Retaining Participants in Outpatient and Community-Based Health Studies: Researchers and Participants in Their Own Words.

PubMed

Odierna, Donna H; Bero, Lisa A

Loss to follow-up can introduce bias into research, making it difficult to develop inclusive evidence-based health policies and practice guidelines. We aimed to deepen understanding of reasons why participants leave or remain in longitudinal health studies. We interviewed 59 researchers and current and former research participants in six focus groups ( n = 55) or interviews ( n = 4) at three study centers in a large academic research institution. We used minimally structured interview guides and inductive thematic analysis to explore participant-level, study-level, and contextual participation barriers and facilitators. Four main themes emerged: transportation, incentives and motivation, caregiver concerns, and the social and physical environment. Themes shared crosscutting issues involving funding, flexibility, and relationships between researchers and research participants. Study-level and contextual factors appear to interact with participant characteristics, particularly socioeconomic status and disease severity to affect participant retention. Participants' characteristics do not seem to be the main cause of study dropout. Researchers and funders might be able to address contextual and study factors in ways that reduce barriers to participation.

Evaluation of item candidates for a diabetic retinopathy quality of life item bank.

PubMed

Fenwick, Eva K; Pesudovs, Konrad; Khadka, Jyoti; Rees, Gwyn; Wong, Tien Y; Lamoureux, Ecosse L

2013-09-01

We are developing an item bank assessing the impact of diabetic retinopathy (DR) on quality of life (QoL) using a rigorous multi-staged process combining qualitative and quantitative methods. We describe here the first two qualitative phases: content development and item evaluation. After a comprehensive literature review, items were generated from four sources: (1) 34 previously validated patient-reported outcome measures; (2) five published qualitative articles; (3) eight focus groups and 18 semi-structured interviews with 57 DR patients; and (4) seven semi-structured interviews with diabetes or ophthalmic experts. Items were then evaluated during 3 stages, namely binning (grouping) and winnowing (reduction) based on key criteria and panel consensus; development of item stems and response options; and pre-testing of items via cognitive interviews with patients. The content development phase yielded 1,165 unique items across 7 QoL domains. After 3 sessions of binning and winnowing, items were reduced to a minimally representative set (n = 312) across 9 domains of QoL: visual symptoms; ocular surface symptoms; activity limitation; mobility; emotional; health concerns; social; convenience; and economic. After 8 cognitive interviews, 42 items were amended resulting in a final set of 314 items. We have employed a systematic approach to develop items for a DR-specific QoL item bank. The psychometric properties of the nine QoL subscales will be assessed using Rasch analysis. The resulting validated item bank will allow clinicians and researchers to better understand the QoL impact of DR and DR therapies from the patient's perspective.

78 FR 40823 - Reports, Forms, and Record Keeping Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

... at time of approval. Title: National Survey of Principal Drivers of Vehicles with a Rear Seat Belt... from both groups and information on their passengers seat belt usage habits, as well as the... use computer-assisted telephone interviewing to reduce interview length and minimize recording errors...

Discovering Physical Abuse: Insights from a Follow-Up Study of Delinquents.

ERIC Educational Resources Information Center

Stein, Abby; Lewis, Dorothy Otnow

1992-01-01

Incarcerated Connecticut youth (n=66) were interviewed using a protocol that elicited more self-reports of abusive experiences than did earlier direct questions about maltreatment. Conflicts underlying denial or minimization of abuse are discussed, along with interview strategies for overcoming them. (Author/DB)

How parents perceive screen viewing in their 5-6 year old child within the context of their own screen viewing time: a mixed-methods study.

PubMed

Thompson, Janice L; Sebire, Simon J; Kesten, Joanna M; Zahra, Jesmond; Edwards, Mark; Solomon-Moore, Emma; Jago, Russell

2017-06-01

Few studies have examined parental perceptions of their child's screen-viewing (SV) within the context of parental SV time. This study qualitatively examined parents' perceptions of their 5-6-year-old child's SV within the context of their own quantitatively measured SV. A mixed-methods design employed semi-structured telephone interviews, demographic and SV questionnaires, objectively-measured physical activity and sedentary time. Deductive content analysis was used to explore parents' perceptions of, and concerns about, their child's SV, and management of their child's SV. Comparisons were made between parent-child dyads reporting low (<2-h per day) versus high SV time. Fifty-three parents were interviewed (94.3% mothers), with 52 interviews analysed. Fifteen parent-child dyads (28.8%) exceeded the 2-h SV threshold on both weekdays and weekend days; 5 parent-child dyads (9.6%) did not exceed this threshold. The remaining 32 dyads reported a combination of parent or child exceeding/not exceeding the SV threshold on either weekdays or weekend days. Three main themes distinguished the 15 parent-child dyads exceeding the SV threshold from the 5 dyads that did not: 1) parents' personal SV-related views and behaviours; 2) the family SV environment; and 3) setting SV rules and limits. Parents in the dyads not exceeding the SV threshold prioritized and engaged with their children in non-SV behaviours for relaxation, set limits around their own and their child's SV-related behaviours, and described an environment supportive of physical activity. Parents in the dyads exceeding the SV threshold were more likely to prioritise SV as a shared family activity, and described a less structured SV environment with minimal rule setting, influenced their child's need for relaxation time. The majority of parents in this study who exceeded the SV threshold expressed minimal concern and a relaxed approach to managing SV for themselves and their child(ren), suggesting a need to raise awareness amongst these parents about the time they spend engaging in SV. Parents may understand their SV-related parenting practices more clearly if they are encouraged to examine their own SV behaviours. Designing interventions aimed to create environments that are less supportive of SV, with more structured approaches to SV parenting strategies are warranted.

Parents of children with neurogenic bowel dysfunction: their experiences of using transanal irrigation with their child.

PubMed

Sanders, C; Bray, L; Driver, C; Harris, V

2014-11-01

Neurogenic bowel dysfunction in children is a lifelong condition often resulting in the need for active bowel management programmes, such as transanal irrigation. Parents are central in the decision-making process to initiate and carry out treatments until such a time their child becomes independent. Minimal research has focussed on examining parents' experiences of undertaking transanal irrigation with their child. This study aimed to explore parents' experiences of learning about and using irrigation with their child and how parents motivated their children to become independent. Semi-structured telephone interviews were conducted with parents with experience of using transanal irrigation with their child. Interviews were undertaken by a parent researcher. Data were analysed using qualitative content analysis. Eighteen telephone interviews (16 mothers, 1 father and 1 carer) were conducted. Parents shared how they had negotiated getting started and using transanal irrigation with their child. They discussed a sense of success derived from their confidence in using and mastering irrigation, the process of making decisions to continue or stop using irrigation and how they motivated themselves and their child to continue with the irrigation regime. Challenges included minimizing their child's distress during the irrigation procedure and how they negotiated and moved towards their child becoming independent. Despite the emotional difficulty parents experienced as a result of the invasive nature of transanal irrigation most parents reported an improvement in their child's faecal continence which positively impacted on the child and family's lives. The child's physical ability and emotional readiness to develop independent irrigation skills in the future concerned some parents. The experiences shared by parents in this study has the capacity to inform transanal irrigation nursing and medical care. © 2013 John Wiley & Sons Ltd.

Comparative Reliability of Structured Versus Unstructured Interviews in the Admission Process of a Residency Program

PubMed Central

Blouin, Danielle; Day, Andrew G.; Pavlov, Andrey

2011-01-01

Background Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. Methods In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Results Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. Conclusions A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains established as essential to succeed in this residency program. PMID:23205201

Comparative reliability of structured versus unstructured interviews in the admission process of a residency program.

PubMed

Blouin, Danielle; Day, Andrew G; Pavlov, Andrey

2011-12-01

Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains established as essential to succeed in this residency program.

Evaluation of Practicing sustainable Industrial Solid Waste Minimization by Manufacturing Firms in Malaysia: Strengths and Weaknesses.

PubMed

Mallak, Shadi Kafi; Bakri Ishak, Mohd; Mohamed, Ahmad Fariz

2016-09-13

Malaysia is facing an increasing trend in industrial solid waste generation due to industrial development.Thus there is a paramount need in taking a serious action to move toward sustainable industrial waste management. The main aim of this study is to assess practicing solid waste minimization by manufacturing firms in Shah Alam industrial state, Malaysia. This paper presents a series of descriptive and inferential statistical analysis regarding the level and effects of practicing waste minimization methods, and seriousness of barriers preventing industries from practicing waste minimization methods. For this purpose the survey questions were designed such that both quantitative (questionnaire) and qualitative (semi-structures interview) data were collected concurrently. Analysis showed that, the majority of firms (92%) dispose their wastes rather than practice other sustainable waste management options. Also waste minimization methods such as segregation of wastes, on-site recycle and reuse, improve housekeeping and equipment modification were found to have significant contribution in waste reduction (p<0.05). Lack of expertise (M=3.50), lack of enough information (M= 3.54), lack of equipment modification (M= 3.16) and lack of specific waste minimization guidelines (M=3.49) have higher mean scores comparing with other barriers in different categories. These data were interpreted for elaborating of SWOT and TOWS matrix to highlight strengths, weaknesses, threats and opportunities. Accordingly, ten policies were recommended for improvement of practicing waste minimization by manufacturing firms as the main aim of this research. Implications This manuscript critically analysis waste minimization practices by manufacturing firms in Malaysia. Both qualitative and quantitative data collection and analysis were conducted to formulate SWOT and TOWS matrix in order to recommend policies and strategies for improvement of solid waste minimization by manufacturing industries. The results contribute to the knowledge and the findings of this study provide a useful baseline information and data on industrial solid waste generation and waste minimization practice.

Systematic methodological review: developing a framework for a qualitative semi-structured interview guide.

PubMed

Kallio, Hanna; Pietilä, Anna-Maija; Johnson, Martin; Kangasniemi, Mari

2016-12-01

To produce a framework for the development of a qualitative semi-structured interview guide. Rigorous data collection procedures fundamentally influence the results of studies. The semi-structured interview is a common data collection method, but methodological research on the development of a semi-structured interview guide is sparse. Systematic methodological review. We searched PubMed, CINAHL, Scopus and Web of Science for methodological papers on semi-structured interview guides from October 2004-September 2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected 10 papers. We analysed the data using the qualitative content analysis method. Our analysis resulted in new synthesized knowledge on the development of a semi-structured interview guide, including five phases: (1) identifying the prerequisites for using semi-structured interviews; (2) retrieving and using previous knowledge; (3) formulating the preliminary semi-structured interview guide; (4) pilot testing the guide; and (5) presenting the complete semi-structured interview guide. Rigorous development of a qualitative semi-structured interview guide contributes to the objectivity and trustworthiness of studies and makes the results more plausible. Researchers should consider using this five-step process to develop a semi-structured interview guide and justify the decisions made during it. © 2016 John Wiley & Sons Ltd.

Construction in Occupied Spaces

NASA Astrophysics Data System (ADS)

Ward, Andrew E.; Azhar, Salman; Khalfan, Malik

2017-06-01

Conducting construction activities in occupied environments presents a great challenge due to the additional logistical requirements and the presence of the building occupants. The aim of this research is to gather and evaluate the means and methods to successfully plan, manage, and execute construction activities in occupied spaces in an effort to provide consolidated industry tools and strategies for maintaining a schedule and minimizing the impact on the occupants. The methodology of the research utilizes an exploratory approach to gather qualitative data. The data was collected through interviews with industry professionals to identify industry best practices. The semi-structured interviews provided a platform for the documents, lessons learned, and the techniques and strategies used for occupied construction by the construction industry. The information obtained in the interview process identified six themes that are critical to achieving and maintaining quality in occupied construction. These themes of the schedule, cost, customer satisfaction, planning, fire/life safety and utilities, and contractor management are reviewed in detail, and the paper discusses how to manage each element. The analysis and extracted management techniques, procedures and strategies can be used by the construction industry for future projects by focusing on the critical aspects of occupied construction and the manner in which to succeed with it.

Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study.

PubMed

McLennan, Stuart; Schwappach, David; Harder, Yves; Staender, Sven; Elger, Bernice

2017-08-01

To identify the spectrum of patient safety issues in office-based surgery and anaesthesia in Switzerland. Purposive sample of 23 experts in surgery and anaesthesia and quality and regulation in Switzerland. Data were collected via individual qualitative interviews using a researcher-developed semi-structured interview guide between March 2016 and September 2016. Interviews were transcribed and analysed using conventional content analysis. Issues were categorised under the headings "structure", "process", and "outcome". Experts identified two key overarching patient safety and regulatory issues in relation to office-based surgery and anaesthesia in Switzerland. First, experts repeatedly raised the current lack of data and transparency of the setting. It is unknown how many surgeons are operating in offices, how many and what types of operations are being done, and what the outcomes are. Secondly, experts also noted the limited oversight and regulation of the setting. While some standards exists, most experts felt that more minimal safety standards are needed regarding the requirements that must be met to do office-based surgery and what can and cannot be done in the office-based setting are needed, but they advocated a self-regulatory approach. There is a lack of empirical data regarding the quantity and quality office-based surgery and anaesthesia in Switzerland. Further research is needed to address these research gaps and inform health policy in relation to patient safety in office-based surgery and anaesthesia in Switzerland. Copyright © 2017. Published by Elsevier GmbH.

Risk assessment with victims of intimate partner violence: investigating the gap between research and practice.

PubMed

Cattaneo, Lauren Bennett; Chapman, Aliya R

2011-10-01

In intimate partner violence (IPV) risk assessment, there is consensus that a large gap exists between research and practice. This exploratory study interviewed 13 practitioners working with IPV victims to generate ideas about the nature of this gap, and found that only two conducted standardized risk assessment. Others felt imposing structure might detract from the quality of their work. Results support the need for different techniques in different contexts; some adjust only speed of services according to their risk perception, whereas others use in-depth information to customize services. Perspectives appear particularly disparate regarding victim minimization of risk. Implications for future work are discussed.

Structured Interviews: Developing Interviewing Skills in Human Resource Management Courses

ERIC Educational Resources Information Center

Doll, Jessica L.

2018-01-01

Structured interviews are widely used in the employment process; however, students often have little experience asking and responding to structured interview questions. In a format similar to "speed dating," this exercise actively engages students in the interview process. Students pair off to gain experience as an interviewer by asking…

Are clinical impressions of adolescent substance use accurate?

PubMed

Wilson, Celeste R; Sherritt, Lon; Gates, Erin; Knight, John R

2004-11-01

To compare providers' impressions of adolescents' level of substance use with diagnostic classifications from a structured diagnostic interview. Secondary analysis of data was conducted from a validation study of the CRAFFT substance abuse screening test of 14- to 18-year-old medical clinic patients (n = 533) and their corresponding medical care providers (n = 109) at an adolescent clinic affiliated with a large tertiary care pediatric hospital. Medical care providers completed a form that recorded their clinical impressions of patients' level of alcohol and drug involvement (none, minimal, problem, abuse, dependence) and demographic characteristics. The form included brief diagnostic descriptions for each level of use. After the medical visit, patients completed the Adolescent Diagnostic Interview (ADI), a structured diagnostic interview that yields diagnoses of abuse and dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). On the basis of their past 12 months of alcohol and drug use on the ADI interview, adolescents were classified into 5 mutually exclusive diagnostic groups. "None" was defined by no reported use of alcohol or drugs during the past year. "Minimal use" was defined as use of alcohol or drugs but no report of any substance-related problems. "Problem use" was defined as reporting 1 or more substance-related problems but no diagnosis of abuse or dependence. "Abuse" was defined by meeting any 1 of 4 DSM-IV diagnostic criteria for either alcohol or drug abuse but no diagnosis of dependence. "Dependence" was defined by meeting any 3 of 7 diagnostic criteria for either alcohol or drug dependence, with or without a diagnosis of abuse. Proportions were compared using Fisher exact test. Agreement was assessed with the weighted kappa, and these analyses were stratified by substance used (ie, alcohol vs drug) and demographic characteristics. Sensitivity, specificity, and positive and negative predictive values were calculated from 2 x 2 tables. Compared with the criterion standard interview, providers identified significantly fewer patients with problem use and abuse and no patients with dependence. Of >100 patients whom the ADI classified with substance problem use, providers correctly identified 18. Of 50 patients who were classified with a diagnosis of alcohol or drug abuse, providers correctly identified 10. Of 36 patients who were classified with a diagnosis of alcohol or drug dependence, providers correctly identified none. For the 86 adolescents who were classified with a substance-related disorder (ie, abuse or dependence), providers' impressions were "none" (24.4%), "minimal use" (50%), "problem use" (15.1%), "abuse" (10.5%), and "dependence" (0%). There was only marginal agreement between providers' impressions and diagnoses related to alcohol use (kappa = .29), drug use (kappa = .31), and any substance use (kappa = .30). Kappa was not significantly affected by the patient's age, but it was by gender. Among boys, kappa was significantly higher for impressions of drug use versus alcohol use (kappa = .48 vs kappa = .27); and, among drug users, kappa was significantly higher among boys compared with girls (kappa = .48 vs kappa = .24). Kappa did not differ significantly across race/ethnicity subgroups, although there is a suggestive trend toward higher agreement for black non-Hispanic compared with white non-Hispanic adolescents (kappa = .35 vs kappa = .21). Kappa did not differ significantly on the basis of the visit type, but the size of this difference (kappa = .36 vs kappa = .24) suggests that the longer well-child visit yielded greater identification of substance-related pathology. Providers' impressions had a sensitivity of .63 for identifying use of alcohol or drugs. However, sensitivity was poor for identification of problem use (.14), abuse (.10), and dependence (0), whereas specificity and positive predictive values were high. Of the 86 adolescents with a diagnosis of abuse or dependence, 75.6% were correctly identified by providers as using substances; however, the level of use in 50% of these adolescents was reported by providers as minimal. In this study, clinical impressions of adolescents' alcohol/drug involvement underestimated substance-related pathology. When providers thought that use was present, there was a very high likelihood that a problem or disorder existed. The use of structured screening devices would likely improve identification of adolescents with substance-related pathology in primary care settings and should be considered for use with all adolescent patients, rather than only those who are perceived to be at higher risk.

A qualitative study of doctors' and nurses' barriers to communicating with seriously ill patients about their dependent children.

PubMed

Dencker, Annemarie; Rix, Bo Andreassen; Bøge, Per; Tjørnhøj-Thomsen, Tine

2017-12-01

Research indicates that health personnel caring for seriously ill patients with dependent children aged 0 to 18 years often avoid discussing with them the challenges of being a family with a parent in treatment. Children of seriously ill patients risk serious trauma and emotional difficulty later in life and depend on adult support to minimize these consequences. Patients suffer anxiety about supporting their children during their illness. Because of their potentially pivotal role in supporting patients in enabling parent-child communication, we examined HP's structural and emotional barriers to communicating with patients about their children. The study was based on 49 semi-structured, in-depth interviews with doctors and nurses working with haematology, gynaecological cancer, and neurointensive care. Both interviews and analysis addressed emotional and structural barriers, drawing on the theoretical framework of Maturana's domains. The study found structural barriers (eg, lack of space in the medical recording system, professional code, time pressure, and lack of training) and emotional barriers (eg, the painful nature of the situation and the perceived need of keeping professional distance). We found that emotional barriers tended to grow when structural barriers were not addressed. Our study indicates (1) the need to use templates and manual procedures to gather and process information about children in medical records; (2) the need for managerial backing for addressing children of seriously ill patients and time spent on it; and (3) the need for future HP training programmes to include how to implement procedures and how to address all barriers. Copyright © 2017 John Wiley & Sons, Ltd.

The Canadian Urology Fair: a model for minimizing the financial and academic costs of the residency selection process.

PubMed

Grober, Ethan D; Matsumoto, Edward D; Jewett, Michael A S; Chin, Joseph L

2003-12-01

In 1994, the Canadian urology residency training programs designed the "Canadian Urology Fair"--a single-site (Toronto, Ont.), 1-day fair to conduct the personal interview portion of the residency selection process. The objective of the current study was to evaluate the success of the Urology Fair in achieving its original goals of decreasing the financial burden and minimizing time away from medical training for applicants and faculty. Both candidates and Canadian urology training programs were surveyed regarding the financial and academic costs (days absent) of attending the 2001 Urology Fair. Data from the 2001 Canadian Resident Matching Service (CaRMS) was used to compare the financial and academic costs of attending personal interviews incurred by candidates declaring urology as their first-choice discipline to candidates interviewing with other surgical specialties throughout Canada. Financial costs incurred by candidates to attend the Urology Fair (mean Can dollar 367) were significantly lower than candidates' estimated costs of attending on-site interviews at the individual programs (mean Can dollar 2065). The financial costs of attending personal interviews by CaRMS applicants declaring urology as their first-choice discipline (mean Can dollar 2002) were significantly lower than the costs incurred by applicants interviewing with other surgical disciplines (mean Can dollar 2744). Financial costs to urology programs attending the fair (mean Can dollar 1931) were not significantly greater than the programs' estimated costs of conducting on-site interviews at their respective program locations (mean Can dollar 1825). Days absent from medical school to attend interviews were significantly lower among CaRMS applicants declaring urology as their first-choice discipline (3 d) compared with applicants who interviewed with other surgical specialties (9.1 d). The Canadian Urology Fair represents an innovative and efficient method for residency programs to conduct the personal interview portion of the residency selection process and should serve as a model for making the interview process less expensive and time-consuming for both candidates and faculty.

A method for reducing misclassification in the extended Glasgow Outcome Score.

PubMed

Lu, Juan; Marmarou, Anthony; Lapane, Kate; Turf, Elizabeth; Wilson, Lindsay

2010-05-01

The eight-point extended Glasgow Outcome Scale (GOSE) is commonly used as the primary outcome measure in traumatic brain injury (TBI) clinical trials. The outcome is conventionally collected through a structured interview with the patient alone or together with a caretaker. Despite the fact that using the structured interview questionnaires helps reach agreement in GOSE assessment between raters, significant variation remains among different raters. We introduce an alternate GOSE rating system as an aid in determining GOSE scores, with the objective of reducing inter-rater variation in the primary outcome assessment in TBI trials. Forty-five trauma centers were randomly assigned to three groups to assess GOSE scores on sample cases, using the alternative GOSE rating system coupled with central quality control (Group 1), the alternative system alone (Group 2), or conventional structured interviews (Group 3). The inter-rater variation between an expert and untrained raters was assessed for each group and reported through raw agreement and with weighted kappa (kappa) statistics. Groups 2 and 3 without central review yielded inter-rater agreements of 83% (weighted kappa = 0.81; 95% CI 0.69, 0.92) and 83% (weighted kappa = 0.76, 95% CI 0.63, 0.89), respectively, in GOS scores. In GOSE, the groups had an agreement of 76% (weighted kappa = 0.79; 95% CI 0.69, 0.89), and 63% (weighted kappa = 0.70; 95% CI 0.60, 0.81), respectively. The group using the alternative rating system coupled with central monitoring yielded the highest inter-rater agreement among the three groups in rating GOS (97%; weighted kappa = 0.95; 95% CI 0.89, 1.00), and GOSE (97%; weighted kappa = 0.97; 95% CI 0.91, 1.00). The alternate system is an improved GOSE rating method that reduces inter-rater variations and provides for the first time, source documentation and structured narratives that allow a thorough central review of information. The data suggest that a collective effort can be made to minimize inter-rater variation.

Interviews or postal questionnaires? Comparisons of data about women's experiences with maternity services.

PubMed

Cartwright, A

1988-01-01

Surveys by personal interview are often assumed to be superior to those conducted by mail questionnaire. An experimental study of experiences and attitudes of 800 newly delivered mothers revealed surprising advantages to postal surveys: they are cheaper, more easily repeatable, and minimize interviewer effects. While response rates differed, the quality of responses was similar, except between middle- and working-class mothers. Postal surveys can be used with considerable assurance in national studies of fairly intimate experiences of pregnancy and delivery.

Drugs of Abuse and Novel Psychoactive Substances at Outdoor Music Festivals in Colorado

PubMed Central

Fox, Jacob; Smith, Alexis; Yale, Alexander; Chow, Christopher; Alaswad, Elsa; Cushing, Tracy; Monte, Andrew A.

2017-01-01

Background Drugs of abuse (DOA) are widely used in the United States and are ubiquitous at outdoor music festivals. Attendees at music festivals are at high-risk for novel psychoactive substance (NPS) use, which is becoming more prevalent worldwide. No U.S. studies have employed an qualitative approach to investigate the etiologies of both traditional DOA and NPS use amongst music festival attendees. Objectives The objective of this study was to improve understanding of the knowledge, attitudes, beliefs, and practices of festival attendees using NPS and DOA. Methods We conducted semi-structured interviews of 171 attendees during the Sonic Bloom and Arise music festivals in Colorado in 2015 and 2016. Discrete variables were summarized with descriptive statistics. The anonymous, multi-domain interview documented the knowledge, attitudes beliefs, and practices underlying DOA use, which were analyzed with qualitative methods. Results We enrolled 171 participants that endorsed DOA use at the festivals. Most were experienced DOA users, who perceived minimal risks associated with DOA and NPS use. Nearly all unanimously reported normalization of DOA at music festivals. Participants popularly cited empathogenic, entactogenic, and entheogenic effects of DOA as their primary motivations for use. NPS use was endorsed by 39.8% (n = 68) of respondents, all of whom identified as being experienced DOA users. Conclusions This population of novel psychoactive substance users is primarily composed of experienced drug users that endorsed use because of low cost, minimal perceived risk, accessibility, and normalization of drug use at music festivals. PMID:29148866

Drugs of Abuse and Novel Psychoactive Substances at Outdoor Music Festivals in Colorado.

PubMed

Fox, Jacob; Smith, Alexis; Yale, Alexander; Chow, Christopher; Alaswad, Elsa; Cushing, Tracy; Monte, Andrew A

2018-06-07

Drugs of abuse (DOA) are widely used in the United States and are ubiquitous at outdoor music festivals. Attendees at music festivals are at high-risk for novel psychoactive substance (NPS) use, which is becoming more prevalent worldwide. No U.S. studies have employed an qualitative approach to investigate the etiologies of both traditional DOA and NPS use amongst music festival attendees. The objective of this study was to improve understanding of the knowledge, attitudes, beliefs, and practices of festival attendees using NPS and DOA. We conducted semi-structured interviews of 171 attendees during the Sonic Bloom and Arise music festivals in Colorado in 2015 and 2016. Discrete variables were summarized with descriptive statistics. The anonymous, multi-domain interview documented the knowledge, attitudes beliefs, and practices underlying DOA use, which were analyzed with qualitative methods. We enrolled 171 participants that endorsed DOA use at the festivals. Most were experienced DOA users, who perceived minimal risks associated with DOA and NPS use. Nearly all unanimously reported normalization of DOA at music festivals. Participants popularly cited empathogenic, entactogenic, and entheogenic effects of DOA as their primary motivations for use. NPS use was endorsed by 39.8% (n = 68) of respondents, all of whom identified as being experienced DOA users. This population of novel psychoactive substance users is primarily composed of experienced drug users that endorsed use because of low cost, minimal perceived risk, accessibility, and normalization of drug use at music festivals.

Adolescent Boys’ Experiences of First Sex

PubMed Central

Ghani, Nadia; McKenzie, Fatima; Rosenberger, Joshua G.; Bell, David L.

2012-01-01

There are limited contextual data regarding first sexual experiences of younger adolescent men. Yet these data that are needed to inform STI and early fatherhood prevention efforts, particularly in lower income communities. Using qualitative methods, 14 adolescent men (ages 14–16, all low income, most African American) from a mid-sized U.S. city were asked about relationships and sexual experiences in a one hour face-to-face semi-structured interview, with two follow-up interviews at 6–9 month intervals. Story-telling was encouraged. Descriptions of first sex were identified, and then analysed for narrative structure and shared concepts. The dominant narrative of first sex proceeded through three steps: (1) Preparation, which involved identification of a sexualised space, mentoring by an older man, and pre-planning; (2) the event, which involved looking for cues indicating sexual interest and consent from a female partner, feelings of fear/nervousness, and first sex itself; and (3) afterwards, which involved a return to prior activities, minimal verbal exchange and a general positive feeling, sometimes accompanied by later disappointment. Mentorship, initiation by the female, and idealising sex as a romantic experience, played important roles in constructing the context of first sex. These factors should be incorporated in harm-reduction interventions for young men in similar contexts. PMID:22762432

Experiences of peer support for children and adolescents whose parents and siblings have mental illness.

PubMed

Foster, Kim; Lewis, Peter; McCloughen, Andrea

2014-05-01

There is minimal published literature on experiences of peer support programs for children/adolescents in families affected by mental illness. This study aimed to explore children's and adolescents' perspectives of the ON FIRE peer support program. An exploratory qualitative study with 14 children/adolescents 9-17 years of age who participated in semi-structured interviews. Thematic analysis resulted in three themes of experience. Participants made connections with others in the program, developed personal strengths, and learned how to contribute to others' well-being. Participants derived substantial personal benefit from peer support. Use of social media and the Internet may facilitate future program delivery. © 2014 Wiley Periodicals, Inc.

Exception reporting in the Quality and Outcomes Framework: views of practice staff - a qualitative study.

PubMed

Campbell, Stephen; Hannon, Kerin; Lester, Helen

2011-04-01

Exception reporting allows practices to exclude eligible patients from indicators or an entire clinical domain of the Quality and Outcomes Framework (QOF). It is a source of contention, viewed by some as a 'gaming' mechanism. To explore GP and practice staff views and experiences of exception reporting in the QOF. Qualitative semi-structured interviews. Interviews with 24 GPs, 20 practice managers, 13 practice nurses, and nine other staff were conducted in 27 general practices in the UK. Semi-structured interviews, analysed using open explorative thematic coding. Exception reporting was seen as a clinically necessary part of the QOF. Exempting patients, particularly for discretionary reasons, was seen as an 'exception to the rule' that was justified either in terms of practising patient-centred care within a framework of population-based health measures or because of the poor face validity of the indicators. Rates in all practices were described as minimal and the threat of external scrutiny from primary care trusts kept rates low. However, GPs were happy to defend using discretionary exception codes for individual patients. Exception reporting was used, particularly at the end of the payment year, to meet unmet targets and to prevent the practice being penalised financially. Overt gaming was seen as something done by 'other' practices. Only two GPs admitted to occasional inappropriate exception reporting. Exception reporting is seen by most GPs and practice staff as an important and defensible safeguard against inappropriate treatment or over-treatment of patients. However, a minority of practitioners also saw it as a gaming mechanism.

Formative infant feeding experiences and education of NICU nurses.

PubMed

Cricco-Lizza, Roberta

2009-01-01

To explore the formative infant feeding experiences and education of NICU nurses. An ethnography was undertaken over 14 months in a level IV NICU in a free standing pediatric hospital in the Northeastern U.S. Purposeful sampling was used to select informants. General informants included 114 NICU nurses who were observed and informally interviewed an average of 3.5 times. Eighteen of these served as key informants and each was formally interviewed once with an additional average of 12 observations/informal interviews. Descriptions of feeding experiences and education were coded and analyzed for recurring patterns using NUD*IST software. The NICU nurses identified a norm for formula feeding during their formative experiences as children. The nurses described increased exposure to varied feeding methods during their adulthood, but breastfeeding was often associated with difficulties among their families and friends. The nurses in this study recounted minimal exposure to breastfeeding in nursing school. The nurses' personal experiences with breastfeeding were laden with strong emotional reactions intertwined with their feelings about motherhood. Nurses' past experiences and education must be addressed if efforts are to be made to promote breastfeeding in the NICU. Breastfeeding education programs for nurses should include reflective components to help nurses identify structural barriers and reframe any negative personal experiences.

Divorcing Mothers’ Use of Protective Strategies: Differences Over Time and by Violence Experience

PubMed Central

Haselschwerdt, Megan L.; Mitchell, Elissa Thomann; Raffaelli, Marcela; Hardesty, Jennifer L.

2015-01-01

Objective The current study considered protective strategy use at various points in time for divorcing mothers with a range of marital violence experiences (including no history of violence and different types of violence). Method Divorcing mothers (N = 170) from one Midwestern county participated in two in-person interviews that included structured assessments of intimate partner violence (IPV) during the last year of marriage and use of protective strategies at three time points – last year of marriage and at separation (both assessed at Time 1) and since the first interview (at a three month follow-up). Results Divorcing mothers, regardless of marital violence experience, used an array of private and public protective strategies during the last year of marriage, at separation, and at the three-month follow up interview. In general, mothers who experienced coercive controlling violence reported using more protective strategies than mothers who experienced situational couple violence or no violence. Strategy use peaked at separation with an increase in public strategy use. Conclusions All divorcing mothers use a range of active coping strategies over time, yet findings emphasize the importance of making distinctions between types of IPV so that divorcing mothers receive individualized resources and support that best meet their needs and minimize potentials risks and losses as they navigate the divorce process. PMID:26858851

Collecting reliable information about violence against women safely in household interviews: experience from a large-scale national survey in South Asia.

PubMed

Andersson, Neil; Cockcroft, Anne; Ansari, Noor; Omer, Khalid; Chaudhry, Ubaid Ullah; Khan, Amir; Pearson, Luwei

2009-04-01

This article describes the first national survey of violence against women in Pakistan from 2001 to 2004 covering 23,430 women. The survey took account of methodological and ethical recommendations, ensuring privacy of interviews through one person interviewing the mother-in-law while another interviewed the eligible woman privately. The training module for interviewers focused on empathy with respondents, notably increasing disclosure rates. Only 3% of women declined to participate, and 1% were not permitted to participate. Among women who disclosed physical violence, only one third had previously told anyone. Surveys of violence against women in Pakistan not using methods to minimize underreporting could seriously underestimate prevalence.

Caregiver reports of patient-initiated violence in psychosis.

PubMed

Onwumere, Juliana; Grice, Sarah; Garety, Philippa; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth

2014-07-01

Aggressive behaviour in psychosis is not uncommon. Community provision for people with psychosis has left informal caregivers to take on a greater role in their care. However, few studies have explored links between patient-initiated violence in mental health caregiving relationships and caregiver functioning. Our study investigated caregiver reports of aggressive acts committed by their relative with psychosis and their links to caregiver appraisals of the caregiving relationship and caregiver outcomes. Caregivers of patients with a recent relapse of psychosis, recruited to a psychological therapy trial, completed the audiotaped Camberwell Family Interview at baseline. This semi-structured interview includes questions on the quality of the relationship between caregiver and patient, and patient history of violence. Seventy-two transcripts of interviews were assessed for reports of patient-initiated violence. One-half of the caregiver sample (52.9%) reported an incident of patient-initiated violence during their interview; 62.2% of these involved violence toward themselves, and 24.3% toward property. Reports of patient violence were associated with caregiver ratings of hostility expressed toward patients, lower self-esteem, and emotion-focused coping. People caring on their own were more likely to report incidents of patient violence. Younger patients, males, and inpatients were more frequently identified as having a history of this kind of violence. Our findings suggested that caregiver reports of patient-initiated violence in psychosis are not uncommon. Mental health staff need to be aware of the risks of such violence for caregivers of people with psychosis, and consider appropriate procedures for minimizing it.

Tearing down the Berlin wall: social workers' perspectives on joint working with general practice.

PubMed

Kharicha, Kalpa; Iliffe, Steve; Levin, Enid; Davey, Barbara; Fleming, Cass

2005-08-01

The arrangements for delivering social work and primary health care to older people in England and Wales are currently subject to rapid re-configuration, with the development of integrated primary care and social services trusts. To investigate perceptions of joint working in social services and general practice. The study setting was two London boroughs covered by one health authority, one NHS Community Health Services Trust, four Primary Care Groups and two social services departments. All social work team managers in both areas were interviewed together with a purposive sample of social workers with a high number of older clients on their caseloads. A sample of GPs was sought using a sampling frame of practice size in each borough. Structured interviews with open and closed questions were used. Tape-recorded interviews were transcribed and subject to thematic analysis. Analysis of emergent themes was aided by the use of Atlas-ti. Social workers and GPs agree on the need for joint working, but have different understandings of it, each profession wanting the other to change its organizational culture. Co-location of social and health care is seen as desirable, but threatening to social work. Concerns about differences in power and hierarchical authority are evident and explicit in social work perspectives. Conflict resolution strategies include risk minimization, adopting pragmatic, case-specific solutions rather than remaining consistent with policy, using nurses as mediators, and resorting to authority. Although this is a study from urban areas in England, its findings may have wider significance since we have found that resources and professional skills may be more important than organizational arrangements in collaborative working between disciplines. Primary Care Trusts in England and Wales should promote awareness of these different perspectives, perceived risks and conflict minimization strategies in their work on clinical governance and professional development.

75 FR 69677 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... interviews will participate in this interview. Questions vary by respondent type. 6. Post-implementation semi... semi-structured interviews will participate in this interview. Questions do not vary by respondent type... each nursing home. 4. Pre-implementation semi-structured interview--The purpose of this interview is to...

Experiences of structural vulnerability among exotic dancers in Baltimore, Maryland: co-occurring social and economic antecedents of HIV/STI risk

PubMed Central

Brantley, Meredith L.; Footer, Katherine; Lim, Sahnah; Kerrigan, Deanna; Sherman, Susan G.

2017-01-01

Women who grow up in an environment of economic scarcity often face limited opportunities for upward mobility, as a result of challenges securing stable housing, quality education, and high-paying, steady employment. Chronically unstable women often also have reduced capacity to protect themselves against HIV/STI related harm when engaging in sexual activity or illicit drug use. Characterizing and targeting the structural contexts that facilitate HIV/STI risk are critical to effective design and implementation of drug and sexual harm reduction interventions. This study explores the nature and progression of structural vulnerability experienced by female exotic dancers during their early lives through the initial months of exotic dancing. We also examine the roles of drug use and social relationships regarding experiences of structural vulnerability and engagement in sexual risk behavior. We conducted semi-structured in-depth interviews with exotic dancers working in Baltimore City and County exotic dance clubs during July 2014 and May 2015. Using thematic analysis, interviews revealed important individual, social, and economic effects of structural vulnerability. Many dancers depicted early experiences of residential transience, violence, and independence, and were raised in an environment of social and economic scarcity. The accumulation of chronic, overlapping social and economic disadvantage continued upon entry into dancing. Substance use emerged as an important issue for the majority of women, operating cyclically as both precursor to and product of accumulating social and economic hardship. Dancers also revealed social strategies that buffered the effects of structural vulnerability and minimized exposure to workplace-related drug and sexual risks. This study provides insight on an understudied group of at-risk women with a unique demographic profile. Findings illustrate how the effects of structural vulnerability, substance abuse, social strategies, and opportunities for economic gain through sexual services in the workplace converge to produce varying levels of HIV/STI risk among exotic dancers. PMID:29040840

[Can the local energy minimization refine the PDB structures of different resolution universally?].

PubMed

Godzi, M G; Gromova, A P; Oferkin, I V; Mironov, P V

2009-01-01

The local energy minimization was statistically validated as the refinement strategy for PDB structure pairs of different resolution. Thirteen pairs of structures with the only difference in resolution were extracted from PDB, and the structures of 11 identical proteins obtained by different X-ray diffraction techniques were represented. The distribution of RMSD value was calculated for these pairs before and after the local energy minimization of each structure. The MMFF94 field was used for energy calculations, and the quasi-Newton method was used for local energy minimization. By comparison of these two RMSD distributions, the local energy minimization was proved to statistically increase the structural differences in pairs so that it cannot be used for refinement purposes. To explore the prospects of complex refinement strategies based on energy minimization, randomized structures were obtained by moving the initial PDB structures as far as the minimized structures had been moved in a multidimensional space of atomic coordinates. For these randomized structures, the RMSD distribution was calculated and compared with that for minimized structures. The significant differences in their mean values proved the energy surface of the protein to have only few minima near the conformations of different resolution obtained by X-ray diffraction for PDB. Some other results obtained by exploring the energy surface near these conformations are also presented. These results are expected to be very useful for the development of new protein refinement strategies based on energy minimization.

Community-based health and schools of nursing: supporting health promotion and research.

PubMed

Shannon, Crystal

2014-01-01

This article examines the role of community-based schools of nursing in the promotion of public health and research in poverty-stricken areas. This was a three-phase study (questionnaire and key-informants' interviews) that surveyed representatives of prelicensure associate and baccalaureate nursing schools (n=17), nursing-school key informants (n=6) and community leaders (n=10). A 13-question web-based survey and semi-structured interview of key informants elicited data on demographics, nursing program design, exposure of faculty and students to various research and health promotion methods, and beliefs about student involvement. Nursing schools participated minimally in community-based health promotion (CBHP) and community-based participatory research saw reduced need for student involvement in such activities, cited multiple barriers to active community collaboration, and reported restricted community partnerships. CBHP was recognized to be a valuable element of health care and student education, but is obstructed by many barriers. This study suggests that nursing schools are not taking full advantage of relationships with community leaders. Recommendations for action are given. © 2013 Wiley Periodicals, Inc.

“People Knew They Could Come Here to Get Help”: An Ethnographic Study of Assisted Injection Practices at a Peer-Run ‘Unsanctioned’ Supervised Drug Consumption Room in a Canadian Setting

PubMed Central

McNeil, Ryan; Small, Will; Lampkin, Hugh; Shannon, Kate; Kerr, Thomas

2013-01-01

People who require help injecting are disproportionately vulnerable to drug-related harm, including HIV transmission. North America’s only sanctioned SIF operates in Vancouver, Canada under an exemption to federal drug laws, which imposes operating regulations prohibiting assisted injections. In response, the Vancouver Area Network of Drug Users (VANDU) launched a peer-run unsanctioned SIF in which trained peer volunteers provide assisted injections to increase the coverage of supervised injection services and minimize drug-related harm. We undertook qualitative interviews (n=23) and ethnographic observation (50 hours) to explore how this facility shaped assisted injection practices. Findings indicated that VANDU reshaped the social, structural, and spatial contexts of assisted injection practices in a manner that minimized HIV and other health risks, while allowing people who require help injecting to escape drug scene violence. Findings underscore the need for changes to regulatory frameworks governing SIFs to ensure that they accommodate people who require help injecting. PMID:23797831

The Structured Interview and Interviewer Training in the Admissions Process

PubMed Central

Cox, Wendy C.; White-Harris, Carla; Blalock, Susan J.

2007-01-01

Objectives To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training. Methods A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation. Results Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews. Conclusions Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy. PMID:17998980

Acceptance of a structured diagnostic interview in children, parents, and interviewers.

PubMed

Neuschwander, Murielle; In-Albon, Tina; Meyer, Andrea H; Schneider, Silvia

2017-09-01

The objective of this study was to investigate the satisfaction and acceptance of a structured diagnostic interview in clinical practice and in a research setting. Using the Structured Diagnostic Interview for Mental Disorders in Children and Adolescents (Kinder-DIPS), 28 certified interviewers conducted 202 interviews (115 with parents, 87 with children). After each interview, children, parents, and interviewers completed a questionnaire assessing the overall satisfaction (0 = not at all satisfied to 100 = totally satisfied) and acceptance (0 = completely disagree to 3 = completely agree) with the interview. Satisfaction ratings were highly positive, all means >82. The mean of the overall acceptance for children was 2.43 (standard deviation [SD] = 0.41), 2.54 (SD = 0.33) of the parents, 2.30 (SD = 0.43) of the children's interviewers, and 2.46 (SD = 0.32) of the parents' interviewers. Using separate univariate regression models, significant predictors for higher satisfaction and acceptance with the interview are higher children's Global Assessment of Functioning, fewer number of children's diagnoses, shorter duration of the interview, a research setting, female sex of the interviewer, and older age of the interviewer. Results indicate that structured diagnostic interviews are highly accepted by children, parents, and interviewers. Importantly, this is true for different treatment settings. Copyright © 2017 John Wiley & Sons, Ltd.

Male and female viewpoints on female circumcision in Ekpeye, Rivers State, Nigeria.

PubMed

Briggs, L A

2002-12-01

One hundred and ninety five male and female volunteers across the social strata were interviewed using structured questionnaire. Data were analysed using frequency tables. The study revealed that 74.7% of female respondents were circumcised. They believe that the practice would help prevent sexual promiscuity, curb sexual desires and that it is a custom they cannot do without. Most of the men would not marry an uncircumcised female, while a substantial number of the respondents would like to circumcise their daughters. Community effort to eradicate the practice is very minimal. Based on the findings, it is suggested that communities where female genital mutilation (FGM) is practiced as a social norm should be involved in eradication campaigns with support from national and international organisations.

The search for equality: representations of the smoking act among adolescent women.

PubMed

Sánchez Martínez, J Adriana; Ribeiro, Cléa Regina de Oliveira

2008-01-01

This study aimed to discover the representations of the smoking habit in both non-smoking and smoking female adolescents from a high school in Querétaro, Mexico. It is a qualitative research, carried out with 14 female adolescents in 2005. A semi-structured interview and a socioeconomic survey were used to collect data. Results evidenced adolescents know the biomedical discourse, which proposes that smoking causes serious consequences to health. However, there are other symbolic reasons that influence its use such as the search for equality and image, since they think men find smoking women more attractive and mature. Peer pressure represents an important factor for women to smoke by validating its practice and minimizing its effects to the body.

Distributed health literacy among people living with type 2 diabetes in Portugal: Defining levels of awareness and support.

PubMed

Abreu, Liliana; Nunes, João Arriscado; Taylor, Peter; Silva, Susana

2018-01-01

This study embraces a patient-centred and narrative-oriented notion of health literacy, exploring how social networks and personal experiences constitute distributed health literacy (DHL) by mapping out health literacy mediators of each individual and how they enable self-management skills and knowledge of health conditions. Semi-structured interviews with 26 patients with type 2 diabetes were conducted in a Primary Care Center of Porto (Portugal) from October 2014 to December 2015. Data were collected based on McGill Illness Narrative Interview (MINI). Following the grounded theory, interviews were analysed as case-based and process-tracing-oriented. Three awareness narratives emerged: (i) a narrative of minimisation revealing minimal impact of diabetes in patients' lives and daily routines, resignation towards "inevitable" consequences of the diagnosis and dependence of a large network of health literacy mediators; (ii) a narrative of empathy, where patients tended to mention readjustments in their lives by following medical recommendations regarding medication without criticism and with few health literacy mediators; (iii) a narrative of disruption, with patients highlighting the huge impact of diabetes on their lives and their individual responsibility and autonomy with respect to the management of diabetes and the search for alternatives to medication, relying on a very restrictive network of mediators. Exploring meanings given to diagnosis, identifying health mediators and analysing the structure of social networks can contribute to understand the distributed nature of health literacy. Assessing DHL can assist health professionals and those providing care in the community in promoting health literacy and providing models for a more patient-centred health system. © 2017 John Wiley & Sons Ltd.

"Where to find those doctors?" A qualitative study on barriers and facilitators in access to and utilization of health care services by Polish migrants in Norway.

PubMed

Czapka, Elżbieta Anna; Sagbakken, Mette

2016-09-01

Poles constitute the largest group of migrants in Norway. Research confirms a steady inflow and a minimal outflow of Polish migrants. One of the key aspects of migrants' structural integration is access to health care services. This study explored barriers to and facilitators of Polish migrants' access to Norwegian health care services. A qualitative interview-based study was carried out between November 2013 and July 2014. The study is part of a larger, ongoing mixed-method study of Polish migrants' access to health care services in Norway. Semi-structured interviews were conducted with 19 Polish migrants in Oslo. The interviews were transcribed, coded, and analyzed. Thematic analysis was performed to identify barriers and facilitators related to the use of Norwegian health care services. Migrants experienced several barriers to and facilitators of access to health care services in Norway. The barriers most often mentioned were problems resulting from insufficient command of the language, related communication problems, and lack of knowledge about navigating the Norwegian health care system. Other barriers related to the organization of the health care system, perceptions of doctors' skills and practices, and attitudes among health personnel. Factors such as having a Polish social network, meeting friendly health personnel, and perceptions of equal treatment of all patients, facilitated access to and use of health care services. The study shows that there are both system- and patient-related barriers to and facilitators of migrants' access to health services in Norway. These findings suggest that successful inclusion of migrants into the Norwegian health system requires regular evaluation of access and utilization of health care services.

A Method for Reducing Misclassification in the Extended Glasgow Outcome Score

PubMed Central

Marmarou, Anthony; Lapane, Kate; Turf, Elizabeth; Wilson, Lindsay

2010-01-01

Abstract The eight-point extended Glasgow Outcome Scale (GOSE) is commonly used as the primary outcome measure in traumatic brain injury (TBI) clinical trials. The outcome is conventionally collected through a structured interview with the patient alone or together with a caretaker. Despite the fact that using the structured interview questionnaires helps reach agreement in GOSE assessment between raters, significant variation remains among different raters. We introduce an alternate GOSE rating system as an aid in determining GOSE scores, with the objective of reducing inter-rater variation in the primary outcome assessment in TBI trials. Forty-five trauma centers were randomly assigned to three groups to assess GOSE scores on sample cases, using the alternative GOSE rating system coupled with central quality control (Group 1), the alternative system alone (Group 2), or conventional structured interviews (Group 3). The inter-rater variation between an expert and untrained raters was assessed for each group and reported through raw agreement and with weighted kappa (κ) statistics. Groups 2 and 3 without central review yielded inter-rater agreements of 83% (weighted κ = 0.81; 95% CI 0.69, 0.92) and 83% (weighted κ = 0.76, 95% CI 0.63, 0.89), respectively, in GOS scores. In GOSE, the groups had an agreement of 76% (weighted κ = 0.79; 95% CI 0.69, 0.89), and 63% (weighted κ = 0.70; 95% CI 0.60, 0.81), respectively. The group using the alternative rating system coupled with central monitoring yielded the highest inter-rater agreement among the three groups in rating GOS (97%; weighted κ = 0.95; 95% CI 0.89, 1.00), and GOSE (97%; weighted κ = 0.97; 95% CI 0.91, 1.00). The alternate system is an improved GOSE rating method that reduces inter-rater variations and provides for the first time, source documentation and structured narratives that allow a thorough central review of information. The data suggest that a collective effort can be made to minimize inter-rater variation. PMID:20334503

Improving healthcare systems' disclosures of large-scale adverse events: a Department of Veterans Affairs leadership, policymaker, research and stakeholder partnership.

PubMed

Elwy, A Rani; Bokhour, Barbara G; Maguire, Elizabeth M; Wagner, Todd H; Asch, Steven M; Gifford, Allen L; Gallagher, Thomas H; Durfee, Janet M; Martinello, Richard A; Schiffner, Susan; Jesse, Robert L

2014-12-01

The Department of Veterans Affairs (VA) mandates disclosure of large-scale adverse events to patients, even if risk of harm is not clearly present. Concerns about past disclosures warranted further examination of the impact of this policy. Through a collaborative partnership between VA leaders, policymakers, researchers and stakeholders, the objective was to empirically identify critical aspects of disclosure processes as a first step towards improving future disclosures. Semi-structured interviews were conducted with participants at nine VA facilities where recent disclosures took place. Ninety-seven stakeholders participated in the interviews: 38 employees, 28 leaders (from facilities, regions and national offices), 27 Veteran patients and family members, and four congressional staff members. Facility and regional leaders were interviewed by telephone, followed by a two-day site visit where employees, patients and family members were interviewed face-to-face. National leaders and congressional staff also completed telephone interviews. Interviews were analyzed using rapid qualitative assessment processes. Themes were mapped to the stages of the Crisis and Emergency Risk Communication model: pre-crisis, initial event, maintenance, resolution and evaluation. Many areas for improvement during disclosure were identified, such as preparing facilities better (pre-crisis), creating rapid communications, modifying disclosure language, addressing perceptions of harm, reducing complexity, and seeking assistance from others (initial event), managing communication with other stakeholders (maintenance), minimizing effects on staff and improving trust (resolution), and addressing facilities' needs (evaluation). Through the partnership, five recommendations to improve disclosures during each stage of communication have been widely disseminated throughout the VA using non-academic strategies. Some improvements have been made; other recommendations will be addressed through implementation of a large-scale adverse event disclosure toolkit. These toolkit strategies will enable leaders to provide timely and transparent information to patients and families, while reducing the burden on employees and the healthcare system during these events.

Stakeholders' views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs.

PubMed

Kalkman, Shona; van Thiel, Ghislaine J M W; Grobbee, Diederick E; Meinecke, Anna-Katharina; Zuidgeest, Mira G P; van Delden, Johannes J M

2016-08-22

We explored the views of key stakeholders to identify the ethical challenges of pragmatic trials investigating pharmaceutical drugs. A secondary aim was to capture stakeholders' attitudes towards the implementation of pragmatic trials in the drug development process. We conducted semistructured, in-depth interviews among individuals from different key stakeholder groups (academia and independent research institutions, the pharmaceutical industry, regulators, Health Technology Assessment (HTA) agencies and patients' organizations) through telephone or face-to-face sessions. Interviews were structured around the question "what challenges were experienced or perceived during the design, conduct and/or review of pragmatic trials." Respondents were additionally asked about their views on implementation of pragmatic trials in the drug development process. Thematic analysis was used to identify the ethically relevant features across data sets. We interviewed 34 stakeholders in 25 individual sessions and four group sessions. The four perceived challenges of ethical relevance were: (1) less controlled conditions creating safety concerns, (2) comparison with usual care potentially compromising clinical equipoise, (3) tailored or waivers of informed consent affecting patient autonomy, and (4) minimal interference with "real-world" practice reducing the knowledge value of trial results. We identified stakeholder concerns regarding risk assessment, use of suboptimal usual care as a comparator, tailoring of informed consent procedures and ensuring the social value of pragmatic trials. These concerns increased when respondents were asked about pragmatic trials conducted before market authorization.

Perceived workplace mistreatment: Case of Latina hotel housekeepers.

PubMed

Hsieh, Yu-Chin Jerrie; Sönmez, Sevil; Apostolopoulos, Yorghos; Lemke, Michael Kenneth

2017-01-01

Latina hotel housekeepers' social class, gender, race/ethnicity, nationality, and United States immigration status render them particularly vulnerable to workplace mistreatment. We sought to reveal the array of policy- and interpersonal-related mistreatment experienced by Latina hotel housekeepers in the southeastern United States employed at 75 local hotels which included 4-star, 3-star, 2-star, and 1-star properties. This ethnographic study involved 27 in-depth interviews with Latina hotel housekeepers. Using semi-structured in-depth interview guides, participants were interviewed until collected data reached saturation. Data were coded to explore themes and relationships for the housekeepers' work environments, and thick descriptions of these environments were developed. Participants ranged in work experience from 1 to 15 years, with all but one unable to reach full-time status, and were paid between $7.25 and $8.00 per hour. Policy-related phenomena, such as low pay, lack of paid sick leave or overtime, and absence of appropriate cleaning tools or protective equipment were all perceived as forms of mistreatment by Latina hotel housekeepers. Interpersonal mistreatment in the form of supervisor favoritism, unfair work assignments, biased allocation of cleaning supplies, disrespect, and verbal abuse due to ethnicity was also perceived. Latina hotel housekeepers endure mistreatment that impacts their psychosocial and physical occupational health. We provide recommendations to minimize workplace mistreatment and improve well-being of Latina hotel housekeepers.

Paternal mental health following perceived traumatic childbirth.

PubMed

Inglis, Christian; Sharman, Rachael; Reed, Rachel

2016-10-01

the objective behind the current study was to explore the experiences and perceptions of fathers after childbirth trauma, an area of minimal research. This is part two of a two-part series conducted in 2014 researching the mental health of fathers after experiencing a perceived traumatic childbirth. qualitative methodology using semi-structured interviews and reporting of qualitative questions administered in part one's online survey (Inglis, 2014). interviews conducted face-to-face at an Australian University or on Skype. sixty-nine responded to the online qualitative questions and of these seven were interviewed. thematic analysis of verbal and written qualitative responses. thematic analysis of qualitative survey data and interviews found a global theme 'standing on the sideline' which encompassed two major themes of witnessing trauma: unknown territory, and the aftermath: dealing with it, and respective subthemes. according to the perceptions and experiences of the fathers, there was a significant lack of communication between birthing teams and fathers, and fathers experienced a sense of marginalisation before, during, and after the traumatic childbirth. The findings of this study suggest that these factors contributed to the perception of trauma in the current sample. Whilst many fathers reported the negative impact of the traumatic birth on themselves and their relationships, some reported post-traumatic growth from the experience and others identified friends and family as a valuable source of support. improved communication between midwifery staff and fathers before, during and after childbirth may reduce the rates of paternal postpartum mental health difficulties and experiences of trauma. Copyright © 2016 Elsevier Ltd. All rights reserved.

Caregiver Reports of Patient-Initiated Violence in Psychosis

PubMed Central

Onwumere, Juliana; Grice, Sarah; Garety, Philippa; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth

2014-01-01

Objective: Aggressive behaviour in psychosis is not uncommon. Community provision for people with psychosis has left informal caregivers to take on a greater role in their care. However, few studies have explored links between patient-initiated violence in mental health caregiving relationships and caregiver functioning. Our study investigated caregiver reports of aggressive acts committed by their relative with psychosis and their links to caregiver appraisals of the caregiving relationship and caregiver outcomes. Method: Caregivers of patients with a recent relapse of psychosis, recruited to a psychological therapy trial, completed the audiotaped Camberwell Family Interview at baseline. This semi-structured interview includes questions on the quality of the relationship between caregiver and patient, and patient history of violence. Seventy-two transcripts of interviews were assessed for reports of patient-initiated violence. Results: One-half of the caregiver sample (52.9%) reported an incident of patient-initiated violence during their interview; 62.2% of these involved violence toward themselves, and 24.3% toward property. Reports of patient violence were associated with caregiver ratings of hostility expressed toward patients, lower self-esteem, and emotion-focused coping. People caring on their own were more likely to report incidents of patient violence. Younger patients, males, and inpatients were more frequently identified as having a history of this kind of violence. Conclusions: Our findings suggested that caregiver reports of patient-initiated violence in psychosis are not uncommon. Mental health staff need to be aware of the risks of such violence for caregivers of people with psychosis, and consider appropriate procedures for minimizing it. Clinical Trial Registration Number: ISRCTN83557988 PMID:25007421

Disability and Mental Disorders in the Canadian Armed Forces

PubMed Central

Weeks, Murray; Zamorski, Mark A.

2016-01-01

Objectives: The initial goal was to validate the use of a self-report measure of disability in the Canadian Armed Forces (CAF). The main goal was to document the extent of disability in personnel with and without mental disorders. Methods: Data were obtained from the 2013 Canadian Forces Mental Health Survey; the sample included 6700 Regular Forces personnel. Disability was measured with the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS-2); established cut points were used to demarcate severe, moderate, minimal, and no disability. The following recent (past-year) and remote (lifetime but not past-year) disorders were assessed with diagnostic interviews: posttraumatic stress disorder, major depressive episode, generalized anxiety disorder, panic disorder, and alcohol use disorder. Results: The WHODAS-2 showed good internal consistency (α = 0.89) and a 1-factor structure. Most personnel had no disability (59.2%) or minimal disability (30.8%). However, an important minority had moderate or severe disability (8.4% and 1.6%, respectively). Individuals with recent disorders reported greater disability than those without lifetime disorders, although many had minimal or no disability (41.2% and 24.7%, respectively). Disability increased with the number of recent disorders. Relative to those without lifetime disorders, individuals with remote disorders showed slightly greater disability, but most had no disabilty (57.1%) or minimal disability (35.0%). Conclusions: The 12-item WHODAS-2 is a valid measure of disability in the CAF. Mental disorders may be important drivers of disability in this population, although limited residual disability is seen in individuals with remote disorders. PMID:27270743

The Economic Burden of Orthopedic Surgery Residency Interviews on Applicants.

PubMed

Fogel, Harold A; Finkler, Elissa S; Wu, Karen; Schiff, Adam P; Nystrom, Lukas M

2016-01-01

The intense competition for orthopedic surgery residency positions influences the interview process. The financial impact on residency applicants is less well understood. The purpose of the present study was to define the economic burden of the orthopedic surgery residency interview process while additionally describing how applicants finance the expense. We distributed surveys to 48 nonrotating applicants at our institution's residency interview days for the 2015 match year. The survey consisted of eleven questions specific to the costs of interviewing for orthopedic surgery residency positions. The survey response rate was 90% (43/48). Applicants applied to a median of 65 orthopedic surgery residency programs (range 21-88) and targeted a median of 15 interviews (range 12-25). The mean cost estimate for a single interview was $450 (range $200-800) and the cost estimate for all interviews was $7,119 (range $2,500-15,000). Applicants spent a mean of $344 (range $0-750) traveling to our interview. Seventy-two percent borrowed money to finance their interview costs and 28% canceled interviews for financial reasons. The financial cost of interviewing for orthopedic surgery is substantial and a majority of applicants add to their educational debt by taking out loans to finance interviews. Future considerations should be made to minimize these costs for an already financially burdened population.

How I Learned to Design and Conduct Semi-Structured Interviews: An Ongoing and Continuous Journey

ERIC Educational Resources Information Center

Rabionet, Silvia E.

2011-01-01

Qualitative interviewing is a flexible and powerful tool to capture the voices and the ways people make meaning of their experience Learning to conduct semi-structure interviews requires the following six stages: (a) selecting the type of interview; (b) establishing ethical guidelines, (c) crafting the interview protocol; (d) conducting and…

Effects of a training in the Disability Assessment Structured Interview on the interviews of Dutch insurance physicians.

PubMed

Spanjer, Jerry; van de Mei, Sijrike; Cornelius, Bert; Brouwer, Sandra; van der Klink, Jac

2016-08-01

The Disability Assessment Structured Interview (DASI) is a semi-structured interview for assessing functional limitations of claimants in a work disability evaluation. The aim of this study is to evaluate the effect of a 3-day DASI training course on the quality of assessment interviews of insurance physicians (IPs). In a pretest-posttest study, 55 IPs employed at the Dutch National Institute for Employee Benefits Schemes completed a 3-day DASI training. Before (T0), directly after the training (T1) and after 3 months follow-up (T2), these IPs filled out questionnaires that measured knowledge, skills, attitude and self-efficacy. Furthermore, in 10 disability assessment cases interview duration, IP's satisfaction, amount of acquired information and confidence of judgement were measured. Finally, the amount of information reported was measured in three randomly selected disability assessment reports of each IP. IP's knowledge, skills and self-efficacy improved significantly after the training. The attitude of the IPs changed towards a more open attitude and structuring of the interview. Satisfaction about the interview, amount of acquired information and confidence of their judgement all increased. The DASI training improved the quality of assessment interviews of IPs. A semi-structured interview, like the DASI, can help physicians to pay more attention to activity limitations and participation in addition to medical information. Implications for Rehabilitation Experienced IPs are able to change their disability assessment interview routine after training. In determining work ability, IPs should pay more attention to claimant's activity limitations and participation in addition to medical information. A semi-structured interview as the DASI can help IPs to pay more attention to claimant's functioning. A 3-day DASI training for IPs can increase their confidence in their judgement and provides significantly more information in their assessment reports.

