latter is vowel-initial (e.g. peti/t.a/mi = > peti[ta]mi "boyfriend"). The study compares three groups of L2 French students learning…

Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST

PubMed Central

Zullo, Melissa; Boxer, Rebecca; Moore, Shirley M.

2012-01-01

Patients recovering from cardiac events are increasingly using postacute care, such as home health care and skilled nursing facility services. The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self- Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation program were compared in a sample of 38 older adults; 17 who received the Cardiac TRUST program and 21 who received usual care only. At discharge from postacute care, the intervention group had a trend for higher levels of self-efficacy for exercise outcomes (X=39.1, SD=7.4) than the usual care group (X=34.5; SD=7.0) (t-test 1.9, p=.06). During the 6 weeks following discharge, compared with the usual care group, the intervention group had more attendance in out-patient cardiac rehabilitation (33% compared to 11.8%, F=7.1, p=.03) and a trend toward more steps walked during the first week (X=1,307, SD=652 compared to X=782, SD=544, t-test 1.8, p=.07). The feasibility of the intervention was better for the home health participants than for those in the skilled nursing facility and there were no safety concerns. The provision of cardiac-focused rehabilitation during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient cardiac rehabilitation for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted. PMID:22084960

HIV-positive pregnant and postpartum women's perspectives about Option B+ in Malawi: a qualitative study.

PubMed

Katirayi, Leila; Namadingo, Hazel; Phiri, Mafayo; Bobrow, Emily A; Ahimbisibwe, Allan; Berhan, Aida Yemane; Buono, Nicole; Moland, Karen Marie; Tylleskär, Thorkild

2016-01-01

The implementation of lifelong antiretroviral treatment (ART) for all pregnant women (Option B+) in Malawi has resulted in a significant increase in the number of HIV-positive pregnant women initiating treatment. However, research has highlighted the challenge of retaining newly initiated women in care. This study explores barriers and facilitators that affect a woman's decision to initiate and to adhere to Option B+. A total of 39 in-depth interviews and 16 focus group discussions were conducted. Eligible women were ≥18 years old, living with HIV and either pregnant and receiving antenatal care from a study site or had delivered a child within the last 18 months, breastfed their child and received services at one of the study sites. Eligible women were identified by healthcare workers (HCWs) in the antenatal clinic and ART unit. Focus groups were also conducted with HCWs employed in these departments. Qualitative data were analyzed using Maxqda version 10 (VERBI Software, Berlin, Germany). The general perception towards the drug regimen used in Option B+ was positive; women reported fewer side effects and acknowledged the positive benefits of ART. Women felt hopeful about prolonging their life and having an HIV-uninfected baby, yet grappled with the fact that ART is a lifelong commitment. Women and HCWs discussed challenges with the counselling services for prevention of mother-to-child HIV transmission under the new Option B+ guidelines, and many women struggled with initiating ART on the same day as learning their HIV status. Women wanted to discuss their circumstances with their husbands first, receive a CD4 count and obtain an HIV test at another facility to confirm their HIV status. HCWs expressed concern that women might just agree to take the drugs to please them. HCWs also discussed concerns around loss to follow-up and drug resistance. Although Option B+ has significantly increased the number of women initiating ART, there are still challenges that need to be addressed to strengthen initiation, adherence and retention in care. Strategies to strengthen the counselling services upon diagnosis need to be developed to improve same-day initiation of ART and long-term adherence.

HIV-positive pregnant and postpartum women's perspectives about Option B+ in Malawi: a qualitative study

PubMed Central

Katirayi, Leila; Namadingo, Hazel; Phiri, Mafayo; Bobrow, Emily A; Ahimbisibwe, Allan; Berhan, Aida Yemane; Buono, Nicole; Moland, Karen Marie; Tylleskär, Thorkild

2016-01-01

Introduction The implementation of lifelong antiretroviral treatment (ART) for all pregnant women (Option B+) in Malawi has resulted in a significant increase in the number of HIV-positive pregnant women initiating treatment. However, research has highlighted the challenge of retaining newly initiated women in care. This study explores barriers and facilitators that affect a woman's decision to initiate and to adhere to Option B+. Methods A total of 39 in-depth interviews and 16 focus group discussions were conducted. Eligible women were ≥18 years old, living with HIV and either pregnant and receiving antenatal care from a study site or had delivered a child within the last 18 months, breastfed their child and received services at one of the study sites. Eligible women were identified by healthcare workers (HCWs) in the antenatal clinic and ART unit. Focus groups were also conducted with HCWs employed in these departments. Qualitative data were analyzed using Maxqda version 10 (VERBI Software, Berlin, Germany). Results The general perception towards the drug regimen used in Option B+ was positive; women reported fewer side effects and acknowledged the positive benefits of ART. Women felt hopeful about prolonging their life and having an HIV-uninfected baby, yet grappled with the fact that ART is a lifelong commitment. Women and HCWs discussed challenges with the counselling services for prevention of mother-to-child HIV transmission under the new Option B+ guidelines, and many women struggled with initiating ART on the same day as learning their HIV status. Women wanted to discuss their circumstances with their husbands first, receive a CD4 count and obtain an HIV test at another facility to confirm their HIV status. HCWs expressed concern that women might just agree to take the drugs to please them. HCWs also discussed concerns around loss to follow-up and drug resistance. Conclusions Although Option B+ has significantly increased the number of women initiating ART, there are still challenges that need to be addressed to strengthen initiation, adherence and retention in care. Strategies to strengthen the counselling services upon diagnosis need to be developed to improve same-day initiation of ART and long-term adherence. PMID:27312984

Additional follow-up telephone counselling and initial smoking relapse: a longitudinal, controlled study.

PubMed

Wu, Lei; He, Yao; Jiang, Bin; Zuo, Fang; Liu, Qinghui; Zhang, Li; Zhou, Changxi

2016-04-20

Smoking cessation services can help smokers to quit; however, many smoking relapse cases occur over time. Initial relapse prevention should play an important role in achieving the goal of long-term smoking cessation. Several studies have focused on the effect of extended telephone support in relapse prevention, but the conclusions remain conflicting. From October 2008 to August 2013, a longitudinal, controlled study was performed in a large general hospital of Beijing. The smokers who sought treatment at our smoking cessation clinic were non-randomised and divided into 2 groups: face-to-face individual counselling group (FC group), and face-to-face individual counselling plus telephone follow-up counselling group (FCF group). No pharmacotherapy was offered. The timing of initial smoking relapse was compared between FC and FCF groups. Predictors of initial relapse were investigated during the first 180 days, using the Cox proportional hazards model. Of 547 eligible male smokers who volunteered to participate, 457 participants (117 in FC group and 340 in FCF group) achieved at least 24 h abstinence. The majority of the lapse episodes occurred during the first 2 weeks after the quit date. Smokers who did not receive the follow-up telephone counselling (FC group) tended to relapse to smoking earlier than those smokers who received the additional follow-up telephone counselling (FCF group), and the log-rank test was statistically significant (p=0.003). A Cox regression model showed that, in the FCF group, being married, and having a lower Fagerström test score, normal body mass index and doctor-diagnosed tobacco-related chronic diseases, were significantly independent protective predictors of smoking relapse. Within the limitations of this study, it can be concluded that additional follow-up telephone counselling might be an effective strategy in preventing relapse. Further research is still needed to confirm our findings. 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/

Prescription opioid abuse and diversion in an urban community: the results of an ultrarapid assessment.

PubMed

Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Beard, Ronald A

2009-04-01

Prescription-drug diversion is a topic about which comparatively little is known, and systematic information garnered from prescription-drug abusers and dealers on the specific mechanisms of diversion is extremely limited. A pilot ultrarapid assessment was carried out in Wilmington, Delaware, during December 2006 to better understand the scope and dynamics of prescription-drug abuse and diversion. This involved focus groups with prescription-drug abusers and key informant interviews with police, regulatory officials, prescription-drug dealers, and pill brokers. The research team recruited focus group participants from the two residential substance abuse treatment programs in Wilmington reporting the highest proportions of prescription drug abusing clients. A total of six focus groups were conducted with 32 patients in these two programs. Dealers were recruited from the same treatment facilities, and three in-depth interviews were completed. In-depth interviews were also conducted with two prescription pill brokers recruited through the authors' existing contacts in the drug abusing community. Six in-depth interviews were conducted with representatives from a number of Delaware agencies-the Attorney General's Office, the Department of Professional Regulation, the State Police; the Wilmington Police Department, and the Newark Police Department. In-depth interview and focus group guides were developed for each of the target populations. The in-depth interviews with police and regulatory officials focused on the extent of prescription drug abuse and diversion in the community, the types of drugs most commonly diverted, and mechanisms being used to channel the drugs to the illicit market. The focus group areas of inquiry with prescription drug abusers included general perceptions of the prescription drug problem in Delaware, sources and mechanisms of access to prescription drugs, popularity and prices of prescription medications on the street, as well as the initiation and progression of prescription and illicit drug abuse. The primary sources of prescription drugs on the street were the elderly, patients with pain, and doctor shoppers, as well as pill brokers and dealers who work with all of the former. The popularity of prescription drugs in the street market was rooted in the abusers' perceptions of these drugs as 1) less stigmatizing; 2) less dangerous; and, 3) less subject to legal consequences than illicit drugs. For many, the abuse of prescription opioids also appeared to serve as a gateway to heroin use. The diversion of prescription opioids might be reduced through physician education focusing on 1) recognizing that a patient is misusing and/or diverting prescribed medications; 2) considering a patient's risk for opioid misuse before initiating opioid therapy; and 3) understanding the variation in the abuse potential of different opioid medications currently on the market. Patient education also appears appropriate in the areas of safeguarding medications, disposal of unused medications, and understanding the consequences of manipulating physicians and selling their medications.

From Doing to Learning: Changed focus during a pre-school learning study project on organic decomposition

NASA Astrophysics Data System (ADS)

Ljung-Djärf, Agneta; Magnusson, Andreas; Peterson, Sam

2014-03-01

We explored the use of the learning study (LS) model in developing Swedish pre-school science learning. This was done by analysing a 3-cycle LS project implemented to help a group of pre-school teachers (n = 5) understand their science educational practice, by collaboratively and systematically challenging it. Data consisted of video recordings of 1 screening (n = 7), 1 initial planning meeting, 3 analysis meetings, 3 interventions, and 78 individual test interviews with the children (n = 26). The study demonstrated that the teachers were initially uncomfortable with using scientific concepts and with maintaining the children's focus on the object of learning without framing it with play. During the project, we noted a shift in focus towards the object of learning and how to get the children to discern it. As teachers' awareness changed, enhanced learning was noted among the children. The study suggests that the LS model can promote pre-school science learning as follows: by building on, re-evaluating, and expanding children's experiences; and by helping the teachers focus on and contrast critical aspects of an object of learning, and to reflect on the use of play, imagination, and concepts and on directing the children's focus when doing so. Our research showed that the LS model holds promise to advance pre-school science learning by offering a theoretical tool useable to shift the focus from doing to learning while teaching science using learning activities.

Initiatives to improve feedback culture in the final year of a veterinary program.

PubMed

Warman, Sheena M; Laws, Emma J; Crowther, Emma; Baillie, Sarah

2014-01-01

Despite the recognized importance of feedback in education, student satisfaction with the feedback process in medical and veterinary programs is often disappointing. We undertook various initiatives to try to improve the feedback culture in the final clinical year of the veterinary program at the University of Bristol, focusing on formative verbal feedback. The initiatives included E-mailed guidelines to staff and students, a faculty development workshop, and a reflective portfolio task for students. Following these initiatives, staff and students were surveyed regarding their perceptions of formative feedback in clinical rotations, and focus groups were held to further explore issues. The amount of feedback appeared to have increased, along with improved recognition of feedback by students and increased staff confidence and competence in the process. Other themes that emerged included inconsistencies in feedback among staff and between rotations; difficulties with giving verbal feedback to students, particularly when it relates to professionalism; the consequences of feedback for both staff and students; changes and challenges in students' feedback-seeking behavior; and the difficulties in providing accurate, personal end-of-rotation assessments. This project has helped improve the feedback culture within our clinics; the importance of sustaining and further developing the feedback culture is discussed in this article.

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.

Mobile information and communication in the hospital outpatient service.

PubMed

Jen, Wen-Yuan; Chao, Chia-Chen; Hung, Ming-Chien; Li, Yu-Chuan; Chi, Y P

2007-08-01

Most healthcare providers provide mobile service for their medical staff; however, few healthcare providers provide mobile service as part of their outpatient service. The mobile outpatient service system (MOSS) focuses on illness treatment, illness prevention and patient relation management for outpatient service users. Initiated in a local hospital in Taiwan, the MOSS pilot project was developed to improve outpatient service quality and pursue higher patient safety. This study focuses on the development of the MOSS. The workflow, architecture and target users of the MOSS are delineated. In addition, there were two surveys conducted as part of this study. After a focus group of medical staff identified areas in which outpatient services might be improved by the MOSS, the first survey was administered to outpatients to confirm the focus group's intuitions. The second administration of the survey explored outpatient satisfaction after they used the MOSS service. With regard to outpatient attitudes, about 93% of participants agreed that the mobile outpatient service improved outpatient service quality. In the area of outpatient satisfaction, about 89% of participants indicated they were satisfied with the mobile outpatient service. Supported by our study finding, we propose that more diverse mobile outpatient services can be provided in the future.

Compound scale-up at the discovery-development interface.

PubMed

Nikitenko, Antonia A

2006-11-01

As a result of an economically challenging environment within the pharmaceutical industry, pharmaceutical companies and their departments must increase productivity and cut costs to stay in line with the market. Discovery-led departments such as the medicinal chemistry and lead optimization groups focus on synthesizing large varieties of compounds in minimal amounts, while the chemical development groups must then deliver a few chosen leads employing an optimized synthesis method and using multi-kilogram quantities of material. A research group at the discovery-development interface has the task of medium-scale synthesis which is important in the lead selection stage. The primary objective of this group is the initial scale-up of promising leads for extensive physicochemical and biological testing. The challenge of the interface group involves overcoming synthetic issues within the rigid, accelerated timelines.

Formation of an environmental restoration user group for radiological controls

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

Morris, R.L.

1993-12-31

An Environmental Restoration User Group for Radiological Controls will be proposed. Article 116 of the Radiological Control Manual encourages contractors to establish informal working associations that promote dialogue among similar facilities. Chem-Nuclear Geotech, Inc., is willing to initially organize and lead a users group to work on common problems, define standard methods, publish a Radiological Work Practices Handbook, and recommend regulatory changes to make environmental restoration programs more cost effective without compromising radiological control. A charter for the users group will be proposed. A questionnaire will be distributed to interested persons to assist in development of focus groups and agendamore » items for the first meeting. The first meeting is planned for May 25-26, 1993, in Grand Junction Colorado. All interested persons are welcome to attend.« less

Combined dietary and exercise intervention for control of serum cholesterol in the workplace

NASA Technical Reports Server (NTRS)

Angotti, C. M.; Chan, W. T.; Sample, C. J.; Levine, M. S.

2000-01-01

PURPOSE: To elucidate a potential combined dietary and exercise intervention affect on cardiovascular risk reduction of the National Aeronautics and Space Administration Headquarters employees. DESIGN: A nonexperimental, longitudinal, clinical-chart review study (1987 to 1996) of an identified intervention group and a reference (not a control) group. SETTING: The study group worked in an office environment and participated in the annual medical examinations. SUBJECTS: An intervention group of 858 people with initially elevated serum cholesterol, and a reference group of 963 people randomly sampled from 10% of the study group. MEASURES: Serum cholesterol data were obtained for both groups, respectively, from pre- and postintervention and annual examinations. The reference group was adjusted by statistical exclusion of potential intervention participants. Regression equations (cholesterol vs. study years) for the unadjusted/adjusted reference groups were tested for statistical significance. INTERVENTION: An 8-week individualized, combined dietary and exercise program was instituted with annual follow-ups and was repeated where warranted. RESULTS: Only the unadjusted (but not the adjusted) reference group with initial mean total serum cholesterol levels above 200 mg/dL shows a significant 9-year decline trend and significant beta coefficient tests. An intervention effect is suggested. Mean high density lipoprotein cholesterol rose slightly in the intervention group but was maintained in the reference group. CONCLUSION: With potential design limitations, the NASA intervention program focusing on a high risk group may be associated to some degree, if not fully, with an overall cardiovascular risk profile improvement.

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.

Embracing technology? Using change management strategies to improve the use of continuous lateral rotation therapy.

PubMed

Cybulski, Pamela; Zantinge, Johanna; Abbott-McNeil, Deanna

2006-01-01

The purpose of this quality improvement initiative was to improve the utilization of continuous lateral rotation therapy (CLRT) in a nine-bed community hospital ICU within the context of a nurse-driven protocol. Nursing focus groups, analyzed using a strength, weakness, opportunity, threat (SWOT) approach, resulted in the implementation of four interventions over seven weeks. Change management strategies guided all aspects of the project. Results showed a modest increase in the utilization of CLRT. This initiative demonstrates that change management strategies may assist with the incorporation of technology into nursing practice by increasing empowerment and creating an attachment to and responsibility for outcomes.

Using a qualitative approach for understanding hospital-affiliated integrated clinical and fitness facilities: characteristics and members' experiences.

PubMed

Yang, Jingzhen; Kingsbury, Diana; Nichols, Matthew; Grimm, Kristin; Ding, Kele; Hallam, Jeffrey

2015-06-19

With health care shifting away from the traditional sick care model, many hospitals are integrating fitness facilities and programs into their clinical services in order to support health promotion and disease prevention at the community level. Through a series of focus groups, the present study assessed characteristics of hospital-affiliated integrated facilities located in Northeast Ohio, United States and members' experiences with respect to these facilities. Adult members were invited to participate in a focus group using a recruitment flyer. A total of 6 focus groups were conducted in 2013, each lasting one hour, ranging from 5 to 12 participants per group. The responses and discussions were recorded and transcribed verbatim, then analyzed independently by research team members. Major themes were identified after consensus was reached. The participants' average age was 57, with 56.8% currently under a doctor's care. Four major themes associated with integrated facilities and members' experiences emerged across the six focus groups: 1) facility/program, 2) social atmosphere, 3) provider, and 4) member. Within each theme, several sub-themes were also identified. A key feature of integrated facilities is the availability of clinical and fitness services "under one roof". Many participants remarked that they initially attended physical therapy, becoming members of the fitness facility afterwards, or vice versa. The participants had favorable views of and experiences with the superior physical environment and atmosphere, personal attention, tailored programs, and knowledgeable, friendly, and attentive staff. In particular, participants favored the emphasis on preventive care and the promotion of holistic health and wellness. These results support the integration of wellness promotion and programming with traditional medical care and call for the further evaluation of such a model with regard to participants' health outcomes.

Repetitive shock wave therapy improves muscular microcirculation.

PubMed

Kisch, Tobias; Wuerfel, Waldemar; Forstmeier, Vinzent; Liodaki, Eirini; Stang, Felix H; Knobloch, Karsten; Mailaender, Peter; Kraemer, Robert

2016-04-01

Extracorporeal shock wave therapy (ESWT) is mainly applied in tendon as well as bone problems based on stem-cell activation and healing acceleration. The effect of ESWT on muscle tissue is much less understood to date. However, from a clinical perspective, muscle injuries are of distinct interest especially in elite athletes such as soccer players. A total of 26 rats were randomized into two groups. Group A received a single application of high-energetic focused ESWT (0.3 mJ/mm(2), 4 Hz, 1000 impulses, 10 J), whereas group B underwent the same procedure every 10 min for three sessions (3 × 0.3 mJ/mm(2), 4 Hz, 3 × 1000 impulses, totaling 30 J). Blood flow at a depth of 8 mm was measured continuously and noninvasively by a combined Laser-Doppler-Imaging and photospectrometric technique (Oxygen-to-see, O2C, LEA Medizintechnik, Germany). One minute after the application of high-energy ESWT blood flow in group A increased by 16.5% (P = 0.007). Thereafter, it decreased from minute 2 after application and remained significantly unchanged to baseline value until the end of the measuring period at 50 min (P = 0.550). Group B showed a similar significant increase in blood flow of 16.4% (P = 0.049) and a decrease afterward, too. After the second focused ESWT blood flow was boosted to 26.6% (P = 0.004), remaining significantly elevated until the third application was initiated. Muscular blood flow was increased to 29.8% after the third focused ESWT (P < 0.001), remaining significantly increased for another 10 min. Focused ESWT enhances blood flow in the muscle of rats. Moreover, repetitive ESWT extended this beneficial effect. Copyright © 2016 Elsevier Inc. All rights reserved.

Multiple spacecraft configuration designs for coordinated flight missions

NASA Astrophysics Data System (ADS)

Fumenti, Federico; Theil, Stephan

2018-06-01

Coordinated flight allows the replacement of a single monolithic spacecraft with multiple smaller ones, based on the principle of distributed systems. According to the mission objectives and to ensure a safe relative motion, constraints on the relative distances need to be satisfied. Initially, differential perturbations are limited by proper orbit design. Then, the induced differential drifts can be properly handled through corrective maneuvers. In this work, several designs are surveyed, defining the initial configuration of a group of spacecraft while counteracting the differential perturbations. For each of the investigated designs, focus is placed upon the number of deployable spacecraft and on the possibility to ensure safe relative motion through station keeping of the initial configuration, with particular attention to the required Δ V budget and the constraints violations.

Initiating policy, systems, and environmental changes for childhood obesity prevention by engaging six faith-based organizations.

PubMed

Boutain, Doris M; McNees, Molly

2013-01-01

Little is known about how to engage faith-organizations, especially churches, when using policy, systems, and environmental (PSE) change approaches for prevention. This article documents the PSE changes implemented by engaging 6 faith organizations, with an estimated reach of 3500 members, for 18 months. Timeline (n = 6), focus group (n = 6), report (n = 18), and observational meeting (n = 16) and event (n = 5) summaries were analyzed using content analysis. Early changes were usually environmental changes. Mid and later changes focused on policy and systems change. Churches structured for process and outcome accountability and person-centered accountability can accomplish PSE changes.

Patient participation in general practice based undergraduate teaching: a focus group study of patient perspectives

PubMed Central

Park, Sophie E; Allfrey, Caroline; Jones, Melvyn M; Chana, Jasprit; Abbott, Ciara; Faircloth, Sofia; Higgins, Nicola; Abdullah, Laila

2017-01-01

Background Patients make a crucial contribution to undergraduate medical education. Although a national resource is available for patients participating in research, none is as yet available for education. Aim This study aimed to explore what information patients would like about participation in general practice based undergraduate medical education, and how they would like to obtain this information. Design and setting Two focus groups were conducted in London-based practices involved in both undergraduate and postgraduate teaching. Method Patients both with and without teaching experience were recruited using leaflets, posters, and patient participation groups. An open-ended topic guide explored three areas: perceived barriers that participants anticipated or had experienced; patient roles in medical education; and what help would support participation. Focus groups were audiorecorded, transcribed, and analysed thematically. Results Patients suggested ways of professionalising the teaching process. These were: making information available to patients about confidentiality, iterative consent, and normalising teaching in the practice. Patients highlighted the importance of relationships, making information available about their GPs’ involvement in teaching, and initiating student–patient interactions. Participants emphasised educational principles to maximise exchange of information, including active participation of students, patient identification of student learner needs, and exchange of feedback. Conclusion This study will inform development of patient information resources to support their participation in teaching and access to information both before and during general practice based teaching encounters. PMID:28360073

The role of women in the donation consent decision: building on previous research.

PubMed

Dodd-McCue, Diane; Tartaglia, Alexander; Cowherd, Robin

2007-09-01

Recently published findings emphasize the dominant role of women in the donation discussion. With some noteworthy exceptions, the empirical literature on gender and donation, and the role of gender in healthcare decisions as well as donation, is limited. To provide preliminary information needed to begin theoretical or framework development and to initiate more rigorous research on the role of gender in donation discussions. This exploratory study is a descriptive qualitative retrospective study using focus group methodology. Two focus groups were conducted in 2 major cities in the organ procurement organization's service area. Participants were women who were involved in the donation discussion within the past 5 years; 6 participated in 1 session, 8 in the other. The focus group discussions highlight the role of women in the donation process relative to information needs, information usage, and the ensuring dynamics of the donation discussion. Compared to men, women tend to seek more information and reframe this information for others. Because women are frequently central in family communication networks, they serve as a communication conduit for other family members and may influence others. Involving key women decision makers in the early stages of the donation discussion and providing information elaboration build on women's central placement and role in family communication network processes. The significance of women's central placement may carry cultural implications, particularly for racial or ethnic groups with strong matriarchal or extended kinship structures.

Patient participation in general practice based undergraduate teaching: a focus group study of patient perspectives.

PubMed

Park, Sophie E; Allfrey, Caroline; Jones, Melvyn M; Chana, Jasprit; Abbott, Ciara; Faircloth, Sofia; Higgins, Nicola; Abdullah, Laila

2017-04-01

Patients make a crucial contribution to undergraduate medical education. Although a national resource is available for patients participating in research, none is as yet available for education. This study aimed to explore what information patients would like about participation in general practice based undergraduate medical education, and how they would like to obtain this information. Two focus groups were conducted in London-based practices involved in both undergraduate and postgraduate teaching. Patients both with and without teaching experience were recruited using leaflets, posters, and patient participation groups. An open-ended topic guide explored three areas: perceived barriers that participants anticipated or had experienced; patient roles in medical education; and what help would support participation. Focus groups were audiorecorded, transcribed, and analysed thematically. Patients suggested ways of professionalising the teaching process. These were: making information available to patients about confidentiality, iterative consent, and normalising teaching in the practice. Patients highlighted the importance of relationships, making information available about their GPs' involvement in teaching, and initiating student-patient interactions. Participants emphasised educational principles to maximise exchange of information, including active participation of students, patient identification of student learner needs, and exchange of feedback. This study will inform development of patient information resources to support their participation in teaching and access to information both before and during general practice based teaching encounters. © British Journal of General Practice 2017.

Development and Initial Validation of Military Deployment-Related TBI Quality-of-Life Item Banks.

PubMed

Toyinbo, Peter A; Vanderploeg, Rodney D; Donnell, Alison J; Mutolo, Sandra A; Cook, Karon F; Kisala, Pamela A; Tulsky, David S

2016-01-01

To investigate unique factors that affect health-related quality of life (QOL) in individuals with military deployment-related traumatic brain injury (MDR-TBI) and to develop appropriate assessment tools, consistent with the TBI-QOL/PROMIS/Neuro-QOL systems. Three focus groups from each of the 4 Veterans Administration (VA) Polytrauma Rehabilitation Centers, consisting of 20 veterans with mild to severe MDR-TBI, and 36 VA providers were involved in early stage of new item banks development. The item banks were field tested in a sample (N = 485) of veterans enrolled in VA and diagnosed with an MDR-TBI. Focus groups and survey. Developed item banks and short forms for Guilt, Posttraumatic Stress Disorder/Trauma, and Military-Related Loss. Three new item banks representing unique domains of MDR-TBI health outcomes were created: 15 new Posttraumatic Stress Disorder items plus 16 SCI-QOL legacy Trauma items, 37 new Military-Related Loss items plus 18 TBI-QOL legacy Grief/Loss items, and 33 new Guilt items. Exploratory and confirmatory factor analyses plus bifactor analysis of the items supported sufficient unidimensionality of the new item pools. Convergent and discriminant analyses results, as well as known group comparisons, provided initial support for the validity and clinical utility of the new item response theory-calibrated item banks and their short forms. This work provides a unique opportunity to identify issues specific to individuals with MDR-TBI and ensure that they are captured in QOL assessment, thus extending the existing TBI-QOL measurement system.

