Sample records for qualitative longitudinal study

  1. Developing longitudinal qualitative designs: lessons learned and recommendations for health services research.

    PubMed

    Calman, Lynn; Brunton, Lisa; Molassiotis, Alex

    2013-02-06

    Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study. Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time. As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.

  2. Optimising qualitative longitudinal analysis: Insights from a study of traumatic brain injury recovery and adaptation.

    PubMed

    Fadyl, Joanna K; Channon, Alexis; Theadom, Alice; McPherson, Kathryn M

    2017-04-01

    Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health-care are not well documented in the literature. This article reviews three challenges encountered in a large longitudinal qualitative descriptive study about experiences of recovery and adaptation after traumatic brain injury in New Zealand, and the strategies and technologies used to address them. These were (i) tracking coding and analysis decisions during an extended analysis period; (ii) navigating interpretations over time and in response to new data; and (iii) exploiting data volume and complexity. Concept mapping during coding review, a considered combination of information technologies, employing both cross-sectional and narrative analysis, and an expectation that subanalyses would be required for key topics helped us manage the study in a way that facilitated useful and novel insights. These strategies could be applied in other qualitative longitudinal studies in healthcare inquiry to optimise data analysis and stimulate important insights. © 2016 John Wiley & Sons Ltd.

  3. Giftedness, Trauma, and Development: A Qualitative, Longitudinal Case Study

    ERIC Educational Resources Information Center

    Peterson, Jean Sunde

    2014-01-01

    A qualitative, longitudinal, phenomenological case study explored how a gifted female experienced various life events and aspects of development during adolescence and young adulthood (ages 15-30 years), particularly as related to multiple traumatic experiences, which were revealed late in the first year of the study. Additional experiences, well…

  4. Social Class and Japanese Mothers' Support of Young Children's Education: A Qualitative Study

    ERIC Educational Resources Information Center

    Yamamoto, Yoko

    2015-01-01

    The impact of social class backgrounds on young children's educational experiences has attracted increasing attention in early childhood research. However, few longitudinal studies related to social class and parental involvement in young children's education are available, especially in East Asian contexts. In this longitudinal qualitative study,…

  5. A Reflection on the Methodology Used for a Qualitative Longitudinal Study

    ERIC Educational Resources Information Center

    Evangelinou-Yiannakis, Angela

    2017-01-01

    This paper presents a reflection on the methodology used for a qualitative longitudinal study of the teaching of Modern Greek (Greek) in Western Australia under the Seconded Teachers from Greece Scheme (STGS). The study, a first of its kind, addressed an area of need in the teaching of Greek, investigating the perspectives of the key stakeholders…

  6. A Video Feedback Intervention for Workforce Development: Exploring Staff Perspective Using Longitudinal Qualitative Methodology

    ERIC Educational Resources Information Center

    James, Deborah Michelle; Hall, Alex; Lombardo, Chiara; McGovern, Will

    2016-01-01

    Background: In this study, we explored the impact of staff training that used video feedback to help staff see the effect of their interactional work with service users. The study was based at a large organization delivering services for children and adults with autism. Materials and Methods: A longitudinal qualitative study with semi-structured…

  7. Generating qualitative data by design: the Australian Longitudinal Study on Women's Health qualitative data collection.

    PubMed

    Tavener, Meredith; Chojenta, Catherine; Loxton, Deborah

    2016-07-15

    Objectives and importance of study: The purpose of this study was to illustrate how qualitative free-text comments, collected within the context of a health survey, represent a rich data source for understanding specific phenomena. Work conducted with data from the Australian Longitudinal Study on Women's Health (ALSWH) was used to demonstrate the breadth and depth of qualitative information that can be collected. The ALSWH has been collecting data on women's health since 1996, and represents a unique opportunity for understanding lived experiences across the lifecourse. A multiple case study design was used to demonstrate the techniques that researchers have used to manage free-text qualitative comments collected by the ALSWH. Eleven projects conducted using free-text comments are discussed according to the method of analysis. These methods include coding (both inductively and deductively), longitudinal analyses and software-based analyses. This work shows that free-text comments are a data resource in their own right, and have the potential to provide rich and valuable information about a wide variety of topics.

  8. Longitudinal changes in quantitative and qualitative indicators of word and story recall in young-old and old-old adults.

    PubMed

    Small, B J; Dixon, R A; Hultsch, D F; Hertzog, C

    1999-03-01

    The present study examined longitudinal changes in quantitative and qualitative measures of episodic memory. The sample, taken from the Victoria Longitudinal Study, consisted of 158 young-old adults (initially 55 to 70 years old) and 84 old-old adults (initially 71 to 86 years old) who were tested three times over six years. Average word and text recall, as well as five indicators of qualitative aspects of word recall (e.g., number of categories recalled) and one indicator of structure of text recall (i.e., levels of information) were used. For word recall, although both age groups exhibited negative longitudinal changes in quantitative performance, overall qualitative performance was generally stable. Two qualitative indicators (number of categories and intrusions) showed modest decline and one (organization at recall) showed improvement. Results for overall text recall showed significant performance increments for the young-old group, whereas the old-old group exhibited slight declines in overall performance. Analyses of qualitative measures showed stable structure of hierarchical recall, with the old-old being impaired at all levels of detail in the stories. Overall results suggest that some underlying structural characteristics of word and text recall may be maintained into late life even when significant overall decline is observed.

  9. New Statistical Techniques for Evaluating Longitudinal Models.

    ERIC Educational Resources Information Center

    Murray, James R.; Wiley, David E.

    A basic methodological approach in developmental studies is the collection of longitudinal data. Behavioral data cen take at least two forms, qualitative (or discrete) and quantitative. Both types are fallible. Measurement errors can occur in quantitative data and measures of these are based on error variance. Qualitative or discrete data can…

  10. Is Qualitative Research Second Class Science? A Quantitative Longitudinal Examination of Qualitative Research in Medical Journals

    PubMed Central

    Shuval, Kerem; Harker, Karen; Roudsari, Bahman; Groce, Nora E.; Mills, Britain; Siddiqi, Zoveen; Shachak, Aviv

    2011-01-01

    Background Qualitative research appears to be gaining acceptability in medical journals. Yet, little is actually known about the proportion of qualitative research and factors affecting its publication. This study describes the proportion of qualitative research over a 10 year period and correlates associated with its publication. Design A quantitative longitudinal examination of the proportion of original qualitative research in 67 journals of general medicine during a 10 year period (1998–2007). The proportion of qualitative research was determined by dividing original qualitative studies published (numerator) by all original research articles published (denominator). We used a generalized estimating equations approach to assess the longitudinal association between the proportion of qualitative studies and independent variables (i.e. journals' country of publication and impact factor; editorial/methodological papers discussing qualitative research; and specific journal guidelines pertaining to qualitative research). Findings A 2.9% absolute increase and 3.4-fold relative increase in qualitative research publications occurred over a 10 year period (1.2% in 1998 vs. 4.1% in 2007). The proportion of original qualitative research was independently and significantly associated with the publication of editorial/methodological papers in the journal (b = 3.688, P = 0.012); and with qualitative research specifically mentioned in guidelines for authors (b = 6.847, P<0.001). Additionally, a higher proportion of qualitative research was associated only with journals published in the UK in comparison to other countries, yet with borderline statistical significance (b = 1.776, P = 0.075). The journals' impact factor was not associated with the publication of qualitative research. Conclusions Despite an increase in the proportion of qualitative research in medical journals over a 10 year period, the proportion remains low. Journals' policies pertaining to qualitative research, as expressed by the appearance of specific guidelines and editorials/methodological papers on the subject, are independently associated with the publication of original qualitative research; irrespective of the journals' impact factor. PMID:21383987

  11. College Women's Female Friendships: A Longitudinal View

    ERIC Educational Resources Information Center

    Aleman, Ana M. Martinez

    2010-01-01

    This article presents a longitudinal qualitative study of the cognitive value of female friendships formed in college and seeks to appraise the meaning of the phenomenon for the participants. To grasp the temporal effects of the longitudinal data in this study, the author examines and assesses the relevant developmental literature, particularly…

  12. Changing Green Subjectivities in Outdoor and Environmental Education: A Qualitative Study

    ERIC Educational Resources Information Center

    Preston, Lou

    2012-01-01

    This article draws on a longitudinal qualitative study of Australian tertiary students studying Outdoor and Environmental Education. It draws on the work of Foucault and Darier to consider how "environmental governmentality" shapes the conduct, desires and attitudes of these students over time. Attention is drawn to normalising and…

  13. Methodological developments in qualitative longitudinal research: the advantages and challenges of regular telephone contact with participants in a qualitative longitudinal interview study.