NEGOTIATING STRUCTURAL VULNERABILITY FOLLOWING REGULATORY CHANGES TO A PROVINCIAL METHADONE PROGRAM IN VANCOUVER, CANADA: A QUALITATIVE STUDY

PubMed Central

McNeil, Ryan; Kerr, Thomas; Anderson, Solanna; Maher, Lisa; Keewatin, Chereece; Milloy, MJ; Wood, Evan; Small, Will

2015-01-01

While regulatory frameworks governing methadone maintenance therapy (MMT) require highly regimented treatment programs that shape treatment outcomes, little research has examined the effects of regulatory changes to these programs on those receiving treatment, and located their experiences within the wider context of socialstructural inequities. In British Columbia (BC), Canada, provincial regulations governing MMT have recently been modified, including: replacing the existing methadone formulation with Methadose® (pre-mixed and 10 times more concentrated); prohibiting pharmacy delivery of methadone; and, prohibiting pharmacies incentives for methadone dispensation. We undertook this study to examine the impacts of these changes on a structurally vulnerable population enrolled in MMT in Vancouver, BC. Qualitative interviews were conducted with 34 people enrolled in MMT and recruited from two ongoing observational prospective cohort studies comprised of drug-using individuals in the six-month period in 2014 following these regulatory changes. Interview transcripts were analyzed thematically, and by drawing on the concept of ‘structural vulnerability’. Findings underscore how these regulatory changes disrupted treatment engagement, producing considerable health and social harms. The introduction of Methadose® precipitated increased withdrawal symptoms. The discontinuation of pharmacy delivery services led to interruptions in MMT and codispensed HIV medications due to constraints stemming from their structural vulnerability (e.g., poverty, homelessness). Meanwhile, the loss of pharmacy incentives limited access to material supports utilized by participants to overcome barriers to MMT, while diminishing their capacity to assert some degree of agency in negotiating dispensation arrangements with pharmacies. Collectively, these changes functioned to compromise MMT engagement and increased structural vulnerability to harm, including re-initiation of injection drug use and participation in high-risk incomegenerating strategies. Greater attention to the impacts of social-structural inequities on MMT engagement is needed when modifying MMT programs, especially as other jurisdictions are adopting similar changes. Comprehensive environmental supports should be provided to minimize adverse outcomes during transitional periods. PMID:25875323

Exploratory and Confirmatory Factor Analyses of the Structured Interview for Disorders of Extreme Stress

ERIC Educational Resources Information Center

Scoboria, Alan; Ford, Julian; Lin, Hsiu-ju; Frisman, Linda

2008-01-01

Two studies were conducted to provide the first empirical examination of the factor structure of a revised version of the clinically derived Structured Interview for Disorders of Extreme Stress, a structured interview designed to assess associated features of posttraumatic stress disorder (PTSD) thought to be related to early onset, interpersonal,…

Reliability of a structured interview for admission to an emergency medicine residency program.

PubMed

Blouin, Danielle

2010-10-01

Interviews are most important in resident selection. Structured interviews are more reliable than unstructured ones. We sought to measure the interrater reliability of a newly designed structured interview during the selection process to an Emergency Medicine residency program. The critical incident technique was used to extract the desired dimensions of performance. The interview tool consisted of 7 clinical scenarios and 1 global rating. Three trained interviewers marked each candidate on all scenarios without discussing candidates' responses. Interitem consistency and estimates of variance were computed. Twenty-eight candidates were interviewed. The generalizability coefficient was 0.67. Removing the central tendency ratings increased the coefficient to 0.74. Coefficients of interitem consistency ranged from 0.64 to 0.74. The structured interview tool provided good although suboptimal interrater reliability. Increasing the number of scenarios improves reliability as does applying differential weights to the rating scale anchors. The latter would also facilitate the identification of those candidates with extreme ratings.

Concurrent optimization of material spatial distribution and material anisotropy repartition for two-dimensional structures

NASA Astrophysics Data System (ADS)

Ranaivomiarana, Narindra; Irisarri, François-Xavier; Bettebghor, Dimitri; Desmorat, Boris

2018-04-01

An optimization methodology to find concurrently material spatial distribution and material anisotropy repartition is proposed for orthotropic, linear and elastic two-dimensional membrane structures. The shape of the structure is parameterized by a density variable that determines the presence or absence of material. The polar method is used to parameterize a general orthotropic material by its elasticity tensor invariants by change of frame. A global structural stiffness maximization problem written as a compliance minimization problem is treated, and a volume constraint is applied. The compliance minimization can be put into a double minimization of complementary energy. An extension of the alternate directions algorithm is proposed to solve the double minimization problem. The algorithm iterates between local minimizations in each element of the structure and global minimizations. Thanks to the polar method, the local minimizations are solved explicitly providing analytical solutions. The global minimizations are performed with finite element calculations. The method is shown to be straightforward and efficient. Concurrent optimization of density and anisotropy distribution of a cantilever beam and a bridge are presented.

Effectiveness of motivational interviewing for improving physical activity self-management for adults with type 2 diabetes: A review.

PubMed

Soderlund, Patricia Davern

2018-03-01

Objectives This review examines the effectiveness of motivational interviewing for physical activity self-management for adults diagnosed with diabetes mellitus type 2. Motivational interviewing is a patient centered individually tailored counseling intervention that aims to elicit a patient's own motivation for health behavior change. Review questions include (a) How have motivational interviewing methods been applied to physical activity interventions for adults with diabetes mellitus type 2? (b) What motivational interviewing approaches are associated with successful physical activity outcomes with diabetes mellitus 2? Methods Database searches used PubMed, CINAHL, and PsycINFO for the years 2000 to 2016. Criteria for inclusion was motivational interviewing used as the principal intervention in the tradition of Miller and Rollnick, measurement of physical activity, statistical significance reported for physical activity outcomes, quantitative research, and articles written in English. Results A total of nine studies met review criteria and four included motivational interviewing interventions associated with significant physical activity outcomes. Discussion Findings suggest motivational interviewing sessions should target a minimal number of self-management behaviors, be delivered by counselors proficient in motivational interviewing, and use motivational interviewing protocols with an emphasis placed either on duration or frequency of sessions.

Minimal measures for Euler-Lagrange flows on finite covering spaces

NASA Astrophysics Data System (ADS)

Wang, Fang; Xia, Zhihong

2016-12-01

In this paper we study the minimal measures for positive definite Lagrangian systems on compact manifolds. We are particularly interested in manifolds with more complicated fundamental groups. Mather’s theory classifies the minimal or action-minimizing measures according to the first (co-)homology group of a given manifold. We extend Mather’s notion of minimal measures to a larger class for compact manifolds with non-commutative fundamental groups, and use finite coverings to study the structure of these extended minimal measures. We also define action-minimizers and minimal measures in the homotopical sense. Our program is to study the structure of homotopical minimal measures by considering Mather’s minimal measures on finite covering spaces. Our goal is to show that, in general, manifolds with a non-commutative fundamental group have a richer set of minimal measures, hence a richer dynamical structure. As an example, we study the geodesic flow on surfaces of higher genus. Indeed, by going to the finite covering spaces, the set of minimal measures is much larger and more interesting.

A Spatial View of the Interpersonal Structure of Family Interviews: Similarities and Differences Across Counselors.

ERIC Educational Resources Information Center

Friedlander, Myrna L.; Highlen, Pamela S.

1984-01-01

Examined the interpersonal structures of interviews by Ackerman, Bowen, Jackson, and Whitaker with the same family to identify common features across counselors. Multidimensional scaling provided a spatial representation of the hidden structure in the communication patterns of these interviews. Correlations indicated counselors' interactions were…

Use of the Interview in Resident Candidate Selection: A Review of the Literature.

PubMed

Stephenson-Famy, Alyssa; Houmard, Brenda S; Oberoi, Sidharth; Manyak, Anton; Chiang, Seine; Kim, Sara

2015-12-01

Although the resident candidate interview is costly and time-consuming for both applicants and programs, it is considered critically important for resident selection. Noncognitive attributes, including communication skills and professionalism, can be assessed by the personal interview. We conducted a review of the literature on the residency interview to identify the interview characteristics used for resident selection and to ascertain to what extent the interview yields information that predicts future performance. We searched PubMed and Scopus using the following search terms: residency, internship, interview, selection, and performance. We extracted information on characteristics of the interview process, including type of interview format, measures taken to minimize bias by interviewers, and testing of other clinical/surgical skills. We identified 104 studies that pertained to the resident selection interview, with highly varied interview formats and assessment tools. A positive correlation was demonstrated between a medical school academic record and the interview, especially for unblinded interview formats. A total of 34 studies attempted to correlate interview score with performance in residency, with mixed results. We also identified a number of studies that included personality testing, clinical skills testing, or surgical skills testing. Our review identified a wide variety of approaches to the selection interview and a range of factors that have been studied to assess its effectiveness. More research needs to be done not only to address and ascertain appropriate interview formats that predict positive performance in residency, but also to determine interview factors that can predict both residents' "success" and program attrition.

Developing a customized multiple interview for dental school admissions.

PubMed

Gardner, Karen M

2014-04-01

From the early 1980s until recently, the University of British Columbia Faculty of Dentistry had employed the Canadian Dental Association (CDA) Structured Interview in its Phase 2 admissions process (with those applicants invited for interviews). While this structured interview had demonstrated reliability and validity, the Faculty of Dentistry came to believe that a multiple interview process using scenarios would help it better identify applicants who would match its mission. After a literature review that investigated such interview protocols as unstructured, semi-structured, computerized, and telephone formats, a multiple interview format was chosen. This format was seen as an emerging trend, with evidence that it has been deemed fairer by applicants, more reliable by interviewers, more difficult for applicants to provide set answers for the scenarios, and not to require as many interviewers as other formats. This article describes the process undertaken to implement a customized multiple interview format for admissions and reports these outcomes of the process: a smoothly running multiple interview; effective training protocols for staff, interviewers, and applicants; and reports from successful applicants and interviewers that they felt the multiple interview was a more reliable and fairer recruiting tool than other models.

The Inevitability of Infidelity: Sexual Reputation, Social Geographies, and Marital HIV Risk in Rural Mexico

PubMed Central

Hirsch, Jennifer S.; Meneses, Sergio; Thompson, Brenda; Negroni, Mirka; Pelcastre, Blanca; del Rio, Carlos

2007-01-01

Marriage presents the single greatest risk for HIV infection among women in rural Mexico. We drew on 6 months of participant observation, 20 marital case studies, 37 key informant interviews, and archival research to explore the factors that shape HIV risk among married women in one of the country’s rural communities. We found that culturally constructed notions of reputation in this community lead to sexual behavior designed to minimize men’s social risk (threats to one’s social status or relationships), rather than viral risk and that men’s desire for companionate intimacy may actually increase women’s risk for HIV infection. We also describe the intertwining of reputation-based sexual identities with structurally patterned sexual geographies (i.e. the social spaces that shape sexual behavior). We propose that, because of the structural nature of men’s extramarital sexual behavior, intervention development should concentrate on sexual geographies and risky spaces rather than risky behaviors or identities. PMID:17463368

76 FR 4700 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

.... Questions vary by respondent type. 5. Post-training semi-structured interview--The purpose of this interview.... Questions vary by respondent type. 6. Post-implementation semi-structured interview--The purpose of this... in this interview. Questions do not vary by respondent type. Estimated Annual Respondent Burden...

Implementation of an Audio Computer-Assisted Self-Interview (ACASI) System in a General Medicine Clinic

PubMed Central

Deamant, C.; Smith, J.; Garcia, D.; Angulo, F.

2015-01-01

Summary Background Routine implementation of instruments to capture patient-reported outcomes could guide clinical practice and facilitate health services research. Audio interviews facilitate self-interviews across literacy levels. Objectives To evaluate time burden for patients, and factors associated with response times for an audio computer-assisted self interview (ACASI) system integrated into the clinical workflow. Methods We developed an ACASI system, integrated with a research data warehouse. Instruments for symptom burden, self-reported health, depression screening, tobacco use, and patient satisfaction were administered through touch-screen monitors in the general medicine clinic at the Cook County Health & Hospitals System during April 8, 2011-July 27, 2012. We performed a cross-sectional study to evaluate the mean time burden per item and for each module of instruments; we evaluated factors associated with longer response latency. Results Among 1,670 interviews, the mean per-question response time was 18.4 [SD, 6.1] seconds. By multivariable analysis, age was most strongly associated with prolonged response time and increased per decade compared to < 50 years as follows (additional seconds per question; 95% CI): 50–59 years (1.4; 0.7 to 2.1 seconds); 60–69 (3.4; 2.6 to 4.1); 70–79 (5.1; 4.0 to 6.1); and 80–89 (5.5; 4.1 to 7.0). Response times also were longer for Spanish language (3.9; 2.9 to 4.9); no home computer use (3.3; 2.8 to 3.9); and, low mental self-reported health (0.6; 0.0 to 1.1). However, most interviews were completed within 10 minutes. Conclusions An ACASI software system can be included in a patient visit and adds minimal time burden. The burden was greatest for older patients, interviews in Spanish, and for those with less computer exposure. A patient’s self-reported health had minimal impact on response times. PMID:25848420

Implementation of an audio computer-assisted self-interview (ACASI) system in a general medicine clinic: patient response burden.

PubMed

Trick, W E; Deamant, C; Smith, J; Garcia, D; Angulo, F

2015-01-01

Routine implementation of instruments to capture patient-reported outcomes could guide clinical practice and facilitate health services research. Audio interviews facilitate self-interviews across literacy levels. To evaluate time burden for patients, and factors associated with response times for an audio computer-assisted self interview (ACASI) system integrated into the clinical workflow. We developed an ACASI system, integrated with a research data warehouse. Instruments for symptom burden, self-reported health, depression screening, tobacco use, and patient satisfaction were administered through touch-screen monitors in the general medicine clinic at the Cook County Health & Hospitals System during April 8, 2011-July 27, 2012. We performed a cross-sectional study to evaluate the mean time burden per item and for each module of instruments; we evaluated factors associated with longer response latency. Among 1,670 interviews, the mean per-question response time was 18.4 [SD, 6.1] seconds. By multivariable analysis, age was most strongly associated with prolonged response time and increased per decade compared to < 50 years as follows (additional seconds per question; 95% CI): 50-59 years (1.4; 0.7 to 2.1 seconds); 60-69 (3.4; 2.6 to 4.1); 70-79 (5.1; 4.0 to 6.1); and 80-89 (5.5; 4.1 to 7.0). Response times also were longer for Spanish language (3.9; 2.9 to 4.9); no home computer use (3.3; 2.8 to 3.9); and, low mental self-reported health (0.6; 0.0 to 1.1). However, most interviews were completed within 10 minutes. An ACASI software system can be included in a patient visit and adds minimal time burden. The burden was greatest for older patients, interviews in Spanish, and for those with less computer exposure. A patient's self-reported health had minimal impact on response times.

Strategies used by breast cancer survivors to address work-related limitations during and after treatment.

PubMed

Sandberg, Joanne C; Strom, Carla; Arcury, Thomas A

2014-01-01

The primary objective of this exploratory study was to delineate the broad range of adjustments women breast cancer survivors draw upon to minimize cancer-related limitations at the workplace. The study also analyzed whether survivors used strategies to address work-related limitations in isolation or in combination with other strategies, and whether they used formal or informal strategies. Semi-structured, in-depth interviews were conducted with 14 women who were employed at the time of diagnosis of breast cancer and who continued to work during treatment or returned to work. Interviews were conducted 3 to 24 months after diagnosis. An iterative process was used to systematically analyze the data (the transcripts) using qualitative methods. Participants who worked during or after treatment adjusted their work schedule, performed fewer or other tasks, modified or changed their work environment, reduced non-work activities at the workplace, used cognitive prompts, and acted preemptively to make work tasks manageable after their return to work. Survivors used multiple adjustments and drew upon both formal and informal tactics to minimize or prevent cancer- or treatment-related effects from negatively affecting job performance. Knowledge about the broad range of both formal and informal strategies identified in this study may enable health care and social services providers, as well as cancer survivors and employers, to identify a wide range of specific strategies that may reduce the negative effects of work-related limitations in specific work settings. Insights gained from this analysis should inform future research on work and cancer survivorship. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Is Being Gifted a Social Handicap?

ERIC Educational Resources Information Center

Coleman, Laurence J.; Cross, Tracy L.

1988-01-01

Interviews with 15 gifted/talented adolescents indicated that many of them experienced giftedness as a social handicap. Some students coped with this by managing information about themselves to minimize their visibility as gifted students to others. (Author/JDD)

Popular or Unpopular? Therapists' Use of Structured Interviews and Their Estimation of Patient Acceptance

ERIC Educational Resources Information Center

Bruchmuller, Katrin; Margraf, Jurgen; Suppiger, Andrea; Schneider, Silvia

2011-01-01

An accurate diagnosis is an important precondition for effective psychotherapeutic treatment. The use of structured interviews provides the gold standard for reliable diagnosis. Suppiger et al. (2009) showed that structured interviews have a high acceptance among patients. On a scale from 0 ("not at all satisfied") to 100 ("totally…

State Minority Health Officers' Perceptions of their Successes and Barriers to Reducing Racial and Ethnic Health Disparities.

PubMed

Diehr, Aaron J; Jordan, Timothy R; Price, James H; Sheu, Jiunn-Jye; Dake, Joseph A

2018-06-01

Minimal research has been conducted to examine the impact and reach of state offices of minority health (SOMH) and their role in reducing racial and ethnic health disparities within their states. Accordingly, the purpose of this study was to describe the shared experiences of SOMH officers to provide context for why these individuals believe that state organizational efforts have not yielded much success in reducing racial and ethnic health disparity gaps. Using a telephone interview guide, the investigators conducted telephone interviews with SOMH officers. Data were analyzed thematically based on emergent patterns in participant responses. A total of 47 of 50 state officers (94%) completed the interview. Though many officers were encouraged by increased awareness regarding health disparities, nearly every officer listed inadequate resources as the most impactful barrier impeding the success of their offices' missions. SOMH continue to be severely underfunded and are concerned about their potential for success, leaving them with minimal ability to engage in activities beyond educational awareness campaigns. For SOMH officers to be successful in eliminating disparities, legislators must provide them with adequate funding so they can engage in wider-reaching interventions targeting the social determinants of health.

Productivity benefits of minimally invasive surgery in patients with chronic sacroiliac joint dysfunction.

PubMed

Saavoss, Josh D; Koenig, Lane; Cher, Daniel J

2016-01-01

Sacroiliac joint (SIJ) dysfunction is associated with a marked decrease in quality of life. Increasing evidence supports minimally invasive SIJ fusion as a safe and effective procedure for the treatment of chronic SIJ dysfunction. The impact of SIJ fusion on worker productivity is not known. Regression modeling using data from the National Health Interview Survey was applied to determine the relationship between responses to selected interview questions related to function and economic outcomes. Regression coefficients were then applied to prospectively collected, individual patient data in a randomized trial of SIJ fusion (INSITE, NCT01681004) to estimate expected differences in economic outcomes across treatments. Patients who receive SIJ fusion using iFuse Implant System(®) have an expected increase in the probability of working of 16% (95% confidence interval [CI] 11%-21%) relative to nonsurgical patients. The expected change in earnings across groups was US $3,128 (not statistically significant). Combining the two metrics, the annual increase in worker productivity given surgical vs nonsurgical care was $6,924 (95% CI $1,890-$11,945). For employees with chronic, severe SIJ dysfunction, minimally invasive SIJ fusion may improve worker productivity compared to nonsurgical treatment.

The Economic Burden of Orthopedic Surgery Residency Interviews on Applicants

PubMed Central

Fogel, Harold A.; Finkler, Elissa S.; Wu, Karen; Schiff, Adam P.; Nystrom, Lukas M.

2016-01-01

Background The intense competition for orthopedic surgery residency positions influences the interview process. The financial impact on residency applicants is less well understood. The purpose of the present study was to define the economic burden of the orthopedic surgery residency interview process while additionally describing how applicants finance the expense. Methods We distributed surveys to 48 nonrotating applicants at our institution’s residency interview days for the 2015 match year. The survey consisted of eleven questions specific to the costs of interviewing for orthopedic surgery residency positions. Results The survey response rate was 90% (43/48). Applicants applied to a median of 65 orthopedic surgery residency programs (range 21-88) and targeted a median of 15 interviews (range 12-25). The mean cost estimate for a single interview was $450 (range $200-800) and the cost estimate for all interviews was $7,119 (range $2,500-15,000). Applicants spent a mean of $344 (range $0-750) traveling to our interview. Seventy-two percent borrowed money to finance their interview costs and 28% canceled interviews for financial reasons. Conclusions The financial cost of interviewing for orthopedic surgery is substantial and a majority of applicants add to their educational debt by taking out loans to finance interviews. Future considerations should be made to minimize these costs for an already financially burdened population. PMID:27528831

Hope as seen through the eyes of homeless children.

PubMed

Herth, K

1998-11-01

Children now constitute the largest segment of the homeless population. Multiple studies have identified the adverse effects of homelessness on children's health, development, academic success, and behaviour. Minimal literature exists that describes homeless children from the perspective of their strengths. The purpose of this study was to investigate the meaning of hope in homeless children and to identify strategies that children use in fostering and maintaining their hope. Using the technique of methodological triangulation (semi-structured interviews and drawings) the investigator collected data on a convenience sample of 60 homeless children (6 to 16 years old) currently residing in homeless shelters. Transcriptions of the audio-taped interviews were analysed following Colaizzi's method of analysis. Transcript statements were compared with the drawings. Five themes representing hope emerged from the data: connectedness, internal resources, cognitive strategies, energy, and hope objects. School age children drew story book tale characters, pre-adolescents drew real life situations, and adolescents drew future plans to represent their hopes. An understanding of hope from the perspective of homeless children could provide a basis upon which to develop interventions that engender hope and to develop programmes that build on the hopes that children had already developed.

The potential impact of intelligent power wheelchair use on social participation: perspectives of users, caregivers and clinicians.

PubMed

Rushton, Paula W; Kairy, Dahlia; Archambault, Philippe; Pituch, Evelina; Torkia, Caryne; El Fathi, Anas; Stone, Paula; Routhier, François; Forget, Robert; Pineau, Joelle; Gourdeau, Richard; Demers, Louise

2015-05-01

To explore power wheelchair users', caregivers' and clinicians' perspectives regarding the potential impact of intelligent power wheelchair use on social participation. Semi-structured interviews were conducted with power wheelchair users (n = 12), caregivers (n = 4) and clinicians (n = 12). An illustrative video was used to facilitate discussion. The transcribed interviews were analyzed using thematic analysis. Three main themes were identified based on the experiences of the power wheelchair users, caregivers and clinicians: (1) increased social participation opportunities, (2) changing how social participation is experienced and (3) decreased risk of accidents during social participation. Findings from this study suggest that an intelligent power wheelchair would enhance social participation in a variety of important ways, thereby providing support for continued design and development of this assistive technology. An intelligent power wheelchair has the potential to: Increase social participation opportunities by overcoming challenges associated with navigating through crowds and small spaces. Change how social participation is experienced through "normalizing" social interactions and decreasing the effort required to drive a power wheelchair. Decrease the risk of accidents during social participation by reducing the need for dangerous compensatory strategies and minimizing the impact of the physical environment.

The role of certified nursing assistants in nursing homes.

PubMed

Pennington, Karen; Scott, Jill; Magilvy, Kathy

2003-11-01

OBJECTIVE Pilot study to examine the experiences of the certified nursing assistants (CNAs) in Colorado nursing homes. CNAs provide 80% to 90% of the care to residents in nursing homes. Their reported turnover rate is as high as 400% in some studies, and the potential pool of CNAs is dwindling. As the demand for CNAs increases, their experiences must be understood to effectively address recruitment and retention issues. Minimally structured interviews of 12 CNAs in 6 Colorado nursing homes and observations of care provided were conducted. Atlas/Ti software was used as a data management tool for analyzing and coding data. The overriding theme that emerged from the interviews was "we love our jobs." Three patterns of thought and behavior emerged: attributes of the CNA, working conditions of the CNA, and future success of the CNA and the nursing home. Issues important to CNAs revolved around basic motivational factors, such as job enrichment opportunities, personal growth opportunities, recognition, responsibility, and sense of achievement. Leadership must become creative and build on that base, providing CNAs with job mobility, job enrichment opportunities, recognition, and increased job responsibility, producing positive outcomes not only for the CNA but also for the resident and the facility.

Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

PubMed

Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

2015-01-01

Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD. Copyright © 2015 Elsevier Inc. All rights reserved.

Perceptions of parenting children with type 1 diabetes diagnosed in early childhood

PubMed Central

Smaldone, Arlene; Ritholz, Marilyn D.

2009-01-01

Introduction To explore perceptions of psychosocial adaptations in parenting young children with type 1 diabetes (T1DM) from diagnosis through childhood. Method Fourteen parents of eleven T1DM children diagnosed at ≤5 years participated in semi-structured interviews. Data were analyzed using content analysis. Results Significant themes were: Diagnostic Experiences: Frustrations, fears and doubts: Parents described inadequate diagnostic experiences with pediatricians where concerns were minimized and sometimes delayed diagnosis. Although hospitalization occurred abruptly, communication with specialists was more satisfactory. Adapting to Diabetes: Parents described isolation in caring for their child’s T1DM. Family and friends had minimal understanding of T1DM care. Support groups lessened mothers’ isolation, but fathers were less positive about this experience. Parental adaptation was more effective when responsibility for diabetes decision-making was shared. All parents reported never mastering diabetes management. Negotiating Developmental Transitions: Normative childhood events were stressful requiring that parents balance concerns to foster child participation. Conclusions Pediatric providers can improve diagnostic and treatment experiences for parents of T1DM children by recognizing feelings of isolation and lack of mastery, providing attentive communication, encouraging parental teamwork, and offering ongoing anticipatory guidance. PMID:21320680

Development and reliability of a structured interview guide for the Montgomery Asberg Depression Rating Scale (SIGMA).

PubMed

Williams, Janet B W; Kobak, Kenneth A

2008-01-01

The Montgomery-Asberg Depression Rating Scale (MADRS) is often used in clinical trials to select patients and to assess treatment efficacy. The scale was originally published without suggested questions for clinicians to use in gathering the information necessary to rate the items. Structured and semi-structured interview guides have been found to improve reliability with other scales. To describe the development and test-retest reliability of a structured interview guide for the MADRS (SIGMA). A total of 162 test-retest interviews were conducted by 81 rater pairs. Each patient was interviewed twice, once by each rater conducting an independent interview. The intraclass correlation for total score between raters using the SIGMA was r=0.93, P<0.0001. All ten items had good to excellent interrater reliability. Use of the SIGMA can result in high reliability of MADRS scores in evaluating patients with depression.

A Study of the Structure and Content of Principal Selection Interviews in Pennsylvania

ERIC Educational Resources Information Center

Weber, Elizabeth A.

2012-01-01

The principal plays a key role in student success. The employment interview is a critical element in the principal selection process. This study examined the interview structure and the content of the interview questions that districts used in their principal search for the 2011-2012 school year. The research-based practices for interview…

The myth of the normal, average human brain--the ICBM experience: (1) subject screening and eligibility.

PubMed

Mazziotta, John C; Woods, Roger; Iacoboni, Marco; Sicotte, Nancy; Yaden, Kami; Tran, Mary; Bean, Courtney; Kaplan, Jonas; Toga, Arthur W

2009-02-01

In the course of developing an atlas and reference system for the normal human brain throughout the human age span from structural and functional brain imaging data, the International Consortium for Brain Mapping (ICBM) developed a set of "normal" criteria for subject inclusion and the associated exclusion criteria. The approach was to minimize inclusion of subjects with any medical disorders that could affect brain structure or function. In the past two years, a group of 1685 potential subjects responded to solicitation advertisements at one of the consortium sites (UCLA). Subjects were screened by a detailed telephone interview and then had an in-person history and physical examination. Of those who responded to the advertisement and considered themselves to be normal, only 31.6% (532 subjects) passed the telephone screening process. Of the 348 individuals who submitted to in-person history and physical examinations, only 51.7% passed these screening procedures. Thus, only 10.7% of those individuals who responded to the original advertisement qualified for imaging. The most frequent cause for exclusion in the second phase of subject screening was high blood pressure followed by abnormal signs on neurological examination. It is concluded that the majority of individuals who consider themselves normal by self-report are found not to be so by detailed historical interviews about underlying medical conditions and by thorough medical and neurological examinations. Recommendations are made with regard to the inclusion of subjects in brain imaging studies and the criteria used to select them.

Sexual harassment--a touchy subject for nurses.

PubMed

Cogin, Julie; Fish, Alan

2009-01-01

The purpose of this paper is to examine prevalence of sexual harassment (SH) in nursing and the environmental factors that contribute to incidents of SH. A mixed-method research methodology is adopted. A total of 538 questionnaires are collected from nurses working in eight different hospitals across metropolitan and rural areas in Australia. A total of 23 in-depth semi-structured interviews are conducted. Prevalence of SH in nursing is high with 60 percent of female nurses and 34 percent of male nurses reporting a SH incident in the two-year period prior to this paper. The questionnaire data suggest that patients are the most likely perpetrator, however, the interviews name physicians as typical perpetrators. A model is tested via structural equation modelling and revealed that leadership behaviors, an unbalanced job gender ratio and no prior socialization are positively associated with SH. This paper closes gaps in theory by introducing a new framework explaining the contextual factors that heighten a nurses' probability of being harassed. Some variables such as organizational culture and specific nursing units have not been explored and can be considered a limitation of the paper. The results of this paper assist health professionals to adopt proactive practices for managing SH and plan a workforce where SH is minimized. This paper illustrates the prevalence of different types of SH and the causes for male and female nurses that have not been investigated previously. The results help health managers make informed decisions in regard to intervention strategies.

Conducting preference assessments for youth with disorders of consciousness during rehabilitation.

PubMed

Amari, Adrianna; Suskauer, Stacy J; Paasch, Valerie; Grodin, Lauren K; Slomine, Beth S

2017-08-01

Care and rehabilitation for individuals with disorders of consciousness (DOC) can be challenging; the use of observational data collection, individualized treatment programs, and incorporation of preferred, personally meaningful and salient items may be helpful in addressing such challenges during assessment and intervention. In this article, we extend the predominantly adult literature on use of salient items to promote differential responding by describing our methodology to identify preferred items across sensory domains for application during inpatient rehabilitation with children with DOC. Details on the indirect and direct preference assessment procedures rooted in applied behavior analysis that we have tailored for this population are provided. We describe steps of the procedures, including structured caregiver interview, staff survey, item inclusion, in vivo single-item stimulus preference assessment, and treatment. Clinical case examples further illustrate implementation of our methodology, observed response topographies, individually identified preferred items, and their application for 3 children in a minimally conscious state. In addition, we introduce a new structured caregiver interview, the Preference Assessment for Youth with Disorders of Consciousness (PAYDOC), modeled on the Reinforcer Assessment for Individuals with Severe Disabilities (RAISD; Fisher, Piazza, Bowman, & Amari, 1996) and modified to be appropriate for future use as a clinical tool to enhance assessment of preferences with this pediatric brain injury population. This methodology can be used to identify highly idiosyncratic stimuli that can be incorporated in multiple ways throughout rehabilitation to optimize care for youth with DOC. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Responsibility and expectations in antiretroviral therapy--patients' versus doctors' perspective.

PubMed

Largu, Maria Alexandra; Dorobăţ, Carmen; Oprea, L; Astărăstoae, V; Manciuc, Carmen

2015-01-01

This paper aims to uncover what patients really expect form ART, and also what infectious diseases doctors expect from a patient's ART regime, thus exploring an important side of adherence to ART. From July to November 2014 we have conducted a qualitative study regarding both patients' and doctors' expectations form the ART. We interviewed 30 patients and 4 doctors. We used semi-structured interviews that were conducted in the Psychosocial Compartment of the HIV/AIDS Regional Center in Iasi. The patients we interviewed came from all 6 counties in the Moldova area. Age varied from 16 years to 59 years; 55% were female and 45% male. 30% came from a rural area. The most common expectations that patients have regarding ART are: "to help me live", "not to make me feel sick", "to be easy to take (not to big, not a lot)", "not to show on the outside what I have on the inside". The infectious diseases doctors that we interviewed work in the HIV/AIDS Regional Center in Iasi. Their expectations regarding an ART regimen for patients were: "to reduce HIV viral load", "to increase CD4 cell count" and "to have minimal impact on the proper functioning of other organs". Patients consider themselves the only factors responsible for their own ART adherence in 56.6% of cases; 20% consider the doctor to be responsible for their adherence, 16.6% feel that their family, friends, and spouse are responsible, and 6.6% (2 patients) couldn't answer. Infectious diseases doctors considered that patients are 100% responsible for adhering to the antiretroviral therapy. In order to assure adherence to the ART it is important to explore both the doctor and the patient's perspective and to find ways to find a common ground in building a healthy relationship.

A qualitative study of community pharmacists' opinions on the provision of osteoporosis disease state management services in Malaysia.

PubMed

Nik, Jah; Lai, Pauline Siew Mei; Ng, Chirk Jenn; Emmerton, Lynne

2016-08-30

Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services. Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach. Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care. The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.

Use of the Interview in Resident Candidate Selection: A Review of the Literature

PubMed Central

Stephenson-Famy, Alyssa; Houmard, Brenda S.; Oberoi, Sidharth; Manyak, Anton; Chiang, Seine; Kim, Sara

2015-01-01

Background Although the resident candidate interview is costly and time-consuming for both applicants and programs, it is considered critically important for resident selection. Noncognitive attributes, including communication skills and professionalism, can be assessed by the personal interview. Objective We conducted a review of the literature on the residency interview to identify the interview characteristics used for resident selection and to ascertain to what extent the interview yields information that predicts future performance. Methods We searched PubMed and Scopus using the following search terms: residency, internship, interview, selection, and performance. We extracted information on characteristics of the interview process, including type of interview format, measures taken to minimize bias by interviewers, and testing of other clinical/surgical skills. Results We identified 104 studies that pertained to the resident selection interview, with highly varied interview formats and assessment tools. A positive correlation was demonstrated between a medical school academic record and the interview, especially for unblinded interview formats. A total of 34 studies attempted to correlate interview score with performance in residency, with mixed results. We also identified a number of studies that included personality testing, clinical skills testing, or surgical skills testing. Conclusions Our review identified a wide variety of approaches to the selection interview and a range of factors that have been studied to assess its effectiveness. More research needs to be done not only to address and ascertain appropriate interview formats that predict positive performance in residency, but also to determine interview factors that can predict both residents' “success” and program attrition. PMID:26692964

Experiences and expectations of women with urogenital prolapse: a quantitative and qualitative exploration.

PubMed

Srikrishna, S; Robinson, D; Cardozo, L; Cartwright, R

2008-10-01

To explore the expectations and goals of women undergoing surgery for urogenital prolapse using both a quantitative quality of life approach exploring symptom bother and a qualitative interview-based approach exploring patient goals and expectations. Prospective observational study. Tertiary referral centre for urogynaecology. Forty-three women with symptomatic pelvic organ prolapse were recruited from the waiting list for pelvic floor reconstructive surgery. All women were assessed with a structured clinical interview on an individual basis. The data obtained were transcribed verbatim and then analysed thematically based on the grounded theory. Individual codes and subcodes were identified to develop a coding framework. The prolapse quality-of-life (pQoL) questionnaire was used to determine the impact of pelvic organ prolapse on the woman's daily life. We arbitrarily classified 'bother' as minimal, mild, moderate and marked if scores ranged from 0 to 25, 25-50, 50-75 and 75-100, respectively. The degree of prolapse was objectively quantified using the pelvic organ prolapse quantification (POP-Q) system. Quantitative data were analysed using SPSS. Ethical approval was obtained from the Kings College Hospital Ethics Committee. Quantitative data from POP-Q, subjective data from pQoL, qualitative data based on the structured clinical interview. Forty-three women were recruited over the first 1 year of the study. Their mean age was 56 years (range 36-78) and mean parity was 2 (range 0-6). The mean ordinal stage of the prolapse was 2 (range stages 1-4). Quantitative analysis of the pQoL data suggested that the main domains affected were prolapse impact on life (mean score 74.71) and personal relationships (mean score 46.66). Qualitative analysis based on the clinical interview suggested that these women were most affected by the actual physical symptoms of prolapse (bulge, pain and bowel problems) as well by the impact prolapse has on their sexual function. While disease-specific QoL questionnaires allow broad comparisons to be made assessing patient bother, they may lack the sensitivity to assess individual symptoms. A qualitative approach may individualize patient care and ultimately improve patient satisfaction and overall outcome when treating women complaining of urogenital prolapse.

Redispensing of medicines unused by patients: a qualitative study among stakeholders.

PubMed

Bekker, Charlotte L; Gardarsdottir, Helga; Egberts, Toine C G; Bouvy, Marcel L; van den Bemt, Bart J F

2017-02-01

Background Medication waste has undesirable economic and environmental consequences. This waste is partly unavoidable, but might be reduced by redispensing medicines unused by patients. However, there is little knowledge of stakeholders' views on the redispensing. Objective To identify the stakeholders' views on the redispensing of medicines unused by patients. Setting Dutch healthcare system. Method Semi-structured interviews were conducted with 19 Dutch stakeholders from September 2014 until April 2015. The interview guide included two themes: medication waste and redispensing of unused medicines. The latter included qualitative-, legal- and financial aspects and stakeholder involvement, with specific attention to the patient. Interview transcripts were subjected to thematic content analysis. Main outcome measure Requirements related to the redispensing of unused medicines. Results All stakeholders considered the redispensing of medicines desirable if the implementation is feasible and the requirements for the safe redispensing are met. All of them pointed out that the product quality of redispensed medicines should be guaranteed and that it should be clear who is responsible for the quality of redispensed medicines. The stakeholders stated that transparent communication to patients is essential to guarantee trust in the redispensing system and that patients should be willing to use redispensed medicines. Moreover, the redispensing system's benefits should outweigh the costs and a minimal economic value of medicines suitable for redispensing should be determined. Conclusion Redispensing unused medicines could decrease medication waste if several requirements are met. For successful implementation of a redispensing system, all relevant stakeholders should be involved and cooperate as a joint-force.

Impact of Potential Accreditation and Certification in Family Medicine Maternity Care.

PubMed

Eden, Aimee R; Peterson, Lars E

2017-01-01

Advanced maternity care training in family medicine is highly variable at both the residency and fellowship levels. Declining numbers of family physicians providing maternity care services may exacerbate disparities in access to maternal and child care, especially in rural and other underserved communities. Accreditation of maternity care fellowships and board certification may be one potential avenue to address this trend. This study sought to understand the perceptions and beliefs of key family medicine stakeholders in advanced maternity care regarding the formalization of maternity care training through fellowship accreditation and the creation of a certificate of added qualification (CAQ). In 2014 and 2015, the authors conducted semi-structured interviews with 51 key stakeholders in family medicine maternity care. Transcribed interviews were coded using an iterative process to identify themes and patterns until saturation was reached. Participants generally supported both maternity care fellowship accreditation and a CAQ and recognized multiple advantages such as legitimization of training. Many had concerns about potential negative unintended consequences such as a loss of curricular flexibility; however, most felt that these could be mediated. Only a few did not support one or both aspects of formalization. Most participants interviewed support formalizing maternity care fellowship training in family medicine through accreditation and a subsequent CAQ, if implemented with attention to minimizing the potential negative consequences. Such formalization would recognize the advanced skill and training of family physicians practicing advanced maternity care and could address some access issues to essential maternity care services for rural and other underserved populations.

Potential Risks of Ecological Momentary Assessment Among Persons Who Inject Drugs.

PubMed

Roth, Alexis M; Rossi, John; Goldshear, Jesse L; Truong, Quan; Armenta, Richard F; Lankenau, Stephen E; Garfein, Richard S; Simmons, Janie

2017-06-07

Ecological momentary assessment (EMA)-which often involves brief surveys delivered via mobile technology-has transformed our understanding of the individual and contextual micro-processes associated with legal and illicit drug use. However, little empirical research has focused on participant's perspective on the probability and magnitude of potential risks in EMA studies. To garner participant perspectives on potential risks common to EMA studies of illicit drug use. We interviewed 38 persons who inject drugs living in San Diego (CA) and Philadelphia (PA), United States. They completed simulations of an EMA tool and then underwent a semi-structured interview that systematically explored domains of risk considered within the proposed revisions to the Federal Policy for the Protection of Human Subjects or the "Common Rule." Interviews were transcribed verbatim and coded systematically to explore psychological, physical, social, legal, and informational risks from participation. Participants perceived most risks to be minimal. Some indicated that repetitive questioning about mood or drug use could cause psychological (i.e., anxiety) or behavioral risks (i.e., drug use relapse). Ironically, the questions that were viewed as risky were considered motivational to engage in healthy behaviors. The most cited risks were legal and social risks stemming from participant concerns about data collection and security. Improving our understanding of these issues is an essential first step to protect human participants in future EMA research. We provide a brief set of recommendations that can aid in the design and ethics review of the future EMA protocol with substance using populations.

Perceptions and Attitudes of Egyptian Health Professionals and Policy-Makers towards Pharmaceutical Sales Representatives and Other Promotional Activities

PubMed Central

Kamal, Susan; Holmberg, Christine; Russell, Jean; Bochenek, Tomasz; Tobiasz-Adamczyk, Beata; Fischer, Christiane; Tinnemann, Peter

2015-01-01

Background Pharmaceutical promotion activities in low and middle-income countries are often neither regulated nor monitored. While Egypt has the highest population and per capita use of medicines in the Arab world, we know very little about pharmaceutical companies promotional activities in the country. Aim To explore and analyze the perceptions of physicians towards promotional and marketing activities of pharmaceutical companies among physicians and pharmacists in Egypt. Methodology Perspectives of different healthcare system stakeholders were explored through semi-structured, in-depth interviews conducted in 2014 in Cairo, Egypt. Interviewees were chosen via purposive sampling and snowball technique. Each interview was recorded and transcribed. Then qualitative, thematic analysis was conducted with the help of NVIVO software. Findings The majority of physicians and pharmacists acknowledged exposure to pharmaceutical promotion. It was commonly believed that interaction with the pharmaceutical industry is necessary and both associated risks and benefits were acknowledged. The interviewed physicians considered themselves competent enough to minimize risks and maximize benefits to their prescribing habits. Views diverged on the extent and magnitude of the risks and benefits of pharmaceutical promotion, especially in regard to the influence on patients’ health. Conclusions Pharmaceutical promotion in Egypt is intensely directed at prescribers and dispensers. Physicians, pharmacists and policymakers expressed little skepticism to the influence of promotion towards their individual prescribing. Raising awareness of the pitfalls of pharmaceutical promotion is necessary, especially among the less experienced physicians. PMID:26473484

Implementing clinical governance in Isfahan hospitals: Barriers and solutions, 2014.

PubMed

Ferdosi, Masoud; Ziyari, Farhad Bahman; Ollahi, Mehran Nemat; Salmani, Amaneh Rahim; Niknam, Noureddin

2016-01-01

In the new approach, all health care providers have been obligated to maintain and improve the quality and have been accountable for it. One of the ways is the implementation of clinical governance (CG). More accurate understanding of its challenges can help to improve its performance. In this study, barriers of CG implementation are investigated from the perspective of the hospitals involved. Besides, some solutions are suggested based on stakeholders' opinions. This study used combined method (qualitative content analysis and questionnaire) in hospitals affiliated to Isfahan University of Medical Sciences in 2014. First, experts, and stakeholders talked about CG implementation obstacles in a semi-structured interview. Interviews were confirmed by the interviewee (double check). After analyzing the interviews using reduction coding the questionnaire was drawn up. The questionnaire "validity was confirmed by Cronbach's alpha (0/891)" and its reliability was obtained using experts confirmation. Data analyzing was performed using SPSS (18) software. According to results staffing and management factors were the main obstacles. After them, were factors related to organizational culture, infrastructure elements, information, sociocultural and then process factors. The learning barriers were in final rank. Thirty-four solutions was proposed by experts and divided into subset of eight major barriers. Most solutions were offered on modifying processes and minimal solutions about modifying of organizational culture, sociocultural, and educational factors. Removing the obstacles, especially management and human resource factors can be effective by facilitating and accelerating CG. Furthermore, use of experts and stakeholders opinions can help to remove CG barriers.

Use of the Analytic Hierarchy Process for Medication Decision-Making in Type 2 Diabetes

PubMed Central

Maruthur, Nisa M.; Joy, Susan M.; Dolan, James G.; Shihab, Hasan M.; Singh, Sonal

2015-01-01

Aim To investigate the feasibility and utility of the Analytic Hierarchy Process (AHP) for medication decision-making in type 2 diabetes. Methods We conducted an AHP with nine diabetes experts using structured interviews to rank add-on therapies (to metformin) for type 2 diabetes. During the AHP, participants compared treatment alternatives relative to eight outcomes (hemoglobin A1c-lowering and seven potential harms) and the relative importance of the different outcomes. The AHP model and instrument were pre-tested and pilot-tested prior to use. Results were discussed and an evaluation of the AHP was conducted during a group session. We conducted the quantitative analysis using Expert Choice software with the ideal mode to determine the priority of treatment alternatives. Results Participants judged exenatide to be the best add-on therapy followed by sitagliptin, sulfonylureas, and then pioglitazone. Maximizing benefit was judged 21% more important than minimizing harm. Minimizing severe hypoglycemia was judged to be the most important harm to avoid. Exenatide was the best overall alternative if the importance of minimizing harms was prioritized completely over maximizing benefits. Participants reported that the AHP improved transparency, consistency, and an understanding of others’ perspectives and agreed that the results reflected the views of the group. Conclusions The AHP is feasible and useful to make decisions about diabetes medications. Future studies which incorporate stakeholder preferences should evaluate other decision contexts, objectives, and treatments. PMID:26000636

Minimal measures on surfaces of higher genus

NASA Astrophysics Data System (ADS)

Wang, Fang

We study the minimal measures for positive definite autonomous Lagrangian systems defined on the tangent bundles of compact surfaces with genus greater than one. We present some results on the structure of minimal measures on compact surfaces. Specifically, we give a finer description of the structure of minimal measures with rational rotation vectors for geodesic flows on compact surfaces.

Validation of molecular crystal structures from powder diffraction data with dispersion-corrected density functional theory (DFT-D).

PubMed

van de Streek, Jacco; Neumann, Marcus A

2014-12-01

In 2010 we energy-minimized 225 high-quality single-crystal (SX) structures with dispersion-corrected density functional theory (DFT-D) to establish a quantitative benchmark. For the current paper, 215 organic crystal structures determined from X-ray powder diffraction (XRPD) data and published in an IUCr journal were energy-minimized with DFT-D and compared to the SX benchmark. The on average slightly less accurate atomic coordinates of XRPD structures do lead to systematically higher root mean square Cartesian displacement (RMSCD) values upon energy minimization than for SX structures, but the RMSCD value is still a good indicator for the detection of structures that deserve a closer look. The upper RMSCD limit for a correct structure must be increased from 0.25 Å for SX structures to 0.35 Å for XRPD structures; the grey area must be extended from 0.30 to 0.40 Å. Based on the energy minimizations, three structures are re-refined to give more precise atomic coordinates. For six structures our calculations provide the missing positions for the H atoms, for five structures they provide corrected positions for some H atoms. Seven crystal structures showed a minor error for a non-H atom. For five structures the energy minimizations suggest a higher space-group symmetry. For the 225 SX structures, the only deviations observed upon energy minimization were three minor H-atom related issues. Preferred orientation is the most important cause of problems. A preferred-orientation correction is the only correction where the experimental data are modified to fit the model. We conclude that molecular crystal structures determined from powder diffraction data that are published in IUCr journals are of high quality, with less than 4% containing an error in a non-H atom.

Validation of molecular crystal structures from powder diffraction data with dispersion-corrected density functional theory (DFT-D)

PubMed Central

van de Streek, Jacco; Neumann, Marcus A.

2014-01-01

In 2010 we energy-minimized 225 high-quality single-crystal (SX) structures with dispersion-corrected density functional theory (DFT-D) to establish a quantitative benchmark. For the current paper, 215 organic crystal structures determined from X-ray powder diffraction (XRPD) data and published in an IUCr journal were energy-minimized with DFT-D and compared to the SX benchmark. The on average slightly less accurate atomic coordinates of XRPD structures do lead to systematically higher root mean square Cartesian displacement (RMSCD) values upon energy minimization than for SX structures, but the RMSCD value is still a good indicator for the detection of structures that deserve a closer look. The upper RMSCD limit for a correct structure must be increased from 0.25 Å for SX structures to 0.35 Å for XRPD structures; the grey area must be extended from 0.30 to 0.40 Å. Based on the energy minimizations, three structures are re-refined to give more precise atomic coordinates. For six structures our calculations provide the missing positions for the H atoms, for five structures they provide corrected positions for some H atoms. Seven crystal structures showed a minor error for a non-H atom. For five structures the energy minimizations suggest a higher space-group symmetry. For the 225 SX structures, the only deviations observed upon energy minimization were three minor H-atom related issues. Preferred orientation is the most important cause of problems. A preferred-orientation correction is the only correction where the experimental data are modified to fit the model. We conclude that molecular crystal structures determined from powder diffraction data that are published in IUCr journals are of high quality, with less than 4% containing an error in a non-H atom. PMID:25449625

Developing Teaching Strategies in the EHR Era: A Survey of GME Experts.

PubMed

Atwater, Amber R; Rudd, Mariah; Brown, Audrey; Wiener, John S; Benjamin, Robert; Lee, W Robert; Rosdahl, Jullia A

2016-10-01

There is limited information on the impact of widespread adoption of the electronic health record (EHR) on graduate medical education (GME). To identify areas of consensus by education experts, where the use of EHR impacts GME, with the goal of developing strategies and tools to enhance GME teaching and learning in the EHR environment. Information was solicited from experienced US physician educators who use EPIC EHR following 3 steps: 2 rounds of online surveys using the Delphi technique, followed by telephone interviews. The survey contained 3 stem questions and 52 items with Likert-scale responses. Consensus was defined by predetermined cutoffs. A second survey reassessed items for which consensus was not initially achieved. Common themes to improve GME in settings with an EHR were compiled from the telephone interviews. The panel included 19 physicians in 15 states in Round 1, 12 in Round 2, and 10 for the interviews. Ten items were found important for teaching and learning: balancing focus on EHR documentation with patient engagement achieved 100% consensus. Other items achieving consensus included adequate learning time, balancing EHR data with verbal history and physical examination, communicating clinical thought processes, hands-on EHR practice, minimizing data repetition, and development of shortcuts and templates. Teaching strategies incorporating both online software and face-to-face solutions were identified during the interviews. New strategies are needed for effective teaching and learning of residents and fellows, capitalizing on the potential of the EHR, while minimizing any unintended negative impact on medical education.

A new structured interview for children with autism spectrum disorder based on the DSM-IV.

PubMed

Hansakunachai, Tippawan; Roongpraiwan, Rawiwan; Sombuntham, Tasnawat; Limprasert, Pornprot; Ruangdaraganon, Nichara

2014-08-01

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder in children. The clinical spectrum of ASD includes autism, childhood disintegrative disorder Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). Although the DSM-IVcriteria are well acceptedforASD diagnosis, there are some known limitations for clinicians. The most important issue is lack'ofspecific age-appropriate items in each domain. Thus, the DSM-IVneeds some modifications in order to be appropriate for clinical use. To develop a structured interview for children based on the DSM-IVdiagnostic criteria ofautism and PDD-NOS. MATERIAL ANDMETHOD: From June 2006 to December 2008, 140 Thai children, 121 boys and 19 girls, already diagnosed with ASD, were recruited through the child development clinics of Ramathibodi and Thammasat University Hospitals in Thailand. A 26-item structured interview was developed with scoring according to the DSM-IVdiagnostic criteria for autism andPDD- NOS. To test the accuracy of the structured interview and its reliability, 32 children with ASD were selected and interviewed by four clinicians using the new instrument. One clinician interviewed the parents or caregivers, while three others independently took notes and observed the play behavior of the children. All items from the structured interview as scored by each clinician were compared using inter-rater agreement statistics (Kappa). All of the original 140 patients were then clinically diagnosed again using the structured interview and the results were compared with the initial diagnoses. Ofthe 140patients originally diagnosed with ASD, 110 and 30patients were finally diagnosed with the new interview as having autism and PDD-NOS, respectively. The initial diagnoses from 15 cases (10.7%) were changed according to the structured interview Inter-rater reliability among the four clinicians showed a good level ofagreement (Kappa = 0.897) with statistical significance (p<0.001). The authors only compared the items in the structured interview between the autism and PDD-NOSgroups from 105 cases aged 2-5 years (79 cases with autism and 26 cases with PDD-NOS) because there were only 4 cases with PDD-NOS in the other age groups. Highly significant differences (p<0.001) in clinical items between patients with autism and patients with PDD-NOS from the final diagnoses were noted in 6 of 8 items in the category of restricted, repetitive and stereotyped patterns ofbehavior, interests and activities, which were more common in the autism group than the PDD-NOS group. In addition, the autism group had higher frequencies of using finger-pointing to indicate interest rather than verbalization, and idiosyncratic language, than the PDD-NOS group. The newly developed structured interview for Thai children with ASD had a high level ofinterrater reliability between four clinicians. However, most children tested using this structured interview were 2-5years ofage, and the study did not include non-autistic groups. The application ofthis structured interview needs further study with a wider variety ofcases, such as ASD cases from different age groups, children with delayed development and normal children.

Reflecting on the experience of interviewing online: perspectives from the Internet and HIV study in London.

PubMed

Davis, M; Bolding, G; Hart, G; Sherr, L; Elford, J

2004-11-01

This paper considers some of the strengths and weaknesses of conducting synchronous online interviews for qualitative research. It is based on a study among gay/bisexual men that used both qualitative and quantitative methods to explore the association between seeking sex through the Internet and HIV transmission risk. Between June 2002 and January 2004, 128 gay/bisexual men living in London were interviewed one-to-one by the first author (MD) about their experience of using the Internet to find sexual partners and negotiating condom use for anal sex. Thirty-five men were interviewed online, while 93 were interviewed face-to-face (i.e. offline). This paper draws on MD's experience of conducting these interviews--both online and face-to-face. Synchronous online interviews have the advantage of being cheap, convenient and attractive to people who do not like face-to-face interviews. However, some of the social conventions and technical limitations of computer-mediated-communication can introduce ambiguity into the online dialogue. To minimize this ambiguity, both interviewer and interviewee have to edit their online interaction. One of the distinctive features of the online interview is that it emerges as a form of textual performance. This raises fundamental questions about the suitability of the synchronous online interview for exploring sensitive topics such as risky sexual behaviour.

Impact of Time to Maternal Interview on Interview Responses in the National Birth Defects Prevention Study

PubMed Central

Tinker, Sarah C.; Gibbs, Cassandra; Strickland, Matthew J.; Devine, Owen J.; Crider, Krista S.; Werler, Martha M.; Anderka, Marlene T.; Reefhuis, Jennita

2013-01-01

Prenatal exposures often are assessed using retrospective interviews. Time from exposure to interview may influence data accuracy. We investigated the association of time to interview (TTI) with aspects of interview responses in the National Birth Defects Prevention Study, a population-based case-control study of birth defects in 10 US states. Mothers completed a computer-assisted telephone interview 1.5–24 months after their estimated date of delivery. Proxy metrics for interview quality were whether certain exposures were reported, whether the start month of reported medication use or illness was reported, or whether responses were missing. Interaction by case status was assessed. Interviews were completed with 30,542 mothers (22,366 cases and 8,176 controls) who gave birth between 1997 and 2007. Mothers of cases were interviewed later than were mothers of controls (11.7 months vs. 9.5 months, respectively). In adjusted analyses, having a TTI that was greater than 6 months was associated with only a few aspects of interview responses (e.g., start month of pseudoephedrine use). Interaction by case-control status was observed for some exposures; mothers of controls had a greater reduction in interview quality with increased TTI in these instances (e.g., report of morning sickness, start month of acetaminophen use and ibuprofen use). The results suggest that TTI might impact interview responses; however, the impact may be minimal and specific to the type of exposure. PMID:23645625

Impact of time to maternal interview on interview responses in the National Birth Defects Prevention Study.

PubMed

Tinker, Sarah C; Gibbs, Cassandra; Strickland, Matthew J; Devine, Owen J; Crider, Krista S; Werler, Martha M; Anderka, Marlene T; Reefhuis, Jennita

2013-06-01

Prenatal exposures often are assessed using retrospective interviews. Time from exposure to interview may influence data accuracy. We investigated the association of time to interview (TTI) with aspects of interview responses in the National Birth Defects Prevention Study, a population-based case-control study of birth defects in 10 US states. Mothers completed a computer-assisted telephone interview 1.5-24 months after their estimated date of delivery. Proxy metrics for interview quality were whether certain exposures were reported, whether the start month of reported medication use or illness was reported, or whether responses were missing. Interaction by case status was assessed. Interviews were completed with 30,542 mothers (22,366 cases and 8,176 controls) who gave birth between 1997 and 2007. Mothers of cases were interviewed later than were mothers of controls (11.7 months vs. 9.5 months, respectively). In adjusted analyses, having a TTI that was greater than 6 months was associated with only a few aspects of interview responses (e.g., start month of pseudoephedrine use). Interaction by case-control status was observed for some exposures; mothers of controls had a greater reduction in interview quality with increased TTI in these instances (e.g., report of morning sickness, start month of acetaminophen use and ibuprofen use). The results suggest that TTI might impact interview responses; however, the impact may be minimal and specific to the type of exposure.

[Stress at the emergency service: possibilities and limits of new managerial strategies].

PubMed

Boller, Erika

2003-12-01

The current study with health professionals from an emergency service intended to identify stress-precipitating factors and to evidence possible managerial and political alternatives in order to minimize the intensity of stress symptoms. The data were collected through a semi-structured interview and, later on, complemented by observation. As found out, the working environment is an agent that causes stress, resulting from daily circumstances faced through factors from the working environment as well as from subjective ones. Neither factors from the context and from the working environment nor anti-stress care performed by the workers were observed. Considering the local reality, possibilities and limits are presented for the implementation and direction of political strategies addressed to the higher administration and for the development of institutional and personal strategies that allow coping stress.

Ethical issues experienced by intensive care unit nurses in everyday practice.

PubMed

Fernandes, Maria I D; Moreira, Isabel M P B

2013-02-01

This research aims to identify the ethical issues perceived by intensive care nurses in their everyday practice. It also aims to understand why these situations were considered an ethical issue and what interventions/strategies have been or are expected to be developed so as to minimize them. Data were collected using a semi-structured interview with 15 nurses working at polyvalent intensive care units in 4 Portuguese hospitals, who were selected by the homogenization of multiple samples. The qualitative content analysis identified end-of-life decisions, privacy, interaction, team work, and health-care access as emerging ethical issues. Personal, team, and institutional aspects emerge as reasons behind the experience of these issues. Personal and team resources are used in and for solving these issues. Moral development and training are the most significant strategies.

Assembling Precise Truss Structures With Minimal Stresses

NASA Technical Reports Server (NTRS)

Sword, Lee F.

1996-01-01

Improved method of assembling precise truss structures involves use of simple devices. Tapered pins that fit in tapered holes indicate deviations from prescribed lengths. Method both helps to ensure precision of finished structures and minimizes residual stresses within structures.

Price-Minimizing Behaviors in a Cohort of Smokers before and after a Cigarette Tax Increase.

PubMed

Betzner, Anne; Boyle, Raymond G; St Claire, Ann W

2016-06-17

Cigarette tax increases result in a reduced demand for cigarettes and increased efforts by smokers to reduce their cost of smoking. Less is known about how smokers think about their expenditures for cigarettes and the possible mechanisms that underlie price-minimizing behaviors. In-depth longitudinal interviews were conducted with Minnesota smokers to explore the factors that influence smokers' decisions one month prior to a $1.75 cigarette tax increase and again one and three months after the increase. A total of 42 were sampled with 35 completed interviews at all three time points, resulting in 106 interviews across all participants at all time points. A qualitative descriptive approach examined smoking and buying habits, as well as reasons behind these decisions. A hierarchy of ways to save money on cigarettes included saving the most money by changing to roll your own pipe tobacco, changing to a cheaper brand, cutting down or quitting, changing to cigarillos, and buying online. Using coupons, shopping around, buying by the carton, changing the style of cigarette, and stocking up prior to the tax increase were described as less effective. Five factors emerged as impacting smokers' efforts to save money on cigarettes after the tax: brand loyalty, frugality, addiction, stress, and acclimation.

Price-Minimizing Behaviors in a Cohort of Smokers before and after a Cigarette Tax Increase

PubMed Central

Betzner, Anne; Boyle, Raymond G.; St. Claire, Ann W.

2016-01-01

Cigarette tax increases result in a reduced demand for cigarettes and increased efforts by smokers to reduce their cost of smoking. Less is known about how smokers think about their expenditures for cigarettes and the possible mechanisms that underlie price-minimizing behaviors. In-depth longitudinal interviews were conducted with Minnesota smokers to explore the factors that influence smokers’ decisions one month prior to a $1.75 cigarette tax increase and again one and three months after the increase. A total of 42 were sampled with 35 completed interviews at all three time points, resulting in 106 interviews across all participants at all time points. A qualitative descriptive approach examined smoking and buying habits, as well as reasons behind these decisions. A hierarchy of ways to save money on cigarettes included saving the most money by changing to roll your own pipe tobacco, changing to a cheaper brand, cutting down or quitting, changing to cigarillos, and buying online. Using coupons, shopping around, buying by the carton, changing the style of cigarette, and stocking up prior to the tax increase were described as less effective. Five factors emerged as impacting smokers’ efforts to save money on cigarettes after the tax: brand loyalty, frugality, addiction, stress, and acclimation. PMID:27322301

On complexity of trellis structure of linear block codes

NASA Technical Reports Server (NTRS)

Lin, Shu

1990-01-01

The trellis structure of linear block codes (LBCs) is discussed. The state and branch complexities of a trellis diagram (TD) for a LBC is investigated. The TD with the minimum number of states is said to be minimal. The branch complexity of a minimal TD for a LBC is expressed in terms of the dimensions of specific subcodes of the given code. Then upper and lower bounds are derived on the number of states of a minimal TD for a LBC, and it is shown that a cyclic (or shortened cyclic) code is the worst in terms of the state complexity among the LBCs of the same length and dimension. Furthermore, it is shown that the structural complexity of a minimal TD for a LBC depends on the order of its bit positions. This fact suggests that an appropriate permutation of the bit positions of a code may result in an equivalent code with a much simpler minimal TD. Boolean polynomial representation of codewords of a LBC is also considered. This representation helps in study of the trellis structure of the code. Boolean polynomial representation of a code is applied to construct its minimal TD. Particularly, the construction of minimal trellises for Reed-Muller codes and the extended and permuted binary primitive BCH codes which contain Reed-Muller as subcodes is emphasized. Finally, the structural complexity of minimal trellises for the extended and permuted, and double-error-correcting BCH codes is analyzed and presented. It is shown that these codes have relatively simple trellis structure and hence can be decoded with the Viterbi decoding algorithm.