Epidermal growth factor receptor in non-small cell lung cancer

PubMed Central

2015-01-01

Following the identification of a group of patients in the initial tyrosine kinase inhibitor (TKI) trials for lung cancer, there has been detailed focus on which patients may benefit from inhibitor therapy. This article reviews the background, genetics and prevalence of epidermal growth factor mutations in non-small cell lung cancer (NSCLC). Additionally, the prevalence in unselected patients is compared against various other reviews. PMID:25870793

An Assessment of the Impact of Functional Literacy Initiatives for Women Groups towards Sustainable Livelihoods in the Savelugu/Nanton District of Ghana

ERIC Educational Resources Information Center

Mohammed, Adams Mashoud

2011-01-01

Most microcredit institutions focus on giving out credit to their clients with the assumption that these clients have the capacity and ability to manage the credit efficiently and the human capital to operate efficiently. There is evidence to show that most women in the Savelugu/Nanton district of Ghana have access to credit but lack the…

Small High Schools at Work: A Case Study of Six Gates-Funded Schools in New York City. A Report to the Bill & Melinda Gates Foundation

ERIC Educational Resources Information Center

Fancsali, Cheri; Jaffe-Walter, Reva; Mitchell-McKnight, Vernay; Nevarez, Nancy; Orellana, Eliana, Williams Rose, Lea

2010-01-01

The Academy for Educational Development (AED) conducted a case study of six public high schools in New York City as part of a multifaceted evaluation of a small schools initiative funded by the Bill & Melinda Gates Foundation. Through surveys, interviews, and focus groups, the authors gathered information and opinions from the schools'…

Succession planning and leadership development: critical business strategies for healthcare organizations.

PubMed

Collins, Sandra K; Collins, Kevin S

2007-01-01

As labor shortages intensify, succession planning and leadership development have become strategic initiatives requiring rigorous consideration. Traditional methods of replacing personnel will not accommodate the vacancies expected to plague healthcare organizations. Managers should focus on identifying potential gaps of key personnel and adapting programs to accommodate organizational need. Attention should be placed on capturing the intellectual capital existent in the organization and developing diverse groups of leadership candidates.

Psychosocial Aspects of ART Counseling: A Comparison of HIV Beliefs and Knowledge in PMTCT and ART-Naïve Women.

PubMed

Gouse, Hetta; Henry, Michelle; Robbins, Reuben N; Lopez-Rios, Javier; Mellins, Claude A; Remien, Robert H; Joska, John A

Antiretroviral therapy (ART)-readiness counseling has been deemed critical to adherence, instilling knowledge, and promoting positive beliefs and attitudes. In the landscape of changing policy in South Africa, some ART initiators have had prior ART-readiness counseling (e.g., for prevention-of-mother-to-child-transmission [PMTCT] programs). The extent to which previous counseling resulted in retained knowledge and belief is unknown, which may be important to the promotion of women's ART adherence. We compared 320 women living with HIV and initiating ART, with and without prior PMTCT on HIV knowledge, treatment, beliefs, and attitudes. The PMTCT group held more accurate beliefs and more positive attitudes about ART. Both groups lacked understanding of basic HIV biology. Nondisclosure of HIV status was high. Thus, in individuals re-initiating therapy, some knowledge about HIV and its treatment was not well retained. Tailored education and counseling may be critical to adherence, with a focus on biological concepts that impact ART resistance. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

National Institutes of Health Blood and Marrow Transplant Late Effects Initiative: The Healthcare Delivery Working Group Report

PubMed Central

Hashmi, Shahrukh K; Bredeson, Christopher; Duarte, Rafael F; Farnia, Stephanie; Ferrey, Susan; Fitzhugh, Courtney; Flowers, Mary ED; Gajewski, James; Gastineau, Dennis; Greenwald, Melissa; Jagasia, Madan; Martin, Patricia; Rizzo, J Douglas; Schmit-Pokorny, Kimberly; Majhail, Navneet S

2016-01-01

Hematopoietic cell transplantation (HCT) survivors are at risk for development of late complications and require lifelong monitoring for screening and prevention of late effects. There is an increasing appreciation of the issues related to healthcare delivery and coverage that are faced by HCT survivors. The 2016 National Institutes of Health Blood and Marrow Transplant Late Effects Initiative included an international and broadly representative Healthcare Delivery Working Group that was tasked with identifying research gaps pertaining to healthcare delivery and to identify initiatives that may yield a better understanding of the long-term value and costs of care for HCT survivors. There is a paucity of literature in this area. Critical areas in need of research include pilot studies of novel and information technology supported models of care delivery and coverage for HCT survivors along with development and validation of instruments that capture patient reported outcomes. Investment in infrastructure to support this research such as linkage of databases including electronic health records and routine inclusion of endpoints that will inform analyses focused around care delivery and coverage are required. PMID:27713091

Treatment of HIV infection: Swedish recommendations 2009.

PubMed

Josephson, Filip; Albert, Jan; Flamholc, Leo; Gisslén, Magnus; Karlström, Olof; Moberg, Lars; Navér, Lars; Svedhem, Veronica; Svennerholm, Bo; Sönnerborg, Anders

2009-01-01

On 4 previous occasions, in 2002, 2003, 2005 and 2007, the Swedish Medical Products Agency (Läkemedelsverket) and the Swedish Reference Group for Antiviral Therapy (RAV) have jointly published recommendations for the treatment of HIV infection. In November 2008, an expert group under the guidance of RAV once more revised the guidelines, of which this is a translation into English. The most important updates in the present guidelines include the following: (a) treatment initiation is now recommended at a CD4 cell count of approximately 350/microl; (b) new recommendations for first-line therapy: abacavir/lamivudine or tenofovir/emtricitabine in combination with efavirenz or a boosted protease inhibitor (PI/r); (c) an increased focus on reducing the use of antiretroviral drugs that may cause lipoatrophy; (d) an emphasis on quality assurance of HIV care through the use of InfCare HIV; (e) considerably altered recommendations for the initiation of antiretroviral therapy in children. All infants (<1 y) should start antiretroviral therapy, regardless of immune status. Also, absolute CD4+ cell counts, rather than percentage, may be used to guide treatment initiation in children above the age of 5 y.

Managing treatment for end-stage renal disease--a qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence.

PubMed

Griva, K; Ng, H J; Loei, J; Mooppil, N; McBain, H; Newman, S P

2013-01-01

Although adherence to hemodialysis (HD) regimes is important to maximise good clinical outcomes, it remains suboptimal and not well understood, particularly for those in non-Western settings and patients from Asian cultures. This qualitative study sought to explore cultural perspectives on facilitators and barriers to treatment adherence in HD patients. A descriptive exploratory design was used for the study, incorporating individual semi-structured interviews (n = 17) and three focus groups (n = 20). Each interview/focus group was audio-taped and transcribed verbatim, and coding was conducted by two coders using an iterative process. Study participants identified personal and social/contextual factors as major barriers or facilitators of treatment adherence. Barriers include time consumption, forgetfulness, concerns about safety, poor knowledge/understanding, poor communication and lack of control/social pressure. Participants also identified facilitators, both internal (self-initiated) and external (initiated by family, health care professional and peers) to ensure treatment adherence. These included support from family members and social obligation towards others, risk perception, establishment of routines and peer support. Internal and external factors can hinder or facilitate adherence to diet, fluid and medications in the context of dialysis. Several of these barriers/facilitators can be effectively addressed in the context of interventions and psycho-educational programmes.

Cruise ships and bush medicine: Globalization on the Atlantic Coast of Nicaragua and effects on the health of Creole women

PubMed Central

Mitchell, Emma McKim; Steeves, Richard; Dillingham, Rebecca

2014-01-01

Objectives Global health research into the relationship between health, economic inequalities, and globalization is necessary to address increasing health disparities in low income countries. Nicaragua has high levels of poverty and extreme poverty when compared with other Central and South American Countries. Design Photovoice and ethnographic research methods were used to explore health experiences of Creole women in Bluefields, Nicaragua and the intersections between culture, socioeconomic status, and gender. Sample Twelve Creole women participants, ages 18–45. Measurements After initial focus groups, participants used disposable cameras to document health experiences. Follow up interviews were conducted about the meaning of each photo. Participants then selected photos to be included in a city-wide photoshow. Results In initial focus groups, participants described great distress over changes they perceived in Creole culture and how these changes affect the health of the next generation. Participants related most of these changes to the economy and globalization. Photos taken were primarily of aspects of Creole culture, including household practices and traditional remedies from Creole culture. Conclusions Findings on the relationships between culture, disease and community-identified health risks in this minority population can help healthcare providers and public health policy makers develop and sustain culturally appropriate health interventions. PMID:24766610

Cruise ships and bush medicine: globalization on the Atlantic Coast of Nicaragua and effects on the health of Creole women.

PubMed

Mitchell, Emma McKim; Steeves, Richard; Dillingham, Rebecca

2015-01-01

Global health research into the relationship between health, economic inequalities, and globalization is necessary to address increasing health disparities in low income countries. Nicaragua has high levels of poverty and extreme poverty when compared with other Central and South American Countries. Photovoice and ethnographic research methods were used to explore health experiences of Creole women in Bluefields, Nicaragua and the intersections between culture, socioeconomic status, and gender. Twelve Creole women participants, ages 18-45. After initial focus groups, participants used disposable cameras to document health experiences. Follow-up interviews were conducted about the meaning of each photo. Participants then selected photos to be included in a city-wide photoshow. In initial focus groups, participants described great distress over changes they perceived in Creole culture and how these changes affect the health of the next generation. Participants related most of these changes to the economy and globalization. Photos taken were primarily of aspects of Creole culture, including household practices and traditional remedies from Creole culture. Findings on the relationships between culture, disease, and community-identified health risks in this minority population can help health care providers and public health policymakers develop and sustain culturally appropriate health interventions. © 2014 Wiley Periodicals, Inc.

Wyoming Landscape Conservation Initiative Science and Management Workshop Proceedings, May 12-14, 2009, Laramie, Wyoming

USGS Publications Warehouse

Nuccio, Vito F.; D'Erchia, Frank D.; Parady, K.(compiler); Mellinger, A.

2010-01-01

The U.S. Geological Survey (USGS) hosted the second Wyoming Landscape Conservation Initiative (WLCI) Science and Management Workshop at the University of Wyoming Conference Center and Hilton Garden Inn on May 12, 13, and 14, 2009, in Laramie, Wyo. The workshop focused on six topics seen as relevant to ongoing WLCI science and management activities: mapping and modeling resources for decisionmaking; data information and management; fish and wildlife research; changing landscapes; monitoring; and reclamation and offsite mitigation. Panelists gave presentations on ongoing research in these six areas during plenary sessions followed by audience discussions. Three breakout groups focused on discussing wildlife, reclamation, and monitoring. Throughout the plenary sessions, audience discussions, and breakout groups, several needs were repeatedly emphasized by panelists and workshop participants: developing a conservation plan and identifying priority areas and species for conservation actions; gaining a deeper understanding of sagebrush ecology; identifying thresholds for wildlife that can be used to create an 'early warning system' for managers; continuing to collect basic data across the landscape; facilitating even greater communication and partnership across agencies and between scientists and land managers; and engaging proactively in understanding new changes on the landscape such as wind energy development and climate change. Detailed proceedings from the workshop are captured and summarized in this report.

Focus Groups Move Online: Feasibility of Tumblr Use for eHealth Curriculum Development.

PubMed

Elliot, Diane; Rohlman, Diane; Parish, Megan

2015-03-27

Constructing successful online programs requires engaging potential users in development. However, assembling focus groups can be costly and time consuming. The aim of this study is to assess whether Tumblr can be used to prioritize activities for an online younger worker risk reduction and health promotion program. Younger summer parks and recreation employees were encouraged to visit Tumblr using weekly announcements and competitions. Each week, new activities were posted on Tumblr with linked survey questions. Responses were downloaded and analyzed. An average of 36 young workers rated each activity on its likeability and perceived educational value. The method was feasible, efficient, and sustainable across the summer weeks. Ratings indicated significant differences in likeability among activities (P<.005). Tumblr is a means to crowdsource formative feedback on potential curricular components when assembling an online intervention. This paper describes its initial use as well as suggestions for future refinements.

Planting Seeds to Grow Healthy Children: Strategic Community Partnerships.

PubMed

Alicea-Planas, Jessica; Sullivan, Kelly; Tran, Hang; Cruz, Anna

2018-02-01

More than one third of U.S adults are considered obese, and childhood obesity has more than doubled in the past 30 years. Food security can influence obesity, in particular, within inner cities where access to healthy food is often limited. The use of a mobile food truck program (with refrigeration) was implemented in two large inner cities in Connecticut as part of an initiative aimed at helping low-income families with young children gain access to healthy food and nutrition education. Collaborating with community child care centers was used. The experiences of the families who participated in the program were assessed via focus groups. Main ideas derived from the focus groups were participant satisfaction with money saving suggestions, ideas for how to make healthier choices, and excitement about opportunities to receive foods that they would not normally buy. This innovative mobile food truck program demonstrated the value of strategic community partnerships to influence health.

HPV Vaccine and Latino Immigrant Parents: If They Offer It, We Will Get It

PubMed Central

Genoff, Margaux; Gonzalez, Cynthia; Shuk, Elyse; Gany, Francesca

2015-01-01

HPV vaccination rates remain low in the fast growing Latino children population while we continue to observe large HPV-associated cancer disparities in the Latino population. In this study, we sought to elucidate Latino immigrant parents’ barriers to obtaining the HPV vaccine for their children. Five focus groups were conducted with Latino immigrant parents of minors (i.e., 9–17 year old) who had not yet initiated the HPV vaccine series. Three major findings were identified from the focus groups: (1) low levels of awareness and knowledge of HPV and the HPV vaccine, (2) high confidence that parent can get the vaccine for their eligible child and (3) lack of provider recommendation as the main barrier to vaccination. Children of Latino immigrant parents could benefit from increased provider recommendation for the HPV vaccine while providing tailored HPV information to parents. PMID:26001843

An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand.

PubMed

Han, Hahrie; Nicholas, Alexandra; Aimer, Margaret; Gray, Jonathon

2015-12-01

To examine whether being an organizer in a community organizing program improves personal agency and self-reported mental health outcomes among low-income Pacific Island youth in Auckland, New Zealand. Counties Manukau Health initiated a community organizing campaign led and run by Pacific Island youth. We used interviews, focus groups and pre- and post-campaign surveys to examine changes among 30 youths as a result of the campaign. Ten youths completed both pre- and post-campaign surveys. Eleven youths participated in focus groups, and four in interviews. Overall, youths reported an increased sense of agency and improvements to their mental health. Community organizing has potential as a preventive approach to improving mental health and developing agency over health among disempowered populations. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Defining engagement in adolescent substance abuse treatment.

PubMed

Pullmann, Michael D; Ague, Starcia; Johnson, Tamara; Lane, Stephanie; Beaver, Kevon; Jetton, Elizabeth; Rund, Evangejalynn

2013-12-01

Youth engagement in substance use treatment is an important construct for research and practice, but it has been thinly and inconsistently defined in the literature. Most research has measured engagement by initiation, attendance, and retention in treatment. Because youth generally enter substance use treatment as a result of compliance with external requirements, defining engagement in this way might be insufficient. This qualitative participatory research study describes five focus groups with 31 adults working with youth in substance use treatment. Focus groups were designed and conducted by youth researchers in collaboration with university-based partners. We categorized participants' descriptions of engagement into five domains, identified as "CARES": Conduct, Attitudes, Relationships, Empowerment, and Social Context. These domains represent a comprehensive and ecologically-based definition of engagement that situates engagement in the context and trajectory of youth development, has clear implications for assertive clinical practice, and provides a foundation for developing an operationalized measure.

Teacher quality: a comparison of National Board-certified and non-Board-certified teachers of deaf students.

PubMed

Scheetz, Nanci A; Martin, David S

2006-01-01

THE STUDY was designed to identify specific components of teacher excellence, focusing initially on the characteristics of the small number of teachers of the deaf who are certified by the National Board for Professional Teaching Standards (NBPTS), then comparing those with the characteristics of other teachers identified as master teachers by university faculty in teacher preparation in deafness. Classroom observation, written lesson plans, teacher questionnaires on beliefs, and content analysis of interactive electronic focus groups were used to compare the two groups of teachers. Results indicated similarities between Board-certified and non-Board-certified master teachers in regard to teacher behaviors and commitment to well-founded pedagogical principles. Differences were found in classroom priorities and in the greater level of interconnectivity expressed by Board-certified teachers as the result of becoming Board certified. Recommendations are made for preparing teachers of deaf students.

High energy physics in cosmic rays

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

Jones, Lawrence W.

2013-02-07

In the first half-century of cosmic ray physics, the primary research focus was on elementary particles; the positron, pi-mesons, mu-mesons, and hyperons were discovered in cosmic rays. Much of this research was carried out at mountain elevations; Pic du Midi in the Pyrenees, Mt. Chacaltaya in Bolivia, and Mt. Evans/Echo Lake in Colorado, among other sites. In the 1960s, claims of the observation of free quarks, and satellite measurements of a significant rise in p-p cross sections, plus the delay in initiating accelerator construction programs for energies above 100 GeV, motivated the Michigan-Wisconsin group to undertake a serious cosmic raymore » program at Echo Lake. Subsequently, with the succession of higher energy accelerators and colliders at CERN and Fermilab, cosmic ray research has increasingly focused on cosmology and astrophysics, although some groups continue to study cosmic ray particle interactions in emulsion chambers.« less

The effect of tuberculosis and tuberculosis contact tracing on school function: an exploratory focus group study.

PubMed

Upshur, R E; Deadman, L; Howorth, P; Shortt, L

1999-01-01

Selected schools in East York, an ethnically diverse municipality of 110,000 people within Toronto. To explore school staff's attitudes and beliefs about the nature of tuberculosis and its possible effect on the function and culture of schools. Four focus groups of 6-8 school staff, lasting from 1 to 1.5 hours, were held in the spring of 1997 at four different schools deemed to be at high risk for tuberculosis contact tracing. The study identified the following dominant themes: fear of tuberculosis and its impact on school, lack of knowledge and the need for education concerning tuberculosis, and issues in multiculturalism. Tuberculosis was perceived by staff of East York schools to be a source of fear. Lack of accurate and reliable information concerning tuberculosis contributes to this situation. Staff identified age-specific and culturally relevant, educational initiatives as means to reduce this fear.

Public and private dental services in NSW: a geographic information system analysis of access to care for 7 million Australians.

PubMed

Willie-Stephens, Jenny; Kruger, Estie; Tennant, Marc

2014-06-01

To investigate the distribution of public and private dental practices in NSW in relation to population distribution and socioeconomic status. Dental practices (public and private) were mapped and overlayed with Census data on Collection District population and Socio-Economic Indexes for Areas (SEIFA). Overall, there was an uneven geographic distribution of public and private dental practices across NSW. When the geographic distribution was compared to population socioeconomics it was found that in rural NSW, 12% of the most disadvantaged residents lived further than 50km from a public dental practice, compared to 0% of the least disadvantaged. In Sydney, 9% of the three most disadvantaged groups lived greater than 7.5km from a public dental practice, compared to 21% of the three least disadvantaged groups. The findings of this study can contribute to informing decisions to determine future areas for focus of dental resource development (infrastructure and workforce) and identifying subgroups in the population (who are geographically isolated from accessing care) where public health initiatives focused on amelioration of disease consequences should be a focus.

Aftershock communication during the Canterbury Earthquakes, New Zealand: implications for response and recovery in the built environment

USGS Publications Warehouse

Julia Becker,; Wein, Anne; Sally Potter,; Emma Doyle,; Ratliff, Jamie L.

2015-01-01

On 4 September 2010, a Mw7.1 earthquake occurred in Canterbury, New Zealand. Following the initial earthquake, an aftershock sequence was initiated, with the most significant aftershock being a Mw6.3 earthquake occurring on 22 February 2011. This aftershock caused severe damage to the city of Christchurch and building failures that killed 185 people. During the aftershock sequence it became evident that effective communication of aftershock information (e.g., history and forecasts) was imperative to assist with decision making during the response and recovery phases of the disaster, as well as preparedness for future aftershock events. As a consequence, a joint JCDR-USGS research project was initiated to investigate: • How aftershock information was communicated to organisations and to the public; • How people interpreted that information; • What people did in response to receiving that information; • What information people did and did not need; and • What decision-making challenges were encountered relating to aftershocks. Research was conducted by undertaking focus group meetings and interviews with a range of information providers and users, including scientists and science advisors, emergency managers and responders, engineers, communication officers, businesses, critical infrastructure operators, elected officials, and the public. The interviews and focus group meetings were recorded and transcribed, and key themes were identified. This paper focuses on the aftershock information needs for decision-making about the built environment post-earthquake, including those involved in response (e.g., for building assessment and management), recovery/reduction (e.g., the development of new building standards), and readiness (e.g. between aftershocks). The research has found that the communication of aftershock information varies with time, is contextual, and is affected by interactions among roles, by other information, and by decision objectives. A number of general and specific insights into improving the communication of aftershock information are provided.

Promising Practices in Citywide Afterschool Initiatives. CityWorks: Focus on Infrastructure.

ERIC Educational Resources Information Center

Hall, Georgia

This brief is the first in a series featuring promising practices in city-wide after-school initiatives, with a focus at the infrastructure level, focusing on the infrastructure representing the underlying elements or framework that hold a system or initiative together. The brief identifies practices to support the public relations function and…

Using and Applying Focus Groups in Climate Change Impact Assessment Projects

NASA Astrophysics Data System (ADS)

DeLorme, D.; Hagen, S.

2011-12-01

The focus group social science research method is an efficient and flexible data collection tool with broad applicability across disciplines and contexts. Through group dynamics, this interviewing approach offers strengths in gathering candid, spontaneous comments and detailed firsthand descriptions from stakeholders' perspectives. The method, which can stand alone or be integrated with other research frameworks, has much potential for helping to manage complex issues of global change. For optimal outcomes, however, careful planning and procedures are paramount. This presentation offers guidance in this regard via examples, tips, and lessons learned from a multidisciplinary NOAA-funded project: Ecological Effects of Sea Level Rise in the Northern Gulf of Mexico (EESLR-NGOM). Focus groups are a key component of the EESLR-NGOM project as they are being used to better understand coastal resource managers' operational and information behaviors and needs regarding sea level rise (SLR), erosion, and hurricane storm surge impact; to learn how to best develop and translate the project's expected scientific results into straightforward, useful, and readily-disseminated products; and to gather outreach recommendations. As part of an EESLR-NGOM project kickoff workshop, 12 coastal resource managers participated voluntarily in a focus group. A summary of findings and illustrative participant quotations will be included in the presentation. The initial focus group was productive in gaining insights into challenges and opportunities associated with a climate change project such as the EESLR-NGOM. It highlighted the importance of considering the interrelationships of natural and built environments and new avenues for resilience and sustainability. The coastal resource managers are not only end-users but also opinion leaders in their local communities who will diffuse this information widely through their networks of other potential end-users. Engaging coastal resource managers in this manner will result in successful communication and tailoring of the scientific products so that they are most appropriate and beneficial in helping to determine the viability of future management actions relative to predicted conditions and will put resource managers in a more knowledgeable position to inform policy makers as to the likely results of their decisions. Further, by addressing the gap in the interdisciplinary literature on regionally-based climate change issues as studied using qualitative social science research approaches such as focus groups, our work makes theoretical and methodological scholarly contributions.

Children's Oncology Group's 2013 blueprint for research: behavioral science.

PubMed

Noll, Robert B; Patel, Sunita K; Embry, Leanne; Hardy, Kristina K; Pelletier, Wendy; Annett, Robert D; Patenaude, Andrea; Lown, E Anne; Sands, Stephen A; Barakat, Lamia P

2013-06-01

Behavioral science has long played a central role in pediatric oncology clinical service and research. Early work focused on symptom relief related to side effects of chemotherapy and pain management related to invasive medical procedures. As survival rates improved, the focused has shifted to examination of the psychosocial impact, during and after treatment, of pediatric cancer and its treatment on children and their families. The success of the clinical trials networks related to survivorship highlights an even more critical role in numerous domains of psychosocial research and care. Within the cooperative group setting, the field of behavioral science includes psychologists, social workers, physicians, nurses, and parent advisors. The research agenda of this group of experts needs to focus on utilization of psychometrically robust measures to evaluate the impact of treatment on children with cancer and their families during and after treatment ends. Over the next 5 years, the field of behavioral science will need to develop and implement initiatives to expand use of standardized neurocognitive and behavior batteries; increase assessment of neurocognition using technology; early identification of at-risk children/families; establish standards for evidence-based psychosocial care; and leverage linkages with the broader behavioral health pediatric oncology community to translate empirically supported research clinical trials care to practice. Copyright © 2012 Wiley Periodicals, Inc.

Anticipated and Actual Implementation of Case-Based Learning by Dental Faculty Members During and After Training.

PubMed

Behar-Horenstein, Linda S; Catalanotto, Frank A; Nascimento, Marcelle M

2015-09-01

The aims of this study were to describe the processes used to train dental faculty members in case-based learning (CBL) and to determine their beliefs about the anticipated implementation of CBL and perceptions of actual implementation following use of the CBL approach. Participants were dental faculty members at the University of Florida who received a four-day intensive training course in the use of CBL. Two focus groups were conducted. The first occurred during training to assess how the participants anticipated using CBL. The second was conducted during the faculty members' implementation of CBL. All 19 trainees participated in focus group 1 (100%). During the course of the study, two faculty members left the school; of the remaining 17, 12 participated in focus group 2 (participation rate of 71%). The findings showed that initially the faculty members were hesitant and uncertain about using CBL. Following implementation, those issues dissipated, as the participants began to consider how to optimize the effectiveness of CBL as a legitimate method for fostering student ownership of learning and active participation. Understanding what CBL means for individual educators at varying stages of change will likely allow the dental education community to better anticipate and address tensions and challenges that faculty members are likely to experience.

Perceptions of sport science students on the potential applications and limitations of blended learning in their education: a qualitative study.

PubMed

Keogh, Justin W L; Gowthorp, Lisa; McLean, Michelle

2017-09-01

This study sought to gain insight into blended learning-naive sports science students' understanding and perceptions of the potential benefits and limitations of blended (hybrid) learning, which has been defined as the thoughtful integration of face-to-face and online instructional approaches. Five focus groups, each comprising 3-4 students from either the undergraduate or postgraduate sports science programmes were conducted. The focus groups were facilitated by a researcher who was not involved in sports science. Audio recordings of the focus groups were transcribed verbatim. NVivo software was used to code the transcripts to identify the themes and subthemes. Students generally had little initial understanding of blended learning. When provided with a definition, they believed that blended learning could improve educational outcomes and assist those who were legitimately unable to attend a session. Their reservations about blended learning mainly related to some students not being sufficiently autonomous to undertake independent study, timetabling considerations and access to reliable Internet services. For blended learning to be effective, students felt the online material had to be interactive, engaging and complement the face-to-face sessions. Better understanding the perceptions of the students in the current study may assist educators who are considering implementing blended learning in their teaching.

Engendering development and disasters.

PubMed

Bradshaw, Sarah

2015-01-01

Over the last two decades the different impacts of disasters on women and men have been acknowledged, leading to calls to integrate gender into disaster risk reduction and response. This paper explores how evolving understandings of ways of integrating gender into development have influenced this process, critically analysing contemporary initiatives to 'engender' development that see the inclusion of women for both efficiency and equality gains. It has been argued that this has resulted in a 'feminisation of responsibility' that can reinforce rather than challenge gender relations. The construction of women affected by disasters as both an at-risk group and as a means to reduce risk suggests similar processes of feminisation. The paper argues that if disaster risk reduction initiatives are to reduce women's vulnerability, they need to focus explicitly on the root causes of this vulnerability and design programmes that specifically focus on reducing gender inequalities by challenging unequal gendered power relations. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Laypersons' views of material incentives for enhancing colorectal cancer screening.

PubMed

Hagoel, Lea; Rennert, Gad; Feder-Bubis, Paula

2015-10-01

Colorectal cancer (CRC) early detection improves health outcomes; screening programmes invest efforts in initiating invitations to target populations to be tested. Enhanced adherence is essential for reduction of morbidity and mortality. Participation rates in Israel are still relatively low. To explore lay views regarding the concept of receiving material incentives in exchange for enhanced adherence to CRC screening. Qualitative study. Between November 2009 and February 2010 six focus group discussions were carried out in two urban, middle and low socio-economic status primary care clinics in a Northern city in Israel. Participants were eligible individuals for CRC screening, aged 50-68 (N = 24). Data analysis followed the principles of grounded theory, supported by qualitative software. Participants found administering incentives in exchange for CRC screening inappropriate on rational and moral grounds. They valued their relations with the medical team and the health system more than the potential gain expected. Individuals eligible for CRC screening perceived themselves as responsible for their health, admitting difficulties in realizing this responsibility. Incentives were reported unsuitable for solving reported screening difficulties and a potential harm to the doctor-patient relationship. Focus group participants expressed an unconventional voice towards the use of material incentives. They pointed to the need for focused support of health behaviour change and valued their autonomy. While a proportion of the invitees in the target population see the importance of screening and appreciate the HMO's initiative to invite them for testing, they also expressed their need for support from the HMO in realizing the recommended health behaviour. © 2013 John Wiley & Sons Ltd.