    PubMed

    Carduff, Emma; Murray, Scott A; Kendall, Marilyn

    2015-04-11

    Qualitative longitudinal research is an evolving methodology, particularly within health care research. It facilitates a nuanced understanding of how phenomena change over time and is ripe for innovative approaches. However, methodological reflections which are tailored to health care research are scarce. This article provides a synthesised and practical account of the advantages and challenges of maintaining regular telephone contact between interviews with participants in a qualitative longitudinal study. Participants with metastatic colorectal cancer were interviewed at 3 time points over the course of a year. Half the group also received monthly telephone calls to explore the added value and the feasibility of capturing change as close to when it was occurring as possible. The data gathered from the telephone calls added context to the participants' overall narrative and informed subsequent interviews. The telephone calls meant we were able to capture change close to when it happened and there was a more evolved, and involved, relationship between the researcher and the participants who were called on a monthly basis. However, ethical challenges were amplified, boundaries of the participant/researcher relationship questioned, and there was the added analytical burden. The telephone calls facilitated a more nuanced understanding of the illness experience to emerge, when compared with the interview only group. The findings suggest that intensive telephone contact may be justified if retention is an issue, when the phenomena being studied is unpredictable and when participants feel disempowered or lack control. These are potential issues for research involving participants with long-term illness.

  14. The Pre-Incubator: A Longitudinal Study of 10 Years of University Pre-Incubation in Wales

    ERIC Educational Resources Information Center

    Voisey, Pamela; Jones, Paul; Thomas, Brychan

    2013-01-01

    This paper describes a longitudinal study of over 10 years of university pre-incubation in Wales, using case studies of incubated businesses to track their performance since 2001. Surviving "graduated" businesses were investigated and quantitative and qualitative data were gathered to profile the current status of these businesses and…

  15. Code-Switching and Gender: A Longitudinal Study of Spanish/English Speaking Fraternal Boy-Girl Twins

    ERIC Educational Resources Information Center

    Robinson, Colin

    2015-01-01

    Researchers from Jean Piaget (1932) to Sehlauoi (2008) have utilized small case studies to intensively examine naturally occurring child language production in the home environment. This qualitative, 5-year longitudinal, five-year case study continues the focus of previous research on child bilingualism and code-switching; however, it aims to…

  16. Gifted Girls and Nonmathematical Aspirations: A Longitudinal Case Study of Two Gifted Korean Girls

    ERIC Educational Resources Information Center

    Lee, Kyeong Hwa; Sriraman, Bharath

    2012-01-01

    In this longitudinal study of two gifted Korean girls, experiences with early admittance into a gifted program are charted alongside their family and societal experiences that ultimately influenced their career choices in nonmathematical fields. The 8-year-long qualitative study involved extensive interviews with the two gifted girls and their…

  17. Language Learning at Key Stage 2: Findings from a Longitudinal Study

    ERIC Educational Resources Information Center

    Cable, Carrie; Driscoll, Patricia; Mitchell, Rosamond; Sing, Sue; Cremin, Teresa; Earl, Justine; Eyres, Ian; Holmes, Bernardette; Martin, Cynthia; Heins, Barbara

    2012-01-01

    This paper discusses some of the findings from a 3-year longitudinal study of language learning in the upper stage of English primary schools, i.e. at Key Stage 2. This largely qualitative study (commissioned by the then Department for Children, Schools and Families) was designed to explore and document developing provision and practice in a…

  18. A Longitudinal Study of Preservice Elementary Teachers' Personal and Science Teaching Efficacy.

    ERIC Educational Resources Information Center

    Ginns, Ian S.; Watters, James J.

    This paper reports the results of a longitudinal study into the personal and science teaching efficacy of a group of preservice elementary teachers. Quantitative and qualitative research methods were employed in the study. Using a pretest and a post-test one group research design, quantitative data were obtained from the administration of a…

  19. A Quantitative Assessment of Lareau's Qualitative Conclusions about Class, Race, and Parenting

    ERIC Educational Resources Information Center

    Cheadle, Jacob E.; Amato, Paul R.

    2011-01-01

    The authors used the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999, to test ideas from Lareau's qualitative study of social class differences in parenting. Consistent with Lareau, a confirmatory factor analysis supported the general concerted cultivation construct--a parenting strategy that subsumes parents' school…

  20. "A Writer More than . . . A Child": A Longitudinal Study Examining Adolescent Writer Identity

    ERIC Educational Resources Information Center

    Lammers, Jayne C.; Marsh, Valerie L.

    2018-01-01

    This article reconsiders theoretical claims of identity fluidity, stability, and agency through a longitudinal case study investigating one adolescent's writing over time and across spaces. Qualitative data spanning her four years of high school were collected and analyzed using a grounded theory approach with literacy-and-identity theory…

  1. Where Is the Engineering I Applied For? A Longitudinal Study of Students' Transition into Higher Education Engineering, and Their Considerations of Staying or Leaving

    ERIC Educational Resources Information Center

    Holmegaard, Henriette Tolstrup; Madsen, Lene Møller; Ulriksen, Lars

    2016-01-01

    This paper presents results from a qualitative longitudinal study of students' transition into higher education engineering. The study aims at comparing upper-secondary school students' expectations of engineering with their actual experiences when encountering the engineering programme. It explores how this encounter provides a platform for…

  2. Breaking Up Is Hard to Do: A Qualitative Interview Study of How and Why Youth Mentoring Relationships End

    ERIC Educational Resources Information Center

    Spencer, Renée; Basualdo-Delmonico, Antoinette; Walsh, Jill; Drew, Alison L.

    2017-01-01

    Endings in youth mentoring relationships have received little empirical attention despite the fact that many relationships do end. The present study utilized qualitative interview data collected from participants in a longitudinal study of community-based mentoring relationships to examine how and why the relationships ended and how participants…

  3. Social Identities among Engineering Students and through Their Transition to Work: A Longitudinal Study

    ERIC Educational Resources Information Center

    Jungert, Tomas

    2013-01-01

    This article draws on a longitudinal and qualitative study of students in a master's program in engineering. Interpretative phenomenological analysis was used to analyze annual, semi-structured interviews with ten students, from the first semester until one year after graduation. The program enjoys a high status and has a reputation of being…

  4. Low-Income Mothers' Food Practices with Young Children: A Qualitative Longitudinal Study

    ERIC Educational Resources Information Center

    Harden, Jeni; Dickson, Adele

    2015-01-01

    Objective: Young children living in socioeconomically deprived areas of Scotland have an increased risk of becoming overweight or obese. To enhance understanding of the wider contexts within which family food practices are developed, this study examined the experiences of low-income mothers with young children. Design: Qualitative longitudinal…

  5. Positive Life Experiences: A Qualitative, Cross-Sectional, Longitudinal Study of Gifted Graduates

    ERIC Educational Resources Information Center

    Peterson, Jean Sunde; Canady, Kate; Duncan, Nancy

    2012-01-01

    At the culmination of an 11-year qualitative, cross-sectional study of life events, 48 high-ability high school graduates fitting common stereotypes associated with giftedness completed an open-ended questionnaire, part of which focused on positive life experiences and sources of support. Findings included that intense investment in academics,…

  6. Lesbian, Gay, and Heterosexual Couples in Open Adoption Arrangements: A Qualitative Study

    ERIC Educational Resources Information Center

    Goldberg, Abbie E.; Kinkler, Lori A.; Richardson, Hannah B.; Downing, Jordan B.

    2011-01-01

    Little research has attended to the role of gender and sexual orientation in shaping open adoption dynamics. This qualitative, longitudinal study of 45 adoptive couples (15 lesbian, 15 gay, and 15 heterosexual couples) examined adopters' motivations for open adoption, changes in attitudes about openness, and early relationship dynamics. Key…

  7. Are We There Yet?: A Longitudinal Look at E-Books through Students' Eyes

    ERIC Educational Resources Information Center

    Hobbs, Kendall; Klare, Diane

    2016-01-01

    Starting in summer 2011, two librarians at Wesleyan University annually interviewed and directed usability studies with undergraduate students to determine how students interact with academic e-books. In 2014, the librarians used a campuswide quantitative survey to supplement these longitudinal qualitative findings. While students are increasingly…

  8. "Changes in Levels of Social Isolation and Loneliness among Older People in a Rural Area: A Twenty-Year Longitudinal Study"

    ERIC Educational Resources Information Center

    Wenger, G. Clare; Burholt, Vanessa

    2004-01-01

    The Bangor Longitudinal Study of Aging (BLSA), conducted in rural Wales from 1979 to 1999, followed a cohort of survivors from more than 500 people over 20 years. Using both quantitative and qualitative data from the study, the factors associated with increases and decreases in loneliness and social isolation were identified. The study was based…

  9. Special Issue: Assessing Meaning Making and Self-Authorship--Theory, Research, and Application

    ERIC Educational Resources Information Center

    Baxter Magolda, Marcia B.; King, Patricia M.