Nursing and Dental Hygiene Selection Procedures. Part I: The Structured Interview as a Tool for Selecting Students into an Associate of Arts Degree Program.

ERIC Educational Resources Information Center

Tatham, Elaine L.; And Others

A structured interview procedure was used during the spring of 1975 as a tool in selecting nursing and dental hygiene students at Johnson County Community College. Potential students had two 20-minute interviews: one by a staff member of the program to which application was made, and one by another staff member. Interviewers rated the applicants…

Validation of a Brief Structured Interview: The Children's Interview for Psychiatric Syndromes (ChIPS).

PubMed

Young, Matthew E; Bell, Ziv E; Fristad, Mary A

2016-12-01

Evidence-based assessment is important in the treatment of childhood psychopathology. While researchers and clinicians frequently use structured diagnostic interviews to ensure reliability, the most commonly used instrument, the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS) is too long for most clinical applications. The Children's Interview for Psychiatric Syndromes (ChIPS/P-ChIPS) is a highly-structured brief diagnostic interview. The present study compared K-SADS and ChIPS/P-ChIPS diagnoses in an outpatient clinical sample of 50 parent-child pairs aged 7-14. Agreement between most diagnoses was moderate to high between the instruments and with consensus clinical diagnoses. ChIPS was significantly briefer to administer than the K-SADS. Interviewer experience level and participant demographics did not appear to affect agreement. Results provide further evidence for the validity of the ChIPS and support its use in clinical and research settings.

Free energy minimization to predict RNA secondary structures and computational RNA design.

PubMed

Churkin, Alexander; Weinbrand, Lina; Barash, Danny

2015-01-01

Determining the RNA secondary structure from sequence data by computational predictions is a long-standing problem. Its solution has been approached in two distinctive ways. If a multiple sequence alignment of a collection of homologous sequences is available, the comparative method uses phylogeny to determine conserved base pairs that are more likely to form as a result of billions of years of evolution than by chance. In the case of single sequences, recursive algorithms that compute free energy structures by using empirically derived energy parameters have been developed. This latter approach of RNA folding prediction by energy minimization is widely used to predict RNA secondary structure from sequence. For a significant number of RNA molecules, the secondary structure of the RNA molecule is indicative of its function and its computational prediction by minimizing its free energy is important for its functional analysis. A general method for free energy minimization to predict RNA secondary structures is dynamic programming, although other optimization methods have been developed as well along with empirically derived energy parameters. In this chapter, we introduce and illustrate by examples the approach of free energy minimization to predict RNA secondary structures.

Reproducing the Ensemble Average Polar Solvation Energy of a Protein from a Single Structure: Gaussian-Based Smooth Dielectric Function for Macromolecular Modeling.

PubMed

Chakravorty, Arghya; Jia, Zhe; Li, Lin; Zhao, Shan; Alexov, Emil

2018-02-13

Typically, the ensemble average polar component of solvation energy (ΔG polar solv ) of a macromolecule is computed using molecular dynamics (MD) or Monte Carlo (MC) simulations to generate conformational ensemble and then single/rigid conformation solvation energy calculation is performed on each snapshot. The primary objective of this work is to demonstrate that Poisson-Boltzmann (PB)-based approach using a Gaussian-based smooth dielectric function for macromolecular modeling previously developed by us (Li et al. J. Chem. Theory Comput. 2013, 9 (4), 2126-2136) can reproduce that ensemble average (ΔG polar solv ) of a protein from a single structure. We show that the Gaussian-based dielectric model reproduces the ensemble average ΔG polar solv (⟨ΔG polar solv ⟩) from an energy-minimized structure of a protein regardless of the minimization environment (structure minimized in vacuo, implicit or explicit waters, or crystal structure); the best case, however, is when it is paired with an in vacuo-minimized structure. In other minimization environments (implicit or explicit waters or crystal structure), the traditional two-dielectric model can still be selected with which the model produces correct solvation energies. Our observations from this work reflect how the ability to appropriately mimic the motion of residues, especially the salt bridge residues, influences a dielectric model's ability to reproduce the ensemble average value of polar solvation free energy from a single in vacuo-minimized structure.

Designing Structured Interviews for Educational Research. ERIC/AE Digest.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Assessment and Evaluation, Washington, DC.

This digest reviews the basic building blocks of a structured interview, points out some of the pitfalls in interviewing, and suggests ways for researchers to avoid these difficulties to produce questions that have the best possibility of generating reliable and accurate data on the topics of interest. The data collection instrument is a document…

Contribution of Patient Interviews as Part of a Comprehensive Approach to the Identification of Drug-Related Problems on Geriatric Wards.

PubMed

Stämpfli, Dominik; Boeni, Fabienne; Gerber, Andy; Bättig, Victor A D; Hersberger, Kurt E; Lampert, Markus L

2018-06-19

Inappropriate prescribing is linked to increased risks for adverse drug reactions and hospitalisation. Combining explicit and implicit criteria of inappropriate prescribing with the information obtained in patient interviews seems beneficial with regard to the identification of drug-related problems (DRPs) in hospitalised patients. We aimed to investigate the inclusion of pharmacist interviews as part of medication reviews (including the use of explicit and implicit criteria of inappropriate prescribing) to identify DRPs in older inpatients. Clinical medication reviews were performed on geriatric and associated physical and neurological rehabilitation wards in a regional secondary care hospital. Data from electronic medical records, laboratory data, and current treatment regimens were complemented with a novel structured patient interview performed by a clinical pharmacist. The structured interview questioned patients on administration issues, prescribed medication, self-medication, and allergies. The reviews included the use of current treatment guidelines, the Medication Appropriateness Index, the Screening Tool of Older People's Prescriptions (STOPP, v2), and the Screening Tool to Alert to Right Treatment (START, v2). The potential relevance of the DRPs was estimated using the German version of the CLEO tool. In 110 patients, 595 DRPs were identified, averaging 5.4 per patient (range 0-17). The structured interviews identified 249 DRPs (41.8%), of which 227 were not identified by any other source of information. The majority of DRPs (213/249, i.e. 85.5%) identified by patient interview were estimated to be of minor clinical relevance (i.e. limited adherence, knowledge, quality of life, or satisfaction). We demonstrated that structured patient interviews identified additional DRPs that other sources did not identify. Embedded within a comprehensive approach, the structured patient interviews were needed as data resource for over one-third of all DRPs.

Identifying Time Periods of Minimal Thermal Gradient for Temperature-Driven Structural Health Monitoring

PubMed Central

Reilly, John; Glisic, Branko

2018-01-01

Temperature changes play a large role in the day to day structural behavior of structures, but a smaller direct role in most contemporary Structural Health Monitoring (SHM) analyses. Temperature-Driven SHM will consider temperature as the principal driving force in SHM, relating a measurable input temperature to measurable output generalized strain (strain, curvature, etc.) and generalized displacement (deflection, rotation, etc.) to create three-dimensional signatures descriptive of the structural behavior. Identifying time periods of minimal thermal gradient provides the foundation for the formulation of the temperature–deformation–displacement model. Thermal gradients in a structure can cause curvature in multiple directions, as well as non-linear strain and stress distributions within the cross-sections, which significantly complicates data analysis and interpretation, distorts the signatures, and may lead to unreliable conclusions regarding structural behavior and condition. These adverse effects can be minimized if the signatures are evaluated at times when thermal gradients in the structure are minimal. This paper proposes two classes of methods based on the following two metrics: (i) the range of raw temperatures on the structure, and (ii) the distribution of the local thermal gradients, for identifying time periods of minimal thermal gradient on a structure with the ability to vary the tolerance of acceptable thermal gradients. The methods are tested and validated with data collected from the Streicker Bridge on campus at Princeton University. PMID:29494496

Identifying Time Periods of Minimal Thermal Gradient for Temperature-Driven Structural Health Monitoring.

PubMed

Reilly, John; Glisic, Branko

2018-03-01

Temperature changes play a large role in the day to day structural behavior of structures, but a smaller direct role in most contemporary Structural Health Monitoring (SHM) analyses. Temperature-Driven SHM will consider temperature as the principal driving force in SHM, relating a measurable input temperature to measurable output generalized strain (strain, curvature, etc.) and generalized displacement (deflection, rotation, etc.) to create three-dimensional signatures descriptive of the structural behavior. Identifying time periods of minimal thermal gradient provides the foundation for the formulation of the temperature-deformation-displacement model. Thermal gradients in a structure can cause curvature in multiple directions, as well as non-linear strain and stress distributions within the cross-sections, which significantly complicates data analysis and interpretation, distorts the signatures, and may lead to unreliable conclusions regarding structural behavior and condition. These adverse effects can be minimized if the signatures are evaluated at times when thermal gradients in the structure are minimal. This paper proposes two classes of methods based on the following two metrics: (i) the range of raw temperatures on the structure, and (ii) the distribution of the local thermal gradients, for identifying time periods of minimal thermal gradient on a structure with the ability to vary the tolerance of acceptable thermal gradients. The methods are tested and validated with data collected from the Streicker Bridge on campus at Princeton University.

Use of Skype in interviews: the impact of the medium in a study of mental health nurses.

PubMed

Oates, Jennifer

2015-03-01

To discuss the use of Skype as a medium for undertaking semi-structured interviews. Internet-based research is becoming increasingly popular, as communication using the internet takes a bigger role in our working and personal lives. Technology such as Skype allows research encounters with people across geographical divides. The semi-structured interview is a social encounter with a set of norms and expectations for both parties ( Doody and Noonan 2012 ). Proceedings must take account of the social context of both semi-structured interviews per se, and that of internet mediated communication. The findings of the qualitative phase of a mixed-methods study are compared with other reports comparing the use of Skype with face-to-face and telephone interviews. This paper is a methodological discussion of the use of Skype as an online research methodology. Choosing Skype as a means of interviewing may affect the characteristics of participants and decisions about consent. Rapport, sensitivity and collaboration may be addressed differently in Skype interviews compared with face-to-face interviews. Skype offers researchers the opportunity to reach a geographical spread of participants more safely, cheaply and quickly than face-to-face meetings. Rapport, sensitivity and degrees of collaboration can be achieved using this medium. The use of Skype as a medium for semi-structured interview research is better understood. This paper contributes to the growing body of literature on the use of the internet as a medium for research by nurses.

Implementation of safety management systems in Hong Kong construction industry - A safety practitioner's perspective.

PubMed

Yiu, Nicole S N; Sze, N N; Chan, Daniel W M

2018-02-01

In the 1980s, the safety management system (SMS) was introduced in the construction industry to mitigate against workplaces hazards, reduce the risk of injuries, and minimize property damage. Also, the Factories and Industrial Undertakings (Safety Management) Regulation was introduced on 24 November 1999 in Hong Kong to empower the mandatory implementation of a SMS in certain industries including building construction. Therefore, it is essential to evaluate the effectiveness of the SMS in improving construction safety and identify the factors that influence its implementation in Hong Kong. A review of the current state-of-the-practice helped to establish the critical success factors (CSFs), benefits, and difficulties of implementing the SMS in the construction industry, while structured interviews were used to establish the key factors of the SMS implementation. Results of the state-of-the-practice review and structured interviews indicated that visible senior commitment, in terms of manpower and cost allocation, and competency of safety manager as key drivers for the SMS implementation. More so, reduced accident rates and accident costs, improved organization framework, and increased safety audit ratings were identified as core benefits of implementing the SMS. Meanwhile, factors such as insufficient resources, tight working schedule, and high labor turnover rate were the key challenges to the effective SMS implementation in Hong Kong. The findings of the study were consistent and indicative of the future development of safety management practice and the sustainable safety improvement of Hong Kong construction industry in the long run. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

The link between quality and accreditation of residency programs: the surveyors’ perceptions

PubMed Central

dos Santos, Renato Antunes; Snell, Linda; Tenorio Nunes, Maria do Patrocinio

2017-01-01

ABSTRACT Accreditation of medical residency programs has become globally important. Currently it is moving from the goal of attaining minimal standards to a model of continuous improvement. In some countries, the accreditation system engages peers (physicians) to survey residency programs. The surveyors are sometimes volunteers, usually engaged in multiple clinical and education activities. Few studies have investigated the benefits of residency program evaluation and accreditation from the perspective of the surveyors. As peers they both conduct and receive accreditation surveys, which puts them in a privileged position in that it provides the surveyor with an opportunity to share experiences and knowledge and apply what is learned in their own context. The objective of this study is to obtain the perceptions of these surveyors about the impact of an accreditation system on residency programs. Surveyors participated in semi-structured interviews. A thematic analysis was performed on the interview data, and resulting topics were grouped into five themes: Burden (of documentation and of time needed); Efficiency and efficacy of the accreditation process; Training and experience of surveyors; Being a peer; Professional skills and recognition of surveyors. These categories were organized into two major themes: ‘Structure and Process’ and ‘Human Resources’. The study participants proposed ways to improve efficiency including diminish the burden of documentation to the physicians involved in the process and to increase efforts on training programs and payment for surveyors and program directors. Based on the results we propose a conceptual framework to improve accreditation systems. Abbreviations: PD: Program director PMID:28178919

The Myth of the Normal, Average Human Brain—The ICBM Experience: (1) Subject Screening and Eligibility

PubMed Central

Mazziotta, John C.; Woods, Roger; Iacoboni, Marco; Sicotte, Nancy; Yaden, Kami; Tran, Mary; Bean, Courtney; Kaplan, Jonas; Toga, Arthur W.

2009-01-01

In the course of developing an atlas and reference system for the normal human brain throughout the human age span from structural and functional brain imaging data, the International Consortium for Brain Mapping (ICBM) developed a set of “normal” criteria for subject inclusion and the associated exclusion criteria. The approach was to minimize inclusion of subjects with any medical disorders that could affect brain structure or function. In the past two years, a group of 1,685 potential subjects responded to solicitation advertisements at one of the consortium sites (UCLA). Subjects were screened by a detailed telephone interview and then had an in-person history and physical examination. Of those who responded to the advertisement and considered themselves to be normal, only 31.6% (532 subjects) passed the telephone screening process. Of the 348 individuals who submitted to in-person history and physical examinations, only 51.7% passed these screening procedures. Thus, only 10.7% of those individuals who responded to the original advertisement qualified for imaging. The most frequent cause for exclusion in the second phase of subject screening was high blood pressure followed by abnormal signs on neurological examination. It is concluded that the majority of individuals who consider themselves normal by self-report are found not to be so by detailed historical interviews about underlying medical conditions and by thorough medical and neurological examinations. Recommendations are made with regard to the inclusion of subjects in brain imaging studies and the criteria used to select them. PMID:18775497

Information Management of a Structured Admissions Interview Process in a Medical College with an Apple II System

PubMed Central

O'Reilly, Robert; Fedorko, Steve; Nicholson, Nigel

1983-01-01

This paper describes a structured interview process for medical school admissions supported by an Apple II computer system which provides feedback to interviewers and the College admissions committee. Presented are the rationale for the system, the preliminary results of analysis of some of the interview data, and a brief description of the computer program and output. The present data show that the structured interview yields very high interrater reliability coefficients, is acceptable to the medical school faculty, and results in quantitative data useful in the admission process. The system continues in development at this time, a second year of data will be shortly available, and further refinements are being made to the computer program to enhance its utilization and exportability.

A cognitive task analysis of information management strategies in a computerized provider order entry environment.

PubMed

Weir, Charlene R; Nebeker, Jonathan J R; Hicken, Bret L; Campo, Rebecca; Drews, Frank; Lebar, Beth

2007-01-01

Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system.

The balancing act: Exploring stigma, economic need and disclosure among male sex workers in Ho Chi Minh City, Vietnam

PubMed Central

Closson, Elizabeth F.; Colby, Donn J.; Nguyen, Thi; Cohen, Samuel S.; Biello, Katie; Mimiaga, Matthew J.

2014-01-01

In Vietnam, there is an emerging HIV epidemic among men who have sex with men (MSM). Male sex workers (MSWs) engage in high-risk sexual behaviours that make them particularly vulnerable to HIV infection. In 2010, 23 MSM in Ho Chi Minh City (HCMC) who recently received payment for sex with another man completed in-depth qualitative interviews exploring motivations for sex work, patterns of sex work disclosure and experiences of social stigma. Interviews were recorded, transcribed and translated into English and analysed using a qualitative descriptive approach. Low wages, unstable employment, and family remittances were motivating factors for MSM in HCMC to sell sex. Participants described experiences of enacted and felt social stigma related to their involvement in sex work. In response, they utilized stigma management techniques aimed at concealment of involvement in sex work. Such strategies restricted sexual communication with non-paying sex partners and potentially limited their ability to seek social support from family and friends. Departing from decontextualized depictions of sex work disclosure, our findings describe how decisions to reveal involvement in sex work are shaped by social and structural factors such as social stigma, techniques to minimize exposure to stigma, economic imperatives and familial responsibilities. PMID:25555192

Disclosing a dementia diagnosis: what do patients and family consider important?

PubMed

Mastwyk, Maree; Ames, David; Ellis, Kathryn A; Chiu, Edmond; Dow, Briony

2014-08-01

The literature available on the format of the feedback session following assessment of memory impairment is minimal. This study explored how this information should be presented from the perspective of patients and their families. Thirty-two semi-structured interviews were conducted with memory clinic patients and their carer at the clinic visit that followed the feedback session, to ask: what they recalled, what they found helpful, and what they thought was the best way to disclose a diagnosis of dementia. A second interview was conducted with 14 patient/carer dyads at their next appointment. Recall of information from the feedback session was variable. Most respondents (76% of patients; 66% of carers) thought that a direct approach was best when informing the patient of a dementia diagnosis, and that both written information and compassion demonstrated by the doctor were helpful. Opinions on whether all the information should be given at once or in stages were divided. The current format of the feedback session needs revision to improve recall. Patients and their families want a direct approach to be used by a supportive and professional doctor with an opportunity to ask questions. They want the support of a family member or friend when they are told of their diagnosis and they would like a written summary to refer to afterwards.

Identifying Future Scientists: Predicting Persistence into Research Training

PubMed Central

2007-01-01

This study used semistructured interviews and grounded theory to look for characteristics among college undergraduates that predicted persistence into Ph.D. and M.D./Ph.D. training. Participants in the summer undergraduate and postbaccalaureate research programs at the Mayo Clinic College of Medicine were interviewed at the start, near the end, and 8–12 months after their research experience. Of more than 200 themes considered, five characteristics predicted those students who went on to Ph.D. and M.D./Ph.D. training or to M.D. training intending to do research: 1) Curiosity to discover the unknown, 2) Enjoyment of problem solving, 3) A high level of independence, 4) The desire to help others indirectly through research, and 5) A flexible, minimally structured approach to the future. Web-based surveys with different students confirmed the high frequency of curiosity and/or problem solving as the primary reason students planned research careers. No evidence was found for differences among men, women, and minority and nonminority students. Although these results seem logical compared with successful scientists, their constancy, predictive capabilities, and sharp contrast to students who chose clinical medicine were striking. These results provide important insights into selection and motivation of potential biomedical scientists and the early experiences that will motivate them toward research careers. PMID:18056303

"Who'll do all these if I'm not around?": Bonding social capital and health and well-being of inpatients.

PubMed

Amoah, Padmore Adusei; Koduah, Adwoa Owusuaa; Gyasi, Razak Mohammed

2018-12-01

Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions-that were both 'expected' and 'encouraged'- reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending 'unapproved' alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery.

Is the short form 36 (SF-36) suitable for routine health outcomes assessment in health care for older people? Evidence from preliminary work in community based health services in England.

PubMed Central

Hill, S; Harries, U; Popay, J

1996-01-01

STUDY OBJECTIVE: To examine the short form 36 (SF-36) health status measure when used to assess older people's views of the outcome of community based health care. DESIGN: Completion of a structured questionnaire, before and after intervention alongside in-depth interviews with a subsample of the interviewees. SETTING: Community based continence and mental health services in two health authorities in the North West Health Region. PATIENTS: Forty seven older people newly referred to mental health services or continence services between December 1992 and April 1993 participated. MAIN RESULTS: The SF-36 showed minimal change over time for both patient groups. The more detailed in-depth interviews showed that people experienced positive changes and derived value from contact with services in a number of important ways. For many reasons these benefits were not reflected in their SF-36 scores. CONCLUSIONS: The SF-36 is not likely to be the "measure of choice" for this type of evaluation, particularly where it involves older patient groups who have high levels of comorbidity. The content of the SF-36 and its lack of detail for individual assessment of change means it masks rather than illuminates patients' views of outcome. PMID:8762362

Exploring telemonitoring and self-management by patients with chronic obstructive pulmonary disease: a qualitative study embedded in a randomized controlled trial.

PubMed

Fairbrother, Peter; Pinnock, Hilary; Hanley, Janet; McCloughan, Lucy; Sheikh, Aziz; Pagliari, Claudia; McKinstry, Brian

2013-12-01

To explore patient and professional views on self-management in the context of telemonitoring in chronic obstructive pulmonary disease (COPD). Semi-structured interviews with patients with COPD and healthcare professionals participating in a randomized controlled trial of telemonitoring in Lothian, Scotland, explored experiences of using telemonitoring, and dynamics in patient-practitioner relationships. Transcribed data were analyzed using the Framework approach. 38 patients (mean age 67.5 years) and 32 professionals provided 70 interviews. Patients considered that telemonitoring empowered self-management by enhancing their understanding of COPD and providing additional justification for their decisions to adjust treatment or seek professional advice. Professionals discussed telemonitoring as promoting compliance with medical advice and encouraged patients to exercise personal responsibility within clinical parameters, but expressed concerns about promoting the sick role and creating dependence on telemonitoring. Telemonitoring assisted many patients to embrace greater responsibility for their health but the model of service provision remained clinician-centered. A medical model of 'compliant self-management' may paradoxically have promoted dependence on professionals. Patients and professionals shared responsibility for meeting the central objective of prompt management of exacerbations of COPD. Care is needed, however, to minimize the risk in some patients, of telemonitoring increasing dependence on practitioner support. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Identifying future scientists: predicting persistence into research training.

PubMed

McGee, Richard; Keller, Jill L

2007-01-01

This study used semistructured interviews and grounded theory to look for characteristics among college undergraduates that predicted persistence into Ph.D. and M.D./Ph.D. training. Participants in the summer undergraduate and postbaccalaureate research programs at the Mayo Clinic College of Medicine were interviewed at the start, near the end, and 8-12 months after their research experience. Of more than 200 themes considered, five characteristics predicted those students who went on to Ph.D. and M.D./Ph.D. training or to M.D. training intending to do research: 1) Curiosity to discover the unknown, 2) Enjoyment of problem solving, 3) A high level of independence, 4) The desire to help others indirectly through research, and 5) A flexible, minimally structured approach to the future. Web-based surveys with different students confirmed the high frequency of curiosity and/or problem solving as the primary reason students planned research careers. No evidence was found for differences among men, women, and minority and nonminority students. Although these results seem logical compared with successful scientists, their constancy, predictive capabilities, and sharp contrast to students who chose clinical medicine were striking. These results provide important insights into selection and motivation of potential biomedical scientists and the early experiences that will motivate them toward research careers.

The researchers have left the building: what contributes to sustaining school-based interventions following the conclusion of formal research support?

PubMed

Friend, Sarah; Flattum, Colleen F; Simpson, Danielle; Nederhoff, Dawn M; Neumark-Sztainer, Dianne

2014-05-01

This study examined the sustainability of New Moves, a school-based program aimed at decreasing weight-related problems in adolescent girls. The National Cancer Institute recognizes New Moves as a research-tested intervention program that produced positive behavioral and psychosocial outcomes. Ten schools participated in the sustainability study. Teachers completed a survey and interview, and research staff observed 1 physical education (PE) class within 2 years of the study's completion. Qualitative data were grouped by themes. Frequencies were calculated using quantitative data. All schools continued all-girls PE classes using New Moves components following the study period. Fewer schools continued the nutrition and social support classroom modules and individual coaching sessions while no schools continued lunch get-togethers. Program components were sustained in both New Moves intervention schools and control schools. Programs are most likely to be sustained if they (1) fit into the current school structure, (2) receive buy-in by teachers, and (3) require minimal additional funds or staff time. Providing control schools with minimal training and intervention resources was sufficient to continue program components if staff perceived the program was important for students' health and compatible within the school's existing infrastructure. © 2014, American School Health Association.

The Interview as a Technique for Assessing Oral Ability: Some Guidelines for Its Use.

ERIC Educational Resources Information Center

Nambiar, Mohana

1990-01-01

Some guidelines are offered that detail the complexities involved in interviewing for language testing purposes. They cover strategies for structuring interviews (informal conversational, interview guide, standardized open-ended), questions, interviewing skills, and physical setting. (five references) (LB)

Energy minimization for self-organized structure formation and actuation

NASA Astrophysics Data System (ADS)

Kofod, Guggi; Wirges, Werner; Paajanen, Mika; Bauer, Siegfried

2007-02-01

An approach for creating complex structures with embedded actuation in planar manufacturing steps is presented. Self-organization and energy minimization are central to this approach, illustrated with a model based on minimization of the hyperelastic free energy strain function of a stretched elastomer and the bending elastic energy of a plastic frame. A tulip-shaped gripper structure illustrates the technological potential of the approach. Advantages are simplicity of manufacture, complexity of final structures, and the ease with which any electroactive material can be exploited as means of actuation.

Stakeholders' Perspectives on Stakeholder-engaged Research (SER): Strategies to Operationalize Patient-centered Outcomes Research Principles for SER.

PubMed

Mackie, Thomas I; Sheldrick, Radley C; de Ferranti, Sarah D; Saunders, Tully; Rojas, Erick G; Leslie, Laurel K

2017-01-01

US federal funding agencies increasingly incentivize stakeholder-engaged research which represents a paradigm shift toward incorporating a range of stakeholders in research design, conduct, and dissemination. We use qualitative methods to capture experience-based recommendations on how to operationalize 4 Patient-Centered Outcomes Research (PCOR) principles in stakeholder-engaged research, specifically: (1) reciprocal relationships; (2) colearning; (3) partnership; and (4) trust, transparency, and honesty. We conducted semistructured interviews with members of a stakeholder panel who participated in a 2-year comparative effectiveness study of cholesterol screening and treatment among young adults. Participants included 8 young adults and parent panelists and 11 professional panelists (clinicians, researchers, policy developers, and disseminators). The interview guide included questions about the 4 PCOR principles and queried preferred strategies to attain them. Interview transcripts were analyzed using an a priori and emergent coding structure. Participants provided strategies to promote the 4 PCOR principles. Although some stakeholder-identified strategies were complementary, others conflicted due to (1) competing ideologies identified among the principles, and (2) distinct stakeholder preferences. Illustrative of competing ideologies, participants simultaneously preferred receiving relevant articles before calls (to facilitate colearning) but also minimal outside reading (to achieve partnership). Illustrative of distinct stakeholder preferences, young adult and parent panelists generally preferred calls to occur on weekends/evenings, whereas professional panelists preferred mid-week work hours. Our exploratory study provides stakeholder-identified strategies to achieve the 4 PCOR principles, and demonstrates the need to identify, acknowledge, and address potentially conflicting strategies due to the potential for competing ideologies or variation in stakeholder preferences.

Post procedure headache in patients treated for neurovascular arteriovenous malformations and aneurysms using endovascular therapy.

PubMed

Khan, Sabrina; Amin, Faisal Mohammad; Hauerberg, John; Holtmannspötter, Markus; Petersen, Julie Falkenberg; Fakhril-Din, Zainab; Gaist, David; Ashina, Messoud

2016-12-01

Though endovascular therapy (EVT) is increasingly applied in the treatment of intracranial vascular lesions, little is known about the effect of EVT on post-procedure headache. We aimed to investigate the prevalence of headache in patients who have undergone EVT for cerebral arteriovenous malformations (AVMs) and aneurysms. A total of 324 patients underwent EVT treatment for aneurysms and AVMs at the Danish National Hospital from January 2012 to December 2014. We applied strict exclusion criteria in order to minimize the effect of other factors on headache occurrence, e.g., craniotomy. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire. Headaches were classified according to ICHD-III beta criteria. The 59 patients underwent treatment of aneurysms (n = 43), cranial dural fistulas (n = 11), and AVMs (n = 5). There was a significant increase in overall headache (p = 0.017) and tension-type headache (TTH) (p = 0.012) within the first 3 months after EVT compared to 1 month before EVT. However, at interview time (median 2.5 years post-EVT), the increase in overall headache, migraine, and tension-type headache was not statistically significant. A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 4, TTH 10). At interview time, 50 % of these new headaches still persisted. Our results suggest a temporary increase in headache in the first 3 months after EVT, which normalizes over time. Clinicians may use this knowledge to better inform their patients of functional outcomes after their EVT procedure.

Anxiety and Fear of Recurrence Despite a Good Prognosis: An Interview Study with Differentiated Thyroid Cancer Patients.

PubMed

Hedman, Christel; Strang, Peter; Djärv, Therese; Widberg, Ida; Lundgren, Catharina Ihre

2017-11-01

Despite a good prognosis, fear of recurrence is prevalent, even several years after a diagnosis of differentiated thyroid cancer (DTC). For this reason, the aim of this study was to make an in-depth exploration of anxiety, sources of anxiety, and protective strategies. In order to capture a broad description of the phenomenon, a purposeful, maximum variation sampling strategy regarding age, sex, stage of disease, educational level, and time since diagnosis was used. In total, 21 patients were included in the study. Semi-structured interviews were tape-recorded, transcribed verbatim, and analyzed with a qualitative content analysis. Patients with and without recurrences narrated a picture indicating anxiety related to their current situation; future risks and threats were central to this picture. However, they initially minimized or even denied having anxiety, but subsequently described it as a major problem at the end of the interviews. Anxiety was related to risk of recurrence and the risk of developing other cancers, but also to fears of a future situation where no further treatment options were available. Previous experiences of delayed investigations added to these fears. In order to cope, patients developed protective strategies in order to keep evasive and frightening thoughts away. Everyday life, distractions, and focusing on "the small things in life" were examples of such strategies. Anxiety is a common, although partially hidden, problem in DTC survivors, as they tended to deny it early in the dialogues. As anxiety is clearly related to follow-up routines, these should therefore be revaluated.

Modified personal interviews: resurrecting reliable personal interviews for admissions?

PubMed

Hanson, Mark D; Kulasegaram, Kulamakan Mahan; Woods, Nicole N; Fechtig, Lindsey; Anderson, Geoff

2012-10-01

Traditional admissions personal interviews provide flexible faculty-student interactions but are plagued by low inter-interview reliability. Axelson and Kreiter (2009) retrospectively showed that multiple independent sampling (MIS) may improve reliability of personal interviews; thus, the authors incorporated MIS into the admissions process for medical students applying to the University of Toronto's Leadership Education and Development Program (LEAD). They examined the reliability and resource demands of this modified personal interview (MPI) format. In 2010-2011, LEAD candidates submitted written applications, which were used to screen for participation in the MPI process. Selected candidates completed four brief (10-12 minutes) independent MPIs each with a different interviewer. The authors blueprinted MPI questions to (i.e., aligned them with) leadership attributes, and interviewers assessed candidates' eligibility on a five-point Likert-type scale. The authors analyzed inter-interview reliability using the generalizability theory. Sixteen candidates submitted applications; 10 proceeded to the MPI stage. Reliability of the written application components was 0.75. The MPI process had overall inter-interview reliability of 0.79. Correlation between the written application and MPI scores was 0.49. A decision study showed acceptable reliability of 0.74 with only three MPIs scored using one global rating. Furthermore, a traditional admissions interview format would take 66% more time than the MPI format. The MPI format, used during the LEAD admissions process, achieved high reliability with minimal faculty resources. The MPI format's reliability and effective resource use were possible through MIS and employment of expert interviewers. MPIs may be useful for other admissions tasks.

Surgery resident selection and evaluation. A critical incident study.

PubMed

Edwards, J C; Currie, M L; Wade, T P; Kaminski, D L

1993-03-01

This article reports a study of the process of selecting and evaluating general surgery residents. In personnel psychology terms, a job analysis of general surgery was conducted using the Critical Incident Technique (CIT). The researchers collected 235 critical incidents through structured interviews with 10 general surgery faculty members and four senior residents. The researchers then directed the surgeons in a two-step process of sorting the incidents into categories and naming the categories. The final essential categories of behavior to define surgical competence were derived through discussion among the surgeons until a consensus was formed. Those categories are knowledge/self-education, clinical performance, diagnostic skills, surgical skills, communication skills, reliability, integrity, compassion, organization skills, motivation, emotional control, and personal appearance. These categories were then used to develop an interview evaluation form for selection purposes and a performance evaluation form to be used throughout residency training. Thus a continuum of evaluation was established. The categories and critical incidents were also used to structure the interview process, which has demonstrated increased interview validity and reliability in many other studies. A handbook for structuring the interviews faculty members conduct with applicants was written, and an interview training session was held with the faculty. The process of implementation of the structured selection interviews is being documented currently through qualitative research.

Motivational Influences on the Safer Sex Behavior of Agency-based Male Sex Workers

PubMed Central

Smith, Michael D.; Seal, David W.

2017-01-01

Although indoor male sex workers (MSWs) have been found to engage in lower rates of HIV risk behavior with clients than street-based MSWs, few studies have examined the motivations behind such practices. We interviewed 30 MSWs working for the same escort agency regarding their safer sex practices with clients and their reasons for these. As in other research, MSWs reported little risk behavior with clients. Five motivational themes related to safer sex on the job emerged: health concerns, emotional intimacy, client attractiveness, relationships, and structural work factors. Results suggest that participants engaged in rational decision-making relative to sex with clients, facilitated by reduced economic incentive for riskier behavior and a supportive social context. MSWs desired a safe sexual work place, personal integrity, and minimal negative consequences to personal relationships. Collaborating with sex work employers to study their role in encouraging a safer workplace may be important to future research. PMID:18288599

Exposure to asbestos: psychological responses of mesothelioma patients

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

Lebovits, A.H.; Chahinian, A.P.; Holland, J.C.

1983-01-01

Thirty-eight patients with a diagnosis of malignant mesothelioma participated in a semi-structured interview to evaluate asbestos exposure, acquisition of increased risk information, and retrospective reporting of cognitive and behavioral reactions (particularly smoking behavior) to risk information. Twenty-eight patients (74%) had direct occupational contact with asbestos, and six patients (16%) reported indirect nonoccupational exposure to asbestos. Only two (10%) of the directly exposed patients acquired risk information from professional sources prior to diagnosis of mesothelioma. The most frequently reported reaction to learning of increased risk of cancer was a denial of the risk by minimizing personal exposure. Few patients reported beingmore » concerned about the information of increased risk. Smoking behavior did not change as a result of risk information, nor was there any increase in visits to physicians. Guidelines for psychosocial management of at-risk groups are recommended.« less

Altruism in Clinical Research: Coordinators’ Orientation to their Professional Roles

PubMed Central

Fisher, Jill A.; Kalbaugh, Corey A.

2011-01-01

Background Research coordinators have significant responsibilities in clinical trials that often require them to find unique ways to manage their jobs, thus re-shaping their professional identities. Purpose The purpose of this study is to identify how research coordinators manage role and ethical conflicts within clinical research trials. Method A qualitative study combining observation and 63 semi-structured interviews at 25 research organizations was used. Discussion Altruism is a recurring theme in how research coordinators define and view their work. Conclusion Altruism is adopted by research coordinators: 1) to teach patient-subjects the appropriate reasons to participate in clinical research, 2) to minimize the conflict between research and care, and 3) to contest the undervaluation of coordinating. Altruism is a strategy employed to handle the various conflicts they experience in a difficult job, and it has become part of the professional identity of clinical research coordinators. PMID:22083045

Motivational influences on the safer sex behavior of agency-based male sex workers.

PubMed

Smith, Michael D; Seal, David W

2008-10-01

Although indoor male sex workers (MSWs) have been found to engage in lower rates of HIV risk behavior with clients than street-based MSWs, few studies have examined the motivations behind such practices. We interviewed 30 MSWs working for the same escort agency regarding their safer sex practices with clients and their reasons for these. As in other research, MSWs reported little risk behavior with clients. Five motivational themes related to safer sex on the job emerged: health concerns, emotional intimacy, client attractiveness, relationships, and structural work factors. Results suggest that participants engaged in rational decision-making relative to sex with clients, facilitated by reduced economic incentive for riskier behavior and a supportive social context. MSWs desired a safe sexual work place, personal integrity, and minimal negative consequences to personal relationships. Collaborating with sex work employers to study their role in encouraging a safer workplace may be important to future research.

Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.

PubMed

Jeffs, Lianne; Grinspun, Doris; Closson, Tom; Mainville, Marie-Claude

2015-09-01

Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization. Qualitative study design using semi-structured interviews and thematic analysis. Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site. Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare. Copyright © 2015 Longwoods Publishing.

Disadvantaged Former Miners' Perspectives on Smoking Cessation: A Qualitative Study

ERIC Educational Resources Information Center

White, Simon; Baird, Wendy

2013-01-01

Objective: To explore disadvantaged former miners' perspectives in north Derbyshire, United Kingdom (UK) on smoking and smoking cessation. Methods: In-depth, audiotaped interviews with 16 disadvantaged former miners who smoked or had stopped smoking within six months. Results: Perceptions of being able to stop smoking with minimal difficulty and…

"On the Sidelines": Access to Autism-Related Services in the West Bank

ERIC Educational Resources Information Center

Dababnah, Sarah; Bulson, Kathleen

2015-01-01

We examined access to autism-related services among Palestinians (N = 24) raising children with autism spectrum disorder (ASD) in the West Bank. Using qualitative methods, we identified five primary interview themes. Poor screening, diagnostic, and psychoeducational practices were prevalent, as parents reported service providers minimized parental…

76 FR 14400 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

...) the use of automated collection techniques or other forms of information technology to minimize the.... Proposed Project: National Survey of Single Parent Caregivers--OMB No. 0990-NEW-OWH; HHS, Office on Women's... under a one-year request, and will contact individuals using computer-assisted telephone interviewing...

Steady as She Goes

ERIC Educational Resources Information Center

Villano, Matt

2009-01-01

With colleges and universities struggling to minimize the effects of the troubled economy, it certainly isn't an easy time to be a CIO. This article presents an interview with a panel of higher education IT leaders about best practices for steering IT through economic crisis. Panelists included Jan Biros, associate VP for instructional technology…

Exploring the Values of Chaplains in Government Primary Schools

ERIC Educational Resources Information Center

Isaacs, Amy Kate; Mergler, Amanda

2018-01-01

Minimal prior research has examined the school chaplaincy programme in Australia. This exploratory study sought to identify the values primary school chaplains feel are the most important to them personally, and in their role as chaplain. Eight chaplains working in government primary schools were interviewed. Inductive thematic analysis was used…

Inspired by the Slum

ERIC Educational Resources Information Center

Pratapchandran, Sarat

2009-01-01

An innovative learning technique that originated in a slum in India's capital, New Delhi, sets the stage for "Q&A" that is now the Oscar winning movie, "Slumdog Millionaire". In an interview, Dr. Sugata Mitra, the creator of this new educational pedagogy termed Minimally Invasive Education (MIE), explains how it can help…

On the formulation of a minimal uncertainty model for robust control with structured uncertainty

NASA Technical Reports Server (NTRS)

Belcastro, Christine M.; Chang, B.-C.; Fischl, Robert

1991-01-01

In the design and analysis of robust control systems for uncertain plants, representing the system transfer matrix in the form of what has come to be termed an M-delta model has become widely accepted and applied in the robust control literature. The M represents a transfer function matrix M(s) of the nominal closed loop system, and the delta represents an uncertainty matrix acting on M(s). The nominal closed loop system M(s) results from closing the feedback control system, K(s), around a nominal plant interconnection structure P(s). The uncertainty can arise from various sources, such as structured uncertainty from parameter variations or multiple unsaturated uncertainties from unmodeled dynamics and other neglected phenomena. In general, delta is a block diagonal matrix, but for real parameter variations delta is a diagonal matrix of real elements. Conceptually, the M-delta structure can always be formed for any linear interconnection of inputs, outputs, transfer functions, parameter variations, and perturbations. However, very little of the currently available literature addresses computational methods for obtaining this structure, and none of this literature addresses a general methodology for obtaining a minimal M-delta model for a wide class of uncertainty, where the term minimal refers to the dimension of the delta matrix. Since having a minimally dimensioned delta matrix would improve the efficiency of structured singular value (or multivariable stability margin) computations, a method of obtaining a minimal M-delta would be useful. Hence, a method of obtaining the interconnection system P(s) is required. A generalized procedure for obtaining a minimal P-delta structure for systems with real parameter variations is presented. Using this model, the minimal M-delta model can then be easily obtained by closing the feedback loop. The procedure involves representing the system in a cascade-form state-space realization, determining the minimal uncertainty matrix, delta, and constructing the state-space representation of P(s). Three examples are presented to illustrate the procedure.

Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.

PubMed

Levis, Brooke; Benedetti, Andrea; Riehm, Kira E; Saadat, Nazanin; Levis, Alexander W; Azar, Marleine; Rice, Danielle B; Chiovitti, Matthew J; Sanchez, Tatiana A; Cuijpers, Pim; Gilbody, Simon; Ioannidis, John P A; Kloda, Lorie A; McMillan, Dean; Patten, Scott B; Shrier, Ian; Steele, Russell J; Ziegelstein, Roy C; Akena, Dickens H; Arroll, Bruce; Ayalon, Liat; Baradaran, Hamid R; Baron, Murray; Beraldi, Anna; Bombardier, Charles H; Butterworth, Peter; Carter, Gregory; Chagas, Marcos H; Chan, Juliana C N; Cholera, Rushina; Chowdhary, Neerja; Clover, Kerrie; Conwell, Yeates; de Man-van Ginkel, Janneke M; Delgadillo, Jaime; Fann, Jesse R; Fischer, Felix H; Fischler, Benjamin; Fung, Daniel; Gelaye, Bizu; Goodyear-Smith, Felicity; Greeno, Catherine G; Hall, Brian J; Hambridge, John; Harrison, Patricia A; Hegerl, Ulrich; Hides, Leanne; Hobfoll, Stevan E; Hudson, Marie; Hyphantis, Thomas; Inagaki, Masatoshi; Ismail, Khalida; Jetté, Nathalie; Khamseh, Mohammad E; Kiely, Kim M; Lamers, Femke; Liu, Shen-Ing; Lotrakul, Manote; Loureiro, Sonia R; Löwe, Bernd; Marsh, Laura; McGuire, Anthony; Mohd Sidik, Sherina; Munhoz, Tiago N; Muramatsu, Kumiko; Osório, Flávia L; Patel, Vikram; Pence, Brian W; Persoons, Philippe; Picardi, Angelo; Rooney, Alasdair G; Santos, Iná S; Shaaban, Juwita; Sidebottom, Abbey; Simning, Adam; Stafford, Lesley; Sung, Sharon; Tan, Pei Lin Lynnette; Turner, Alyna; van der Feltz-Cornelis, Christina M; van Weert, Henk C; Vöhringer, Paul A; White, Jennifer; Whooley, Mary A; Winkley, Kirsty; Yamada, Mitsuhiko; Zhang, Yuying; Thombs, Brett D

2018-06-01

Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit. A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15-3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98-10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) (OR = 0.96; 95% CI = 0.56-1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26-0.97). The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

The Analysis of Prospective Chemistry Teachers' Cognitive Structure: The Subject of Covalent and Ionic Bonding

ERIC Educational Resources Information Center

Temel, Senar; Özcan, Özgür

2016-01-01

This study aims to analyse prospective chemistry teachers' cognitive structure related to the subject of covalent and ionic bonding. Semi-structured interviews were conducted with the participants in order to determine their cognitive structure, and the interviews were audio recorded to prevent the loss of data. The data were transcribed and…

Eyewitness performance in cognitive and structured interviews.

PubMed

Memon, A; Wark, L; Holley, A; Bull, R; Koehnken, G

1997-09-01

This paper addresses two methodological and theoretical questions relating to the Cognitive Interview (CI), which previous research has found to increase witness recall in interviews. (1) What are the effects of the CI mnemonic techniques when communication techniques are held constant? (2) How do trained interviewers compare with untrained interviewers? In this study, witnesses (college students) viewed a short film clip of a shooting and were questioned by interviewers (research assistants) trained in conducting the CI or a Structured Interview (SI)--similar to the CI except for the "cognitive" components--or by untrained interviewers (UI). The CI and SI groups recalled significantly more correct information compared to the UI group. However they also reported more errors and confabulated details. Theoretical and practical implications of the results are discussed in terms of precisely identifying the CI facilitatory effects and consequent good practice in the forensic setting.

Students' Communicative Resources in Relation to Their Conceptual Understanding--The Role of Non-Conventionalized Expressions in Making Sense of Visualizations of Protein Function

ERIC Educational Resources Information Center

Rundgren, Carl-Johan; Hirsch, Richard; Chang Rundgren, Shu-Nu; Tibell, Lena A. E.

2012-01-01

This study examines how students explain their conceptual understanding of protein function using visualizations. Thirteen upper secondary students, four tertiary students (studying chemical biology), and two experts were interviewed in semi-structured interviews. The interviews were structured around 2D illustrations of proteins and an animated…

Interview from anywhere: feasibility and utility of web-based videoconference interviews in the gastroenterology fellowship selection process.

PubMed

Daram, Sumanth R; Wu, Ruonan; Tang, Shou-Jiang

2014-02-01

Traditional personal interviews are subject to limitations imposed by geographic, financial, and scheduling constraints. Web-based videoconferencing (WVC) has the potential to simplify the interview process. This study was intended to evaluate the feasibility and utility of WVC using standard tablets/computers with videoconferencing capability in gastroenterology (GI) fellowship interviews. At a single institution, 16 GI fellowship applicants participated in WVC with one interviewer, who was present at a remote location 750 miles away. In addition, each of the candidates underwent traditional interviews with four faculty members at the program site. All study interviewees used an iPad2 (Apple, iOS 5.1; Apple) with a videoconferencing application (Facetime). The interviewer (SRD) used Facetime on a MacBook Pro (Apple, Mac OS X 10.7.3). Each candidate completed a voluntary paper survey after completion of all assigned faculty interviews. The average age of the candidates was 30 years (range, 27-37 years). Fourteen candidates were native English speakers. Candidates expressed a high level of satisfaction, with 13 candidates (81%) stating that their WVC experience met or exceeded their expectations, and 87% of candidates stating that WVC should be an option in fellowship interviews. In addition, 25% of candidates felt that their WVC experience was equivalent to or better than their traditional interview experience on the same day. WVC can be an effective and useful tool in the fellowship interview process. It affords candidates increased flexibility, cost saving, convenience, and provides an option for participating in the selection process at more programs. For the programs and faculty, WVC has a potential to be an effective screening tool, can help minimize loss of clinical revenue and can also be an acceptable alternative to in-person interviews.

Decreasing Damaging Effects of Stress-Bound Situations: Towards a New Model of Leadership under Stress

DTIC Science & Technology

1987-01-01

interviews encompassed a clinical interview and a critical incident interview . The clinical interview was semi-structured coaprising three aain...data. In the critical incident interview the subject was asked, first, to recall and to describe a particularly hard, difficult or threatening

Tailoring the Interview Process for More Effective Personnel Selection.

ERIC Educational Resources Information Center

Saville, Anthony

Structuring the initial teacher employment interview adds validity to selection and appropriately utilizes human resources. Five aspects of an effective interview program include: (1) developing a job analysis plan; (2) reviewing the applications; (3) planning for the interview; (4) the interview instrument; and (5) legal implications. An…

The psychiatric interview: validity, structure, and subjectivity.

PubMed

Nordgaard, Julie; Sass, Louis A; Parnas, Josef

2013-06-01

There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews that are historically rooted in logical positivism and behaviorism. These theoretical approaches marked decisively the so-called "operational revolution in psychiatry" leading to the creation of DSM-III. This paper attempts to examine the theoretical assumptions that underlie the use of a fully structured psychiatric interview. We address the ontological status of pathological experience, the notions of symptom, sign, prototype and Gestalt, and the necessary second-person processes which are involved in converting the patient's experience (originally lived in the first-person perspective) into an "objective" (third person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform faithful distinctions in this particular domain, we need a more adequate approach, that is, an approach that is guided by phenomenologically informed considerations. Our theoretical discussion draws upon clinical examples derived from structured and semi-structured interviews. We conclude that fully structured interview is neither theoretically adequate nor practically valid in obtaining psycho-diagnostic information. Failure to address these basic issues may have contributed to the current state of malaise in the study of psychopathology.

The objective structured interview for medical student selection

PubMed Central

Powis, D A; Neame, R L B; Bristow, T; Murphy, L B

1988-01-01

An objective structured interview is an integral part of the process of selecting and admitting applicants to study medicine at this university. During the nine years (to the end of 1986) that the interview has been used 1600 candidates were interviewed out of roughly 13 000 applicants, and from these, 584 students were admitted to the course. Analysis of the interview data was carried out based on two aspects of student progress: graduation with honours and failure to complete the course of study. The interview as a whole, and especially some of the subscales, appears to identify students who may fail to complete the course: it may also help to predict which students are likely to graduate with honours. PMID:3126966

“Prefacing the Script” as an Ethical Response to State-Mandated Abortion Counseling

PubMed Central

Lassiter, Dragana; Mercier, Rebecca; Bryant, Amy; Lyerly, Anne Drapkin

2016-01-01

BACKGROUND Laws governing abortion provision are proliferating throughout the United States, yet little is known about how these laws affect providers. We investigated the experiences of abortion providers in North Carolina practicing under the 2011 Women’s Right to Know Act, which mandates that women receive counseling with specific, state-prescribed information at least 24 hours prior to an abortion. We focus here on a subset of the data to examine one strategy by which providers worked to minimize moral conflicts generated by the counseling procedure. Drawing on Erving Goffman’s work on language and social interaction, we highlight how providers communicated moral objections and layered meanings through a practice that we call prefacing the script. METHODS We conducted semi-structured interviews with 31 physicians, nurses, physician assistants, and clinic managers who provide abortion care in North Carolina. Audio-recorded interviews were transcribed verbatim and analyzed using an inductive, iterative analytic approach, which included reading for context, interpretive memo-writing, and focused coding. RESULTS Roughly half of the participants (14/31) reported that they or the clinicians who performed the counseling in their institution routinely prefaced the counseling script with qualifiers, disclaimers, and apologies that clarified their relationship to the state-mandated content. We identified three performative functions of this practice: 1) enacting a frame shift from a medical to a legal interaction, 2) distancing the speaker from the authorial voice of the counseling script, and 3) creating emotional alignment. CONCLUSIONS Prefacing state-mandated abortion counseling scripts constitutes a practical strategy providers use to balance the obligation to comply with state law with personal and professional responsibilities to provide tailored care, emotional support, and serve the patient’s best interests. Our findings suggest that language constitutes a powerful resource for navigating and minimizing moral conflicts in healthcare. PMID:27570793

Investigating Clinically and Scientifically Useful Cut Points on the Compulsive Sexual Behavior Inventory

PubMed Central

Miner, Michael H.; Raymond, Nancy; Coleman, Eli; Romine, Rebecca Swinburne

2017-01-01

Introduction One of the major obstacles to conducting epidemiological research and determining the incidence and prevalence of compulsive sexual behavior has been the lack of relevant, empirically derived cut points on the various instruments that have been used to measure the concept. Aim To further develop the Compulsive Sexual Behavior Inventory (CSBI) through exploring predictive validity and developing an empirically determined and clinically useful cut point for defining CSB. Methods A sample of 242 men who have sex with men was recruited from various sites in a moderate-size Midwestern city. Participants were assigned to a CSB group or a control group using an interview for the diagnosis that was patterned after the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. The 22-item CSBI was administered as part of a larger battery of self-report inventories. Main Outcome Measures ROC analyses were used to compute AUC measures to ascertain predictive validity of the total scale, the control subscale and the violence subscale. Cut-points were determined through consensus of experts balancing sensitivity and specificity as determined by ROC curves. Results Analyses indicated that the 22-item CSBI was a good predictor of group membership, as was the 13-item control subscale. The Violence subscale added little to the predictive accuracy of the instrument and thus, it likely measures something other than CSB. Two relevant cut points were found, one that minimized false negatives and another, more conservative cut-point that minimized false positives. Conclusion The CSBI as currently configured measures two different constructions and only the Control subscale is helpful in diagnosing CSB. We have, therefore, decided to eliminate the Violence subscale and move forward with a 13-item scale that we have named the CSBI-13. Two cut points were developed from this revised scale, one which is useful as a clinical screening and the other, more conservative measure useful for etiological and epidemiological research. PMID:28499521

Minimization of color shift generated in RGBW quad structure.

NASA Astrophysics Data System (ADS)

Kim, Hong Chul; Yun, Jae Kyeong; Baek, Heume-Il; Kim, Ki Duk; Oh, Eui Yeol; Chung, In Jae

2005-03-01

The purpose of RGBW Quad Structure Technology is to realize higher brightness than that of normal panel (RGB stripe structure) by adding white sub-pixel to existing RGB stripe structure. However, there is side effect called 'color shift' resulted from increasing brightness. This side effect degrades general color characteristics due to change of 'Hue', 'Brightness' and 'Saturation' as compared with existing RGB stripe structure. Especially, skin-tone colors show a tendency to get darker in contrast to normal panel. We"ve tried to minimize 'color shift' through use of LUT (Look Up Table) for linear arithmetic processing of input data, data bit expansion to 12-bit for minimizing arithmetic tolerance and brightness weight of white sub-pixel on each R, G, B pixel. The objective of this study is to minimize and keep Δu'v' value (we commonly use to represent a color difference), quantitative basis of color difference between RGB stripe structure and RGBW quad structure, below 0.01 level (existing 0.02 or higher) using Macbeth colorchecker that is general reference of color characteristics.

An examination of the association between interviewer question type and story-grammar detail in child witness interviews about abuse.

PubMed

Feltis, Brooke B; Powell, Martine B; Snow, Pamela C; Hughes-Scholes, Carolyn H

2010-06-01

This study compared the effects of open-ended versus specific questions, and various types of open-ended questions, in eliciting story-grammar detail in child abuse interviews. The sample included 34 police interviews with child witnesses aged 5-15 years (M age=9 years, 9 months). The interviewers' questions and their relative sub-types were classified according to definitions reported in the child interview training literature. The children's responses were classified according to the proportion of story grammar and the prevalence of individual story grammar elements as defined by Stein and Glenn (1979). Open-ended questions were more effective at eliciting story grammar than specific questions. This finding was revealed across three age groups, two interview phases and irrespective of how question effectiveness was measured. However, not all types of open-ended questions were equally effective. Open-ended questions that encouraged a broad response, or asked the child to elaborate on a part of their account, elicited more story-grammar detail compared to open-ended questions that requested clarification of concepts or descriptions of the next (or another) activity or detail within a sequence. This study demonstrates that children's ability to provide story-grammar detail is maximised when there is minimal prompting from the interviewer. Given the association between story grammar production and victim credibility, greater guidance is warranted in interviewer training programs in relation to the effects and administration of different types of open-ended questions. Copyright 2010 Elsevier Ltd. All rights reserved.

Qualitative Evaluation of the Coach Training within a Community Paramedicine Care Transitions Intervention.

PubMed

Lau, Hunter Singh; Hollander, Matthew M; Cushman, Jeremy T; DuGoff, Eva H; Jones, Courtney M C; Kind, Amy J H; Lohmeier, Michael T; Coleman, Eric A; Shah, Manish N

2018-02-12

The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition. This study forms part of an ongoing randomized controlled trial evaluating a community paramedic-implemented CTI to enhance the ED-to-home transition. The community paramedics' training covered the following domains: the CTI program, geriatrics, effective coaching, ED discharge processes, and community paramedicine. Sixteen months after starting the study, we conducted audio-recorded semi-structured interviews with community paramedics at both study sites. After transcribing the interviews, team members independently coded the transcripts. Ensuing group analysis sessions led to the development of final codes and identifying common themes. Finally, we conducted member checking to confirm our interpretations of the interview data. We interviewed all 8 participating community paramedics. Participants consisted solely of non-Hispanic whites, included 5 women, and had a mean age of 43. Participants had extensive backgrounds in healthcare, primarily as EMS providers, but minimal experience with community paramedicine. All reported some prior geriatrics training. Four themes emerged from the interviews: (1) paramedics with positive attitudes and willingness to acquire the needed knowledge and skills will succeed as CTI coaches; (2) active rather than passive learning is preferred by paramedics; (3) the existing training could benefit from adjustments such as added content on mental health, dementia, and substance abuse issues, as well as content on coaching subjects with a range of illness severity; and (4) continuing education should address the paramedic coaches' evolving needs as they develop proficiency with the CTI. Paramedics as CTI coaches represent an untapped resource for supporting ED-to-home care transitions. Our results provide the necessary first step to make the community paramedic CTI coach more successful. These findings may apply to training for similar community paramedicine roles, but additional research must investigate this possibility.

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

Bird, Lori; Cochran, Jaquelin; Wang, Xi

This report examines U.S. curtailment practices, with a particular emphasis on utilities in the Western states. The information presented here is based on a series of interviews conducted with utilities, system operators, wind energy developers, and non-governmental organizations. The report provides case studies of curtailment experience and examines the reasons for curtailment, curtailment procedures, compensation, and practices that can minimize curtailment.

"Something Is Wrong with My Child": A Phenomenological Account of a Search for a Diagnosis.

ERIC Educational Resources Information Center

Ahern, Kathy

2000-01-01

Notes children with movement difficulties do not receive neat diagnostic classification, as they have normal intelligence and minimal neurological signs. Details a study based on interviews of 11 parents of children with movement difficulties that revealed that parent involvement and knowledge is critical to acquiring professional attention.…

Chronically Ill Children: Divisions of Labor.

ERIC Educational Resources Information Center

Oremland, Evelyn K.

(A division of labor model was applied in a study of the efforts to minimize health crises and maximize benefits of medical protocols in eight families, each with a hemophilic school-age boy. Subject families were studied for a 5-year period through participant-observer techniques including interviews with the children in their homes, with the…

From Contests to Cocktail Parties: Strategies for Impromptu Speaking.

ERIC Educational Resources Information Center

Katchen, Johanna E.

Classroom techniques are offered for teaching students how to present a spontaneous (impromptu) speech in a second language, such as for use at a job interview or cocktail party. It is first suggested that such classroom activity be graded minimally to help lower students' level of apprehension. Then strategies for approaching impromptu speech…

Linking Research, Extension and Farmers: The Case of Mangrove Swamp Rice Cultivation in Sierra Leone.

ERIC Educational Resources Information Center

Zinnah, Moses Moroe

1994-01-01

Interviews with 124 rice farmers in Sierra Leone revealed that farmers and extension staff have minimal participation and input in testing of new cultivation technologies. The top-down research approach has limited contact among researchers, extension staff, and farmers and affected the utility and application of research. (SK)

Drug Usage and Health Characteristics in Non-Institutionalized Mexican-American Elderly.

ERIC Educational Resources Information Center

Vener, A. M.; And Others

1980-01-01

Results of in-depth interviews with 32 elderly Mexican Americans revealed minimal potential hazardous drug interactions. Mexican Americans showed a disinclination to utilize over-the-counter drugs to alleviate minor ailments. Professionals involved in health care delivery systems for the aging should become aware of the special needs of ethnic…

Television Violence: An Intervention to Reduce Its Impact on Children

ERIC Educational Resources Information Center

Rosenkoetter, Lawrence I.; Rosenkoetter, Sharon E.; Acock, Alan C.

2008-01-01

In an attempt to minimize the adverse effects of television violence, the authors implemented a classroom-based intervention with 496 children in 32 classrooms (grades 1 to 4). The intervention consisted of 28 brief lessons conducted by university staff over the course of 7 months. Participants were individually interviewed prior to the…

The Intellectual Disability Mortality Disadvantage: Diminishing with Age?

ERIC Educational Resources Information Center

Landes, Scott D.

2017-01-01

On average, adults with intellectual disability (ID) have higher mortality risk than their peers in the general population. However, the effect of age on this mortality disadvantage has received minimal attention. Using data from the 1986-2011 National Health Interview Survey-Linked Mortality Files (NHIS-LMF), discrete time hazard models were used…

Self-Disclosure in Male-Female Encounters.

ERIC Educational Resources Information Center

Pellegrini, Robert J.; And Others

Male and female subjects identified as very attractive or very unattractive worked in an interview-like situation with a listener of the opposite sex who was presented so as to maximize or minimize his or her natural attractiveness. Intimacy of self-disclosure was found to be significantly greater for females than for males, significantly greater…

Pragmatic, consensus-based minimum standards and structured interview to guide the selection and development of cancer support group leaders: a protocol paper.