Exploring African-American and Latino Teens’ Perceptions of Contraception and Access to Reproductive Health Care Services

PubMed Central

Galloway, Charlotte T.; Duffy, Jennifer L.; Dixon, Rena P.; Fuller, Taleria R.

2017-01-01

Purpose Reducing disparities in teen pregnancy and birth rates among African American and Latina teens is a central focus of a community-wide teen pregnancy prevention initiative implemented by the South Carolina Campaign to Prevent Teen Pregnancy. Disparities in teen pregnancy and birth rates are driven, in part, by differential access to contraception and reproductive health care services. The purpose of this qualitative study was to understand African American and Latino teens’ 1) preferences for finding health information, 2) perceptions of accessing reproductive health services, and 3) beliefs about contraception. Methods As a part of this community-wide initiative, eight focus groups were conducted in the Fall of 2012 with African American and Latino male and female youth from two communities in South Carolina. Among eight focus groups of youth, teens most often reported parents, other trusted relatives, and the Internet as sources of health information. Results Participants discussed the value of social media and television advertisements for reaching young people and emphasized the importance of privacy, a desire for a teen-only clinic, and the need for friendly clinical staff. Participants’ comments often reflected inaccurate beliefs about the reliability and correct usage of contraceptive methods. Female participants also reported side effects of birth control as a potential barrier to use. Conclusions Ensuring that teens’ beliefs and perceptions are taken into account when developing, marketing, and implementing culturally competent reproductive health care services is important to improve access to care for all teens in Horry and Spartanburg Counties. PMID:28235437

Exploring African-American and Latino Teens' Perceptions of Contraception and Access to Reproductive Health Care Services.

PubMed

Galloway, Charlotte T; Duffy, Jennifer L; Dixon, Rena P; Fuller, Taleria R

2017-03-01

Reducing disparities in teen pregnancy and birth rates among African American and Latina teens is a central focus of a community-wide teen pregnancy prevention initiative implemented by the South Carolina Campaign to Prevent Teen Pregnancy. Disparities in teen pregnancy and birth rates are driven, in part, by differential access to contraception and reproductive health care services. The purpose of this qualitative study was to understand African American and Latino teens' 1) preferences for finding health information, 2) perceptions of accessing reproductive health services, and 3) beliefs about contraception. As a part of this community-wide initiative, eight focus groups were conducted in the Fall of 2012 with African American and Latino male and female youth from two communities in South Carolina. Among eight focus groups of youth, teens most often reported parents, other trusted relatives, and the Internet as sources of health information. Participants discussed the value of social media and television advertisements for reaching young people and emphasized the importance of privacy, a desire for a teen-only clinic, and the need for friendly clinical staff. Participants' comments often reflected inaccurate beliefs about the reliability and correct usage of contraceptive methods. Female participants also reported side effects of birth control as a potential barrier to use. Ensuring that teens' beliefs and perceptions are taken into account when developing, marketing, and implementing culturally competent reproductive health care services is important to improve access to care for all teens in Horry and Spartanburg Counties. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Telling our stories: heroin-assisted treatment and SNAP activism in the Downtown Eastside of Vancouver.

PubMed

Boyd, Susan; Murray, Dave; MacPherson, Donald

2017-05-18

This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver. This article highlights SNAP members' experiences as research subjects in Canada's second clinical trial conducted in Vancouver, Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), that began recruitment of research participants in 2011. This paper draws on one brainstorming session, three focus groups, and field notes, with the SALOME/NAOMI Association of Patients (SNAP) in late 2013 about their experiences as research subjects in Canada's second clinical trial, SALOME in the DTES of Vancouver, and fieldwork from a 6-year period (March 2011 to February 2017) with SNAP members. SNAP's research draws on research principles developed by drug user groups and critical methodological frameworks on community-based research for social justice. The results illuminate how participating in the SALOME clinical trial impacted the lives of SNAP members. In addition, the findings reveal how SNAP member's advocacy for HAT impacts the group in positive ways. Seven major themes emerged from the analysis of the brainstorming and focus groups: life prior to SALOME, the clinic setting and routine, stability, 6-month transition, support, exiting the trial and ethics, and collective action, including their participation in a constitutional challenge in the Supreme Court of BC to continue receiving HAT once the SALOME trial ended. HAT benefits SNAP members. They argue that permanent HAT programs should be established in Canada because they are an effective harm reduction initiative, one that also reduces opioid overdose deaths.

Esuba: a psychoeducation group for incarcerated survivors of abuse.

PubMed

Roe-Sepowitz, Dominique E; Bedard, Laura E; Pate, Kerensa N; Hedberg, E C

2014-02-01

This study examined the effects associated with a trauma and abuse-focused psychoeducation group for incarcerated women on decreasing trauma symptoms. A total of 320 women participated in 34 groups in five prisons that followed a manualized intervention. A one-group pretest-posttest design was used to examine changes on 10 Trauma Symptom Inventory subscales (Anxious Arousal, Depression, Anger/Irritability, Intrusive Experiences, Defensive Avoidance, Dissociation, Sexual Concerns, Dysfunctional Sexual Behavior, Impaired Self-Reference, and Tension Reduction Behavior). Analyses indicated significant improvement on all 10 trauma subscales. Small effect sizes were found on all of the subscales. The findings of this study are encouraging and are the first step toward more rigorous evaluation of this pilot program. These findings provide initial support for the use of group psychoeducation intervention to address traumatic stress symptoms with incarcerated women.

Racial/ethnic differences in the influence of cultural values, alcohol resistance self-efficacy, and alcohol expectancies on risk for alcohol initiation.

PubMed

Shih, Regina A; Miles, Jeremy N V; Tucker, Joan S; Zhou, Annie J; D'Amico, Elizabeth J

2012-09-01

Prior research has reported racial/ethnic differences in the early initiation of alcohol use, suggesting that cultural values that are central to specific racial/ethnic groups may be influencing these differences. This 1-year longitudinal study examines associations between two types of cultural values, parental respect (honor for one's parents) and familism (connectedness with family), both measured at baseline, and subsequent alcohol initiation in a sample of 6,054 (approximately 49% male, 57% Hispanic, 22% Asian, 18% non-Hispanic White, and 4% non-Hispanic Black) middle school students in Southern California. We tested whether the associations of cultural values with alcohol initiation could be explained by baseline measures of alcohol resistance self-efficacy (RSE) and alcohol expectancies. We also explored whether these pathways differed by race/ethnicity. In the full sample, adolescents with higher parental respect were less likely to initiate alcohol use, an association that was partially explained by higher RSE and fewer positive alcohol expectancies. Familism was not significantly related to alcohol initiation. Comparing racial/ethnic groups, higher parental respect was protective against alcohol initiation for Whites and Asians, but not Blacks or Hispanics. There were no racial/ethnic differences in the association between familism and alcohol initiation. Results suggest that cultural values are important factors in the decision to use alcohol and these values appear to operate in part, by influencing alcohol positive expectancies and RSE. Interventions that focus on maintaining strong cultural values and building strong bonds between adolescents and their families may help reduce the risk of alcohol initiation. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Timing of the initiation of antenatal care: An exploratory qualitative study of women and service providers in East London.

PubMed

Hatherall, Bethan; Morris, Joanne; Jamal, Farah; Sweeney, Lorna; Wiggins, Meg; Kaur, Inderjeet; Renton, Adrian; Harden, Angela

2016-05-01

to explore the factors which influence the timing of the initiation of a package of publically-funded antenatal care for pregnant women living in a diverse urban setting a qualitative study involving thematic analysis of 21 individual interviews and six focus group discussions. Newham, a culturally diverse borough in East London, UK PARTICIPANTS: individual interviews were conducted with 21 pregnant and postnatal women and focus group discussions were conducted with a total of 26 health service staff members(midwives and bilingual health advocates) and 32 women from four community groups (Bangladeshi, Somali, Lithuanian and Polish). initial care-seeking by pregnant women is influenced by the perception that the package of antenatal care offered by the National Health Service is for viable and continuing pregnancies, as well as little perceived urgency in initiating antenatal care. This is particularly true when set against competing responsibilities and commitments in women's lives and for pregnancies with no apparent complications or disconcerting symptoms. Barriers to access to this package of antenatal care include difficulties in navigating the health service and referral system, which are compounded for women unable to speak English, and service provider delays in the processing of referrals. Accessing antenatal care was sometimes equated with relinquishing control, particularly for young women and women for whom language barriers prohibit active engagement with care. if women are to be encouraged to seek antenatal care from maternity services early in pregnancy, the purpose and value to all women of doing so need to be made clear across the communities in which they live. As a woman may need time to accept her pregnancy and address other priorities in her life before seeking antenatal care, it is crucial that once she does decide to seek such care, access is quick and easy. Difficulties found in navigating the system of referral for antenatal care point to a need for improved access to primary care and a simple and efficient process of direct referral to antenatal care, alongside the delivery of antenatal care which is woman-centred and experienced as empowering. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Timing of the initiation of antenatal care: An exploratory qualitative study of women and service providers in East London

PubMed Central

Hatherall, Bethan; Morris, Joanne; Jamal, Farah; Sweeney, Lorna; Wiggins, Meg; Kaur, Inderjeet; Renton, Adrian; Harden, Angela

2016-01-01

Objective to explore the factors which influence the timing of the initiation of a package of publically-funded antenatal care for pregnant women living in a diverse urban setting Design a qualitative study involving thematic analysis of 21 individual interviews and six focus group discussions. Setting Newham, a culturally diverse borough in East London, UK Participants individual interviews were conducted with 21 pregnant and postnatal women and focus group discussions were conducted with a total of 26 health service staff members(midwives and bilingual health advocates) and 32 women from four community groups (Bangladeshi, Somali, Lithuanian and Polish). Findings initial care-seeking by pregnant women is influenced by the perception that the package of antenatal care offered by the National Health Service is for viable and continuing pregnancies, as well as little perceived urgency in initiating antenatal care. This is particularly true when set against competing responsibilities and commitments in women’s lives and for pregnancies with no apparent complications or disconcerting symptoms. Barriers to access to this package of antenatal care include difficulties in navigating the health service and referral system, which are compounded for women unable to speak English, and service provider delays in the processing of referrals. Accessing antenatal care was sometimes equated with relinquishing control, particularly for young women and women for whom language barriers prohibit active engagement with care. Conclusions and implications for practice if women are to be encouraged to seek antenatal care from maternity services early in pregnancy, the purpose and value to all women of doing so need to be made clear across the communities in which they live. As a woman may need time to accept her pregnancy and address other priorities in her life before seeking antenatal care, it is crucial that once she does decide to seek such care, access is quick and easy. Difficulties found in navigating the system of referral for antenatal care point to a need for improved access to primary care and a simple and efficient process of direct referral to antenatal care, alongside the delivery of antenatal care which is woman-centred and experienced as empowering. PMID:27106937

Culture and Process Change as a Priority for Patient Engagement in Medicines Development

PubMed Central

Dewulf, Lode; Hoos, Anton; Geissler, Jan; Todaro, Veronica; Schneider, Roslyn F.; Garzya, Vincenzo; Garvey, Andrew; Robinson, Paul; Saffer, Tonya; Krug, Sarah; Sargeant, Ify

2016-01-01

Patient Focused Medicines Development (PFMD) is a not-for-profit independent multinational coalition of patients, patient stakeholders, and the pharmaceutical industry with interests across diverse disease areas and conditions. PFMD aims to facilitate an integrated approach to medicines development with all stakeholders involved early in the development process. A key strength of the coalition that differentiates it from other groups that involve patients or patient groups is that PFMD has patient organizations as founding members, ensuring that the patient perspective is the starting point when identifying priorities and developing solutions to meet patients’ needs. In addition, PFMD has from inception been formed as an equal collaboration among patient groups, patients, and pharmaceutical industry and has adopted a unique trans-Atlantic setup and scope that reflects its global intent. This parity extends to its governance model, which ensures at least equal or greater share of voice for patient group members. PFMD is actively inviting additional members and aims to expand the collaboration to include stakeholders from other sectors. The establishment of PFMD is particularly timely as patient engagement (PE) has become a priority for many health stakeholders and has led to a surge of mostly disconnected activities to deliver this. Given the current plethora of PE initiatives, an essential first step has been to determine, based on a comprehensive mapping, those strategic areas of most need requiring a focused initial effort from the perspective of all stakeholders. PFMD has identified four priority areas that will need to be addressed to facilitate implementation of PE. These are (1) culture and process change, (2) development of a global meta-framework for PE, (3) information exchange, and (4) training. This article discusses these priority themes and ongoing or planned PFMD activities within each. PMID:28232876

Motivating Low Socioeconomic Status Smokers to Accept Evidence-Based Smoking Cessation Treatment: A Brief Intervention for the Community Agency Setting

PubMed Central

Reeder, Kevin M.; TerBeek, Erin G.; Fiore, Michael C.; Baker, Timothy B.

2015-01-01

Introduction: Individuals of low socioeconomic status (SES), smoke at very high rates but make fewer and less successful quit attempts than do other smokers. Low-SES smokers have specific beliefs about smoking and quitting that may serve as barriers to making quit attempts. The purpose of this study was to test the impact of a brief intervention addressing these beliefs on making calls to a telephone quit line. Methods: Of 522 smokers entering the study at 5 Wisconsin Salvation Army (SA) sites, 102 expressed motivation to quit and served as a comparison group. The remaining 420 smokers were not motivated to quit and were randomly assigned to 1 of 3 conditions: an intervention group who received brief counseling focused on cessation goals and beliefs, an attention-control group, and a low contact control group. The primary outcome was the rate at which smokers made a call to the Wisconsin tobacco quit line (WTQL) during their SA visit. Secondary outcome measures included motivational variables, stage of change, changes in beliefs about smoking and quitting, and self-reported abstinence. Results: Unmotivated participants in the intervention condition called the WTQL at a significantly higher rate (12.2%) than did those in the 2 control conditions (2.2% and 1.4%) (p < .01) and approached the rate of calling by participants who were initially motivated to quit (15.7%). Intervention condition participants also showed improved motivation to quit and stage of change. Conclusions: A brief, targeted motivational intervention focusing on cessation goals and beliefs increased the initiation of an evidence-based tobacco cessation treatment by low-SES smokers. PMID:26180226

Culture and Process Change as a Priority for Patient Engagement in Medicines Development.

PubMed

Boutin, Marc; Dewulf, Lode; Hoos, Anton; Geissler, Jan; Todaro, Veronica; Schneider, Roslyn F; Garzya, Vincenzo; Garvey, Andrew; Robinson, Paul; Saffer, Tonya; Krug, Sarah; Sargeant, Ify

2017-01-01

Patient Focused Medicines Development (PFMD) is a not-for-profit independent multinational coalition of patients, patient stakeholders, and the pharmaceutical industry with interests across diverse disease areas and conditions. PFMD aims to facilitate an integrated approach to medicines development with all stakeholders involved early in the development process. A key strength of the coalition that differentiates it from other groups that involve patients or patient groups is that PFMD has patient organizations as founding members, ensuring that the patient perspective is the starting point when identifying priorities and developing solutions to meet patients' needs. In addition, PFMD has from inception been formed as an equal collaboration among patient groups, patients, and pharmaceutical industry and has adopted a unique trans-Atlantic setup and scope that reflects its global intent. This parity extends to its governance model, which ensures at least equal or greater share of voice for patient group members. PFMD is actively inviting additional members and aims to expand the collaboration to include stakeholders from other sectors. The establishment of PFMD is particularly timely as patient engagement (PE) has become a priority for many health stakeholders and has led to a surge of mostly disconnected activities to deliver this. Given the current plethora of PE initiatives, an essential first step has been to determine, based on a comprehensive mapping, those strategic areas of most need requiring a focused initial effort from the perspective of all stakeholders. PFMD has identified four priority areas that will need to be addressed to facilitate implementation of PE. These are (1) culture and process change, (2) development of a global meta-framework for PE, (3) information exchange, and (4) training. This article discusses these priority themes and ongoing or planned PFMD activities within each.

Expecting the unexpected: A mixed methods study of violence to EMS responders in an urban fire department.

PubMed

Taylor, Jennifer A; Barnes, Brittany; Davis, Andrea L; Wright, Jasmine; Widman, Shannon; LeVasseur, Michael

2016-02-01

Struck by injuries experienced by females were observed to be higher compared to males in an urban fire department. The disparity was investigated while gaining a grounded understanding of EMS responder experiences from patient-initiated violence. A convergent parallel mixed methods design was employed. Using a linked injury dataset, patient-initiated violence estimates were calculated comparing genders. Semi-structured interviews and a focus group were conducted with injured EMS responders. Paramedics had significantly higher odds for patient-initiated violence injuries than firefighters (OR 14.4, 95%CI: 9.2-22.2, P < 0.001). Females reported increased odds of patient-initiated violence injuries compared to males (OR = 6.25, 95%CI 3.8-10.2), but this relationship was entirely mediated through occupation (AOR = 1.64, 95%CI 0.94-2.85). Qualitative data illuminated the impact of patient-initiated violence and highlighted important organizational opportunities for intervention. Mixed methods greatly enhanced the assessment of EMS responder patient-initiated violence prevention. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Chronically ill Canadians' experiences of being unattached to a family doctor: a qualitative study of marginalized patients in British Columbia.

PubMed

Crooks, Valorie A; Agarwal, Gina; Harrison, Angela

2012-07-16

Unattached patients do not have a regular primary care provider. Initiatives are being developed to increase attachment rates across Canada. Most existing attention paid to patient unattachment has focused on quantifying the problem and health system costs. Our purpose is to qualitatively identify the implications of chronically ill patients' experiences of unattachment for health policy and planning to provide policy-relevant insights for Canadian attachment initiatives. Three focus groups were conducted with marginalized chronically ill individuals residing in a mid-sized city in British Columbia who are unattached to a family doctor. We use the term marginalized as a descriptor to acknowledge that by virtue of their low socio-economic status and lack of attachment the participants are marginalized in Canada's health care system Focus groups were structured as an open conversation organized around a series of probing questions. They were digitally recorded and transcribed verbatim. Thematic analysis was employed. Twenty-six individuals participated in the focus groups. The most common chronic illnesses reported were active drug addiction or recovery (and their associated symptoms), depression, arthritis, and hepatitis C. Participants identified life transitions as being the root cause for not having a family doctor. There was a strong sense that unsuccessful attempts to get a family doctor reflected that they were undesirable patients. Participants wanted to experience having a trusting relationship with a regular family doctor as they believed it would encourage greater honesty and transparency. One of the main health concerns regarding lack of access to a regular family doctor is that participants lacked access to preventative care. Participants were also concerned about having a discontinuous medical record due to unattachment. Participants perceived that there are many benefits to be had by having attachment to a regular family doctor and that experiencing unattachment challenged their health and access to health care. We encourage more research to be done on the lived experience of unattachment in order to provide on-the-ground insights that policy-makers require in order to develop responsive, patient-centred supports and programs.

The Healthy Migrant Families Initiative: development of a culturally competent obesity prevention intervention for African migrants.

PubMed

Renzaho, Andre M N; Halliday, Jennifer A; Mellor, David; Green, Julie

2015-03-19

Although obesity among immigrants remains an important area of study given the increasing migrant population in Australia and other developed countries, research on factors amenable to intervention is sparse. The aim of the study was to develop a culturally-competent obesity prevention program for sub-Saharan African (SSA) families with children aged 12-17 years using a community-partnered participatory approach. A community-partnered participatory approach that allowed the intervention to be developed in collaborative partnership with communities was used. Three pilot studies were carried out in 2008 and 2009 which included focus groups, interviews, and workshops with SSA parents, teenagers and health professionals, and emerging themes were used to inform the intervention content. A cultural competence framework containing 10 strategies was developed to inform the development of the program. Using findings from our scoping research, together with community consultations through the African Review Panel, a draft program outline (skeleton) was developed and presented in two separate community forums with SSA community members and health professionals working with SSA communities in Melbourne. The 'Healthy Migrant Families Initiative (HMFI): Challenges and Choices' program was developed and designed to assist African families in their transition to life in a new country. The program consists of nine sessions, each approximately 1 1/2 hours in length, which are divided into two modules based on the topic. The first module 'Healthy lifestyles in a new culture' (5 sessions) focuses on healthy eating, active living and healthy body weight. The second module 'Healthy families in a new culture' (4 sessions) focuses on parenting, communication and problem solving. The sessions are designed for a group setting (6-12 people per group), as many of the program activities are discussion-based, supported by session materials and program resources. Strong partnerships and participation by SSA migrant communities enabled the design of a culturally competent and evidence-based intervention that addresses obesity prevention through a focus on healthy lifestyles and healthy families. Program implementation and evaluation will further inform obesity prevention interventions for ethnic minorities and disadvantaged communities.

Content-Related Interactions in Self-initiated Study Groups

NASA Astrophysics Data System (ADS)

Christian, Karen; Talanquer, Vicente

2012-09-01

The central goal of the present exploratory study was to investigate the nature of the content-related interactions in study groups independently organized by college organic chemistry students. We were particularly interested in the identification of the different factors that affected the emergence of opportunities for students to co-construct understanding and engage in higher levels of cognitive processing. Our results are based on the analysis of in situ observations of 34 self-initiated study sessions involving over a 100 students in three academic semesters. The investigation revealed three major types of social regulation processes, teaching, tutoring, and co-construction in the observed study sessions. However, the extent to which students engaged in each of them varied widely from one session to another. This variability was mostly determined by the specific composition of the study groups and the nature of the study tasks in which they were engaged. Decisions about how to organize the study session, the relative content knowledge and conceptual understanding expressed by the participants, as well as the cognitive level of the problems that guided group work had a strong impact on the nature of student interactions. Nevertheless, group talk in the observed study groups was mostly focused on low-level cognitive processes. The results of our work provide insights on how to better support students' productive engagement in study groups.

Regulatory focus as a mediator of the influence of initiating structure and servant leadership on employee behavior.

PubMed

Neubert, Mitchell J; Kacmar, K Michele; Carlson, Dawn S; Chonko, Lawrence B; Roberts, James A

2008-11-01

In this research, the authors test a model in which the regulatory focus of employees at work mediates the influence of leadership on employee behavior. In a nationally representative sample of 250 workers who responded over 2 time periods, prevention focus mediated the relationship of initiating structure to in-role performance and deviant behavior, whereas promotion focus mediated the relationship of servant leadership to helping and creative behavior. The results indicate that even though initiating structure and servant leadership share some variance in explaining other variables, each leadership style incrementally predicts disparate outcomes after controlling for the other style and dispositional tendencies. A new regulatory focus scale, the Work Regulatory Focus (WRF) Scale, also was developed and initially validated for this study. Implications for the results and the WRF Scale are discussed.

Epilepsy in autism: A pathophysiological consideration.

PubMed

Nomura, Yoshiko; Nagao, Yuri; Kimura, Kazue; Hachimori, Kei; Segawa, Masaya

2010-11-01

Eighty cases of idiopathic autism with epilepsy and 97 cases without epilepsy were studied to evaluate the pathophysiology of epilepsy in autism. The initial visit to this clinic ranged 8months-30years 3months of age, and the current ages are 5years 8months-42years 3months, 60% reaching to over 30years of age. The average follow up duration is 22.2years±9.4years. The ages of onset of epilepsy were from 7months to 30years of age, with the two peaks at 3.2years and 16.7years. EEG central focus appeared earlier than frontal focus. Abnormality of locomotion and atonic NREM were observed more frequently in epileptic group. These suggest the neuronal system related to abnormality of locomotion and atonic NREM, which are the hypofunction of the brainstem monoaminergic system, is the pathomechanism underling the epilepsy in autism. By showing the abnormal sleep-wake rhythm and locomotion being the very initial symptoms in autism, we had shown the hypofunction of the brainstem monoaminergic system is the initial pathomechanism of autism. Thus, epilepsy in autism is not the secondary manifestation, but one of the pathognomonic symptoms of autism. The brainstem monoaminergic system project to the wider cortical area, and the initial monoaminergic hypofunction may lead to the central focus which appears earlier. The failure of the monoaminergic (serotonergic) system causes dysfunction of the pedunculo-pontine nucleus (PPN) and induces dysfunction of the dopamine (DA) system, and with development of the DA receptor supersensitivity consequently disinhibits the thalamo-frontal pathway, which after maturation of this pathway in teens cause the epileptogenesis in the frontal cortex. Copyright © 2010 Elsevier B.V. All rights reserved.

Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool.

PubMed

Kaplan, Stephen J; Seabott, Heather M; Cunningham, Erika B; Helman, James D; Calderon, Alvin; Thirlby, Richard C; Schenarts, Kimberly D

The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. Four residency training institutions in Washington state between February 2016 and March 2017. General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Hansel and Gretel Walk in the Forest, Landowners Walk in the Woods: A Qualitative Examination of the Language Used by Family Forest Owners

Treesearch

Kyle Andrejczyk; Brett J. Butler; Mary L. Tyrrell; Judith Langer

2016-01-01

In 2007, a series of focus groups with family forest owners was conducted as part of a social marketing initiative with the aim of increasing conservation activities on private forestlands. Participants in the study were asked how they perceive and experience their land and how they understand certain terminology used by forestry professionals. Results show that family...

Hypersonic Experimental and Computational Capability, Improvement and Validation. Volume 2

NASA Technical Reports Server (NTRS)

Muylaert, Jean (Editor); Kumar, Ajay (Editor); Dujarric, Christian (Editor)

1998-01-01

The results of the phase 2 effort conducted under AGARD Working Group 18 on Hypersonic Experimental and Computational Capability, Improvement and Validation are presented in this report. The first volume, published in May 1996, mainly focused on the design methodology, plans and some initial results of experiments that had been conducted to serve as validation benchmarks. The current volume presents the detailed experimental and computational data base developed during this effort.

Frequency Conversion of Single Photons: Physics, Devices, and Applications

DTIC Science & Technology

2012-07-01

Ginzton lab who have also been instrumental have been Steve Sensarn, Il-Woong Jung , Kelley Rivoire, Gary Shambat, Sonia Buckley, Kiarash Aghaie, Na...My initial projects in the Fejer group were focused on modeling a synchronously pumped OPO for terahertz generation. A ps-pulsed 1064-nm laser...detection of the spin state of a single nucleus in silicon. Physical Review B, 69(12):125306, March 2004. BIBLIOGRAPHY 151 [116] Carl A. Kocher and

Leadership for Student Learning: Restructuring School District Leadership. School Leadership for the 21st Century Initiative: A Report of the Task Force on School District Leadership.

ERIC Educational Resources Information Center

Institute for Educational Leadership, Washington, DC.

This report displays the themes and concerns that worried a cross-section of carefully selected educators and leaders in government, business, and civic groups. While failing to agree completely on the nature of the problems or their solutions, Task Force members were in accord on two conclusions: that district leaders must focus on the goal of…

Texas A&M University in the JET Collaboration - Final Report

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

Fries, Rainer; Ko, Che-Ming

This final report summarizes the work done by PIs at Texas A&M University within the JET Topical Collaboration. The main focus of the group at Texas A&M has been the development and implementation of a hadronization model suitable to calculate hadronization of jet showers in heavy ion collisions event by event. The group successfully developed a hybrid model of parton recombination and remnant string fragmentation including recombination with thermal partons. A code realizing this model was developed and shared with other JET members. In addition, the group at Texas A&M worked on both open and hidden heavy flavor probes. Inmore » particular, they developed a description of heavy flavor hadronization based on recombination, and consistent with in-medium scattering rates of heavy quarks, and suggested the D s meson as a precise probe of the hadronization mechanism. Another noteworthy focus of their work was electromagnetic probes, in particular, dileptons and photons from interactions of jets with the medium. In the soft sector the group has made several contributions to modern topics, e.g. the splitting of elliptic flow between isospin partners and the role of the initial strong gluon fields.« less

Subsonic Maneuvering Effectiveness of High Performance Aircraft Which Employ Quasi-Static Shape Change Devices

NASA Technical Reports Server (NTRS)

Montgomery, Raymond C.; Scott, Michael A.; Weston, Robert P.