    2012-01-01

    In this monograph, the authors identify milestones in the journey toward self-authorship based on the theoretical work of Kegan (1982, 1994) and Baxter Magolda (2001b, 2008, 2009a), as well as the empirical findings from Baxter Magolda's longitudinal study (2001b, 2009a) and the qualitative longitudinal portion of the Wabash National Study of…

  10. Goals Set in the Land of the Living/Dying: A Longitudinal Study of Patients Living with Advanced Cancer

    ERIC Educational Resources Information Center

    Nissim, Rinat; Rennie, David; Fleming, Stephen; Hales, Sarah; Gagliese, Lucia; Rodin, Gary

    2012-01-01

    A longitudinal qualitative research study was undertaken to provide an understanding of a prolonged experience of advanced cancer, as seen through the eyes of dying individuals. Using a variant of the grounded theory method, the authors theoretically sampled, from outpatient clinics in a large comprehensive cancer treatment center, 27 patients…

  11. The Influence of Elective Surgery on Functional Health in Veterans with PTSD

    DTIC Science & Technology

    2012-12-21

    elective surgery in veterans with PTSD. Design : A longitudinal, mixed method, quasi-experimental, nonequivalent control group study was conducted...longitudinal, mixed method, quasi-experimental, nonequivalent control group study was conducted. Methods and Sample: Physical and mental health...Methods Procedures." In Research design : qualitative, quantitative , and mixed methods approaches, 203-226. Thousand Oaks, Calif.: Sage Publications

  12. Scrutinizing Practicum for a More Powerful Teacher Education: A Longitudinal Study with Pre-Service Teachers

    ERIC Educational Resources Information Center

    Serdar Tülüce, Hande; Çeçen, Sevdeger

    2016-01-01

    This study aims to explore the role of school-based practicum in promoting pre-service English language teachers' professional development through the use of a longitudinal design in combination with qualitative methods. To achieve this aim, pre-service teachers were asked to successively reflect on video-recordings of their micro-lessons in their…

  13. Models Matter--The Final Report of the National Longitudinal Evaluation of Comprehensive School Reform

    ERIC Educational Resources Information Center

    Aladjem, Daniel K.; LeFloch, Kerstin Carlson; Zhang, Yu; Kurki, Anja; Boyle, Andrea; Taylor, James E.; Herrmann, Suzannah; Uekawa, Kazuaki; Thomsen, Kerri; Fashola, Olatokunbo

    2006-01-01

    The National Longitudinal Evaluation of Comprehensive School Reform (NLECSR) is a quantitative and qualitative study of behavior, decisions, processes, and outcomes. It employs a quasi-experimental design with matched treatment and comparison schools. NLECSR seeks to determine the effects of CSR models on student achievement in about 650…

  14. A Longitudinal Examination of Preservice Teachers' Technological Pedagogical Content Knowledge in the Context of Undergraduate Teacher Education

    ERIC Educational Resources Information Center

    Mouza, Chrystalla; Nandakumar, Ratna; Yilmaz Ozden, Sule; Karchmer-Klein, Rachel

    2017-01-01

    This study used longitudinal data to investigate the development of preservice teachers' Technological Pedagogical Content Knowledge (TPACK) throughout their initial teacher education program in the United States. Quantitative and qualitative data were collected at four different points in time. Findings indicated that teacher preparation…

  15. Qualitative differences between traditional and rural-longitudinal medical student OSCE performance.

    PubMed

    Zink, Therese; Power, David V; Olson, Kenneth; Harris, Ilene B; Brooks, Kathleen D

    2010-01-01

    To ensure adequate observation, supervision, and mentoring of trainees, long-term preceptorships or apprenticeships are being reestablished in medical education. Equivalence in academic performance has been demonstrated between longitudinal students in the Rural Physician Associate Program (RPAP), who spend 9 months in a rural community during their third year of medical school, and their peers who complete their clerkships at different hospitals and clinics (traditional). We qualitatively reviewed the end of session Objective Structured Clinical Examination (OSCE) for both groups and compared their performances. The high and low performers on four OSCE scenarios (cough, dysuria in a teen, preventive care in an older male, medication reconciliation) for two cohorts of students: longitudinal (n=47) and traditional primary care clerkship students (n=60) were selected for review. These 16 videotapes were reviewed independently by three researchers. The themes and subthemes were discussed over four meetings. Both high and low scoring longitudinal students demonstrated more consistent use of rapport building skills. Longitudinal students appeared to have an effective pattern in their patient interactions and were more rehearsed at explaining preventive care recommendations such as the pros and cons of the prostate-specific antigen (PSA) test. Traditional students displayed a more complete mastery of the adolescent interview and followed a mnemonic taught during lecture. Qualitative assessment of OSCE data reveals information not captured in the quantitative scores. In this study, longitudinal students demonstrated better mastery of rapport building and content knowledge and had an effective routine to their patient encounters not evident in the traditional students' scenarios.

  16. The Effects of an Undergraduate Programme of Preschool Teaching on Preservice Teachers' Attitudes Towards Early Mathematics Education in Turkey: A Longitudinal Study

    ERIC Educational Resources Information Center

    Kesicioglu, Oguz Serdar

    2015-01-01

    The aim of this study is to set forth preservice teachers' attitudes towards early mathematics education. For this purpose, quantitative and qualitative research methods were used conjunctively and the research was planned in accordance with a "screening model". The longitudinal screening model, one of the screening models, was used in…

  17. Psychosocial predictors of non-adherence to chronic medication: systematic review of longitudinal studies

    PubMed Central

    Zwikker, Hanneke E; van den Bemt, Bart J; Vriezekolk, Johanna E; van den Ende, Cornelia H; van Dulmen, Sandra

    2014-01-01

    Objectives Several cross-sectional studies suggest that psychosocial factors are associated with non-adherence to chronic preventive maintenance medication (CPMM); however, results from longitudinal associations have not yet been systematically summarized. Therefore, the objective of this study was to systematically synthesize evidence of longitudinal associations between psychosocial predictors and CPMM non-adherence. Materials and methods PUBMED, EMBASE, CINAHL, and PsychINFO databases were searched for studies meeting our inclusion criteria. The reference lists and the ISI Web of Knowledge of the included studies were checked. Studies were included if they had an English abstract, involved adult populations using CPMM living in Western countries, and if they investigated associations between psychosocial predictors and medication non-adherence using longitudinal designs. Data were extracted according to a literature-based extraction form. Study quality was independently judged by two researchers using a framework comprising six bias domains. Studies were considered to be of high quality if ≥four domains were free of bias. Psychosocial predictors for non-adherence were categorized into five pre-defined categories: beliefs/cognitions; coping styles; social influences and social support; personality traits; and psychosocial well-being. A qualitative best evidence synthesis was performed to synthesize evidence of longitudinal associations between psychosocial predictors and CPMM non-adherence. Results Of 4,732 initially-identified studies, 30 (low-quality) studies were included in the systematic review. The qualitative best evidence synthesis demonstrated limited evidence for absence of a longitudinal association between CPMM non-adherence and the psychosocial categories. The strength of evidence for the review’s findings is limited by the low quality of included studies. Conclusion The results do not provide psychosocial targets for the development of new interventions in clinical practice. This review clearly demonstrates the need for high-quality, longitudinal research to identify psychosocial predictors of medication non-adherence. PMID:24851043

  18. Qualitative Simulator Study of Longitudinal Stick Forces and Displacements Desirable During Tracking

    NASA Technical Reports Server (NTRS)

    Faber, Stanley

    1958-01-01

    In this study in which an airplane simulator with one degree of freedom (pitch) was used, results were determined for three conditions of airplane dynamics. For an undamped natural frequency of 1/2 cps with a damping ratio of 0.18 and for an undamped natural frequency of 1 cps with a damping ratio of 0.11, moderate longitudinal stick forces and displacements were desired.

  19. Enabling Analysis of Big, Thick, Long, and Wide Data: Data Management for the Analysis of a Large Longitudinal and Cross-National Narrative Data Set.

    PubMed

    Winskell, Kate; Singleton, Robyn; Sabben, Gaelle

    2018-03-01

    Distinctive longitudinal narrative data, collected during a critical 18-year period in the history of the HIV epidemic, offer a unique opportunity to examine how young Africans are making sense of evolving developments in HIV prevention and treatment. More than 200,000 young people from across sub-Saharan Africa took part in HIV-themed scriptwriting contests held at eight discrete time points between 1997 and 2014, creating more than 75,000 narratives. This article describes the data reduction and management strategies developed for our cross-national and longitudinal study of these qualitative data. The study aims to inform HIV communication practice by identifying cultural meanings and contextual factors that inform sexual behaviors and social practices, and also to help increase understanding of processes of sociocultural change. We describe our sampling strategies and our triangulating methodologies, combining in-depth narrative analysis, thematic qualitative analysis, and quantitative analysis, which are designed to enable systematic comparison without sacrificing ethnographic richness.