PubMed

Pomery, Amanda; Schofield, Penelope; Xhilaga, Miranda; Gough, Karla

2017-06-30

Across the globe, peer support groups have emerged as a community-led approach to accessing support and connecting with others with cancer experiences. Little is known about qualities required to lead a peer support group or how to determine suitability for the role. Organisations providing assistance to cancer support groups and their leaders are currently operating independently, without a standard national framework or published guidelines. This protocol describes the methods that will be used to generate pragmatic consensus-based minimum standards and an accessible structured interview with user manual to guide the selection and development of cancer support group leaders. We will: (A) identify and collate peer-reviewed literature that describes qualities of support group leaders through a systematic review; (B) content analyse eligible documents for information relevant to requisite knowledge, skills and attributes of group leaders generally and specifically to cancer support groups; (C) use an online reactive Delphi method with an interdisciplinary panel of experts to produce a clear, suitable, relevant and appropriate structured interview comprising a set of agreed questions with behaviourally anchored rating scales; (D) produce a user manual to facilitate standard delivery of the structured interview; (E) pilot the structured interview to improve clinical utility; and (F) field test the structured interview to develop a rational scoring model and provide a summary of existing group leader qualities. The study is approved by the Department Human Ethics Advisory Group of The University of Melbourne. The study is based on voluntary participation and informed written consent, with participants able to withdraw at any time. The results will be disseminated at research conferences and peer review journals. Presentations and free access to the developed structured interview and user manual will be available to cancer agencies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Pragmatic, consensus-based minimum standards and structured interview to guide the selection and development of cancer support group leaders: a protocol paper

PubMed Central

Schofield, Penelope; Xhilaga, Miranda; Gough, Karla

2017-01-01

Introduction Across the globe, peer support groups have emerged as a community-led approach to accessing support and connecting with others with cancer experiences. Little is known about qualities required to lead a peer support group or how to determine suitability for the role. Organisations providing assistance to cancer support groups and their leaders are currently operating independently, without a standard national framework or published guidelines. This protocol describes the methods that will be used to generate pragmatic consensus-based minimum standards and an accessible structured interview with user manual to guide the selection and development of cancer support group leaders. Methods and analysis We will: (A) identify and collate peer-reviewed literature that describes qualities of support group leaders through a systematic review; (B) content analyse eligible documents for information relevant to requisite knowledge, skills and attributes of group leaders generally and specifically to cancer support groups; (C) use an online reactive Delphi method with an interdisciplinary panel of experts to produce a clear, suitable, relevant and appropriate structured interview comprising a set of agreed questions with behaviourally anchored rating scales; (D) produce a user manual to facilitate standard delivery of the structured interview; (E) pilot the structured interview to improve clinical utility; and (F) field test the structured interview to develop a rational scoring model and provide a summary of existing group leader qualities. Ethics and dissemination The study is approved by the Department Human Ethics Advisory Group of The University of Melbourne. The study is based on voluntary participation and informed written consent, with participants able to withdraw at any time. The results will be disseminated at research conferences and peer review journals. Presentations and free access to the developed structured interview and user manual will be available to cancer agencies. PMID:28667202

[The semi-structured interview: at the border of public health and anthropology].

PubMed

Imbert, Geneviève

2010-09-01

The interview is the tool for data collection the most used in the context of research conducted in health sciences, human sciences and social sciences. After completing some generalities about the different types of interviews, the focus is on semi-structured interview during its various stages including the processing and data analysis, this from the return of a lived experience of research in work on the border of the field of public health and that of anthropology. If this approach and contextualized the semistructured interview may a priori appear specific, the reader interested in the development of qualitative research in a humanistic perspective and the implementation of multidisciplinary strategies to ascertain its universal character.

Taking 'women's work' 'like a man': husbands' experiences of care work.

PubMed

Calasanti, Toni; King, Neal

2007-08-01

We adopted a feminist, structural approach to husbands' experiences of caring for wives with Alzheimer's disease. This framework posited that men and women draw upon gender repertoires-situational ideals of behavior based upon their respective structural locations-that create gendered experiences of stress and coping strategies. We used a qualitative, constructivist approach to analyze in-depth interviews with 22 spousal caregivers and observations within support groups. Our analysis focused on the nine husbands, the strategies these men reported using to deal with problems that arose in their care work, and the extent to which these are congruent with the masculinities of White men in the United States. We found that these husbands' approaches to caregiving and their strategies for dealing with the work and feelings involved were rooted in their sense of selves as men. We outline their overall approaches to caregiving, identify six strategies husbands used to deal with problems stemming from care work-exerting force, focusing on tasks, blocking emotions, minimizing disruption, distracting attention, and self-medicating-and tie these to their structural positions as working-, middle-, and professional-class men. Theories of gender differences in the performance or quality of care work should tie these to structural arrangements. Unless the gendered bases upon which different styles or experiences are removed (i.e., structural inequality), designers of interventions cannot and should not expect to use the experience of one group to inform appropriate strategies for the other.

Outcome-Based Practice: Disclosure Rates of Child Sexual Abuse Comparing Allegation Blind and Allegation Informed Structured Interviews.

ERIC Educational Resources Information Center

Cantlon, Julie; And Others

1996-01-01

This study evaluated the use of "allegation blind" interviews (in which interviewers did not know the specific allegation involved) with children (n=1535) suspected of being victims of child sexual abuse. The "allegation blind" interview technique yielded a statistically higher disclosure rate than the "allegation informed" interviews. (Author/DB)

Validation of a Brief Structured Interview: The Children’s Interview for Psychiatric Syndromes (ChIPS)

PubMed Central

Young, Matthew E.; Bell, Ziv E.; Fristad, Mary A.

2016-01-01

Evidence-based assessment is important in the treatment of childhood psychopathology (Jensen-Doss, 2011). While researchers and clinicians frequently use structured diagnostic interviews to ensure reliability, the most commonly used instrument, the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS; Kaufman et al., 1997), is too long for most clinical applications. The Children’s Interview for Psychiatric Syndromes, (ChIPS/P-ChIPS; Weller, Weller, Rooney, & Fristad, 1999a; 1999b) is a highly-structured brief diagnostic interview. The present study compared K-SADS and ChIPS/P-ChIPS diagnoses in an outpatient clinical sample of 50 parent-child pairs aged 7–14. Agreement between most diagnoses was moderate to high between instruments and with consensus clinical diagnoses. ChIPS was significantly briefer to administer than the K-SADS. Interviewer experience level and participant demographics did not appear to affect agreement. Results provide further evidence for the validity of the ChIPS and support its use in clinical and research settings. PMID:27761777

Minimal entropy approximation for cellular automata

NASA Astrophysics Data System (ADS)

Fukś, Henryk

2014-02-01

We present a method for the construction of approximate orbits of measures under the action of cellular automata which is complementary to the local structure theory. The local structure theory is based on the idea of Bayesian extension, that is, construction of a probability measure consistent with given block probabilities and maximizing entropy. If instead of maximizing entropy one minimizes it, one can develop another method for the construction of approximate orbits, at the heart of which is the iteration of finite-dimensional maps, called minimal entropy maps. We present numerical evidence that the minimal entropy approximation sometimes outperforms the local structure theory in characterizing the properties of cellular automata. The density response curve for elementary CA rule 26 is used to illustrate this claim.

Primary health care teams and the patient perspective: a social network analysis.

PubMed

Cheong, Lynn H M; Armour, Carol L; Bosnic-Anticevich, Sinthia Z

2013-01-01

Multidisciplinary care (MDC) has been proposed as a potential strategy to address the rising challenges of modern health issues. However, it remains unclear as to how patients' health connections may impact on multidisciplinary processes and outcomes. This research aims to gain a deeper understanding of patients' potential role in MDC: i) describe patients' health networks, ii) compare different care groups, iii) gain an understanding of the nature and extent of their interactions, and iv) identify the role of pharmacists within patient networks. In-depth, semi-structured interviews were conducted with asthma patients from Sydney, Australia. Participants were recruited from a range of standard asthma health care access points (community group) and a specialized multidisciplinary asthma clinic (clinic group). Quantitative social network analysis provided structural insight into asthma networks while qualitative social network analysis assisted in interpretation of network data. A total of 47 interviews were conducted (26 community group participants and 21 clinic group participants). Although participants' asthma networks consisted of a range of health care professionals (HCPs), these did not reflect or encourage MDC. Not only did participants favor minimal interaction with any HCP, they preferred sole-charge care and were found to strongly rely on lay individuals such as family and friends. While general practitioners and respiratory specialists were participants' principal choice of HCP, community pharmacists were less regarded. Limited opportunities were presented for HCPs to collaborate, particularly pharmacists. As patients' choices of HCPs may strongly influence collaborative processes and outcomes, this research highlights the need to consider patient perspectives in the development of MDC models in primary care. Copyright © 2013 Elsevier Inc. All rights reserved.

Within-prison drug injection among HIV-infected male prisoners in Indonesia: a highly constrained choice.

PubMed

Culbert, Gabriel J; Waluyo, Agung; Iriyanti, Mariska; Muchransyah, Azalia P; Kamarulzaman, Adeeba; Altice, Frederick L

2015-04-01

In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released. This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia. 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory. Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥ 10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR = 3.29, 95%CI = 1.30-8.31, p = 0.011) and daily drug injection before arrest (AOR = 5.23, 95%CI = 1.42-19.25, p = 0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment. Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Within-Prison Drug Injection among HIV-infected Male Prisoners in Indonesia: A Highly Constrained Choice

PubMed Central

Culbert, Gabriel J.; Waluyo, Agung; Iriyanti, Mariska; Muchransyah, Azalia P.; Kamarulzaman, Adeeba; Altice, Frederick L.

2016-01-01

Background In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released. Aims This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia. Methods 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory. Results Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR=3.29, 95%CI=1.30–8.31, p=0.011) and daily drug injection before arrest (AOR=5.23, 95%CI=1.42–19.25, p=0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment. Conclusions Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm. PMID:25659895

Tubal Ligation in Catholic Hospitals: A Qualitative Study of Ob-Gyns’ Experiences

PubMed Central

Stulberg, Debra B.; Hoffman, Yael; Dahlquist, Irma Hasham; Freedman, Lori R.

2014-01-01

Objective Tubal sterilization remains one of the most commonly requested contraceptive methods in the United States. Catholic hospital policy prohibits all sterilizations, but this ban is not uniformly enforced. We conducted this study to assess obstetrician-gynecologists’ beliefs and experiences with tubal ligation in Catholic hospitals. Study Design We interviewed 31 obstetrician-gynecologists geographically dispersed throughout the U.S. who responded to a national survey and agreed to be contacted for a follow-up interview or who were referred by colleagues from the survey sample. Twenty-seven had experienced working in a Catholic hospital. Interviews were open-ended and guided by a semi-structured instrument. Transcripts were thematically analyzed. Results Obstetrician-gynecologists disagreed with strict prohibition of sterilizations, especially when denying a tubal ligation placed the patient at increased medical risk. Cesarean delivery in Catholic hospitals raised frustration for obstetrician-gynecologists when the hospital prohibited a simultaneous tubal ligation and, thus, sent the patient for an unnecessary subsequent surgery. Obstetrician-gynecologists described some hospitals allowing tubal ligations in limited circumstances, but these workarounds were vulnerable to changes in enforcement. Some obstetrician-gynecologists reported that Catholic policy posed greater barriers for low-income patients and those with insurance restrictions. Conclusion Obstetrician-gynecologists working in Catholic hospitals in this study did not share the Church’s beliefs on sterilization. Research to understand patients’ experiences and knowledge of their sterilization options is warranted in order to promote women’s autonomy and minimize risk of harm. Implications Statement Tubal sterilization, even when medically indicated or in conjunction with cesarean delivery, is severely restricted for women delivering in Catholic hospitals. For women whose only access to hospital care is at a Catholic institution, religious policies can prevent them from receiving a desired sterilization and place them at risk for future undesired pregnancy. PMID:24912729

Engaging Stakeholders in Patient-Centered Outcomes Research Regarding School-Based Sealant Programs.

PubMed

Chi, Donald L; Milgrom, Peter; Gillette, Jane

2018-02-01

Purpose: The purpose of this study was to use qualitative methods to describe the key lessons learned during the stakeholder engagement stage of planning a randomized clinical trial comparing outcomes of silver diamine fluoride (SDF) as an alternative to pit-and-fissure sealants in a school-based delivery system. Methods: Eighteen caregivers and community-based stakeholders with involvement in the school-based sealant program Sealants for Smiles from the state of Montana, were recruited for this qualitative study. United States (U.S.) Patient-Centered Outcomes Research Institute (PCORI) methodology standards were used to develop two semi-structured interview guides consisting of 6 questions. One interview guide was used for telephone interviews with caregivers and the second was used for a stakeholder focus group. Content analytic methods were used to analyze the data. Results: All participants believed that a study comparing SDF and sealants was clinically relevant. Non-caregiver stakeholders agreed with the proposed primary outcome of the study (caries prevention) whereas caregivers also emphasized the importance of child-centered outcomes such as minimizing dental anxiety associated with dental care. Stakeholders described potential concerns associated with SDF such as staining and perceptions of safety and discussed ways to address these concerns through community engagement, appropriate framing of the study, proper consent procedures, and ongoing safety monitoring during the trial. Finally, stakeholders suggested dissemination strategies such as direct communication of findings through professional organizations and encouraging insurance plans to incentivize SDF use by reimbursing dental providers. Conclusions: Involving key stakeholders in early planning is essential in developing patient-centered research questions, outcomes measures, study protocols, and dissemination plans for oral health research involving a school-based delivery system. Copyright © 2018 The American Dental Hygienists’ Association.

Change in life satisfaction of adults with pediatric-onset spinal cord injury.

PubMed

Chen, Yuying; Anderson, Caroline J; Vogel, Lawrence C; Chlan, Kathleen M; Betz, Randal R; McDonald, Craig M

2008-12-01

To examine the change in life satisfaction over time and potential contributing factors among adults with pediatric-onset spinal cord injury (SCI). Prospective dynamic cohort study. Community. Individuals who sustained a SCI before age 19 years (N=278) were initially interviewed at age 24 years or older and followed on an annual basis between 1996 and 2006. Not applicable. A structured telephone interview was conducted to obtain the measures of Satisfaction with Life Scale (SWLS), physical independence, participation, and psychologic functioning. The hierarchical linear modeling was performed to characterize individual person-specific time paths and estimate the average rate of change in SWLS over time. A total of 1171 interviews were conducted among 184 men and 94 women (89% white; baseline age, 27.1+/-3.4 y; baseline years since injury, 12.8+/-4.9). The initial SWLS score averaged 24.2 and was estimated to increase by 0.14 a year (P=.10). After adjusting for potential confounding factors, the overall life satisfaction was significantly higher for women and those who were married/living with a partner; were employed/students; did not use illicit drugs; and scored high in the FIM, the mental health component of the Short Form-12, and the social integration subscale of the Craig Handicap Assessment and Reporting Technique. The rate of change in life satisfaction did not differ significantly by any personal, medical, and psychosocial characteristics under investigation. The study findings suggest that people who feel unsatisfied with life initially are likely to stay unsatisfied over time if the critical determinant factors remain unchanged in their life. To minimize the risk of decreasing life satisfaction, several modifiable risk factors identified in the present study could be targeted for intervention.

Sustaining a quality improvement culture in local health departments applying for accreditation.

PubMed

Verma, Pooja; Moran, John W

2014-01-01

This article focuses on local health departments (LHDs) that are advanced in accreditation and quality improvement (QI) efforts and the barriers and facilitators associated with sustaining improvements and building an organizational culture of QI. To understand the barriers and facilitators associated with building and sustaining progress toward a QI culture in LHDs. Quantitative data from a self-reporting survey and qualitative data from telephone interviews. Twenty-two LHDs across the United States responded to the survey. Ten of the 22 LHD respondents participated in telephone interviews. QI lead staff at LHDs that are advanced in accreditation preparation and QI. Self-reported LHD survey ratings against indicators for a QI culture, and the identified barriers and facilitators around sustaining QI initiatives. Of the 6 domains of a QI culture measured in the survey, the percentages of respondents that scored themselves highly to at least 1 indicator in each domain are as follows: leadership commitment (100%); employee empowerment (100%); teamwork and collaboration (100%); continuous process improvement (86%); customer focus (72%); and QI infrastructure (64%). Qualitative data from 10 telephone interviews revealed that key barriers to sustaining progress around QI included staff turnover, budget cuts, and major crises or events that arise as priority. Key facilitators included leadership commitment, accreditation, and dedication of resources and staff time to QI. When engaging in QI, LHDs should consider investing efforts in gaining leadership support and dedicating staff time early in the QI journey to ensure that QI efforts and initiatives are sustained. Local health departments interested in developing a QI culture should also consider pursuing accreditation, as it provides a structured framework for continuous improvement. They should also actively develop QI knowledge and skills among all staff members to minimize the negative impact of staff turnover.

75 FR 69674 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... following data collections will be implemented: (1) Semi-structured interviews will be conducted in-person... pre- and postimplementation interviews will be conducted and separate interview guides will be used for staff and leaders. Pre-implementation, the interviews will focus on current knowledge, attitudes...

The use of impression management tactics in structured interviews: a function of question type?

PubMed

Ellis, Aleksander P J; West, Bradley J; Ryan, Ann Marie; DeShon, Richard P

2002-12-01

This study investigated impression management tactic use during structured interviews containing both experience-based and situational questions. Specifically, the authors examined whether applicants' use of impression management tactics depended on question type. Results from 119 structured interviews indicated that almost all of the applicants used some form of impression management. Significantly more assertive than defensive impression management tactics were used, and among assertive tactics, applicants tended to use self-promotion rather than ingratiation. However, different question types prompted the use of different impression management tactics. Ingratiation tactics were used significantly more when applicants answered situational questions, whereas self-promotion tactics were used significantly more when applicants answered experience-based questions. Furthermore, the use of self-promotion and ingratiation tactics was positively related to interviewer evaluations.

The Multidimensional Aggression Scale for the Structured Doll Play Interview

ERIC Educational Resources Information Center

Abramson, Paul R.; And Others

1974-01-01

A multidimensional aggression scoring system for preschool children's responses to the structured doll play interview is described. The system, which incorporates previous investigator's findings, scales doll play responses along three dimensions of aggression: intensity, agent, and directionality. (Author)

Survey of Micro Enterprise.

ERIC Educational Resources Information Center

European Social Fund, Dublin (Ireland).

Government support of microenterprise/entrepreneurship in Ireland was examined through structured interviews with 81 of 120 microentrepreneurs (68% response rate) identified as clients of local enterprise support agencies and/or completers of enterprise training and structured interviews with representatives of 25 local, voluntary, and private…

Diagnostic Efficiency among Psychiatric Outpatients of a Self-Report Version of a Subset of Screen Items of the Structured Clinical Interview for DSM-IV-TR Personality Disorders (SCID-II)

ERIC Educational Resources Information Center

Germans, Sara; Van Heck, Guus L.; Masthoff, Erik D.; Trompenaars, Fons J. W. M.; Hodiamont, Paul P. G.

2010-01-01

This article describes the identification of a 10-item set of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) items, which proved to be effective as a self-report assessment instrument in screening personality disorders. The item selection was based on the retrospective analyses of 495 SCID-II interviews. The…

A Cognitive Task Analysis of Information Management Strategies in a Computerized Provider Order Entry Environment

PubMed Central

Weir, Charlene R.; Nebeker, Jonathan J.R.; Hicken, Bret L.; Campo, Rebecca; Drews, Frank; LeBar, Beth

2007-01-01

Objective Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Design Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Measurements Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Results Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Conclusion Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system. PMID:17068345

Parents’ experiences of participating in an intervention on tobacco prevention in Child Health Care

PubMed Central

2014-01-01

Background Child health care is an important arena for tobacco prevention in Sweden. The aim of this study was to describe parents’ experiences from participating in a nursebased tobacco prevention intervention. Methods Eleven parents were interviewed using semi-structured interviews. The material was analysed in a qualitative content analysis process. Results The analysis emerged four categories; Receiving support, Respectful treatment, Influence on smoking habits and Receiving information. The parents described how the CHC nurses treated them with support and respect. They described the importance of being treated with respect for their autonomy in their decisions about smoking. They also claimed that they had received little or no information about health consequences for children exposed to environmental tobacco smoke (ETS). The findings also indicate that both the questionnaire used and the urine-cotinine test had influenced parents’ smoking. Conclusion The clinical implication is that CHC is an important arena for preventive work aiming to minimize children’s tobacco smoke exposure. CHC nurses can play an important role in tobacco prevention but should be more explicit in their communication with parents about tobacco issues. The SiCET was referred to as an eye-opener and can be useful in the MI dialogues nurses perform in order to support parents in their efforts to protect their children from ETS. PMID:24612749

Limited clinical reasoning skills used by novice physiotherapists when involved in the assessment and management of patients with shoulder problems: a qualitative study

PubMed Central

May, Stephen; Withers, Sarah; Reeve, Sarah; Greasley, Alison

2010-01-01

The aim of this study was to explore the clinical reasoning process used by novice physical therapists in specific patient problems. Nine physical therapists in the UK with limited experience of managing musculoskeletal problems were included. Semi-structured interviews were conducted on how novice physical therapists would assess and manage a patient with a shoulder problem; interviews were transcribed and analyzed using framework analysis. To be included as a final theme at least 50% of participants had to mention that theme. A large number of items (n = 93) were excluded as fewer than 50% of participants referred to each item. Included items related to seven main themes: history (16), physical exam (13), investigations (1), diagnostic reasoning (1), clinical reasoning process (diagnostic pathway) (3), clinical reasoning process (management pathway) (5) and treatment options (1). Items mostly related to information gathering, although there was some use of hypothetico-deductive clinical reasoning there appeared to be limited understanding of the clinical implications of data gathered, and clinical reasoning through use of pattern recognition was minimal. Major weaknesses were apparent in the clinical reasoning skills of these novice therapists compared to previous reports of expert clinical reasoning, indicating areas for development in the education of student and junior physical therapists. PMID:21655390

Negotiating identity and self-image: perceptions of falls in ambulatory individuals with spinal cord injury - a qualitative study.

PubMed

Jørgensen, Vivien; Roaldsen, Kirsti Skavberg

2017-04-01

Explore and describe experiences and perceptions of falls, risk of falling, and fall-related consequences in individuals with incomplete spinal cord injury (SCI) who are still walking. A qualitative interview study applying interpretive content analysis with an inductive approach. Specialized rehabilitation hospital. A purposeful sample of 15 individuals (10 men), 23 to 78 years old, 2-34 years post injury with chronic incomplete traumatic SCI, and walking ⩾75% of time for mobility needs. Individual, semi-structured face-to-face interviews were recorded, condensed, and coded to find themes and subthemes. One overarching theme was revealed: "Falling challenges identity and self-image as normal" which comprised two main themes "Walking with incomplete SCI involves minimizing fall risk and fall-related concerns without compromising identity as normal" and "Walking with incomplete SCI implies willingness to increase fall risk in order to maintain identity as normal". Informants were aware of their increased fall risk and took precautions, but willingly exposed themselves to risky situations when important to self-identity. All informants expressed some conditional fall-related concerns, and a few experienced concerns limiting activity and participation. Ambulatory individuals with incomplete SCI considered falls to be a part of life. However, falls interfered with the informants' identities and self-images as normal, healthy, and well-functioning. A few expressed dysfunctional concerns about falling, and interventions should target these.

The ELPAT living organ donor Psychosocial Assessment Tool (EPAT): from 'what' to 'how' of psychosocial screening - a pilot study.

PubMed

Massey, Emma K; Timmerman, Lotte; Ismail, Sohal Y; Duerinckx, Nathalie; Lopes, Alice; Maple, Hannah; Mega, Inês; Papachristou, Christina; Dobbels, Fabienne

2018-01-01

Thorough psychosocial screening of donor candidates is required in order to minimize potential negative consequences and to strive for optimal safety within living donation programmes. We aimed to develop an evidence-based tool to standardize the psychosocial screening process. Key concepts of psychosocial screening were used to structure our tool: motivation and decision-making, personal resources, psychopathology, social resources, ethical and legal factors and information and risk processing. We (i) discussed how each item per concept could be measured, (ii) reviewed and rated available validated tools, (iii) where necessary developed new items, (iv) assessed content validity and (v) pilot-tested the new items. The resulting ELPAT living organ donor Psychosocial Assessment Tool (EPAT) consists of a selection of validated questionnaires (28 items in total), a semi-structured interview (43 questions) and a Red Flag Checklist. We outline optimal procedures and conditions for implementing this tool. The EPAT and user manual are available from the authors. Use of this tool will standardize the psychosocial screening procedure ensuring that no psychosocial issues are overlooked and ensure that comparable selection criteria are used and facilitate generation of comparable psychosocial data on living donor candidates. © 2017 Steunstichting ESOT.

Work reality perceived by individuals with impairments: a biopsychosocial experience.

PubMed

Coelho, Cecília Martins; Sampaio, Rosana Ferreira; Luz, Madel Therezinha; Mancini, Marisa Cotta

2013-01-01

Individuals with different impairments are working in the formal and/or informal market despite physical and attitudinal barriers. To date, few studies have addressed this situation from the perspective of the individuals. Apprehend factors that restrict work performance in the perspective of workers with impairments and identify the strategies employed and the difficulties faced. Individuals with impairment who exercised paid activities. Thirty semi-structured interviews and eleven observations of individuals in work activities. Limitations stemming from participants' disability and health status had an influence over their execution of tasks, but did not compromise work performance. Environmental factors that impacted as facilitators or barriers were: lack of preparation of colleagues, employers, education and rehabilitation systems; attitudes and coexistence; accessibility, implementation of land use policies, urban structures and transportation; products and technology; and distributive policies. Personal factors (upbringing, self-esteem, good mood, outgoingness, communicability, willpower, age and how the disability was acquired) also influenced participation at work. Important strategies included recognizing and sharing capabilities and needs, which minimized or eliminated difficulties at work. Workers with impairments developed effective strategies for dealing with adverse situations, which remained in the individual realm. Working with impairments is a complex experience that demands overcoming old paradigms.

Minimally Invasive Dentistry

MedlinePlus

... geta poker friv Home InfoBites Find an AGD Dentist Your Family's Oral Health About the AGD Dental ... structure. It focuses on prevention, remineralization, and minimal dentist intervention. Using scientific advances, minimally invasive dentistry allows ...

Patients' values and preferences of the expected efficacy of hip arthroscopy for osteoarthritis: a protocol for a multinational structured interview-based study combined with a randomised survey on the optimal amount of information to elicit preferences.

PubMed

Zhang, Yuqing; Tikkinen, Kari A O; Agoritsas, Thomas; Ayeni, Olufemi R; Alexander, Paul; Imam, Maha; Yoo, Daniel; Tsalatsanis, Athanasios; Djulbegovic, Benjamin; Thabane, Lehana; Schünemann, Holger; Guyatt, Gordon H

2014-10-17

Symptomatic hip osteoarthritis (OA) is a disabling condition with up to a 25% cumulative lifetime risk. Total hip arthroplasty (THA) is effective in relieving patients' symptoms and improving function. It is, however, associated with substantial risk of complications, pain and major functional limitation before patients can return to full function. In contrast, hip arthroscopy (HA) is less invasive and can postpone THA. However, there is no evidence regarding the delay in the need for THA that patients would find acceptable to undergoing HA. Knowing patients' values and preferences (VP) on this expected delay is critical when making recommendations regarding the advisability of HA. Furthermore, little is known on the optimal amount of information regarding interventions and outcomes needed to present in order to optimally elicit patients' VP. We will perform a multinational, structured interview-based survey of preference in delay time for THA among patients with non-advanced OA who failed to respond to conservative therapy. We will combine these interviews with a randomised trial addressing the optimal amount of information regarding the interventions and outcomes required to elicit preferences. Eligible patients will be randomly assigned (1 : 1) to either a short or a long format of health scenarios of THA and HA. We will determine each patient's VP using a trade-off and anticipated regret exercises. Our primary outcomes for the combined surveys will be: (1) the minimal delay time in the need for THA surgery that patients would find acceptable to undertaking HA, (2) patients' satisfaction with the amount of information provided in the health scenarios used to elicit their VPs. The protocol has been approved by the Hamilton Integrated Research Ethics Board (HIREB13-506). We will disseminate our study findings through peer-reviewed publications and conference presentations, and make them available to guideline makers issuing recommendations addressing HA and THA. 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.

Patients’ values and preferences of the expected efficacy of hip arthroscopy for osteoarthritis: a protocol for a multinational structured interview-based study combined with a randomised survey on the optimal amount of information to elicit preferences

PubMed Central

Zhang, Yuqing; Tikkinen, Kari A O; Agoritsas, Thomas; Ayeni, Olufemi R; Alexander, Paul; Imam, Maha; Yoo, Daniel; Tsalatsanis, Athanasios; Djulbegovic, Benjamin; Thabane, Lehana; Schünemann, Holger; Guyatt, Gordon H

2014-01-01

Introduction Symptomatic hip osteoarthritis (OA) is a disabling condition with up to a 25% cumulative lifetime risk. Total hip arthroplasty (THA) is effective in relieving patients’ symptoms and improving function. It is, however, associated with substantial risk of complications, pain and major functional limitation before patients can return to full function. In contrast, hip arthroscopy (HA) is less invasive and can postpone THA. However, there is no evidence regarding the delay in the need for THA that patients would find acceptable to undergoing HA. Knowing patients’ values and preferences (VP) on this expected delay is critical when making recommendations regarding the advisability of HA. Furthermore, little is known on the optimal amount of information regarding interventions and outcomes needed to present in order to optimally elicit patients’ VP. Methods and analysis We will perform a multinational, structured interview-based survey of preference in delay time for THA among patients with non-advanced OA who failed to respond to conservative therapy. We will combine these interviews with a randomised trial addressing the optimal amount of information regarding the interventions and outcomes required to elicit preferences. Eligible patients will be randomly assigned (1 : 1) to either a short or a long format of health scenarios of THA and HA. We will determine each patient's VP using a trade-off and anticipated regret exercises. Our primary outcomes for the combined surveys will be: (1) the minimal delay time in the need for THA surgery that patients would find acceptable to undertaking HA, (2) patients’ satisfaction with the amount of information provided in the health scenarios used to elicit their VPs. Ethics and dissemination The protocol has been approved by the Hamilton Integrated Research Ethics Board (HIREB13-506). We will disseminate our study findings through peer-reviewed publications and conference presentations, and make them available to guideline makers issuing recommendations addressing HA and THA. PMID:25326208

Telephone-based Assessments to Minimize Missing Data in Longitudinal Depression Trials: A Project IMPACTS Study Report

PubMed Central

Claassen, Cindy; Kurian, Ben; Trivedi, Madhukar H.; Grannemann, Bruce D.; Tuli, Ekta; Pipes, Ronny; Preston, Anne Marie; Flood, Ariell

2012-01-01

Purpose Missing data in clinical efficacy and effectiveness trials continue to be a major threat to the validity of study findings. The purpose of this report is to describe methods developed to ensure completion of outcome assessments with public mental health sector subjects participating in a longitudinal, repeated measures study for the treatment of major depressive disorder. We developed longitudinal assessment procedures that included telephone-based clinician interviews in order to minimize missing data commonly encountered with face-to-face assessment procedures. Methods A pre-planned, multi-step strategy was developed to ensure completeness of data collection. The procedure included obtaining multiple pieces of patient contact information at baseline, careful education of both staff and patients concerning the purpose of assessments, establishing good patient rapport, and finally being flexible and persistent with phone appointments to ensure the completion of telephone-based follow-up assessments. A well-developed administrative and organizational structure was also put in place prior to study implementation. Results The assessment completion rate for the primary outcome for 310 of 504 subjects who enrolled and completed 52 weeks (at the time of manuscript) of telephone-based follow-up assessments was 96.8%. Conclusion By utilizing telephone-based follow-up procedures and adapting our easy-to-use pre-defined multi-step approach, researchers can maximize patient data retention in longitudinal studies. PMID:18761427

Physical Activity in the Life of a Woman with Cerebral Palsy: Physiotherapy, Social Exclusion, Competence, and Intimacy

ERIC Educational Resources Information Center

Gaskin, Cadeyrn J.; Andersen, Mark B.; Morris, Tony

2012-01-01

Although physical activity can have substantial mental and physical health benefits, people with cerebral palsy usually lead sedentary lives. To understand, at an individual level, this inactivity, we interviewed a 29-year-old minimally active woman with cerebral palsy (Alana) about the meanings and experiences of physical activity throughout her…

Debt-Repaying Mechanism in Chinese Relationships: An Exploration of the Folk Concepts of "Pao" and Human Emotional Debt.

ERIC Educational Resources Information Center

Chang, Hui-Ching; Holt, G. Richard

1994-01-01

Explores the mechanisms of "pao" and human emotional debt underlying Chinese human relationships through interviews with 55 Chinese in Taiwan. The definition, recompensation, minimization, and manipulation of human emotional debt and the linguistic code by which relations can be made closer or more distant following the principles of…

Learning Together with Parents of Children with Disabilities: Bringing Parent-Professional Partnership Education to a New Level

ERIC Educational Resources Information Center

Murray, Mary M.; Curran, Erin M.

2008-01-01

Parent/professional partnerships have been credited with improving outcomes for children and enhancing satisfaction for both parents and professionals. Family involvement in preservice programs is minimal and often limited to parent panels or parent involvement in a class activity such as an interview. Preservice students who have had multiple…

Analysis of the Special Studies Program Based on the Interviews of Its Students.

ERIC Educational Resources Information Center

Esp, Barbarann; Torelli, Alexis

The special studies program at Hofstra University is designed for high school graduates applying to the university whose educational backgrounds require a more personalized approach to introductory college work. An attempt is made to minimize the risk of poor academic performance during the first year in college. A random sample of 24 students in…

Body Disfigurement and the Quality of Life of Adolescents with Pectus Excavatum: Effects of the Nuss Procedure

ERIC Educational Resources Information Center

Roberts, Jillian; MacMath, Sheryl; English, Margot; Martin, Joan; Hayashi, Al; Sigalet, David L.

2006-01-01

This article takes a comprehensive look at the effects of pectus excavatum, a congenital deformity with psychosocial and physical ramifications, and the Nuss procedure on the quality of life of adolescents. The Nuss procedure is a minimally invasive corrective surgery. Twenty-five participants from Calgary, Alberta were interviewed (10 adolescents…

FUNDAMENTALS LEARNING LABORATORIES IN INDUSTRIAL EDUCATION CENTERS, TECHNICAL INSTITUTES AND COMMUNITY COLLEGES IN NORTH CAROLINA.

ERIC Educational Resources Information Center

MARTIN, WALTER TRAVIS, JR.

IN 1964, NORTH CAROLINA ESTABLISHED A SYSTEM OF "FUNDAMENTALS LEARNING LABORATORIES" WHERE ADULTS MIGHT OBTAIN PROGRAMED SELF-INSTRUCTION AT MINIMAL COST (A $2.00 REGISTRATION FEE). IN A DESCRIPTIVE STUDY OF THE 17 LABORATORIES OPERATING IN 1965, DATA WERE GATHERED BY QUESTIONNAIRES AND INTERVIEWS. FINDINGS INCLUDED THE FOLLOWING-- (1)…

A Qualitative Inquiry of the Roles, Responsibilities, and Relationships within Work-Based Learning Supervision

ERIC Educational Resources Information Center

Kenny, Maureen E.; Medvide, Mary Beth; Minor, Kelly A.; Walsh-Blair, Lynn Y.; Bempechat, Janine; Seltzer, Joanne M. Ruane; Blustein, David L.

2015-01-01

Although meaningful work experience and the support of caring adults are recognized as factors that promote positive youth development, research has given minimal attention to the role of the work-based learning (WBL) supervisor. Interviews with 12 supervisors, from work sites that were identified as successful by leaders from a Catholic high…

Enhancing Student Experiential Learning with Structured Interviews

ERIC Educational Resources Information Center

Cornell, Robert M.; Johnson, Carol B.; Schwartz, William C., Jr.

2013-01-01

Learning through experience can be rewarding but intimidating. To maximize the benefits of experiential learning assignments, students need to have confidence in their abilities. The authors report how a structured-interview instrument effectively facilitated experiential learning for accounting students without extensive content-specific…

The role of the medical provider in the evaluation of sexually abused children and adolescents.

PubMed

Newton, Alice Whittier; Vandeven, Andrea Marie

2010-11-01

It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles of the physician and nurse have changed. In the United States, current practice often uses a multidisciplinary assessment involving skilled forensic interviewing of the child and a medical examination done by a medical provider with specialized training in sexual abuse. In order to minimize child interviews, these assessments are frequently held in settings such as child advocacy centers, where forensic interviewers and medical clinicians, child protective service workers, and police and district attorneys can work jointly to address the legal and protective issues in a coordinated fashion.

The Clinical Interview and the Measurement of Conceptual Change.

ERIC Educational Resources Information Center

Posner, George J.; Gertzog, William A.

1982-01-01

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

Interviewing Youthful Suspects in Alleged Sex Crimes: A Descriptive Analysis

ERIC Educational Resources Information Center

Hershkowitz, Irit; Horowitz, Dvora; Lamb, Michael E.; Orbach, Yael; Sternberg, Kathleen J.

2004-01-01

Objective: To introduce and evaluate a structured interview protocol designed for investigative interviews of youthful alleged perpetrators of child sexual abuse. Method: Seventy-two alleged perpetrators ranging from 9 to 14 years of age (M=12 years) were interviewed by 1 of 13 experienced youth investigators, employed by the Israeli Ministry of…

Experimental validation of structural optimization methods

NASA Technical Reports Server (NTRS)

Adelman, Howard M.

1992-01-01

The topic of validating structural optimization methods by use of experimental results is addressed. The need for validating the methods as a way of effecting a greater and an accelerated acceptance of formal optimization methods by practicing engineering designers is described. The range of validation strategies is defined which includes comparison of optimization results with more traditional design approaches, establishing the accuracy of analyses used, and finally experimental validation of the optimization results. Examples of the use of experimental results to validate optimization techniques are described. The examples include experimental validation of the following: optimum design of a trussed beam; combined control-structure design of a cable-supported beam simulating an actively controlled space structure; minimum weight design of a beam with frequency constraints; minimization of the vibration response of helicopter rotor blade; minimum weight design of a turbine blade disk; aeroelastic optimization of an aircraft vertical fin; airfoil shape optimization for drag minimization; optimization of the shape of a hole in a plate for stress minimization; optimization to minimize beam dynamic response; and structural optimization of a low vibration helicopter rotor.

Enzyme-adenylate structure of a bacterial ATP-dependent DNA ligase with a minimized DNA-binding surface.

PubMed

Williamson, Adele; Rothweiler, Ulli; Leiros, Hanna Kirsti Schrøder

2014-11-01

DNA ligases are a structurally diverse class of enzymes which share a common catalytic core and seal breaks in the phosphodiester backbone of double-stranded DNA via an adenylated intermediate. Here, the structure and activity of a recombinantly produced ATP-dependent DNA ligase from the bacterium Psychromonas sp. strain SP041 is described. This minimal-type ligase, like its close homologues, is able to ligate singly nicked double-stranded DNA with high efficiency and to join cohesive-ended and blunt-ended substrates to a more limited extent. The 1.65 Å resolution crystal structure of the enzyme-adenylate complex reveals no unstructured loops or segments, and suggests that this enzyme binds the DNA without requiring full encirclement of the DNA duplex. This is in contrast to previously characterized minimal DNA ligases from viruses, which use flexible loop regions for DNA interaction. The Psychromonas sp. enzyme is the first structure available for the minimal type of bacterial DNA ligases and is the smallest DNA ligase to be crystallized to date.

Male genital trauma

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

Jordan, G.H.; Gilbert, D.A.

1988-07-01

We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disablingmore » chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. 38 references.« less

Improving Junior Infantry Officer Leader Development and Performance

DTIC Science & Technology

2017-06-09

researcher used a qualitative literature review and semi-structured interview methodology to analyze Army leadership theories and leader development...researcher used a qualitative literature review and semi-structured interview methodology to analyze Army leadership theories and leader development...CHAPTER 3 RESEARCH METHODOLOGY ..............................................................132 CHAPTER 4 QUALITATIVE ANALYSIS

The "Suicide Guard Rail": a minimal structural intervention in hospitals reduces suicide jumps.

PubMed

Mohl, Andreas; Stulz, Niklaus; Martin, Andrea; Eigenmann, Franz; Hepp, Urs; Hüsler, Jürg; Beer, Jürg H

2012-08-04

Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital's windows, a metal guard rail was installed at each window of the high-rise building. In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital's windows occurred among 119,269 inpatients. This figure was significantly reduced to 2 fatal incidents among 104,435 inpatients treated during the 78 months immediately following the installation of the rails at the hospital's windows (χ2 = 4.34, df = 1, p = .037). Even a minimal structural intervention might prevent suicide jumps in a general hospital. Further work is needed to examine the effectiveness of minimal structural interventions in preventing suicide jumps.

The “Suicide Guard Rail”: a minimal structural intervention in hospitals reduces suicide jumps

PubMed Central

2012-01-01

Background Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital’s windows, a metal guard rail was installed at each window of the high-rise building. Results In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital’s windows occurred among 119,269 inpatients. This figure was significantly reduced to 2 fatal incidents among 104,435 inpatients treated during the 78 months immediately following the installation of the rails at the hospital’s windows (χ2 = 4.34, df = 1, p = .037). Conclusions Even a minimal structural intervention might prevent suicide jumps in a general hospital. Further work is needed to examine the effectiveness of minimal structural interventions in preventing suicide jumps. PMID:22862804

Views of Classroom Teachers Concerning Students with Reading Difficulties

ERIC Educational Resources Information Center

Kayabasi, Zehra Esra Ketenoglu

2017-01-01

This study aimed to try to understand the views and attitudes of classroom teachers concerning students with reading difficulties. Data was collected using the semi-structured interview technique, which is among the qualitative data collection techniques. The researcher prepared a semi-structured interview with 5 questions to be addressed to…

Building the Professional Identity of Research Assistants: A Phenomenological Research

ERIC Educational Resources Information Center

Büyükgöze, Hilal; Gün, Feyza

2017-01-01

This research aims to investigate the determining factors in how research assistants build their professional identity. In the study, which is a qualitative research method patterned on phenomenology, data was collected using a semi-structured interview form. Structured interviews were conducted with seven research assistants selected from a…

Narratives from the Online Frontier: A K-12 Student's Experience in an Online Learning Environment

ERIC Educational Resources Information Center

Barbour, Michael; Siko, Jason; Sumara, JaCinda; Simuel-Everage, Kaye

2012-01-01

Despite a large increase in the number of students enrolled in online courses, published research on student experiences in these environments is minimal. This article reports the narrative analysis of a series of interviews conducted with a female student at a brick-and-mortar school enrolled in a single virtual school course. Her narratives…

Utilization of Optimization for Design of Morphing Wing Structures for Enhanced Flight

NASA Astrophysics Data System (ADS)

Detrick, Matthew Scott

Conventional aircraft control surfaces constrain maneuverability. This work is a comprehensive study that looks at both smart material and conventional actuation methods to achieve wing twist to potentially improve flight capability using minimal actuation energy while allowing minimal wing deformation under aerodynamic loading. A continuous wing is used in order to reduce drag while allowing the aircraft to more closely approximate the wing deformation used by birds while loitering. The morphing wing for this work consists of a skin supported by an underlying truss structure whose goal is to achieve a given roll moment using less actuation energy than conventional control surfaces. A structural optimization code has been written in order to achieve minimal wing deformation under aerodynamic loading while allowing wing twist under actuation. The multi-objective cost function for the optimization consists of terms that ensure small deformation under aerodynamic loading, small change in airfoil shape during wing twist, a linear variation of wing twist along the length of the wing, small deviation from the desired wing twist, minimal number of truss members, minimal wing weight, and minimal actuation energy. Hydraulic cylinders and a two member linkage driven by a DC motor are tested separately to provide actuation. Since the goal of the current work is simply to provide a roll moment, only one actuator is implemented along the wing span. Optimization is also used to find the best location within the truss structure for the actuator. The active structure produced by optimization is then compared to simulated and experimental results from other researchers as well as characteristics of conventional aircraft.

Perceptions about safety and risks in gender-based violence research: implications for the ethics review process.

PubMed

Sikweyiya, Yandisa; Jewkes, Rachel

2011-10-01

Does research on gender-based violence (GBV) pose greater than minimal risk to researchers and participants? This question needs to be understood particularly in light of hesitancy by Institutional Review Boards to approve research on GBV. The safety and risks of doing GBV studies and the implications for the ethical review process have not been a focus of much research. This qualitative study collected data through in-depth interviews with 12 experienced GBV researchers from various countries and a desk review. This paper explores researchers' interpretation of and meanings of the safety recommendations as provided in the WHO guidelines and whether there is empirical evidence on the presence of risks and safety concerns unique to GBV research. Informants raised a number of safety concerns about GBV research, yet in the interviews there were very few examples of problems having occurred, possibly because of the precautions applied. This paper argues that the notion that GBV studies carry greater than minimal risk when ethics precautions are followed is based on speculation, not evidence. It highlights the need for empirical evidence to support assertions of risk in research.

The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

PubMed Central

Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

2014-01-01

Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

Dynamics of Forensic Interviews with Suspected Abuse Victims Who Do Not Disclose Abuse

ERIC Educational Resources Information Center

Hershkowitz, Irit; Orbach, Yael; Lamb, Michael E.; Sternberg, Kathleen J.; Horowitz, Dvora

2006-01-01

Objectives: The present study was designed to explore structural differences between forensic interviews in which children made allegations and those in which children did not make allegations. Methodology: Fifty forensic interviews of 4- to 13-year-old suspected victims of abuse who did not disclose abuse during the interview were compared with…

Cotton Dust Exposure and Resulting Respiratory Disorders Among Home-Based Garment Workers.

PubMed

Silpasuwan, Pimpan; Prayomyong, Somchit; Sujitrat, Dusit; Suwan-Ampai, Plernpit

2016-03-01

Cotton dust exposures and resulting respiratory disorders among Thai home-based garment workers in Bangkok were explored. Structured interviews focused on occupational health assessments of respiratory disorders; workflow process observations, lung function screening tests, and garment dust density assessments were used to gather data. Results revealed that garment workers in this study had worked in home-based tailoring an average of 14.88 years; 88.5% reported average health status, only 2.6% currently smoked cigarettes, and 8.6% had impaired lung function. The prevalence of respiratory disorders in this occupational group was 25%. Significant respiratory tract signs and symptoms were associated with lung function capacity (odds ratio [OR] = 52.15, 95% confidence interval [CI] = [6.49, 419.60]). Long work hours and few preventive behaviors were significantly associated with respiratory disorders (OR = 2.89 and OR = 10.183, respectively). Improving working conditions at home and minimizing fabric dust exposure among garment workers are recommended. © 2015 The Author(s).

Therapeutic effects of ritual ayahuasca use in the treatment of substance dependence--qualitative results.

PubMed

Loizaga-Velder, Anja; Verres, Rolf

2014-01-01

This qualitative empirical study explores the ritual use of ayahuasca in the treatment of addictions. Ayahuasca is an Amazonian psychedelic plant compound created from an admixture of the vine Banisteriopsis caapi and the bush Psychotria viridis. The study included interviews with 13 therapists who apply ayahuasca professionally in the treatment of addictions (four indigenous healers and nine Western mental health professionals with university degrees), two expert researchers, and 14 individuals who had undergone ayahuasca-assisted therapy for addictions in diverse contexts in South America. The study provides empirically based hypotheses on therapeutic mechanisms of ayahuasca in substance dependence treatment. Findings indicate that ayahuasca can serve as a valuable therapeutic tool that, in carefully structured settings, can catalyze neurobiological and psychological processes that support recovery from substance dependencies and the prevention of relapse. Treatment outcomes, however, can be influenced by a number of variables that are explained in this study. In addition, issues related to ritual transfer and strategies for minimizing undesired side-effects are discussed.

Undocumented Status as a Social Determinant of Occupational Safety and Health: The Workers’ Perspective

PubMed Central

Flynn, Michael A.; Eggerth, Donald E.; Jacobson, C. Jeffrey

2015-01-01

Background Undocumented immigration to the United States has grown dramatically over the past 25 years. This study explores undocumented status as a social determinant of occupational health by examining its perceived consequences on workplace safety of Latino immigrants. Methods Guided by the Theory of Work Adjustment, qualitative analysis was conducted on transcripts from focus groups and individual interviews conducted with a convenience sample of Latino immigrant workers. Results Participants reported that unauthorized status negatively impacted their safety at work and resulted in a degree of alienation that exceeded the specific proscriptions of the law. Participants overwhelming used a strategy of disengagement to cope with the challenges they face as undocumented immigrants. Conclusion This study describes the complex web of consequences resulting from undocumented status and its impact on occupational health. This study presents a framework connecting the daily work experiences of immigrants, the coping strategy of disengagement, and efforts to minimize the impact of structural violence. PMID:26471878

Reusable Rocket Engine Advanced Health Management System. Architecture and Technology Evaluation: Summary

NASA Technical Reports Server (NTRS)

Pettit, C. D.; Barkhoudarian, S.; Daumann, A. G., Jr.; Provan, G. M.; ElFattah, Y. M.; Glover, D. E.

1999-01-01

In this study, we proposed an Advanced Health Management System (AHMS) functional architecture and conducted a technology assessment for liquid propellant rocket engine lifecycle health management. The purpose of the AHMS is to improve reusable rocket engine safety and to reduce between-flight maintenance. During the study, past and current reusable rocket engine health management-related projects were reviewed, data structures and health management processes of current rocket engine programs were assessed, and in-depth interviews with rocket engine lifecycle and system experts were conducted. A generic AHMS functional architecture, with primary focus on real-time health monitoring, was developed. Fourteen categories of technology tasks and development needs for implementation of the AHMS were identified, based on the functional architecture and our assessment of current rocket engine programs. Five key technology areas were recommended for immediate development, which (1) would provide immediate benefits to current engine programs, and (2) could be implemented with minimal impact on the current Space Shuttle Main Engine (SSME) and Reusable Launch Vehicle (RLV) engine controllers.

Socializing Identity Through Practice: A Mixed Methods Approach to Family Medicine Resident Perspectives on Uncertainty.

PubMed

Ledford, Christy J W; Cafferty, Lauren A; Seehusen, Dean A

2015-01-01

Uncertainty is a central theme in the practice of medicine and particularly primary care. This study explored how family medicine resident physicians react to uncertainty in their practice. This study incorporated a two-phase mixed methods approach, including semi-structured personal interviews (n=21) and longitudinal self-report surveys (n=21) with family medicine residents. Qualitative analysis showed that though residents described uncertainty as an implicit part of their identity, they still developed tactics to minimize or manage uncertainty in their practice. Residents described increasing comfort with uncertainty the longer they practiced and anticipated that growth continuing throughout their careers. Quantitative surveys showed that reactions to uncertainty were more positive over time; however, the difference was not statistically significant. Qualitative and quantitative results show that as family medicine residents practice medicine their perception of uncertainty changes. To reduce uncertainty, residents use relational information-seeking strategies. From a broader view of practice, residents describe uncertainty neutrally, asserting that uncertainty is simply part of the practice of family medicine.

Children and adolescents living with diabetes and celiac disease.

PubMed

Brancaglioni, Bianca de Cássia Alvarez; Rodrigues, Grasiele Caroline; Damião, Elaine Buchhorn Cintra; Queiroz, Márcia Silva; Nery, Márcia

2016-03-01

Objective To understand the experience of children and adolescents living with type 1 diabetes and celiac disease. Method This is a qualitative exploratory-descriptive study. The participants were 3 children and 2 adolescents. The data were collected by means of semi-structured interviews between January and September 2012 at the participant's residence or at the diabetic outpatient clinic of the Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo in São Paulo, Brazil. The content analysis technique was used to process the data. Results The key aspect of the illness experience of the patients was their diet, but with different meanings. The children had difficulty following the diet, while the adolescents reported that they had greater difficulty coping with the social and affective aspects of their diet. Conclusion The results reinforce the importance of nurses who seek strategies, together with the patients and their families, that help minimize the difficulties of these patients, especially with regard to managing the diet imposed by both diseases.

Physician Information Needs in Managing Delirium

PubMed Central

Taft, Teresa; Nelsen, Scott D; Slager, Stacey; Weir, Charlene

2017-01-01

Delirium has the highest occurrence rate of any complication in hospitalized adults over the age of 65. The study objective was to determine physician information needs for use in the development of electronic clinical decision support for physicians managing the care of patients with delirium. Critical incident interviews were conducted with 8 experienced internal medicine physicians and 1 cardiologist. Thematic analysis revealed the following 6 themes: 1) Clinician’s experience an impoverished information field for mental status, 2) Uncertainty is pervasive, 3) Extensive information foraging effort is required for cohesive story building, 4) Goal Conflict leads to missed diagnosis and early closure, 5) Diffusion of Responsibility for treating delirium is common, and 6) Use of structured delirium resources is minimal. Elicited information needs were identified and physician recommendations for improving access to information needed in managing the care of patient’s with delirium are reported. Information elicited in this study is useful for designing delirium clinical decision support that supports physician cognition.

Tobacco industry allegations of "illegal lobbying" and state tobacco control.

PubMed

Bialous, S A; Fox, B J; Glantz, S A

2001-01-01

This study assessed the perceived effect of tobacco industry allegations of "illegal lobbying" by public health professionals on policy interventions for tobacco control. Structured interviews were conducted with state health department project managers in all 17 National Cancer Institute-funded American Stop Smoking Intervention Study (ASSIST) states. Documentation and media records related to ASSIST from the National Cancer Institute, health advocates, and the tobacco industry were analyzed. The tobacco industry filed formal complaints of illegal lobbying activities against 4 ASSIST states. These complaints had a temporary chilling effect on tobacco control policy interventions in those states. ASSIST states not targeted by the tobacco industry developed an increased awareness of the industry's tactics and worked to prepare for such allegations to minimize disruption of their activities. Some self-reported self-censorship in policy activity occurred in 11 of the 17 states (65%). Public health professionals need to educate themselves and the public about the laws that regulate lobbying activities and develop their strategies, including their policy activities, accordingly.

Tobacco industry allegations of "illegal lobbying" and state tobacco control.

PubMed Central

Bialous, S A; Fox, B J; Glantz, S A

2001-01-01

OBJECTIVES: This study assessed the perceived effect of tobacco industry allegations of "illegal lobbying" by public health professionals on policy interventions for tobacco control. METHODS: Structured interviews were conducted with state health department project managers in all 17 National Cancer Institute-funded American Stop Smoking Intervention Study (ASSIST) states. Documentation and media records related to ASSIST from the National Cancer Institute, health advocates, and the tobacco industry were analyzed. RESULTS: The tobacco industry filed formal complaints of illegal lobbying activities against 4 ASSIST states. These complaints had a temporary chilling effect on tobacco control policy interventions in those states. ASSIST states not targeted by the tobacco industry developed an increased awareness of the industry's tactics and worked to prepare for such allegations to minimize disruption of their activities. Some self-reported self-censorship in policy activity occurred in 11 of the 17 states (65%). CONCLUSIONS: Public health professionals need to educate themselves and the public about the laws that regulate lobbying activities and develop their strategies, including their policy activities, accordingly. PMID:11189827

The drama of end of life care at home.

PubMed

Newbury, Jenny

Many terminally ill patients want to die at home. Family carers are fundamental to achieving this, but often feel anxious and unprepared for the role. Supporting them is vital in palliative care. To explore the experiences of carers of patients dying at home, in particular their expectations and preparedness for the dying process. The study followed a qualitative approach. In-depth, semi-structured interviews with 15 carers were carried out. Carers experienced uncertainty and felt unrehearsed for their role. They were reluctant to seek information to give them a script for their performance because it was too painful to contemplate the patient's death. The carers needed the direction of health and social care professionals, and the help of paid carers, but experiences of these services varied. The study highlighted the drama of the situation for carers, and the anxiety of being the leading player on stage with minimal preparation. Nurses play a crucial role in supporting carers and can use a "dramaturgical" perspective to guide them in giving carers the direction they need.

Undocumented status as a social determinant of occupational safety and health: The workers' perspective.

PubMed

Flynn, Michael A; Eggerth, Donald E; Jacobson, C Jeffrey

2015-11-01

Undocumented immigration to the United States has grown dramatically over the past 25 years. This study explores undocumented status as a social determinant of occupational health by examining its perceived consequences on workplace safety of Latino immigrants. Guided by the Theory of Work Adjustment, qualitative analysis was conducted on transcripts from focus groups and individual interviews conducted with a convenience sample of Latino immigrant workers. Participants reported that unauthorized status negatively impacted their safety at work and resulted in a degree of alienation that exceeded the specific proscriptions of the law. Participants overwhelming used a strategy of disengagement to cope with the challenges they face as undocumented immigrants. This study describes the complex web of consequences resulting from undocumented status and its impact on occupational health. This study presents a framework connecting the daily work experiences of immigrants, the coping strategy of disengagement, and efforts to minimize the impact of structural violence. © 2015 Wiley Periodicals, Inc.

The Reliability of Psychiatric Diagnosis Revisited

PubMed Central

Rankin, Eric; France, Cheryl; El-Missiry, Ahmed; John, Collin

2006-01-01

Background: The authors reviewed the topic of reliability of psychiatric diagnosis from the turn of the 20th century to present. The objectives of this paper are to explore the reasons of unreliability of psychiatric diagnosis and propose ways to improve the reliability of psychiatric diagnosis. Method: The authors reviewed the literature on the concept of reliability of psychiatric diagnosis with emphasis on the impact of interviewing skills, use of diagnostic criteria, and structured interviews on the reliability of psychiatric diagnosis. Results: Causes of diagnostic unreliability are attributed to the patient, the clinician and psychiatric nomenclature. The reliability of psychiatric diagnosis can be enhanced by using diagnostic criteria, defining psychiatric symptoms and structuring the interviews. Conclusions: The authors propose the acronym ‘DR.SED,' which stands for diagnostic criteria, reference definitions, structuring the interview, clinical experience, and data. The authors recommend that clinicians use the DR.SED paradigm to improve the reliability of psychiatric diagnoses. PMID:21103149

The role of complex emotions in inconsistent diagnoses of schizophrenia.

PubMed

Gara, Michael A; Vega, William A; Lesser, Ira; Escamilla, Michael; Lawson, William B; Wilson, Daniel R; Fleck, David E; Strakowski, Stephen M

2010-09-01

In the case of large-scale epidemiological studies, there is evidence of substantial disagreement when lay diagnoses of schizophrenia based on structured interviews are compared with expert diagnoses of the same patients. Reasons for this level of disagreement are investigated in the current study, which made use of advances in text-mining techniques and associated structural representations of language expressions. Specifically, the current study examined whether content analyses of transcribed diagnostic interviews obtained from 150 persons with serious psychiatric disorders yielded any discernable patterns that correlated with diagnostic inconsistencies of schizophrenia. In summary, it was found that the patterning or structure of spontaneous self-reports of emotion states in the diagnostic interview was associated with diagnostic inconsistencies of schizophrenia, irrespective of confounders; i.e., age of patient, gender, or ethnicity. In particular, complex emotion patterns were associated with greater disagreement between experts and trained lay interviewers than were simpler patterns.

Minimizing distortion and internal forces in truss structures by simulated annealing

NASA Technical Reports Server (NTRS)

Kincaid, Rex K.; Padula, Sharon L.

1990-01-01

Inaccuracies in the length of members and the diameters of joints of large space structures may produce unacceptable levels of surface distortion and internal forces. Here, two discrete optimization problems are formulated, one to minimize surface distortion (DSQRMS) and the other to minimize internal forces (FSQRMS). Both of these problems are based on the influence matrices generated by a small-deformation linear analysis. Good solutions are obtained for DSQRMS and FSQRMS through the use of a simulated annealing heuristic.

Reliability of DSM-III anxiety disorder categories using a new structured interview.

PubMed

Di Nardo, P A; O'Brien, G T; Barlow, D H; Waddell, M T; Blanchard, E B

1983-10-01

The reliability of DSM-III anxiety disorder diagnoses was determined using a new structured interview, the Anxiety Disorders Interview Schedule (ADIS). Two interviewers examined 60 consecutive outpatients at an anxiety disorders clinic and assigned primary and secondary diagnoses based on the ADIS. The kappa statistic, calculated on the basis of perfect matches on primary diagnoses, indicated good agreement for anxiety, affective, and adjustment disorders, as well as for the specific anxiety disorder categories of agoraphobia, panic, social phobia, and obsessive-compulsive disorder, but not for generalized anxiety disorder. We evaluated the causes for diagnostic disagreement, particularly in relation to the difficult differentiation between generalized anxiety disorder and other anxiety disorders.

Visualization of Topology through Simulation

NASA Astrophysics Data System (ADS)

Mulderig, Andrew; Beaucage, Gregory; Vogtt, Karsten; Jiang, Hanqiu

Complex structures can be decomposed into their minimal topological description coupled with complications of tortuosity. We have found that a stick figure representation can account for the topological content of any structure and coupling with scaling measures of tortuosity we can reconstruct an object. This deconstruction is native to static small-angle scattering measurements where we can obtain quantitative measures of the tortuous structure and the minimal topological structure. For example, a crumpled sheet of paper is composed of a minimal sheet structure and parameters reflecting the extent of crumpling. This quantification yields information that can be used to calculate the hydrodynamic radius, radius of gyration, structural conductive pathway, modulus, and other properties of complex structures. The approach is general and has been applied to a wide range of nanostructures from crumpled graphene to branched polymers and unfolded proteins and RNA. In this poster we will demonstrate how simple structural simulations can be used to reconstruct from these parameters a 3d representation of the complex structure through a heuristic approach. Several examples will be given from nano-fractal aggregates.

The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center (SIST-M): development, reliability, and cross-sectional validation of a brief structured clinical dementia rating interview.

PubMed

Okereke, Olivia I; Copeland, Maura; Hyman, Bradley T; Wanggaard, Taylor; Albert, Marilyn S; Blacker, Deborah

2011-03-01

The Clinical Dementia Rating (CDR) and CDR Sum-of-Boxes can be used to grade mild but clinically important cognitive symptoms of Alzheimer disease. However, sensitive clinical interview formats are lengthy. To develop a brief instrument for obtaining CDR scores and to assess its reliability and cross-sectional validity. Using legacy data from expanded interviews conducted among 347 community-dwelling older adults in a longitudinal study, we identified 60 questions (from a possible 131) about cognitive functioning in daily life using clinical judgment, inter-item correlations, and principal components analysis. Items were selected in 1 cohort (n=147), and a computer algorithm for generating CDR scores was developed in this same cohort and re-run in a replication cohort (n=200) to evaluate how well the 60 items retained information from the original 131 items. Short interviews based on the 60 items were then administered to 50 consecutively recruited older individuals, with no symptoms or mild cognitive symptoms, at an Alzheimer's Disease Research Center. Clinical Dementia Rating scores based on short interviews were compared with those from independent long interviews. In the replication cohort, agreement between short and long CDR interviews ranged from κ=0.65 to 0.79, with κ=0.76 for Memory, κ=0.77 for global CDR, and intraclass correlation coefficient for CDR Sum-of-Boxes=0.89. In the cross-sectional validation, short interview scores were slightly lower than those from long interviews, but good agreement was observed for global CDR and Memory (κ≥0.70) as well as for CDR Sum-of-Boxes (intraclass correlation coefficient=0.73). The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center is a brief, reliable, and sensitive instrument for obtaining CDR scores in persons with symptoms along the spectrum of mild cognitive change.