1998-01-01

This paper represents an initial study on the use of quasi-static shape change devices in aircraft maneuvering. The macroscopic effects and requirements for these devices in flight control are the focus of this study. Groups of devices are postulated to replace the conventional leading-edge flap (LEF) and the all-moving wing tip (AMT) on the tailless LMTAS-ICE (Lockheed Martin Tactical Aircraft Systems - Innovative Control Effectors) configuration. The maximum quasi-static shape changes are 13.8% and 7.7% of the wing section thickness for the LEF and AMT replacement devices, respectively. A Computational Fluid Dynamics (CFD) panel code is used to determine the control effectiveness of groups of these devices. A preliminary design of a wings-leveler autopilot is presented. Initial evaluation at 0.6 Mach at 15,000 ft. altitude is made through batch simulation. Results show small disturbance stability is achieved, however, an increase in maximum distortion is needed to statically offset five degrees of sideslip. This only applies to the specific device groups studied, encouraging future research on optimal device placement.

Report on the Joint EU-US Workshop on Microbial Community Dynamics: Cooperation and Competition

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

Wall, Judy D.

2013-07-01

The European Commission (EC)-United States (US) Task Force on Biotechnology Research has a longstanding joint Working Group on Biotechnology for the Environment whose mission is to foster collaborations between researchers in the European Union (EU) and US in the field of environmental biotechnology. A special focus of the Working Group is to increase scientific interchange between early career scientists in the US and EU. Such interactions initiate a foundation of respect and trust needed to develop long-term collaborations. In order to realize the full potential for the application of modern technologies to obtain a sustainable biosphere, it is vital tomore » create conduits for knowledge exchange among scientists worldwide engaged in environmental microbial biotechnology research. Since its formation in 1994, the Working Group has organized many activities for early career scientists designed to promote this scientific exchange, including two week courses with hands-on research experience, intensive workshops of two or three days, and research scholar exchanges of one to six months. These interactions are focused on environmental problems that respect no international boundaries.« less

Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups

PubMed Central

Grayson, M. Lindsay; Macesic, Nenad; Huang, G. Khai; Bond, Katherine; Fletcher, Jason; Gilbert, Gwendolyn L.; Gordon, David L.; Hellsten, Jane F.; Iredell, Jonathan; Keighley, Caitlin; Stuart, Rhonda L.; Xuereb, Charles S.; Cruickshank, Marilyn

2015-01-01

Introduction Important culture-change initiatives (e.g. improving hand hygiene compliance) are frequently associated with variable uptake among different healthcare worker (HCW) categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design. Materials and Methods We used an innovative personality-profiling tool (ColourGrid®) to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data) to: a) compare the relative accuracy of these two sources; b) identify differences between HCW groups and c) use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence). Results Results from 34,243 HCWs (HR data) and 1045 survey participants (PS data) suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services) and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting) senior medical officers (SMO, VMO) and junior hospital medical officers (HMO), with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence. Discussion Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality profiling based on HR data may represent a useful means of developing a national culture-change “blueprint” for HCW education. PMID:26489012

Group hypnotherapy for irritable bowel syndrome with long-term follow-up.

PubMed

Gerson, Charles D; Gerson, Jessica; Gerson, Mary-Joan

2013-01-01

This study tested whether group gut-focused hypnotherapy would improve irritable bowel syndrome (IBS). Several possible outcome predictors were also studied. Before treatment, 75 patients completed a Symptom Severity Scale, a Mind-Body attribution questionnaire, and a Quality of Relationship Inventory (QRI). The symptom scale was completed posttreatment, 3, 6, and 12 months later. There was significant symptom reduction at each data point (p < .001). Sixty percent had a reduction of more than 50 points, indicative of clinical improvement. Initial severity score (p = .0004) and QRI conflict (p = .057) were directly correlated with a response to hypnotherapy, while attribution of symptoms to mind (emotional) causation was inversely correlated (p = .0056). The authors conclude that group hypnotherapy is effective in patients with IBS.

Challenges for the Protection of Critical ICT-Based Financial Infrastructures

NASA Astrophysics Data System (ADS)

Hämmerli, Bernhard M.; Arendt, Henning H.

A workshop was held in Frankfurt during September 24-25, 2007, in order to initiate a dialogue between financial industry (FI) stakeholders and Europe’s top-level research community. The workshop focused on identifying research and development challenges for the protection of critical ICT-based financial infrastructures for the next 5 years: “Protection of Massively Distributed Critical Financial Services” and “Trust in New Value Added Business Chains”. The outcome of the workshop contributed to the development of the research agenda from the perspectives of three working groups. A number of project ideas were spawned based on the workshop, including a coordination actions project entitled PARSIFAL, which this paper will focus on.

Using participatory epidemiology to assess factors contributing to common enteric pathogens in Ontario: results from a workshop held at the Ontario Veterinary College, University of Guelph, Ontario

PubMed Central

2014-01-01

Background Common enteric pathogens that cause gastrointestinal illness are transmitted to humans through food, water or direct contact. This poses a significant concern to public health as enteric pathogens can cause disease in a large number of people, and cost a substantial amount to treat and prevent. In order to gain a better understanding of the occurrence of enteric disease in Ontario, this study explored public health professionals’ perceptions of major contributing factors for common enteric pathogens. Methods A case study was conducted as part of a two week training workshop in Participatory Epidemiology held at the Ontario Veterinary College, University of Guelph, in May 2013. Eight semi-structured interviews and four focus groups were conducted with representatives from the Public Health Agency of Canada, the University of Guelph, and three health regions in Southern Ontario. Written notes and pictures captured the qualitative information provided. Results were then analyzed using the mixed methods techniques of triangulation, convergence, and paradox. Results A total of fifty factors that contribute to enteric disease were identified across all interviews and focus groups. These contributing factors were grouped into key themes (travel, food handling, industry (farm-to-fork), water, geography, demographics, and behaviours) and were categorized as either a risk factor or susceptibility factor. Informants emphasized the complex relationships between the identified factors, and highlighted why these complexities make it difficult to determine where and how a person most likely acquired an enteric pathogen. Workshop participants observed differences in the type and quality of information collected during interviews and focus groups; we hypothesize that this may be attributed to the dynamics between group members (i.e. focus group discussions) as opposed to one-on-one interviews. Conclusions The information gathered will serve as a starting point to further explore contributing factors for common enteric pathogens. The identified complexities would be best explored by conducting additional surveillance, as well as interviews and focus groups with a more diverse group of stakeholders. This type of qualitative study can enhance knowledge of enteric pathogen surveillance and contribute to the development of resources and initiatives to holistically address the occurrence of gastrointestinal illness. PMID:24767430

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

PubMed

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

2017-10-01

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

Evaluation of the clinical and antimicrobial effects of the Er:YAG laser or topical gaseous ozone as adjuncts to initial periodontal therapy.

PubMed

Yılmaz, Selçuk; Algan, Serdar; Gursoy, Hare; Noyan, Ulku; Kuru, Bahar Eren; Kadir, Tanju

2013-06-01

The aim of this study was to evaluate the clinical and microbiological results of treatment with the Er:YAG laser and topical gaseous ozone application as adjuncts to initial periodontal therapy in chronic periodontitis (CP) patients. Although many studies have evaluated the effectiveness of the Er:YAG laser as an adjunct to initial periodontal therapy, few studies have focused on the use of gaseous ozone as an adjunct. Thirty patients with CP were randomly divided into three parallel groups, each composed of 10 individuals with at least four teeth having at least one approximal site with a probing depth (PD) of ≥5 mm and a sulcus bleeding index (SBI) ≥2 in each quadrant. Groups of patients received: (1) Scaling and root planing (SRP)+Er:YAG laser; (2) SRP+topical gaseous ozone; or (3) SRP alone. The microbiological and clinical parameters were monitored at day 0 and day 90. At the end of the observation period, statistically significant improvements in clinical parameters were observed within each group. Parallel to the clinical changes, all treatments reduced the number of total bacteria and the proportion of obligately anaerobic microorganisms. Although intergroup comparisons of microbiological parameters showed no significant differences, clinical findings, including attachment gain and PD reduction, were found to be statistically significant in favor of the SRP+Er:YAG laser group. Although statistically nonsignificant, the fact that the obligate anaerobic change was mostly observed in the SRP+Er:YAG laser group, and a similar decrease was noted in the SRP+topical gaseous ozone group, shows that ozone has an antimicrobial effect equivalent to that of the Er:YAG laser.

Blended learning networks supported by information and communication technology: an intervention for knowledge transformation within family care of older people.

PubMed

Hanson, Elizabeth; Magnusson, Lennart; Sennemark, Eva

2011-08-01

This article describes an innovative practice called Blended Learning Networks (BLNs) whose aim is to enable older people, their families, and care providers to exchange knowledge, learn together, and support each other in local development work so that care is improved for older people. BLNs were established in 31 municipalities, headed up by a local facilitator. They were supported by a national themed network consisting of virtual meetings between local facilitators and national facilitators at the Swedish National Family Care Competence Centre. An evaluation was conducted to explore the utility of the BLNs so that any improvements to the model could be instigated. Focus group interviews were conducted with members of 9 BLNs, and self-evaluation questions were discussed in 16 BLNs. Limitations are that not all BLN members participated in the evaluation, and local facilitators conducting self-evaluations were not trained in focus group dynamics. Virtual focus groups were carried out with 26 of the 31 local facilitators and with the national facilitators. Participants reported an increased understanding of caregiver issues and of each group's roles. Of particular value were the stories shared by caregivers and the potential for change locally due to the involvement of decision makers. The practice demanded considerable skills of the local facilitators. An initial education for new local facilitators was deemed necessary. BLNs is a unique practice of community communications and knowledge transfer as it creates partnerships among all key stakeholder groups that act as a catalyst for improving care for older people.

Evaluation of antismoking advertising campaigns.

PubMed

Goldman, L K; Glantz, S A

1998-03-11

Active and passive smoking are the first and third leading preventable causes of death. Many states are running or initiating antitobacco media campaigns. To review research on the effectiveness of different antismoking messages and published evidence of the effectiveness of paid antismoking advertising. Focus group studies conducted by professional advertising agencies that contract with California, Massachusetts, and Michigan to run their antismoking advertising campaigns, the Centers for Disease Control and Prevention's Media Campaign Resource Book, and copies of the advertisements. In total, we reviewed the results of 186 focus groups involving more than 1500 children and adults dealing with 118 advertisements that had actually been aired and additional concept advertisements that were not produced. Published literature was located using MEDLINE and standard bibliographic sources on the effectiveness of large, paid antitobacco media campaigns. We also reviewed reports and studies conducted by, or for, the California and Massachusetts health departments on program effectiveness, and conducted our own comparison of California vs Massachusetts using cigarette consumption data from the Tobacco Institute. All available studies. Eight advertising strategies to prevent people from starting to smoke and persuading them to stop were reviewed: industry manipulation, secondhand smoke, addiction, cessation, youth access, short-term effects, long-term health effects, and romantic rejection. These focus groups identified strategies that would be expected to be effective and ineffective. Regression analysis was used to compare the cost-effectiveness of the California and Massachusetts programs. Focus group participants indicated that industry manipulation and secondhand smoke are the most effective strategies for denormalizing smoking and reducing cigarette consumption. Addiction and cessation can be effective when used in conjunction with the industry manipulation and secondhand smoke strategies. Youth access, short-term effects, long-term health effects, and romantic rejection are not effective strategies. More aggressive advertising strategies appear to be more effective at reducing tobacco consumption.

Development of a web-based executive functioning intervention for adolescents with epilepsy: The Epilepsy Journey.

PubMed

Modi, Avani C; Schmidt, Matthew; Smith, Aimee W; Turnier, Luke; Glaser, Noah; Wade, Shari L

2017-07-01

Youth with epilepsy exhibit significant deficits in executive functioning (EF), yet there are few interventions to improve EF for adolescents. The aims of the current study were to develop an individually-tailored intervention, called Epilepsy Journey, to improve aspects of EF through an iterative, patient-centered process including focus groups and usability testing. Five adolescents and caregivers participated in focus groups. This input was used to develop ten learning modules based on subscales of the Behavioral Rating Inventory of Executive Functions and key issues that may impact EF in adolescents. Six adolescents participated in usability testing and a usability expert conducted a heuristic evaluation. Demographic information, chart reviews and measures of EF were also completed. Focus group participants and their parents reported difficulties with memory, attention, organization, monitoring, initiation, impulsivity, emotional control, sleep, awareness in schools and managing stress. They also identified successful strategies to address memory and organizational difficulties. Usability testing of the resultant Epilepsy Journey modules revealed problems with navigation and identified features that promoted usability, including progress bars and interactive modules. Program modifications were made after each usability trial resulting in a relatively brief, interactive and readily navigable program. Perceived utility was high with all but one participant. Participants rated the content as helpful and indicated they would recommend Epilepsy Journey to others. Feedback from the focus group and usability testing yielded a feasible, acceptable, relevant and user-friendly web-based intervention for adolescents with epilepsy. The Epilepsy Journey program will be further tested in an open pilot with adolescents with epilepsy and associated EF deficits. Copyright © 2017 Elsevier Inc. All rights reserved.

Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews

PubMed Central

Atwine, Fortunate; Hultsjö, Sally; Albin, Björn; Hjelm, Katarina

2015-01-01

Introduction Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers. Methods Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups. Results Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends. Conclusion The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care. PMID:26090034

"Psychiatry is not a science like others" - a focus group study on psychotropic prescribing in primary care.

PubMed

Hedenrud, Tove M; Svensson, Staffan A; Wallerstedt, Susanna M

2013-08-12

Psychotropic drug prescribing is problematic and knowledge of factors affecting the initiation and maintenance of such prescribing is incomplete. Such knowledge could provide a basis for the design of interventions to change prescribing patterns for psychotropics. The aim of this study was to explore the views of general practitioners (GPs), GP interns, and heads of primary care units on factors affecting the prescribing of psychotropic drugs in primary care. We performed four focus group discussions in Gothenburg, Sweden, with a total of 21 participants (GPs, GP interns, and heads of primary care units). The focus group discussions were transcribed verbatim and analyzed using manifest content analysis. Three different themes emerged from the focus group discussions. The first theme Seeking care for symptoms, reflects the participants' understanding of why patients approach primary care and comprised categories such as knowledge, attitudes, and society and the media. The second theme, Lacking a framework, resources, and treatment alternatives, which reflects the conditions for the physician-patient interaction, comprised categories such as economy and resources, technology, and organizational aspects. The third theme, Restricting or maintaining prescriptions, with the subthemes Individual factors and External influences, reflects the physicians' internal decision making and comprised categories such as emotions, knowledge, and pharmaceutical industry. The results of the present study indicate that a variety of factors may affect the prescribing of psychotropic medications in primary care. Many factors were related to characteristics of the patient, the physician or their interaction, rather than the patients' medical needs per se. The results may be useful for interventions to improve psychotropic prescribing in primary care.

Emergency medicine in the general practice internship in Finnmark county.

PubMed

Hunnålvatn, Kaja Hansen; Ivan, Daniela; Wisborg, Torben

2017-12-12

It is preferred that duty doctors in municipal health services participate in call-outs in emergency situations. The frequency of participation has previously been shown to vary. We wanted to examine the newly qualified doctors’ expectations and experiences – both before and after the general practice internship – of emergency medicine and ambulance call-outs. All 23 of the interns who were to undertake their general practice internship in Finnmark county in the period 2015–16 answered a questionnaire and participated in a focus group interview before the start of the internship. Twenty-one of the interns participated in the focus group interview after completing the internship. Each doctor took part in two interviews. We analysed the transcripts from the focus group interviews using the grounded theory method. The responses from the questionnaire before the general practice internship showed that the interns felt they needed more training in intravenous cannulation and in teamwork. Their expectations in connection with the challenges of call-outs are best characterised by the core category ‘Can I do anything useful?’ from the focus groups before the internship. After the internship, however, the core category ‘It all went well in the end’, was the best fit. Due to short transport times and their knowledge of certain patients, some of the doctors chose not to take part in call-outs. During the general practice internship, the interns were initially anxious about whether they might be superfluous in call-outs, but eventually found their footing in the call-out role. The study shows that there is a need for more practice in certain practical procedures, and that doctors’ non-technical skills need to be improved. This can be done through training in team leader roles before the general practice internship.

Barriers to education of overseas doctors in paediatrics: a qualitative study in South Yorkshire.

PubMed

Mahajan, J; Stark, P

2007-03-01

To explore the factors that may influence the progress of doctors who come from the Indian subcontinent to train in paediatrics in the UK. Overseas doctors training in paediatrics in Rotherham, Sheffield and Doncaster participated in the study. Focus groups were used to collect data; two focus groups, each with 4-5 participants, were conducted at 6-week intervals. Semistructured, one-to-one interviews were conducted to add more understanding and depth to issues highlighted in the focus groups. The focus groups and interviews were audiotaped; the tapes were transcribed and data were analysed using the Grounded Theory; open codes were formed and concepts identified using microanalysis, and initial theories were built. Lack of information about the National Health Service (NHS)/Royal Colleges, inappropriate communication skills, difficulties in team working, difficulties in preparing for Royal College examinations, visa and job hunting, and social and cultural isolation were identified as major barriers. Problems arose not only from difficulties with language but also from use of local and colloquial words, different accents and difficulty in communicating sensitive issues. Lack of understanding of role in teams and difficulties in working in multiprofessional setting all contributed to the problems. Cultural differences inside and outside the workplace, and social isolation were also highlighted. Induction programmes, mentoring, awareness of the issues within the teams, and courses in communication specifically directed at overseas doctors were identified as means to overcome these barriers. Several intercultural factors were identified that could act as barriers to the progress of overseas doctors training in paediatrics in the UK. Increased awareness of these factors within the teams would be the first step in resolving some of the issues.

Combining Photovoice and focus groups: engaging Latina teens in community assessment.

PubMed

Hannay, Jayme; Dudley, Robert; Milan, Stephanie; Leibovitz, Paula K

2013-03-01

Latino adolescents, especially girls, experience higher obesity rates and are more likely to be physically unfit than non-Latino white peers. Out-of-school programs to increase physical activity and fitness in older Latino teens are critical, but sustained engagement is challenging. This study combined a community-based participatory research methodology, Photovoice, with focus groups to engage Latina teens and their parents in identifying barriers to physical activity and initiating policy change actions to address them. The study investigates the effectiveness of applying Photovoice as both an evaluation tool and a leadership/advocacy intervention in a community-based obesity prevention program. Focus group data were collected between July 2009 and October 2010 and analyzed between November 2010 and July 2011. Five focus groups were held with adults (n = 41: 95% Latino) and four with teens (n = 36: 81% Latino, 10% non-Hispanic white, 9% African-American). All participants (19 teens, six adults) were Latino. Spanish-speaking staff of a community-based agency, program staff, high school guidance counselors, and a job development agency recruited participants. Teens aged 14-19 years enrolled in New Britain CT, high schools, and their parents were eligible. Data from Photovoice workshops (three with teens, two with parent-teen dyads) were collected and concurrently analyzed between July 2009 and August 2011. Teens criticized school-based physical exercise programs in favor of out-of-school exercise and career advice. Parental restrictions and work, transportation, and safety issues were cited as barriers to afterschool physical activity programs. Photovoice can empower teens and parents to address exercise barriers by promoting advocacy that leads to policy change (e.g., an out-of-school physical education option). Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Sexual spanking, the self, and the construction of deviance.

PubMed

Plante, Rebecca F

2006-01-01

Using interview and observation data from a group of consensual, heterosexual adults interested in sexual spanking, I describe members' sexual stories and stigma neutralization techniques. Sexual stories are situated within broader cultural contexts that help individuals construct meaning and identities. I describe group members' stories about their initial interest in sexualized spankings. Focusing on a specific event at one party, I show how these stories help to create scene-specific stigma neutralization techniques. Participants strive to differentiate themselves from sadomasochistic activities and to create normative behavioral expectations within their scenes. I conclude that all of this can ultimately be viewed as part of the complex sexual adaptations that people make.

Promotion of Immunizations for Health Professionals in Europe: A Qualitative Study in Seven European Member States.

PubMed

Dalma, Archontoula; Karnaki, Pania; Baka, Agoritsa; Raftopoulos, Vasilios; Zota, Dina; Veloudaki, Afroditi; Garrison, Amanda; Ellis Montalban, Paloma; Dhanani, Zainub; Linos, Athena

2018-01-01

Health Care Workers (HCWs) are a high-risk group for contracting Vaccine-Preventable Diseases who, despite legislation and guidance, remain undervaccinated. In order to understand their barriers and needs, focus groups were formed with 278 physicians, nurses, infection-control personnel, and policy-makers in 7 EU MS. Several implications for the development of promotional initiatives were identified including the need to overcome organizational barriers, to sensitize HCWs about the importance of immunization and to provide specific up-to-date information about vaccinations covering prevalence of diseases, protection years, side effects, administration times, antibody examinations, costs and immunization settings.

The development and initial validation of a questionnaire to measure help-seeking behaviour in patients with new onset rheumatoid arthritis.

PubMed

Stack, Rebecca J; Mallen, Christian D; Deighton, Chris; Kiely, Patrick; Shaw, Karen L; Booth, Alison; Kumar, Kanta; Thomas, Susan; Rowan, Ian; Horne, Rob; Nightingale, Peter; Herron-Marx, Sandy; Jinks, Clare; Raza, Karim

2015-12-01

Early treatment for rheumatoid arthritis (RA) is vital. However, people often delay in seeking help at symptom onset. An assessment of the reasons behind patient delay is necessary to develop interventions to promote rapid consultation. Using a mixed methods design, we aimed to develop and test a questionnaire to assess the barriers to help seeking at RA onset. Questionnaire items were extracted from previous qualitative studies. Fifteen people with a lived experience of arthritis participated in focus groups to enhance the questionnaire's face validity. The questionnaire was also reviewed by groups of multidisciplinary health-care professionals. A test-retest survey of 41 patients with newly presenting RA or unclassified arthritis assessed the questionnaire items' intraclass correlations. During focus groups, participants rephrased questions, added questions and deleted items not relevant to the questionnaire's aims. Participants organized items into themes: early symptom experience, initial reactions to symptoms, self-management behaviours, causal beliefs, involvement of significant others, pre-diagnosis knowledge about RA, direct barriers to seeking help and relationship with GP. The test-retest survey identified seven items (out of 79) with low intraclass correlations which were removed from the final questionnaire. The involvement of people with a lived experience of arthritis and multidisciplinary health-care professionals in the preliminary validation of the DELAY (delays in evaluating arthritis early) questionnaire has enriched its development. Preliminary assessment established its reliability. The DELAY questionnaire provides a tool for researchers to evaluate individual, cultural and health service barriers to help-seeking behaviour at RA onset. © 2014 John Wiley & Sons Ltd.

Economic burden of clinical trials in lung cancer in a German Comprehensive Cancer Center.

PubMed

Kron, F; Kostenko, A; Scheffler, M; Müller, D; Glossmann, J-P; Fischer, R; Michels, S; Nogova, L; Hallek, M; Zander, T; Wolf, J

2017-06-01

The recent success of individualized lung cancer therapy has triggered fundamental changes in clinical research strategies. To date there is a strong focus on early proof of concept trials in genetically preselected small patient subgroups. This analysis focuses on the economic burden caused by such trials for advanced lung cancer patients in a German Comprehensive Cancer Center (CCC). The profit margins between recruiting groups with ≤3 and >3 patients were compared. Clinical and economic data from clinical trials for advanced lung cancer (LC), pharma-sponsored trials (PhST) as well as investigator initiated trials (IIT), conducted between 2011 and 2015 at the Center for Integrated Oncology (CIO) Cologne, were analyzed using a profit-center calculation model. 161 patients were enrolled in 27 clinical trials. The key economic parameter determining costs and payments was the 'trial visits'. In comparison of the two groups (A≤3; B>3 patients enrolled) we found negative profit margins for the low recruiting group (€ -1444). Concerning the number of visits significant differences were found between PhST and IIT (p=0.009). Additionally, sub-analysis show structural differences in cost composition by conducting PhST and IIT. Trials with low patient numbers and IIT, do not cover the cost. To ensure adequate, cost-covering compensation by pharmaceutical companies CCCs have to thoroughly calculate the cost of early proof of concept trials. The findings of this study also underline the need for novel structures in public funding for investigator-initiated clinical trials in precision medicine. Copyright © 2017 Elsevier B.V. All rights reserved.

Hookah Smoking Behavior Initiation in the Context of Millennials

PubMed Central

Castaneda, Gail; Barnett, Tracey E.; Soule, Eric K; Young, Mary Ellen

2016-01-01

Objectives This study aims to examine current hookah users’ perceptions, attitudes, and normative beliefs regarding hookah smoking to further elucidate the rise in hookah smoking prevalence among young adults (aged 18–24 years) and reveal why hookah smoking is perceived as less harmful than other forms of tobacco consumption. Study Design Qualitative. Methods Data analysis of six focus group interviews with hookah smokers between 18–24 years was analyzed using a grounded theory approach. Focus groups were evenly split between frequent and infrequent hookah users, and were predominantly composed of college students, with two groups of hookah users consisting of 18–24 year olds of non-student status. Results Hookah users shared a much larger set of positive hookah smoking behavioral beliefs as opposed to negative behavioral beliefs. Generational traits served as the overarching commonality among the behavior performance initiation determinants observed. The most notable generational trends observed were within the cultural category, which included the following millennial characteristics: autonomy, personalization, novelty appeal, convenience, globally oriented, entertainment, collaboration, health conscious, and valuing their social network. Conclusions Millennial hookah users revealed mindfulness regarding both potential negative and positive reasons stemming from continued hookah use; however, behavioral beliefs were primarily fixated on the perception that hookah smoking was a healthier alternative to cigarette smoking. Future implications for this study’s findings include generating more positive ways to express these traits for young adults; policy implications include raising hookah bar age limits, implementing indoor smoking restrictions, and limiting the ease of accessibility for purchasing hookah supplies. PMID:27003670

Hookah smoking behavior initiation in the context of Millennials.

PubMed

Castañeda, G; Barnett, T E; Soule, E K; Young, M E

2016-08-01

This study aims to examine current hookah users' perceptions, attitudes, and normative beliefs regarding hookah smoking to further elucidate the rise in hookah smoking prevalence among young adults (aged 18-24 years) and reveal why hookah smoking is perceived as less harmful than other forms of tobacco consumption. Qualitative. Data from six focus group interviews with hookah smokers aged between 18 and 24 years were analyzed using a grounded theory approach. Focus groups were evenly split between frequent and infrequent hookah users, and were predominantly composed of college students, with two groups of hookah users consisting of 18-24 year olds of non-student status. Hookah users shared a much larger set of positive hookah smoking behavioral beliefs as opposed to negative behavioral beliefs. Generational traits served as the overarching commonality among the behavior performance initiation determinants observed. The most notable generational trends observed were within the cultural category, which included the following millennial characteristics: autonomy, personalization, novelty appeal, convenience, globally oriented, entertainment, collaboration, health conscious, and valuing their social network. Millennial hookah users revealed mindfulness regarding both potential negative and positive reasons stemming from continued hookah use; however, behavioral beliefs were primarily fixated on the perception that hookah smoking was a healthier alternative to cigarette smoking. Future implications for this study's findings include generating more positive ways to express these traits for young adults; policy implications include raising hookah bar age limits, implementing indoor smoking restrictions, and limiting the ease of accessibility for purchasing hookah supplies. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Traumatic brain injury patient-reported outcome measure: identification of health-related quality-of-life issues relevant to individuals with traumatic brain injury.