  20. Multiple and multidimensional transitions from trainee to trained doctor: a qualitative longitudinal study in the UK.

    PubMed

    Gordon, Lisi; Jindal-Snape, Divya; Morrison, Jill; Muldoon, Janine; Needham, Gillian; Siebert, Sabina; Rees, Charlotte

    2017-12-01

    To explore trainee doctors' experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors' successful transition experiences? (3) What is the impact of MMTs on trained doctors? A qualitative longitudinal study underpinned by MMT theory. Four training areas (health boards) in the UK. 20 doctors, 19 higher-stage trainees within 6 months of completing their postgraduate training and 1 staff grade, associate specialist or specialty doctor, were recruited to the 9-month longitudinal audio-diary (LAD) study. All completed an entrance interview, 18 completed LADs and 18 completed exit interviews. Data were analysed cross-sectionally and longitudinally using thematic Framework Analysis. Participants experienced a multiplicity of expected and unexpected, positive and negative work-related transitions (eg, new roles) and home-related transitions (eg, moving home) during their trainee-trained doctor transition. Factors facilitating or inhibiting successful transitions were identified at various levels: individual (eg, living arrangements), interpersonal (eg, presence of supportive relationships), systemic (eg, mentoring opportunities) and macro (eg, the curriculum provided by Medical Royal Colleges). Various impacts of transitions were also identified at each of these four levels: individual (eg, stress), interpersonal (eg, trainees' children spending more time in childcare), systemic (eg, spending less time with patients) and macro (eg, delayed start in trainees' new roles). Priority should be given to developing supportive relationships (both formal and informal) to help trainees transition into their trained doctor roles, as well as providing more opportunities for learning. Further longitudinal qualitative research is now needed with a longer study duration to explore transition journeys for several years into the trained doctor role. © 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.

  1. A qualitative natural history study of ME/CFS in the community.

    PubMed

    Anderson, Valerie R; Jason, Leonard A; Hlavaty, Laura E

    2014-01-01

    In previous qualitative research on Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS), researchers have focused on the experiences of patients with ME/CFS in tertiary care samples. This qualitative study examined the natural history of people with ME/CFS (n = 19) from a community-based sample. Findings highlighted multilayered themes involving the illness experience and the physical construction of ME/CFS. In addition, this study further illuminated unique subthemes regarding community response and treatment, which have implications for understanding the progression of ME/CFS as well as experiences of those within patient networks. There is a need for more longitudinal qualitative research on epidemiological samples of patients with ME/CFS.

  2. Long-Term Outcomes of Services for Two Persons with Significant Disabilities with Differing Educational Experiences: A Qualitative Consideration of the Impact of Educational Experiences

    ERIC Educational Resources Information Center

    Ryndak, Diane Lea; Ward, Terri; Alper, Sandra; Montgomery, Jennifer Wilson; Storch, Jill F.

    2010-01-01

    Though research exists related to effective services in inclusive general education settings for students with significant disabilities, there are no longitudinal investigations of adult outcomes for persons with significant disabilities who received services in inclusive general education settings. This study uses qualitative methods to describe…

  3. Methodological considerations in the use of audio diaries in work psychology: Adding to the qualitative toolkit.

    PubMed

    Crozier, Sarah E; Cassell, Catherine M

    2016-06-01

    The use of longitudinal methodology as a means of capturing the intricacies in complex organizational phenomena is well documented, and many different research strategies for longitudinal designs have been put forward from both a qualitative and quantitative stance. This study explores a specific emergent qualitative methodology, audio diaries, and assesses their utility for work psychology research drawing on the findings from a four-stage study addressing transient working patterns and stress in UK temporary workers. Specifically, we explore some important methodological, analytical and technical issues for practitioners and researchers who seek to use these methods and explain how this type of methodology has much to offer when studying stress and affective experiences at work. We provide support for the need to implement pluralistic and complementary methodological approaches in unearthing the depth in sense-making and assert their capacity to further illuminate the process orientation of stress. This study illustrates the importance of verbalization in documenting stress and affective experience as a mechanism for accessing cognitive processes in making sense of such experience.This study compares audio diaries with more traditional qualitative methods to assess applicability to different research contexts.This study provides practical guidance and a methodological framework for the design of audio diary research and design, taking into account challenges and solutions for researchers and practitioners.

  4. Deconstructing the complexity of substance use among young men who have sex with men (YMSM) by optimizing the role of qualitative strategies in a mixed methods study.

    PubMed

    Kubicek, Katrina; Weiss, George; Iverson, Ellen F; Kipke, Michele D

    2010-04-01

    Qualitative data can be a powerful tool in developing interventions for substance use and other HIV-risk behaviors. Mixed methods design offers researchers the ability to obtain data that provides both breadth and depth to their research questions. However, the integration of qualitative data in mixed methods research has been limited. This paper describes the qualitative study design of the Healthy Young Men's Study, a longitudinal mixed method study with an ethnically diverse cohort of young men who have sex with men (YMSM) (N = 526) in Los Angeles. Integral to this discussion is how a mixed methods study can address common challenges such as sampling, representation and integration of both datasets.

  5. Ethical Mindfulness and Reflexivity: Managing a Research Relationship with Children and Young People in a 14-Year Qualitative Longitudinal Research (QLR) Study

    ERIC Educational Resources Information Center

    Warin, Jo

    2011-01-01

    This article draws on the articulation of a value for reflexivity that has accumulated within qualitative methods debates in the past decade. It demonstrates how reflexivity is interwoven with the concept of ethical mindfulness. The argument has developed from a consideration of the ethical dilemmas that were a salient aspect of an ongoing…

  6. Is being resolute better than being pragmatic when it comes to breastfeeding? Longitudinal qualitative study investigating experiences of women intending to breastfeed using the Theoretical Domains Framework.

    PubMed

    Jardine, E E; McLellan, J; Dombrowski, S U

    2017-09-01

    In the UK, initiating then discontinuing breastfeeding before two weeks post-partum is common. The aim of this longitudinal qualitative study was to explore which psychosocial factors may influence discontinuation. A sample of 10 pregnant women intending to breastfeed were recruited. A longitudinal qualitative design was used to capture views prior to and two weeks following birth. Semi-structured interviews were conducted underpinned by the Theoretical Domains Framework to explore a comprehensive list of psychosocial factors. Four women discontinued breastfeeding at the time of the second interview. Pre-partum differences were identified between maintainers and discontinuers; discontinuers appeared to have stronger intentions to breastfeed based on their self-determination, self-confidence and perception of fewer barriers to breastfeeding. Post-partum, discontinuers highlighted how they felt physically unable to carry on; their feeding experiences elicited negative emotions and pain. Negative emotions appeared to be exacerbated by original breastfeeding beliefs and advice given by healthcare professionals. The women in this study who discontinued breastfeeding showed less cognitive flexibility, which appeared to exacerbate post-partum emotional distress, when they encountered difficulties. Women with strong intentions and self-determination might benefit from support in anticipating potential barriers and identifying ways of overcoming them. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Qualitative longitudinal study of episodic disability experiences of older women living with HIV in Ontario, Canada.

    PubMed

    Solomon, Patricia; O'Brien, Kelly K; Nixon, Stephanie; Letts, Lori; Baxter, Larry; Gervais, Nicole

    2018-04-20

    To examine the episodic disability experiences of older women living with HIV over time. Qualitative longitudinal study, conducting semistructured in-depth interviews on four occasions over a 20-month time frame. Inductive thematic analyses were conducted cross-sectionally and longitudinally. Participants were recruited from HIV community organisations in Canada. 10 women aged 50 years or older living with HIV for more than 6 years. Two major themes related to the episodic nature of the women's disability. Women were living with multiple and complex sources of uncertainty over time including: unpredictable health challenges, worrying about cognition, unreliable weather, fearing stigma and the effects of disclosure, maintaining housing and adequate finances, and fulfilling gendered and family roles. Women describe strategies to deal with uncertainty over time including withdrawing and limiting activities and participation and engaging in meaningful activities. This longitudinal study highlighted the disabling effects of HIV over time in which unpredictable fluctuations in illness and health resulted in uncertainty and worrying about the future. Environmental factors, such as stigma and weather, may put older women living with HIV at a greater risk for social isolation. Strategies to promote dealing with uncertainty and building resilience are warranted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Deconstructing the complexity of substance use among young men who have sex with men (YMSM) by optimizing the role of qualitative strategies in a mixed methods study

    PubMed Central

    Kubicek, Katrina; Weiss, George; Iverson, Ellen F.; Kipke, Michele D.