When More Is Less: Feedback Effects in Perceptual Category Learning

ERIC Educational Resources Information Center

Maddox, W. Todd; Love, Bradley C.; Glass, Brian D.; Filoteo, J. Vincent

2008-01-01

Rule-based and information-integration category learning were compared under minimal and full feedback conditions. Rule-based category structures are those for which the optimal rule is verbalizable. Information-integration category structures are those for which the optimal rule is not verbalizable. With minimal feedback subjects are told whether…

KENNEDY SPACE CENTER, FLA. - Launch Pad 39A undergoes sandblasting of its metal structures and surfaces. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

NASA Image and Video Library

2003-09-12

KENNEDY SPACE CENTER, FLA. - Launch Pad 39A undergoes sandblasting of its metal structures and surfaces. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

Assessment of personality functioning: validity of the operationalized psychodynamic diagnosis axis IV (structure).

PubMed

Doering, Stephan; Burgmer, Markus; Heuft, Gereon; Menke, Dina; Bäumer, Brigitta; Lübking, Margit; Feldmann, Marcus; Schneider, Gudrun

2014-01-01

The assessment of personality functioning has recently become a focus of psychiatric diagnostics. The interview-based Operationalized Psychodynamic Diagnosis (OPD-2) provides a 'structure axis' for the assessment of personality functioning. One hundred twenty-four psychiatric patients were diagnosed by means of the Structured Clinical Interviews for DSM-IV (SCID-I and SCID-II), underwent OPD-2 interviews, and completed 9 questionnaires. The OPD-2 structure axis shows good interrater reliability (intraclass correlation = 0.793). Correlations between the OPD-2 structure axis domains and a priori selected questionnaire scales were of medium size and significant. Patients with a personality disorder (PD) showed significantly worse personality functioning than those without. In cluster B PD, personality functioning was more severely impaired than in cluster C PD. The OPD-2 structure axis shows good reliability as well as concurrent and discriminant validity and can be recommended for clinical use and research purposes. © 2013 S. Karger AG, Basel.

A Hierarchy of Medicine: Health Strategies of Elder Khmer Refugees in the United States

ERIC Educational Resources Information Center

Lewis, Denise C.

2007-01-01

This study addresses ways Khmer refugee elders utilize traditional herbal medicine with Western biomedicine in the treatment and prevention of illnesses. Methods include semi-structured and informal interviews with elders and family members, semi-structured interviews with local health care providers and Khmer physicians, and participant…

Post-Evaluation of an Entrepreneurship Program for Inner-City Youth

ERIC Educational Resources Information Center

Doucet, LaRon

2010-01-01

This study evaluated program graduates of National Foundation for Teaching Entrepreneurship 1 to years after completing the program in inner city schools of Los Angeles, California. Twenty-seven out of 150 graduates participated in 2 semi-structured interviews in Northern and Southern California, or long semi-structured telephone interviews for…

Post-Traumatic Stress Disorder in Maltreated Youth: A Study of Diagnostic Comorbidity and Child Factors

ERIC Educational Resources Information Center

Linning, Lisa M.; Kearney, Christopher A.

2004-01-01

The study of post-traumatic stress disorder (PTSD) in maltreated youth has received increased attention, though extensive comparisons to maltreated youth without PTSD and administrations of anxiety-based structured diagnostic interviews remain needed. We examined maltreated youth with or without PTSD using structured diagnostic interviews and…

Work Values, Cognitive Strategies, and Applicant Reactions in a Structured Pre-Employment Interview for Ethical Integrity.

ERIC Educational Resources Information Center

Pawlowski, Donna R.; Hollwitz, John

2000-01-01

Notes that companies emphasize ethical behavior, and schools and professional groups devote many resources to applied ethics training. Describes initial construct validation of a structured ethical integrity pre-employment interview. Reviews evidence relating to cognitive and impression management strategies used when college students encounter an…

Semi-Structured Interview Protocol for Constructing Logic Models

ERIC Educational Resources Information Center

Gugiu, P. Cristian; Rodriguez-Campos, Liliana

2007-01-01

This paper details a semi-structured interview protocol that evaluators can use to develop a logic model of a program's services and outcomes. The protocol presents a series of questions, which evaluators can ask of specific program informants, that are designed to: (1) identify key informants basic background and contextual information, (2)…

Exploration of Quality-of-Life Goals in Individuals with Spinal Cord Injury

ERIC Educational Resources Information Center

Kullmann, Lajos; Toth, Katalin

2012-01-01

The aim of the study is to investigate the applicability of structured interviews for exploration of quality-of-life goals using an established instrument. Structured interviews were performed using WHOQOL-BREF and Disabilities Module as guideline with 35 clients admitted for first rehabilitation intervention after spinal cord injury. Although…

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

ERIC Educational Resources Information Center

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

2012-01-01

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

University Lecturers' and Students' Views on Mass Education: A Case Study of Great Zimbabwe University

ERIC Educational Resources Information Center

Mapako, Felix; Mareva, Rugare; Gonye, Jairos; Gamira, Daniel

2012-01-01

The study focused on university lecturers' and students' views on mass education at university level. The inquiry employed both a qualitative and quantitative research design in which twenty lecturers were purposively sampled and interviewed using semi-structured interview guides.A semi-structured questionnaire was also administered to fifty…

Using information and communications technology in a national population-based survey: the Kenya AIDS Indicator Survey 2012.

PubMed

Ojwang', James K; Lee, Veronica C; Waruru, Anthony; Ssempijja, Victor; Ng'ang'a, John G; Wakhutu, Brian E; Kandege, Nicholas O; Koske, Danson K; Kamiru, Samuel M; Omondi, Kenneth O; Kakinyi, Mutua; Kim, Andrea A; Oluoch, Tom

2014-05-01

With improvements in technology, electronic data capture (EDC) for large surveys is feasible. EDC offers benefits over traditional paper-based data collection, including more accurate data, greater completeness of data, and decreased data cleaning burden. The second Kenya AIDS Indicator Survey (KAIS 2012) was a population-based survey of persons aged 18 months to 64 years. A software application was designed to capture the interview, specimen collection, and home-based testing and counseling data. The application included: interview translations for local languages; options for single, multiple, and fill-in responses; and automated participant eligibility determination. Data quality checks were programmed to automate skip patterns and prohibit outlier responses. A data sharing architecture was developed to transmit the data in real-time from the field to a central server over a virtual private network. KAIS 2012 was conducted between October 2012 and February 2013. Overall, 68,202 records for the interviews, specimen collection, and home-based testing and counseling were entered into the application. Challenges arose during implementation, including poor connectivity and a systems malfunction that created duplicate records, which prevented timely data transmission to the central server. Data cleaning was minimal given the data quality control measures. KAIS 2012 demonstrated the feasibility of using EDC in a population-based survey. The benefits of EDC were apparent in data quality and minimal time needed for data cleaning. Several important lessons were learned, such as the time and monetary investment required before survey implementation, the importance of continuous application testing, and contingency plans for data transmission due to connectivity challenges.

A mixed-method examination of food marketing directed towards children in Australian supermarkets.

PubMed

Campbell, Sarah; James, Erica L; Stacey, Fiona G; Bowman, Jennifer; Chapman, Kathy; Kelly, Bridget

2014-06-01

The purpose of this study was to determine the prevalence of children's food requests, and parents' experiences of food marketing directed towards children, in the supermarket environment. A mixed-method design was used. Firstly, intercept interviews were conducted with parents accompanied by a child/children on exiting supermarkets (sampled from a large regional centre in Australia). Parents were asked about the prevalence and types of food requests by child/children during their supermarket visit and whether they purchased these foods. Secondly, focus groups (n = 13) and telephone interviews (n = 3) were conducted exploring parents' experiences of supermarket shopping with children and the impact of child-directed marketing. Of the 158 intercept survey participants (30% response rate), 73% reported a food request during the supermarket visit. Most requested food items (88%) were unhealthy foods, with chocolate/confectionery being the most common food category requested (40%). Most parents (70%) purchased at least one food item requested during the shopping trip. Qualitative interviews identified four themes associated with food requests and prompts in the supermarket: parents' experience of pester power in the supermarket; prompts for food requests in the supermarket; parental responses to pestering in the supermarket environment, and; strategies to manage pestering and minimize requests for food items. Food requests from children are common during supermarket shopping. Despite the majority of the requests being unhealthy, parents often purchase these foods. Parents reported difficulties dealing with constant requests and expressed desire for environmental changes including confectionery-free checkouts, minimization of child friendly product placement and reducing children's exposure to food marketing.

Influences on decision-making for undergoing plastic surgery: a mental models and quantitative assessment.

PubMed

Darisi, Tanya; Thorne, Sarah; Iacobelli, Carolyn

2005-09-01

Research was conducted to gain insight into potential clients' decisions to undergo plastic surgery, their perception of benefits and risks, their judgment of outcomes, and their selection of a plastic surgeon. Semistructured, open-ended interviews were conducted with 60 people who expressed interest in plastic surgery. Qualitative analysis revealed their "mental models" regarding influences on their decision to undergo plastic surgery and their choice of a surgeon. Interview results were used to design a Web-based survey in which 644 individuals considering plastic surgery responded. The desire for change was the most direct motivator to undergo plastic surgery. Improvements to physical well-being were related to emotional and social benefits. When prompted about risks, participants mentioned physical, emotional, and social risks. Surgeon selection was a critical influence on decisions to undergo plastic surgery. Participants gave considerable weight to personal consultation and believed that finding the "right" plastic surgeon would minimize potential risks. Findings from the Web-based survey were similar to the mental models interviews in terms of benefit ratings but differed in risk ratings and surgeon selection criteria. The mental models interviews revealed that interview participants were thoughtful about their decision to undergo plastic surgery and focused on finding the right plastic surgeon.

Parent Experience With False-Positive Newborn Screening Results for Cystic Fibrosis.

PubMed

Hayeems, Robin Z; Miller, Fiona A; Barg, Carolyn J; Bombard, Yvonne; Kerr, Elizabeth; Tam, Karen; Carroll, June C; Potter, Beth K; Chakraborty, Pranesh; Davies, Christine; Milburn, Jennifer; Patton, Sarah; Bytautas, Jessica P; Taylor, Louise; Price, April; Gonska, Tanja; Keenan, Katherine; Ratjen, Felix; Guttmann, Astrid

2016-09-01

The risk of psychosocial harm in families of infants with false-positive (FP) newborn bloodspot screening (NBS) results for cystic fibrosis (CF) is a longstanding concern. Whether well designed retrieval and confirmatory testing systems can mitigate risks remains unknown. Using a mixed-methods cohort design, we obtained prospective self-report data from mothers of infants with FP CF NBS results 2 to 3 months after confirmatory testing at Ontario's largest follow-up center, and from a randomly selected control sample of mothers of screen negative infants from the same region. Mothers completed a questionnaire assessing experience and psychosocial response. A sample of mothers of FP infants completed qualitative interviews. One hundred thirty-four mothers of FP infants (response rate, 55%) and 411 controls (response rate, 47%) completed questionnaires; 54 mothers of FP infants were interviewed. Selected psychosocial response measures did not detect psychosocial distress in newborns or 1 year later (P > .05). Mothers recalled distress during notification of the positive result and in the follow-up testing period related to fear of chronic illness, but valued the screening system of care in mitigating concerns. Although immediate distress was reported among mothers of FP infants, selected psychometric tools did not detect these concerns. The NBS center from which mothers were recruited minimizes delay between notification and confirmatory testing and ensures trained professionals are communicating results and facilitating follow-up. These factors may explain the presence of minimal psychosocial burden. The screening system reflected herein may be a model for NBS programs working to minimize FP-related psychosocial harm. Copyright © 2016 by the American Academy of Pediatrics.

The Dispersion Tensor and Its Unique Minimizer in Hashin-Shtrikman Micro-structures

NASA Astrophysics Data System (ADS)

Bălilescu, Loredana; Conca, Carlos; Ghosh, Tuhin; San Martín, Jorge; Vanninathan, Muthusamy

2018-05-01

In this paper, we introduce a macroscopic quantity, namely the dispersion tensor or the Burnett coefficients in the class of generalized Hashin-Shtrikman micro-structures (Tartar in The general theory of homogenization, volume 7 of Lecture notes of the Unione Matematica Italiana, Springer, Berlin, p 281, 2009). In the case of two-phase materials associated with the periodic Hashin-Shtrikman structures, we settle the issue that the dispersion tensor has a unique minimizer, which is the so called Apollonian-Hashin-Shtrikman micro-structure.

Validation of experimental molecular crystal structures with dispersion-corrected density functional theory calculations.

PubMed

van de Streek, Jacco; Neumann, Marcus A

2010-10-01

This paper describes the validation of a dispersion-corrected density functional theory (d-DFT) method for the purpose of assessing the correctness of experimental organic crystal structures and enhancing the information content of purely experimental data. 241 experimental organic crystal structures from the August 2008 issue of Acta Cryst. Section E were energy-minimized in full, including unit-cell parameters. The differences between the experimental and the minimized crystal structures were subjected to statistical analysis. The r.m.s. Cartesian displacement excluding H atoms upon energy minimization with flexible unit-cell parameters is selected as a pertinent indicator of the correctness of a crystal structure. All 241 experimental crystal structures are reproduced very well: the average r.m.s. Cartesian displacement for the 241 crystal structures, including 16 disordered structures, is only 0.095 Å (0.084 Å for the 225 ordered structures). R.m.s. Cartesian displacements above 0.25 A either indicate incorrect experimental crystal structures or reveal interesting structural features such as exceptionally large temperature effects, incorrectly modelled disorder or symmetry breaking H atoms. After validation, the method is applied to nine examples that are known to be ambiguous or subtly incorrect.

Vocational Decision-Making Interview. Administration Manual.

ERIC Educational Resources Information Center

Czerlinsky, Thomas; McCray, Paul M.

This guide is intended to assist rehabilitation counselors, school guidance personnel, and others involved in administering and interpreting the results of the Vocational Decision-Making Interview (VDMI). (The VDMI is a structured interview instrument that was developed to facilitate the assessment of an individual's vocational decision-making…

76 FR 13412 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

...) Screening questionnaire--used to recruit research participants for the needs assessment interviews...) Needs assessment interviews--consisting of semi-structured interviews with non-users of the Health IT... those persons that ``screen-in'' will complete the demographics section). The needs assessment will be...

Interviewer effects on non-response propensity in longitudinal surveys: a multilevel modelling approach

PubMed Central

Vassallo, Rebecca; Durrant, Gabriele B; Smith, Peter W F; Goldstein, Harvey

2015-01-01

The paper investigates two different multilevel approaches, the multilevel cross-classified and the multiple-membership models, for the analysis of interviewer effects on wave non-response in longitudinal surveys. The models proposed incorporate both interviewer and area effects to account for the non-hierarchical structure, the influence of potentially more than one interviewer across waves and possible confounding of area and interviewer effects arising from the non-random allocation of interviewers across areas. The methods are compared by using a data set: the UK Family and Children Survey. PMID:25598587

Prediction of protein tertiary structure to low resolution: performance for a large and structurally diverse test set.

PubMed

Eyrich, V A; Standley, D M; Friesner, R A

1999-05-14

We report the tertiary structure predictions for 95 proteins ranging in size from 17 to 160 residues starting from known secondary structure. Predictions are obtained from global minimization of an empirical potential function followed by the application of a refined atomic overlap potential. The minimization strategy employed represents a variant of the Monte Carlo plus minimization scheme of Li and Scheraga applied to a reduced model of the protein chain. For all of the cases except beta-proteins larger than 75 residues, a native-like structure, usually 4-6 A root-mean-square deviation from the native, is located. For beta-proteins larger than 75 residues, the energy gap between native-like structures and the lowest energy structures produced in the simulation is large, so that low RMSD structures are not generated starting from an unfolded state. This is attributed to the lack of an explicit hydrogen bond term in the potential function, which we hypothesize is necessary to stabilize large assemblies of beta-strands. Copyright 1999 Academic Press.

Moral Reasoning in Violent Contexts: Displaced and Non-Displaced Colombian Children's Evaluations of Moral Transgressions, Retaliation, and Reconciliation

ERIC Educational Resources Information Center

Ardila-Rey, Alicia; Killen, Melanie; Brenick, Alaina

2009-01-01

In order to assess the effects of displacement and exposure to violence on children's moral reasoning, Colombian children exposed to minimal violence (non-displaced or low risk; N = 99) and to extreme violence (displaced or high risk; N = 94), evenly divided by gender at 6, 9, and 12 years of age, were interviewed regarding their evaluation of…

78 FR 75353 - Agency Information Collection Activities: Proposed Collection: Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... cognitive interviews, focus groups, usability tests, field tests/pilot interviews, and experimental research... as more basic research on response errors in surveys. HRSA staff use various techniques to evaluate... interview structure consists of respondents first answering a draft survey question and then providing...

Cut income taxes with reorganization planning.

PubMed

Miller, J E

1985-04-01

It is necessary to plan when reorganizing a corporate structure, to minimize taxes at the tax-exempt parent organization level and avoid unexpected tax consequences at year-end. With an awareness of the income tax rules, proper debt structuring during the reorganization phase is possible and should enable the financial manager to minimize total income tax.

A Structured Forensic Interview Protocol Improves the Quality and Informativeness of Investigative Interviews with Children: A Review of Research Using the NICHD Investigative Interview Protocol

ERIC Educational Resources Information Center

Lamb, Michael; Orbach, Yael; Hershkowitz, Irit; Esplin, Phillip W.; Horowitz, Dvora

2007-01-01

Objective: To show how the results of research on children's memory, communicative skills, social knowledge, and social tendencies can be translated into guidelines that improve the quality of forensic interviews of children. Method: We review studies designed to evaluate children's capacities as witnesses, explain the development of the…

Key stakeholders' perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs.

PubMed

Ernecoff, Natalie C; Witteman, Holly O; Chon, Kristen; Chen, Yanquan Iris; Buddadhumaruk, Praewpannarai; Chiarchiaro, Jared; Shotsberger, Kaitlin J; Shields, Anne-Marie; Myers, Brad A; Hough, Catherine L; Carson, Shannon S; Lo, Bernard; Matthay, Michael A; Anderson, Wendy G; Peterson, Michael W; Steingrub, Jay S; Arnold, Robert M; White, Douglas B

2016-06-01

Although barriers to shared decision making in intensive care units are well documented, there are currently no easily scaled interventions to overcome these problems. We sought to assess stakeholders' perceptions of the acceptability, usefulness, and design suggestions for a tablet-based tool to support communication and shared decision making in ICUs. We conducted in-depth semi-structured interviews with 58 key stakeholders (30 surrogates and 28 ICU care providers). Interviews explored stakeholders' perceptions about the acceptability of a tablet-based tool to support communication and shared decision making, including the usefulness of modules focused on orienting families to the ICU, educating them about the surrogate's role, completing a question prompt list, eliciting patient values, educating about treatment options, eliciting perceptions about prognosis, and providing psychosocial support resources. The interviewer also elicited stakeholders' design suggestions for such a tool. We used constant comparative methods to identify key themes that arose during the interviews. Overall, 95% (55/58) of participants perceived the proposed tool to be acceptable, with 98% (57/58) of interviewees finding six or more of the seven content domains acceptable. Stakeholders identified several potential benefits of the tool including that it would help families prepare for the surrogate role and for family meetings as well as give surrogates time and a framework to think about the patient's values and treatment options. Key design suggestions included: conceptualize the tool as a supplement to rather than a substitute for surrogate-clinician communication; make the tool flexible with respect to how, where, and when surrogates can access the tool; incorporate interactive exercises; use video and narration to minimize the cognitive load of the intervention; and build an extremely simple user interface to maximize usefulness for individuals with low computer literacy. There is broad support among stakeholders for the use of a tablet-based tool to improve communication and shared decision making in ICUs. Eliciting the perspectives of key stakeholders early in the design process yielded important insights to create a tool tailored to the needs of surrogates and care providers in ICUs. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding the Experiences of Rural Community-Dwelling Older Adults in Using a New DVD-Delivered Otago Exercise Program: A Qualitative Study.

PubMed

Agha, Arun; Liu-Ambrose, Teresa Y L; Backman, Catherine L; Leese, Jennifer; Li, Linda C

2015-08-13

The home-based Otago Exercise Program (OEP) has been shown to reduce the occurrence of falls in community-dwelling seniors. A new OEP DVD was recently developed for people living in rural communities to be used with minimal coaching by a physical therapist. This study aimed to understand older adults' experiences using the DVD-delivered OEP and explore barriers and facilitators to implementing the DVD-delivered OEP from the participants' perspectives. Rural community-dwelling older adults (75 years and older) who participated in a six-month DVD-delivered OEP study were invited to participate in this qualitative study. Two small group interviews were initially conducted to explore the breadth of participants' experiences with the program. These were followed by semi-structured individual interviews to gain an in-depth understanding of these experiences. An inductive constant comparison analysis of the transcripts was performed. To ensure methodological rigor, field notes, journaling, and an audit trail were maintained, supplemented by peer-review. Of 32 eligible participants, five participated in group interviews and 16 in individual interviews. Three themes emerged. Theme 1, The OEP DVD-useful training tool but in need of more pep, represented participants' experiences that the DVD provided important guidance at program onset, but was too slow and low-energy for longer-term use. Theme 2, Gaining control over one's exercise regimen, but sometimes life gets in the way of staying active, described participants' appreciation of the program's flexibility, but personal health concerns and everyday lives posed challenges to adhering to the program. Theme 3, Social creatures-wanting greater human connection during exercise, described how some participants desired further social interactions for enhancing motivation and receiving guidance. Individuals should be encouraged to refer to the OEP user manual or DVD as needed and engage friends and family in exercises. The importance of exercise even when living with health problems should be raised at program onset, and participants should be supported in working through challenging issues. Health professionals should work with individuals to integrate the program with their everyday activities.

What vaccine product attributes do immunization program stakeholders value? Results from interviews in six low- and middle-income countries.

PubMed

Kristensen, Debra D; Bartholomew, Kate; Villadiego, Shirley; Lorenson, Kristina

2016-12-07

This study attempts to capture the opinions of stakeholders working in immunization programs in low- and middle-income countries to understand how vaccine products could be improved to better meet their needs and to obtain feedback on specific vaccine product attributes including the number of doses per container and ease of preparing a dose for administration. We also reviewed how procurement decisions are made within immunization programs. Semi-structured interviews were undertaken with 158 immunization stakeholders in Brazil, China, India, Peru, the Philippines, and Tanzania. Interviewees included national decision-makers and advisors involved in vaccine-purchasing decisions (n=30), national Expanded Programme on Immunization managers (n=6), and health and logistics personnel at national, subnational, and health-facility levels (n=122). Immunization stakeholders at all levels of the supply chain valued vaccine product attributes that prevent heat damage, decrease vaccine wastage, and simplify delivery. Minimizing the time required to prepare a dose is especially valued by those closest to the work of actually administering vaccines. Respondents appreciated the benefits of lower-multidose presentations on reducing wastage but seemed to prefer single-dose vials even more. They also expressed concern about the need for training and the potential for confusion and vial contamination if opened vials of liquid preservative-free vaccines are not handled properly. Procurement decision-making processes varied widely between countries, though most relied heavily on international agencies and vaccine manufacturers for information. Copyright © 2016. Published by Elsevier Ltd.

Negotiating identity and self-image: perceptions of falls in ambulatory individuals with spinal cord injury – a qualitative study

PubMed Central

Jørgensen, Vivien; Roaldsen, Kirsti Skavberg

2016-01-01

Objective: Explore and describe experiences and perceptions of falls, risk of falling, and fall-related consequences in individuals with incomplete spinal cord injury (SCI) who are still walking. Design: A qualitative interview study applying interpretive content analysis with an inductive approach. Setting: Specialized rehabilitation hospital. Subjects: A purposeful sample of 15 individuals (10 men), 23 to 78 years old, 2-34 years post injury with chronic incomplete traumatic SCI, and walking ⩾75% of time for mobility needs. Methods: Individual, semi-structured face-to-face interviews were recorded, condensed, and coded to find themes and subthemes. Results: One overarching theme was revealed: “Falling challenges identity and self-image as normal” which comprised two main themes “Walking with incomplete SCI involves minimizing fall risk and fall-related concerns without compromising identity as normal” and “Walking with incomplete SCI implies willingness to increase fall risk in order to maintain identity as normal”. Informants were aware of their increased fall risk and took precautions, but willingly exposed themselves to risky situations when important to self-identity. All informants expressed some conditional fall-related concerns, and a few experienced concerns limiting activity and participation. Conclusion: Ambulatory individuals with incomplete SCI considered falls to be a part of life. However, falls interfered with the informants’ identities and self-images as normal, healthy, and well-functioning. A few expressed dysfunctional concerns about falling, and interventions should target these. PMID:27170274

Factors Affecting the Development and Sustainability of Communities of Practice Among Primary Care Physicians in Hong Kong.

PubMed

Poon, Man Kay; Lam, Tai Pong

2017-01-01

Primary care physicians (PCPs) maintain high standards of medical care by partaking in continuous learning. The learning model of communities of practice (COPs) is increasingly being used in the field of health care. This study explores the establishment and maintenance of COPs among PCPs in Hong Kong. Sequential, semi-structured individual interview and focus group interview were conducted to explore the purposes for partaking in continuous learning, as well as barriers and facilitators for attendance among private nonspecialist PCPs in Hong Kong. Data were drawn from the discourses related to COPs. Thematic analysis with constant comparison was performed until data saturation was reached. PCPs voluntarily established COPs to solve clinical problems from the existing networks. Clinical interest, practice orientation, and recruitment of new members through endorsement by the existing members fostered group coherence. Conversation and interaction among members generated the "best" practice with knowledge that was applicable in specific clinical scenarios in primary care setting. COPs rejected commercial sponsorship to minimize corporate influences on learning. Updating medical knowledge, solving clinical problems, maintaining openness, engendering a sense of trust and ownership among members, and fulfilling psychosocial needs were integral to sustainability. Seeking secretariat support to aid in the logistics of meetings, enhancing external learning resources, and facilitation skills training of facilitators from professional bodies may further incentivize members to maintain COPs. Autonomy of group learning activities, recruiting specialists and allied health professionals, training facilitators, and undertaking discussion in multimedia may achieve the sustainability of COPs.

Sexual health promotion in Chennai, India: key role of communication among social networks.

PubMed

Sivaram, Sudha; Johnson, Sethulakshmi; Bentley, Margaret E; Go, Vivian F; Latkin, Carl; Srikrishnan, A K; Celentano, David D; Solomon, Suniti

2005-12-01

Communication about sex and sexual health is an important facilitator in gaining accurate knowledge about prevention of sexually transmitted diseases (STDs) and promotion of sexual health. Understanding how and with whom communication about sex occurs and the nature of the information exchanged is valuable in designing sexual risk prevention interventions. In this study of low-income communities residents in Chennai, India, our aim was to understand the composition of personal communication networks, the nature of information related to sex and sexual health that is exchanged in these networks and the value of communication among members of these networks. We conducted in-depth open-ended interviews using a structured interview guide with 43 individuals. We also conducted 12 focus group discussions. Individuals were selected using snowball sampling. Our results indicate that information about sex and sexual health is exchanged within and between four groups: married women, married men, unmarried men and unmarried women. Communication leads to an expansion of sexual networks among unmarried men and treatment seeking behaviour for STDs in all groups. Unmarried men offer immense potential for intervention given the range of topics related to sex and sexual health that are discussed and the risky sexual behaviours practiced. Spousal communication about sexual behaviour or sexual health is minimal and shifting norms for prevention would be difficult. Interventions identifying communication networks and influencing the natural communication patterns in these networks may be a viable HIV prevention strategy in the study area.

"I Always Feel Like I Have to Rush…" Pet Owner and Small Animal Veterinary Surgeons' Reflections on Time during Preventative Healthcare Consultations in the United Kingdom.

PubMed

Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L

2018-02-08

Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare.

Strategies for Supporting Physician-Scientists in Faculty Roles: A Narrative Review With Key Informant Consultations.

PubMed

Lingard, Lorelei; Zhang, Peter; Strong, Michael; Steele, Margaret; Yoo, John; Lewis, James

2017-10-01

Physician-scientists are a population in decline globally. Solutions to reverse this decline often have focused on the training pipeline. Less attention has been paid to reducing attrition post training, when physician-scientists take up faculty roles. However, this period is a known time of vulnerability because of the pressures of clinical duties and the long timeline to securing independent research funding. This narrative review explored existing knowledge regarding how best to support physician-scientists for success in their faculty roles. The authors searched the Medline, Embase, ERIC, and Cochrane Library databases for articles published from 2000 to 2016 on this topic and interviewed key informants in 2015 to solicit their input on the review results. The authors reviewed 78 articles and interviewed 16 key informants. From the literature, they developed a framework of organizational (facilitate mentorship, foster community, value the physician-scientist role, minimize financial barriers) and individual (develop professional and research skills) strategies for supporting physician-scientists. They also outlined key knowledge gaps representing topics either rarely or never addressed in the reviewed articles (percent research time, structural hypocrisy, objective assessment, group metrics, professional identity). The key informants confirmed the identified strategies and discussed how the gaps were particularly important and impactful. This framework offers a basis for assessing an organization's existing support strategies, identifying outstanding needs, and developing targeted programming. The identified gaps require attention, as they threaten to undermine the benefits of existing support strategies.

“I Always Feel Like I Have to Rush…” Pet Owner and Small Animal Veterinary Surgeons’ Reflections on Time during Preventative Healthcare Consultations in the United Kingdom

PubMed Central

Robinson, Natalie J.; Dean, Rachel S.

2018-01-01

Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare. PMID:29419766

Caregiving and mutuality among long-term colorectal cancer survivors with ostomies: qualitative study.

PubMed

Altschuler, Andrea; Liljestrand, Petra; Grant, Marcia; Hornbrook, Mark C; Krouse, Robert S; McMullen, Carmit K

2018-02-01

The cancer caregiving literature focuses on the early phases of survivorship, but caregiving can continue for decades when cancer creates disability. Survivors with an ostomy following colorectal cancer (CRC) have caregiving needs that may last decades. Mutuality has been identified as a relationship component that can affect caregiving. This paper discusses how mutuality may affect long-term ostomy caregiving. We conducted semi-structured, in-depth interviews with 31 long-term CRC survivors with ostomies and their primary informal caregivers. Interviewees were members of an integrated health care delivery system in the USA. We used inductive theme analysis techniques to analyze the interviews. Most survivors were 71 years of age or older (67%), female (55%), and with some college education (54%). Two thirds lived with and received care from spouses. Caregiving ranged from minimal support to intimate assistance with daily ostomy care. While some survivors received caregiving far beyond what was needed, others did not receive adequate caregiving for their health care needs. Low mutuality created challenges for ostomy caregiving. Mutuality impacts the quality of caregiving, and this quality may change over time, depending on various factors. Emotional feedback and amplification is the proposed mechanism by which mutuality may shift over time. Survivorship care should include assessment and support of mutuality as a resource to enhance health outcomes and quality of life for survivors with long-term caregiving needs and their caregivers. Appropriate questionnaires can be identified or developed to assess mutuality over the survivorship trajectory.

Returning to School After Adolescent Cancer: A Qualitative Examination of Australian Survivors' and Their Families' Perspectives.

PubMed

McLoone, Jordana K; Wakefield, Claire E; Butow, Phyllis; Fleming, Catharine; Cohn, Richard J

2011-06-01

To examine key factors related to adolescent cancer survivors' return to school after cancer treatment completion, which can be a time of complex transition. Seventy semi-structured interviews were conducted with 19 adolescent cancer survivors (mean age 16.1 years), 21 mothers, 15 fathers, and 15 siblings from 22 Australian families. The conceptual framework of Miles and Huberman (1994) was employed to analyze interview data and emergent themes were organized using the software package QSR NVivo 8.0. Barriers to successful school re-entry included symptoms of fatigue, anxiety (particularly regarding examinations), and poor communication between families and the broader school community. Changing grade or school typically extinguished pre-existing support networks and was perceived by parents as a period of unmet need. Support from friends, teachers, tutors, and the hospital outreach nurse were seen as instrumental in creating a positive school re-entry experience. However, the majority of participants reported that support from the school counselor was minimal. Siblings reported this period as relatively non-impactful regarding their own education. Additional support is needed to help parents navigate the education system and to advocate effectively for their child's academic needs beyond the immediate re-entry period. There is strong potential for school counselors to increase the level of support they provide adolescents and their parents during the school re-entry period. The impact of this period on siblings' education is under-studied and warrants further research.

Hearing protection use in manufacturing workers: a qualitative study.

PubMed

Reddy, Ravi K; Welch, David; Thorne, Peter; Ameratunga, Shanthi

2012-01-01

Occupational noise is a significant contributor to disabling hearing loss worldwide. Noise-induced hearing loss (NIHL) has resulted in huge human and economic consequences costing New Zealand approximately $53M annually and rising. A high proportion of hearing loss claims are made by workers in the manufacturing sector. Hearing protection devices (HPDs) are used together with engineering and administrative controls to minimize noise exposure and to prevent hearing loss. Unfortunately, inconsistent and improper use of HPDs has hindered efforts to prevent NIHL. The purpose of this study was to understand the factors that influence the use of HPDs amongst a group of manufacturing workers in New Zealand. A purposive sample of twenty-five workers was recruited to take part in semi-structured interviews. The open-ended questions were aimed at exploring the participants' knowledge, attitude, beliefs, and behavior towards noise and HPDs. The data were analyzed using conventional content analysis and key themes emerged in relation to HPD use. Themes that emerged from the interviews either supported good hearing protection behavior or acted as barriers against it. Five major themes, (perception of noise, hearing preservation, reluctance to use HPDs, workplace interaction, and value of hearing) and sub-themes described various factors that influence hearing protection use. Both personal and environmental factors influence the use of HPDs. Based on this study, personal and environmental factors need to be targeted for further research using ecological models to develop interventions that promote HPD use amongst workers.

Exploring Methods for Developing Behaviorally Anchored Rating Scales for Evaluating Structured Interview Performance. Research Report. ETS RR-17-28

ERIC Educational Resources Information Center

Kell, Harrison J.; Martin-Raugh, Michelle P.; Carney, Lauren M.; Inglese, Patricia A.; Chen, Lei; Feng, Gary

2017-01-01

Behaviorally anchored rating scales (BARS) are an essential component of structured interviews. Use of BARS to evaluate interviewees' performance is associated with greater predictive validity and reliability and less bias. BARS are time-consuming and expensive to construct, however. This report explores the feasibility of gathering participants'…

Evaluating the Gold Standard: A Review and Meta-Analysis of the Structured Interview of Reported Symptoms

ERIC Educational Resources Information Center

Green, Debbie; Rosenfeld, Barry

2011-01-01

The Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) is often touted as the gold standard of measures of feigning. This label likely arises in part out of the impressive accuracy rates reported in the extensive validation research that preceded its publication. However, since its publication, researchers not only…

Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day.

PubMed

Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K

2017-12-01

Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year, with each applicant participating in an average of 2 to 4 individual interviews per interview day and interviews commonly lasting between 5 and 15 minutes.

The use of semi-structured interviews for the characterisation of farmer irrigation practices

NASA Astrophysics Data System (ADS)

O'Keeffe, J.; Buytaert, W.; Mijic, A.; Brozovic, N.; Sinha, R.

2015-08-01

Generating information on the behaviours, characteristics and drivers of users, as well on the resource itself, is vital in developing sustainable and realistic water security options. In this paper we present a methodology for collecting qualitative and quantitative data on water use practices through semi-structured interviews. This approach facilitates the collection of detailed information on actors' decisions in a convenient and cost-effective manner. The interview is organised around a topic guide, which helps lead the conversation in a standardised way while allowing sufficient opportunity to identify relevant issues previously unknown to the researcher. In addition, semi-structured interviews can be used to obtain certain types of quantitative data. While not as accurate as direct measurements, it can provide useful information on local practices and farmers' insights. We present an application of the methodology on two districts in the State of Uttar Pradesh in North India. By means of 100 farmer interviews, information was collected on various aspects of irrigation practices, including irrigation water volumes, irrigation cost, water source and their spatial variability. A statistical analysis of the information, along with some data visualisation is also presented, which highlights a significant variation in irrigation practices both within and between the districts. Our application shows that semi-structured interviews are an effective and efficient method of collecting both qualitative and quantitative information for the assessment of drivers, behaviours and their outcomes in a data scarce region. The collection of this type of data could significantly improve insight on water resources, leading to more realistic management options and increased water security in the future.

Poor Accrual in Palliative Research Studies: An Update From the Rapid Response Radiotherapy Program

PubMed Central

Lien, Karen; Zeng, Liang; Bradley, Nicole; Culleton, Shaelyn; Popovic, Marko; Di Giovanni, Julia; Jamani, Rehana; Cramarossa, Gemma; Nguyen, Janet; Koo, Kaitlin; Jon, Florencia; Chow, Edward

2011-01-01

Background In June 2003, the Rapid Response Radiotherapy Program (RRRP) implemented changes to recruitment strategies in attempts to increase patient accrual to research studies. Such modifications included the use of a dedicated research assistant to screen for and identify eligible study patients, the introduction of more appropriate inclusion criteria, and the switch towards telephone interviews to minimize patient burden. The purpose of this study is to provide an update on patient accrual in the RRRP. Methods All patients seen in the RRRP from January 2002 to December 2009 were recorded in a prospective database. Reasons for referral, eligibility for clinical trials, reasons for non-accrual, and various demographics information were recorded. Descriptive statistics summarized findings. Results A total of 4726 patient visits were recorded from January 1st, 2002 to December 31st, 2009. Prior to changes, the overall rate of accrual into research studies was 14.9% versus 48.1% after changes were implemented. Patients were not accrued onto studies mainly to due ineligibility according to study protocol. Other reasons such as language barrier (12.1%), physician objection (3.5%), patient declining participation (11.3%) and lack of a research assistant (9.3%) were cited. Conclusions Changes in clinical structure and study design can significantly impact accrual patterns in palliative radiotherapy studies. Despite these changes however, the majority of patients are still not enrolled in studies. Therefore additional efforts need to be made to maximize patient accrual and minimize attrition. PMID:29147251

Childhood Trauma and Minimization/Denial in People with and without a Severe Mental Disorder.

PubMed

Church, Chelsea; Andreassen, Ole A; Lorentzen, Steinar; Melle, Ingrid; Aas, Monica

2017-01-01

Background: Childhood trauma has garnered extensive research concerning its role in the psychopathology of mental disorders, including psychosis. The Childhood Trauma Questionnaire (CTQ) utilizes a minimization/denial (MD) scale to denote potential under-reporters of trauma, yet MD scores are infrequently reported and validations of the scale are lacking in the literature. Elucidate differences in MD between patients with severe mental disorders to healthy individuals, and secondly, investigate if MD influences reports of childhood trauma between the groups. Methods: We included 621 patients with a DSM-schizophrenia spectrum, bipolar spectrum diagnosis, or major depression disorder with psychotic features and 299 healthy controls as part of the NORMENT study in Oslo, Norway. History of childhood trauma was obtained using the CTQ. Clinical diagnoses were assessed using the Structured Clinical Interview for DSM Disorders. Results: A significantly greater proportion of healthy controls (42.8%) had a positive MD score compared to patients (26.7%). When controlling for MD, the patient group still exhibited elevated reports of childhood trauma compared to controls (Cohen's d = 1.27), concordant with reports of childhood trauma being more frequently reported in a population of severe mental disorders. Conclusion: Elevated MD in the healthy control group could suggest an enhanced self-serving bias, potentially attenuated in the psychiatric group. Clinicians and researchers would benefit from including the MD component of CTQ when assessing retrospective information on childhood trauma to rule out potential effect of MD.

Fourth-grade children's dietary recall accuracy is influenced by retention interval (target period and interview time).

PubMed

Baxter, Suzanne Domel; Hardin, James W; Guinn, Caroline H; Royer, Julie A; Mackelprang, Alyssa J; Smith, Albert F

2009-05-01

For a 24-hour dietary recall, two possible target periods are the prior 24 hours (24 hours immediately preceding the interview time) and previous day (midnight to midnight of the day before the interview), and three possible interview times are morning, afternoon, and evening. Target period and interview time determine the retention interval (elapsed time between to-be-reported meals and the interview), which, along with intervening meals, can influence reporting accuracy. The effects of target period and interview time on children's accuracy for reporting school meals during 24-hour dietary recalls were investigated. DESIGN AND SUBJECTS/SETTING: During the 2004-2005, 2005-2006, and 2006-2007 school years in Columbia, SC, each of 374 randomly selected fourth-grade children (96% African American) was observed eating two consecutive school meals (breakfast and lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions defined by crossing two target periods with three interview times. Each condition had 62 or 64 children (half boys). Accuracy for reporting school meals was quantified by calculating rates for omissions (food items observed eaten but unreported) and intrusions (food items reported eaten but unobserved); a measure of total inaccuracy combined errors for reporting food items and amounts. For each accuracy measure, analysis of variance was conducted with target period, interview time, their interaction, sex, interviewer, and school year in the model. There was a target-period effect and a target-period by interview-time interaction on omission rates, intrusion rates, and total inaccuracy (six P values <0.004). For prior-24-hour recalls compared to previous-day recalls, and for prior-24-hour recalls in the afternoon and evening compared to previous-day recalls in the afternoon and evening, omission rates were better by one third, intrusion rates were better by one half, and total inaccuracy was better by one third. To enhance children's dietary recall accuracy, target periods and interview times that minimize the retention interval should be chosen.

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

DTIC Science & Technology

2016-03-01

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

Simulated Oral Proficiency Interviews: Recent Developments. ERIC Digest.

ERIC Educational Resources Information Center

Malone, Margaret

This digest discusses the simulated oral proficiency interview (SOPI), a performance-based, tape-mediated speaking test. The SOPI follows the general structure of the oral proficiency interview (OPI) used by government agencies and the American Council on the Teaching of Foreign Languages (ACTFL) to measure speaking proficiency. Whereas the OPI is…

Impression Management in the Psychiatric Interview: Quality, Style, and Individual Differences

ERIC Educational Resources Information Center

Sherman, Mark; And Others

1975-01-01

The ability of 24 Veterans Administration Day Treatment Center psychiatric outpatients to vary intentionally their degree of apparent psychopathology during structured interviews was studied. Patients defined as sick presenters behaved in a significantly more pathological manner during an interview preceded by "fake sick" instructions than they…

Characteristics of zero-absenteeism in hospital care.

PubMed

Schreuder, J A H; Roelen, C A M; van der Klink, J J L; Groothoff, J W

2013-06-01

Literature on sickness presenteeism is emerging, but still little is known about employees who are never absent from work due to injuries or illness. Insight into the determinants and characteristics of such zero-absentees may provide clues for preventing sickness absence. To investigate the characteristics of zero-absentees, defined as employees without sickness absence over a period of 5 years. A mixed-method qualitative study comprising semi-structured interviews and focus groups for which Azjen and Fishbein's theory of planned behaviour was used as a framework. Zero-absentees working in hospital care were invited for semi-structured interviews until saturation was reached. The results of semi-structured interviews were validated in two focus groups. Of 1053 hospital employees, 47 were zero-absentees of whom 31 (66%) agreed to participate in the study. After 16 semi-structured interviews, no new insights or information were gathered from the interviews. The remaining 15 employees were invited to two (n = 8 and n = 7) focus groups. Personal attitudes and self-efficacy were more important in zero-absenteeism than social pressures of managers, colleagues or patients. Zero-absentees were found to be intrinsically motivated to try attending work when ill. In the present study population of hospital employees, we found indications that zero-absenteeism and sickness presenteeism might be different types of work attendance. Managers should realize that zero-absentees are driven by intrinsic motivation rather than social pressures to attend work.

Hypochondriasis Y-BOCS: a study of the psychometric properties of a clinician-administered semi-structured interview to assess hypochondriacal thoughts and behaviours.

PubMed

Greeven, Anja; Spinhoven, Philip; van Balkom, Anton J L M

2009-01-01

This study investigated the psychometric properties of the first clinician-administered semi-structured interview for assessing the severity of hypochondriacal symptoms. The Hypochondriasis Yale-Brown Obsessive-Compulsive Scale (H-YBOCS) consisted of three a priori dimensions: hypochondriacal obsessions, compulsions and avoidance. The 16-item interview was conducted with 112 participants with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, hypochondriasis. We analysed factor analytic structure, reliability, construct validity and sensitivity to change. Factor analysis supported a three-factor model similar to the a priori dimensions. Internal consistency ranged from satisfactory to good. Inter-rater reliability was excellent. The construct validity was low to moderate. The H-YBOCS was sensitive for measuring changes in symptom severity. The H-YBOCS is a (factorially) valid and coherent interview with a high level of agreement across different raters. The relatively low discriminant validity could be due to co-morbid anxiety and depressive disorders. Overall, the H-YBOCS seems to be a promising contribution to the assessment of hypochondriasis. *The hypochondriasis Y-BOCS is a feasible clinician rated interview to assess the severity of hypochondriacal complaints.

Accelerating atomic structure search with cluster regularization

NASA Astrophysics Data System (ADS)

Sørensen, K. H.; Jørgensen, M. S.; Bruix, A.; Hammer, B.

2018-06-01

We present a method for accelerating the global structure optimization of atomic compounds. The method is demonstrated to speed up the finding of the anatase TiO2(001)-(1 × 4) surface reconstruction within a density functional tight-binding theory framework using an evolutionary algorithm. As a key element of the method, we use unsupervised machine learning techniques to categorize atoms present in a diverse set of partially disordered surface structures into clusters of atoms having similar local atomic environments. Analysis of more than 1000 different structures shows that the total energy of the structures correlates with the summed distances of the atomic environments to their respective cluster centers in feature space, where the sum runs over all atoms in each structure. Our method is formulated as a gradient based minimization of this summed cluster distance for a given structure and alternates with a standard gradient based energy minimization. While the latter minimization ensures local relaxation within a given energy basin, the former enables escapes from meta-stable basins and hence increases the overall performance of the global optimization.

Combining traditional anatomy lectures with e-learning activities: how do students perceive their learning experience?

PubMed

Lochner, Lukas; Wieser, Heike; Waldboth, Simone; Mischo-Kelling, Maria

2016-02-21

The purpose of this study was to investigate how students perceived their learning experience when combining traditional anatomy lectures with preparatory e-learning activities that consisted of fill-in-the-blank assignments, videos, and multiple-choice quizzes. A qualitative study was conducted to explore changes in study behaviour and perception of learning. Three group interviews with students were conducted and thematically analysed. Data was categorized into four themes: 1. Approaching the course material, 2. Understanding the material, 3. Consolidating the material, and 4. Perceived learning outcome. Students appreciated the clear structure of the course, and reported that online activities encouraged them towards a first engagement with the material. They felt that they were more active during in-class sessions, described self-study before the end-of-term exam as easier, and believed that contents would remain in their memories for a longer time. By adjusting already existing resources, lectures can be combined fairly easily and cost-effectively with preparatory e-learning activities. The creation of online components promote well-structured courses, can help minimize 'student passivity' as a characteristic element of lectures, and can support students in distributing their studies throughout the term, thus suggesting enhanced learning. Further research work should be designed to confirm the afore-mentioned findings through objective measurements of student learning outcomes.

'We have to put up with it--don't we?' The experience of being the registered nurse on duty, managing a violent incident involving an elderly patient: a phenomenological study.

PubMed

Chambers, N

1998-02-01

The incidence of violence directed towards nurses is well known. However, despite guidelines and training aimed at preventing or minimizing these incidents, recent reports indicate an increase in their occurrence. This phenomenological study investigated the experiences of five registered nurses who had to manage a violent incident involving an elderly patient. The purpose of this was to discover what these nurses 'know' about the structure of such an experience and, through the use of Colaizzi's method of data analysis, present this knowledge in the form of an exhaustive description of the experience. Taped interviews were used to collect the data. The analytical process revealed that the experience is structured around five themes: professional competence, nursing identity, powerlessness and oppression, loss (neglected and deserted) and strategies for survival. The discussion analyses these themes and the relationships between them, highlighting the issues of nurse autonomy and exercising accountability. The implications for nursing practice, education and research include recognition of nurses as a professional group to enable autonomous practice, the ways in which nurses' perceptions of nursing knowledge may affect their educative role and the need to extend this study further to provide answers to the questions raised therein.

Property rights violations as a structural driver of women's HIV risks: a qualitative study in Nyanza and Western Provinces, Kenya.

PubMed

Dworkin, Shari L; Grabe, Shelly; Lu, Tiffany; Hatcher, Abigail M; Hatcher, Abbey; Kwena, Zachary; Bukusi, Elizabeth; Mwaura-Muiru, Esther

2013-07-01

While access to and control over assets can minimize women's HIV risk, little is known about the processes through which property rights violations increase the sexual transmission of HIV. The current study focused on two rural areas in Nyanza and Western Province, Kenya where HIV prevalence was high (23.8-33 %) and property rights violations were common. The current work drew on in-depth interview data collected from 50 individuals involved in the development and implementation of a community-led land and property rights program. The program was designed to respond to property rights violations, prevent disinheritance and asset stripping, and reduce HIV risk among women. In our findings, we detailed the social and economic mechanisms through which a loss of property rights was perceived to influence primary and secondary prevention of HIV. These included: loss of income, loss of livelihood and shelter, and migration to slums, markets, or beaches where the exchange of sex for food, money, shelter, clothing, or other goods was common. We also examined the perceived influence of cultural practices, such as wife inheritance, on HIV risk. In the conclusions, we made recommendations for future research in the science-base focused on the development of property ownership as a structural HIV prevention and treatment intervention.

Factors influencing commencement and adherence to a home-based balance exercise program for reducing risk of falls: perceptions of people with Alzheimer's disease and their caregivers.

PubMed

Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Byrne, Karin N; Dodd, Karen J

2012-07-01

Balance exercise is an important component of falls-prevention interventions, with growing evidence that it can be beneficial for people with Alzheimer's disease (AD). However, to implement a balance exercise program successfully for people with AD it is important to consider factors that can affect commencement and adherence to the program. This qualitative study explored these factors. Ten participants with AD, who had completed a six-month home-based balance exercise program, and their caregivers (n = 9) participated. A phenomenological theoretical framework with semi-structured interviews was used for data collection and analysis. Factors influencing the decision to commence the program were: possible benefits of the program, recommendations from health professionals, value of research, positive attitude towards exercise, and minimizing caregivers' burden. Factors influencing adherence to the program were grouped under 11 themes: six themes facilitated completion (program characteristics, physiotherapist, exercise recording sheet, caregivers' support, sense of commitment, and perceived benefit) and five themes were barriers (pre-existing conditions, dislike of structured exercise, absence from home, caregiver's health or commitment, and bad weather). A home-based exercise program with regular support from a physiotherapist and caregiver are key elements facilitating continuing program adherence in people with AD.

Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy.

PubMed

Zierler, S; Rothman, K J

1985-08-08

To clarify the association of Bendectin and other drugs used in early pregnancy with the occurrence of congenital heart disease, we interviewed 298 mothers of children with congenital heart disease and 738 mothers of healthy controls. Differential recall of drug use by mothers of affected children and mothers of controls was evaluated by comparison of information collected by interview with that recorded in the prenatal record. Data derived from maternal interviews were generally consistent with the record data. Reported Bendectin use was minimally associated with congenital heart disease (prevalence odds ratio, 1.1; 90 per cent confidence interval, 0.8 to 1.5). The data from this study were consistent with previously reported associations of other drugs with congenital heart disease. In particular, aspirin use in early pregnancy was associated with about a twofold increase in the frequency of defects in septation of the truncus arteriosus (prevalence odds ratio, 2.1; 90 per cent confidence interval, 1.1 to 3.9).

Stakeholders' contributions to tailored implementation programs: an observational study of group interview methods.

PubMed

Huntink, Elke; van Lieshout, Jan; Aakhus, Eivind; Baker, Richard; Flottorp, Signe; Godycki-Cwirko, Maciek; Jäger, Cornelia; Kowalczyk, Anna; Szecsenyi, Joachim; Wensing, Michel

2014-12-06

Tailored strategies to implement evidence-based practice can be generated in several ways. In this study, we explored the usefulness of group interviews for generating these strategies, focused on improving healthcare for patients with chronic diseases. Participants included at least four categories of stakeholders (researchers, quality officers, health professionals, and external stakeholders) in five countries. Interviews comprised brainstorming followed by a structured interview and focused on different chronic conditions in each country. We compared the numbers and types of strategies between stakeholder categories and between interview phases. We also determined which strategies were actually used in tailored intervention programs. In total, 127 individuals participated in 25 group interviews across five countries. Brainstorming generated 8 to 120 strategies per group; structured interviews added 0 to 55 strategies. Healthcare professionals and researchers provided the largest numbers of strategies. The type of strategies for improving healthcare practice did not differ systematically between stakeholder groups in four of the five countries. In three out of five countries, all components of the chosen intervention programs were mentioned by the group of researchers. Group interviews with different stakeholder categories produced many strategies for tailored implementation of evidence-based practice, of which the content was largely similar across stakeholder categories.

"Nobody came to help": interviews with women convicted of filicide in Malaysia.

PubMed

Razali, Salmi; Fisher, Jane; Kirkman, Maggie

2018-03-22

Although filicide is of serious concern, it is poorly understood in Malaysia. Our interviews with health and policy professionals revealed that they attribute responsibility for filicide to women's failure to comply with social norms and religious teachings. This research sought to understand the meaning of and background to filicide from the perspectives of women who have been convicted of filicide in Malaysia. In-depth interviews were conducted in person with all eligible and consenting women convicted of filicide and incarcerated in prisons or forensic psychiatric institutions. Women's accounts were translated into English and analysed using interpretative phenomenological analysis and interpreted using narrative theory. Interviews with nine women convicted of filicide yielded evidence that others were implicated in the crime but punished less severely, if at all, and that the women had experienced lifelong gender-based violence and marginalisation with minimal access to health and social care. These findings illuminate an inadequately understood phenomenon in Malaysia and reveal why existing strategies to reduce filicide, which reflect key stakeholders' views, have had little impact. They reveal the pervasive harm of violence against women and children and its link to filicide.

Multistate outbreak of Listeria monocytogenes infections linked to whole apples used in commercially produced, prepackaged caramel apples: United States, 2014-2015.

PubMed

Angelo, K M; Conrad, A R; Saupe, A; Dragoo, H; West, N; Sorenson, A; Barnes, A; Doyle, M; Beal, J; Jackson, K A; Stroika, S; Tarr, C; Kucerova, Z; Lance, S; Gould, L H; Wise, M; Jackson, B R

2017-04-01

Whole apples have not been previously implicated in outbreaks of foodborne bacterial illness. We investigated a nationwide listeriosis outbreak associated with caramel apples. We defined an outbreak-associated case as an infection with one or both of two outbreak strains of Listeria monocytogenes highly related by whole-genome multilocus sequence typing (wgMLST) from 1 October 2014 to 1 February 2015. Single-interviewer open-ended interviews identified the source. Outbreak-associated cases were compared with non-outbreak-associated cases and traceback and environmental investigations were performed. We identified 35 outbreak-associated cases in 12 states; 34 (97%) were hospitalized and seven (20%) died. Outbreak-associated ill persons were more likely to have eaten commercially produced, prepackaged caramel apples (odds ratio 326·7, 95% confidence interval 32·2-3314). Environmental samples from the grower's packing facility and distribution-chain whole apples yielded isolates highly related to outbreak isolates by wgMLST. This outbreak highlights the importance of minimizing produce contamination with L. monocytogenes. Investigators should perform single-interviewer open-ended interviews when a food is not readily identified.

Reliability of DSM-III diagnoses for major depression and generalized anxiety disorder using the structured clinical interview for DSM-III.

PubMed

Riskind, J H; Beck, A T; Berchick, R J; Brown, G; Steer, R A

1987-09-01

This study examined the interrater reliability of generalized anxiety disorder (GAD) and major depressive disorder (MDD) diagnoses derived from the Structured Clinical Interview for DSM-III (SCID). Using videotaped interviews, paired raters made independent diagnoses of 75 psychiatric outpatients. The percent agreement of the raters was 82% for MDD and 86% for GAD; the respective kappa values were .72 and .79. The results indicated that the SCID can be employed reliably to differentiate MDD from GAD. The SCID is recommended for further research with these disorders.

Applying ethnic equivalence and cultural values models to African-American teens' perceptions of parents.

PubMed

Lamborn, Susie D; Felbab, Amanda J

2003-10-01

This study evaluated both the parenting styles and family ecologies models with interview responses from 93 14- and 15-year-old African-American adolescents. The parenting styles model was more strongly represented in both open-ended and structured interview responses. Using variables from the structured interview as independent variables, regression analyses contrasted each model with a joint model for predicting self-esteem, self-reliance, work orientation, and ethnic identity. Overall, the findings suggest that a joint model that combines elements from both models provides a richer understanding of African-American families.

Healthcare professionals experience with motivational interviewing in their encounter with obese pregnant women.

PubMed

Lindhardt, Christina Louise; Rubak, Sune; Mogensen, Ole; Hansen, Helle Ploug; Goldstein, Henri; Lamont, Ronald F; Joergensen, Jan Stener

2015-07-01

to explore and describe how healthcare professionals in the Southern Region of Denmark experienced motivational interviewing as a communication method when working with pregnant women with obesity. a qualitative, descriptive study based on face-to-face interviews with 11 obstetric healthcare professionals working in a perinatal setting. a thematic descriptive method was applied to semi-structured interviews. The healthcare professional's experiences were recorded verbatim during individual semi-structured qualitative interviews, transcribed, and analysed using a descriptive analysis methodology. motivational interviewing was found to be a useful method when communicating with obese pregnant women. The method made the healthcare professionals more aware of their own communication style both when encountering pregnant women and in their interaction with colleagues. However, most of the healthcare professionals emphasised that time was crucial and they had to be dedicated to the motivational interviewing method. The healthcare professionals further stated that it enabled them to become more professional in their daily work and made some of them feel less 'burned out', 'powerless' and 'stressed' as they felt they had a communication method in handling difficult workloads. healthcare professionals experienced motivational interviewing to be a useful method when working perinatally. The motivational interviewing method permitted heightened awareness of the healthcare professionals communication method with the patients and increased their ability to handle a difficult workload. Overall, lack of time restricted the use of the motivational interviewing method on a daily basis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Boosted ARTMAP: modifications to fuzzy ARTMAP motivated by boosting theory.

PubMed

Verzi, Stephen J; Heileman, Gregory L; Georgiopoulos, Michael

2006-05-01

In this paper, several modifications to the Fuzzy ARTMAP neural network architecture are proposed for conducting classification in complex, possibly noisy, environments. The goal of these modifications is to improve upon the generalization performance of Fuzzy ART-based neural networks, such as Fuzzy ARTMAP, in these situations. One of the major difficulties of employing Fuzzy ARTMAP on such learning problems involves over-fitting of the training data. Structural risk minimization is a machine-learning framework that addresses the issue of over-fitting by providing a backbone for analysis as well as an impetus for the design of better learning algorithms. The theory of structural risk minimization reveals a trade-off between training error and classifier complexity in reducing generalization error, which will be exploited in the learning algorithms proposed in this paper. Boosted ART extends Fuzzy ART by allowing the spatial extent of each cluster formed to be adjusted independently. Boosted ARTMAP generalizes upon Fuzzy ARTMAP by allowing non-zero training error in an effort to reduce the hypothesis complexity and hence improve overall generalization performance. Although Boosted ARTMAP is strictly speaking not a boosting algorithm, the changes it encompasses were motivated by the goals that one strives to achieve when employing boosting. Boosted ARTMAP is an on-line learner, it does not require excessive parameter tuning to operate, and it reduces precisely to Fuzzy ARTMAP for particular parameter values. Another architecture described in this paper is Structural Boosted ARTMAP, which uses both Boosted ART and Boosted ARTMAP to perform structural risk minimization learning. Structural Boosted ARTMAP will allow comparison of the capabilities of off-line versus on-line learning as well as empirical risk minimization versus structural risk minimization using Fuzzy ARTMAP-based neural network architectures. Both empirical and theoretical results are presented to enhance the understanding of these architectures.

Living with Autistic Spectrum Disorder: Parental Experiences of Raising a Child with Autistic Spectrum Disorder (ASD)

ERIC Educational Resources Information Center

Glazzard, Jonathan; Overall, Katy

2012-01-01

The focus of the study was to explore parental experiences of raising a child with autistic spectrum disorder (ASD). A mixed-method approach consisting of questionnaires and semi-structured interviews was used in order to elicit parental perspectives of raising a child with ASD. Two semi-structured interviews were conducted with parents of…

Nebraska Collegiate Methods Professors' Perceptions of the Next Generation Science Standards: A Semi-Structured Interview Approach

ERIC Educational Resources Information Center

Rasmussen, Ashley B.

2017-01-01

This study utilized a semi-structured interview approach to identify how college methods professors in Nebraska are engaging pre-service K-12 teachers with the Next Generation Science Standards and to determine if this information is being carried over to Nebraska K-12 classrooms. The study attempted to address these items by answering the…

Self-Reported Factors that Contribute to the Success of the Nontraditional Student in a Five Semester Nursing Program

ERIC Educational Resources Information Center

Olson, Joann K.

2010-01-01

The purpose of this qualitative, phenomenological study was to describe factors that nontraditional nursing students reported as helpful in their success in the nursing program. Two men and eight women took part in structured one-time interviews. Structured interviews were conducted with the participants in settings that were chosen by the…

"Yes, but Suppose Everyone Turned Gay?": The Structure of Attitudes toward Gay and Lesbian Rights among Islamic Youth in Belgium

ERIC Educational Resources Information Center

Hooghe, Marc; Dejaeghere, Yves; Claes, Ellen; Quintelier, Ellen

2010-01-01

Various quantitative studies have suggested the occurrence of hostile feelings toward LGBT rights among Islamic communities in Western societies. We know less, however, about the structure of these attitudes among Belgian Islamic youth. Based on focus groups and in-depth interviews, we try to disentangle these elements. The interviews suggest that…

A methodology for formulating a minimal uncertainty model for robust control system design and analysis

NASA Technical Reports Server (NTRS)

Belcastro, Christine M.; Chang, B.-C.; Fischl, Robert

1989-01-01

In the design and analysis of robust control systems for uncertain plants, the technique of formulating what is termed an M-delta model has become widely accepted and applied in the robust control literature. The M represents the transfer function matrix M(s) of the nominal system, and delta represents an uncertainty matrix acting on M(s). The uncertainty can arise from various sources, such as structured uncertainty from parameter variations or multiple unstructured uncertainties from unmodeled dynamics and other neglected phenomena. In general, delta is a block diagonal matrix, and for real parameter variations the diagonal elements are real. As stated in the literature, this structure can always be formed for any linear interconnection of inputs, outputs, transfer functions, parameter variations, and perturbations. However, very little of the literature addresses methods for obtaining this structure, and none of this literature addresses a general methodology for obtaining a minimal M-delta model for a wide class of uncertainty. Since have a delta matrix of minimum order would improve the efficiency of structured singular value (or multivariable stability margin) computations, a method of obtaining a minimal M-delta model would be useful. A generalized method of obtaining a minimal M-delta structure for systems with real parameter variations is given.