PubMed

Carlozzi, Noelle E; Tulsky, David S; Kisala, Pamela A

2011-10-01

This 2-part qualitative study explored health-related quality of life (HRQOL) in individuals with traumatic brain injury (TBI). A community-based participatory action research design was used, which emphasizes collaboration between researchers and individuals with disabilities to ensure that results are relevant for individuals with TBI. In study 1, community members (N=20) with TBI served as "experts" during 1-on-1 semistructured interviews, reviewing current HRQOL items and identifying HRQOL issues commonly experienced by individuals with TBI. Each participant identified at least 31 issues, with most generating more than 90 responses, highlighting the multifaceted nature of HRQOL in TBI. Study 2 consisted of 7 patient/consumer groups (33 individuals with TBI), 4 caregiver groups (17 caregivers), and 2 provider groups (15 providers). Qualitative analysis of patient focus groups indicated that 48% of focus group comments were related to emotional issues; 23%, to social functioning; 14%, to physical functioning; 11%, to cognition; and 7%, to personality changes (caregiver and provider focus group analysis indicated identical patterns of findings). In addition, both studies evaluated the applicability in TBI of generic items developed by the Patient-Reported Outcomes Measurement Information System and the Neurology Quality of Life Measurement initiative. Findings suggest that although there is some overlap between current generic measures of HRQOL and concepts reported by individuals with TBI, these generic measures do not capture the full complexity of HRQOL in TBI. TBI-targeted item banks are needed to ensure sensitive assessment of HRQOL in TBI. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Fostering supportive community connections through mothers' groups and playgroups.

PubMed

Strange, Cecily; Fisher, Colleen; Howat, Peter; Wood, Lisa

2014-12-01

The aim of this study was to explore the ways that mothers' groups and playgroups support families with children aged 0-5 years and foster community connectedness in newer residential communities in Perth, Western Australia. The transition to parenthood is a time of increased support need. Changing community demography has resulted in a loss of traditional support structures and an increased need for local community initiatives to support families with young children. A qualitative descriptive design was used for this initial phase of a mixed methods sequential exploratory study. Data were collected between December 2011-August 2012. Interviews and focus groups conducted with 39 mothers provided insights from 16 mothers' groups and 13 playgroups. In addition, interviews were undertaken with three child health nurses and four local government early childhood staff. For the participants in this study, mothers' groups and playgroups provided opportunities to learn about parenting, to build a supportive network, to forge friendships and a connectedness to the local community. The families who relocated often experienced isolation until new groups and social networks were found. In general, where participation in mothers' groups and playgroups facilitated relationships with others from the local community, connectedness to that community was reported by participants to be enhanced. Mothers' groups and playgroups provide important community development opportunities and appear to help reduce potential isolation for mothers with young children. The findings are of interest to nurses and other health professionals working with families with young children. © 2014 John Wiley & Sons Ltd.

Achieving health for a lifetime: a community engagement assessment focusing on school-age children to decrease obesity in Durham, North Carolina.

PubMed

Corsino, Leonor; McDuffie, Jennifer R; Kotch, Jonathan; Coeytaux, Remy; Fuemmeler, Bernard F; Murphy, Gwen; Miranda, Marie Lynn; Poirier, Brenda; Morton, Janet; Reese, David; Baker, Sharon; Carter, Heidi; Freeman, Rebecca; Blue, Colleen; Yancy, William S

2013-01-01

Obesity is a prominent problem in the United States and in North Carolina. One way of combating it is with community-engaged interventions that foster collaboration between health-oriented organizations and community residents. Our purpose was to assemble a multifaceted group in Durham, North Carolina, to identify factors affecting obesity-related lifestyle behaviors; assess policies, resources, and the population's perception of the problem of obesity; and develop plans to improve health outcomes related to obesity. A team consisting of more than 2 dozen partners was assembled to form Achieving Health for a Lifetime (AHL) in order to study and address obesity in the community, initially focusing on elementary school-age children. The team developed a resource guide by collecting information by telephone interviews of provider organizations; geospatial resource maps were created using high-resolution geographic information systems, Duke's Data Support Repository, and county and city records; and focus groups were conducted using the nominal group technique. The AHL team, in collaboration with 2 other teams focused on diabetes and cardiovascular disease, identified 32 resources for diabetes, 20 for obesity, and 13 for cardiovascular disease. Using Geographic Information Systems (GIS), the team identified an area of Durham that had only 1 supermarket, but 34 fast-food restaurants and 84 convenience stores. The focus on particular neighborhoods means that the information obtained might not pertain to all neighborhoods. The AHL team was able to assemble a large community partnership in Durham that will allow the members of the community to continue to work toward making residents healthier. Communities facing similar challenges can learn from this experience.

Statistical Analysis of Warfare: Identification of Winning Factors with a Focus on Irregular Warfare

DTIC Science & Technology

2015-09-01

Defense HERO Historical Evaluation and Research Organization IDPs Internally Displaced Persons IFR Initial Force Ratio INITA Relative Imitative...armies started combating non-state, widely dispersed groups. Although this change appears to be quite simple, it has had a deep impact on military...1789–1961: A Study of the Impact of the French, Industrial, and Russian Revolutions on War and its Conduct (Boston, MA: Da Capo Press, 1992). 10 Ibid

Tethered Satellite System Contingency Investigation Board

NASA Technical Reports Server (NTRS)

1992-01-01

The Tethered Satellite System (TSS-1) was launched aboard the Space Shuttle Atlantis (STS-46) on July 31, 1992. During the attempted on-orbit operations, the Tethered Satellite System failed to deploy successfully beyond 256 meters. The satellite was retrieved successfully and was returned on August 6, 1992. The National Aeronautics and Space Administration (NASA) Associate Administrator for Space Flight formed the Tethered Satellite System (TSS-1) Contingency Investigation Board on August 12, 1992. The TSS-1 Contingency Investigation Board was asked to review the anomalies which occurred, to determine the probable cause, and to recommend corrective measures to prevent recurrence. The board was supported by the TSS Systems Working group as identified in MSFC-TSS-11-90, 'Tethered Satellite System (TSS) Contingency Plan'. The board identified five anomalies for investigation: initial failure to retract the U2 umbilical; initial failure to flyaway; unplanned tether deployment stop at 179 meters; unplanned tether deployment stop at 256 meters; and failure to move tether in either direction at 224 meters. Initial observations of the returned flight hardware revealed evidence of mechanical interference by a bolt with the level wind mechanism travel as well as a helical shaped wrap of tether which indicated that the tether had been unwound from the reel beyond the travel by the level wind mechanism. Examination of the detailed mission events from flight data and mission logs related to the initial failure to flyaway and the failure to move in either direction at 224 meters, together with known preflight concerns regarding slack tether, focused the assessment of these anomalies on the upper tether control mechanism. After the second meeting, the board requested the working group to complete and validate a detailed integrated mission sequence to focus the fault tree analysis on a stuck U2 umbilical, level wind mechanical interference, and slack tether in upper tether control mechanism and to prepare a detailed plan for hardware inspection, test, and analysis including any appropriate hardware disassembly.

Tethered Satellite System Contingency Investigation Board

NASA Astrophysics Data System (ADS)

1992-11-01

The Tethered Satellite System (TSS-1) was launched aboard the Space Shuttle Atlantis (STS-46) on July 31, 1992. During the attempted on-orbit operations, the Tethered Satellite System failed to deploy successfully beyond 256 meters. The satellite was retrieved successfully and was returned on August 6, 1992. The National Aeronautics and Space Administration (NASA) Associate Administrator for Space Flight formed the Tethered Satellite System (TSS-1) Contingency Investigation Board on August 12, 1992. The TSS-1 Contingency Investigation Board was asked to review the anomalies which occurred, to determine the probable cause, and to recommend corrective measures to prevent recurrence. The board was supported by the TSS Systems Working group as identified in MSFC-TSS-11-90, 'Tethered Satellite System (TSS) Contingency Plan'. The board identified five anomalies for investigation: initial failure to retract the U2 umbilical; initial failure to flyaway; unplanned tether deployment stop at 179 meters; unplanned tether deployment stop at 256 meters; and failure to move tether in either direction at 224 meters. Initial observations of the returned flight hardware revealed evidence of mechanical interference by a bolt with the level wind mechanism travel as well as a helical shaped wrap of tether which indicated that the tether had been unwound from the reel beyond the travel by the level wind mechanism. Examination of the detailed mission events from flight data and mission logs related to the initial failure to flyaway and the failure to move in either direction at 224 meters, together with known preflight concerns regarding slack tether, focused the assessment of these anomalies on the upper tether control mechanism. After the second meeting, the board requested the working group to complete and validate a detailed integrated mission sequence to focus the fault tree analysis on a stuck U2 umbilical, level wind mechanical interference, and slack tether in upper tether control mechanism and to prepare a detailed plan for hardware inspection, test, and analysis including any appropriate hardware disassembly.

Improving metabolic monitoring in patients maintained on antipsychotics in Penang, Malaysia.

PubMed

Hor, Esther Sl; Subramaniam, Sivasangari; Koay, Jun Min; Bharathy, Arokiamary; Vasudevan, Umadevi; Panickulam, Joseph J; Ng, InnTiong; Arif, Nor Hayati; Russell, Vincent

2016-02-01

To evaluate the monitoring of metabolic parameters among outpatients maintained on antipsychotic medications in a general hospital setting in Malaysia and to assess the impact of a local monitoring protocol. By performing a baseline audit of files from a random sample of 300 patients prescribed antipsychotic medications for at least 1 year; we determined the frequency of metabolic monitoring. The findings informed the design of a new local protocol, on which clinical staff was briefed. We re-evaluated metabolic monitoring immediately after implementation, in a small sample of new referrals and current patients. We explored staff perceptions of the initiative with a follow-up focus group, 6 months post-implementation. The baseline audit revealed a sub-optimal frequency of metabolic parameter recording. Re-audit, following implementation of the new protocol, revealed improved monitoring but persisting deficits. Dialogue with the clinical staff led to further protocol modification, clearer definition of staff roles and use of a standard recording template. Focus group findings revealed positive perceptions of the initiative, but persisting implementation barriers, including cultural issues surrounding waist circumference measurement. Responding to challenges in achieving improved routine metabolic monitoring of patients maintained on antipsychotics required on-going dialogue with the clinical staff, in order to address both service pressures and cultural concerns. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The family physician's perceived role in preventing and guiding hospital admissions at the end of life: a focus group study.

PubMed

Reyniers, Thijs; Houttekier, Dirk; Pasman, H Roeline; Stichele, Robert Vander; Cohen, Joachim; Deliens, Luc

2014-01-01

Family physicians play a pivotal role in providing end-of-life care and in enabling terminally ill patients to die in familiar surroundings. The purpose of this study was to explore the family physicians' perceptions of their role and the difficulties they have in preventing and guiding hospital admissions at the end of life. Five focus groups were held with family physicians (N= 39) in Belgium. Discussions were transcribed verbatim and analyzed using a constant comparative approach. Five key roles in preventing and guiding hospital admissions at the end of life were identified: as a care planner, anticipating future scenarios; as an initiator of decisions in acute situations, mostly in an advisory manner; as a provider of end-of-life care, in which competency and attitude is considered important; as a provider of support, particularly by being available during acute situations; and as a decision maker, taking overall responsibility. Family physicians face many different and complex roles and difficulties in preventing and guiding hospital admissions at the end of life. Enhancing the family physician's role as a gatekeeper to hospital services, offering the physicians more end-of-life care training, and developing or expanding initiatives to support them could contribute to a lower proportion of hospital admissions at the end of life. © 2014 Annals of Family Medicine, Inc.

How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project.

PubMed

Bromley, Elizabeth; Eisenman, David P; Magana, Aizita; Williams, Malcolm; Kim, Biblia; McCreary, Michael; Chandra, Anita; Wells, Kenneth B

2017-10-21

Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups ( n = 5) and interviews ( n = 6 coalition members; n = 16 facilitators) to compare coalitions' strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods.

How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project

PubMed Central

Bromley, Elizabeth; Eisenman, David P.; Magana, Aizita; Williams, Malcolm; Kim, Biblia; McCreary, Michael; Chandra, Anita; Wells, Kenneth B.

2017-01-01

Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups (n = 5) and interviews (n = 6 coalition members; n = 16 facilitators) to compare coalitions’ strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods. PMID:29065491

Characterization of Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome: A Qualitative Analysis.

PubMed

Rodrigue, Claudie; Beauchesne, Marie-France; Mallette, Valérie; Lemière, Catherine; Larivée, Pierre; Blais, Lucie

2017-06-01

Approximately 15-20% of patients with chronic obstructive pulmonary disease (COPD) also display characteristics of asthma. In May 2014, the asthma-COPD overlap syndrome (ACOS) was briefly addressed in the Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy documents. We evaluated how pulmonologists diagnose and treat ACOS and how they assess its control. Pulmonologists from two university healthcare centers, having ≥ 1 year experience, treating patients with asthma, COPD, or ACOS, were invited to participate in focus groups. Two focus groups (1 hour duration) were convened with seven and five participants, respectively. According to pulmonologists from both institutions, ACOS is a new name for an existing syndrome rather than a new disease. It is characterized by incomplete reversible airflow limitations and changes in forced expiratory volume in one second over time. The pulmonologists noted that its diagnosis must be based on clinical characteristics, pulmonary function test results, and clinical intuition. To diagnose ACOS, pulmonologists must rely on their clinical judgment. They also agreed that the treatment of patients with ACOS should target the features of both asthma and COPD. Pulmonologists from both institutions used asthma control criteria to assess ACOS control. A deeper understanding would enable clinicians to establish specific criteria for the diagnosis, treatment, and follow-up of subjects with ACOS.

A GEO Initiative to Support the Sustainable Development Goals

NASA Astrophysics Data System (ADS)

Friedl, L.

2016-12-01

The United Nations Agenda 2030 serves as a global development agenda for progress on economic, social and environmental sustainability. These Sustainable Development Goals (SDG) have a specific provision for the use of Earth observations and geospatial information to support progress. The international Group on Earth Observations, GEO, has a dedicated initiative focused on the SDGs. This initiative supports efforts to integrate Earth observations and geospatial information into national development and monitoring frameworks for the SDGs. It helps enables countries and stakeholders to leverage Earth observations to support the implementation, planning, measuring, monitoring, reporting, and evaluation of the SDGs. This paper will present an overview of the GEO initiative and ways that Earth observations support the development goals. It will address how information and knowledge can be shared on effective methods to apply Earth observations to the SDGs and their associated targets and indicators. It will also highlight some existing information sources and tools on the SDGs, which can help identify key approaches for developing a knowledge base.

Teaching personal initiative beats traditional training in boosting small business in West Africa.

PubMed

Campos, Francisco; Frese, Michael; Goldstein, Markus; Iacovone, Leonardo; Johnson, Hillary C; McKenzie, David; Mensmann, Mona

2017-09-22

Standard business training programs aim to boost the incomes of the millions of self-employed business owners in developing countries by teaching basic financial and marketing practices, yet the impacts of such programs are mixed. We tested whether a psychology-based personal initiative training approach, which teaches a proactive mindset and focuses on entrepreneurial behaviors, could have more success. A randomized controlled trial in Togo assigned microenterprise owners to a control group ( n = 500), a leading business training program ( n = 500), or a personal initiative training program ( n = 500). Four follow-up surveys tracked outcomes for firms over 2 years and showed that personal initiative training increased firm profits by 30%, compared with a statistically insignificant 11% for traditional training. The training is cost-effective, paying for itself within 1 year. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Sifting, sorting and saturating data in a grounded theory study of information use by practice nurses: a worked example.

PubMed

Hoare, Karen J; Mills, Jane; Francis, Karen

2012-12-01

The terminology used to analyse data in a grounded theory study can be confusing. Different grounded theorists use a variety of terms which all have similar meanings. In the following study, we use terms adopted by Charmaz including: initial, focused and axial coding. Initial codes are used to analyse data with an emphasis on identifying gerunds, a verb acting as a noun. If initial codes are relevant to the developing theory, they are grouped with similar codes into categories. Categories become saturated when there are no new codes identified in the data. Axial codes are used to link categories together into a grounded theory process. Memo writing accompanies this data sifting and sorting. The following article explains how one initial code became a category providing a worked example of the grounded theory method of constant comparative analysis. The interplay between coding and categorization is facilitated by the constant comparative method. © 2012 Wiley Publishing Asia Pty Ltd.

Challenges in volunteering from cancer care volunteers perspectives.

PubMed

Kamaludin, Kauthar Mohamad; Muhammad, Mazanah; Wahat, Nor Wahiza Abdul; Ibrahim, Rahimah

2013-01-01

The involvement of non-government organizations (NGOs) and support groups has helped strengthen public health services in addressing cancer care burden. Owing to the contribution of volunteers in cancer care, this article documents a qualitative study that examined challenges in attracting and retaining cancer care volunteers as part of the effort to develop a volunteer recruitment model. Data were collected through three focus group discussions involving 19 cancer support group members in Malaysia. Findings of the study revealed that mobility and locality appeared to be significant in Malaysian context, while the need for financial support and time flexibility are challenges faced by cancer support groups to attract and retain volunteers. The findings imply that cancer care initiatives can benefit from more local volunteers but at the same time these volunteers require flexibility and financial support to sustain their engagement.

The initial zones of the atrioventricular node: really neglected anatomical features of potential clinical significance?

PubMed

Kozłowski, D; Kozłowska, M; Kosiński, A; Woźniak, P; Piwko, G; Kamiński, R; Grzybiak, M; Poland, G Raczak

2007-11-01

The constant evolution of medical knowledge and accompanying development of diagnostic and treatment possibilities for arrhythmias and conduction disturbances has reawakened interest in the structure and function of the conduction system of the human heart, especially in the region of the atrioventricular (AV) junction and within the junction itself. Of the large number of studies dealing with the AV junction few focus on the initial zones of the AV node. These were described for the first time by Tawara in 1906. Similarly, Anderson et al. distinguished two origins of the AV node, the left one running towards the basis of the mitral valve and the right one leading towards the tricuspid valve. The differences in length and scale could be the result of the adoption of different reference points. The study was carried out on the material of 50 human hearts, of both sexes and ranging in age from 22 to 93, which were fixed in 10% formalin and 98% ethanol solution. The tissue obtained was fixed in the 10% formalin solution and, after being sunk in the paraffin, was cut into layers of about 10 mum thick. According to the age of the hearts, every 10(th) or 6(th) section was stained by the Masson-Goldner method. The preparations were examined under a LEICA 2000 and BIOLAR 2 microscope at magnifications of 2x to 400x. Each of the 50 examined hearts contained the atrioventricular node and its initial parts. We observed that the initial zone of the AV node is created by an assembly of cells typical for a conduction system that can create three groups that are initially independent of each other and are always arranged around the AV nodal artery. In all the hearts examined we found at least two initial parts of the node: the superior and inferior. These two groups were present in 45 hearts (90%). In the last 5 cases (10%) there was also a middle group. No cases were found either with a single initial group or without any initial groups. In the sections examined the superior group appeared to be first in 27 hearts (54%), while in 23 cases (46%) the inferior group was first. The length of each group was measured from its first appearance to its first direct contact with the second part. The length of the superior part varied from 0.15 to 2.91 mm (mean 0.90 +/- 0.6 mm), the inferior from 0.11 to 2.41 mm (mean 0.88 +/- 0.6 mm) and the middle from 0.67 to 2.21 mm (mean 1.04 +/- 0.7 mm). As mentioned above, in all 50 hearts there was a direct connection between the atrial muscle and the upper origin of AV node. Furthermore, in all sections (100%) the same part of the interatrial septal muscle was connected to the compact part of the node. Additionally, in 3 cases (6%) we were able to observe direct connections between the muscle fibres running from the fasciculus limbicus inferior to the initial zone of the AV node: in 2 cases (4%) with the superior group and in 1 case (2%) with the inferior group. In 8% of the material the atrial muscle of the supra-orificial zone made direct contact with the superior initial group and the compact zone of the node and in 10% there was contact between the suborificial muscle and the inferior group and the compact part of the node. This configuration was not observed in relation to the middle and inferior groups.

Attitudes and beliefs to the uptake and maintenance of physical activity among community-dwelling South Asians aged 60-70 years: a qualitative study.

PubMed

Horne, M; Skelton, D A; Speed, S; Todd, C

2012-05-01

To identify the attitudes and beliefs associated with the uptake and adherence of physical activity among community-dwelling South Asians aged 60-70 years. A qualitative research study using an ethnographic approach. Focus groups and in-depth interviews were conducted to explore motivational factors associated with initiating and maintaining physical activity. Data analysis followed the framework approach. Health, maintaining independence and social support were important in terms of initiating physical activity. Social support, psychosocial elements of activity, health and integrating physical activity within everyday activities were important for adherence to physical activity. The need for gendered physical activity sessions was important to initiating exercise among Muslim South Asians aged 60-70 years. Promoting active lifestyles and building physical activity in and around day-to-day activities are important strategies in increasing activity levels. However, the needs for culturally appropriate facilities, peer mentors who could assist those with language barriers, specific tailored advice, advice on integrating physical activity in everyday life and general social support could promote uptake and subsequent adherence among this population group. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

National Institutes of Health Blood and Marrow Transplant Late Effects Initiative: The Healthcare Delivery Working Group Report.

PubMed

Hashmi, Shahrukh K; Bredeson, Christopher; Duarte, Rafael F; Farnia, Stephanie; Ferrey, Susan; Fitzhugh, Courtney; Flowers, Mary E D; Gajewski, James; Gastineau, Dennis; Greenwald, Melissa; Jagasia, Madan; Martin, Patricia; Rizzo, J Douglas; Schmit-Pokorny, Kimberly; Majhail, Navneet S

2017-05-01

Hematopoietic cell transplantation (HCT) survivors are at risk for development of late complications and require lifelong monitoring for screening and prevention of late effects. There is an increasing appreciation of the issues related to healthcare delivery and coverage faced by HCT survivors. The 2016 National Institutes of Health Blood and Marrow Transplant Late Effects Initiative included an international and broadly representative Healthcare Delivery Working Group that was tasked with identifying research gaps pertaining to healthcare delivery and to identify initiatives that may yield a better understanding of the long-term value and costs of care for HCT survivors. There is a paucity of literature in this area. Critical areas in need of research include pilot studies of novel and information technology supported models of care delivery and coverage for HCT survivors along with development and validation of instruments that capture patient-reported outcomes. Investment in infrastructure to support this research, such as linkage of databases including electronic health records and routine inclusion of endpoints that will inform analyses focused around care delivery and coverage, is required. Copyright © 2017 The American Society for Blood and Marrow Transplantation. All rights reserved.

Spacecraft COst REduction Team (SCORE): TQM/CI on a massive scale

NASA Technical Reports Server (NTRS)

Bullard, Jerry D.

1992-01-01

The business of building satellites and space systems has matured. Few missions require, or can afford, excellent performance at any price. The new paradigm is doing more with less, providing quality systems at lower cost--in other words, doing our job 'Faster-Better-Cheaper.' The TRW Spacecraft COst REduction (SCORE) initiative was launched in 1990 by Daniel S. Goldin, then general manager of TRW's Space & Technology Group. The SCORE mission is to apply continuous improvement (CI) techniques to effect major reductions in the cost (our primary goal) and span time (as a corollary) required for the production of spacecraft. SCORE is a multi-year initiative that is having a profound effect on both the procedural and the cultural aspects of how we do business. The objectives of this initiative are being realized. The focus of this paper is not on the results of SCORE per se, but rather on the things we have leaned about how to do continuous improvement on a massive scale, with multilevel (hierarchical) CI teams. The following sections summarize the chronology of the SCORE initiative, from team formation to development of the year-end report for 1991. Lessons learned, the core of this presentation, are discussed--with particular focus on the unique aspects of SCORE. The SCORE initiative is continuing and, as a part of our evolving culture, will never end. It has resulted in profound insights into the way we do work and (the topic at hand) how to do CI for large and complex multidisciplinary development activities.

A phenomenological research study: Perspectives of student learning through small group work between undergraduate nursing students and educators.

PubMed

Wong, Florence Mei Fung

2018-06-18

Small group work is an effective teaching-learning approach in nursing education to enhance students' learning in theoretical knowledge and skill development. Despite its potential advantageous effects on learning, little is known about its actual effects on students' learning from students' and educators' perspectives. To understand students' learning through small group work from the perspectives of students and educators. A qualitative study with focus group interviews was carried out. Semi-structured interviews with open-ended questions were performed with 13 undergraduate nursing students and 10 educators. Four main themes, "initiative learning", "empowerment of interactive group dynamics", "factors for creating effective learning environment", and "barriers influencing students' learning", were derived regarding students' learning in small group work based on the perspectives of the participants. The results showed the importance of learning attitudes of students in individual and group learning. Factors for creating an effective learning environment, including preference for forming groups, effective group size, and adequacy of discussion, facilitate students' learning with the enhancement of learning engagement in small group work. The identified barriers, such as "excessive group work", "conflicts", and "passive team members" can reduce students' motivation and enjoyment of learning. Small group work is recognized as an effective teaching method for knowledge enhancement and skill development in nursing education. All identified themes are important to understand the initiatives of students and group learning, factors influencing an effective learning environment, and barriers hindering students' learning. Nurse educators should pay more attention to the factors that influence an effective learning environment and reduce students' commitment and group dynamics. Moreover, students may need further support to reduce barriers that impede students' learning motivation and enjoyment. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Gulf of Mexico Coastal Ocean Observing System: A Decade of Data Aggregation and Services.

NASA Astrophysics Data System (ADS)

Howard, M.; Gayanilo, F.; Kobara, S.; Baum, S. K.; Currier, R. D.; Stoessel, M. M.

2016-02-01

The Gulf of Mexico Coastal Ocean Observing System Regional Association (GCOOS-RA) celebrated its 10-year anniversary in 2015. GCOOS-RA is one of 11 RAs organized under the NOAA-led U.S. Integrated Ocean Observing System (IOOS) Program Office to aggregate regional data and make these data publicly-available in preferred forms and formats via standards-based web services. Initial development of GCOOS focused on building elements of the IOOS Data Management and Communications Plan which is a framework for end-to-end interoperability. These elements included: data discovery, catalog, metadata, online-browse, data access and transport. Initial data types aggregated included near real-time physical oceanographic, marine meteorological and satellite data. Our focus in the middle of the past decade was on the production of basic products such as maps of current oceanographic conditions and quasi-static datasets such as bathymetry and climatologies. In the latter part of the decade we incorporated historical physical oceanographic datasets and historical coastal and offshore water quality data into our holdings and added our first biological dataset. We also developed web environments and products to support Citizen Scientists and stakeholder groups such as recreational boaters. Current efforts are directed towards applying data quality assurance (testing and flagging) to non-federal data, data archiving at national repositories, serving and visualizing numerical model output, providing data services for glider operators, and supporting marine biodiversity observing networks. GCOOS Data Management works closely with the Gulf of Mexico Research Initiative Information and Data Cooperative and various groups involved with Gulf Restoration. GCOOS-RA has influenced attitudes and behaviors associated with good data stewardship and data management practices across the Gulf and will to continue to do so into the next decade.

Caribbean Heat Threatens Health, Well-being and the Future of Humanity.

PubMed

Macpherson, Cheryl C; Akpinar-Elci, Muge

2015-07-01

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen.

Caribbean Heat Threatens Health, Well-being and the Future of Humanity

PubMed Central

Macpherson, Cheryl C.; Akpinar-Elci, Muge

2015-01-01

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen. PMID:26180551

New pediatric vision screener, part II: electronics, software, signal processing and validation.

PubMed

Gramatikov, Boris I; Irsch, Kristina; Wu, Yi-Kai; Guyton, David L

2016-02-04

We have developed an improved pediatric vision screener (PVS) that can reliably detect central fixation, eye alignment and focus. The instrument identifies risk factors for amblyopia, namely eye misalignment and defocus. The device uses the birefringence of the human fovea (the most sensitive part of the retina). The optics have been reported in more detail previously. The present article focuses on the electronics and the analysis algorithms used. The objective of this study was to optimize the analog design, data acquisition, noise suppression techniques, the classification algorithms and the decision making thresholds, as well as to validate the performance of the research instrument on an initial group of young test subjects-18 patients with known vision abnormalities (eight male and 10 female), ages 4-25 (only one above 18) and 19 controls with proven lack of vision issues. Four statistical methods were used to derive decision making thresholds that would best separate patients with abnormalities from controls. Sensitivity and specificity were calculated for each method, and the most suitable one was selected. Both the central fixation and the focus detection criteria worked robustly and allowed reliable separation between normal test subjects and symptomatic subjects. The sensitivity of the instrument was 100 % for both central fixation and focus detection. The specificity was 100 % for central fixation and 89.5 % for focus detection. The overall sensitivity was 100 % and the overall specificity was 94.7 %. Despite the relatively small initial sample size, we believe that the PVS instrument design, the analysis methods employed, and the device as a whole, will prove valuable for mass screening of children.