    2010-01-01

    Qualitative data can be a powerful tool in developing interventions for substance use and other HIV-risk behaviors. Mixed-methods design offers researchers the ability to obtain data that provides both breadth and depth to their research. However, the integration of qualitative data in mixed-methods research has been limited. This paper describes the qualitative design of the Healthy Young Men’s Study, a longitudinal mixed-method study with an ethnically diverse cohort of young men who have sex with men (YMSM) (N=526) in Los Angeles. Integral to this discussion is how a mixed-methods study can address common challenges such as sampling, representation and integration. PMID:20222783

  9. Participants' Accounts on Their Decision to Join a Cohort Study With an Attached Biobank: A Qualitative Content Analysis Study Within Two German Studies.

    PubMed

    Nobile, Hélène; Bergmann, Manuela M; Moldenhauer, Jennifer; Borry, Pascal

    2016-07-01

    Reliable participation and sustained retention rates are crucial in longitudinal studies involving human subjects and biomaterials. Understanding the decision to enroll is an essential step to develop adequate strategies promoting long-term participation. Semi-structured interviews were implemented with newly recruited and long-term participants randomly drawn from two ongoing longitudinal studies with a biobank component in Germany. Iterative qualitative content analysis was applied to the transcribed interviews. Participants (n = 31) expressed their decision to enroll or remain in the study as the result of the complex interplay of individual factors, institutional cues, study-related features, and societal dynamics. Different forms of trust were identified as central within the elements used to explain participation and could be compared to Dibben, Morris, and Lean's dynamic model of interpersonal trust. Given these high levels of trust, an investigation of the morality of the trustful relationship at stake between participants and research(ers) is warranted. © The Author(s) 2016.

  10. A novel metadata management model to capture consent for record linkage in longitudinal research studies.

    PubMed

    McMahon, Christiana; Denaxas, Spiros

    2017-11-06

    Informed consent is an important feature of longitudinal research studies as it enables the linking of the baseline participant information with administrative data. The lack of standardized models to capture consent elements can lead to substantial challenges. A structured approach to capturing consent-related metadata can address these. a) Explore the state-of-the-art for recording consent; b) Identify key elements of consent required for record linkage; and c) Create and evaluate a novel metadata management model to capture consent-related metadata. The main methodological components of our work were: a) a systematic literature review and qualitative analysis of consent forms; b) the development and evaluation of a novel metadata model. We qualitatively analyzed 61 manuscripts and 30 consent forms. We extracted data elements related to obtaining consent for linkage. We created a novel metadata management model for consent and evaluated it by comparison with the existing standards and by iteratively applying it to case studies. The developed model can facilitate the standardized recording of consent for linkage in longitudinal research studies and enable the linkage of external participant data. Furthermore, it can provide a structured way of recording consent-related metadata and facilitate the harmonization and streamlining of processes.

  11. The Myth of Peer Influence in Adolescent Smoking Initiation

    ERIC Educational Resources Information Center

    Arnett, Jeffrey Jensen

    2007-01-01

    The widespread belief that peer influence is the primary cause of adolescent smoking initiation is examined and called into question. Correlational and longitudinal studies purporting to demonstrate peer influence are analyzed, and their limitations described. Qualitative interview studies of adolescent smoking initiation are presented as…

  12. The evaluation of a healthcare passport to improve quality of care and communication for people living with dementia (EQuIP): a protocol paper for a qualitative, longitudinal study.

    PubMed

    Leavey, Gerard; Abbott, Aine; Watson, Max; Todd, Stephen; Coates, Vivien; McIlfactrick, Sonja; McCormack, Brendan; Waterhouse-Bradley, Bethany; Curran, Emma

    2016-08-09

    There is an urgent need for the development of simple communication tools that convey the strengths, assets, and healthcare needs of people living with dementia. A Healthcare Passport may improve communication with range of health and social support services, enhancing quality and continuity of care, and to permit a consideration of the challenges and how these might be managed effectively and compassionately. This study aims to evaluate the acceptability and use of this type of intervention for people living with dementia and their carers. This is a qualitative longitudinal study informed by a critical realist review. The participants will be individuals identified as having mild-moderate dementia and informal carers. The in-depth interviews will occur at three points over the course of 18 months as they use the passport. This will be supplemented by analysis of the content of the passports and information from health and social care providers on the daily practicalities of using the passport in a range of healthcare settings. By using a critical realist review and a qualitative, longitudinal approach, the study allows for the assessment of a complex intervention in a manner which goes beyond evaluating the basic efficacy of the passport, but looking more deeply at how it worked, for whom, and in what context. It has the potential to develop new data on how interventions improve communication across a range of service providers, while encouraging health and social care professionals to respect and encourage the development of self-management and retention of personhood throughout the progression of life-limiting illnesses.

  13. Exposing the Backstage: Critical Reflections on a Longitudinal Qualitative Study of Residents’ Care Networks in Assisted Living

    PubMed Central

    Kemp, Candace L.; Ball, Mary M.; Morgan, Jennifer Craft; Doyle, Patrick J.; Burgess, Elisabeth O.; Dillard, Joy A.; Barmon, Christina E.; Fitzroy, Andrea F.; Helmly, Victoria E.; Avent, Elizabeth S.; Perkins, Molly M.

    2018-01-01

    In this article, we analyze the research experiences associated with a longitudinal qualitative study of residents’ care networks in assisted living. Using data from researcher meetings, field notes, and memos, we critically examine our design and decision making and accompanying methodological implications. We focus on one complete wave of data collection involving 28 residents and 114 care network members in four diverse settings followed for 2 years. We identify study features that make our research innovative, but that also represent significant challenges. They include the focus and topic; settings and participants; scope and design complexity; nature, modes, frequency, and duration of data collection; and analytic approach. Each feature has methodological implications, including benefits and challenges pertaining to recruitment, retention, data collection, quality, and management, research team work, researcher roles, ethics, and dissemination. Our analysis demonstrates the value of our approach and of reflecting on and sharing methodological processes for cumulative knowledge building. PMID:27651072

  14. Exposing the Backstage: Critical Reflections on a Longitudinal Qualitative Study of Residents' Care Networks in Assisted Living.

    PubMed

    Kemp, Candace L; Ball, Mary M; Morgan, Jennifer Craft; Doyle, Patrick J; Burgess, Elisabeth O; Dillard, Joy A; Barmon, Christina E; Fitzroy, Andrea F; Helmly, Victoria E; Avent, Elizabeth S; Perkins, Molly M

    2017-07-01

    In this article, we analyze the research experiences associated with a longitudinal qualitative study of residents' care networks in assisted living. Using data from researcher meetings, field notes, and memos, we critically examine our design and decision making and accompanying methodological implications. We focus on one complete wave of data collection involving 28 residents and 114 care network members in four diverse settings followed for 2 years. We identify study features that make our research innovative, but that also represent significant challenges. They include the focus and topic; settings and participants; scope and design complexity; nature, modes, frequency, and duration of data collection; and analytic approach. Each feature has methodological implications, including benefits and challenges pertaining to recruitment, retention, data collection, quality, and management, research team work, researcher roles, ethics, and dissemination. Our analysis demonstrates the value of our approach and of reflecting on and sharing methodological processes for cumulative knowledge building.

  15. Applications of Research to Camping.

    ERIC Educational Resources Information Center

    Henderson, Karla A.

    1987-01-01

    Considers contributions of basic/theoretical, applied/practical, and marketing research to the field of camping. Outlines research concerns: application of qualitative methods, practical application of marketing research, effective research dissemination, and focus on longitudinal studies using larger samples. Affirms role of research to document…

  16. The significance of relationships

    NASA Astrophysics Data System (ADS)

    Burningham, Kate

    2017-12-01

    Understanding individual energy use can inform interventions for energy conservation. A longitudinal qualitative interview study shows that energy use behaviour is not simply a matter of individual choice, but rather is influenced by unique personal circumstances and familial and social relationships, which change over time.

  17. Challenging Inquiry and Building Community: Analyzing ESL and Bilingual Teachers' Narratives

    ERIC Educational Resources Information Center

    Musanti, Sandra I.

    2017-01-01

    The study explores English as a second language (ESL) and bilingual teachers' narratives within a learning community as they collectively engage in reflecting on practices to more effectively support English learners. This longitudinal qualitative study integrates narrative inquiry approach and critical incident methodology. Participants were…

  18. Saving Face: Managing Rapport in a Problem-Based Learning Group

    ERIC Educational Resources Information Center

    Robinson, Leslie; Harris, Ann; Burton, Rob

    2015-01-01

    This qualitative study investigated the complex social aspects of communication required for students to participate effectively in Problem-Based Learning and explored how these dynamics are managed. The longitudinal study of a group of first-year undergraduates examined interactions using Rapport Management as a framework to analyse communication…

  19. Programs of Study: A Cross-Study Examination of Programs in Three States

    ERIC Educational Resources Information Center

    Stringfield, Sam; Shumer, Robert; Stipanovic, Natalie; Murphy, Nora

    2013-01-01

    The National Research Center on Career and Technical Education has supported four studies on one of the major components of Perkins legislation: programs of study. In this article, we present qualitative data linking the research center's longitudinal projects based on programs of study, via a one-time cross-case study of sites deemed highly…

  20. Transfer, Lead, Look Inward: Further Study of Preservice School Librarians' Development

    ERIC Educational Resources Information Center

    Mardis, Marcia A.