Extension of the lower bound of monitor solutions of maximally permissive supervisors to non-α net systems

NASA Astrophysics Data System (ADS)

Wu, W. H.; Chao, D. Y.

2016-07-01

Traditional region-based liveness-enforcing supervisors focus on (1) maximal permissiveness of not losing legal states, (2) structural simplicity of minimal number of monitors, and (3) fast computation. Lately, a number of similar approaches can achieve minimal configuration using efficient linear programming. However, it is unclear as to the relationship between the minimal configuration and the net structure. It is important to explore the structures involved for the fewest monitors required. Once the lower bound is achieved, further iteration to merge (or reduce the number of) monitors is not necessary. The minimal strongly connected resource subnet (i.e., all places are resources) that contains the set of resource places in a basic siphon is an elementary circuit. Earlier, we showed that the number of monitors required for liveness-enforcing and maximal permissiveness equals that of basic siphons for a subclass of Petri nets modelling manufacturing, called α systems. This paper extends this to systems more powerful than the α one so that the number of monitors in a minimal configuration remains to be lower bounded by that of basic siphons. This paper develops the theory behind and shows examples.

Thematic Analysis of the Effectiveness of an Inpatient Mindfulness Group for Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Yildiran, Hatice; Holt, Rachel R.

2015-01-01

The study focused on the effectiveness of group mindfulness for people with intellectual disabilities in an assessment and treatment unit. Six participants with mild or moderate intellectual disabilities were interviewed using semi-structured interviews. The interviews focused on identifying the benefits and difficulties of using mindfulness. The…

Evaluation of an Interview Skills Training Package for Adolescents with Speech, Language and Communication Needs

ERIC Educational Resources Information Center

Mathrick, Rachel; Meagher, Tina; Norbury, Courtenay Frazier

2017-01-01

Background & Aims: We evaluated a structured intervention programme aimed at preparing adolescents with developmental language disorders for job interviews. Our primary outcome measures included change in ratings of verbal and non-verbal social communication behaviours evident during mock interviews. Methods & Procedures: In study 1, 12…

Finding Self: A Qualitative Study of Transgender, Transitioning, and Adulterated Silicone

ERIC Educational Resources Information Center

Wallace, Phyllis M.

2010-01-01

Objective: To describe the development and testing of a theory-based interview guide. To increase awareness of adulterated silicone use among Transgender. Design: A qualitative study based on semi-structured interviews. Setting: Interviews were conducted in Chicago, Illinois, USA. Method: Seven transgender adults aged 18 and over were interviewed…

Rater Perceptions of Bias Using the Multiple Mini-Interview Format: A Qualitative Study

ERIC Educational Resources Information Center

Alweis, Richard L.; Fitzpatrick, Caroline; Donato, Anthony A.

2015-01-01

Introduction: The Multiple Mini-Interview (MMI) format appears to mitigate individual rater biases. However, the format itself may introduce structural systematic bias, favoring extroverted personality types. This study aimed to gain a better understanding of these biases from the perspective of the interviewer. Methods: A sample of MMI…

Convergence of Scores on the Interview and Questionnaire Versions of the Eating Disorder Examination: A Meta-Analytic Review

ERIC Educational Resources Information Center

Berg, Kelly C.; Peterson, Carol B.; Frazier, Patricia; Crow, Scott J.

2011-01-01

Significant discrepancies have been found between interview- and questionnaire-based assessments of psychopathology; however, these studies have typically compared instruments with unmatched item content. The Eating Disorder Examination (EDE), a structured interview, and the questionnaire version of the EDE (EDE-Q) are considered the preeminent…

Self-Injurious Thoughts and Behaviors Interview: Development, Reliability, and Validity in an Adolescent Sample

ERIC Educational Resources Information Center

Nock, Matthew K.; Holmberg, Elizabeth B.; Photos, Valerie I.; Michel, Bethany D.

2007-01-01

The authors developed the Self-Injurious Thoughts and Behaviors Interview (SITBI) and evaluated its psychometric properties. The SITBI is a structured interview that assesses the presence, frequency, and characteristics of a wide range of self-injurious thoughts and behaviors, including suicidal ideation, suicide plans, suicide gestures, suicide…

78 FR 17409 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... through a web-based survey and telephone interview (OMB 0920-0650, exp. 6/30/2013). The web-based survey... separately from their core research. A structured telephone interview with a key PRC informant obtains... the annual interview. Changes to be implemented include (1) changing the platform of the web-based...

Development of an Accessible Audio Computer-Assisted Self-Interview (A-CASI) to Screen for Abuse and Provide Safety Strategies for Women with Disabilities

ERIC Educational Resources Information Center

Oschwald, Mary; Renker, Paula; Hughes, Rosemary B.; Arthur, Anne; Powers, Laurie E.; Curry, Mary Ann

2009-01-01

To increase safety and minimize the risk of interpersonal violence, it is critical that women with disabilities and Deaf women have an opportunity to identify whether or not abuse is happening in their lives. Awareness and knowledge of what constitutes abusive behaviors is an essential first step in addressing interpersonal violence. This article…

Implementation of a workplace smoking ban in bars: the limits of local discretion.

PubMed

Montini, Theresa; Bero, Lisa A

2008-12-08

In January 1998, the California state legislature extended a workplace smoking ban to bars. The purpose of this study was to explore the conditions that facilitate or hinder compliance with a smoking ban in bars. We studied the implementation of the smoking ban in bars by interviewing three sets of policy participants: bar employers responsible for complying with the law; local government officials responsible for enforcing the law; and tobacco control activists who facilitated implementation. We transcribed the interviews and did a qualitative analysis of the text. The conditions that facilitated bar owners' compliance with a smoking ban in bars included: if the cost to comply was minimal; if the bars with which they were in competition were in compliance with the smoking ban; and if there was authoritative, consistent, coordinated, and uniform enforcement. Conversely, the conditions that hindered compliance included: if the law had minimal sanctions; if competing bars in the area allowed smoking; and if enforcement was delayed or inadequate. Many local enforcers wished to forfeit their local discretion and believed the workplace smoking ban in bars would be best implemented by a state agency. The potential implication of this study is that, given the complex nature of local politics, smoking bans in bars are best implemented at a broader provincial or national level.

Prenatal HIV testing: the compartmentalization of women's sexual risk exposure and the return of the maternal fetal conflict.

PubMed

Kelly, Kristin; Hampson, Sarah Cote; Huff, Jamie

2012-01-01

The purpose of the researchers in this study was to investigate how women who were being tested for HIV during their pregnancies were evaluating, conceptualizing, and negotiating their risk of infection. The study included two focus groups and 20 in-depth interviews with 30 patients, ages 17-38 years, from diverse ethnic/racial, social, and economic backgrounds. Qualitative analyses of the interview transcripts revealed support for the idea that pregnant women have a responsibility to minimize risks to their fetus, with all interviewees describing actions to minimize those risks while pregnant. Two sub-themes emerged that were related to the presence of differences in how interviewees conceptualized risk depending on the type of risk being discussed. In the case of diet and lifestyle influences, interviewees framed their health and the health of the fetus as connected. In contrast, when the issue of HIV risk and testing was raised, the interviewees described the risk of HIV to themselves and their fetuses as separate concerns and, with few exceptions, reported no effort to reduce the risk of becoming infected while pregnant (beyond consenting to HIV screening while receiving prenatal care). Findings suggest the importance of developing HIV prevention messages that counter the compartmentalization of risk during pregnancy.

Validation of missed space-group symmetry in X-ray powder diffraction structures with dispersion-corrected density functional theory.

PubMed

Hempler, Daniela; Schmidt, Martin U; van de Streek, Jacco

2017-08-01

More than 600 molecular crystal structures with correct, incorrect and uncertain space-group symmetry were energy-minimized with dispersion-corrected density functional theory (DFT-D, PBE-D3). For the purpose of determining the correct space-group symmetry the required tolerance on the atomic coordinates of all non-H atoms is established to be 0.2 Å. For 98.5% of 200 molecular crystal structures published with missed symmetry, the correct space group is identified; there are no false positives. Very small, very symmetrical molecules can end up in artificially high space groups upon energy minimization, although this is easily detected through visual inspection. If the space group of a crystal structure determined from powder diffraction data is ambiguous, energy minimization with DFT-D provides a fast and reliable method to select the correct space group.

Space station preliminary design report

NASA Technical Reports Server (NTRS)

1982-01-01

The results of a 3 month preliminary design and analysis effort is presented. The configuration that emerged consists of a very stiff deployable truss structure with an overall triangular cross section having universal modules attached at the apexes. Sufficient analysis was performed to show feasibility of the configuration. An evaluation of the structure shows that desirable attributes of the configuration are: (1) the solar cells, radiators, and antennas will be mounted to stiff structure to minimize control problems during orbit maintenance and correction, docking, and attitude control; (2) large flat areas are available for mounting and servicing of equipment; (3) Large mass items can be mounted near the center of gravity of the system to minimize gravity gradient torques; (4) the trusses are lightweight structures and can be transported into orbit in one Shuttle flight; (5) the trusses are expandable and will require a minimum of EVA; and (6) the modules are anticipated to be structurally identical except for internal equipment to minimize cost.

Trained student pharmacists' telephonic collection of patient medication information: Evaluation of a structured interview tool.

PubMed

Margolis, Amanda R; Martin, Beth A; Mott, David A

2016-01-01

To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Descriptive analysis of patient medication lists collected with telephone interviews. Ten trained student pharmacists collected the medication lists. Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking, community-dwelling older adults using a structured interview tool to collect and document medication lists. Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists' adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio-recorded interviews to the medication list information documented in an electronic medical record. On average, it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high, with an overall proportion of asked scripted probes of 83.75% (95% confidence interval [CI], 80.62-86.88%). Accuracy was also high for both prescription (95.1%; 95% CI, 94.3-95.8%) and nonprescription (90.5%; 95% CI, 89.4-91.4%) medications. Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication lists to facilitate MTM sessions in the community pharmacy setting. Evaluating the sustainability of using student pharmacists or trained technicians to collect medication lists is needed. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Trained student pharmacists’ telephonic collection of patient medication information: Evaluation of a structured interview tool

PubMed Central

Margolis, Amanda R.; Martin, Beth A.; Mott, David A.

2016-01-01

Objective To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Design Descriptive analysis of patient medication lists collected via telephone interviews. Participants 10 trained student pharmacists collected the medication lists. Intervention Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking community dwelling older adults using a structured interview tool to collect and document medication lists. Main outcome measures Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists’ adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio recorded interviews to the medication list information documented in an electronic medical record. Results On average it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high with an overall proportion of asked scripted probes of 83.75% (95%CI: 80.62–86.88%). Accuracy was also high for both prescription (95.1%, 95%CI: 94.3–95.8%) and non-prescription (90.5%, 95%CI: 89.4–91.4%) medications. Conclusion Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication lists to facilitate MTM sessions in the community pharmacy setting. Evaluating the sustainability of using student pharmacists or trained technicians to collect medication lists is needed. PMID:27000165

Evaluating different methods used in ethnobotanical and ecological studies to record plant biodiversity

PubMed Central

2014-01-01

Background This study compares the efficiency of identifying the plants in an area of semi-arid Northeast Brazil by methods that a) access the local knowledge used in ethnobotanical studies using semi-structured interviews conducted within the entire community, an inventory interview conducted with two participants using the previously collected vegetation inventory, and a participatory workshop presenting exsiccates and photographs to 32 people and b) inventory the vegetation (phytosociology) in locations with different histories of disturbance using rectangular plots and quadrant points. Methods The proportion of species identified using each method was then compared with Cochran’s Q test. We calculated the use value (UV) of each species using semi-structured interviews; this quantitative index was correlated against values of the vegetation’s structural importance obtained from the sample plot method and point-centered quarter method applied in two areas with different historical usage. The analysis sought to correlate the relative importance of plants to the local community (use value - UV) with the ecological importance of the plants in the vegetation structure (importance value - IV; relative density - RD) by using different sampling methods to analyze the two areas. Results With regard to the methods used for accessing the local knowledge, a difference was observed among the ethnobotanical methods of surveying species (Q = 13.37, df = 2, p = 0.0013): 44 species were identified in the inventory interview, 38 in the participatory workshop and 33 in the semi-structured interviews with the community. There was either no correlation between the UV, relative density (RD) and importance value (IV) of some species, or this correlation was negative. Conclusion It was concluded that the inventory interview was the most efficient method for recording species and their uses, as it allowed more plants to be identified in their original environment. To optimize researchers’ time in future studies, the use of the point-centered quarter method rather than the sample plot method is recommended. PMID:24916833

A Concept for Power Cycling the Electronics of CALICE-AHCAL with the Train Structure of ILC

NASA Astrophysics Data System (ADS)

Göottlicher, Peter; The Calice-Collaboration

Particle flow algorithm calorimetry requires high granularity three-dimensional readout. The tight power requirement of 40 μW/channel is reached by enabling readout ASIC currents only during beam delivery, corresponding to a 1% duty cycle. EMI noise caused by current switching needs to be minimized by the power system and this paper presents ideas, simulations and first measurements for minimizing disturbances. A carefully design of circuits, printed circuit boards, grounding scheme and use of floating supplies allows current loops to be closed locally, stabilized voltages and minimal currents in the metal structures.

Using Information and Communications Technology in a National Population-Based Survey: The Kenya AIDS Indicator Survey 2012

PubMed Central

Ojwang’, James K.; Lee, Veronica C.; Waruru, Anthony; Ssempijja, Victor; Ng’ang’a, John G.; Wakhutu, Brian E.; Kandege, Nicholas O.; Koske, Danson K.; Kamiru, Samuel M.; Omondi, Kenneth O.; Kakinyi, Mutua; Kim, Andrea A.; Oluoch, Tom

2016-01-01

Background With improvements in technology, electronic data capture (EDC) for large surveys is feasible. EDC offers benefits over traditional paper-based data collection, including more accurate data, greater completeness of data, and decreased data cleaning burden. Methods The second Kenya AIDS Indicator Survey (KAIS 2012) was a population-based survey of persons aged 18 months to 64 years. A software application was designed to capture the interview, specimen collection, and home-based testing and counseling data. The application included: interview translations for local languages; options for single, multiple, and fill-in responses; and automated participant eligibility determination. Data quality checks were programmed to automate skip patterns and prohibit outlier responses. A data sharing architecture was developed to transmit the data in realtime from the field to a central server over a virtual private network. Results KAIS 2012 was conducted between October 2012 and February 2013. Overall, 68,202 records for the interviews, specimen collection, and home-based testing and counseling were entered into the application. Challenges arose during implementation, including poor connectivity and a systems malfunction that created duplicate records, which prevented timely data transmission to the central server. Data cleaning was minimal given the data quality control measures. Conclusions KAIS 2012 demonstrated the feasibility of using EDC in a population-based survey. The benefits of EDC were apparent in data quality and minimal time needed for data cleaning. Several important lessons were learned, such as the time and monetary investment required before survey implementation, the importance of continuous application testing, and contingency plans for data transmission due to connectivity challenges. PMID:24732816

Self-report of tobacco use status: comparison of paper-based questionnaire, online questionnaire, and direct face-to-face interview--implications for meaningful use.

PubMed

Steffen, Mark W; Murad, Mohammad Hassan; Hays, J Taylor; Newcomb, Richard D; Molella, Robin G; Cha, Stephen S; Hagen, Philip T

2014-06-01

Identifying tobacco use status is essential to address use and provide resources to help patients quit. Being able to collect this information in an electronic format will become increasingly important, as the Centers for Medicare and Medicaid Services has included the assessment of tobacco use as part of its Stage 1 Meaningful Use criteria. The objective was to compare the accuracy of online vs. paper assessment methods to ascertain cigarette smoking status using a face-to-face structured interview as the gold standard. This was a retrospective analysis of a stratified opportunity sample of consecutive patients, reporting in 2010 for a periodic health evaluation, who completed either a scannable paper-based form or an online questionnaire and underwent a standardized rooming interview. Compared with face-to-face structured interview, the overall observed agreement and kappa coefficient for both methods combined (paper and online) were 97.7% and 0.69 (95% confidence interval (CI) 0.51-0.86) . For the online form they were 97.4% and 0.61 (95% CI 0.33-0.90), and for the paper form they were 97.9% and 0.75 (95% CI 0.54-0.96). There was no statistically significant difference in agreement between the online and paper-based methods (P=0.76) compared with a face-to-face structured interview. Online assessment of tobacco use status is as accurate as a paper questionnaire, and both methods have greater than 97% observed agreement with a face-to-face structured interview. The use of online assessment of tobacco use status has several advantages and more widespread use should be explored.

Denial of risk: The effects of positive impression management on risk assessments for psychopathic and nonpsychopathic offenders.

PubMed

Gillard, Nathan D; Rogers, Richard

2015-01-01

Risk assessments for offenders often combine past records with current clinical findings from observations, interviews, and test data. Conclusions based on these risk assessments are highly consequential, sometimes resulting in increased criminal sentences or prolonged hospitalization. Therefore, many offenders are motivated to intentionally minimize risk factors and their negative consequences. Positive impression management (PIM) is especially likely to occur in offenders with high psychopathic traits because goal-directed deception is reflected in several of psychopathy's core traits of the disorder, such as manipulativeness, glibness, and superficial charm. However, this connection appears to be based on the conceptual understanding of psychopathy, and has rarely been examined empirically for either frequency of or success at deception. The current study examined the ability of a jail sample to intentionally minimize risk factors and related criminal attributes using a repeated measures, simulation design. In general, offenders were able to effectively use PIM to lower scores on the HCR-20 and the Self-Appraisal Questionnaire (SAQ), while the Psychological Inventory of Criminal Thinking Styles (PICTS), as a measure of cognitive styles, was more resistant to such minimization. Psychopathic traits, especially high Factor 1 scores (i.e., affective/interpersonal), were associated with greater PIM. Important differences in the willingness and ability to use deception were found based on the (a) mode of administration (i.e., interview vs. self-report) and (b) level of psychopathy as measured by the Psychopathy Checklist - Revised (PCL-R). The important implications of this research are discussed for risk assessment procedures regarding likely areas of deception and its detection. The current research also informs the growing literature on the connection between psychopathic traits and deception. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Inter-rater reliability and validity of the OPD-CA axes structure and conflict].

PubMed

Benecke, Cord; Bock, Astrid; Wieser, Elke; Tschiesner, Reinhard; Lochmann, Martha; Küspert, Felicia; Schorn, Robert; Viertler, Bernhard; Steinmayr-Gensluckner, Maria

2011-01-01

The manual of the Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) is an instrument meanwhile widespread in the clinical practice to assess psychodynamic dimensions. Publications of inter-rater agreement and validity are still outstanding. This study assessed the interrater-reliability and validity for the axis structure and the axis conflict. 60 adolescents between 14 and 17 years, with and without psychic disorders, were diagnosed with the Operationalized Psychodynamic Diagnostics in childhood and adolescence (Arbeitskreis OPD-KJ, 2007) and SCID-II-interviews and questionnaires. A partial sample of 36 OPD-CA-interviews was the data basis for the assessment of inter-rater agreement. Calculations of validity for axis structure and axis conflict were made with the whole sample. Inter-rater agreement for the axis structure and the axis conflict showed good to very good weighted Kappa coefficients among the trained raters. Validity of the axis structure showed good results. The Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) allows a reliable diagnostic of axis structure and axis conflict, if the ratings are done on the basis of semistructured videotaped interviews by trained raters. The axis structure shows validity, while the results concerning the validity of the axis conflict remain unclear.

Optimal Superpositioning of Flexible Molecule Ensembles

PubMed Central

Gapsys, Vytautas; de Groot, Bert L.

2013-01-01

Analysis of the internal dynamics of a biological molecule requires the successful removal of overall translation and rotation. Particularly for flexible or intrinsically disordered peptides, this is a challenging task due to the absence of a well-defined reference structure that could be used for superpositioning. In this work, we started the analysis with a widely known formulation of an objective for the problem of superimposing a set of multiple molecules as variance minimization over an ensemble. A negative effect of this superpositioning method is the introduction of ambiguous rotations, where different rotation matrices may be applied to structurally similar molecules. We developed two algorithms to resolve the suboptimal rotations. The first approach minimizes the variance together with the distance of a structure to a preceding molecule in the ensemble. The second algorithm seeks for minimal variance together with the distance to the nearest neighbors of each structure. The newly developed methods were applied to molecular-dynamics trajectories and normal-mode ensembles of the Aβ peptide, RS peptide, and lysozyme. These new (to our knowledge) superpositioning methods combine the benefits of variance and distance between nearest-neighbor(s) minimization, providing a solution for the analysis of intrinsic motions of flexible molecules and resolving ambiguous rotations. PMID:23332072

Kenya's health workforce information system: a model of impact on strategic human resources policy, planning and management.

PubMed

Waters, Keith P; Zuber, Alexandra; Willy, Rankesh M; Kiriinya, Rose N; Waudo, Agnes N; Oluoch, Tom; Kimani, Francis M; Riley, Patricia L

2013-09-01

Countries worldwide are challenged by health worker shortages, skill mix imbalances, and maldistribution. Human resources information systems (HRIS) are used to monitor and address these health workforce issues, but global understanding of such systems is minimal and baseline information regarding their scope and capability is practically non-existent. The Kenya Health Workforce Information System (KHWIS) has been identified as a promising example of a functioning HRIS. The objective of this paper is to document the impact of KHWIS data on human resources policy, planning and management. Sources for this study included semi-structured interviews with senior officials at Kenya's Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation (MOPHS), the Department of Nursing within MOMS, the Nursing Council of Kenya, Kenya Medical Practitioners and Dentists Board, Kenya's Clinical Officers Council, and Kenya Medical Laboratory Technicians and Technologists Board. Additionally, quantitative data were extracted from KHWIS databases to supplement the interviews. Health sector policy documents were retrieved from MOMS and MOPHS websites, and reviewed to assess whether they documented any changes to policy and practice as having been impacted by KHWIS data. Interviews with Kenyan government and regulatory officials cited health workforce data provided by KHWIS influenced policy, regulation, and management. Policy changes include extension of Kenya's age of mandatory civil service retirement from 55 to 60 years. Data retrieved from KHWIS document increased relicensing of professional nurses, midwives, medical practitioners and dentists, and interviewees reported this improved compliance raised professional regulatory body revenues. The review of Government records revealed few references to KHWIS; however, documentation specifically cited the KHWIS as having improved the availability of human resources for health information regarding workforce planning, management, and development. KHWIS data have impacted a range of improvements in health worker regulation, human resources management, and workforce policy and planning at Kenya's ministries of health. Published by Elsevier Ireland Ltd.

A qualitative study: Mothers of late preterm infants relate their experiences of community-based care

PubMed Central

Dosani, Aliyah; Oliver, Lynnette May; Lodha, Abhay K; Young, Marilyn

2017-01-01

Purpose In Alberta, the high occurrence of late preterm infants and early hospital discharge of mother-infant dyads has implications for postpartum care in the community. Shortened hospital stay and complexities surrounding the care of biologically and developmentally immature late preterm infants heighten anxiety and fears. Our descriptive phenomenological study explores mothers’ experience of caring for their late preterm infants in the community. Methods Eleven mothers were interviewed using a semi-structured interview guide. Interview transcripts were analysed using an interpretive thematic approach. Findings The mothers’ hospital experience informed their perspective that being a late preterm infant was not a “big deal,” and they tended to treat their infant as normal. “Feeding was really problem,” especially the variability in feeding effectiveness, which was not anticipated. Failing to recognize late preterm infants’ feeding distress exemplified lack of knowledge of feeding cues and tendencies to either rationalize or minimize feeding concerns. Public health nurses represent a source of informational support for managing neonatal morbidities associated with being late preterm; however, maternal experiences with public health nurses varied. Some nurses used a directive style that overwhelmed certain mothers. Seeing multiple public health nurses and care providers was not always effective, given inconsistent and contradictory guidance to care. These new and changing situations increased maternal anxiety and stress and influenced maternal confidence in care. Fathers, family, and friends were important sources of emotional support. Conclusion After discharge, mothers report their lack of preparation to meet the special needs of their late preterm infants. Current approaches to community-based care can threaten maternal confidence in care. New models and pathways of care for late preterm infants and their families need to be responsive to the spectrum of feeding issues encountered, limit duplication of services, and ensure consistent and effective care that parents will accept. PMID:28334033

Lifetime Duration of Depressive Disorders in Patients With Type 2 Diabetes

PubMed Central

Crick, Kent A.; Long, Molly; Saha, Chandan; Shubrook, Jay H.

2016-01-01

OBJECTIVE Depression in patients with type 2 diabetes (T2D) is associated with long-term complications, disability, and early mortality. No studies have systematically examined the length of episodes and remission in adults with major depressive disorder (MDD) and T2D. This study examined the course of depressive disorders in patients with T2D and MDD. RESEARCH DESIGN AND METHODS Participants (N = 50) enrolled in a behavioral intervention for adults with T2D and MDD were interviewed using the Structured Clinical Interview for DSM-IV-TR to assess history of depressive disorders at baseline (lifetime history), postintervention, and 3-month follow-up. Onset and remission dates were recorded for all Axis I depressive disorders from birth to final interview. RESULTS Average number of MDD episodes was 1.8 with a mean duration of 23.4 months (SD 31.9; range 0.5–231.3). Over the life course, mean exposure to MDD was 43.1 months (SD 46.5; range 0.5–231.3). Kaplan-Meier survival curve analysis indicated median episode duration decreased with subsequent episodes (14 months, first episode; 9 months, second episode; P < 0.002). In patients with multiple depressive episodes, recovery time was shorter with each subsequent episode (P = 0.002). No differences in length of episode or remission were observed based on chronology of T2D diagnosis. CONCLUSIONS The overall exposure to depression in this sample of adults with T2D represents a substantial period of time that can contribute to negative medical and psychiatric outcomes. Recurrent episodes decrease in duration as do recovery periods, resulting in a waxing and waning pattern. Findings from this study underscore the need to effectively diagnose and treat depression in patients with T2D to minimize risk of future depressive episodes. PMID:27729427

Ten-Year Course of Borderline Personality Disorder

PubMed Central

Gunderson, John G.; Stout, Robert L.; McGlashan, Thomas H.; Shea, M. Tracie; Morey, Leslie C.; Grilo, Carlos M.; Zanarini, Mary C.; Yen, Shirley; Markowitz, John C.; Sanislow, Charles; Ansell, Emily; Pinto, Anthony; Skodol, Andrew E.

2011-01-01

Context Borderline personality disorder (BPD) is traditionally considered chronic and intractable. Objective To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design A collaborative study of treatment-seeking, 18-to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning. Setting Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities. Participants Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 with MDD but no personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose personality disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P<.001) and minimally slower than for other personality disorders (P<.03). Twelve percent of patients with BPD relapsed, a rate less frequent and slower than for patients with MDD (P<.001) and other personality disorders (P=.008). All BPD criteria declined at similar rates. Social function scores showed severe impairment with only modest albeit statistically significant improvement; patients with BPD remained persistently more dysfunctional than the other 2 groups (P<.001). Reductions in criteria predicted subsequent improvements in DSM-IV Axis V Global Assessment of Functioning scores (P<.001). Conclusions The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder. PMID:21464343

Negotiating place and gendered violence in Canada's largest open drug scene.

PubMed

McNeil, Ryan; Shannon, Kate; Shaver, Laura; Kerr, Thomas; Small, Will

2014-05-01

Vancouver's Downtown Eastside is home to Canada's largest street-based drug scene and only supervised injection facility (Insite). High levels of violence among men and women have been documented in this neighbourhood. This study was undertaken to explore the role of violence in shaping the socio-spatial relations of women and 'marginal men' (i.e., those occupying subordinate positions within the drug scene) in the Downtown Eastside, including access to Insite. Semi-structured qualitative interviews were conducted with 23 people who inject drugs (PWID) recruited through the Vancouver Area Network of Drug Users, a local drug user organization. Interviews included a mapping exercise. Interview transcripts and maps were analyzed thematically, with an emphasis on how gendered violence shaped participants' spatial practices. Hegemonic forms of masculinity operating within the Downtown Eastside framed the everyday violence experienced by women and marginal men. This violence shaped the spatial practices of women and marginal men, in that they avoided drug scene milieus where they had experienced violence or that they perceived to be dangerous. Some men linked their spatial restrictions to the perceived 'dope quality' of neighbourhood drug dealers to maintain claims to dominant masculinities while enacting spatial strategies to promote safety. Environmental supports provided by health and social care agencies were critical in enabling women and marginal men to negotiate place and survival within the context of drug scene violence. Access to Insite did not motivate participants to enter into "dangerous" drug scene milieus but they did venture into these areas if necessary to obtain drugs or generate income. Gendered violence is critical in restricting the geographies of men and marginal men within the street-based drug scene. There is a need to scale up existing environmental interventions, including supervised injection services, to minimize violence and potential drug-related risks among these highly-vulnerable PWID. Copyright © 2013 Elsevier B.V. All rights reserved.

NEGOTIATING PLACE AND GENDERED VIOLENCE IN CANADA’S LARGEST OPEN DRUG SCENE

PubMed Central

McNeil, Ryan; Shannon, Kate; Shaver, Laura; Kerr, Thomas; Small, Will

2014-01-01

Background Vancouver’s Downtown Eastside is home to Canada’s largest street-based drug scene and only supervised injection facility (Insite). High levels of violence among men and women have been documented in this neighbourhood. This study was undertaken to explore the role of violence in shaping the socio-spatial relations of women and ‘marginal men’ (i.e., those occupying subordinate positions within the drug scene) in the Downtown Eastside, including access to Insite. Methods Semi-structured qualitative interviews were conducted with 23 people who inject drugs (PWID) recruited through the Vancouver Area Network of Drug Users, a local drug user organization. Interviews included a mapping exercise. Interview transcripts and maps were analyzed thematically, with an emphasis on how gendered violence shaped participants’ spatial practices. Results Hegemonic forms of masculinity operating within the Downtown Eastside framed the everyday violence experienced by women and marginal men. This violence shaped the spatial practices of women and marginal men, in that they avoided drug scene milieus where they had experienced violence or that they perceived to be dangerous. Some men linked their spatial restrictions to the perceived 'dope quality' of neighbourhood drug dealers to maintain claims to dominant masculinities while enacting spatial strategies to promote safety. Environmental supports provided by health and social care agencies were critical in enabling women and marginal men to negotiate place and survival within the context of drug scene violence. Access to Insite did not motivate participants to enter into “dangerous” drug scene milieus but they did venture into these areas if necessary to obtain drugs or generate income. Conclusion Gendered violence is critical in restricting the geographies of men and marginal men within the street-based drug scene. There is a need to scale up existing environmental interventions, including supervised injection services, to minimize violence and potential drug-related risks among these highly-vulnerable PWID. PMID:24332972

Help-Seeking Behaviors for Intimate Partner Violence Perpetration by Men Receiving Substance Use Treatment: A Mixed-Methods Secondary Analysis.

PubMed

Hashimoto, Nozomu; Radcliffe, Polly; Gilchrist, Gail

2018-05-01

Despite the high prevalence of intimate partner violence (IPV) perpetration by men receiving substance use treatment, little is known about their help-seeking behaviors for IPV. A secondary analysis of a mixed-methods study of men receiving substance use treatment who perpetrated IPV examined the prevalence, characteristics, and barriers associated with IPV perpetration disclosure and help-seeking. In total, 170 men were interviewed using a structured questionnaire, and a subsample of 20 were interviewed in-depth about their experiences. Logistic regression determined variables associated with disclosure and help-seeking. Thematic analysis of the in-depth interviews explored barriers to disclosure and help-seeking. Only half the participants had told anyone about their IPV perpetration and about one quarter reported having sought any sort of support. Whereas participants were more likely to disclose their IPV perpetration to informal resources (such as friends or family), they tended to seek help from formal resources (such as health professionals or the police). A greater proportion of physical IPV perpetrators, who had disclosed, had been arrested or had police involvement for IPV, suggesting that their disclosure may not have been voluntary. The following themes emerged from the qualitative data about the barriers to disclosure and help-seeking for IPV perpetration: fear that their children would be taken into care by social services, shame and embarrassment, and a minimization or normalization of their behavior. In addition, many participants highlighted that they had never been previously asked about IPV during treatment for substance use and stressed the need for greater expertise in or knowledge of this topic from specialist services. Substance use treatment services should enquire about men's relationships and IPV perpetration to facilitate disclosure and provide support. Further research is necessary to determine the context of disclosure and help-seeking for IPV perpetration to increase the likelihood of identification.

Patient Satisfaction With Maternity Waiting Homes in Liberia: A Case Study During the Ebola Outbreak.

PubMed

Lori, Jody R; Munro-Kramer, Michelle L; Shifman, Jordan; Amarah, Patricia N M; Williams, Garfee

2017-03-01

Liberia in West Africa has one of the highest maternal mortality ratios in the world (990/100,000 live births). Many women in Liberia live in rural, remote villages with little access to safe maternity services. The World Health Organization has identified maternity waiting homes (MWHs) as one strategy to minimize the barrier of distance in accessing a skilled birth attendant. However, limited data exist on satisfaction with MWHs or maternal health care in Liberia. This mixed-methods case study examines women's satisfaction with their stay at a MWH and compares utilization rates before and during the Ebola outbreak. From 2012 to 2014, 650 women who stayed at one of 6 MWHs in rural Liberia during the perinatal or postnatal period were surveyed. Additionally, 60 semi-structured interviews were conducted with traditional providers, skilled birth attendants, and women utilizing the MWHs. Quantitative analyses assessed satisfaction rates before and during the Ebola outbreak. Content analysis of semi-structured interviews supplemented the quantitative data and provided a lens into the elements of satisfaction with the MWHs. The majority of women who utilized the MWHs stated they would suggest the MWH to a friend or relative who was pregnant (99.5%), and nearly all would utilize the home again (98.8%). Although satisfaction with the MWHs significantly decreased during the Ebola outbreak (P < .001), participants were satisfied overall with the MWHs. Content analysis identified areas of satisfaction that encompassed the themes of restful and supportive environment as well as areas for improvement such as lacking necessary resources and loneliness. This case study demonstrated that women using MWHs in Bong County, Liberia are generally satisfied with their experience and plan to use an MWH again during future pregnancies to access a skilled birth attendant for birth. Women are also willing to encourage family and friends to use MWHs. © 2017 by the American College of Nurse-Midwives.

Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs

PubMed Central

Jacobson, Julie; Mosher, Aryc W.; Walson, Judd L.

2016-01-01

Background While some evidence supports the beneficial effects of integrating neglected tropical disease (NTD) programs to optimize coverage and reduce costs, there is minimal information regarding when or how to effectively operationalize program integration. The lack of systematic analyses of integration experiences and of integration processes may act as an impediment to achieving more effective NTD programming. We aimed to learn about the experiences of NTD stakeholders and their perceptions of integration. Methodology We evaluated differences in the definitions, roles, perceived effectiveness, and implementation experiences of integrated NTD programs among a variety of NTD stakeholder groups, including multilateral organizations, funding partners, implementation partners, national Ministry of Health (MOH) teams, district MOH teams, volunteer rural health workers, and community members participating in NTD campaigns. Semi-structured key informant interviews were conducted. Coding of themes involved a mix of applying in-vivo open coding and a priori thematic coding from a start list. Findings In total, 41 interviews were conducted. Salient themes varied by stakeholder, however dominant themes on integration included: significant variations in definitions, differential effectiveness of specific integrated NTD activities, community member perceptions of NTD programs, the influence of funders, perceived facilitators, perceived barriers, and the effects of integration on health system strength. In general, stakeholder groups provided unique perspectives, rather than contrarian points of view, on the same topics. The stakeholders identified more advantages to integration than disadvantages, however there are a number of both unique facilitators and challenges to integration from the perspective of each stakeholder group. Conclusions Qualitative data suggest several structural, process, and technical opportunities that could be addressed to promote more effective and efficient integrated NTD elimination programs. We highlight a set of ten recommendations that may address stakeholder concerns and perceptions regarding these key opportunities. For example, public health stakeholders should embrace a broader perspective of community-based health needs, including and beyond NTDs, and available platforms for addressing those needs. PMID:27776127

Our chairman is very efficient: community participation in the delivery of primary health care in Ibadan, Southwest Nigeria.

PubMed

Iyanda, Omowunmi Folake; Akinyemi, Oluwaseun Oladapo

2017-01-01

Community participation is rapidly being viewed as a requirement for the successful acceptance of health services; it integrates a complicated process which involves customs, beliefs, culture and power relations, not only structures and policies. Yet, there is a wide knowledge gap and changes favouring community participation in primary health care is still minimal. This study aims to assess the process indicators and other factors influencing community participation in the delivery of primary health care. This descriptive cross-sectional study using qualitative methods was conducted in Ibadan South East Local Government Area of Oyo State, Nigeria between July and September, 2015. The interview and Focus Group Discussion guides centred around five participation indicators of needs assessment, leadership, resource mobilization, organization and management was used to collect data. A total of 12 in-depth interviews and four FGDs were conducted among male and female respondents consisting PHC service providers and community members purposively selected from four wards of the LGA. Spidergrams were constructed to visualize the levels of community participation from respondents' opinions. About 51.1% of the 45 respondents (with mean age 45.5 ± 8.09 years) were males. The respondents view community participation in the delivery of PHC in the LGA as being wide (open). Majority of the service users believe and agree that the level of community participation in their wards is about average while the service providers believed that participation was very high. However, respondents identified female representation, collaboration with pre-existing community structures, top-down and bottom-up approach to service delivery as factors affecting community participation in PHC delivery. This study provides a baseline data on community participation in the delivery of primary health care. Community participation is still an important principle in the delivery of primary health care and it guarantees the positive changes desired in the uptake and sustainability of primary health care programmes.

Antibiotic sales in rural and urban pharmacies in northern Vietnam: an observational study

PubMed Central

2014-01-01

Background The irrational overuse of antibiotics should be minimized as it drives the development of antibiotic resistance, but changing these practices is challenging. A better understanding is needed of practices and economic incentives for antibiotic dispensing in order to design effective interventions to reduce inappropriate antibiotic use. Here we report on both quantitative and qualitative aspects of antibiotic sales in private pharmacies in northern Vietnam. Method A cross-sectional study was conducted in which all drug sales were observed and recorded for three consecutive days at thirty private pharmacies, 15 urban and 15 rural, in the Hanoi region in 2010. The proportion of antibiotics to total drug sales was assessed and the revenue was calculated for rural and urban settings. Pharmacists and drug sellers were interviewed by a semi-structured questionnaire and in-depth interviews to understand the incentive structure of antibiotic dispensing. Results In total 2953 drug sale transactions (2083 urban and 870 rural) were observed. Antibiotics contributed 24% and 18% to the total revenue of pharmacies in urban and rural, respectively. Most antibiotics were sold without a prescription: 88% in urban and 91% in rural pharmacies. The most frequent reported reason for buying antibiotics was cough in the urban setting (32%) and fever in the rural area (22%). Consumers commonly requested antibiotics without having a prescription: 50% in urban and 28% in rural area. The qualitative data revealed that drug sellers and customer’s knowledge of antibiotics and antibiotic resistance were low, particularly in rural area. Conclusion Over the counter sales of antibiotic without a prescription remains a major problem in Vietnam. Suggested areas of improvement are enforcement of regulations and pricing policies and educational programs to increase the knowledge of drug sellers as well as to increase community awareness to reduce demand-side pressure for drug sellers to dispense antibiotics inappropriately. PMID:24555709

Our chairman is very efficient: community participation in the delivery of primary health care in Ibadan, Southwest Nigeria

PubMed Central

Iyanda, Omowunmi Folake; Akinyemi, Oluwaseun Oladapo

2017-01-01

Introduction Community participation is rapidly being viewed as a requirement for the successful acceptance of health services; it integrates a complicated process which involves customs, beliefs, culture and power relations, not only structures and policies. Yet, there is a wide knowledge gap and changes favouring community participation in primary health care is still minimal. This study aims to assess the process indicators and other factors influencing community participation in the delivery of primary health care. Methods This descriptive cross-sectional study using qualitative methods was conducted in Ibadan South East Local Government Area of Oyo State, Nigeria between July and September, 2015. The interview and Focus Group Discussion guides centred around five participation indicators of needs assessment, leadership, resource mobilization, organization and management was used to collect data. A total of 12 in-depth interviews and four FGDs were conducted among male and female respondents consisting PHC service providers and community members purposively selected from four wards of the LGA. Spidergrams were constructed to visualize the levels of community participation from respondents' opinions. Results About 51.1% of the 45 respondents (with mean age 45.5 ± 8.09 years) were males. The respondents view community participation in the delivery of PHC in the LGA as being wide (open). Majority of the service users believe and agree that the level of community participation in their wards is about average while the service providers believed that participation was very high. However, respondents identified female representation, collaboration with pre-existing community structures, top-down and bottom-up approach to service delivery as factors affecting community participation in PHC delivery. Conclusion This study provides a baseline data on community participation in the delivery of primary health care. Community participation is still an important principle in the delivery of primary health care and it guarantees the positive changes desired in the uptake and sustainability of primary health care programmes. PMID:29187927

New and Improved? A Comparison of the Original and Revised Versions of the Structured Interview of Reported Symptoms

ERIC Educational Resources Information Center

Green, Debbie; Rosenfeld, Barry; Belfi, Brian

2013-01-01

The current study evaluated the accuracy of the Structured Interview of Reported Symptoms, Second Edition (SIRS-2) in a criterion-group study using a sample of forensic psychiatric patients and a community simulation sample, comparing it to the original SIRS and to results published in the SIRS-2 manual. The SIRS-2 yielded an impressive…

The Structured Clinically Relevant Interview for Psychiatrists in Training (SCRIPT): A New Standardized Assessment Tool for Recruitment in the UK

ERIC Educational Resources Information Center

Rao, Rahul

2007-01-01

Objective: The multifaceted nature of training and the diverse backgrounds of potential Senior House Officers (Postgraduate Residents) require a novel approach to the selection of trainees wishing to pursue a career in psychiatry. The author reports the properties of a semi-structured interview (the SCRIPT) for assessing doctors short-listed for a…

Scaphoid tuberosity excursion is minimized during a dart-throwing motion: A biomechanical study.

PubMed

Werner, Frederick W; Sutton, Levi G; Basu, Niladri; Short, Walter H; Moritomo, Hisao; St-Amand, Hugo

2016-01-01

The purpose of this study was to determine whether the excursion of the scaphoid tuberosity and therefore scaphoid motion is minimized during a dart-throwing motion. Scaphoid tuberosity excursion was studied as an indicator of scaphoid motion in 29 cadaver wrists as they were moved through wrist flexion-extension, radioulnar deviation, and a dart-throwing motion. Study results demonstrate that excursion was significantly less during the dart-throwing motion than during either wrist flexion-extension or radioulnar deviation. If the goal of early wrist motion after carpal ligament or distal radius injury and reconstruction is to minimize loading of the healing structures, a wrist motion in which scaphoid motion is minimal should reduce length changes in associated ligamentous structures. Therefore, during rehabilitation, if a patient uses a dart-throwing motion that minimizes his or her scaphoid tuberosity excursion, there should be minimal changes in ligament loading while still allowing wrist motion. Bench research, biomechanics, and cross-sectional. Not applicable. The study was laboratory based. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Patients' and clinicians' experiences of wound care in Canada: a descriptive qualitative study.

PubMed

Woo, K Y; Wong, J; Rice, K; Coelho, S; Haratsidis, E; Teague, L; Rac, V E; Krahn, M

2017-07-01

This study sought to explore patients' and clinicians' perceptions and experiences with the provision of standard care by a home care nurse alone or by a multidisciplinary wound care team. The interviews were conducted using an in-depth semi structured format; following a funnel idea of starting out broad and narrowing down, ensuring that all the necessary topics were covered by the end of the interview. A purposive sample of 16 patients with different wound types were interviewed to ensure that the data would reflect the range and diversity of treatment and care experience. To reflect the diversity of experiences 12 clinicians from various clinical backgrounds were interviewed. Based on the analysis of the interviews, there are four overarching themes: wound care expertise is required across health-care sectors, psychosocial needs of patients with chronic wounds are key barriers to treatment concordance, structured training, and a well-coordinated multidisciplinary team approach. Results of this qualitative study identified different barriers and facilitators that affect the experiences of community-based wound care.

Reshould I Take More MIS Courses? Implications from Interviews with Business Recruiters

ERIC Educational Resources Information Center

He, Jun; Guo, Yi Maggie

2015-01-01

It is important for MIS educators to have a good understanding of what IT knowledge and skills are required in business. In this study, 103 open job positions in the Midwestern United States were investigated via semi-structured interviews with hiring companies. The interviews with key business recruiters suggest that IT knowledge and skills are…

A Four-Year Follow-Up of Means-End Outcomes from Outdoor Adventure Programs

ERIC Educational Resources Information Center

Goldenberg, Marni; Soule, Katherine E.

2015-01-01

Means-end theory was used to analyze differences in outcomes from original interviews and follow-up interviews occurring four years after Outward Bound (OB) and National Outdoor Leadership School (NOLS) 2006 course participation. In 2006, a semi-structured, in-person interview was conducted after participants (N = 510) completed their course. In…

Improving applicant interviewing--using a behavioral-based questioning approach.

PubMed

Strasser, Patricia B

2005-04-01

Selecting the correct person for the job is crucial for occupational health nurse managers. A successful interview takes time to prepare and implement. A structured, well-planned interview using behavioral-based questioning can significantly increase the amount of information a manager has available to determine how a potential candidate may perform in the intended job.

Receiving Video-Based Feedback in Elite Ice-Hockey: A Player's Perspective

ERIC Educational Resources Information Center

Nelson, Lee J.; Potrac, Paul; Groom, Ryan

2014-01-01

The aim of this paper was to provide some rich insights into how an elite ice-hockey player responded to his coaches' pedagogical delivery of video-based feedback sessions. Data for this study were gathered through a series of in-depth, semi-structured interviews and a reflective log relating to those interviews. The interviews were transcribed…

Effect of Language of Interview on the Validity and Reliability of Psychological Well-Being Scales.

ERIC Educational Resources Information Center

Tran, Thanh V.; Williams, Leon F.

1994-01-01

Tested hypothesis that use of different languages in telephone survey could adversely affect cross-cultural comparability of standardized research measures. Of 2,299 persons surveyed in 1988 National Survey of Hispanic Elderly People, 86.6% were interviewed in Spanish and 13.4% were interviewed in English. Factor structure associated with positive…

Applicant Personality and Procedural Justice Perceptions of Group Selection Interviews.

PubMed

Bye, Hege H; Sandal, Gro M

2016-01-01

We investigated how job applicants' personalities influence perceptions of the structural and social procedural justice of group selection interviews (i.e., a group of several applicants being evaluated simultaneously). We especially addressed trait interactions between neuroticism and extraversion (the affective plane) and extraversion and agreeableness (the interpersonal plane). Data on personality (pre-interview) and justice perceptions (post-interview) were collected in a field study among job applicants ( N  = 97) attending group selection interviews for positions as teachers in a Norwegian high school. Interaction effects in hierarchical regression analyses showed that perceptions of social and structural justice increased with levels of extraversion among high scorers on neuroticism. Among emotionally stable applicants, however, being introverted or extraverted did not matter to justice perceptions. Extraversion did not impact on the perception of social justice for applicants low in agreeableness. Agreeable applicants, however, experienced the group interview as more socially fair when they were also extraverted. The impact of applicant personality on justice perceptions may be underestimated if traits interactions are not considered. Procedural fairness ratings for the group selection interview were high, contrary to the negative reactions predicted by other researchers. There was no indication that applicants with desirable traits (i.e., traits predictive of job performance) reacted negatively to this selection tool. Despite the widespread use of interviews in selection, previous studies of applicant personality and fairness reactions have not included interviews. The study demonstrates the importance of previously ignored trait interactions in understanding applicant reactions.

Results of the psychiatric, select-out evaluation of US astronaut applications

NASA Technical Reports Server (NTRS)

Faulk, D. M.; Santy, P. A.; Holland, A. W.; Marsh, R.

1992-01-01

The psychiatric exclusion criteria for astronauts are based on NASA Medical Psychiatric Standards for space flight. Until recently, there were no standardized methods to evaluate disqualifying psychopathology in astronaut applicants. Method: One hundred and six astronaut applicants who had passed the intitial screening were evaluated for Axis 1 and Axis 2 DSM-3-R diagnoses using the NASA structured psychiatric interview. The interview consisted of three parts: (1) an unstructured portion for obtaining biographical and historical information, (2) the schedule for effective disorders-lifetime version (SASDL), specially modified to include all disqualifying Axis 1 mental disorders; and, (3) the personality assessment schedule (PAS) also modified to evaluate for Axis 2 disorders. Results: Nine of 106 candidates (8.5 percent) met diagnostic criteria for six Axis 1 disorders (including V code) or Axis 2 disorders. Two of these disorders were disqualifying for the applicants. 'Near' diagnoses (where applicants met at least 50 percent of the listed criteria) were assessed to demonstrate that clinicians using the interview were able to overcome applicants' reluctance to report symptomatomatology. Conclusion: The use of the NASA structured interview was effective in identifying past and present psychopathology in a group of highly motivated astronaut applicants. This was the first time a structured psychiatric interview had been used in such a setting for this purpose.

Why don't some women return for cervical smears? A hermeneutic phenomenological investigation.

PubMed

Buetow, Stephen; Janes, Ron; Steed, Robin; Ihimaera, Louise; Elley, C Raina

2007-10-01

To enhance understanding of how having a cervical smear can lead some women not to keep up-to-date with this test, a hermeneutic (interpretative) phenomenological study was undertaken. Participants were six purposively selected New Zealand women -- predominantly Māori -- at least 6 months overdue for a follow-up cervical screen in the previous 6 years. Each woman gave an in-depth interview. Transcribed and analyzed via a general inductive approach, the interviews suggested that the smears can violate women's positive aloneness with their bodies, and magnify aloneness as a negative state. Overdueness for the test avoids these effects. To minimize such effects, primary health care needs to acknowledge and address these issues, for example by providing an opportunity to connect the aloneness to trusted others.

Stakeholders' views on data sharing in multicenter studies.

PubMed

Mazor, Kathleen M; Richards, Allison; Gallagher, Mia; Arterburn, David E; Raebel, Marsha A; Nowell, W Benjamin; Curtis, Jeffrey R; Paolino, Andrea R; Toh, Sengwee

2017-09-01

To understand stakeholders' views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. Semistructured interviews with five US stakeholder groups. We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4). Perceptions of the benefits and value of research were the strongest influences toward data sharing; cost and security risks were primary influences against sharing. Privacy-protecting methods that share summary-level data were acknowledged as being appealing, but there were concerns about increased cost and potential loss of research validity. Stakeholders were open to data sharing in multicenter studies that offer value and minimize security risks.

Negotiating ecstasy risk, reward, and control: a qualitative analysis of drug management patterns among ecstasy-using urban young adults.

PubMed

Singer, Elyse Ona; Schensul, Jean J

2011-01-01

This paper is based on qualitative in-depth interviews conducted from 2008 to 2009 with 118 ethnically diverse Ecstasy users from the greater Hartford area, CT, USA. Participants were urban, primarily Black and Hispanic, aged 18 to 36, and had limited higher education compared with samples in previous Ecstasy research. Interviews focused on personal background, history of Ecstasy and other drug use, and recent sexual events. In this paper, we examine: participants' negotiation of perceived risks and benefits of Ecstasy use, behavioral strategies employed to minimize risks, and the relationship of risk-benefit analysis, motivation for use, frequency of use, and polydrug use to participants' sense of control over their Ecstasy use. We conclude with recommendations for intervention approaches and suggestions for future research.

A structured interview for the DSM-III personality disorders. A preliminary report.

PubMed

Stangl, D; Pfohl, B; Zimmerman, M; Bowers, W; Corenthal, C

1985-06-01

With few exceptions, published studies fail to indicate that the DSM-III personality disorders can be distinguished from each other with respect to etiology, prognosis, treatment response, or family history. The Structured Interview for the DSM-III Personality Disorders (SIDP) was developed to improve axis II diagnostic reliability, and hence allow validity testing of axis II. Sixty-three subjects were independently rated by two interviewers using the SIDP. The kappa coefficients for interrater agreement reached .70 or higher for histrionic, borderline, and dependent personalities. While it is impossible to separate the validity testing of the SIDP from validity testing of the DSM-III personality criteria themselves, preliminary results from 102 inpatient SIDP interviews suggest some criterion-based validity with respect to standard personality rating scales and some construct validity with respect to the dexamethasone suppression test.

Assessing quality of a worksite health promotion programme from participants’ views: findings from a qualitative study in Malaysia

PubMed Central

Liau, Siow‐Yen; Hassali, Mohamed‐Azmi A.; Shafie, Asrul A.; Ibrahim, Mohamed‐Izham M.

2014-01-01

Abstract Background  An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme. Objective  To explore the participants’ perceptions of the quality and effectiveness of the ‘Love Your Heart Programme’. Design  A qualitative study using semi‐structured interviews with a purposive sample of participants of the ‘Love Your Heart’ programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio‐recorded, transcribed verbatim and analysed using the principles of grounded theory. Results  A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the ‘Road to a Healthy Heart’ booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them. Discussion and conclusions  In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme. PMID:22050457

Assessing quality of a worksite health promotion programme from participants' views: findings from a qualitative study in Malaysia.

PubMed

Liau, Siow-Yen; Hassali, Mohamed-Azmi A; Shafie, Asrul A; Ibrahim, Mohamed-Izham M

2014-02-01

An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme. To explore the participants' perceptions of the quality and effectiveness of the 'Love Your Heart Programme'. A qualitative study using semi-structured interviews with a purposive sample of participants of the 'Love Your Heart' programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio-recorded, transcribed verbatim and analysed using the principles of grounded theory. A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the 'Road to a Healthy Heart' booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them. In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme. © 2011 John Wiley & Sons Ltd.

Risk perception and moralization among smokers in the USA and Denmark: a qualitative approach.

PubMed

Helweg-Larsen, Marie; Tobias, Margaret R; Cerban, Bettina M

2010-11-01

The present research explored the role that culture plays in smokers' description of their risk perceptions and experiences as targets of moralization. We conducted in-depth qualitative interviews with 15 smokers each from Denmark (a smoking-lenient culture) and the USA (a smoking-prohibitive culture). Smokers said they were well aware of the risks of smoking yet minimized the risks of active and passive smoking; Danes were particularly likely to minimize these risks. Smokers also described many experiences as targets of moralization and accepted some elements of moralized attitudes although overall Danes more strongly rejected moralized opinions. Smokers described adjusting to moralization by changing when and where but not how much they smoked. It is important to consider cultural influences on moralization and risk perception of smoking.

Nonlinear transient analysis via energy minimization

NASA Technical Reports Server (NTRS)

Kamat, M. P.; Knight, N. F., Jr.

1978-01-01

The formulation basis for nonlinear transient analysis of finite element models of structures using energy minimization is provided. Geometric and material nonlinearities are included. The development is restricted to simple one and two dimensional finite elements which are regarded as being the basic elements for modeling full aircraft-like structures under crash conditions. The results indicate the effectiveness of the technique as a viable tool for this purpose.

USAR Credentialing Process Effect on Provider Participation in Medical Readiness Training Exercises and Deployments

DTIC Science & Technology

2016-06-10

APMC, the individual? 4. How are providers notified of delinquencies in their credentialing packet? i.e. something expired or there is a pending...interviews, web site, and doctrine comparisons, very little variance in those areas provide minimal impact on the participation rate of providers in...are points of frustration for practitioners however, the impact that they have is mitigated by the redundancies and good communication between all

Two Sides of the Same Coin: Cannabis Dependence and Mental Health Problems in Help-Seeking Adolescent and Young Adult Outpatients

ERIC Educational Resources Information Center

Norberg, Melissa M.; Battisti, Robert A.; Copeland, Jan; Hermens, Daniel F.; Hickie, Ian B.

2012-01-01

The aim of the current study was to delineate the psychiatric profile of cannabis dependent young people (14-29 years old) with mental health problems (N = 36) seeking treatment via a research study. To do so, the Structured Clinical Interview for DSM-IV-TR Axis I Disorders and the Structured Clinical Interview for DSM-IV Childhood Diagnoses were…

[The psychodynamics of work with iodine-131 in nuclear medicine].

PubMed

da Silveira, Leila Cunha; Guilam, Maria Cristina Rodrigues; de Oliveira, Sergio Ricardo

2013-11-01

This paper seeks to demonstrate to what extent alternative forms adopted in the working process of professionals with iodine-131 in nuclear medicine can assist in managing risks of ionizing radiation. The design is based on the main theoretical concepts of the psychodynamics of work in relation to workers' health. In the case study, data were gathered from 15 workers of a public health institution in the city of Rio de Janeiro by means of semi-structured individual interviews and non-systematic direct observation. Bardin's content analysis method was used for the data analysis. When comparing the results obtained with standard prescribed models, it was found that the respondents had changed their approach. They developed individual defense mechanisms, such as denial of risk, and collective defensive strategies, leading them to tackle the greatest danger as a form of defense. The defensive role of ideologies of the profession are manifest. On the contrary, the acquired knowledge derived from prudence proved effective in minimizing the risks of radiation exposure. The authors discuss the limitations of security management that does not consider the workers' subjectivity and inherent knowledge.

Association between cultural factors and the caregiving burden for Chinese spousal caregivers of frail elderly in Hong Kong.

PubMed

Chan, Christopher L F; Chui, Ernest W T

2011-05-01

The aim of this study was to explore the relationship between cultural factors and the caregiving burden of Chinese spousal caregivers who provided care to their frail partners. A sample consisting of 102 Chinese caregivers for frail elderly spouses was recruited from home care services across various districts in Hong Kong. Structured interviews were conducted with the participants in their homes, measuring demographics, the functional status of the spouse, the degree of assistance required in daily care, perceived health, the caregiver's orientation to traditional Chinese family values, social support, coping, and caregiver burden. Findings of regression analysis indicated that gender, activities of daily living (ADL) status, orientation to traditional Chinese family values, passive coping, and marital satisfaction associated with caregiver burden. Being female, having lower functioning in ADL or a strong orientation toward traditional Chinese family values, employing the strategies of passive coping more frequent, or experiencing a low degree of marital satisfaction were associated with high levels of caregiver burden. These findings provided a basis for developing appropriate interventions to minimize the caregiver burden of spousal family caregivers.

ABC for AIDS prevention in Guinea: migrant gold mining communities address their risks.

PubMed

Kis, Adam Daniel

2010-04-01

Contrary to expectation when compared with other migrant mining zones of sub-Saharan Africa, the nation of Guinea has a comparatively low and stable HIV rate. In addition, the regions with the largest gold, diamond, and bauxite mining operations report the lowest HIV rates within the country. This research set out to explain practices and beliefs within gold mining communities near Siguiri, Guinea--the highest-producing gold mining zone in the country--that may contribute to this phenomenon, particularly as they relate to the Abstinence, Be faithful, use a Condom approach to AIDS prevention. Structured interviews on a randomly selected sample of 460 adults and regular visitation to 16 pharmacies and health clinics within the mining zone yielded data showing that abstinence and condom use are minimally practiced for AIDS prevention. Instead, faithfulness to partners was overwhelmingly reported as the method of choice for AIDS avoidance. In addition, this research explored ways in which local conceptions of fidelity differed from those generally understood in other contexts, including engagement in short-term marriages at the gold mining sites.

Investigating the psychometric properties of the Rosenberg Self-Esteem scale for South African residents of Greater Pretoria.

PubMed

Westaway, Margaret S; Jordaan, Esmè R; Tsai, Jennifer

2015-06-01

Interviewers administered the Rosenberg Self-Esteem scale (RSES) to five groups of Black (formal township and informal settlement), White, Indian, and mixed race adult residents of Greater Pretoria. The results demonstrated that the RSES was psychometrically sound for the five groups. The minimal effects of sociodemographic characteristics on global self-esteem showed that the RSES and its two dimensions, self-competence (SC) and self-liking (SL), were suitable in this setting. All five groups scored above the theoretical midpoint of the RSES, indicating that generally positive self-evaluations appear to be universal. The relationships between positively and negatively worded items, SC, and SL attested to the following: internal structure reliability, congruence between positive and negative items, no negative biases in response, and concordance between SC and SL dimensions. The significant differences between informal settlement residents and the other four groups on global self-esteem, positively and negatively worded items, and SC and SL were possibly due to physiological needs taking precedence over higher order needs. © The Author(s) 2013.

A Case for the Standardized Assessment of Testamentary Capacity

PubMed Central

Brenkel, Megan; Whaley, Kimberley; Herrmann, Nathan; Crawford, Kerri; Hazan, Elias; Cardiff, Laura; Owen, Adrian M.

2018-01-01

Background With an increasingly aged, frail population that holds a disproportionate amount of wealth, clinicians (especially those with expertise in older adults) may be asked with more frequency to offer a clinical opinion on testamentary capacity (TC), the mental capacity to make a will. Method This paper reviews the legal criteria as well as the empirical research on assessment tools for determining testamentary capacity (TC). We also review the relevance of instruments used for the assessment of other decisional capacities in order to evince the potential value of developing a standardized assessment of TC for clinician experts. Results The legal criteria, often referred to as a “test”, for determining requisite TC (Banks v. Goodfellow) have remained much the same since 1870 with minimal clinical input and, as such, there has been little development in TC assessment instruments. Decisional instruments designed to assess Consent to Treatment may have relevance for TC. Conclusion We make the case for a semi-structured interview that includes standardized criteria for the legal test for TC, supplemented by a validated brief neuropsychological assessment, which together comprise a Contemporaneous Assessment Instrument (CAI) for TC. PMID:29581818

DIA2: Web-based Cyberinfrastructure for Visual Analysis of Funding Portfolios.

PubMed

Madhavan, Krishna; Elmqvist, Niklas; Vorvoreanu, Mihaela; Chen, Xin; Wong, Yuetling; Xian, Hanjun; Dong, Zhihua; Johri, Aditya

2014-12-01

We present a design study of the Deep Insights Anywhere, Anytime (DIA2) platform, a web-based visual analytics system that allows program managers and academic staff at the U.S. National Science Foundation to search, view, and analyze their research funding portfolio. The goal of this system is to facilitate users' understanding of both past and currently active research awards in order to make more informed decisions of their future funding. This user group is characterized by high domain expertise yet not necessarily high literacy in visualization and visual analytics-they are essentially casual experts-and thus require careful visual and information design, including adhering to user experience standards, providing a self-instructive interface, and progressively refining visualizations to minimize complexity. We discuss the challenges of designing a system for casual experts and highlight how we addressed this issue by modeling the organizational structure and workflows of the NSF within our system. We discuss each stage of the design process, starting with formative interviews, prototypes, and finally live deployments and evaluation with stakeholders.