A physician-led initiative to improve clinical documentation results in improved health care documentation, case mix index, and increased contribution margin.

PubMed

Aiello, Francesco A; Judelson, Dejah R; Durgin, Jonathan M; Doucet, Danielle R; Simons, Jessica P; Durocher, Dawn M; Flahive, Julie M; Schanzer, Andres

2018-05-04

Clinical documentation is the key determinant of inpatient acuity of illness and payer reimbursement. Every inpatient hospitalization is placed into a diagnosis related group with a relative value based on documented procedures, conditions, comorbidities and complications. The Case Mix Index (CMI) is an average of these diagnosis related groups and directly impacts physician profiling, medical center profiling, reimbursement, and quality reporting. We hypothesize that a focused, physician-led initiative to improve clinical documentation of vascular surgery inpatients results in increased CMI and contribution margin. A physician-led coding initiative to educate physicians on the documentation of comorbidities and conditions was initiated with concurrent chart review sessions with coding specialists for 3 months, and then as needed, after the creation of a vascular surgery documentation guide. Clinical documentation and billing for all carotid endarterectomy (CEA) and open infrainguinal procedures (OIPs) performed between January 2013 and July 2016 were stratified into precoding and postcoding initiative groups. Age, duration of stay, direct costs, actual reimbursements, contribution margin (CM), CMI, rate of complication or comorbidity, major complication or comorbidity, severity of illness, and risk of mortality assigned to each discharge were abstracted. Data were compared over time by standardizing Centers for Medicare and Medicaid Services (CMS) values for each diagnosis related group and using a CMS base rate reimbursement. Among 458 CEA admissions, postcoding initiative CEA patients (n = 253) had a significantly higher CMI (1.36 vs 1.25; P = .03), CM ($7859 vs $6650; P = .048), and CMS base rate reimbursement ($8955 vs $8258; P = .03) than precoding initiative CEA patients (n = 205). The proportion of admissions with a documented major complication or comorbidity and complication or comorbidity was significantly higher after the coding initiative (43% vs 27%; P < .01). Among 504 OIPs, postcoding initiative patients (n = 227) had a significantly higher CMI (2.23 vs 2.05; P < .01), actual reimbursement ($23,203 vs $19,909; P < .01), CM ($12,165 vs $8840; P < .01), and CMS base rate reimbursement ($14,649 vs $13,496; P < .01) than precoding initiative patients (n = 277). The proportion of admissions with a documented major complication or comorbidity and complication or comorbidity was significantly higher after the coding initiative (61% vs 43%; P < .01). For both CEA and OIPs, there were no differences in age, duration of stay, total direct costs, or primary insurance status between the precoding and postcoding patient groups. Accurate and detailed clinical documentation is required for key stakeholders to characterize the acuity of inpatient admissions and ensure appropriate reimbursement; it is also a key component of risk-adjustment methods for assessing quality of care. A physician-led documentation initiative significantly increased CMI and CM. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

On the comparability of knowledge transfer activities - a case study at the German Baltic Sea Coast focusing regional climate services

NASA Astrophysics Data System (ADS)

Meinke, Insa

2017-06-01

In this article the comparability of knowledge transfer activities is discussed by accounting for external impacts. It is shown that factors which are neither part of the knowledge transfer activity nor part of the participating institution may have significant impact on the potential usefulness of knowledge transfer activities. Differences in the potential usefulness are leading to different initial conditions of the knowledge transfer activities. This needs to be taken into account when comparing different knowledge transfer activities, e.g., in program evaluations. This study is focusing on regional climate services at the German Baltic Sea coast. It is based on two surveys and experiences with two identical web tools applied on two regions with different spatial coverage. The results show that comparability among science based knowledge transfer activities is strongly limited through several external impacts. The potential usefulness and thus the initial condition of a particular knowledge transfer activity strongly depends on (1) the perceived priority of the focused topic, (2) the used information channels, (3) the conformity between the research agenda of service providing institutions and information demands in the public, as well as (4) on the spatial coverage of a service. It is suggested to account for the described external impacts for evaluations of knowledge transfer activities. The results show that the comparability of knowledge transfer activities is limited and challenge the adequacy of quantitative measures in this context. Moreover, as shown in this case study, in particular regional climate services should be individually evaluated on a long term perspective, by potential user groups and/or by its real users. It is further suggested that evaluation criteria should be co-developed with these stakeholder groups.

Effective factors in expansion of medical tourism in Iran

PubMed Central

Rezaee, Reza; Mohammadzadeh, Mehdi

2016-01-01

Background: Medical tourism (MT) refers to circumstances in which people travel for medical treatments. The present study focuses on determining factors affecting MT in Iran. Methods: The study uses a mixed method approach. Initially, through a qualitative study, 12 experts were interviewed deeply; then, 22 participants in three equal focus groups expressed their ideas about growth and development of MT in Iran. Based on the expressed ideas, 120 factors were identified and accordingly a structured questionnaire was developed. Some members from the focus groups confirmed the questionnaire’s face and content validity. The reliability of pertinent items was confirmed using Cronbach’s alpha=0.8. Afterwards, 61 eligible subjects filled out this questionnaire. Results: The findings showed that "healthcare quality" and "high level of expertise" are two most attractive factors in MT. However, other factors such as "healthcare costs", and "visa facilities" are among key factors as well. Also, the role of "the healthcare providers" was found to be more prominent than the roles of "the government" and "the general tourist services". Conclusion: Although some attractive MT factors are present currently, MT expansion to a desirable level in Iran requires a comprehensive plan of which its factors were discussed in this paper. PMID:27683650

Effective factors in expansion of medical tourism in Iran.

PubMed

Rezaee, Reza; Mohammadzadeh, Mehdi

2016-01-01

Medical tourism (MT) refers to circumstances in which people travel for medical treatments. The present study focuses on determining factors affecting MT in Iran. The study uses a mixed method approach. Initially, through a qualitative study, 12 experts were interviewed deeply; then, 22 participants in three equal focus groups expressed their ideas about growth and development of MT in Iran. Based on the expressed ideas, 120 factors were identified and accordingly a structured questionnaire was developed. Some members from the focus groups confirmed the questionnaire's face and content validity. The reliability of pertinent items was confirmed using Cronbach's alpha=0.8. Afterwards, 61 eligible subjects filled out this questionnaire. The findings showed that "healthcare quality" and "high level of expertise" are two most attractive factors in MT. However, other factors such as "healthcare costs", and "visa facilities" are among key factors as well. Also, the role of "the healthcare providers" was found to be more prominent than the roles of "the government" and "the general tourist services". Although some attractive MT factors are present currently, MT expansion to a desirable level in Iran requires a comprehensive plan of which its factors were discussed in this paper.

Daughter-initiated health advice to mothers: perceptions of African–American and Latina daughters

PubMed Central

Mosavel, M.; Thomas, T.

2009-01-01

The prevailing paradigm of health exchange within the family is for health advice to flow from parent to child. Consistent with this pattern of exchange, most research has focused on the one-directional influence of the parent on the child and there is thus an absence of literature that explores the ability of adolescents to influence their parents’ health behaviors. This qualitative study addressed this gap by exploring the feasibility of daughters providing health advice to their mothers. Twelve focus groups were conducted with 78 African–American and Latina daughters between the ages of 12 and 17 from low-income neighborhoods in a Mid-Western city in the United States. This study utilized a grounded theory approach to examine the focus group data. The findings indicate that many daughters report that they are already giving their mothers a wide spectrum of advice, including health advice. Differences were found in the reported willingness of African–American daughters when compared to Latina daughters to provide their mothers with specific cancer advice. These data suggest that some of these daughters have the potential to be valuable health education conveyers in the family. PMID:19339373

Heart disease education and prevention program targeting immigrant Latinos: using focus group responses to develop effective interventions.

PubMed

Moreno, C; Alvarado, M; Balcazar, H; Lane, C; Newman, E; Ortiz, G; Forrest, M

1997-12-01

Although research has provided considerable knowledge concerning the positive effects of behavioral change on morbidity and mortality from heart disease and related risk factors, some segments of the population have not benefited equitably from this information. In April 1995, the National Heart, Lung, and Blood Institute (NHLBI) conducted seven focus groups to determine knowledge and attitudes about heart disease and associated risk factors, identify media usage and preferences, and assess publications usage and preferences among Spanish-speaking Latino immigrants residing in the Washington, D.C., metropolitan area. This information was gathered to assist in the development of key messages and strategies for the NHLBI Latino Community Cardiovascular Disease Prevention and Outreach Initiative, Salud para su Corazón--a heart disease prevention and education campaign. Findings from these focus groups indicate that Latinos may not benefit from heart disease prevention messages developed for the general population because of language and cultural differences. The researchers concluded that health education and disease prevention programs targeting the Latino community should develop educational materials and interventions that address language preferences and cultural values. Furthermore, to be effective, these programs should show people how to make positive behavioral changes based on their current circumstances, while remaining sensitive to the fact that Latino immigrants face major life adjustments and many are still greatly influenced by their country of origin.

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

Ethical principles and the rationing of health care: a qualitative study in general practice

PubMed Central

Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

2005-01-01

Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

Conflict and conflict resolution: parent and young teen perceptions.

PubMed

Riesch, Susan K; Gray, Jacqueline; Hoeffs, Mellisa; Keenan, Tia; Ertl, Tammy; Mathison, Kristin

2003-01-01

The purpose of this preliminary study was to describe a novel approach to examine the thinking of parents and young teens about conflict and conflict resolution in their relationship. The novel approach was that teens and parents were asked to solve, in focus groups, a hypothetical conflict situation without, and then with, a structured conflict resolution guide. Two focus groups were conducted. The resulting data were analyzed with use of content analysis from a sample of 8 parent-young teen dyads. The young teens and their parents participated separately from one another in the focus groups. Data demonstrated that the young teens (a) thought parents or siblings initiated most disagreements and that such disagreements were routine, and (b) handled conflict with their parents by trying to prevent it. If a conflict ensued, they used emotion, aggression, cooling off, accepting some of the blame, or submission to resolve it. Parents viewed the disagreements as (a) representing their struggles with their role as a parent or (b) opportunities to instill a sense of intrinsic responsibility in their child. Parents used the strategies of setting clear expectations, parental authority, negotiation, cooling down, and feedback to solve disagreements with their teenage children. We concluded that these parents and young teens do not use a systematic method of solving disagreements but that with structured guidance, the parents and teens were able to resolve conflicts.

Maintaining a balance: a focus group study on living and coping with chronic whiplash-associated disorder

PubMed Central

2010-01-01

Background There is little qualitative insight into how persons with chronic Whiplash-Associated Disorder cope on a day to day basis. This study seeks to identify the symptoms persons with Whiplash-Associated Disorder describe as dominating and explore their self-initiated coping strategies. Methods Qualitative study using focus groups interviews. Fourteen Norwegian men and women with Whiplash-Associated Disorder (I or II) were recruited to participate in two focus groups. Data were analyzed according to a phenomenological approach, and discussed within the model of Cognitive Activation Theory of Stress (CATS). Results Participants reported neck and head pain, sensory hypersensitivity, and cognitive dysfunction following their whiplash injury. Based on the intensity of symptoms, participants divided everyday life into good and bad periods. In good periods the symptoms were perceived as manageable. In bad periods the symptoms intensified and took control of the individual. Participants expressed a constant notion of trying to balance their three main coping strategies; rest, exercise, and social withdrawal. In good periods participants experienced coping by expecting good results from the strategies they used. In bad periods they experienced no or negative relationships between their behavioral strategies and their complaints. Conclusions Neck and head pain, sensory hypersensitivity, and cognitive dysfunction were reported as participants' main complaints. A constant notion of balancing between their three main coping strategies; rest, exercise, and social withdrawal, was described. PMID:20626855

Maintaining a balance: a focus group study on living and coping with chronic whiplash-associated disorder.

PubMed

Krohne, Kariann; Ihlebaek, Camilla

2010-07-13

There is little qualitative insight into how persons with chronic Whiplash-Associated Disorder cope on a day to day basis. This study seeks to identify the symptoms persons with Whiplash-Associated Disorder describe as dominating and explore their self-initiated coping strategies. Qualitative study using focus groups interviews. Fourteen Norwegian men and women with Whiplash-Associated Disorder (I or II) were recruited to participate in two focus groups. Data were analyzed according to a phenomenological approach, and discussed within the model of Cognitive Activation Theory of Stress (CATS). Participants reported neck and head pain, sensory hypersensitivity, and cognitive dysfunction following their whiplash injury. Based on the intensity of symptoms, participants divided everyday life into good and bad periods. In good periods the symptoms were perceived as manageable. In bad periods the symptoms intensified and took control of the individual. Participants expressed a constant notion of trying to balance their three main coping strategies; rest, exercise, and social withdrawal. In good periods participants experienced coping by expecting good results from the strategies they used. In bad periods they experienced no or negative relationships between their behavioral strategies and their complaints. Neck and head pain, sensory hypersensitivity, and cognitive dysfunction were reported as participants' main complaints. A constant notion of balancing between their three main coping strategies; rest, exercise, and social withdrawal, was described.

Exploring participant appreciation of group-based principles for action in community-based physical activity programs for socially vulnerable groups in the Netherlands.

PubMed

Herens, Marion; Wagemakers, Annemarie; Vaandrager, Lenneke; Koelen, Maria

2015-11-25

Physical inactivity is a core risk factor for non-communicable diseases. In the Netherlands, socially vulnerable groups are relatively less active than groups with higher socio-economic status. Community-based health-enhancing physical activity (CBHEPA) programs aim to empower socially vulnerable groups by improving participants' health and wellbeing through physical activity. CBHEPA programs often revolve around group-based principles for action, such as active participation, enjoyment, and fostering group processes. As such principles are rarely made explicit, our study aims to identify which of the group-based principles for action are considered important by participants. Respondents (n = 76) from ten focus groups scored their individual appreciation of group-based principles for action - active participation, enjoyment, and fostering group processes - on a three-point, statement-based scale. Opinions were further discussed in the focus group. Focus group discussions were transcribed and analysed by a team of investigators. The coding procedures, identifying elements appreciated in group-based principles for action, were thematic and data driven. Statements about participatory programming generated much less consensus in appreciation among respondents than statements about enjoyment and fostering group processes. To some extent, group members participated in the development of program content. Participation in group formation or community initiatives was less frequently perceived as something within group members' control. Enjoyment, expressed as physical and emotional experiences, was found to be an individual driver of group exercise. Fostering group processes, expressed as social support, was found to contribute to enjoyment and learning achievements. Responsive leadership, ensuring responsive guidance, by an enthusiastic exercise trainer acting as a role model, were identified as additional necessary principles for action. Group-based principles for action in CBHEPA programs are not clearly demarcated. Fostering group processes is an overarching principle, conditional for the spin-off in terms of enjoyment and active participation. This, in turn, leads to a sense of ownership among participants, who take up responsibility for the exercise group as well as their individual activity behaviour. CBHEPA programs thrive on participants having fun together and exercise trainers' leadership skills. A professional, competent, responsive exercise trainer plays a key role in the organisation and maintenance of CBHEPA programs.

THE CHALLENGING ROLE OF A READING COACH, A CAUTIONARY TALE.

PubMed

Al Otaiba, Stephanie; Hosp, John L; Smartt, Susan; Dole, Janice A

2008-04-01

The purpose of this case study is to describe the challenges one coach faced during the initial implementation of a coaching initiative involving 33 teachers in an urban, high-poverty elementary school. Reading coaches are increasingly expected to play a key role in the professional development efforts to improve reading instruction in order to improve reading achievement for struggling readers. Data sources included initial reading scores for kindergarten and first-graders, pretest and posttest scores of teachers' knowledge, a teacher survey, focus group interviews, project documents, and field notes. Data were analyzed using a mixed methods approach. Findings revealed several challenges that have important implications for research and practice: that teachers encountered new information about teaching early reading that conflicted with their current knowledge, this new information conflicted with their core reading program, teachers had differing perceptions of the role of the reading coach that affected their feelings about the project, and reform efforts are time-intensive.

Mid-career faculty development in academic medicine: How does it impact faculty and institutional vitality?

PubMed Central

Campion, MaryAnn W.; Bhasin, Robina M.; Beaudette, Donald J.; Shann, Mary H.; Benjamin, Emelia J.

2016-01-01

Purpose Faculty vitality is integral to the advancement of higher education. Strengthening vitality is particularly important for mid-career faculty, who represent the largest and most dissatisfied segment. The demands of academic medicine appear to be another factor that may put faculty at risk of attrition. To address these issues, we initiated a ten-month mid-career faculty development program. Methods A mixed-methods quasi-experimental design was used to evaluate the program's impact on faculty and institutional vitality. Pre/post surveys compared participants with a matched reference group. Quantitative data were augmented by interviews and focus groups with multiple stakeholders. Results At the program's conclusion, participants showed statistically significant gains in knowledge, skills, attitudes, and connectivity when compared to the referents. Conclusion Given that mid-career faculty development in academic medicine has not been extensively studied, our evaluation provides a useful perspective to guide future initiatives aimed at enhancing the vitality and leadership capacity of mid-career faculty. PMID:27942418

Bacterial Sigma Factors and Anti-Sigma Factors: Structure, Function and Distribution

PubMed Central

Paget, Mark S.

2015-01-01

Sigma factors are multi-domain subunits of bacterial RNA polymerase (RNAP) that play critical roles in transcription initiation, including the recognition and opening of promoters as well as the initial steps in RNA synthesis. This review focuses on the structure and function of the major sigma-70 class that includes the housekeeping sigma factor (Group 1) that directs the bulk of transcription during active growth, and structurally-related alternative sigma factors (Groups 2–4) that control a wide variety of adaptive responses such as morphological development and the management of stress. A recurring theme in sigma factor control is their sequestration by anti-sigma factors that occlude their RNAP-binding determinants. Sigma factors are then released through a wide variety of mechanisms, often involving branched signal transduction pathways that allow the integration of distinct signals. Three major strategies for sigma release are discussed: regulated proteolysis, partner-switching, and direct sensing by the anti-sigma factor. PMID:26131973

Mid-career faculty development in academic medicine: How does it impact faculty and institutional vitality?

PubMed

Campion, MaryAnn W; Bhasin, Robina M; Beaudette, Donald J; Shann, Mary H; Benjamin, Emelia J

2016-09-01

Faculty vitality is integral to the advancement of higher education. Strengthening vitality is particularly important for mid-career faculty, who represent the largest and most dissatisfied segment. The demands of academic medicine appear to be another factor that may put faculty at risk of attrition. To address these issues, we initiated a ten-month mid-career faculty development program. A mixed-methods quasi-experimental design was used to evaluate the program's impact on faculty and institutional vitality. Pre/post surveys compared participants with a matched reference group. Quantitative data were augmented by interviews and focus groups with multiple stakeholders. At the program's conclusion, participants showed statistically significant gains in knowledge, skills, attitudes, and connectivity when compared to the referents. Given that mid-career faculty development in academic medicine has not been extensively studied, our evaluation provides a useful perspective to guide future initiatives aimed at enhancing the vitality and leadership capacity of mid-career faculty.

Initiation of insulin for type 2 diabetes mellitus patients: what are the issues? A qualitative study.

PubMed

Tan, A M; Muthusamy, L; Ng, C C; Phoon, K Y; Ow, J H; Tan, N C

2011-11-01

Type 2 diabetes mellitus is a progressive condition in which the pancreatic beta-cell function deteriorates with increasing duration of the disease. When good glycaemic control is not achieved despite adherence to oral hypoglycaemic drugs, healthy diet and lifestyle, insulin should be initiated. However, this is often delayed due to various reasons. We aimed to determine the issues relating to insulin initiation for diabetic patients managed in primary care polyclinics in Singapore. Qualitative data was obtained during four focus group discussions, with participation from healthcare professionals (HCPs), including physicians and nurses, and type 2 diabetes mellitus patients. The data was transcribed into text, coded and grouped into themes. Launching the topic and doctor-patient communication on insulin therapy were key issues in insulin initiation. Patient barriers to insulin commencement included: refusal to acknowledge the need for insulin therapy; its perception as a social stigma, an inconvenient mode of treatment or punishment for failure; and fear of needles, side-effects and complications. The HCP's attitude and experience with insulin therapy were also possible barriers. Our findings highlight that insulin initiation is affected by the complex interaction between the patients and HCPs, and other system factors. Patients may harbour misconceptions about insulin due to the late introduction of insulin therapy by HCPs or the way the therapy is being communicated to them. The key issues to address are the disparity in perceptions of diabetic control between HCPs and patients, and education regarding the need for insulin therapy.

A qualitative descriptive study of risk reduction for coronary disease among the Hong Kong Chinese.

PubMed

Chan, Choi Wan; Lopez, Violeta

2014-01-01

Achieving optimal control and reduction in coronary heart disease (CHD) risks in Hong Kong (HK) remains significant and requires exploring. This article addresses the ability to reduce CHD risks among the HK Chinese. Through secondary analysis, a qualitative descriptive design using focus group interviews and content analysis were adopted. Older and younger adults were invited for the study. An interview schedule was used to guide discussions during focus group interviews. Four categories emerged from the data: planning of health actions, control of risk-reducing behavior, perceived opportunities for understanding CHD, and chest pain appraisal. Local culture and population needs play a central role in disease perception and prevention. The findings are essential to target strategies for initiating health acts for younger adults and establish public education resources that underscore understanding of CHD risk, symptom recognition, and disease management, particularly among those middle-aged and older people at high risk and with the diseased populations. © 2013 Wiley Periodicals, Inc.

Use of personal phones by senior nursing students to access health care information during clinical education: staff nurses' and students' perceptions.

PubMed

Wittmann-Price, Ruth A; Kennedy, Lynn D; Godwin, Catherine

2012-11-01

Research indicates that having electronic resources readily available increases learners' ability to make clinical decisions and confidence in patient care. This mixed-method, descriptive pilot study collected data about senior prelicensure nursing students using smartphones, a type of mobile electronic device (MED), in the clinical area. The smartphones contained nursing diagnosis, pharmacology, and laboratory information; an encyclopedia; and the MEDLINE database. Student (n = 7) data about smartphone use during a 10-week clinical rotation were collected via student-recorded usage logs and focus group recordings. Staff nurses' (n = 5) perceptions of students' use of smartphones for clinical educational resources were collected by anonymous survey. Both the focus group transcript and staff surveys were evaluated and the themes summarized by content analysis. Positive results and barriers to use, such as cost and technological comfort levels, are discussed. The results may help nurse educators and administrators initiate further research of MEDs as a clinical resource. Copyright 2012, SLACK Incorporated.

Privacy and Technology: Folk Definitions and Perspectives

PubMed Central

Kwasny, Michelle N.; Caine, Kelly E.; Rogers, Wendy A.; Fisk, Arthur D.

2017-01-01

In this paper we present preliminary results from a study of individual differences in privacy beliefs, as well as relate folk definitions of privacy to extant privacy theory. Focus groups were conducted with young adults aged 18–28 and older adults aged 65–75. Participants first shared their individual definitions of privacy, followed by a discussion of privacy in six scenarios chosen to represent a range of potentially invasive situations. Taken together, Westin’s and Altman’s theories of privacy accounted for both younger and older adults’ ideas about privacy, however, neither theory successfully accounted for findings across all age and gender groups. Whereas males tended to think of privacy in terms of personal needs and convenience, females focused more on privacy in terms of others, respecting privacy rights, and safety. Older adults tended to be more concerned about privacy of space rather than information privacy. Initial results reinforce the notion that targeting HCI design to the user population, even with respect to privacy, is critically important. PMID:29057397

A Mixed-Method Approach on Digital Educational Games for K12: Gender, Attitudes and Performance

NASA Astrophysics Data System (ADS)

Law, Effie Lai-Chong; Gamble, Tim; Schwarz, Daniel; Kickmeier-Rust, Michael D.; Holzinger, Andreas

Research on the influence of gender on attitudes towards and performance in digital educational games (DEGs) has quite a long history. Generally, males tend to play such games more engagingly than females, consequently attitude and performance of males using DEGs should be presumably higher than that of females. This paper reports an investigation of a DEG, which was developed to enhance the acquisition of geographical knowledge, carried out on British, German and Austrian K12 students aged between 11 and 14. Methods include a survey on initial design concepts, user tests on the system and two single-gender focus groups. Gender and cultural differences in gameplay habit, game type preferences and game character perceptions were observed. The results showed that both genders similarly improved their geographical knowledge, although boys tended to have a higher level of positive user experience than the girls. The qualitative data from the focus groups illustrated some interesting gender differences in perceiving various aspects of the game.

Continued investigation of LDEF's structural frame and thermal blankets by the Meteoroid and Debris Special Investigation Group

NASA Technical Reports Server (NTRS)

See, Thomas H.; Mack, Kimberly S.; Warren, Jack L.; Zolensky, Michael E.; Zook, Herbert A.

1993-01-01

This report focuses on the data acquired by detailed examination of LDEF intercostals, 68 of which are now in possession of the Meteoroid and Debris Special Investigation Group (M&D SIG) at JSC. In addition, limited data will be presented for several small sections from the A0178 thermal control blankets that were examined/counted prior to being shipped to Principal Investigators (PI's) for scientific study. The data presented here are limited to measurements of crater and penetration-hole diameters and their frequency of occurrence which permits, yet also constrains, more model-dependent, interpretative efforts. Such efforts will focus on the conversion of crater and penetration-hole sizes to projectile diameters (and masses), on absolute particle fluxes, and on the distribution of particle-encounter velocities. These are all complex issues that presently cannot be pursued without making various assumptions which relate, in part, to crater-scaling relationships, and to assumed trajectories of natural and man-made particle populations in LEO that control the initial impact conditions.

Astrobites as a Pedagogical Tool in Classrooms

NASA Astrophysics Data System (ADS)

Khullar, Gourav; Tsang, Benny Tsz Ho; Sanders, Nathan; Kohler, Susanna; Shipp, Nora; Astrobites Collaboration

2018-06-01

Astrobites is a graduate-student organization that publishes an online astrophysical literature blog (astrobites.org), and has published brief and accessible summaries of more than 1600 articles from the astrophysical literature since its founding in 2010. Our graduate-student generated content is widely being utilised as a pedagogical tool to bring current research into the classroom of higher education. We aim to study the effectiveness of Astrobites in teaching of current research, via the AAS Education & Professional Development Mini-Grant funded in Fall 2017. This talk gives an overview of the functioning of Astrobites, our past pedagogical initiatives, as well as a brief description of the grant proposal. We describe the workings of our teaching workshop at the 231st AAS Meeting in January 2018, as well as a 10-educator focus group that has been assembled to conduct a post-workshop follow-up that serves as a dataset for our research study. We present here a brief analysis of the workshop, the focus group and preliminary inferences.

Context-Based Pedagogy: A Framework From Experience.

PubMed

Kantar, Lina D

2016-07-01

Attempts to transform teaching practice are inadvertently subjected to several hurdles, mostly attributed to the lack of a guiding framework. This study aimed at unraveling the conceptual underpinnings of the context-based pedagogy, being perceived the pedagogy that prepares professionals for future practice. Through focus group interviews, data were collected from 16 nursing students who had case studies as the main instructional format in three major courses. The participants were divided into three focus groups, and interview questions were based on three educational parameters: the learning environment, instructional format, and instructional process. Initial findings revealed an array of classroom activities that characterize each parameter. An in-depth analysis of these activities converged on four concepts: (a) dynamic learning environment, (b) realism, (c) thinking dispositions, and (d) professional formation. These concepts improvise a beginning framework for educators and curriculum leaders that can be used to integrate cases in the curriculum and to facilitate the contextualization of knowledge. [J Nurs Educ. 2016;55(7):391-395.]. Copyright 2016, SLACK Incorporated.

Development of an mHealth Intervention (iSTEP) to Promote Physical Activity among People Living with HIV.