    2013-01-01

    School librarianship is affected by the widespread challenges affecting schools and changing notions of school libraries' relevancy. The purpose of this study was to ascertain how these societal trends influenced educators' decisions to be school librarians. In this second phase of a longitudinal qualitative study, five school library program…

  1. Outcomes of Orphanhood in Ethiopia: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Camfield, Laura

    2011-01-01

    The paper addresses the question of whether parental death always has a strongly negative effect on children's outcomes using quantitative and qualitative data from Young Lives, a longitudinal study of childhood poverty in Ethiopia. It investigates the validity of potential mediating factors identified by other studies in Sub-Saharan Africa using…

  2. A Longitudinal Study of Teaching Practice and Early Career Decisions: A Cautionary Tale

    ERIC Educational Resources Information Center

    Cochran-Smith, Marilyn; McQuillan, Patrick; Mitchell, Kara; Terrell, Dianna Gahlsdorf; Barnatt, Joan; D'Souza, Lisa; Jong, Cindy; Shakman, Karen; Lam, Karen; Gleeson, Ann Marie

    2012-01-01

    Although the turnover rate among beginning teachers has been a major concern for some time, most studies do not link teacher retention with teaching practice. In contrast, this study looks specifically at career decisions coupled with practice. Guided by a view of teaching as social and cultural practice, the study used multiple qualitative data…

  3. NIMH Project Accept (HPTN 043): results from in-depth interviews with a longitudinal cohort of community members.

    PubMed

    Maman, Suzanne; van Rooyen, Heidi; Stankard, Petra; Chingono, Alfred; Muravha, Tshifhiwa; Ntogwisangu, Jacob; Phakathi, Zipho; Srirak, Namtip; F Morin, Stephen

    2014-01-01

    NIMH Project Accept (HPTN 043) is a community- randomized trial to test the safety and efficacy of a community-level intervention designed to increase testing and lower HIV incidence in Tanzania, Zimbabwe, South Africa and Thailand. The evaluation design included a longitudinal study with community members to assess attitudinal and behavioral changes in study outcomes including HIV testing norms, HIV-related discussions, and HIV-related stigma. A cohort of 657 individuals across all sites was selected to participate in a qualitative study that involved 4 interviews during the study period. Baseline and 30-month data were summarized according to each outcome, and a qualitative assessment of changes was made at the community level over time. Members from intervention communities described fewer barriers and greater motivation for testing than those from comparison communities. HIV-related discussions in intervention communities were more grounded in personal testing experiences. A change in HIV-related stigma over time was most pronounced in Tanzania and Zimbabwe. Participants in the intervention communities from these two sites attributed community-level changes in attitudes to project specific activities. The Project Accept intervention was associated with more favorable social norms regarding HIV testing, more personal content in HIV discussions in all study sites, and qualitative changes in HIV-related stigma in two of five sites.

  4. How socioeconomic inequalities impact pathways of care for coronary artery disease among elderly patients: study protocol for a qualitative longitudinal study

    PubMed Central

    Schröder, Sara L; Fink, Astrid; Schumann, Nadine; Moor, Irene; Plehn, Alexander; Richter, Matthias

    2015-01-01

    Introduction Several studies have identified that socioeconomic inequalities in coronary artery disease (CAD) morbidity and mortality lead to a disadvantage in patients with low socioeconomic status (SES). International studies have shown that socioeconomic inequalities also exist in terms of access, utilisation and quality of cardiac care. The aim of this qualitative study is to provide information on the impact of socioeconomic inequalities on the pathway of care for CAD, and to establish which factors lead to socioeconomic inequality of care to form and expand existing scientific theories. Methods and analysis A longitudinal qualitative study with 48 patients with CAD, aged 60–80 years, is being conducted. Patients have been recruited consecutively at the University Hospital in Halle/Saale, Germany, and will be followed for a period of 6 months. Patients are interviewed two times face-to-face using semistructured interviews. Data are transcribed and analysed based on grounded theory. Ethics and dissemination Only participants who have been informed and who have signed a declaration of consent have been included in the study. The study complies rigorously with data protection legislation. Approval of the Ethical Review Committee at the Martin-Luther University Halle-Wittenberg, Germany was obtained. The results of the study will be presented at several congresses, and will be published in high-quality peer-reviewed international journals. Trial registration number This study has been registered with the German Clinical Trials Register and assigned DRKS00007839. PMID:26553827

  5. Nutrition Beliefs of Disadvantaged Parents of Overweight Children

    ERIC Educational Resources Information Center

    Pescud, Melanie; Pettigrew, Simone; Henley, Nadine

    2014-01-01

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

  6. Interpreting Early Career Trajectories

    ERIC Educational Resources Information Center

    Barnatt, Joan; Gahlsdorf Terrell, Dianna; D'Souza, Lisa Andries; Jong, Cindy; Cochran-Smith, Marilyn; Viesca, Kara Mitchell; Gleeson, Ann Marie; McQuillan, Patrick; Shakman, Karen

    2017-01-01

    Career decisions of four teachers are explored through the concept of figured worlds in this qualitative, longitudinal case study. Participants were purposefully chosen for similarity at entry, with a range of career trajectories over time. Teacher career paths included remaining in one school, repeated changes in schools, attrition after…

  7. The Adaptation of the Immigrant Second Generation in America: Theoretical Overview and Recent Evidence

    PubMed Central

    Portes, Alejandro; Fernández-Kelly, Patricia; Haller, William

    2013-01-01

    This paper summarises a research program on the new immigrant second generation initiated in the early 1990s and completed in 2006. The four field waves of the Children of Immigrants Longitudinal Study (CILS) are described and the main theoretical models emerging from it are presented and graphically summarised. After considering critical views of this theory, we present the most recent results from this longitudinal research program in the forum of quantitative models predicting downward assimilation in early adulthood and qualitative interviews identifying ways to escape it by disadvantaged children of immigrants. Quantitative results strongly support the predicted effects of exogenous variables identified by segmented assimilation theory and identify the intervening factors during adolescence that mediate their influence on adult outcomes. Qualitative evidence gathered during the last stage of the study points to three factors that can lead to exceptional educational achievement among disadvantaged youths. All three indicate the positive influence of selective acculturation. Implications of these findings for theory and policy are discussed. PMID:23626483

  8. Evaluation of Oral Performance in Outsourced Call Centres: An Exploratory Case Study

    ERIC Educational Resources Information Center

    Friginal, Eric

    2013-01-01

    This case study discusses the development and use of an oral performance assessment instrument intended to evaluate Filipino agents' customer service transactions with callers from the United States (US). The design and applications of the instrument were based on a longitudinal, qualitative observation of language training and customer service…

  9. Raising Reading Achievement in an "At Risk", Low Socioeconomic, Multicultural Intermediate School

    ERIC Educational Resources Information Center

    Fletcher, Jo; Grimley, Michael; Greenwood, Janinka; Parkhill, Faye

    2013-01-01

    This article focuses on a multicultural, low socioeconomic, intermediate school that over the 4 years of this longitudinal, qualitative, case study made substantial positive shifts in developing a more effective learning environment and improving students' reading achievement. The study found that the factors appearing to have the most influence…

  10. The Professionalization of Dental Students: The Application of Socio-Anthropological Methodology.

    ERIC Educational Resources Information Center

    Platt, Larry A.; Bailey, Wilfrid C.

    This paper discusses the advantages of using both qualitative and quantitative methodological procedures in investigating attitudinal and perception changes in the population studied. This project is part of a 4-year longitudinal study involving 24 dental students and 29 faculty members of a new southern dental school. The paper reviews some of…

  11. From Affinity and Beyond: A Study of Online Literacy Conversations and Communities

    ERIC Educational Resources Information Center

    Albers, Peggy; Pace, Christi L.; Odo, Dennis Murphy

    2016-01-01

    Digital technologies make possible new avenues for sharing and accessing literacy research and practices worldwide. Among the myriad of options available, web seminars have become popular online learning venues. The current investigation is part of Global Conversations in Literacy Research (GCLR), a longitudinal and qualitative study now in its…

  12. Educational Leadership in a Competitive State: A Contradiction in Terms?

    ERIC Educational Resources Information Center

    Moos, Lejf

    2012-01-01

    Purpose: The purpose of this paper is to explore how important the choice of theoretical perspective is on the analyses of empirical data from a Danish case study. Design/methodology/approach: The empirical bases for the analyses are qualitative, longitudinal case studies of school leadership in the International Successful School Principalship…

  13. Images of Imaging: Notes on Doing Longitudinal Field Work.

    ERIC Educational Resources Information Center

    Barley, Stephen R.