Legal Agreements and the Governance of Research Commons: Lessons from Materials Sharing in Mouse Genomics

PubMed Central

Mishra, Amrita

2014-01-01

Abstract Omics research infrastructure such as databases and bio-repositories requires effective governance to support pre-competitive research. Governance includes the use of legal agreements, such as Material Transfer Agreements (MTAs). We analyze the use of such agreements in the mouse research commons, including by two large-scale resource development projects: the International Knockout Mouse Consortium (IKMC) and International Mouse Phenotyping Consortium (IMPC). We combine an analysis of legal agreements and semi-structured interviews with 87 members of the mouse model research community to examine legal agreements in four contexts: (1) between researchers; (2) deposit into repositories; (3) distribution by repositories; and (4) exchanges between repositories, especially those that are consortium members of the IKMC and IMPC. We conclude that legal agreements for the deposit and distribution of research reagents should be kept as simple and standard as possible, especially when minimal enforcement capacity and resources exist. Simple and standardized legal agreements reduce transactional bottlenecks and facilitate the creation of a vibrant and sustainable research commons, supported by repositories and databases. PMID:24552652

Work and technological innovation in organic agriculture.

PubMed

Tereso, M J A; Abrahão, R F; Gemma, S F B; Montedo, U B; Menegon, N L; Guarneti, J E; Ribeiro, I A V

2012-01-01

Organic agriculture is a sustainable cultivation ecologically, economically and socially. Several researches in organic agriculture have been made from technical perspectives, economic traits or related to ecological aspects. There are practically no investigations into the nature of the technology used in organic agriculture, especially from an ergonomic perspective. From the activity analysis, this study aimed to map the technology used in the production of organic vegetables. Properties producing organic vegetables were selected representing the State of São Paulo. It was applied an instrument (questionnaire and semi-structured interview) with their managers and it was made visual records to identify adaptations, innovations and technological demands that simultaneously minimize the workload and the difficulties in performing the tasks and increase work productivity. For some of the technological innovations a digital scanner was used to generate a virtual solid model to facilitate its redesign and virtual prototyping. The main results show that organic farmers have little technology in product form. The main innovations that enable competitive advantage or allow higher labor productivity occur in the form of processes, organization and marketing.

UNDERSTANDING THE CONTEXT OF HIV RISK BEHAVIOR AMONG HIV-POSITIVE AND HIV-NEGATIVE FEMALE SEX WORKERS AND MALE BAR CLIENTS FOLLOWING ANTIRETROVIRAL THERAPY ROLLOUT IN MOMBASA, KENYA

PubMed Central

McClelland, Lauren; Wanje, George; Kashonga, Frances; Kibe, Lydiah; McClelland, R. Scott; Kiarie, James; Mandaliya, Kishorchandra; Peshu, Norbert; Kurth, Ann

2011-01-01

This study explored perceptions of HIV following local introduction of antiretroviral therapy (ART), among 30 HIV-positive and -negative female sex workers (FSWs) and 10 male bar patrons in Mombasa, Kenya. Semi-structured interviews were analyzed qualitatively to identify determinants of sexual risk behaviors. ART was not perceived as a barrier to safer sex and in some cases led to decreased high-risk behaviors. Barriers to safer sex included economic pressure and sexual partnership types. Many women reported that negotiating condom use is more difficult in long-term partnerships. These women favored short-term partnerships to minimize risk through consistent condom use. For women living with HIV, concern about maintaining health and avoiding HIV superinfection was a strong motivator of protective behaviors. For HIV-negative women, a negative HIV test was a powerful motivator. Incorporation of context- and serostatus-specific factors (e.g., self-protection for HIV-positive women) into tailored prevention counseling may support high-risk women to reduce risk behaviors. PMID:21861605

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder.

PubMed

Alavi, Seyyed Salman; Mohammadi, Mohammad Reza; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-04-01

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under "impulse control disorder not elsewhere classified". This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. The content validity of the semi- structured clinical interview matched the DSM-IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including "SMS pathological use" and "High monthly cost of using the mobile phone" were added to promote its validity. Internal reliability (Kappa) and test-retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder.

Text-Based On-Line Conferencing: A Conceptual and Empirical Analysis Using a Minimal Prototype.

ERIC Educational Resources Information Center

McCarthy, John C.; And Others

1993-01-01

Analyzes requirements for text-based online conferencing through the use of a minimal prototype. Topics discussed include prototyping with a minimal system; text-based communication; the system as a message passer versus the system as a shared data structure; and three exercises that showed how users worked with the prototype. (Contains 61…

Barriers to weight-related health behaviours: a qualitative comparison of the socioecological conditions between pregnant and post-partum low-income women

PubMed Central

Uesugi, Keriann; Olson, Christine

2015-01-01

The association between socio-ecological factors and poor health outcomes for low-income women and their children has been the focus of disparities research for several decades. This research compares the socio-ecological conditions among low-income women from pregnancy to postpartum and highlights the factors that make weight management increasingly difficult after delivery. As part of the formative research for an online health intervention, group and individual interviews were conducted with low-income pregnant and postpartum women. Five pregnancy group interviews (n=15 women), five postpartum group interviews (n=23 women) and seven individual interviews with a total of 45 participants were conducted in Rochester, NY. All interviews were audio-recorded. The constant comparative method was used to code interview notes and identify emergent themes. Subjects faced many challenges that affected their attitudes, beliefs and their ability to maintain or improve healthy-weight behaviors. These included unemployment, relationship issues, minimal social support, lack of education, limited healthcare access, pre-existing medical conditions and neighborhood disadvantage. Compared to pregnant women, postpartum women faced additional difficulties, such as child illnesses and custody issues. The most striking differences between pregnancy and postpartum related to the family’s medical problems and greater environmental constraints. Many factors detracted from women’s capacity to engage in healthy-weight behaviors postpartum, including challenges present prior to delivery, challenges present prior to delivery that worsen after delivery, and new challenges that begin after delivery. These additional postpartum challenges need to be considered in designing programs, policies and interventions that promote healthy weight. PMID:25040706

Understanding Early Elementary Children's Conceptual Knowledge of Plant Structure and Function through Drawings

PubMed Central

Ellis, Jane P.; Jones, Alan M.

2014-01-01

This study examined children's drawings to explain children's conceptual understanding of plant structure and function. The study explored whether the children's drawings accurately reflect their conceptual understanding about plants in a manner that can be interpreted by others. Drawing, survey, interview, and observational data were collected from 182 students in grades K and 1 in rural southeastern United States. Results demonstrated the children held a wide range of conceptions concerning plant structure and function. These young children held very simple ideas about plants with respect to both their structure and function. Consistent with the drawings, the interviews presented similar findings. PMID:25185222

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

ERIC Educational Resources Information Center

Fitzgerald, Christina; Withers, Paul

2013-01-01

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

Reliability and Validity of the "Children's Interview for Psychiatric Syndromes-Parent Version" in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Witwer, Andrea N.; Lecavalier, Luc; Norris, Megan

2012-01-01

The "Children's Interview for Psychiatric Syndromes-Parent Version" (P-ChIPS) is a structured psychiatric interview designed to assess the presence of psychiatric disorders in children and adolescents. This study examined the reliability and validity of the P-ChIPS in 61 youngsters (6- to 17-years-old) with Autism Spectrum Disorders. Reliability…

Compatibility of the Relationship of Early Recollections and Life Style with Parent Schemas Obtained through Adlerian Interviews

ERIC Educational Resources Information Center

Canel, Azize Nilgün

2016-01-01

In this study, the Adlerian Interview Form has been used as a semi-structured, in-depth interview method to identify the experiences of six participants regarding Adler's concepts of early recollections and life style. Subsequent to transcribing the obtained information, recollections to be included in the analysis were subjected to the criterion…

Interviews in qualitative research.

PubMed

Peters, Kath; Halcomb, Elizabeth

2015-03-01

Interviews are a common method of data collection in nursing research. They are frequently used alone in a qualitative study or combined with other data collection methods in mixed or multi-method research. Semi-structured interviews, where the researcher has some predefined questions or topics but then probes further as the participant responds, can produce powerful data that provide insights into the participants' experiences, perceptions or opinions.

Non-Use of Cochlear Implants in Children: Child and Parent Perspectives

ERIC Educational Resources Information Center

Watson, Linda M.; Gregory, Susan

2005-01-01

Five cases of non-use of cochlear implants by children were investigated through semi-structured interviews with the children and their carers. The children were interviewed at school by a researcher who is deaf, and the carers, all of whom were hearing, were interviewed at home by a hearing researcher when the children were not present. The…

Mental disorders in battered women: an empirical study.

PubMed

Gleason, W J

1993-01-01

Prevalence of mental disorders in 62 battered women receiving services from a Florida battered woman agency was identified by means of a structured interview, the Diagnostic Interview Schedule. Of the total sample of battered women, 30 were in a shelter operated by the agency and 32 were living in their own homes and receiving assistance from the agency. Resultant diagnoses met diagnostic criteria developed in the Diagnostic and Statistical Manual (3rd. ed.) of the American Psychiatric Association. The Diagnostic Interview Schedule is a 263 item structured interview used in the National Institute of Mental Health Epidemiological Catchment Area program carried out in the early 1980s. The Diagnostic Interview Schedule permits the use of 10,953 females in the epidemiological study as a comparison group of normal women. Scoring of the interviews was done by a computer diagnostic program with absolute decision rules. Extremely high prevalence was found for psychosexual dysfunction, major depression, post traumatic stress disorder, generalized anxiety disorder, and obsessive compulsive disorder. These diagnoses appear to reflect the major components of the battered woman syndrome developed by Lenore Walker and the study approximates Walker's request for improved methodology in the research into the psychology of the battered woman.

A theory-based curriculum design for remediation of residents' communication skills.

PubMed

Leung, Fok-Han; Martin, Dawn; Batty, Helen

2009-12-01

Residents requiring remediation are often deficient in communication skills, namely clinical interviewing skills. Residents have to digest large amounts of knowledge, and then apply it in a clinical interview. The patient-centered approach, as demonstrated in the Calgary-Cambridge model and Martin's Map, can be difficult to teach. Before implementing a remediation curriculum, the theoretical educational underpinnings must be sound; curriculum evaluation is often expensive. Before establishing metrics for curriculum evaluation, a starting point is to perform a mental experiment to test theoretical adherence. This article describes an experiential remedial curriculum for communication skills. Educational theories of Kolb, Knowles, Bandura, and Bloom are used to design the curriculum into theory-based design components. Kolb's experiential cycle models the natural sequence of experiencing, teaching, and learning interviewing skills. A curriculum structured around this cycle has multiple intercalations with the above educational theories. The design is strengthened by appropriately timed use of education strategies such as learning contracts, taped interviews, simulations, structured reflection, and teacher role modeling. Importantly, it also models the form of the clinical interview format desired. Through understanding and application of contemporary educational theories, a program to remediate interviewing skills can increase its potential for success.

Cost reduction in space operations - Structuring a planetary program to minimize the annual funding requirement as opposed to minimizing the program runout cost

NASA Technical Reports Server (NTRS)

Herman, D. H.; Niehoff, J. C.; Spadoni, D. J.

1980-01-01

An approach is proposed for the structuring of a planetary mission set wherein the peak annual funding is minimized to meet the annual budget restraint. One aspect of the approach is to have a transportation capability that can launch a mission in any planetary opportunity; such capability can be provided by solar electric propulsion. Another cost reduction technique is to structure a mission test in a time sequenced fashion that could utilize essentially the same spacecraft for the implementation of several missions. A third technique would be to fulfill a scientific objective in several sequential missions rather than attempt to accomplish all of the objectives with one mission. The application of the approach is illustrated by an example involving the Solar Orbiter Dual Probe mission.

Monolithic solid-state lasers for spaceflight

NASA Astrophysics Data System (ADS)

Krainak, Michael A.; Yu, Anthony W.; Stephen, Mark A.; Merritt, Scott; Glebov, Leonid; Glebova, Larissa; Ryasnyanskiy, Aleksandr; Smirnov, Vadim; Mu, Xiaodong; Meissner, Stephanie; Meissner, Helmuth

2015-02-01

A new solution for building high power, solid state lasers for space flight is to fabricate the whole laser resonator in a single (monolithic) structure or alternatively to build a contiguous diffusion bonded or welded structure. Monolithic lasers provide numerous advantages for space flight solid-state lasers by minimizing misalignment concerns. The closed cavity is immune to contamination. The number of components is minimized thus increasing reliability. Bragg mirrors serve as the high reflector and output coupler thus minimizing optical coatings and coating damage. The Bragg mirrors also provide spectral and spatial mode selection for high fidelity. The monolithic structure allows short cavities resulting in short pulses. Passive saturable absorber Q-switches provide a soft aperture for spatial mode filtering and improved pointing stability. We will review our recent commercial and in-house developments toward fully monolithic solid-state lasers.

Minimizing student’s faults in determining the design of experiment through inquiry-based learning

NASA Astrophysics Data System (ADS)

Nilakusmawati, D. P. E.; Susilawati, M.

2017-10-01

The purpose of this study were to describe the used of inquiry method in an effort to minimize student’s fault in designing an experiment and to determine the effectiveness of the implementation of the inquiry method in minimizing student’s faults in designing experiments on subjects experimental design. This type of research is action research participants, with a model of action research design. The data source were students of the fifth semester who took a subject of experimental design at Mathematics Department, Faculty of Mathematics and Natural Sciences, Udayana University. Data was collected through tests, interviews, and observations. The hypothesis was tested by t-test. The result showed that the implementation of inquiry methods to minimize of students fault in designing experiments, analyzing experimental data, and interpret them in cycle 1 students can reduce fault by an average of 10.5%. While implementation in Cycle 2, students managed to reduce fault by an average of 8.78%. Based on t-test results can be concluded that the inquiry method effectively used to minimize of student’s fault in designing experiments, analyzing experimental data, and interpreting them. The nature of the teaching materials on subject of Experimental Design that demand the ability of students to think in a systematic, logical, and critical in analyzing the data and interpret the test cases makes the implementation of this inquiry become the proper method. In addition, utilization learning tool, in this case the teaching materials and the students worksheet is one of the factors that makes this inquiry method effectively minimizes of student’s fault when designing experiments.

Motivational Interviewing Support for a Behavioral Health Internet Intervention for Drivers with Type 1 Diabetes

PubMed Central

Ingersoll, Karen S.; Banton, Thomas; Gorlin, Eugenia; Vajda, Karen; Singh, Harsimran; Peterson, Ninoska; Gonder-Frederick, Linda; Cox, Daniel J.

2015-01-01

While Internet interventions can improve health behaviors, their impact is limited by program adherence. Supporting program adherence through telephone counseling may be useful, but there have been few direct tests of the impact of support. We describe a Telephone Motivational Interviewing (MI) intervention targeting adherence to an Internet intervention for drivers with Type 1 Diabetes, DD.com, and compare completion of intervention benchmarks by those randomized to DD.com plus MI vs. DD.com only. The goal of the pre-intervention MI session was to increase the participant's motivation to complete the Internet intervention and all its assignments, while the goal of the post-treatment MI session was to plan for maintaining changes made during the intervention. Sessions were semi-structured and partially scripted to maximize consistency. MI Fidelity was coded using a standard coding system, the MITI. We examined the effects of MI support vs. no support on number of days from enrollment to program benchmarks. Results show that MI sessions were provided with good fidelity. Users who received MI support completed some program benchmarks such as Core 4 (t176 df= -2.25; p<.03) and 11 of 12 monthly driving diaries significantly sooner, but support did not significantly affect time to intervention completion (t177 df= -1.69; p<. 10) or rates of completion. These data suggest that there is little benefit to therapist guidance for Internet interventions including automated email prompts and other automated minimal supports, but that a booster MI session may enhance collection of follow-up data. PMID:25774342

Health Literacy, Cognitive Ability, and Functional Health Status among Older Adults

PubMed Central

Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S

2014-01-01

Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068

Symptom appraisal, help seeking, and lay consultancy for symptoms of head and neck cancer.

PubMed

Queenan, J A; Gottlieb, B H; Feldman-Stewart, D; Hall, S F; Irish, J; Groome, P A

2018-01-01

Early diagnosis is important in head and neck cancer (HNC) patients to maximize the effectiveness of the treatments and minimize the debilitation associated with both the cancer and the invasive treatments of advanced disease. Many patients present with advanced disease, and there is little understanding as to why. This study investigated patients' symptom appraisal, help seeking, and lay consultancy up to the time they first went to see a health care professional (HCP). We interviewed 83 patients diagnosed with HNC. The study design was cross sectional and consisted of structured telephone interviews and a medical chart review. We gathered information on the participant's personal reactions to their symptoms, characteristics of their social network, and the feedback they received. We found that 18% of the participants thought that their symptoms were urgent enough to warrant further investigation. Participants rarely (6%) attributed their symptoms to cancer. Eighty-nine percent reported that they were unaware of the early warning signs and symptoms of HNC. Fifty-seven percent of the participants disclosed their symptoms to at least one lay consultant before seeking help from an HCP. The lay consultants were usually their spouse (77%), and the most common advice they offered was to see a doctor (76%). Lastly, 81% of the participants report that their spouse influenced their decision to see an HCP. The results of this study suggest that patients frequently believe that their symptoms were nonurgent and that their lay consultants influence their decision to seek help from an HCP. Copyright © 2017 John Wiley & Sons, Ltd.

Challenges and Facilitators to Promoting a Healthy Food Environment and Communicating Effectively with Parents to Improve Food Behaviors of School Children.

PubMed

Luesse, Hiershenee B; Paul, Rachel; Gray, Heewon L; Koch, Pamela; Contento, Isobel; Marsick, Victoria

2018-02-14

Background Childhood obesity is a major public health concern and families play an important role. Improving strategies to reach parents and directing tailored nutrition education to them is needed. Purpose To investigate the challenges and facilitators to promoting a healthy environment at home and to identify communication preferences to inform intervention strategies for effectively reaching low-income urban minority families. Procedure Semi-structured focus group interviews were conducted with four groups involving 16 low-income urban parents (94% female; 88% Hispanic/Latino, 12% African American) of elementary school children. Interviews were transcribed and analyzed applying Social Cognitive Theory and using in-vivo coding. Main Findings The most common barriers to parents providing healthy foods to their children were accommodating child preferences and familial opposition. Parents showed intentionality to engage in healthy behaviors, and often shared procedural knowledge for reaching health goals. The analyses of desired communication channels yielded major preferences: tailored information, information provided through multiple mediums, appropriate duration/frequency of messages, and presented from a voice of authority. Conclusion and Implication While parents expressed desires to be healthy, the home food environment presented substantial challenges. Multi-media supports such as workshops, flyers, and text messaging may be useful to facilitate the sharing of information to minimize the tensions between intentionality and reaching desired goals to be healthy. Some parents thought that information received through text messaging could be easily shared and would act as a voice of authority to support child behavior change.

Impacts of Computerized Physician Documentation in a Teaching Hospital: Perceptions of Faculty and Resident Physicians

PubMed Central

Embi, Peter J.; Yackel, Thomas R.; Logan, Judith R.; Bowen, Judith L.; Cooney, Thomas G.; Gorman, Paul N.

2004-01-01

Objective: Computerized physician documentation (CPD) has been implemented throughout the nation's Veterans Affairs Medical Centers (VAMCs) and is likely to increasingly replace handwritten documentation in other institutions. The use of this technology may affect educational and clinical activities, yet little has been reported in this regard. The authors conducted a qualitative study to determine the perceived impacts of CPD among faculty and housestaff in a VAMC. Design: A cross-sectional study was conducted using semistructured interviews with faculty (n = 10) and a group interview with residents (n = 10) at a VAMC teaching hospital. Measurements: Content analysis of field notes and taped transcripts were done by two independent reviewers using a grounded theory approach. Findings were validated using member checking and peer debriefing. Results: Four major themes were identified: (1) improved availability of documentation; (2) changes in work processes and communication; (3) alterations in document structure and content; and (4) mistakes, concerns, and decreased confidence in the data. With a few exceptions, subjects felt documentation was more available, with benefits for education and patient care. Other impacts of CPD were largely seen as detrimental to aspects of clinical practice and education, including documentation quality, workflow, professional communication, and patient care. Conclusion: CPD is perceived to have substantial positive and negative impacts on clinical and educational activities and environments. Care should be taken when designing, implementing, and using such systems to avoid or minimize any harmful impacts. More research is needed to assess the extent of the impacts identified and to determine the best strategies to effectively deal with them. PMID:15064287

Perceptions of organizational capacity to promote physical activity in Canada and ParticipACTION's influence five years after its relaunch: a qualitative study.

PubMed

Ramanathan, Subha; Faulkner, Guy; Berry, Tanya; Deshpande, Sameer; Latimer-Cheung, Amy E; Rhodes, Ryan E; Spence, John C; Tremblay, Mark S

2018-04-01

ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. The purpose of this study was to qualitatively investigate organizational capacity for physical activity promotion among Canadian organizations, and the influence of ParticipACTION on capacity five years after relaunch. Using a purposive sampling strategy, semi-structured telephone interviews were conducted with 44 key informants representing national, provincial, and local organizations with a mandate to promote physical activity. Interview data were analyzed using a thematic analytic approach. Organizational capacity in terms of partnerships and collaborations, and the general climate for physical activity promotion have improved since ParticipACTION's relaunch. Although financial resources reduced the ability of organizations to fulfil their mandates, internal factors such as skilled employees and sponsorships, and external factors such as technological improvements in communication and information sharing helped to offset this strain. There were mixed feelings on ParticipACTION's contribution to capacity. While ParticipACTION has brought more attention to inactivity, this was perceived as a complement to work already taking place. While some organizations perceived ParticipACTION's relaunch as competition to funding and access to popular media, others found it as an opportunity to co-brand social marketing campaigns, utilizing ParticipACTION's products and reputation. According to participants, organizational capacity to promote physical activity in Canada has increased since 2007 in subtle but important ways because of a strong climate for physical activity promotion, skilled employees, and information sharing technology. Organizational capacity changes were minimally attributed to ParticipACTION.

Psychosocial changes following transition to an aged care home: qualitative findings from Iran.

PubMed

Zamanzadeh, Vahid; Rahmani, Azad; Pakpour, Vahid; Chenoweth, Lynnette Lorraine; Mohammadi, Eesa

2017-06-01

The study explored the psychosocial effects of transitioning from home to an aged care home for older Iranian people. Moving from one's own home to a communal aged care home is challenging for older people and may give rise to numerous psychosocial responses. The extent and intensity of such changes have rarely been explored in Middle Eastern countries. Data were collected through purposive sampling by in-depth semi-structured interviews with 20 participants (17 people living in aged care homes and three formal caregivers). All the interviews were recorded and typed, and conventional qualitative content analysis was used, eliciting common themes. There were four common themes: communication isolation, resource change, monotone institutional life and negative emotional response. Participants lost their previous support systems when transitioning to an aged care home and were not able to establish new ones. Routine care was provided by formal caregivers with little attention to individual needs, and minimal support was given to help maintain the older person's independence. These losses gave rise to negative emotions in some of the participants, depending on their previous lifestyle and accommodation arrangements. The extent and intensity of psychosocial changes occurring in most of the participants following their transition to an aged care home indicates the need for a review of Iranian aged care services. To assist older Iranian people adapt more readily when making the transition to aged care home and to meet their unique psychosocial needs, a family-centred approach to service delivery is recommended. © 2016 John Wiley & Sons Ltd.

Evolutionary Optimization of a Geometrically Refined Truss

NASA Technical Reports Server (NTRS)

Hull, P. V.; Tinker, M. L.; Dozier, G. V.

2007-01-01

Structural optimization is a field of research that has experienced noteworthy growth for many years. Researchers in this area have developed optimization tools to successfully design and model structures, typically minimizing mass while maintaining certain deflection and stress constraints. Numerous optimization studies have been performed to minimize mass, deflection, and stress on a benchmark cantilever truss problem. Predominantly traditional optimization theory is applied to this problem. The cross-sectional area of each member is optimized to minimize the aforementioned objectives. This Technical Publication (TP) presents a structural optimization technique that has been previously applied to compliant mechanism design. This technique demonstrates a method that combines topology optimization, geometric refinement, finite element analysis, and two forms of evolutionary computation: genetic algorithms and differential evolution to successfully optimize a benchmark structural optimization problem. A nontraditional solution to the benchmark problem is presented in this TP, specifically a geometrically refined topological solution. The design process begins with an alternate control mesh formulation, multilevel geometric smoothing operation, and an elastostatic structural analysis. The design process is wrapped in an evolutionary computing optimization toolset.

Resisting Prescribed Opioids: A Qualitative Study of Decision Making in Patients Taking Opioids for Chronic Noncancer Pain.

PubMed

Paterson, Charlotte; Ledgerwood, Kay; Arnold, Carolyn; Hogg, Malcolm; Xue, Charlie; Zheng, Zhen

2016-04-01

Opioids are increasingly prescribed for chronic noncancer pain across the developed world. Clinical guidelines for management of these patients focus on over-use. However, research into other types of long-term medication indicates that many patients minimize drug use whenever possible. To identify the varying influences on patients' decisions about their use of prescribed opioids and explore whether concepts of resistance and minimization of intake apply to these patients. A multiprofessional team performed a qualitative interview study using the constant-comparative method. Patient's decision making was explored in depth and with a thematic analysis utilizing a published "Model of medicine-taking." A purposive sample of 20 participants drawn from two pain clinics in Melbourne, Australia. The sample was biased toward patients interested in nonmedication pain management options. Patients' needs to obtain relief from severe pain, maintain function, and minimize side effects could lead to under-use as well as over-use of prescribed opioids. In keeping with the published Model of medicine-taking, resistance to taking opioids was a common and important influence on behavior. In the face of severe chronic pain, many participants used a variety of strategies to evaluate, avoid, reduce, self-regulate, and replace opioids. Furthermore, participants perceived a resistance to opioids within the system and among some healthcare professionals. This sometimes adversely affected their adherence. Both patients and doctors exhibit aspects of resistance to the use of prescribed opioids for chronic noncancer pain, suggesting that this shared concern could be the basis of a productive therapeutic alliance to improve communication and shared decision making. Clinical guidelines for opioids use for chronic noncancer pain focus on over-use. Our qualitative interview study found that many patients resisted and minimized the use of opioids. Using a published "Model of medicine-taking," we identified various influences on patient decision making. Both patients and doctors had concerns about using opioids for chronic noncancer pain. These could be the basis of a productive therapeutic alliance to improve communication and shared decision making. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Predictors of Depressive Symptoms Among Israeli Jews and Arabs During the Al Aqsa Intifada: A Population-Based Cohort Study

PubMed Central

Tracy, Melissa; Hobfoll, Stevan E.; Canetti–Nisim, Daphna; Galea, Sandro

2009-01-01

PURPOSE We sought to assess the predictors of depressive symptoms in a population–based cohort exposed to ongoing and widespread terrorism. METHODS Interviews of a representative sample of adults living in Israel, including both Jews and Arabs, were conducted between August and September 2004, with follow-up interviews taking place between February and April 2005. Censoring weights were estimated to account for differential loss to follow-up. Zero-inflated negative binomial models with bootstrapped confidence intervals were fit to assess predictors of severity of depressive symptoms, assessed using items from the Patient Health Questionnaire. RESULTS A total of 1613 Israeli residents participated in the baseline interview (80.8% Jewish, 49.4% male, mean age 43 years); 840 residents also participated in the follow-up interview. In multivariable models, Israeli Arab ethnicity, lower household income, lower social support, experiencing economic loss from terrorism, experiencing higher levels of psychosocial resource loss, and meeting criteria for post-traumatic stress disorder were significantly associated with increased severity of depressive symptoms. CONCLUSIONS Material deprivation is the primary modifiable risk factor for depressive symptoms in the context of ongoing terrorism. Efforts to minimize ongoing material and economic stressors may mitigate the mental health consequences of ongoing terrorism. PMID:18261923

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

PubMed

Mackintosh-Franklin, Carolyn

2014-03-01

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

Can you see me? Experiences of nurses working night shift in Australian regional hospitals: a qualitative case study.

PubMed

Powell, Idona

2013-10-01

To report a study that explored the experiences of night-shift nurses, focusing on employee interrelationships and work satisfaction. Night-shift nurses are a critical component in hospital care making it essential to understand the experiences that give meaning to their work and understand how these nurses and the organization can benefit from their contribution to hospital care. A literature review revealed minimal research in this area. Qualitative case study. A qualitative case study using semi-structured interviews and self-completed diaries was conducted in 2010 in regional public hospitals in Australia. Participants were 14 nurses working nights half or more of their shifts in medical or surgical wards. Thematic analysis identified four major areas of concern: work relationships, work environment, work practices and lifestyle impact. Notably, work relationships were most meaningful for nurses on the same shift; night-shift nurses experienced working conditions inferior to their daytime counterparts including a perception of minimal leadership. Despite limited education opportunities, night shift provided opportunity for professional growth for some nurses with a slippage in skills for others; night shift provided flexibility for family and social activities, yet impeded these same activities, primarily due to pervasive fatigue. Night-shift nurses considered their role critical, yet believed that they were poorly regarded. The strong interpersonal relationships developed between night-shift workers need to be capitalized on whilst developing a more effective leadership model, improved work environment, more equitable professional development, and genuine recognition of the critical role of night nurses. © 2013 Blackwell Publishing Ltd.

Household food security and infant feeding practices in rural Bangladesh.

PubMed

Owais, Aatekah; Kleinbaum, David G; Suchdev, Parminder S; Faruque, Asg; Das, Sumon K; Schwartz, Benjamin; Stein, Aryeh D

2016-07-01

To determine the association between household food security and infant complementary feeding practices in rural Bangladesh. Prospective, cohort study using structured home interviews during pregnancy and 3 and 9 months after delivery. We used two indicators of household food security at 3-months' follow-up: maternal Food Composition Score (FCS), calculated via the World Food Programme method, and an HHFS index created from an eleven-item food security questionnaire. Infant feeding practices were characterized using WHO definitions. Two rural sub-districts of Kishoreganj, Bangladesh. Mother-child dyads (n 2073) who completed the 9-months' follow-up. Complementary feeding was initiated at age ≤4 months for 7 %, at 5-6 months for 49 % and at ≥7 months for 44 % of infants. Based on 24 h dietary recall, 98 % of infants were still breast-feeding at age 9 months, and 16 % received ≥4 food groups and ≥4 meals (minimally acceptable diet) in addition to breast milk. Mothers' diet was more diverse than infants'. The odds of receiving a minimally acceptable diet for infants living in most food-secure households were three times those for infants living in least food-secure households (adjusted OR=3·0; 95 % CI 2·1, 4·3). Socio-economic status, maternal age, literacy, parity and infant sex were not associated with infant diet. HHFS and maternal FCS were significant predictors of subsequent infant feeding practices. Nevertheless, even the more food-secure households had poor infant diet. Interventions aimed at improving infant nutritional status need to focus on both complementary food provision and education.

Deliberate acquisition of competence in physiological breech birth: A grounded theory study.

PubMed

Walker, Shawn; Scamell, Mandie; Parker, Pam

2018-06-01

Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems. Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear. How do professionals develop competence and expertise in physiological breech birth? Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition. Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners. The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices. Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The use of semi-structured interviews for the characterisation of farmer irrigation practices

NASA Astrophysics Data System (ADS)

O'Keeffe, Jimmy; Buytaert, Wouter; Mijic, Ana; Brozović, Nicholas; Sinha, Rajiv

2016-05-01

For the development of sustainable and realistic water security, generating information on the behaviours, characteristics, and drivers of users, as well as on the resource itself, is essential. In this paper we present a methodology for collecting qualitative and quantitative data on water use practices through semi-structured interviews. This approach facilitates the collection of detailed information on actors' decisions in a convenient and cost-effective manner. Semi-structured interviews are organised around a topic guide, which helps lead the conversation in a standardised way while allowing sufficient opportunity for relevant issues to emerge. In addition, they can be used to obtain certain types of quantitative data. While not as accurate as direct measurements, they can provide useful information on local practices and users' insights. We present an application of the methodology on farmer water use in two districts in the state of Uttar Pradesh in northern India. By means of 100 farmer interviews, information was collected on various aspects of irrigation practices, including irrigation water volumes, irrigation cost, water source, and their spatial variability. Statistical analyses of the information, along with data visualisation, are also presented, indicating a significant variation in irrigation practices both within and between districts. Our application shows that semi-structured interviews are an effective and efficient method of collecting both qualitative and quantitative information for the assessment of drivers, behaviours, and their outcomes in a data-scarce region. The collection of this type of data could significantly improve insights on water resources, leading to more realistic management options and increased water security in the future.

Interprofessional primary care team meetings: a qualitative approach comparing observations with personal opinions.

PubMed

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

2017-02-01

The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions. Qualitative study involving observations of team meetings and interviews with participants. Eight different IPT meetings (n = 8) in different primary care practices were observed by means of video recordings. Experiences were explored by conducting individual semi-structured interviews (n = 60) with participants (i.e. health care professionals from different disciplines) of the observed team meetings. The data were analysed by means of content analysis. Most participants expressed favourable opinions about their team meetings. However, observations showed that team meetings were more or less hectic, and lacked a clear structure and team coordinator or leader. There appears to be a discrepancy between findings from observations and interviews. From the interviews, four main themes were extracted: (1) Team structure and composition, (2) Patient-centredness, (3) Interaction and (4) Attitude and motivation. IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members' awareness of aspects that could be improved before training them in dealing with specific challenges. © The Author 2016. Published by Oxford University Press.

Displacement Based Multilevel Structural Optimization

NASA Technical Reports Server (NTRS)

Sobieszezanski-Sobieski, J.; Striz, A. G.

1996-01-01

In the complex environment of true multidisciplinary design optimization (MDO), efficiency is one of the most desirable attributes of any approach. In the present research, a new and highly efficient methodology for the MDO subset of structural optimization is proposed and detailed, i.e., for the weight minimization of a given structure under size, strength, and displacement constraints. Specifically, finite element based multilevel optimization of structures is performed. In the system level optimization, the design variables are the coefficients of assumed polynomially based global displacement functions, and the load unbalance resulting from the solution of the global stiffness equations is minimized. In the subsystems level optimizations, the weight of each element is minimized under the action of stress constraints, with the cross sectional dimensions as design variables. The approach is expected to prove very efficient since the design task is broken down into a large number of small and efficient subtasks, each with a small number of variables, which are amenable to parallel computing.

Excimer laser with fluoropolymer lining

DOEpatents

Sze, Robert C.

1982-01-01

A cavity formed of Teflon to provide extended static fill lifetimes for gases containing halogens. A double cavity configuration provides structural integrity to the inner Teflon cavity by maintaining an identical multi-atmospheric pressure within the outer structural cavity to minimize tension on the Teflon inner cavity. Use of a quantity of the lasing gas in the outer cavity or a constituent of that gas minimizes contamination of the lasing gas.

Enhancing motivational interviewing training in a family medicine clerkship.

PubMed

Kaltman, Stacey; WinklerPrins, Vincent; Serrano, Adriana; Talisman, Nicholas

2015-01-01

Despite the prevalence of unhealthy behaviors among patients in the healthcare system, traditional medical training involves little or no exposure to effective behavior change techniques such as Motivational Interviewing. An online learning community for enhanced training in Motivational Interviewing was developed for 3rd-year medical students. The website included educational materials about Motivational Interviewing as well as problematic health behaviors, a repository of exemplar videos and student videos with feedback, and a discussion board. Student participants were given the opportunity to record an encounter with a patient and to receive feedback on their use of Motivational Interviewing from a faculty member. Student volunteers in the Family Medicine Clerkship at Georgetown University School of Medicine were randomized to enhanced training, which included the online learning community, or training as usual. All student volunteers completed a questionnaire assessing self-efficacy initially and at the end of the clerkship. Students also participated in an Observed Structured Clinical Exam, which was subsequently coded by a blinded rater for behavioral counts of Motivational Interviewing techniques, key steps in Motivational Interviewing, and overall Motivational Interviewing style. Students in the enhanced training arm were rated as having significantly higher scores in Motivational Interviewing style in the Observed Structured Clinical Exam than training as usual students. A significant increase in self-efficacy from pre- to posttest in the overall sample was observed but between-group differences were not significant. Student feedback was particularly positive regarding video recorded practice sessions with patients and individualized feedback. The results of this study as well as student feedback suggest that future work should include patient practice sessions and individualized feedback in developing Motivational Interviewing curricula.

Accelerating bridge construction to minimize traffic disruption : research spotlight.

DOT National Transportation Integrated Search

2013-12-01

Since 2008, MDOT has been using accelerated bridge construction, which utilizes prefabricated components and structural placements, to minimize traffic disruptions during bridge replacement or rehabilitation. A recent project provided MDOT with a new...

Acceptability of Bibliotherapy for Patients With Cancer: A Qualitative, Descriptive Study.

PubMed

Roberts, Nicole; Lee, Virginia; Ananng, Bethsheba; Körner, Annett

2016-09-01

To determine the acceptability of a self-help workbook, Mastering the Art of Coping in Good Times and Bad, for patients with cancer.
. Descriptive, qualitative.
. Participants were recruited from the psychosocial support cancer centers of two tertiary care teaching hospitals in Montreal, Quebec, Canada.
. 18 individuals diagnosed with cancer.
. A semistructured interview guide with open-ended questions was used to gather feedback from participants about the workbook. 
. 18 participants completed the interviews from which the data emerged. Two main categories were identified from the respondents' interviews regarding the acceptability of the workbook. The first category focuses on content, whereas the other focuses on recommendations. Interviewees specified the following content as most helpful. Bibliotherapy gives patients access to knowledge to help them cope and engage in their own self-management. The workbook Mastering the Art of Coping in Good Times and Bad may be an acceptable means of helping them manage their stress. 
. Bibliotherapy is not only cost-effective and easy to administer but also an acceptable minimal intervention.

Evaluation of the Criterion and Convergent Validity of the Diagnostic Interview for Social and Communication Disorders in Young and Low-Functioning Children

ERIC Educational Resources Information Center

Maljaars, Jarymke; Noens, Ilse; Scholte, Evert; van Berckelaer-Onnes, Ina

2012-01-01

The Diagnostic Interview for Social and Communication Disorders (DISCO; Wing, 2006) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning…

Gauge Field Localization on Deformed Branes

NASA Astrophysics Data System (ADS)

Tofighi, A.; Moazzen, M.; Farokhtabar, A.

2016-02-01

In this paper, we utilise the Chumbes-Holf da Silva-Hott (CHH) mechanism to investigate the issue of gauge field localization on a deformed brane constructed with one scalar field, which can be coupled to gravity minimally or non-minimally. The study of deformed defects is important because they contain internal structures which may have implications in braneworld models. With the CHH mechanism, we find that the massless zero mode of gauge field, in the case of minimal or non-minimal coupling is localized on the brane. Moreover, in the case of non-minimal coupling, it is shown that, when the non-minimal coupling constant is larger than its critical value, then the zero mode is localized on each sub brane.

On a learning curve for shared decision making: Interviews with clinicians using the knee osteoarthritis Option Grid.

PubMed

Elwyn, Glyn; Rasmussen, Julie; Kinsey, Katharine; Firth, Jill; Marrin, Katy; Edwards, Adrian; Wood, Fiona

2018-02-01

Tools used in clinical encounters to illustrate to patients the risks and benefits of treatment options have been shown to increase shared decision making. However, we do not have good information about how these tools are viewed by clinicians and how clinicians think patients would react to their use. Our aim was to examine clinicians' views about the possible and actual use of tools designed to support patients and clinicians to collaborate and deliberate about treatment options, namely, Option Grid decision aids. We conducted a thematic analysis of qualitative interviews embedded in the intervention phase of a trial of an Option Grid decision aid for osteoarthritis of the knee. Interviews were conducted with 6 participating clinicians before they used the tool and again after clinicians had used the tool with 6 patients. In the first interview, clinicians voiced concerns that the tool would lead to an increase in encounter duration, patient resistance regarding involvement in decision making, and potential information overload. At the second interview, after minimal training, the clinicians reported that the tool had changed their usual way of communicating, and it was generally acceptable and helpful to integrate it into practice. After experiencing the use of Option Grids, clinicians became more willing to use the tools in their clinical encounters with patients. How best to introduce Option Grids to clinicians and adopt their use into practice will need careful consideration of context, workflow, and clinical pathways. © 2016 John Wiley & Sons, Ltd.

Fears, Uncertainties, and Hopes: Patient-Initiated Actions and Doctors’ Responses During Oncology Interviews*

PubMed Central

Beach, Wayne A.; Dozier, David M.

2015-01-01

New cancer patients frequently raise concerns about fears, uncertainties, and hopes during oncology interviews. This study sought to understand when and how patients raise their concerns, how doctors responded to these patient-initiated actions, and implications for communication satisfaction. A sub-sampling of video recorded and transcribed encounters was investigated involving 44 new patients and 14 oncologists. Patients completed pre-post self-report measures about fears, uncertainties, and hopes as well as post-evaluations of interview satisfaction. Conversation Analysis (CA) was employed to initially identify pairs of patient-initiated and doctor-responsive actions. A coding scheme was subsequently developed, and two independent coding teams, comprised of two coders each, reliably identified patient-initiated and doctor-responsive social actions. Interactional findings reveal that new cancer patients initiate actions much more frequently than previous research had identified, concerns are usually raised indirectly, and with minimal emotion. Doctors tend to respond to these concerns immediately, but with even less affect, and rarely partner with patients. From pre-post results it was determined that the higher patients’ reported fears, the higher their post-visit fears and lower their satisfaction. Patients with high uncertainty were highly proactive (e.g., asked more questions), yet reported even greater uncertainties following encounters. Hopeful patients also exited interviews with high hopes. Overall, new patients were very satisfied: Oncology interviews significantly decreased patients’ fears and uncertainties, while increasing hopes. Discussion raises key issues for improving communication and managing quality cancer care. PMID:26134261

Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration.

PubMed

Scott, A J; Wilson, R F

2011-01-01

African Americans living in rural USA experience multiple health disparities as a result of both race and rural geography. An increasing literature suggests that social determinants of health, the social contexts in which people live their lives, are key contributors to these health disparities. Ecological theory provides a valuable conceptual framework for exploring social determinants of health in communities, but few US rural health community-based studies have utilized this approach, or engaged ecological theory to explore rural contexts. This exploratory study blended a community-based, qualitative approach with ecological theory with the objective of identifying potential social determinants of health among African Americans in a rural community in the Deep South, from the perspectives of participants. In-depth interviews were conducted with rural, Deep South African Americans participants who were purposefully sampled to incorporate a range of perspectives. Interview guides structured around five ecological levels (individual, relational, environmental, structural, and superstructural) were used to frame interviews. Iterative content analysis of interview transcripts and field notes identified potential social determinants of health. An 'editing' approach to content analysis was used. Data and analysis quality was tested by triangulation at the level of the researcher, and by member checking with community members. Potential determinants of health were identified at all five levels of the ecological framework. At the individual level, lack of engagement with personal health and health promotion was a recurring theme. Participation in preventive health activities and education was minimal, even when offered in community settings. At the relational level, lack of social capital emerged as another potential social determinant of health, with estrangement between the younger and elder generations as one source, and fractiousness among churches (key institutions in the community) representing another. At the environmental level, the community built environment was an area of concern as it lacked opportunities for physical activity and access to healthy foods. The local job environment was identified as a potential social determinant of health, given the strong ties between income and health. At the structural level, participants complained of cronyism and nepotism favoring Whites in access to jobs, including those where local policies and funding allocations were made (eg funding for the local health department). In education, school system tracking policies were perceived to discourage African Americans from university education. At the superstructural level, high rates of poverty and racism emerged as potential social determinants. Poverty directly limited many African Americans' access to quality health care, and subtle racism was perceived in some delivery of care. Persistent stress from poverty and racism was reported, which creates health risks through physiologic pathways. This study identified potential social determinants of health, at multiple ecological levels, among African Americans in a rural community in the Deep South. The social determinants identified had the ability to impact a variety of health behaviors and health outcomes. The results demonstrate the value of this approach to conducting rural, community-based research. This descriptive and exploratory study highlights the need for quantitative exploration of these issues, as well as the development of context-appropriate, community-based health interventions that address multiple ecological levels.

Implementation of a workplace smoking ban in bars: The limits of local discretion

PubMed Central

Montini, Theresa; Bero, Lisa A

2008-01-01

Background In January 1998, the California state legislature extended a workplace smoking ban to bars. The purpose of this study was to explore the conditions that facilitate or hinder compliance with a smoking ban in bars. Methods We studied the implementation of the smoking ban in bars by interviewing three sets of policy participants: bar employers responsible for complying with the law; local government officials responsible for enforcing the law; and tobacco control activists who facilitated implementation. We transcribed the interviews and did a qualitative analysis of the text. Results The conditions that facilitated bar owners' compliance with a smoking ban in bars included: if the cost to comply was minimal; if the bars with which they were in competition were in compliance with the smoking ban; and if there was authoritative, consistent, coordinated, and uniform enforcement. Conversely, the conditions that hindered compliance included: if the law had minimal sanctions; if competing bars in the area allowed smoking; and if enforcement was delayed or inadequate. Conclusion Many local enforcers wished to forfeit their local discretion and believed the workplace smoking ban in bars would be best implemented by a state agency. The potential implication of this study is that, given the complex nature of local politics, smoking bans in bars are best implemented at a broader provincial or national level. PMID:19063716

Receipt and use of spoken and written over-the-counter medicine information: insights into Australian and UK consumers' experiences.

PubMed

Tong, Vivien; Raynor, David K; Aslani, Parisa

2018-04-01

To explore Australian and UK consumers' receipt and use of spoken and written medicine information and examine the role of leaflets for consumers of over-the-counter (OTC) medicines. Semistructured interviews were conducted with 37 Australian and 39 UK consumers to explore information received with their most recent OTC medicine purchase, and how information was used at different times post-purchase. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Similarities were evident between the key themes identified from Australian and UK consumers' experiences. Consumers infrequently sought spoken information and reported that pharmacy staff provided minimal spoken information for OTC medicines. Leaflets were not always received or wanted and had a less salient role as an information source for repeat OTC purchases. Consumers tended not to read OTC labels or leaflets. Product familiarity led to consumers tending not to seek information on labels or leaflets. When labels were consulted, directions for use were commonly read. However, OTC medicine information in general was infrequently revisited. As familiarity is not an infallible proxy for safe and effective medication use, strategies to promote the value and use of these OTC medicine information sources are important and needed. Minimal spoken information provision coupled with limited written information use may adversely impact medication safety in self-management. © 2017 Royal Pharmaceutical Society.

Minnesota Impulse Disorders Interview (MIDI): Validation of a structured diagnostic clinical interview for impulse control disorders in an enriched community sample.

PubMed

Chamberlain, Samuel R; Grant, Jon E

2018-07-01

Disorders of impulsivity are common, functionally impairing, and highly relevant across different clinical and research settings. Few structured clinical interviews for the identification and diagnosis of impulse control disorders exist, and none have been validated in a community sample in terms of psychometric properties. The Minnesota Impulse control disorders Interview (MIDI v2.0) was administered to an enriched sample of 293 non-treatment seeking adults aged 18-35 years, recruited using media advertisements in two large US cities. In addition to the MIDI, participants undertook extended clinical interview for other mental disorders, the Barratt impulsiveness questionnaire, and the Padua obsessive-compulsive inventory. The psychometric properties of the MIDI were characterized. In logistic regression, the MIDI showed good concurrent validity against the reference measures (versus gambling disorder interview, p < 0.001; Barratt impulsiveness attentional and non-planning scores p < 0.05), and good discriminant validity versus primarily non-impulsive symptoms, including against anxiety, depression, and obsessive-compulsive symptoms (all p > 0.05). Test re-test reliability was excellent (0.95). The MIDI has good psychometric properties and thus may be a valuable interview tool for clinical and research studies involving impulse control disorders. Further research is needed to better understanding the optimal diagnostic classification and neurobiology of these neglected disorders. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Applicants' preference for impression management tactic in employment interviews by Transportation Security Administration.

PubMed

Scudder, Joseph N; Lamude, Kevin G

2009-04-01

Following past findings on employment interviews, this study hypothesized applicants would have a preference for using self-promoting tactics of impression management over other focuses. Self-reports of impression management tactics were collected from 124 applicants who had interviews for screener positions with the Transportation Security Administration. Contrary to the hypothesis, analysis indicated participants reported they used more ingratiation tactics attempting to praise the interviewer than self-promotion tactics which focused on their own accomplishments. Special qualifications for security jobs which required well-developed perceptual abilities and the controlling structure of the interview context were perhaps responsible for present results differing from prior findings.

Interview Day Environment May Influence Applicant Selection of Emergency Medicine Residency Programs.

PubMed

Lewis, Jason; Dubosh, Nicole; Rosen, Carlo; Schoenfeld, David; Fisher, Jonathan; Ullman, Edward

2017-01-01

The structure of the interview day affects applicant interactions with faculty and residents, which can influence the applicant's rank list decision. We aimed to determine if there was a difference in matched residents between those interviewing on a day on which didactics were held and had increased resident and faculty presence (didactic day) versus an interview day with less availability for applicant interactions with residents and faculty (non-didactic day). This was a retrospective study reviewing interview dates of matched residents from 2009-2015. Forty-two (61.8%) matched residents interviewed on a didactic day with increased faculty and resident presence versus 26 (38.2%) on a non-didactic interview day with less availability for applicant interactions (p = 0.04). There is an association between interviewing on a didactic day with increased faculty and resident presence and matching in our program.

Combining traditional anatomy lectures with e-learning activities: how do students perceive their learning experience?

PubMed Central

Wieser, Heike; Waldboth, Simone; Mischo-Kelling, Maria

2016-01-01

Objectives The purpose of this study was to investigate how students perceived their learning experience when combining traditional anatomy lectures with preparatory e-learning activities that consisted of fill-in-the-blank assignments, videos, and multiple-choice quizzes. Methods A qualitative study was conducted to explore changes in study behaviour and perception of learning. Three group interviews with students were conducted and thematically analysed. Results Data was categorized into four themes: 1. Approaching the course material, 2. Understanding the material, 3. Consolidating the material, and 4. Perceived learning outcome.  Students appreciated the clear structure of the course, and reported that online activities encouraged them towards a first engagement with the material. They felt that they were more active during in-class sessions, described self-study before the end-of-term exam as easier, and believed that contents would remain in their memories for a longer time. Conclusions By adjusting already existing resources, lectures can be combined fairly easily and cost-effectively with preparatory e-learning activities. The creation of online components promote well-structured courses, can help minimize ‘student passivity’ as a characteristic element of lectures, and can support students in distributing their studies throughout the term, thus suggesting enhanced learning. Further research work should be designed to confirm the afore-mentioned findings through objective measurements of student learning outcomes. PMID:26897012

Property Rights Violations as a Structural Driver of Women’s HIV Risks: A Qualitative Study in Nyanza and Western Provinces, Kenya

PubMed Central

Grabe, Shelly; Lu, Tiffany; Hatcher, Abbey; Kwena, Zachary; Bukusi, Elizabeth; Mwaura-Muiru, Esther

2013-01-01

While access to and control over assets can minimize women’s HIV risk, little is known about the processes through which property rights violations increase the sexual transmission of HIV. The current study focused on two rural areas in Nyanza and Western Province, Kenya where HIV prevalence was high (23.8–33 %) and property rights violations were common. The current work drew on in-depth interview data collected from 50 individuals involved in the development and implementation of a community-led land and property rights program. The program was designed to respond to property rights violations, prevent disinheritance and asset stripping, and reduce HIV risk among women. In our findings, we detailed the social and economic mechanisms through which a loss of property rights was perceived to influence primary and secondary prevention of HIV. These included: loss of income, loss of livelihood and shelter, and migration to slums, markets, or beaches where the exchange of sex for food, money, shelter, clothing, or other goods was common. We also examined the perceived influence of cultural practices, such as wife inheritance, on HIV risk. In the conclusions, we made recommendations for future research in the science-base focused on the development of property ownership as a structural HIV prevention and treatment intervention. PMID:23179234

Leisure activities among older Germans - a qualitative study.

PubMed

Boggatz, Thomas

2013-05-01

Leisure activities contribute to well-being and health in old age. Community nurses should consequently promote such activities among older persons. To do so they need an understanding of older persons' interest in leisure activities. Social contacts, volunteering and pursuit of hobbies and interests constitute the main aspects of leisure. This study aimed to determine the attitudes of older Germans to these aspects to identify user types of leisure time facilities. A qualitative study was conducted within a community-based project in an industrial town in West Germany. Data were collected with semi-structured guideline interviews and evaluated with qualitative content analysis according to Mayring. With regard to social contacts attitudes ranged from limited need for contacts to being a reliable member in an older persons' club. Social engagement is only found among the latter. Pursuit of hobbies and interest ranged from being a minimal user of leisure time facilities to refined expectations. Inflexible group structures may prevent potential users from participation despite having a programme in accordance with target group needs. Attitudes to leisure activities can be described as a combination of two dimensions: the degree of social involvement and the desired refinement of hobbies and interest. Community nurses who organise social afternoons need to assess these attitudes and should steer social dynamics of in a way that facilitates access for newcomers. © 2012 Blackwell Publishing Ltd.

Robust penalty method for structural synthesis

NASA Technical Reports Server (NTRS)

Kamat, M. P.

1983-01-01

The Sequential Unconstrained Minimization Technique (SUMT) offers an easy way of solving nonlinearly constrained problems. However, this algorithm frequently suffers from the need to minimize an ill-conditioned penalty function. An ill-conditioned minimization problem can be solved very effectively by posing the problem as one of integrating a system of stiff differential equations utilizing concepts from singular perturbation theory. This paper evaluates the robustness and the reliability of such a singular perturbation based SUMT algorithm on two different problems of structural optimization of widely separated scales. The report concludes that whereas conventional SUMT can be bogged down by frequent ill-conditioning, especially in large scale problems, the singular perturbation SUMT has no such difficulty in converging to very accurate solutions.

Minimal metabolic pathway structure is consistent with associated biomolecular interactions

PubMed Central

Bordbar, Aarash; Nagarajan, Harish; Lewis, Nathan E; Latif, Haythem; Ebrahim, Ali; Federowicz, Stephen; Schellenberger, Jan; Palsson, Bernhard O

2014-01-01

Pathways are a universal paradigm for functionally describing cellular processes. Even though advances in high-throughput data generation have transformed biology, the core of our biological understanding, and hence data interpretation, is still predicated on human-defined pathways. Here, we introduce an unbiased, pathway structure for genome-scale metabolic networks defined based on principles of parsimony that do not mimic canonical human-defined textbook pathways. Instead, these minimal pathways better describe multiple independent pathway-associated biomolecular interaction datasets suggesting a functional organization for metabolism based on parsimonious use of cellular components. We use the inherent predictive capability of these pathways to experimentally discover novel transcriptional regulatory interactions in Escherichia coli metabolism for three transcription factors, effectively doubling the known regulatory roles for Nac and MntR. This study suggests an underlying and fundamental principle in the evolutionary selection of pathway structures; namely, that pathways may be minimal, independent, and segregated. PMID:24987116

Cancer caregivers' perceptions of an exercise and nutrition program.

PubMed

Anton, Philip M; Partridge, Julie A; Morrissy, Margaret J

2013-03-01

Little research has addressed exercise and nutrition-based interventions for cancer caregivers. This study explored cancer caregivers' perceptions of participating in a structured exercise and nutrition program alongside cancer survivors for whom they provided care. In-depth, semi-structured interviews were conducted by one interviewer with 12 cancer caregivers about their experiences participating in a structured, 12-week exercise and nutrition program designed for cancer survivors and caregivers to complete concurrently. Interviews were conducted until data saturation was reached. Inductive content analysis from individual interviews indicated three separate, but interrelated, themes: (1) the program was a positive mechanism through which caregivers shared and supported the cancer journey concurrently with survivors, (2) the program led to perceived physical and psychological benefits for both caregivers and survivors, and (3) participants perceived that participation in the program led to feeling increased social support in their caregiving duties. Findings from this study suggest that participating in an exercise- and nutrition-based intervention is viewed positively by caregivers and that the outcomes are seen as beneficial to both caregivers and survivors. Interventions that address the health needs of both members of the caregiver-survivor dyad should continue to be encouraged by allied health professionals.

Situating and Constructing Diversity in Semi-Structured Interviews

PubMed Central

McIntosh, Michele J.; Morse, Janice M.

2015-01-01

Although semi-structured interviews (SSIs) are used extensively in research, scant attention is given to their diversity, underlying assumptions, construction, and broad applications to qualitative and mixed-method research. In this three-part article, we discuss the following: (a) how the SSI is situated historically including its evolution and diversification, (b) the principles of constructing SSIs, and (c) how SSIs are utilized as a stand-alone research method, and as strategy within a mixed-method design. PMID:28462313

Rehabilitation for patients with rheumatic diseases: Patient experiences of a structured goal planning and tailored follow-up programme

PubMed Central

Dager, Turid Nygaard; Kjeken, Ingvild; Berdal, Gunnhild; Sand-Svartrud, Anne-Lene; Bø, Ingvild; Dingsør, Anne; Eppeland, Siv Grødal; Hagfors, Jon; Hamnes, Bente; Nielsen, Merete; Slungaard, Bente; Wigers, Sigrid Hørven; Hauge, Mona-Iren

2017-01-01

Objective: To explore the significance of the content of rehabilitation in terms of achieving a personal outcome, and to understand the significance of tailored follow-up interventions for individual efforts to prolong health behaviour change after rehabilitation. Design: Semi-structured interviews with patients who had received an extended rehabilitation programme. All interviews were transcribed verbatim. A thematic analysis was applied. Subjects: A purposeful sample of 18 patients with rheumatic diseases who had attended specialized multidisciplinary rehabilitation with an extended programme consisting of a self-help booklet, structured goal-setting talks and tailored follow-up calls based on motivational interviewing. Results: Four overarching and interrelated themes were identified. Experienced Person-centred interventions represented a basis for the patients’ motivation and personal outcomes. Confident self-management describes a new confident approach to exercise and illness management after rehabilitation with person-centred interventions. For many, this included reaching a different mindset, a change of illness perception. Continuity of the personal outcomes describes the importance of follow-up telephone calls to maintain the focus on goals and continued efforts. Building on established relationships and practising person-centred communication were essential. Conclusion: Tailoring of communication and rehabilitation interventions may be a premise for enhancing health behaviour, including a beneficial illness perception. Structured goal setting and follow-up telephone calls using motivational interviewing enhance motivation and may contribute to prolonged goal attainment. PMID:29163943

Assessing cannabis use in adolescents and young adults: what do urine screen and parental report tell you?

PubMed

Gignac, Martin; Wilens, Timothy E; Biederman, Joseph; Kwon, A; Mick, E; Swezey, A

2005-10-01

Our analysis compares three approaches to detect the most common drug abused in early adulthood, cannabis: (1) report on direct structured interview; (2) indirect parental report; and (3) urine toxicology screen. We examined data on 207 subjects (36% also met criteria for alcohol abuse; 9% for alcohol dependence) derived from two prospective and ongoing family studies of boys and girls with or without attention-deficit/hyperactivity disorder (ADHD). Assessments relied on the Schedule for Affective Disorders and Schizophrenia (K-SADS-E; under 18 years of age) and on the Structured Clinical Interview for DSM-IV (SCID-IV; over 18 years of age). Urine samples were analyzed with Auccusign DOA5 (on-site screening assay). Ninety-seven percent (97%) of individuals, who reported no use of cannabis within the past month, had a negative urine screening and 79% of individuals, who endorsed cannabis abuse/dependence, had a positive urine screening. The sensitivity of the direct structured interview report was 91%, the specificity 87%, the positive predicting value 67%, and the negative predictive value 97%. Indirect parental reports were found to be less informative on cannabis use than direct report. Direct report of cannabis use, abuse, or dependence during the structured interview is both sensitive and specific when compared to urine toxicology screens and indirect parental reports.

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder

PubMed Central

Alavi, Seyyed Salman; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-01-01

Objective: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under “impulse control disorder not elsewhere classified”. This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Method: Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. Results: The content validity of the semi- structured clinical interview matched the DSM–IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including “SMS pathological use” and “High monthly cost of using the mobile phone” were added to promote its validity. Internal reliability (Kappa) and test–retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. Conclusion: The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder. PMID:27437008

The Educator, Examined.

ERIC Educational Resources Information Center

Sparks, Dennis

1998-01-01

This interview with Phillip Schlechty, a leader in school reform, discusses assumptions about teachers' roles, suggesting teachers be viewed as inventors and leaders of knowledge workers. The interview addresses teachers as inventors; developing school leaders; assumptions about behavior; structural changes in education; building capacity for…

Non-Rigid Structure Estimation in Trajectory Space from Monocular Vision

PubMed Central

Wang, Yaming; Tong, Lingling; Jiang, Mingfeng; Zheng, Junbao

2015-01-01

In this paper, the problem of non-rigid structure estimation in trajectory space from monocular vision is investigated. Similar to the Point Trajectory Approach (PTA), based on characteristic points’ trajectories described by a predefined Discrete Cosine Transform (DCT) basis, the structure matrix was also calculated by using a factorization method. To further optimize the non-rigid structure estimation from monocular vision, the rank minimization problem about structure matrix is proposed to implement the non-rigid structure estimation by introducing the basic low-rank condition. Moreover, the Accelerated Proximal Gradient (APG) algorithm is proposed to solve the rank minimization problem, and the initial structure matrix calculated by the PTA method is optimized. The APG algorithm can converge to efficient solutions quickly and lessen the reconstruction error obviously. The reconstruction results of real image sequences indicate that the proposed approach runs reliably, and effectively improves the accuracy of non-rigid structure estimation from monocular vision. PMID:26473863

Forced migrants involved in setting the agenda and designing research to reduce impacts of complex emergencies: combining Swarm with patient and public involvement.