PubMed

Montoya, Jessica L; Wing, David; Knight, Adam; Moore, David J; Henry, Brook L

2015-01-01

A randomized controlled trial is being conducted in the United States to test the efficacy of a personalized interactive mobile health intervention (iSTEP) designed to increase physical activity (PA) and improve neurocognitive functioning among HIV-positive persons. This article describes an initial qualitative study performed to develop iSTEP for the HIV-positive population, including assessment of PA barriers and facilitators. Two focus groups, with 9 and 12 unique HIV-positive individuals, respectively, were administered to evaluate barriers limiting PA and potential iSTEP content created to encourage greater PA. Group discussions revealed prominent PA barriers, including HIV symptoms (neuropathy, lipoatrophy), antiretroviral medication effects, and fatigue; significant PA facilitators included self-monitoring and family support. Participants provided feedback on strategies to increase PA and expressed positive support for a mobile intervention adapted to personal priorities. These findings will assist the development of novel PA interventions focused on treating the epidemic of HIV-associated neurocognitive disorders. © The Author(s) 2015.

Perspectives of Mobile Versus Fixed Mammography in Santa Clara County, California: A Focus Group Study.

PubMed

Chen, Yi-Ren; Chang-Halpenny, Christine; Kumarasamy, Narmadan A; Venegas, Angela; Braddock Iii, Clarence H

2016-02-12

Our aim was to examine underserved women's perceptions on mobile versus fixed mammography in Santa Clara, California through a focus group study.  Research has shown that medically underserved women have higher breast cancer mortality rates correlated with under-screening and a disproportional rate of late-stage diagnosis. The Community Health Partnership in Santa Clara County, California runs the Community Mammography Access Project (CMAP) that targets nearly 20,000 medically underserved women over the age of 40 in the county through the collaborative effort of an existing safety net of healthcare providers. However, little data exists on the advantages or disadvantages of mobile mammography units from the patient perspective.   We assessed underserved women's perspectives on mammography services in Santa Clara County through two focus groups from women screened at mobile or fixed site programs. Patients were recruited from both CMAP clinics and a county hospital, and focus group data were analyzed using content analysis.  We found that women from both the mobile and fixed sites shared similar motivating factors for getting a mammogram. Both groups recognized that screening was uncomfortable but necessary for good health and had positive feedback about their personal physicians. However, mobile participants, in particular, appreciated the atmosphere of mobile screening, reported shorter wait times, and remarked on the good communication from the clinic staff and empathetic treatment they received. However, mobile participants also expressed concern about the quality of films at mobile sites due to delayed initial reading of the films.   Mobile mammography offers a unique opportunity for women of underserved populations to access high satisfaction screenings, and it encourages a model similar to CMAP in other underserved areas. However, emphasis should be placed on providing a warm and welcoming environment for patients and ensuring the quality of mammography images.

Drug Use and Sex Work Among At-risk Women: A Qualitative Study of Initial Factors.

PubMed

Roshanfekr, Payam; Noori, Roya; Dejman, Masoumeh; Fathi Geshnigani, Zahra; Rafiey, Hassan

2015-06-01

In recent years, there has been an increasing interest in performing research on drug use and sex work among at-risk women. Although there is a well-documented literature of the initial reasons associated with drug use and sex work among women, there is, however, a paucity of information in this area in Iran. This study aimed to explore the initial reasons associated with drug use and sex work in a group of female treatment seekers, who presented health-related risk behaviors, in Tehran, Iran. This qualitative study enrolled a total of 65 at-risk women, from five women-specific drug clinics, who participated in the study in 2011. Individual in-depth interviews were conducted. Focus group interviews were conducted with 10 key informants. All interviews were audio-taped and thematically written. The recorded data were analyzed using ATLASti qualitative research software version 10. The median age of the sample was 34 years. In addition, 44.6% of subjects were opiate users, and 55.4% were users of opiates and methamphetamine. Sex work was the main source of income for almost half of the sample. The most frequently reported reasons, associated with initial drug use, were extrinsic motivations, including the drug-using family, friends or social networks. Intrinsic motivations, including curiosity and individual willingness to use drugs, were other initial reasons. The most frequently reported reasons, associated with initial sex work, included the need to purchase drugs and financial problems. The study findings demonstrated a number of reasons associated with initial drug use and sex work. The role of sex work in providing drugs necessitates education and prevention. Special treatment programs should be implemented to prevent sex work among at-risk women in Iran.

Getting to social action: the Youth Empowerment Strategies (YES!) project.

PubMed

Wilson, Nance; Minkler, Meredith; Dasho, Stefan; Wallerstein, Nina; Martin, Anna C

2008-10-01

This article describes the social action component of the Youth Empowerment Strategies (YES!) project funded by the Centers for Disease Control and Prevention through its community-based prevention research (CBPR) initiative. YES! is designed to promote problem-solving skills, social action, and civic participation among underserved elementary and middle school youth. The after-school program focuses on identifying and building youths' capacities and strengths as a means of ultimately decreasing rates of alcohol, tobacco, and other drug use and other risky behaviors. The article discusses the conceptual models of risk and intervention and factors contributing to successful social action work, including group dynamics, intragroup leadership, facilitator skills, and school-community contexts. Attention is focused on how the nature of the projects themselves played a key role in determining the likelihood of experiencing success. Implications and recommendations for other youth-focused empowerment education projects are discussed, including the effective use of Photovoice in such projects.

Surviving Colorectal Cancer: Long-Term, Persistent Ostomy-Specific Concerns and Adaptations

PubMed Central

Sun, Virginia; Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Mohler, M. Jane; Hornbrook, Mark C.; Herrinton, Lisa J.; Baldwin, Carol M.; Krouse, Robert S.

2012-01-01

Purpose The purpose of this paper is to describe persistent ostomy-specific concerns and adaptations in long-term (> 5 years) colorectal cancer survivors with ostomies. Subjects and Settings Thirty three colorectal cancer survivors who participated in eight gender- and health related Quality of life (HRQOL) stratified focus groups and 130 colorectal cancer survivors who provided written comments to two open-ended questions on ostomy location and pouch problems participated in the study. Data were collected on health maintenance organization members in Oregon, southwestern Washington and northern California. Methods Qualitative data were analyzed for the 8 focus groups and written comments from 2 open-ended survey questions. Discussions from the focus groups were recorded, transcribed and analyzed using content analysis. Written content from the open-ended questions was derived from a mailed questionnaire on health related quality of life in survivors with ostomies and analyzed using content analysis. Results Discussions related to persistent ostomy-related issues more than 5 years after formation were common. Persistent ostomy-related issues were focused on clothing restrictions and adaptations, dietary concerns, issues related to ostomy equipment and self-care, and the constant need to find solutions to adjust and re-adjust to living with an ostomy. Conclusions Ostomy-specific concerns persist 5 years and more for long-term colorectal cancer survivors after initial ostomy formation. Adaptations tend to be individualized and based on trial and error. Findings underscore the need to develop long-term support mechanisms that survivors can access to promote better coping and adjustment to living with an ostomy. PMID:23222968

Integrating Doulas Into First-Trimester Abortion Care: Physician, Clinic Staff, and Doula Experiences.

PubMed

Chor, Julie; Lyman, Phoebe; Ruth, Jean; Patel, Ashlesha; Gilliam, Melissa

2018-01-01

Balancing the need to provide individual support for patients and the need for an efficient clinic can be challenging in the abortion setting. This study explores physician, staff, and specially trained abortion doula perspectives on doula support, one approach to patient support. We conducted separate focus groups with physicians, staff members, and doulas from a high-volume, first-trimester aspiration abortion clinic with a newly established volunteer abortion doula program. Focus groups explored 1) abortion doula training, 2) program implementation, 3) program benefits, and 4) opportunities for improvement. Interviews were transcribed and computer-assisted content analysis was performed; salient findings are presented. Five physicians, 5 staff members, and 4 abortion doulas participated in separate focus group discussions. Doulas drew on both their prior personal skills and experiences in addition to their abortion doula training to provide women with support at the time of abortion. Having doulas in the clinic to assist with women's emotional needs allowed physicians and staff to focus on technical aspects of the procedure. In turn, both physicians and staff believed that introducing doulas resulted in more patient-centered care. Although staff did not experience challenges to integrating doulas, physicians and doulas experienced initial challenges in incorporating doula support into the clinical flow. Staff and doulas reported exchanging skills and techniques that they subsequently used in their interactions with patients. Physicians, clinic staff, and doulas perceive abortion doula support as an approach to provide more patient-centered care in a high-volume aspiration abortion clinic. © 2018 by the American College of Nurse-Midwives.

Translating Anxiety-Focused CBT for Youth in a First Nations Context in Northwestern Ontario

PubMed Central

Nowrouzi, Behdin; Manassis, Katharina; Jones, Emily; Bobinski, Tina; Mushquash, Christopher J.

2015-01-01

Objective: We sought to evaluate a translation of anxiety-focused cognitive behavioral therapy (CBT) to a First Nations children’s mental health provider in rural Ontario and to enhance our understanding of CBT challenges and adaptations unique to the First Nations context. Methods: The study was conceptualized as a mixed methods sequential explanatory approach using a quasi-experimental (before and after) design with quantitative and qualitative components. Data were produced in two ways: questionnaires completed by therapists, parents and clients pre- and post-training, and through a focus group with therapists working with First Nations clients. Participants of this study were a subset of a larger knowledge translation study involving ten agencies, and comprised nine therapists (two males and seven females), and seven children (six males and one female) from a single First Nations agency. The mean age of children was 11.8 years (±2.71), comparable to children in other agencies. Results: First Nations therapists’ scores on a child CBT knowledge questionnaire post-training did not differ from those of therapists in other agencies when controlling for initial values, suggesting comparable training benefit. Children did not differ between groups on any key measures, and all key measures showed improvement from pre- to post-training. Four key themes emerged from therapist focus groups: client challenges, value of supervision, practice challenges, and Northern/rural/remote challenges. Conclusions: The study highlights the importance of delivering a culturally appropriate CBT program to First Nations populations in Northern Ontario, and provides preliminary evidence of its effectiveness. PMID:26336378

Depressive symptomatology in men receiving androgen deprivation therapy for prostate cancer: a controlled comparison.

PubMed

Lee, Morgan; Jim, Heather S; Fishman, Mayer; Zachariah, Babu; Heysek, Randy; Biagioli, Matthew; Jacobsen, Paul B

2015-04-01

Prostate cancer patients who receive androgen deprivation therapy (ADT) often experience many physical and psychological side effects. ADT may be associated with increased risk for depression, but the relationship between ADT and depression is not fully understood. This study used a longitudinal design to assess depressive symptomatology in patients receiving ADT compared with two groups of matched controls. Participants were men initiating ADT treatment (ADT+ group; n = 61) and their matched controls: prostate cancer patients treated with radical prostatectomy (ADT- group; n = 61), and no-cancer controls (CA- group; n = 61). Depressive symptomatology was assessed using the Center for Epidemiological Studies Depression Scale at ADT initiation and again 6 months later. Differences in depressive symptomatology and rates of clinically significant depressive symptomatology were analyzed between groups at each time point and within groups over time. Between baseline and follow-up, ADT+ participants demonstrated increased depressive symptomatology and increased rates of clinically significant depressive symptomatology (ps < 0.05). ADT+ participants also reported greater depressive symptomatology than both control groups at follow-up (ps < 0.001). Rates of clinically significant depressive symptomatology were higher in the ADT+ group than the ADT- and CA- groups at both time points (baseline: 28%, 5%, 12%; follow-up: 39%, 9%, 11%). Findings support the hypothesis that ADT administration yields increases in depression and suggest that the mechanism behind ADT's association with depression should be explored and that prostate cancer patients treated with ADT should receive particular focus in depression screening and intervention. Copyright © 2014 John Wiley & Sons, Ltd.

Depressive Symptomatology in Men Receiving Androgen Deprivation Therapy for Prostate Cancer: A Controlled Comparison

PubMed Central

Lee, Morgan; Jim, Heather S.; Fishman, Mayer; Zachariah, Babu; Heysek, Randy; Biagioli, Matthew; Jacobsen, Paul B.

2014-01-01

Objective Prostate cancer patients who receive androgen deprivation therapy (ADT) often experience many physical and psychological side effects. ADT may be associated with increased risk for depression, but the relationship between ADT and depression is not fully understood. This study used a longitudinal design to assess depressive symptomatology in patients receiving ADT compared to two groups of matched controls. Methods Participants were men initiating ADT treatment (ADT+ group; n = 61) and their matched controls: prostate cancer patients treated with radical prostatectomy (ADT− group; n = 61) and no-cancer controls (CA− group; n = 61). Depressive symptomatology was assessed using the Center for Epidemiological Studies Depression Scale at ADT initiation and again six months later. Differences in depressive symptomatology and rates of clinically-significant depressive symptomatology were analyzed between groups at each time point and within groups over time. Results: Between baseline and follow-up, ADT+ participants demonstrated increased depressive symptomatology and increased rates of clinically-significant depressive symptomatology (ps < .05). ADT+ participants also reported greater depressive symptomatology than both control groups at follow-up (ps < .001). Rates of clinically-significant depressive symptomatology were higher in the ADT+ group than the ADT− and CA− groups at both time points (baseline: 28%, 5%, 12%; follow-up: 39%, 9%, 11%). Conclusions Findings support the hypothesis that ADT administration yields increases in depression and suggest that the mechanism behind ADT’s association with depression should be explored and that prostate cancer patients treated with ADT should receive particular focus in depression screening and intervention. PMID:24924331

Effect of early realignment on length and delayed repair of postpelvic fracture urethral injury.

PubMed

Koraitim, Mamdouh M

2012-04-01

To determine the effect of early realignment of posterior urethral injury on the length and delayed repair of ensuing urethral defect. We reviewed the medical records of 120 patients with a pelvic fracture urethral defect who were referred for delayed repair from elsewhere from 1995 to 2009. The review was focused on 5 variables: initial management of urethral injury, length of urethral defect, type of delayed repair, continence, and erectile function. Of the patients, 26 were excluded from the study and 94 were categorized as having been initially treated by realignment (42 patients, group 1) or suprapubic cystostomy (52 patients, group 2). Urethral defects ≤ 2 cm in length were found in 28 patients (67%) in group 1 versus 22 (42%) in group 2. Defects >2 cm were found in 14 patients (33%) in group 1 versus 30 (58%) in group 2. The repair was accomplished by a simple perineal operation in 32 (76%) and 30 (58%) patients in groups 1 and 2, respectively. An elaborated perineal or perineo-abdominal procedure was required in 10 (24%) and 22 (42%) patients in groups 1 and 2, respectively (all P < .05). Incontinence occurred in 1 patient in group 1. Impotence developed in 10 (28%) of 36 realigned adults and in 2 (5%) of 38 adults with suprapubic cystostomy. Early realignment of posterior urethral injury decreases the length of the ensuing urethral defect and facilitates its delayed repair. Incontinence and impotence appear to result from the injury itself and not the treatment. Copyright © 2012 Elsevier Inc. All rights reserved.

Caregiver involvement in a large clinical systems project.

PubMed Central

Sales, S.; Mathews, P.; Gamblin, D.; Gee, S.

1994-01-01

The Kaiser Permanente Northern California Region (KPNCR) CareGiver Workstation (CGW) Project's mission is to develop and implement a clinical workstation system that will enhance each caregiver-member interaction and aid in the decision-making processes of direct patient care in the inpatient and outpatient settings. The requirements analysis approach for CareGiver Workstation (CGW) is based on the belief that extensive caregiver involvement will provide a better understanding of the diverse needs of Kaiser Permanente Northern California Region (KPNCR). In order to involve as many caregivers as reasonably possible, CGW included a 16 member caregiver core team and 6 different Medical Centers in the requirements definition process. The Medical Centers are referred to as "focus facilities". A "focus group" (caregiver team) at each selected focus facility consisted of a site coordinator and a 24-30 person multidisciplinary team involving physicians, nurses, therapists and other caregivers. The Medical Center selection process identified facilities that provided the best cross-sectional representation of KPNCR. The Lead Focus Facility participated in the initial round of requirements definition activities. These sessions assisted in the design of a simulation that was used at five additional Medical Centers to validate requirements. The five additional Focus Facilities participated in simulation review sessions. Feedback from these sessions was used to revise the simulation and update the requirements document. Caregivers from all six focus facilities and other identified groups participated in a requirements survey to assist CGW with identification of high priority features. Caregiver commitment and continuing involvement are essential for the success of CGW.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7949953

The role of prevention focus under stereotype threat: Initial cognitive mobilization is followed by depletion.

PubMed

Ståhl, Tomas; Van Laar, Colette; Ellemers, Naomi

2012-06-01

Previous research has demonstrated that stereotype threat induces a prevention focus and impairs central executive functions. The present research examines how these 2 consequences of stereotype threat are related. The authors argue that the prevention focus is responsible for the effects of stereotype threat on executive functions and cognitive performance. However, because the prevention focus is adapted to deal with threatening situations, the authors propose that it also leads to some beneficial responses to stereotype threat. Specifically, because stereotype threat signals a high risk of failure, a prevention focus initiates immediate recruitment of cognitive control resources. The authors further argue that this response initially facilitates cognitive performance but that the additional cognitive demands associated with working under threat lead to cognitive depletion over time. Study 1 demonstrates that stereotype threat (vs. control) facilitates immediate cognitive control capacity during a stereotype-relevant task. Study 2 experimentally demonstrates the process by showing that stereotype threat (vs. control) facilitates cognitive control as a default, as well as when a prevention focus has been experimentally induced, but not when a promotion focus has been induced. Study 3 shows that stereotype threat facilitates initial math performance under a prevention focus, whereas no effect is found under a promotion focus. Consistent with previous research, however, stereotype threat impaired math performance over time under a prevention focus, but not under a promotion focus. 2012 APA, all rights reserved

The lesbian custody project.

PubMed

Radford, J

1992-01-01

In the United Kingdom the backlash against feminism in the late 1980s was initially directed at lesbians and was specifically focused on lesbians who are mothers, lesbians engaged in parenting, or lesbians wishing to do so. This backlash was initially orchestrated by a small group of far right politicians, well to the right of the Thatcher government, and was not contained in any political consensus but was developed into a major public issue by the media. This paper documents its effect in terms of a systematic legal attack on lesbian parenting. The aim of the paper is to alert readers to the backlash with a view to resistance. Our argument is that the backlash against lesbians is a first line of attack against all women as mothers.

Improving Care for Children With Cancer in Low- and Middle-Income Countries--a SIOP PODC Initiative.

PubMed

Arora, Ramandeep Singh; Challinor, Julia M; Howard, Scott C; Israels, Trijn

2016-03-01

The Paediatric Oncology in Developing Countries (PODC) committee of International Society of Paediatric Oncology (SIOP) has 10 working groups that provide a forum for individuals to engage, network, and implement improvements in the care of children with cancer in low- and middle-income countries. The development of adapted guidelines (medulloblastoma, retinoblastoma, Wilms tumor, neuroblastoma, retinoblastoma, Burkitt lymphoma, supportive care), advocacy and awareness (on hospital detention and essential drugs), education and training, and global mapping (nutritional practice, abandonment rates, and twinning collaborations) have been the initial areas of focus, and the impact of some of these activities is evident, for example, in the SIOP Africa PODC Collaborative Wilms tumor project. © 2015 Wiley Periodicals, Inc.

WHO Working Group on Technical Specifications for Manufacture and Evaluation of Yellow Fever Vaccines, Geneva, Switzerland, 13-14 May 2009.

PubMed

Ferguson, Morag; Shin, Jinho; Knezevic, Ivana; Minor, Philip; Barrett, Alan

2010-12-06

In May 2009, WHO convened a meeting of Working Group on Technical Specifications for Manufacturing and Evaluating Yellow Fever (YF) Vaccines, Geneva, Switzerland to initiate revision of the WHO Recommendations (formerly, Requirements) for YF vaccine published in WHO Technical Report Series number 872 (1998). The Working Group, consisting of experts from academia, industry, national regulatory authorities and national control laboratories, reviewed the latest issues of safety, efficacy and quality of YF vaccines and agreed that (i) the revision should focus on live attenuated YF vaccine virus 17D lineage; and that (ii) nonclinical and clinical guidelines for new vaccines prepared from 17D lineage be developed. Copyright © 2010. Published by Elsevier Ltd.. All rights reserved.

The Jigsaw Puzzle of mRNA Translation Initiation in Eukaryotes: A Decade of Structures Unraveling the Mechanics of the Process.

PubMed

Hashem, Yaser; Frank, Joachim

2018-03-01

Translation initiation in eukaryotes is a highly regulated and rate-limiting process. It results in the assembly and disassembly of numerous transient and intermediate complexes involving over a dozen eukaryotic initiation factors (eIFs). This process culminates in the accommodation of a start codon marking the beginning of an open reading frame at the appropriate ribosomal site. Although this process has been extensively studied by hundreds of groups for nearly half a century, it has been only recently, especially during the last decade, that we have gained deeper insight into the mechanics of the eukaryotic translation initiation process. This advance in knowledge is due in part to the contributions of structural biology, which have shed light on the molecular mechanics underlying the different functions of various eukaryotic initiation factors. In this review, we focus exclusively on the contribution of structural biology to the understanding of the eukaryotic initiation process, a long-standing jigsaw puzzle that is just starting to yield the bigger picture. Expected final online publication date for the Annual Review of Biophysics Volume 47 is May 20, 2018. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Factors affecting the retention of first-year female science and engineering students at the University of Michigan

NASA Astrophysics Data System (ADS)

Ballard, Juliet Webb

Alarming to many academics is that while the numbers of female students (at the University of Michigan in particular) in SEM (Science, Engineering, and Mathematics) departments have shown increases in enrollment over the past decades, the number of female professionals in the field has decreased. The purpose of the study was to determine the environmental perceptions of female SEM students in the Women in Science and Engineering (WISE) Program at the University of Michigan. The WISE-RP (Residence Program) is an existing living and learning education program at the university that was designed to facilitate the successful retention and graduation of undergraduate female SEM students in the capacity that the admissions statistics should logically imply. The objectives of the study included identification of the perceptions of female students that contribute to, and foster retention of students participating in the WISE-RP program. The knowledge obtained from this evaluation will guide the University of Michigan in formulating specific interventions and retention approaches, both in and out of the classroom. This was achieved by identifying (among other things) commonality of experiences, and female student's perceptions of acceptance, integration and interactivity. The data used in this secondary analysis was collected over a 2 year period (1999--2001). The primary instrument used for data collection was a structured interview protocol utilizing focus groups. The population and samples studied were comprised of: a research project consisting of 36 focus groups from WISE-RP, University Research Opportunity Program, and the University Research Opportunity in Residence Programs; the sample size of the initial project was 180 first year SEM male and female students. The research project consisted of working with a senior research team at the University of Michigan to develop a structured interview instrument, pilot the instrument, and select focus groups. Content analysis was conducted on the open-ended focus group questions. Three themes emerged from the data set: (a) general contributing factors to retention, (b) support networks and programmatic features that contributed to retention, (c) individual/gender specific challenges that students faced. It found that the initial mission of the program has been accomplished, as evidenced by the findings of this study. The University is graduating and retaining female SEM students at a higher rate than at the program's inception. The challenges for the University at this point include: increasing numbers of female SEM faculty, enhancing and focusing the living learning community mission of the program, integrating student affairs components to the program features on an administrative level, committing to longitudinal analysis and assessment of individual incoming students toward identifying strengths and weaknesses, and finally---committing increased resources to these objectives.

Empowering senior citizens for healthy nutrition in Germany: A pilot study.

PubMed

Curbach, Janina; Warrelmann, Berit; Brandstetter, Susanne; Lindacher, Verena; Rueter, Jana; Loss, Julika

2018-04-22

Main goal of this study was to analyse how empowerment processes and bottom-up activities aimed at healthier food choices and food environment could be initiated among a group of senior citizens (between 60 and 75 years old). The intervention was set up as a pilot study in a rural community (15,000 inhabitants) in the federal state of Bavaria, South Eastern Germany. A process evaluation documented how group formation and empowerment processes developed during the course of the intervention. Extensive field notes were taken in 27 meetings, interviews (n = 13) and focus groups (n = 4) were conducted with participants and key persons at different points of the intervention. Data were analysed using content analysis. The intervention succeeded in motivating senior citizens to participate in regular meetings over 11 months. During the intervention, the group members' awareness of factors influencing their eating behaviour increased. Furthermore, they developed ideas to improve the community's food environment and accomplished duties needed to implement these ideas. However, initiating empowerment processes, especially in terms of fostering leadership and transferring responsibility, took longer than expected and could be realised only partially. The findings support a further use and evaluation of the empowerment approach for addressing nutritional aspects among senior citizens. © 2018 John Wiley & Sons Ltd.

Initial Stop Voicing in Bilingual Children With Cochlear Implants and Their Typically Developing Peers With Normal Hearing.

PubMed

Bunta, Ferenc; Goodin-Mayeda, C Elizabeth; Procter, Amanda; Hernandez, Arturo

2016-08-01

This study focuses on stop voicing differentiation in bilingual children with normal hearing (NH) and their bilingual peers with hearing loss who use cochlear implants (CIs). Twenty-two bilingual children participated in our study (11 with NH, M age = 5;1 [years;months], and 11 with CIs, M hearing age = 5;1). The groups were matched on hearing age and a range of demographic variables. Single-word picture elicitation was used with word-initial singleton stop consonants. Repeated measures analyses of variance with three within-subject factors (language, stop voicing, and stop place of articulation) and one between-subjects factor (NH vs. CI user) were conducted with voice onset time and percentage of prevoiced stops as dependent variables. Main effects were statistically significant for language, stop voicing, and stop place of articulation on both voice onset time and prevoicing. There were no significant main effects for NH versus CI groups. Both children with NH and with CIs differentiated stop voicing in their languages and by stop place of articulation. Stop voicing differentiation was commensurate across the groups of children with NH versus CIs. Stop voicing differentiation is accomplished in a similar fashion by bilingual children with NH and CIs, and both groups differentiate stop voicing in a language-specific fashion.

Developing scientists in Hispanic substance use and health disparities research through the creation of a national mentoring network.

PubMed

Bazzi, Angela R; Mogro-Wilson, Cristina; Negi, Nalini Junko; Gonzalez, Jennifer M Reingle; Cano, Miguel Ángel; Castro, Yessenia; Cepeda, Alice

2017-01-01

Hispanics are disproportionately affected by substance use and related health harms yet remain underrepresented across scientific disciplines focused on researching and addressing these issues. An interdisciplinary network of scientists committed to fostering the development of social and biomedical researchers focused on Hispanic substance use and health disparities developed innovative mentoring and career development activities. We conducted a formative evaluation study using anonymous membership and conference feedback data to describe specific mentoring and career development activities developed within the national network. Successful mentoring initiatives and career development activities were infused with cultural and community values supportive of professional integration and persistence. Mentoring initially occurred within an annual national conference and was then sustained throughout the year through formal training programs and informal mentoring networks. Although rigorous evaluation is needed to determine the success of these strategies in fostering long-term career development among scientists conducting Hispanic health and substance use research, this innovative model may hold promise for other groups committed to promoting career development and professional integration and persistence for minority (and non-minority) scientists committed to addressing health disparities.

Use of partnership strategies to build radiation oncology disparities research programs in five Western Pennsylvania communities: an organizational case study.

PubMed

Morgenlander, Keith H; Heron, Dwight E; Schenken, Larry L

2009-01-01

Many cancer treatment and prevention trials as well as surveillance programs suffer from a disproportionately low rate of accrual and a high rate of noncompliance or dropouts of racial minorities and the poor. One suggested strategy to help remediate this trend is to directly involve those targeted populations within the development, implementation, and evaluation of these services. The Radiation Oncology Community Outreach Group (ROCOG) and Neighborhood Cancer Care Cooperative (NCCC) are designed based upon this type of highly collaborative organizational structure, consistent with the general principles of community-based participatory research. Funded by the National Cancer Institute Cancer Disparities Research Partnership program, ROCOG/NCCC provide oncology-focused, community hospital-based initiatives intended to help close the cancer disparities gap. This article presents a descriptive case study of the organizational and political process that preceded our grant proposal submission, the potential benefits and difficulties associated with our extensive collaborative model, and an example of how highly competitive health care organizations can become partners in narrowly focused initiatives aimed at a greater social good.

Intersections and evolution of 'Butch-trans' categories in Puerto Rico: Needs and barriers of an invisible population.