    1990-01-01

    Discusses the processes involved in a field study of technological change in radiology and how researchers can design a qualitative study and then collect data in a systematic and explicit manner. Illustrates the social and human problems of gaining entry into a research site, constructing a research role, and managing relationships. (63…

  14. Scaling up STEM Academies Statewide: Implementation, Network Supports, and Early Outcomes

    ERIC Educational Resources Information Center

    Young, Viki; House, Ann; Sherer, David; Singleton, Corinne; Wang, Haiwen; Klopfenstein, Kristin

    2016-01-01

    This chapter presents a case study of scaling up the T-STEM initiative in Texas. Data come from the four-year longitudinal evaluation of the Texas High School Project (THSP). The evaluation studied the implementation and impact of T-STEM and the other THSP reforms using a mixed-methods design, including qualitative case studies; principal,…

  15. Using Mixed Methods to Study First-Year College Impact on Liberal Arts Learning Outcomes

    ERIC Educational Resources Information Center

    Seifert, Tricia A.; Goodman, Kathleen; King, Patricia M.; Baxter Magolda, Marcia B.

    2010-01-01

    This study details the collection, analysis, and interpretation of data from a national multi-institutional longitudinal mixed methods study of college impact and student development of liberal arts outcomes. The authors found three sets of practices in the quantitative data that corroborated with the themes that emerged from the qualitative data:…

  16. Student Leadership Development: A Functional Framework

    ERIC Educational Resources Information Center

    Hine, Gregory Stephen Colin

    2014-01-01

    This article presents a longitudinal, qualitative case study of a student leadership program in a Catholic secondary school in Perth, Western Australia. Data were collected over a period of three years through multiple methods, including one-on-one interviewing, focus group interviewing, document searches, field notes, and researcher reflective…

  17. The Stigma of Hearing Loss

    ERIC Educational Resources Information Center

    Wallhagen, Margaret I.

    2010-01-01

    Purpose: To explore dimensions of stigma experienced by older adults with hearing loss and those with whom they frequently communicate to target interventions promoting engagement and positive aging. Design and Methods: This longitudinal qualitative study conducted interviews over 1 year with dyads where one partner had hearing loss. Participants…

  18. Teaching Action Research: The Role of Demographics

    ERIC Educational Resources Information Center

    Mcmurray, Adela J.

    2006-01-01

    This article summarizes a longitudinal study of employed MBA students with particular emphasis on findings involving their choice of action research model to implement personal and organizational change in their environment. A multi-method approach merging both quantitative and qualitative techniques was utilized. A questionnaire consisting of…

  19. The influence of racism on cigarette smoking: Longitudinal study of young people in a British multiethnic cohort

    PubMed Central

    Read, Ursula M.; João Silva, Maria; Molaodi, Oarabile R.; Enayat, Zinat E.; Cruickshank, J. Kennedy

    2018-01-01

    Introduction Studies, predominantly from the US, suggest that positive parenting, social support, academic achievement, and ethnic identity may buffer the impact of racism on health behaviours, including smoking, but little is known about how such effects might operate for ethnically diverse young people in the United Kingdom. We use the Determinants of young Adult Social well-being and Health (DASH), the largest UK longitudinal study of ethnically diverse young people, to address the following questions: a) Is racism associated with smoking? b) Does the relationship between racism and smoking vary by gender and by ethnicity? (c) Do religious involvement, parenting style and relationship with parents modify any observed relationship? and d) What are the qualitative experiences of racism and how might family or religion buffer the impact? Methods The cohort was recruited from 51 London schools. 6643 were seen at 11-13y and 4785 seen again at 14-16y. 665 participated in pilot follow-up at 21-23y, 42 in qualitative interviews. Self-report questionnaires included lifestyles, socio-economic and psychosocial factors. Mixed-effect models examined the associations between racism and smoking. Results Smoking prevalence increased from adolescence to age 21-23y, although ethnic minorities remained less likely to smoke. Racism was an independent longitudinal correlate of ever smoking throughout adolescence (odds ratio 1.77, 95% Confidence Interval 1.45–2.17) and from early adolescence to early 20s (1.90, 95% CI 1.25–2.90). Smoking initiation in late adolescence was associated with cumulative exposure to racism (1.77, 95% CI 1.23–2.54). Parent-child relationships and place of worship attendance were independent longitudinal correlates that were protective of smoking. Qualitative narratives explored how parenting, religion and cultural identity buffered the adverse impact of racism. Conclusions Racism was associated with smoking behaviour from early adolescence to early adulthood, regardless of gender, ethnicity or socio-economic circumstances adding to evidence of the need to consider racism as an important social determinant of health across the life course. PMID:29364959

  20. The influence of racism on cigarette smoking: Longitudinal study of young people in a British multiethnic cohort.

    PubMed

    Read, Ursula M; Karamanos, Alexis; João Silva, Maria; Molaodi, Oarabile R; Enayat, Zinat E; Cassidy, Aidan; Cruickshank, J Kennedy; Harding, Seeromanie

    2018-01-01

    Studies, predominantly from the US, suggest that positive parenting, social support, academic achievement, and ethnic identity may buffer the impact of racism on health behaviours, including smoking, but little is known about how such effects might operate for ethnically diverse young people in the United Kingdom. We use the Determinants of young Adult Social well-being and Health (DASH), the largest UK longitudinal study of ethnically diverse young people, to address the following questions: a) Is racism associated with smoking? b) Does the relationship between racism and smoking vary by gender and by ethnicity? (c) Do religious involvement, parenting style and relationship with parents modify any observed relationship? and d) What are the qualitative experiences of racism and how might family or religion buffer the impact? The cohort was recruited from 51 London schools. 6643 were seen at 11-13y and 4785 seen again at 14-16y. 665 participated in pilot follow-up at 21-23y, 42 in qualitative interviews. Self-report questionnaires included lifestyles, socio-economic and psychosocial factors. Mixed-effect models examined the associations between racism and smoking. Smoking prevalence increased from adolescence to age 21-23y, although ethnic minorities remained less likely to smoke. Racism was an independent longitudinal correlate of ever smoking throughout adolescence (odds ratio 1.77, 95% Confidence Interval 1.45-2.17) and from early adolescence to early 20s (1.90, 95% CI 1.25-2.90). Smoking initiation in late adolescence was associated with cumulative exposure to racism (1.77, 95% CI 1.23-2.54). Parent-child relationships and place of worship attendance were independent longitudinal correlates that were protective of smoking. Qualitative narratives explored how parenting, religion and cultural identity buffered the adverse impact of racism. Racism was associated with smoking behaviour from early adolescence to early adulthood, regardless of gender, ethnicity or socio-economic circumstances adding to evidence of the need to consider racism as an important social determinant of health across the life course.

  1. Reasons for Vocabulary Attrition: Revisiting the State of the Art

    ERIC Educational Resources Information Center

    Alharthi, Thamer

    2015-01-01

    This paper reports on a one year, mixed-methods longitudinal case study investigating the neglected area of the perceived reasons why participants forget vocabulary knowledge. The participants were 43 fourth year male Saudi EFL majors at King Abdulaziz University KAU, Saudi Arabia. Quantitative and qualitative data including self-reported…

  2. Uncovering One Trilingual Child's Multi-Literacies Development across Informal and Formal Learning Contexts

    ERIC Educational Resources Information Center

    Kim, Mi Song

    2016-01-01

    Due to globalisation and rapid technological change, today's educators need to help students develop multi-literacy competencies to enable them to function successfully in our culturally and linguistically diverse (CLD) and increasingly connected global and digital society. A qualitative, longitudinal case study attempted to uncover the…

  3. Trading Places: When Teachers Utilize Student Expertise in Technology-Intensive Classrooms.

    ERIC Educational Resources Information Center

    Ringstaff, Cathy; And Others

    Utilizing self-report data from 32 elementary and secondary teachers, this longitudinal, qualitative study examines the role shifts of both teachers and students as they adapted to teaching and learning in educational, technology-rich, Apple Classrooms of Tomorrow environments. At first, teachers in these instructionally innovative classrooms…

  4. Constructing Practical Knowledge of Teaching: Eleven Newly Qualified Language Teachers' Discursive Agency

    ERIC Educational Resources Information Center

    Ruohotie-Lyhty, Maria

    2011-01-01

    This paper explores the professional development of 11 newly qualified foreign language teachers. It draws on a qualitative longitudinal study conducted at the University of Jyvaskyla, Finland between 2002 and 2009. The paper concentrates on the personal side of teacher development by analysing participants' discourses concerning language…

  5. Youth Politics and Local Constructions of Youth

    ERIC Educational Resources Information Center

    Hansson, Kristian; Lundahl, Lisbeth

    2004-01-01

    In the 1990s, temporary youth projects became a common approach to handling youth unemployment and the social integration of young people in Sweden. In a longitudinal, qualitative study, 35 unemployed men and women, attending local youth projects in three Swedish municipalities, were followed over a two-year period. The selected contexts…

  6. Environmental Uncertainty and External Resource Acquisition: Implications for a Developing Research University.

    ERIC Educational Resources Information Center

    Bjork, Lars G.