PubMed

Brainard, Julii Suzanne; Al Assaf, Enana; Omasete, Judith; Leach, Steve; Hammer, Charlotte C; Hunter, Paul R

2017-01-01

The UK's National Institute for Health Research (NIHR) Health Protection Research Unit in Emergency Preparedness and Response was asked to undertake research on how to reduce the impact of complex national/international emergencies on public health. How to focus the research and decide on priority topics was challenging, given the nature of complex events. Using a type of structured brain-storming, the researchers identified the ongoing UK, European and international migration crisis as both complex and worthy of deeper research. To further focus the research, two representatives of forced migrant communities were invited to join the project team as patient and public (PPI) representatives. They attended regular project meetings, insightfully contributed to and advised on practical aspects of potential research areas. The representatives identified cultural obstacles and community needs and helped choose the final research study design, which was to interview forced migrants about their strategies to build emotional resilience and prevent mental illness. The representatives also helped design recruitment documents, and undertake recruitment and interviewer training. Many events with wide-ranging negative health impacts are notable for complexity: lack of predictability, non-linear feedback mechanisms and unexpected consequences. A multi-disciplinary research team was tasked with reducing the public health impacts from complex events, but without a pre-specified topic area or research design. This report describes using patient and public involvement within an adaptable but structured development process to set research objectives and aspects of implementation. An agile adaptive development approach, sometimes described as swarm , was used to identify possible research areas. Swarm is meant to quickly identify strengths and weaknesses of any candidate project, to accelerate early failure before resources are invested. When aspects of the European migration crisis were identified as a potential priority topic area, two representatives of forced migrant communities were recruited to explore possible research ideas. These representatives helped set the specific research objectives and advised on aspects of implementation, still within the swarm framework for project development. Over ten months, many research ideas were considered by the collaborative working group in a series of six group meetings, supplemented by email contact in between. Up to four possible research ideas were scrutinised at any one meeting, with a focus on identifying practical or desirable aspects of each proposed project. Interest settled on a study to solicit original data about successful strategies that forced migrants use to adapt to life in the UK, with an emphasis on successfully promoting resilience and minimizing emotional distress. "Success in resettlement" was identified to be a more novel theme than "barriers to adaption" research. A success approach encourages participation when individuals may find discussion of mental illness stigmatising. The patient representatives helped with design of patient-facing and interview training materials, interviewer training (mock interviews), and aspects of the recruitment. Using patient and public involvement (PPI) within an early failure development approach that itself arises from theory on complex adaptive systems, we successfully implemented a dynamic development process to determine research topic and study design. The PPI representatives were closely involved in setting research objectives and aspects of implementation.

Mesonic spectroscopy of minimal walking technicolor

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

Del Debbio, Luigi; Lucini, Biagio; Patella, Agostino

2010-07-01

We investigate the structure and the novel emerging features of the mesonic nonsinglet spectrum of the minimal walking technicolor theory. Precision measurements in the nonsinglet pseudoscalar and vector channels are compared to the expectations for an IR-conformal field theory and a QCD-like theory. Our results favor a scenario in which minimal walking technicolor is (almost) conformal in the infrared, while spontaneous chiral symmetry breaking seems less plausible.

Periodic minimal surfaces

NASA Astrophysics Data System (ADS)

Mackay, Alan L.

1985-04-01

A minimal surface is one for which, like a soap film with the same pressure on each side, the mean curvature is zero and, thus, is one where the two principal curvatures are equal and opposite at every point. For every closed circuit in the surface, the area is a minimum. Schwarz1 and Neovius2 showed that elements of such surfaces could be put together to give surfaces periodic in three dimensions. These periodic minimal surfaces are geometrical invariants, as are the regular polyhedra, but the former are curved. Minimal surfaces are appropriate for the description of various structures where internal surfaces are prominent and seek to adopt a minimum area or a zero mean curvature subject to their topology; thus they merit more complete numerical characterization. There seem to be at least 18 such surfaces3, with various symmetries and topologies, related to the crystallographic space groups. Recently, glyceryl mono-oleate (GMO) was shown by Longley and McIntosh4 to take the shape of the F-surface. The structure postulated is shown here to be in good agreement with an analysis of the fundamental geometry of periodic minimal surfaces.

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers.

PubMed

Prior, Yeliz; Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-08-01

Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey - Rheumatic Conditions. Face-to-face semi-structured interviews were conducted with occupational therapists ( n  = 9), followed by telephone interviews with their line managers ( n  = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. The main themes emerging from the occupational therapists' interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers' interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. The Work Experience Survey - Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers

PubMed Central

Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-01-01

Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions. Method Face-to-face semi-structured interviews were conducted with occupational therapists (n = 9), followed by telephone interviews with their line managers (n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased. PMID:26321786

Investigating Clinically and Scientifically Useful Cut Points on the Compulsive Sexual Behavior Inventory.

PubMed

Miner, Michael H; Raymond, Nancy; Coleman, Eli; Swinburne Romine, Rebecca

2017-05-01

One of the major obstacles to conducting epidemiologic research and determining the incidence and prevalence of compulsive sexual behavior (CSB) has been the lack of relevant empirically derived cut points on the various instruments that have been used to measure the concept. To further develop the Compulsive Sexual Behavior Inventory (CSBI) through exploring predictive validity and developing an empirically determined and clinically useful cut point for defining CSB. A sample of 242 men who have sex with men was recruited from various sites in a moderate-size Midwestern city. Participants were assigned to a CSB group or a control group using an interview for the diagnosis that was patterned after the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. The 22-item CSBI was administered as part of a larger battery of self-report inventories. Receiver operating characteristic analyses were used to compute area-under-the-curve measurements to ascertain the predictive validity of the total scale, the control subscale, and the violence subscale. Cut points were determined through consensus of experts balancing sensitivity and specificity as determined by receiver operating characteristic curves. Analyses indicated that the 22-item CSBI was a good predictor of group membership, as was the 13-item control subscale. The violence subscale added little to the predictive accuracy of the instrument; thus, it likely measures something other than CSB. Two relevant cut points were found, one that minimized false negatives and another, more conservative cut point that minimized false positives. The CSBI as currently configured measures two different constructions and only the control subscale is helpful in diagnosing CSB. Therefore, we decided to eliminate the violence subscale and move forward with a 13-item scale that we have named the CSBI-13. Two cut points were developed from this revised scale, one that is useful as a clinical screening tool and the other, more conservative measurement that is useful for etiologic and epidemiologic research. Miner MH, Raymond N, Coleman E, Swinburne Romine R. Investigating Clinically and Scientifically Useful Cut Points on the Compulsive Sexual Behavior Inventory. J Sex Med 2017;14:715-720. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Using systems thinking and the Intervention Level Framework to analyse public health planning for complex problems: Otitis media in Aboriginal and Torres Strait Islander children

PubMed Central

Durham, Jo; Vaughan, Lisa; Willis, Cameron D.

2018-01-01

Background Middle ear disease (otitis media) is endemic among Aboriginal and Torres Strait Islander children in Australia and represents an important cause of hearing loss. The disease is the result of a mix of biological, environmental and host risk factors that interact in complex, non-linear ways along a dynamic continuum. As such, it is generally recognised that a holistic, systems approach is required to reverse the high rates of otitis media in Aboriginal and Torres Strait Islander children. The objective of this paper is to examine the alignment between efforts designed to address otitis media in Aboriginal and Torres Strait Islander children in Queensland, Australia and core concepts of systems thinking. This paper’s overall purpose is to identify which combination of activities, and at which level, hold the potential to facilitate systems changes to better support ear health among Aboriginal and Torres Strait Islander children. Methods We began with a review of documents identified in consultation with stakeholders and an online search. In addition, key informants were invited to participate in an online survey and a face-to-face or phone interview. Qualitative interviews using a semi-structured interview guide were used to explore survey responses in more depth. We also undertook interviews at the community level to elicit a diverse range of views. Ideas, statements or activities reported in the documents and interviews as being performed under the Intervention Level Framework were identified using qualitative thematic and content analysis. A quantitative descriptive analysis was also undertaken, whereby data was extracted into an Excel spreadsheet and coded under the relevant strategic directions and performance indicators of the Framework. Subsequently, we coded activities against the five-level intervention framework developed by Malhi and colleagues, that is: 1) paradigm; 2) goals; 3) system structure; 4) feedback and delays; and 5) structural elements. Results Overall, twenty documents were reviewed. We examined surveys and interviews with six key informants. Twenty-four individual and 3 group interviews were conducted across central and community level informants. One hundred and four items were coded from the 20 documents and 156 items from interview data. For both data sets, the majority of activities were coded at the structural elements level. The results suggested three key areas where further work is needed to drive sustained improvements: 1) build the governance structures needed for paradigm shift to achieve a multi-sectoral approach; 2) develop shared system level goals; 3) develop system-wide feedback processes. Conclusions Sustained progress in improving ear health within Aboriginal and Torres Strait Islander children requires a holistic, system-wide approach. To advance such work, governance structures for multi-sectoral collaboration including the development of joint goals and monitoring and feedback are required. Intervening at these higher leverage points could have a profound effect on persistent public health issues. PMID:29561891

Using systems thinking and the Intervention Level Framework to analyse public health planning for complex problems: Otitis media in Aboriginal and Torres Strait Islander children.

PubMed

Durham, Jo; Schubert, Lisa; Vaughan, Lisa; Willis, Cameron D

2018-01-01

Middle ear disease (otitis media) is endemic among Aboriginal and Torres Strait Islander children in Australia and represents an important cause of hearing loss. The disease is the result of a mix of biological, environmental and host risk factors that interact in complex, non-linear ways along a dynamic continuum. As such, it is generally recognised that a holistic, systems approach is required to reverse the high rates of otitis media in Aboriginal and Torres Strait Islander children. The objective of this paper is to examine the alignment between efforts designed to address otitis media in Aboriginal and Torres Strait Islander children in Queensland, Australia and core concepts of systems thinking. This paper's overall purpose is to identify which combination of activities, and at which level, hold the potential to facilitate systems changes to better support ear health among Aboriginal and Torres Strait Islander children. We began with a review of documents identified in consultation with stakeholders and an online search. In addition, key informants were invited to participate in an online survey and a face-to-face or phone interview. Qualitative interviews using a semi-structured interview guide were used to explore survey responses in more depth. We also undertook interviews at the community level to elicit a diverse range of views. Ideas, statements or activities reported in the documents and interviews as being performed under the Intervention Level Framework were identified using qualitative thematic and content analysis. A quantitative descriptive analysis was also undertaken, whereby data was extracted into an Excel spreadsheet and coded under the relevant strategic directions and performance indicators of the Framework. Subsequently, we coded activities against the five-level intervention framework developed by Malhi and colleagues, that is: 1) paradigm; 2) goals; 3) system structure; 4) feedback and delays; and 5) structural elements. Overall, twenty documents were reviewed. We examined surveys and interviews with six key informants. Twenty-four individual and 3 group interviews were conducted across central and community level informants. One hundred and four items were coded from the 20 documents and 156 items from interview data. For both data sets, the majority of activities were coded at the structural elements level. The results suggested three key areas where further work is needed to drive sustained improvements: 1) build the governance structures needed for paradigm shift to achieve a multi-sectoral approach; 2) develop shared system level goals; 3) develop system-wide feedback processes. Sustained progress in improving ear health within Aboriginal and Torres Strait Islander children requires a holistic, system-wide approach. To advance such work, governance structures for multi-sectoral collaboration including the development of joint goals and monitoring and feedback are required. Intervening at these higher leverage points could have a profound effect on persistent public health issues.

A cubic extended interior penalty function for structural optimization

NASA Technical Reports Server (NTRS)

Prasad, B.; Haftka, R. T.

1979-01-01

This paper describes an optimization procedure for the minimum weight design of complex structures. The procedure is based on a new cubic extended interior penalty function (CEIPF) used with the sequence of unconstrained minimization technique (SUMT) and Newton's method. The Hessian matrix of the penalty function is approximated using only constraints and their derivatives. The CEIPF is designed to minimize the error in the approximation of the Hessian matrix, and as a result the number of structural analyses required is small and independent of the number of design variables. Three example problems are reported. The number of structural analyses is reduced by as much as 50 per cent below previously reported results.

Hydrogen-bonded turns in proteins: The case for a recount

PubMed Central

Panasik, Nick; Fleming, Patrick J.; Rose, George D.

2005-01-01

β-Turns are sites at which proteins change their overall chain direction, and they occur with high frequency in globular proteins. The Protein Data Bank has many instances of conformations that resemble β-turns but lack the characteristic N–H(i) → O=C(i − 3) hydrogen bond of an authentic β-turn. Here, we identify potential hydrogen-bonded β-turns in the coil library, a Web-accessible database utility comprised of all residues not in repetitive secondary structure, neither α-helix nor β-sheet (http://www.roselab.jhu.edu/coil). In particular, candidate turns were identified as four-residue segments satisfying highly relaxed geometric criteria but lacking a strictly defined hydrogen bond. Such candidates were then subjected to a minimization protocol to determine whether slight changes in torsion angles are sufficient to shift the conformation into reference-quality geometry without deviating significantly from the original structure. This approach of applying constrained minimization to known structures reveals a substantial population of previously unidentified, stringently defined, hydrogen-bonded β-turns. In particular, 33% of coil library residues were classified as β-turns prior to minimization. After minimization, 45% of such residues could be classified as β-turns, with another 8% in 310 helixes (which closely resemble type III β-turns). Of the remaining coil library residues, 37% have backbone dihedral angles in left-handed polyproline II structure. PMID:16251367

Hydrogen-bonded turns in proteins: the case for a recount.

PubMed

Panasik, Nick; Fleming, Patrick J; Rose, George D

2005-11-01

Beta-turns are sites at which proteins change their overall chain direction, and they occur with high frequency in globular proteins. The Protein Data Bank has many instances of conformations that resemble beta-turns but lack the characteristic N-H(i) --> O=C(i - 3) hydrogen bond of an authentic beta-turn. Here, we identify potential hydrogen-bonded beta-turns in the coil library, a Web-accessible database utility comprised of all residues not in repetitive secondary structure, neither alpha-helix nor beta-sheet (http://www.roselab.jhu.edu/coil). In particular, candidate turns were identified as four-residue segments satisfying highly relaxed geometric criteria but lacking a strictly defined hydrogen bond. Such candidates were then subjected to a minimization protocol to determine whether slight changes in torsion angles are sufficient to shift the conformation into reference-quality geometry without deviating significantly from the original structure. This approach of applying constrained minimization to known structures reveals a substantial population of previously unidentified, stringently defined, hydrogen-bonded beta-turns. In particular, 33% of coil library residues were classified as beta-turns prior to minimization. After minimization, 45% of such residues could be classified as beta-turns, with another 8% in 3(10) helixes (which closely resemble type III beta-turns). Of the remaining coil library residues, 37% have backbone dihedral angles in left-handed polyproline II structure.

Secondary structure model of the RNA recognized by the reverse transcriptase from the R2 retrotransposable element.

PubMed Central

Mathews, D H; Banerjee, A R; Luan, D D; Eickbush, T H; Turner, D H

1997-01-01

RNA transcripts corresponding to the 250-nt 3' untranslated region of the R2 non-LTR retrotransposable element are recognized by the R2 reverse transcriptase and are sufficient to serve as templates in the target DNA-primed reverse transcription (TPRT) reaction. The R2 protein encoded by the Bombyx mori R2 can recognize this region from both the B. mori and Drosophila melanogaster R2 elements even though these regions show little nucleotide sequence identity. A model for the RNA secondary structure of the 3' untranslated region of the D. melanogaster R2 retrotransposon was developed by sequence comparison of 10 species aided by free energy minimization. Chemical modification experiments are consistent with this prediction. A secondary structure model for the 3' untranslated region of R2 RNA from the R2 element from B. mori was obtained by a combination of chemical modification data and free energy minimization. These two secondary structure models, found independently, share several common sites. This study shows the utility of combining free energy minimization, sequence comparison, and chemical modification to model an RNA secondary structure. PMID:8990394

Favorable locations for piezo actuators in plates with good control effectiveness and minimal change in system dynamics

NASA Astrophysics Data System (ADS)

Dhuri, K. D.; Seshu, P.

2007-12-01

Placement and sizing of piezo actuators is normally based on control effectiveness. However, retrofitting of piezoelectric actuators alters the inherent stiffness/mass properties of the parent structure. In rotating structures, the additional mass due to piezo patches contributes to the centrifugal stiffening force. The parent structure is originally designed to have a certain natural frequency spectrum in relation to the disturbance excitation. In the event of failure of the active system, the dynamics of the structure with piezos (now rendered passive) will therefore become significant. Thus it will be helpful to determine locations for mounting piezo patches based on minimal natural frequency change yet with good control authority. In this study, a finite element based procedure for plate structures is presented. Favorable locations for mounting piezos based on minimal natural frequency changes are iteratively evolved from an initial configuration wherein the whole plate is covered with piezos. A modal controllability approach has been used for finding piezo mounting locations from a good controllability perspective. The procedure is demonstrated for simply supported square, swept-back, circular and rotating rectangular plates considering the first four modes.

Expert agreed standards for the selection and development of cancer support group leaders: an online reactive Delphi study.

PubMed

Pomery, Amanda; Schofield, Penelope; Xhilaga, Miranda; Gough, Karla

2018-01-01

The aim of this study was to develop pragmatic, consensus-based minimum standards for the role of a cancer support group leader. Secondly, to produce a structured interview designed to assess the knowledge, skills and attributes of the individuals who seek to undertake the role. An expert panel of 73 academics, health professionals, cancer agency workers and cancer support group leaders were invited to participate in a reactive online Delphi study involving three online questionnaire rounds. Participants determined and ranked requisite knowledge, skills and attributes (KSA) for cancer support group leaders, differentiated ideal from required KSA to establish minimum standards, and agreed on a method of rating KSA to determine suitability and readiness. Forty-five experts (62%) participated in round 1, 36 (49%) in round 2 and 23 (31%) in round 3. In round 1, experts confirmed 59 KSA identified via a systemic review and identified a further 55 KSA. In round 2, using agreement ≥75%, 52 KSA emerged as minimum standards for support group leaders. In round 3, consensus was reached on almost every aspect of the content and structure of a structured interview. Panel member comments guided refinement of wording, re-ordering of questions and improvement of probing questions. Alongside a novel structured interview, the first consensus-based minimum standards have been developed for cancer support group leaders, incorporating expert consensus and pragmatic considerations. Pilot and field testing will be used to appraise aspects of clinical utility and establish a rational scoring model for the structured interview.

Reliability of the Structured Clinical Interview for DSM-5 Sleep Disorders Module.

PubMed

Taylor, Daniel J; Wilkerson, Allison K; Pruiksma, Kristi E; Williams, Jacob M; Ruggero, Camilo J; Hale, Willie; Mintz, Jim; Organek, Katherine Marczyk; Nicholson, Karin L; Litz, Brett T; Young-McCaughan, Stacey; Dondanville, Katherine A; Borah, Elisa V; Brundige, Antoinette; Peterson, Alan L

2018-03-15

To develop and demonstrate interrater reliability for a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Sleep Disorders (SCISD). The SCISD was designed to be a brief, reliable, and valid interview assessment of adult sleep disorders as defined by the DSM-5. A sample of 106 postdeployment active-duty military members seeking cognitive behavioral therapy for insomnia in a randomized clinical trial were assessed with the SCISD prior to treatment to determine eligibility. Audio recordings of these interviews were double-scored for interrater reliability. The interview is 8 pages long, includes 20 to 51 questions, and takes 10 to 20 minutes to administer. Of the nine major disorders included in the SCISD, six had prevalence rates high enough (ie, n ≥ 5) to include in analyses. Cohen kappa coefficient (κ) was used to assess interrater reliability for insomnia, hypersomnolence, obstructive sleep apnea hypopnea (OSAH), circadian rhythm sleep-wake, nightmare, and restless legs syndrome disorders. There was excellent interrater reliability for insomnia (1.0) and restless legs syndrome (0.83); very good reliability for nightmare disorder (0.78) and OSAH (0.73); and good reliability for hypersomnolence (0.50) and circadian rhythm sleep-wake disorders (0.50). The SCISD is a brief, structured clinical interview that is easy for clinicians to learn and use. The SCISD showed moderate to excellent interrater reliability for six of the major sleep disorders in the DSM-5 among active duty military seeking cognitive behavioral therapy for insomnia in a randomized clinical trial. Replication and extension studies are needed. Registry: ClinicalTrials.gov; Title: Comparing Internet and In-Person Brief Cognitive Behavioral Therapy of Insomnia; Identifier: NCT01549899; URL: https://clinicaltrials.gov/ct2/show/NCT01549899. © 2018 American Academy of Sleep Medicine.

A minimal model for the structural energetics of VO2

NASA Astrophysics Data System (ADS)

Kim, Chanul; Marianetti, Chris; The Marianetti Group Team

Resolving the structural, magnetic, and electronic structure of VO2 from the first-principles of quantum mechanics is still a forefront problem despite decades of attention. Hybrid functionals have been shown to qualitatively ruin the structural energetics. While density functional theory (DFT) combined with cluster extensions of dynamical mean-field theory (DMFT) have demonstrated promising results in terms of the electronic properties, structural phase stability has not yet been addressed. In order to capture the basic physics of the structural transition, we propose a minimal model of VO2 based on the one dimensional Peierls-Hubbard model and parameterize this based on DFT calculations of VO2. The total energy versus dimerization in the minimal mode is then solved numerically exactly using density matrix renormalization group (DMRG) and compared to the Hartree-Fock solution. We demonstrate that the Hartree-Fock solution exhibits the same pathologies as DFT+U, and spin density functional theory for that matter, while the DMRG solution is consistent with experimental observation. Our results demonstrate the critical role of non-locality in the total energy, and this will need to be accounted for to obtain a complete description of VO2 from first-principles. The authors acknowledge support from FAME, one of six centers of STARnet, a Semiconductor Research Corporation program sponsored by MARCO and DARPA.

[Driving modes of the interview in phenomenological research: experience report].

PubMed

de Paula, Cristiane Cardoso; Padoin, Stela Maris de Mello; Terra, Marlene Gomes; Souza, Ivis Emília de Oliveira; Cabral, Ivone Evangelista

2014-01-01

This paper aimed to report the experience of driving modes of an interview on data production in phenomenological research. The proposed study is an experience report of a phenomenological investigation in which the researchers present their experience with children, considering the interview as an existential encounter. It describes ways of conducting the interview in its ontic and ontological dimensions. The ontic dimension refers to the facts related to the interview, presented in the researcher, in the researched subject and in the environment; both in its planning and its development. The ontological dimension is based on empathy and intersubjectivity. The interview enables the access to meaningful structures to comprehend the being, as a way of building investigative/assistance possibilities that enable to reveal the being of the human.

Appraising longitudinal trends in the strategic risks cited by risk managers in the international water utility sector, 2005-2015.

PubMed

Chalker, Rosemary T C; Pollard, Simon J T; Leinster, Paul; Jude, Simon

2018-03-15

We report dynamic changes in the priorities for strategic risks faced by international water utilities over a 10year period, as cited by managers responsible for managing them. A content analysis of interviews with three cohorts of risk managers in the water sector was undertaken. Interviews probed the focus risk managers' were giving to strategic risks within utilities, as well as specific questions on risk analysis tools (2005); risk management cultures (2011) and the integration of risk management with corporate decision-making (2015). The coding frequency of strategic (business, enterprise, corporate) risk terms from 18 structured interviews (2005) and 28 semi-structured interviews (12 in 2011; 16 in 2015) was used to appraise changes in the perceived importance of strategic risks within the sector. The aggregated coding frequency across the study period, and changes in the frequency of strategic risks cited at three interview periods identified infrastructure assets as the most significant risk over the period and suggests an emergence of extrinsic risk over time. Extended interviews with three utility risk managers (2016) from the UK, Canada and the US were then used to contextualise the findings. This research supports the ongoing focus on infrastructure resilience and the increasing prevalence of extrinsic risk within the water sector, as reported by the insurance sector and by water research organisations. The extended interviews provided insight into how strategic risks are now driving the implementation agenda within utilities, and into how utilities can secure tangible business value from proactive risk governance. Strategic external risks affecting the sector are on the rise, involve more players and are less controllable from within a utility's own organisational boundaries. Proportionate risk management processes and structures provide oversight and assurance, whilst allowing a focus on the tangible business value that comes from managing strategic risks well. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Maxwell Strata and Cut Locus in the Sub-Riemannian Problem on the Engel Group

NASA Astrophysics Data System (ADS)

Ardentov, Andrei A.; Sachkov, Yuri L.

2017-12-01

We consider the nilpotent left-invariant sub-Riemannian structure on the Engel group. This structure gives a fundamental local approximation of a generic rank 2 sub-Riemannian structure on a 4-manifold near a generic point (in particular, of the kinematic models of a car with a trailer). On the other hand, this is the simplest sub-Riemannian structure of step three. We describe the global structure of the cut locus (the set of points where geodesics lose their global optimality), the Maxwell set (the set of points that admit more than one minimizer), and the intersection of the cut locus with the caustic (the set of conjugate points along all geodesics). The group of symmetries of the cut locus is described: it is generated by a one-parameter group of dilations R+ and a discrete group of reflections Z2 × Z2 × Z2. The cut locus admits a stratification with 6 three-dimensional strata, 12 two-dimensional strata, and 2 one-dimensional strata. Three-dimensional strata of the cut locus are Maxwell strata of multiplicity 2 (for each point there are 2 minimizers). Two-dimensional strata of the cut locus consist of conjugate points. Finally, one-dimensional strata are Maxwell strata of infinite multiplicity, they consist of conjugate points as well. Projections of sub-Riemannian geodesics to the 2-dimensional plane of the distribution are Euler elasticae. For each point of the cut locus, we describe the Euler elasticae corresponding to minimizers coming to this point. Finally, we describe the structure of the optimal synthesis, i. e., the set of minimizers for each terminal point in the Engel group.

Advanced structural design for precision radial velocity instruments

NASA Astrophysics Data System (ADS)

Baldwin, Dan; Szentgyorgyi, Andrew; Barnes, Stuart; Bean, Jacob; Ben-Ami, Sagi; Brennan, Patricia; Budynkiewicz, Jamie; Chun, Moo-Young; Conroy, Charlie; Crane, Jeffrey D.; Epps, Harland; Evans, Ian; Evans, Janet; Foster, Jeff; Frebel, Anna; Gauron, Thomas; Guzman, Dani; Hare, Tyson; Jang, Bi-Ho; Jang, Jeong-Gyun; Jordan, Andres; Kim, Jihun; Kim, Kang-Min; Mendes de Oliveira, Claudia; Lopez-Morales, Mercedes; McCracken, Kenneth; McMuldroch, Stuart; Miller, Joseph; Mueller, Mark; Oh, Jae Sok; Ordway, Mark; Park, Byeong-Gon; Park, Chan; Park, Sung-Joon; Paxson, Charles; Phillips, David; Plummer, David; Podgorski, William; Seifahrt, Andreas; Stark, Daniel; Steiner, Joao; Uomoto, Alan; Walsworth, Ronald; Yu, Young-Sam

2016-07-01

The GMT-Consortium Large Earth Finder (G-CLEF) is an echelle spectrograph with precision radial velocity (PRV) capability that will be a first light instrument for the Giant Magellan Telescope (GMT). G-CLEF has a PRV precision goal of 40 cm/sec (10 cm/s for multiple measurements) to enable detection of Earth-like exoplanets in the habitable zones of sun-like stars1. This precision is a primary driver of G-CLEF's structural design. Extreme stability is necessary to minimize image motions at the CCD detectors. Minute changes in temperature, pressure, and acceleration environments cause structural deformations, inducing image motions which degrade PRV precision. The instrument's structural design will ensure that the PRV goal is achieved under the environments G-CLEF will be subjected to as installed on the GMT azimuth platform, including: Millikelvin (0.001 °K) thermal soaks and gradients 10 millibar changes in ambient pressure Changes in acceleration due to instrument tip/tilt and telescope slewing Carbon fiber/cyanate composite was selected for the optical bench structure in order to meet performance goals. Low coefficient of thermal expansion (CTE) and high stiffness-to-weight are key features of the composite optical bench design. Manufacturability and serviceability of the instrument are also drivers of the design. In this paper, we discuss analyses leading to technical choices made to minimize G-CLEF's sensitivity to changing environments. Finite element analysis (FEA) and image motion sensitivity studies were conducted to determine PRV performance under operational environments. We discuss the design of the optical bench structure to optimize stiffness-to-weight and minimize deformations due to inertial and pressure effects. We also discuss quasi-kinematic mounting of optical elements and assemblies, and optimization of these to ensure minimal image motion under thermal, pressure, and inertial loads expected during PRV observations.

Taxonomy for colorectal cancer screening promotion: Lessons from recent randomized controlled trials.

PubMed

Ritvo, Paul; Myers, Ronald E; Serenity, Mardie; Gupta, Samir; Inadomi, John M; Green, Beverly B; Jerant, Anthony; Tinmouth, Jill; Paszat, Lawrence; Pirbaglou, Meysam; Rabeneck, Linda

2017-08-01

To derive a taxonomy for colorectal cancer screening that advances Randomized Controlled Trials (RCTs) and screening uptake. Detailed publication review, multiple interviews with principal investigators (PIs) and collaboration with PIs as co-authors produced a CRCS intervention taxonomy. Semi-structured interview questions with PIs (Drs. Inadomi, Myers, Green, Gupta, Jerant and Ritvo) yielded details about trial conduct. Interview comparisons led to an iterative process informing serial interviews until a consensus was obtained on final taxonomy structure. These taxonomy headings (Engagement Sponsor, Population Targeted, Alternative Screening Tests, Delivery Methods, and Support for Test Performance (EPADS)) were used to compare studies. Exemplary insights emphasized: 1) direct test delivery to patients; 2) linguistic-ethnic matching of staff to minority subjects; and 3) authorization of navigators to schedule or refer for colonoscopies and/or distribute stool blood tests during screening promotion. PIs of key RCTs (2012-2015) derived a CRCS taxonomy useful in detailed examination of CRCS promotion and design of future RCTs. Copyright © 2017 Elsevier Inc. All rights reserved.

Optimization of rotamers prior to template minimization improves stability predictions made by computational protein design.

PubMed

Davey, James A; Chica, Roberto A

2015-04-01

Computational protein design (CPD) predictions are highly dependent on the structure of the input template used. However, it is unclear how small differences in template geometry translate to large differences in stability prediction accuracy. Herein, we explored how structural changes to the input template affect the outcome of stability predictions by CPD. To do this, we prepared alternate templates by Rotamer Optimization followed by energy Minimization (ROM) and used them to recapitulate the stability of 84 protein G domain β1 mutant sequences. In the ROM process, side-chain rotamers for wild-type (WT) or mutant sequences are optimized on crystal or nuclear magnetic resonance (NMR) structures prior to template minimization, resulting in alternate structures termed ROM templates. We show that use of ROM templates prepared from sequences known to be stable results predominantly in improved prediction accuracy compared to using the minimized crystal or NMR structures. Conversely, ROM templates prepared from sequences that are less stable than the WT reduce prediction accuracy by increasing the number of false positives. These observed changes in prediction outcomes are attributed to differences in side-chain contacts made by rotamers in ROM templates. Finally, we show that ROM templates prepared from sequences that are unfolded or that adopt a nonnative fold result in the selective enrichment of sequences that are also unfolded or that adopt a nonnative fold, respectively. Our results demonstrate the existence of a rotamer bias caused by the input template that can be harnessed to skew predictions toward sequences displaying desired characteristics. © 2014 The Protein Society.

How good strong union men line it out: explorations of the structure and dynamics of coal-miners' class consciousness

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

Yarrow, M.N.

1982-01-01

This study explores how working-class people apprehend and analyze the class dynamics of their social world. As an exploratory empirical study of the structure and dynamics of working-class consciousness, it seeks to develop the theory of actual class consciousness by bringing previous theories into dialogue with the articulated analyses of coal miners in central Appalachia. Although changing conditions are shown to have a powerful effect on class consciousness, the respondents were found to respond differently to the changing context and to remain loyal to important elements of their earlier perspectives. Suggestions are made for how the theory could be developedmore » further. The data for the study are flexibly structured interviews which were conducted with active, retired, and disabled miners in southern West Virginia and western Virginia. A dozen miners were interviewed during the 1978 strike and again the following summer; during the summer of 1978, nineteen additional miners were interviewed.« less

Understanding students' explanations of biological phenomena: Conceptual frameworks or p-prims?

NASA Astrophysics Data System (ADS)

Southerland, Sherry A.; Abrams, Eleanor; Cummins, Catherine L.; Anzelmo, Julie

2001-07-01

This study explores two differing perspectives of the nature of students' biological knowledge structures, conceptual frameworks, and p-prims. Students from four grade levels and from three regions of the United States were asked to explain a variety of biological phenomena. Students' responses to the interview probes were analyzed to describe 1) patterns in the nature of students' explanations across grade levels and interview probes, and 2) the consistency of students' explanations across individual interview probes and across the range of probes. The results were interpreted from both perspectives of knowledge structures. While definitive assertions supporting either perspective could not be made, each hypothesis was explored. Although the more prevalent description of student conceptions within a broader conceptual framework could not be discounted, the p-prim of need as a rationale for change was also found to offer a useful description of knowledge frameworks for this content area. The difficulties endemic to the use of biology for the study of basic knowledge structures are also discussed.

Developing a short version of the Toronto Structured Interview for Alexithymia using item response theory.

PubMed

Sekely, Angela; Taylor, Graeme J; Bagby, R Michael

2018-03-17

The Toronto Structured Interview for Alexithymia (TSIA) was developed to provide a structured interview method for assessing alexithymia. One drawback of this instrument is the amount of time it takes to administer and score. The current study used item response theory (IRT) methods to analyze data from a large heterogeneous multi-language sample (N = 842) to investigate whether a subset of items could be selected to create a short version of the instrument. Samejima's (1969) graded response model was used to fit the item responses. Items providing maximum information were retained in the short model, resulting in the elimination of 12-items from the original 24-items. Despite the 50% reduction in the number of items, 65.22% of the information was retained. Further studies are needed to validate the short version. A short version of the TSIA is potentially of practical value to clinicians and researchers with time constraints. Copyright © 2018. Published by Elsevier B.V.

“It Depends on What You Mean by ‘Disagree’”: Differences between Parent and Child Perceptions of Parent–Child Conflict

PubMed Central

Thomas, Sarah A.; Swan, Anna J.; Ehrlich, Katherine B.; Reynolds, Elizabeth K.; Suarez, Liza; Dougherty, Lea R.; MacPherson, Laura; Pabón, Shairy C.

2014-01-01

We examined a new structured interview of parent–child conflict that assesses parent and child perceptions of behavioral conflict about daily life topics (e.g., doing chores, homework), and whether discrepancies exist on beliefs about these topics. In a sample of 100 parents and children ages 10 to 17 years (M=13.5 years, 52 males, 57 % African-American), informants could reliably distinguish between perceived behavioral conflicts and perceived discrepant beliefs about topics. These scores were also significantly related to questionnaire reports of parent–child conflict. Parent and child questionnaire reports did not significantly differ, yet on the structured interview, parents reported significantly greater levels of perceived conflict and discrepant beliefs relative to child reports. Additionally, structured interview reports of conflict demonstrated incremental validity by relating to child self-reports of delinquent behaviors, when accounting for questionnaire conflict reports. The findings have implications for increasing understanding of the links between parent–child conflict and psychosocial outcomes. PMID:25210227

"It Depends on What You Mean by 'Disagree'": Differences between Parent and Child Perceptions of Parent-Child Conflict.

PubMed

De Los Reyes, Andres; Thomas, Sarah A; Swan, Anna J; Ehrlich, Katherine B; Reynolds, Elizabeth K; Suarez, Liza; Dougherty, Lea R; MacPherson, Laura; Pabón, Shairy C

2012-09-01

We examined a new structured interview of parent-child conflict that assesses parent and child perceptions of behavioral conflict about daily life topics (e.g., doing chores, homework), and whether discrepancies exist on beliefs about these topics. In a sample of 100 parents and children ages 10 to 17 years ( M =13.5 years, 52 males, 57 % African-American), informants could reliably distinguish between perceived behavioral conflicts and perceived discrepant beliefs about topics. These scores were also significantly related to questionnaire reports of parent-child conflict. Parent and child questionnaire reports did not significantly differ, yet on the structured interview, parents reported significantly greater levels of perceived conflict and discrepant beliefs relative to child reports. Additionally, structured interview reports of conflict demonstrated incremental validity by relating to child self-reports of delinquent behaviors, when accounting for questionnaire conflict reports. The findings have implications for increasing understanding of the links between parent-child conflict and psychosocial outcomes.

Self-Reported Pediatric Measures of Physical Activity, Sedentary Behavior and Strength Impact for PROMIS®: Conceptual Framework

PubMed Central

Tucker, Carole A.; Bevans, Katherine B.; Teneralli, Rachel E.; Smith, Ashley Wilder; Bowles, Heather R; Forrest, Christopher B.

2014-01-01

Purpose Children's physical activity (PA) levels are commonly assessed in pediatric clinical research, but rigorous self-report assessment tools for children are scarce, and computer adaptive test implementations are rare. Our objective was to improve pediatric self-report measures of activity using semi-structured interviews with experts and children for conceptualization of a child-informed framework. Methods Semi-structured interviews were conducted to conceptualize physical activity, sedentary behaviors, and strengthening activities. We performed systematic literature reviews to identify item-level concepts used to assess these 3 domains. Results We developed conceptual frameworks for each domain using words and phrases identified by children as relevant. Conclusions Semi-structured interview methods provide valuable information of children's perspectives and the ways children recall previous activities. Conceptualized domains of physical activity are based on the literature and expert views that also reflect children's experiences and understanding providing a basis for pediatric self-report instruments. PMID:25251789

From plans to actions in patient and public involvement: qualitative study of documented plans and the accounts of researchers and patients sampled from a cohort of clinical trials

PubMed Central

Buck, Deborah; Gamble, Carrol; Dudley, Louise; Preston, Jennifer; Hanley, Bec; Williamson, Paula R; Young, Bridget

2014-01-01

Patient and public involvement (PPI) in research is increasingly required, although evidence to inform its implementation is limited. Objective Inform the evidence base by describing how plans for PPI were implemented within clinical trials and identifying the challenges and lessons learnt by research teams. Methods We compared PPI plans extracted from clinical trial grant applications (funded by the National Institute for Health Research Health Technology Assessment Programme between 2006 and 2010) with researchers’ and PPI contributors’ interview accounts of PPI implementation. Analysis of PPI plans and transcribed qualitative interviews drew on the Framework technique. Results Of 28 trials, 25 documented plans for PPI in funding applications and half described implementing PPI before applying for funding. Plans varied from minimal to extensive, although almost all anticipated multiple modes of PPI. Interview accounts indicated that PPI plans had been fully implemented in 20/25 trials and even expanded in some. Nevertheless, some researchers described PPI within their trials as tokenistic. Researchers and contributors noted that late or minimal PPI engagement diminished its value. Both groups perceived uncertainty about roles in relation to PPI, and noted contributors’ lack of confidence and difficulties attending meetings. PPI contributors experienced problems in interacting with researchers and understanding technical language. Researchers reported difficulties finding ‘the right’ PPI contributors, and advised caution when involving investigators’ current patients. Conclusions Engaging PPI contributors early and ensuring ongoing clarity about their activities, roles and goals, is crucial to PPI's success. Funders, reviewers and regulators should recognise the value of preapplication PPI and allocate further resources to it. They should also consider whether PPI plans in grant applications match a trial's distinct needs. Monitoring and reporting PPI before, during and after trials will help the research community to optimise PPI, although the need for ongoing flexibility in implementing PPI should also be recognised. PMID:25475243

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

PubMed

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

2015-06-01

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

Motivational interviewing: experiences of primary care nurses trained in the method.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Kristofferzon, Marja-Leena; Häggström, Elisabeth

2015-03-01

Motivational interviewing is a person-centered counseling style used to promote behavioral change regarding a wide variety of lifestyle problems. Use of motivational interview is growing worldwide and among many different healthcare professions, including primary care nursing. The study aim was to describe motivational interview trained nurses' experiences of motivational interviewing in primary care settings. The study had a qualitative descriptive design. It was carried out in Swedish primary care settings in two county council districts, with 20 primary care nurses trained in motivational interviewing. Half of them used the method in their work, half did not. Qualitative semi-structured interviews were used. Data were analyzed using qualitative content analysis. The nurses experienced that openness to the approach and an encouraging working climate are required to overcome internal resistance and to increase use of motivational interviewing. They also experienced mutual benefit: motivational interviewing elicits and develops abilities in both nurses and patients. For the nurses using it, motivational interviewing is perceived to facilitate work with patients in need of lifestyle change. Lack of training/education, support, interest and appropriate work tasks/patients are reasons for not using motivational interviewing.

Patient-Centered Research to Support the Development of the Symptoms of Major Depressive Disorder Scale (SMDDS): Initial Qualitative Research.

PubMed

McCarrier, Kelly P; Deal, Linda S; Abraham, Lucy; Blum, Steven I; Bush, Elizabeth Nicole; Martin, Mona L; Thase, Michael E; Coons, Stephen Joel

2016-04-01

Content valid, patient-reported outcome (PRO) measures of major depressive disorder (MDD) symptoms are needed to assess MDD treatment benefit. While a range of questionnaires are currently available to evaluate aspects of depression from the patient's perspective, their comprehensiveness and qualitative development histories are unclear. The objective of this study was to describe the process and results of the preliminary qualitative development of a new symptom-based PRO measure intended to assess treatment benefit in MDD clinical trials. Qualitative interviews were conducted with adult MDD patients in the USA who recently experienced a major depressive episode. Experienced interviewers conducted concept elicitation (CE) and cognitive interviews using semi-structured interview guides. The CE interview guide was used to elicit spontaneous reports of symptom experiences along with probing to further explore and confirm concepts. The cognitive interview guide was developed to evaluate concept relevance, understandability, and structure of the draft items, and to facilitate further instrument refinement. Forty patients participated in the CE interviews. A total of 3022 symptom codes, representing 84 different concepts were derived from the transcripts. Data from the CE interviews were considered alongside existing literature and clinical expert opinion during an item-generation process, leading to development of a preliminary version of the Symptoms of Major Depressive Disorder Scale (SMDDS). Fifteen patients participated in three waves of cognitive interviews, during which the SMDDS was further refined. The SMDDS is a 35-item PRO measure intended for use as an endpoint in MDD clinical trials to support medical product labeling. The SMDDS uses a 7-day recall period and verbal rating scales. It was developed in accordance with the US Food and Drug Administration (FDA)'s PRO Guidance and best practices. Qualitative interviews have provided evidence for content validity. Future quantitative studies will confirm the SMDDS's measurement properties and support FDA qualification.

Impact of Role Stressors on the Health of Nurse Managers: A Western Canadian Context.

PubMed

Udod, Sonia A; Cummings, Greta; Care, W Dean; Jenkins, Megan

2017-03-01

A qualitative exploratory inquiry was used to understand nurse managers' (NMs') perceptions of their role stressors, coping strategies, and self-health related outcomes as a result of frequent exposure to stressful situations in their role. Strong nursing leadership is required for desirable staff, patient, and organizational outcomes. A stressed NM will negatively influence staff nurse satisfaction and retention, patient outcomes, and organizational performance. Stress can affect NMs' mental and physical heath, leading to job dissatisfaction and turnover. A qualitative exploratory inquiry was conducted using semistructured interviews with 23 NMs and 1 focus group interview. Findings suggest that coping strategies may be inadequate, given the intensity and demands of the manager role, and could negatively impact NMs' long-term health. Senior nurse leaders can significantly impact the health and productivity of NMs by minimizing the adverse effects of role stress and foster a positive work environment.

Nurses' solutions to prevent inpatient falls in hospital patient rooms.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2008-01-01

Patient fall rates are perceived as the indicator that could be most improved through nurse-led safety strategies or interventions. A safety-driven design with a goal to prevent inpatient fall-related injuries should be a hospital design principle. In this qualitative study, researchers used inductive and deductive methods to understand the clinically accessible solutions to minimize the extrinsic risk factors of inpatient falls. The findings from the nurse interviews were compared with the intervention strategies toward the five primary root causes of fatal falls as suggested by the Joint Commission (2005b). Twenty-four solutions were identified from the nurse interview transcriptions: five were related to the dimension of inadequate caregiver communication, none was associated with the dimension of inadequate staff orientation and training, three were related to inadequate assessment and reassessment, 15 were associated with unsafe care environment, and one was related to inadequate care planning and provision.

How motivation influences breastfeeding duration among low-income women.

PubMed

Racine, Elizabeth F; Frick, Kevin D; Strobino, Donna; Carpenter, Laura M; Milligan, Renee; Pugh, Linda C

2009-05-01

In-depth interviews were conducted with 44 low-income breastfeeding women to explore the incentives and disincentives to breastfeeding experienced within 6 months postpartum. Using an individual net benefit maximization (INBM) framework based on economic theory, we assessed women's motivations, incentives, and disincentives for breastfeeding. Based on the framework and their experience breastfeeding, women fell into 3 groups: intrinsically motivated, extrinsically motivated, and successfully experienced with both intrinsic and extrinsic motivation. Successfully experienced women were most likely to breastfeed to 6 months. Intrinsically motivated women valued breastfeeding but often required information and instruction to reach breastfeeding goals. Extrinsically motivated women were least likely to continue breastfeeding even with support and instruction. Providers can screen women to determine their experience and motivation then tailor interventions accordingly. Intrinsically motivated women may need support and instruction, extrinsically motivated women may benefit from motivational interviewing, and successfully experienced women may need only minimal breastfeeding counseling.

Re-building Trust after Physical Restraint During Involuntary Psychiatric Hospitalization.

PubMed

Khatib, Anwar; Ibrahim, Mahajne; Roe, David

2018-06-01

This study attempted to identify the elements which might best minimize the negative consequences of restriction of inpatients and rebuild therapeutic alliance and trust. Through in depth interviews with 15 psychiatric patients who had experience restrained during the last involuntary psychiatric hospitalization. Analysis of the data revealed three major themes with regard to trust between restrained patient and restraining staff members during restriction of the patient's freedom. Duration of Restriction, Contact with a Staff Member while Restrained, Supportive Interactions and Staff's Response to Restricted Patients' Needs were reported by patients as crucial in determining the way restrained is experienced and its later impact. Physical restraint in psychiatric hospitalizations generates many negative feelings and can even be traumatic. The patients interviewed help us learn how to provide more human and therapeutic interactions even in extreme situations of restrain which can be crucial to rebuild therapeutic alliance and trust. Copyright © 2018 Elsevier Inc. All rights reserved.

French general practitioners' attitudes and reported practices in relation to their participation and effectiveness in a minimal smoking cessation programme for patients.

PubMed

Slama, K; Karsenty, S; Hirsch, A

1999-01-01

To examine the participation and effectiveness of GPs in offering a minimal smoking cessation intervention according to attitudinal and reported behaviour variables. General practitioners were surveyed about their practices and attitudes and then matched pairs of smoking and non-smoking doctors were invited to participate in a regional smoking cessation intervention. The relationship of survey responses and the degree of participation and effectiveness in a smoking cessation trial was examined. Primary care doctors in a large region of southern France, Provence-Alpes-Côte d'Azur (PACA). Two thousand, eight hundred and sixty GPs from the PACA region in France were interviewed about their attitudes and behaviours. From among 371 smoking GPs and 375 non-smoking GPs invited to take part in a smoking cessation trial with patients, 170 smokers and 202 non-smokers participated. The GPs' attitudes and reported professional and personal practices were assessed in a telephone interview. These responses were compared with the GPs' participation in the cessation trial, and with GP "success" (1 or more patients stopping smoking at 1 month, 12 months or both) or "non-success" (no patient cessation at 1 month or at 12 months). A significantly lower proportion of smokers than non-smokers among the GPs who initially accepted did not participate in the study (45% vs. 54.1%, chi 2 = 5.147 df = 1, p < 0.05, difference: 8.3% 95% CI: 1.2%; 15.5%), but thereafter, there were no significant associations between GPs' reported smoking practices and attitudes and the extent of their participation or effectiveness. The study results indicate that, when minimal advice has an effect, it is due more to the systematic nature of the provision of the intervention than to the attitudes or reported practices of the practitioner providing the advice.

Identifying content for the glaucoma-specific item bank to measure quality-of-life parameters.

PubMed

Khadka, Jyoti; McAlinden, Colm; Craig, Jamie E; Fenwick, Eva K; Lamoureux, Ecosse L; Pesudovs, Konrad

2015-01-01

Patient-reported outcomes (PROs) have become essential clinical trial end points. However, a comprehensive, multidimensional, patient-relevant, and precise glaucoma-specific PRO instrument is not available. Therefore, the purpose of this study was to identify content for a new, glaucoma-specific, quality-of-life (QOL) item bank. Content identification was undertaken in 5 phases: (1) identification of extant items in glaucoma-specific instruments and the qualitative literature; (2) focus groups and interviews with glaucoma patients; (3) item classification and selection; (4) expert review and revision of items; and (5) cognitive interviews with patients. A total of 737 unique items (extant items from PRO instruments, 247; qualitative articles, 14 items; focus groups and semistructured interviews, 476 items) were identified. These items were classified into 10 QOL domains. Four criteria (item redundancy, item inconsistent with domain definition, item content too narrow to have wider applicability, and item clarity) were used to remove and refine the items. After the cognitive interviews, the final minimally representative item set had a total of 342 unique items belonging to 10 domains: activity limitation (88), mobility (20), visual symptoms (19), ocular surface symptoms (22), general symptoms (15), convenience (39), health concerns (45), emotional well-being (49), social issues (23), and economic issues (22). The systematic content identification process identified 10 QOL domains, which were important to patients with glaucoma. The majority of the items were identified from the patient-specific focus groups and semistructured interviews suggesting that the existing PRO instruments do not adequately address QOL issues relevant to individuals with glaucoma.

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

Lesperance, Ann M.; Miller, James S.

The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studiesmore » of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.« less

Eye closure helps memory by reducing cognitive load and enhancing visualisation.

PubMed

Vredeveldt, Annelies; Hitch, Graham J; Baddeley, Alan D

2011-10-01

Closing the eyes helps memory. We investigated the mechanisms underlying the eyeclosure effect by exposing 80 eyewitnesses to different types of distraction during the witness interview: blank screen (control), eyes closed, visual distraction, and auditory distraction. We examined the cognitive load hypothesis by comparing any type of distraction (visual or auditory) with minimal distraction (blank screen or eyes closed). We found recall to be significantly better when distraction was minimal, providing evidence that eyeclosure reduces cognitive load. We examined the modality-specific interference hypothesis by comparing the effects of visual and auditory distraction on recall of visual and auditory information. Visual and auditory distraction selectively impaired memory for information presented in the same modality, supporting the role of visualisation in the eyeclosure effect. Analysis of recall in terms of grain size revealed that recall of basic information about the event was robust, whereas recall of specific details was prone to both general and modality-specific disruptions.

No appetite efficacy of a commercial structured lipid emulsion in minimally processed drinks.

PubMed

Smit, H J; Keenan, E; Kovacs, E M R; Wiseman, S A; Mela, D J; Rogers, P J

2012-09-01

Fabuless (Olibra) is a commercially structured lipid emulsion, claimed to be a food ingredient that is effective for food intake and appetite reduction. The present study assessed its efficacy in a yoghurt-based mini-drink undergoing low or minimal food manufacturing (thermal and shear) processes. Study 1: Twenty-four healthy volunteers (16 female, 8 male; age: 18-47 years; body mass index (BMI): 17-28 kg m(-2)) took part in a randomised, placebo-controlled, double-blind parallel crossover trial. Consumption of a minimally processed 'preload' mini-drink (containing two different doses of Fabuless or a control fat) at 2 h after breakfast was followed by appetite and mood ratings, and food intake measured in ad libitum meals at 3 and 7 h post consumption of the preload. Study 2: As Study 1 (16 female, 8 male; age: 20-54 years; BMI: 21-30 kg m(-2)). A chilled, virtually unprocessed, preload breakfast mini-drink (containing minimally processed Fabuless or a control fat) was provided 5 min after a standardised breakfast, followed by appetite and mood ratings, and food intake measured in ad libitum meals at 4 and 8 h post consumption of the preload. The structured lipid emulsion tested had no significant effect on the primary measures of food intake or appetite. Even when exposed to minimal food-manufacturing conditions, Fabuless showed no efficacy on measures of appetite and food intake.

All the World's a School

ERIC Educational Resources Information Center

Young, Jonathan

2017-01-01

This article reports on a research project which focused on the aspirations and identities of students in an international school. Ten boys and ten girls were interviewed using semi-structured and photo-elicitation interviews. This research indicates convincingly that socio-economic background and international capital are crucial factors framing…

Prospective Teachers' Perceptions on Different Aspects of Portfolio

ERIC Educational Resources Information Center

Ok, Ahmet; Erdogan, Mehmet

2010-01-01

This qualitative-case study examined how portfolio and portfolio assessment were perceived by prospective teachers. The participants were 23 prospective teachers from seven different teaching areas from a Turkish university. A semi-structured individual interview was conducted. The interview schedule included 15 open-ended questions. The main…

78 FR 3431 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

... protocols to collect further qualitative information through interviews and/or focus groups with program... Readiness Goals and Head Start Program Functioning'' research project. The purpose of this study is to... functioning. ACF is proposing to use a semi-structured telephone interview protocol to collect information...

The Mentoring Experience: Leadership Development Program Perspectives

ERIC Educational Resources Information Center

Lamm, Kevan W.; Sapp, Rochelle; Lamm, Alexa J.

2017-01-01

Using a semi-structured interview approach, ten mentors from a leadership development program focused on building leaders in Colleges of Agriculture and Life Sciences across the nation provided insights regarding their mentoring method, process, and experiences. Mentors interviewed agreed the mentoring process was beneficial for themselves as well…

Guidelines for Improving Employer Effectiveness in Interviewing Disabled Applicants.

ERIC Educational Resources Information Center

Cole, Joyce Couch; Bragman, Ruth

1985-01-01

This article presents a five-step, structured format to be used in preparing employers for conducting interviews with disabled applicants. Described in this article is a straightforward, convenient tool that can also be used by rehabilitation personnel when providing awareness training and employer education. (Author)

76 FR 53136 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... will be asked about key aspects of their program's structure, activities, and collaborative efforts... per response (in respondent hours) State Health Department Leadership. Interview Guide for Health 7 1 45/60 Department Leadership. CCC Programs Site Visit Preparation..... 7 1 45/60 Interview Guide for...

10 CFR 712.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... derogatory under the criteria listed in 10 CFR part 710, subpart A. Semi-structured interview means an interview by a Designated Psychologist, or a psychologist under his or her supervision, who has the latitude to vary the focus and content of the questions depending on the interviewee's responses. Site...

10 CFR 712.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... derogatory under the criteria listed in 10 CFR part 710, subpart A. Semi-structured interview means an interview by a Designated Psychologist, or a psychologist under his or her supervision, who has the latitude to vary the focus and content of the questions depending on the interviewee's responses. Site...

Brief Report: Prevalence of Psychiatric Disorders in Pregnant Teenagers

ERIC Educational Resources Information Center

Mitsuhiro, Sandro Sendin; Chalem, Elisa; Barros, Marina Carvalho Moraes; Guinsburg, Ruth; Laranjeira, Ronaldo

2009-01-01

Purpose: To evaluate the prevalence of ICD-10 psychiatric disorders in a population of pregnant teenage women from a Brazilian public hospital. Method: 1000 pregnant teenage women were evaluated using the Composite International Diagnostic Interview, a structured interview which establishes diagnoses according to the International Classification…

Improving Large Cetacean Implantable Satellite Tag Designs to Maximize Tag Robustness and Minimize Health Effects to Individual Animals

DTIC Science & Technology

2013-09-30

Designs to Maximize Tag Robustness and Minimize Health Effects to Individual Animals Alexandre N. Zerbini Cascadia Research Collective 218 ½ 4th...the blubber-muscle interface and minimize physical and physiological effects of body penetrating tags to individual animals . OBJECTIVES (1...integrity of designs created in Objective (1) during laboratory experiments and in cetacean carcasses ; (3) Examine structural tissue damage in the

Reluctance to Accept Alcohol Treatment by Alcoholic Liver Disease Transplant Patients: A Qualitative Study

PubMed Central

Heyes, Cathy M.; Schofield, Toni; Gribble, Robert; Day, Carolyn A.; Haber, Paul S.

2016-01-01

Background Liver transplantation (LT) is the optimum treatment for patients with end-stage alcoholic liver disease (ALD). However, despite a recognized risk of relapse to harmful drinking, ALD transplant patients are reluctant to use speciality alcohol treatment to support their abstinence, even when offered within the LT context. This study aimed to understand and identify factors contributing to alcohol treatment reluctance by ALD patients undergoing transplantation. Methods We conducted an in-depth qualitative study of ALD transplant patients. Minimally structured face-to-face interviews explored participants' alcohol-related experiences and their reasons for not using alcohol treatment during the course of their transplantation. Thematic analysis was used to analyze and interpret interview data to understand treatment reluctance based on participants' experiences. Results Five major themes were identified among 3 subgroups of patients (pretransplant and posttransplant abstainers and posttransplant relapsers): (i) the “contract” of mandatory abstinence, (ii) the “gap in the program” involving the lack of candour between patient and staff about alcohol-related matters and the lack of addiction services, (iii) a preference by participants to self-manage their alcohol use disorder, (iv) social support as a facilitator of abstinence and the risk of relapse when social support is diminished, and (v) the fear of stigmatization. Each of these factors were dynamically interrelated and differed slightly for each subgroup. Conclusions The LT services may benefit from the inclusion of integrated specialist addiction services in their model of care. Such an approach may enhance the acceptability of alcohol treatment and reduce the risk of relapse among ALD transplant participants, especially for those whose social supports have diminished. PMID:27795986

North Carolina Medicaid recipient management lock-in program: the pharmacist's perspective.

PubMed

Werth, S Rose; Sachdeva, Nidhi; Roberts, Andrew W; Garrettson, Mariana; Ringwalt, Chris; Moss, Leslie A; Pikoulas, Theodore; Skinner, Asheley Cockrell

2014-11-01

The misuse and abuse of prescription opioids have become an urgent health issue in North Carolina (NC), particularly among Medicaid patients who suffer high rates of morbidity and mortality due to abuse and overdose. The NC Division of Medical Assistance (DMA) implemented a recipient management lock-in program, which limits identified patients for a 12-month period to 1 prescriber and 1 pharmacy for benzodiazepine, opiate, and certain anxiolytic prescriptions in order to prevent misuse and reduce overutilization of Medicaid benefits.  To (a) evaluate pharmacists' perceptions of the implementation of the NC recipient management lock-in program (MLIP) and (b) determine how the beliefs and attitudes of pharmacists could promote or inhibit its success.  We conducted 12 structured phone interviews with NC pharmacists serving lock-in patients. Interview responses were analyzed through construct analysis, which identified themes organized into 3 domains: organization and implementation, perceived effectiveness, and acceptability.  Most respondents reported a positive experience with the program but expressed doubt concerning its impact on prescription drug abuse. The program successfully utilized the pharmacist role as a gatekeeper of controlled substances, and the procedures of the program required no active effort on pharmacists' part. However, respondents suggested that the DMA improve communication and outreach to address pharmacists' lack of knowledge about the program's purpose and confusion over remediating problems that arise with lock-in patients. The DMA should also address the ways in which the program can interfere with access to health care and treatment, allow patients to see multiple physicians within the same clinic, and clarify procedures for patients whose complex health issues require multiple specialists.  Although possible improvements were identified, the NC MLIP has strong potential for success as it utilizes pharmacists' medication gate-keeping role, while minimizing the effort required for successful implementation.

Expert Intraoperative Judgment and Decision-Making: Defining the Cognitive Competencies for Safe Laparoscopic Cholecystectomy.

PubMed

Madani, Amin; Watanabe, Yusuke; Feldman, Liane S; Vassiliou, Melina C; Barkun, Jeffrey S; Fried, Gerald M; Aggarwal, Rajesh

2015-11-01

Bile duct injuries from laparoscopic cholecystectomy remain a significant source of morbidity and are often the result of intraoperative errors in perception, judgment, and decision-making. This qualitative study aimed to define and characterize higher-order cognitive competencies required to safely perform a laparoscopic cholecystectomy. Hierarchical and cognitive task analyses for establishing a critical view of safety during laparoscopic cholecystectomy were performed using qualitative methods to map the thoughts and practices that characterize expert performance. Experts with more than 5 years of experience, and who have performed at least 100 laparoscopic cholecystectomies, participated in semi-structured interviews and field observations. Verbal data were transcribed verbatim, supplemented with content from published literature, coded, thematically analyzed using grounded-theory by 2 independent reviewers, and synthesized into a list of items. A conceptual framework was created based on 10 interviews with experts, 9 procedures, and 18 literary sources. Experts included 6 minimally invasive surgeons, 2 hepato-pancreatico-biliary surgeons, and 2 acute care general surgeons (median years in practice, 11 [range 8 to 14]). One hundred eight cognitive elements (35 [32%] related to situation awareness, 47 [44%] involving decision-making, and 26 [24%] action-oriented subtasks) and 75 potential errors were identified and categorized into 6 general themes and 14 procedural tasks. Of the 75 potential errors, root causes were mapped to errors in situation awareness (24 [32%]), decision-making (49 [65%]), or either one (61 [81%]). This study defines the competencies that are essential to establishing a critical view of safety and avoiding bile duct injuries during laparoscopic cholecystectomy. This framework may serve as the basis for instructional design, assessment tools, and quality-control metrics to prevent injuries and promote a culture of patient safety. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

The newly revised interview for deteriorations in daily living activities in dementia (R-IDDD2): distinguishing initiative from performance at assessment.

PubMed

Giebel, Clarissa M; Challis, David; Montaldi, Daniela

2017-03-01

Minimal evidence exists on the detailed deficits in complex instrumental activities of daily living (IADLs) in mild dementia. The aim of this study was twofold, to validate a revised questionnaire focusing measuring the initiative and performance of IADLs in mild dementia and to explore the relationship between individual IADLs and patient and carer well-being. A total of 183 carers of people with mild dementia completed a further modified Revised Interview for Deterioration in Daily Living Activities 2 (R-IDDD2), which comprised new activities such as computer use, as well as sub-activities on the performance scale. Carers also completed questionnaires assessing patient quality of life (QoL-AD), carer quality of life (AC-QoL), and burden (GHQ-12). Persons with dementia were significantly poorer initiating than performing cleaning, doing repair work, and preparing a hot or cold meal, whereas being poorer at performing dressing and following current affairs. Using the computer, preparing a hot meal, finance, and medication management were most impaired, whereas more basic activities of dressing, washing oneself, brushing hair or teeth, and preparing a hot drink were most preserved. Poor initiative and performance on nearly all activities were significantly related to reduced carer and patient well-being. The R-IDDD2 offers a platform to comprehensively assess everyday functioning. Deteriorations in initiative and performance need to be targeted separately in interventions, as the former requires effective triggering and the latter structured training and support. Most activities were significantly associated with well-being, particularly patient quality of life so that improving any activity should improve well-being.