PubMed

Ramos-Pibernus, Alíxida G; Rodríguez-Madera, Sheilla L; Padilla, Mark; Varas-Díaz, Nelson; Vargas Molina, Ricardo

2016-01-01

Public health research among transgender populations globally has primarily focused on HIV/AIDS. However, trans men remain outside of this conceptual framework, with distinct but overlapping social contexts and needs. In Puerto Rico (PR), the trans men population has remained largely hidden within the 'butch' lesbian community. The objective of this article is to document the identity construction of trans men and 'buchas' (local term to refer to butch lesbians) in PR and its relation to their bodily practices and overall health. We conducted an exploratory qualitative study with 29 trans men and buchas based on ethnographic observation, focus groups, audio-recorded in-depth interviews, and critical discourse analysis. Findings emphasise two domains to be addressed by health policies and initiatives: (1) bodily representations and gender performance, and (2) the meanings of female biological processes. This small-scale ethnographic study represents an initial step towards understanding the social context of this 'invisible' community and significant implications for their health and well-being. We provide several recommendations to address public health concerns of this understudied, marginalised community.

Intersections and evolution of ‘Butch-trans’ categories in Puerto Rico: Needs and barriers of an invisible population

PubMed Central

Ramos-Pibernus, Alíxida G.; Rodríguez-Madera, Sheilla L.; Padilla, Mark; Varas-Díaz, Nelson; Molina, Ricardo Vargas

2016-01-01

Public health research among transgender populations globally has primarily focused on HIV/AIDS. However, trans men remain outside of this conceptual framework, with distinct but overlapping social contexts and needs. In Puerto Rico (PR), the trans men population has remained largely hidden within the ‘butch’ lesbian community. The objective of this article is to document the identity construction of trans men and ‘buchas’ (local term to refer to butch lesbians) in PR and its relation to their bodily practices and overall health. We conducted an exploratory qualitative study with 29 trans men and buchas based on ethnographic observation; focus groups; audio-recorded in-depth interviews; and critical discourse analysis. Findings emphasize two domains to be addressed by health policies and initiatives: 1) bodily representations and gender performance, and 2) the meanings of female biological processes. This small-scale ethnographic study represents an initial step toward understanding the social context of this ‘invisible’ community and significant implications for their health and well-being. We provide several recommendations to address public health concerns of this understudied, marginalized community. PMID:27142002

Female Ex-Offender Perspectives on Drug Initiation, Relapse, and Desire to Remain Drug Free

PubMed Central

Nyamathi, Adeline M.; Srivastava, Neha; Salem, Benissa E.; Wall, Sarah; Kwon, Jordan; Ekstrand, Maria; Hall, Elizabeth; Turner, Susan F.; Faucette, Mark

2016-01-01

Recently-released homeless women residing in temporary residential drug treatment programs are at a critical juncture in the process of recovery, transition and reentry. The purpose of this study was to explore factors influencing initial use of drugs and relapse triggers among a sample of incarcerated women exiting jails and prisons, and who are residing in a residential drug treatment (RDT) program and preparing for reentry into their communities. Among this population, relapse to drug use and recidivism are common. A qualitative study was conducted utilizing focus groups to understand the perspectives of formerly incarcerated, currently homeless women residing in a RDT program. Content analysis generated the development of three broad categories: a) factors associated with first drug use; b) factors involved in relapse; c) factors influencing desire to remain drug free. A discussion follows highlighting the importance of targeted interventions at RDT sites that integrate physical, psychological and social needs to optimize reentry into communities. This would include a focus on building self-esteem, life skills, and providing access to resources such as housing, employment, and healthcare. PMID:27195929

Identifying the role of initial wave parameters on tsunami focusing

NASA Astrophysics Data System (ADS)

Aydın, Baran

2018-04-01

Unexpected local tsunami amplification, which is referred to as tsunami focusing, is attributed to two different mechanisms: bathymetric features of the ocean bottom such as underwater ridges and dipolar shape of the initial wave itself. In this study, we characterize the latter; that is, we explore how amplitude and location of the focusing point vary with certain geometric parameters of the initial wave such as its steepness and crest length. Our results reveal two important features of tsunami focusing: for mild waves maximum wave amplitude increases significantly with transverse length of wave crest, while location of the focusing point is almost invariant. For steep waves, on the other hand, increasing crest length dislocates focusing point significantly, while it causes a rather small increase in wave maximum.

Expanded mental health benefits and outpatient depression treatment intensity.

PubMed

Lo Sasso, Anthony T; Lindrooth, Richard C; Lurie, Ithai Z; Lyons, John S

2006-04-01

The justification for higher cost-sharing for behavioral health treatment is its greater price sensitivity relative to general healthcare treatment. Despite this, recent policy efforts have focused on improving access to behavioral health treatment. We measured the effects on outpatient treatment of depression of a change in mental health benefits for employees of a large U.S.-based corporation. The benefit change involved 3 major elements: reduced copayments for mental health treatment, the implementation of a selective contracting network, and an effort to destigmatize mental illness. Claims data and a difference-in-differences methodology were used to examine how the benefit change affected outpatient treatment of depression. Subjects consisted of 214,517 employee-years of data for individuals who were continuously enrolled for at least 1 full year at the intervention company and 96,365 employee-years in the control group. We measured initiation into treatment of depression and the number of outpatient therapy visits. The benefit change was associated with a 26% increase in the probability of initiating depression treatment. Conditional on initiating treatment, patients in the intervention company received 1.2 additional (P < 0.001) outpatient mental health treatment visits relative to the control group. Our results suggest that the overall effect of the company's benefit change was to significantly increase the number of outpatient visits per episode of treatment conditional on treatment initiation.

Chronic Subdural Hematoma Treated by Small or Large Craniotomy with Membranectomy as the Initial Treatment

PubMed Central

Kim, Jae-Hong; Kim, Jung-Hee; Kong, Min-Ho; Song, Kwan-Young

2011-01-01

Objective There are few studies comparing small and large craniotomies for the initial treatment of chronic subdural hematoma (CSDH) which had non-liquefied hematoma, multilayer intrahematomal loculations, or organization/calcification on computed tomography and magnetic resonance imaging. These procedures were compared to determine which would produce superior postoperative results. Methods Between 2001 and 2009, 317 consecutive patients were surgically treated for CSDH at our institution. Of these, 16 patients underwent a small craniotomy with partial membranectomy and 42 patients underwent a large craniotomy with extended membranectomy as the initial treatment. A retrospective review was performed to compare the postoperative outcomes of these two techniques, focusing on improvement of neurological status, complications, reoperation rate, and days of post-operative hospitalization. Results The mean ages were 69.4±12.1 and 55.6±9.3 years in the small and large craniotomy groups, respectively. The recurrence of hematomas requiring reoperation occurred in 50% and 10% of the small and large craniotomy patients, respectively (p<0.001). There were no significant differences in postoperative neurological status, complications, or days of hospital stay between these two groups. Conclusion Among the cases of CSDH initially requiring craniotomy, the large craniotomy with extended membranectomy technique reduced the reoperation rate, compared to that of the small craniotomy with partial membranectomy technique. PMID:22053228

Research on the precise positioning of customers in large data environment

NASA Astrophysics Data System (ADS)

Zhou, Xu; He, Lili

2018-04-01

Customer positioning has always been a problem that enterprises focus on. In this paper, FCM clustering algorithm is used to cluster customer groups. However, due to the traditional FCM clustering algorithm, which is susceptible to the influence of the initial clustering center and easy to fall into the local optimal problem, the short board of FCM is solved by the gray optimization algorithm (GWO) to achieve efficient and accurate handling of a large number of retailer data.

Air Force Research Initiation Program 1986 Technical Report Volume 1

DTIC Science & Technology

1988-04-01

inaccuracy of meteoroligical measurements. For the convenience of this study, the first two oi these will be further grouped together as ’ modelO ...communication protocol is a set of rules governing the exchange of data between entities forming the network, and is the focus of this research. 1.2.1 The OSI ...This model, termed Open Systems Interconnection ( OSI ), presents standards for the exchange of information among systems that are "open" to one 25-5

Neighborhood-resources for the development of a strong SOC and the importance of understanding why and how resources work: a grounded theory approach.

PubMed

Maass, Ruca; Lindström, Bengt; Lillefjell, Monica

2017-09-12

Providing individuals with psychosocial resources such as sense of coherence (SOC) seems a beneficial strategy for health promotion in the neighborhood. In order to become a supporting theory for health promotion, Salutogenesis should renew its focus on resources for health, and explore how the development of a strong SOC can be facilitated. Relevant issues were explored using a Grounded Theory- approach. Three focus-group-sessions and three in-depth interviews were conducted with strategically sampled participants. The transcripts of the focus groups were initially analyzed line-by-line to ensure that insights emerged from the data. We then applied focused and systemic analyses to achieve axial coding, and to include insights into how social interactions during focus groups may reveal social processes in real-life-neighborhoods. The data from the in-depth interviews were used to validate and fill emerging categories, as well as to ensure data-saturation. Findings indicate the importance of repeated experiences with resources and every-day-challenges to develop a strong SOC. Active engagement with resources is a favorable condition for significant experiences, which enhance the internalization of resources. Core experiences are characterized by a re-organization of resources. Participation in intellectual meaning-making through equal power dialogue seems to broaden perspectives and promote the strengthening of SOC. A strong SOC can also be described as a deeper understanding of how and why resources work, which allows for a more flexible use of resources, including replacing missing resources. A new understanding of SOC as an intuitive understanding of how, why and under which circumstances resources work, as well as a new focus on everyday life and repeated experiences might facilitate new approaches to a purposeful strengthening of SOC through the planning and implementation of public measures.

Initial Development of an E-cigarette Purchase Task: A Mixed Methods Study

PubMed Central

Cassidy, Rachel N.; Tidey, Jennifer W.; Colby, Suzanne M.; Long, Victoria; Higgins, Stephen T.

2017-01-01

Objectives Behavioral economic purchase tasks, which estimate demand for drugs, have been successfully developed for cigarettes and are widely used. However, a validated purchase task does not yet exist for e-cigarettes. The aim of this project was to identify the relevant units for an e-cigarette purchase task (E-CPT). Methods Focus groups (N=28 participants in 7 groups, 2-7 participants per group) consisting of current e-cigarette users were conducted. Participants discussed their daily use patterns, completed a preliminary E-CPT which asked how many puffs of their e-cigarette they would consume per day at escalating prices, and discussed the extent to which the task accurately reflected their real-world behavior. Groups were recorded and transcribed; analysis focused on statements related to daily consumption and the E-CPT. Results Participants were unlikely to quantify their daily use in terms of puffs, and perceptions about the appropriate unit for an E-CPT varied across device type. Users of first-generation devices (eg, cigalikes) reported that the relevant unit was the individual device/cartridge; however, participants who purchased nicotine liquid for their device emphasized that e-liquid volume in milliliters would better reflect their use. Conclusions Multiple versions of the E-CPT may be necessary to provide valid measures of e-cigarette demand. PMID:28824938

Diffraction Seismic Imaging of the Chalk Group Reservoir Rocks

NASA Astrophysics Data System (ADS)

Montazeri, M.; Fomel, S.; Nielsen, L.

2016-12-01

In this study we investigate seismic diffracted waves instead of seismic reflected waves, which are usually much stronger and carry most of the information regarding subsurface structures. The goal of this study is to improve imaging of small subsurface features such as faults and fractures. Moreover, we focus on the Chalk Group, which contains important groundwater resources onshore and oil and gas reservoirs in the Danish sector of the North Sea. Finding optimum seismic velocity models for the Chalk Group and estimating high-quality stacked sections with conventional processing methods are challenging tasks. Here, we try to filter out as much as possible of undesired arrivals before stacking the seismic data. Further, a plane-wave destruction method is applied on the seismic stack in order to dampen the reflection events and thereby enhance the visibility of the diffraction events. After this initial processing, we estimate the optimum migration velocity using diffraction events in order to obtain a better resolution stack. The results from this study demonstrate how diffraction imaging can be used as an additional tool for improving the images of small-scale features in the Chalk Group reservoir, in particular faults and fractures. Moreover, we discuss the potential of applying this approach in future studies focused on such reservoirs.

Lives in isolation: stories and struggles of low-income African American women with panic disorder.

PubMed

Johnson, Michael; Mills, Terry L; Deleon, Jessica M; Hartzema, Abraham G; Haddad, Judella

2009-01-01

Research evidence points to the existence of racial-ethnic disparities in both access to and quality of mental health services for African Americans with panic disorder. Current panic disorder evaluation and treatment paradigms are not responsive to the needs of many African Americans. The primary individual, social, and health-care system factors that limit African Americans' access to care and response to treatment are not well understood. Low-income African American women with panic disorder participated in a series of focus-group sessions designed to elicit (1) their perspectives regarding access and treatment barriers and (2) their recommendations for designing a culturally consistent panic treatment program. Fear of confiding to others about panic symptoms, fear of social stigma, and lack of information about panic disorder were major individual barriers. Within their social networks, stigmatizing attitudes toward mental illness and the mentally ill, discouragement about the use of psychiatric medication, and perceptions that symptoms were the result of personal or spiritual weakness had all interfered with the participants' treatment seeking efforts and contributed to a common experience of severe social isolation. None of the focus-group members had developed fully effective therapeutic relationships with either medical or mental health providers. They described an unmet need for more interactive and culturally authentic relationships with treatment providers. Although the focus-group sessions were not intended to be therapeutic, the women reported that participation in the meetings had been an emotionally powerful and beneficial experience. They expressed a strong preference for the utilization of female-only, panic disorder peer-support groups as an initial step in the treatment/recovery process. Peer-support groups for low-income African American women with panic disorder could address many of the identified access and treatment barriers.

Western Australian Public Opinions of a Minimum Pricing Policy for Alcohol: Study Protocol

PubMed Central

Keatley, David A; Daube, Mike; Hardcastle, Sarah J

2015-01-01

Background Excessive alcohol consumption has significant adverse economic, social, and health outcomes. Recent estimates suggest that the annual economic costs of alcohol in Australia are up to AUD $36 billion. Policies influencing price have been demonstrated to be very effective in reducing alcohol consumption and alcohol-related harms. Interest in minimum pricing has gained traction in recent years. However, there has been little research investigating the level of support for the public interest case of minimum pricing in Australia. Objective This article describes protocol for a study exploring Western Australian (WA) public knowledge, understanding, and reaction to a proposed minimum price policy per standard drink. Methods The study will employ a qualitative methodological design. Participants will be recruited from a wide variety of backgrounds, including ethnic minorities, blue and white collar workers, unemployed, students, and elderly/retired populations to participate in focus groups. Focus group participants will be asked about their knowledge of, and initial reactions to, the proposed policy and encouraged to discuss how such a proposal may affect their own alcohol use and alcohol consumption at the population level. Participants will also be asked to discuss potential avenues for increasing acceptability of the policy. The focus groups will adopt a semi-structured, open-ended approach guided by a question schedule. The schedule will be based on feedback from pilot samples, previous research, and a steering group comprising experts in alcohol policy and pricing. Results The study is expected to take approximately 14 months to complete. Conclusions The findings will be of considerable interest and relevance to government officials, policy makers, researchers, advocacy groups, alcohol retail and licensed establishments and organizations, city and town planners, police, and other stakeholder organizations. PMID:26582408

Integrated Cognitive Behavioral Therapy Versus Cognitive Processing Therapy for Adults With Depression, Substance Use Disorder, and Trauma.

PubMed

Haller, Moira; Norman, Sonya B; Cummins, Kevin; Trim, Ryan S; Xu, Xiaomin; Cui, Ruifeng; Allard, Carolyn B; Brown, Sandra A; Tate, Susan R

2016-03-01

The comorbidity of substance use disorder (SUD), depression, and PTSD is common among veterans. Prior research has shown that among veterans with SUD and depression, those with PTSD did not maintain cognitive-behavioral treatment gains as well as those without PTSD. Thus, the current study was designed to evaluate whether adding trauma-focused treatment following an initial group-based integrated cognitive behavioral treatment (ICBT) for SUD and depression improved treatment outcomes. Participants were 123 veterans (89% male) recruited from the VA San Diego Healthcare System. All participants received ICBT in twice weekly, group-delivered sessions for 12 weeks (Phase 1). Participants were then randomized to receive 12 sessions of individual follow-up sessions (Phase 2) utilizing either ICBT or cognitive processing therapy that was modified to integrate SUD treatment (CPT-M). Results indicated that PTSD and depression symptoms slightly improved at the end of Phase 1 group ICBT and further improved through Phase 2 individual treatment (except for participants without PTSD who received CPT-M), with treatment gains maintained one year later. Substance use significantly improved at the end of Phase 1 group ICBT and these improvements were maintained through Phase 2 and the one year follow-up. Participants in the trauma-focused Phase 2 treatment (CPT-M) exhibited similar levels of symptom reduction and maintenance of treatment gains as those in the non-trauma-focused Phase 2 treatment (ICBT). However, there was a slight advantage for Phase 2 CPT-M over Phase 2 ICBT with respect to heavy drinking outcomes for individuals with PTSD. Overall, the combination of group ICBT followed by either CPT-M or ICBT individual therapy appears to be effective for veterans with depression, SUD, and trauma history. Copyright © 2015. Published by Elsevier Inc.

Western Australian Public Opinions of a Minimum Pricing Policy for Alcohol: Study Protocol.

PubMed

Keatley, David A; Carragher, Natacha; Chikritzhs, Tanya; Daube, Mike; Hardcastle, Sarah J; Hagger, Martin S

2015-11-18

Excessive alcohol consumption has significant adverse economic, social, and health outcomes. Recent estimates suggest that the annual economic costs of alcohol in Australia are up to AUD $36 billion. Policies influencing price have been demonstrated to be very effective in reducing alcohol consumption and alcohol-related harms. Interest in minimum pricing has gained traction in recent years. However, there has been little research investigating the level of support for the public interest case of minimum pricing in Australia. This article describes protocol for a study exploring Western Australian (WA) public knowledge, understanding, and reaction to a proposed minimum price policy per standard drink. The study will employ a qualitative methodological design. Participants will be recruited from a wide variety of backgrounds, including ethnic minorities, blue and white collar workers, unemployed, students, and elderly/retired populations to participate in focus groups. Focus group participants will be asked about their knowledge of, and initial reactions to, the proposed policy and encouraged to discuss how such a proposal may affect their own alcohol use and alcohol consumption at the population level. Participants will also be asked to discuss potential avenues for increasing acceptability of the policy. The focus groups will adopt a semi-structured, open-ended approach guided by a question schedule. The schedule will be based on feedback from pilot samples, previous research, and a steering group comprising experts in alcohol policy and pricing. The study is expected to take approximately 14 months to complete. The findings will be of considerable interest and relevance to government officials, policy makers, researchers, advocacy groups, alcohol retail and licensed establishments and organizations, city and town planners, police, and other stakeholder organizations.

Safe start at home: what parents of newborns need after early discharge from hospital - a focus group study.

PubMed

Kurth, Elisabeth; Krähenbühl, Katrin; Eicher, Manuela; Rodmann, Susanne; Fölmli, Luzia; Conzelmann, Cornelia; Zemp, Elisabeth

2016-03-08

The length of postpartum hospital stay is decreasing internationally. Earlier hospital discharge of mothers and newborns decreases postnatal care or transfers it to the outpatient setting. This study aimed to investigate the experiences of new parents and examine their views on care following early hospital discharge. Six focus group discussions with new parents (n = 24) were conducted. A stratified sampling scheme of German and Turkish-speaking groups was employed. A 'playful design' method was used to facilitate participants communication wherein they used blocks and figurines to visualize their perspectives on care models The visualized constructions of care models were photographed and discussions were audio-recorded and transcribed verbatim. Text and visual data was thematically analyzed by a multi-professional group and findings were validated by the focus group participants. Following discharge, mothers reported feeling physically strained during recuperating from birth and initiating breastfeeding. The combined requirements of infant and self-care needs resulted in a significant need for practical and medical support. Families reported challenges in accessing postnatal care services and lacking inter-professional coordination. The visualized models of ideal care comprised access to a package of postnatal care including monitoring, treating and caring for the health of the mother and newborn. This included home visits from qualified midwives, access to a 24-h helpline, and domestic support for household tasks. Participants suggested that improving inter-professional networks, implementing supervisors or a centralized coordinating center could help to remedy the current fragmented care. After hospital discharge, new parents need practical support, monitoring and care. Such support is important for the health and wellbeing of the mother and child. Integrated care services including professional home visits and a 24-hour help line may help meet the needs of new families.

Using machine learning to identify structural breaks in single-group interrupted time series designs.

PubMed

Linden, Ariel; Yarnold, Paul R

2016-12-01

Single-group interrupted time series analysis (ITSA) is a popular evaluation methodology in which a single unit of observation is being studied, the outcome variable is serially ordered as a time series and the intervention is expected to 'interrupt' the level and/or trend of the time series, subsequent to its introduction. Given that the internal validity of the design rests on the premise that the interruption in the time series is associated with the introduction of the treatment, treatment effects may seem less plausible if a parallel trend already exists in the time series prior to the actual intervention. Thus, sensitivity analyses should focus on detecting structural breaks in the time series before the intervention. In this paper, we introduce a machine-learning algorithm called optimal discriminant analysis (ODA) as an approach to determine if structural breaks can be identified in years prior to the initiation of the intervention, using data from California's 1988 voter-initiated Proposition 99 to reduce smoking rates. The ODA analysis indicates that numerous structural breaks occurred prior to the actual initiation of Proposition 99 in 1989, including perfect structural breaks in 1983 and 1985, thereby casting doubt on the validity of treatment effects estimated for the actual intervention when using a single-group ITSA design. Given the widespread use of ITSA for evaluating observational data and the increasing use of machine-learning techniques in traditional research, we recommend that structural break sensitivity analysis is routinely incorporated in all research using the single-group ITSA design. © 2016 John Wiley & Sons, Ltd.

Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

PubMed Central

2012-01-01

Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face significant barriers to addressing upstream determinants in a meaningful way. If public health cannot directly affect broader societal conditions, interventions should be focused around advocacy and education about the social determinants of health. It is necessary that health be seen for what it is: a political matter. As such, the health sector needs to take a more political approach in finding solutions for health inequities. PMID:22889402

Empathic skills and theory of mind in female adolescents with conduct disorder.

PubMed

Arango Tobón, Olber E; Olivera-La Rosa, Antonio; Restrepo Tamayo, Viviana; Puerta Lopera, Isabel C

2018-01-01

Most studies on conduct disorder (CD) have focused on male adolescents, disregarding analysis of this psychopathology in women. The purpose of this study was to identify differences in empathy and theory of mind (ToM) in a group of adolescent women with CD and a control group. Thirty-six adolescent women were selected from an initial sample of 239 adolescents (CD group = 18, control group = 18). Empathy and ToM were evaluated through objective instruments. Mean comparisons and multivariate analysis were performed to ascertain differences between cases and controls and to propose a prediction model based on clinical status. Significant differences in empathic abilities and ToM were found between the groups. The model that differentiated both groups was composed of eye-reading ability, perspective taking, and personal distress. These findings are consistent with previous studies. Capacity to take the other's perspective and the recognition of emotions in the face are protective factors against CD in women.

From heroin to methadone--social role changes and reinforcement differentials in relation to outcome on methadone. Part I. The study of reinforcement differentials.

PubMed

Cheek, F E; Holstein, C N; Fullam, F A; Arana, G; Tomarchio, T P; Mandell, S

1976-01-01

This study examines the relevance of reinforcements available to the addict in five critical stages of his career to his success on methadone maintenance. In-depth focused interviews were held with 30 addicts who had completed a program of methadone induction and who were characterized by social worker's evaluations as Successful, Marginally Adjusted, or Failures. The Successful group showed a higher initial negative reinforcement followed by higher positive reinforcement on methadone. The Moderately Successful group showed more negative reinforcement before treatment but continued to show negative reinforcements afterwards. The Failures were low on negative reinforcements earlier but negative reinforcements were high after treatment.

Potential in-class strategies to increase children's vegetable consumption.

PubMed

Sharp, Gemma; Pettigrew, Simone; Wright, Shannon; Pratt, Iain S; Blane, Sally; Biagioni, Nicole

2017-06-01

The Crunch&Sip programme is a school-based nutrition initiative designed to increase the fruit, vegetable and water intakes of primary-school children. In recognition of the notable deficits in children's vegetable consumption, the present study explored the receptivity of school staff to a realignment of the Crunch&Sip programme to feature a primary focus on vegetable consumption. This involved investigating school staff members' perceptions of relevant barriers, motivators and facilitators. A multi-method approach was adopted that involved four focus groups and a survey (administered in paper and online formats) containing a mixture of open- and closed-ended items. Western Australia. Staff from Western Australian schools participated in the focus groups (n 37) and survey (n 620). School staff were strongly supportive of modifying the Crunch&Sip programme to focus primarily on children's vegetable consumption and this was generally considered to be a feasible change to implement. Possible barriers identified included children's taste preferences and a perceived lack of parental support. Suggested strategies to overcome these barriers were education sessions for parents and children, teachers modelling vegetable consumption for their students and integrating vegetable-related topics into the school curriculum. School staff are likely to support the introduction of school-based nutrition programmes that specifically encourage the consumption of vegetables. Potential barriers may be overcome through strategies to engage parents and children.

Core groups, antimicrobial resistance and rebound in gonorrhoea in North America.

PubMed

Chan, Christina H; McCabe, Caitlin J; Fisman, David N

2012-04-01

Genital tract infections caused by Neisseria gonorrhoeae are a major cause of sexually transmitted disease worldwide. Surveillance data suggest that incidence has increased in recent years after initially falling in the face of intensified control efforts. The authors sought to evaluate the potential contribution of antimicrobial resistance to such rebound and to identify optimal treatment strategies in the face of resistance using a mathematical model of gonorrhoea. The authors built risk-structured 'susceptible-infectious-susceptible' models with and without the possibility of antibiotic resistance and used these models as a platform for the evaluation of competing plausible treatment strategies, including changing antimicrobial choice when resistance prevalence surpassed fixed thresholds, random assignment of treatment and use of combination antimicrobial therapy. Absent antimicrobial resistance, strategies that focus on treatment of highest risk individuals (the so-called core group) result in collapse of disease transmission. When antimicrobial resistance exists, a focus on the core group causes rebound in incidence, with maximal dissemination of antibiotic resistance. Random assignment of antimicrobial treatment class outperformed the use of fixed resistance thresholds with respect to sustained reduction in gonorrhoea prevalence. Gonorrhoea control is achievable only when core groups are treated, but treatment of core groups maximises dissemination of antimicrobial-resistant strains. This paradox poses a great dilemma to the control and prevention of gonorrhoea and underlines the need for gonococcal vaccines.

Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada.

PubMed

Ziabakhsh, Shabnam; Pederson, Ann; Prodan-Bhalla, Natasha; Middagh, Diane; Jinkerson-Brass, Sharon

2016-11-01

Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs. © 2016 Society for Public Health Education.

Longitudinal changes in microstructural white matter metrics in Alzheimer's disease.

PubMed

Mayo, Chantel D; Mazerolle, Erin L; Ritchie, Lesley; Fisk, John D; Gawryluk, Jodie R

2017-01-01

Alzheimer's disease (AD) is a progressive neurodegenerative disorder. Current avenues of AD research focus on pre-symptomatic biomarkers that will assist with early diagnosis of AD. The majority of magnetic resonance imaging (MRI) based biomarker research to date has focused on neuronal loss in grey matter and there is a paucity of research on white matter. Longitudinal DTI data from the Alzheimer's Disease Neuroimaging Initiative 2 database were used to examine 1) the within-group microstructural white matter changes in individuals with AD and healthy controls at baseline and year one; and 2) the between-group microstructural differences in individuals with AD and healthy controls at both time points. 1) Within-group: longitudinal Tract-Based Spatial Statistics revealed that individuals with AD and healthy controls both had widespread reduced fractional anisotropy (FA) and increased mean diffusivity (MD) with changes in the hippocampal cingulum exclusive to the AD group. 2) Between-group: relative to healthy controls, individuals with AD had lower FA and higher MD in the hippocampal cingulum, as well as the corpus callosum, internal and external capsule; corona radiata; posterior thalamic radiation; superior and inferior longitudinal fasciculus; fronto-occipital fasciculus; cingulate gyri; fornix; uncinate fasciculus; and tapetum. The current results indicate that sensitivity to white matter microstructure is a promising avenue for AD biomarker research. Additional longitudinal studies on both white and grey matter are warranted to further evaluate potential clinical utility.