    External resource acquisition was investigated as one factor associated with the development of the University of New Mexico from an undergraduate teaching institution toward becoming a nationally-ranked graduate research university. A longitudinal, ethnohistorical study was undertaken for the 1967-1978 period. The qualitative research methodology…

  7. Is There Life without Work?

    ERIC Educational Resources Information Center

    Nuttman-Shwartz, Orit

    2007-01-01

    The present study examined the way retirees perceive retirement and continue to work post-retirement. Using a longitudinal design, qualitative and quantitative analyses were performed to examine the effect of preoccupation with work on adjustment to retirement. The findings indicate a wide range of attitudes toward cessation of the working life on…

  8. Experiences of Rural Vocational Rehabilitation Clients Who Leave the System Prematurely: A Qualitative Exploration

    ERIC Educational Resources Information Center

    Rigles, Bethany; Ipsen, Catherine; Arnold, Nancy; Seekins, Tom

    2011-01-01

    Vocational rehabilitation (VR) clients who leave the system prematurely experience worse employment outcomes than clients who stay in services. The authors conducted this study to learn about factors leading to premature exit by rural VR clients. Results will inform survey development for a large longitudinal study on this topic. The authors…

  9. Age, Intelligence, and Event-Related Brain Potentials during Late Childhood: A Longitudinal Study.

    ERIC Educational Resources Information Center

    Stauder, Johannes E. A.; van der Molen, Maurits W.; Molenaar, Peter C. M.

    2003-01-01

    Studied the relationship between event-related brain activity, age, and intelligence using a visual oddball task presented to girls at 9, 10, and 11 years of age. Findings for 26 girls suggest a qualitative shift in the relation between event-related brain activity and intelligence between 9 and 10 years of age. (SLD)

  10. The Impact of In-Service Teacher Education on Language Teachers' Beliefs

    ERIC Educational Resources Information Center

    Borg, Simon

    2011-01-01

    This qualitative longitudinal study examines the impact of an intensive eight-week in-service teacher education programme in the UK on the beliefs of six English language teachers. Drawing on a substantial database of semi-structured interviews, coursework and tutor feedback, the study suggests that the programme had a considerable, if variable,…

  11. What Happens to Students' English after One Year of English­-Medium Course Study at University?

    ERIC Educational Resources Information Center

    Gan, Zhengdong; Stapleton, Paul; Yang, Chi Cheung Ruby

    2015-01-01

    A much under-researched issue in higher education is the extent to which English-medium university courses help students improve their English proficiency in an ESL context. Adopting a longitudinal, mixed methods design in which quantitative and qualitative data were collected and analyzed, the current study tracked English language improvement,…

  12. Perceptions of Healthy Eating: A Qualitative Study of School-Going Children in South India

    ERIC Educational Resources Information Center

    Swaminathan, S.; Thomas, T.; Kurpad, A. V.; Vaz, M.

    2009-01-01

    Objective: To document children's views on healthy eating, perceptions of healthy and unhealthy foods and health consequences of consuming unhealthy foods. Design: Baseline data from a three-year longitudinal study. Setting A purposive sample of 307 school children aged 7 to 15 years were recruited from three schools representing various…

  13. A Study Exploring Learners' Informal Learning Space Behaviors, Attitudes, and Preferences

    ERIC Educational Resources Information Center

    Harrop, Deborah; Turpin, Bea

    2013-01-01

    What makes a successful informal learning space is a topic in need of further research. The body of discourse on informal space design is drawn from learning theory, placemaking, and architecture, with a need for understanding of the synergy between the three. Findings from a longitudinal, quantitative, and qualitative study at Sheffield Hallam…

  14. What Happens to a Nursing Home Chain When Private Equity Takes Over? A Longitudinal Case Study.

    PubMed

    Bos, Aline; Harrington, Charlene

    2017-01-01

    We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5 different data sources. Results show that private equity owners continued and reinforced several strategies that were already put in place before the takeover, including a focus on keeping staffing levels low; the new owners added restructuring, rebranding, and investment strategies such as establishing new companies, where the nursing home chain served as an essential "launch customer."

  15. Strategies to support engagement and continuity of activity during mealtimes for families living with dementia; a qualitative study.

    PubMed

    Keller, Heather H; Martin, Lori Schindel; Dupuis, Sherry; Reimer, Holly; Genoe, Rebecca

    2015-10-09

    Mealtimes are an essential part of living and quality of life for everyone, including persons living with dementia. A longitudinal qualitative study provided understanding of the meaning of mealtimes for persons with dementia and their family care partners. Strategies were specifically described by families to support meaningful mealtimes. The purpose of this manuscript is to describe the strategies devised and used by these families living with dementia. A longitudinal qualitative study was undertaken to explore the meaning and experience of mealtimes for families living with dementia over a three-year period. 27 families [older person with dementia and at least one family care partner] were originally recruited from the community of South-Western Ontario. Individual and dyad interviews were conducted each year. Digitally recorded transcripts were analyzed using grounded theory methodology. Strategies were identified and categorized. Strategies to support quality mealtimes were devised by families as they adapted to their evolving lives. General strategies such as living in the moment, as well as strategies specific to maintaining social engagement and continuity of mealtime activities were reported. In addition to nutritional benefit, family mealtimes provide important opportunities for persons with dementia and their family care partners to socially engage and continue meaningful roles. Strategies identified by participants provide a basis for further education and support to families living with dementia.

  16. L2 Academic Discourse Socialization through Oral Presentations: An Undergraduate Student's Learning Trajectory in Study Abroad

    ERIC Educational Resources Information Center

    Kobayashi, Masaki

    2016-01-01

    The present study provides an in-depth, longitudinal account of an undergraduate student's L2 discourse socialization in an academic exchange program in Canada. By invoking Rogoff's (1995) notion of participatory appropriation, this qualitative case study examined an L2 student's task-related strategies and performance as they evolved over time in…

  17. Post-Primary Education and Capabilities: Insights from Young Women in Rural Uganda

    ERIC Educational Resources Information Center

    Jones, Shelley K.

    2015-01-01

    This paper presents findings from the third stage of a longitudinal, qualitative study involving nine female participants from a class cohort in a secondary school in rural Uganda. Since 2004-05, this study has tracked the progress of these young women's lives, and the present aspect of the study explores the ways in which they have found that…

  18. The Multi-Literacy Development of a Young Trilingual Child: Four Leading Literacy Activities from Birth to Age Six

    ERIC Educational Resources Information Center

    Kim, Mi Song

    2014-01-01

    This study examines the multiplicity of literacies while incorporating multiple modes of meaning to understand a young trilingual child's meaning-making processes. This qualitative study reports the results of a combination of ethnographic observations and a longitudinal case study of one child's multi-literacy development from birth to…

  19. A Winding Road--Professional Trajectories from Higher Education to Working Life: A Case Study of Political Science and Psychology Graduates

    ERIC Educational Resources Information Center

    Nystrom, Sofia; Dahlgren, Madeleine Abrandt; Dahlgren, Lars Owe

    2008-01-01

    This qualitative and longitudinal study focuses on graduate employment and the development of graduate employment paths. The aim of this article is to explore the present professional trajectory from higher education to working life, with particular reference to graduates from two different study programmes at Linkoping University in Sweden:…

  20. Offshore Outsourcing Teacher Inservice Education: The Long-Term Effects of a Four-Month Pedagogical Program on Japanese Teachers of English

    ERIC Educational Resources Information Center

    Cook, Melodie

    2010-01-01

    This longitudinal study tracked five public junior and senior high school Japanese teachers of English (JTEs) who were sponsored by the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) to study English and Communicative Language Teaching (CLT) pedagogy at a host university in Canada. This qualitative case study found…

  1. Managing Criticism in Ph.D. Supervision: A Qualitative Case Study

    ERIC Educational Resources Information Center

    Li, Sarah; Seale, Clive

    2007-01-01

    This article is part of a larger study which presents findings from an in-depth longitudinal case study of a student's Ph.D. journey. It shows how criticism is produced and managed in the supervisory relationship. As well as an overview of types of criticism produced across a range of supervisory interactions, the article presents a micro-analysis…

  2. Women's Voices on Recovery: A Multi-Method Study of the Complexity of Recovery from Child Sexual Abuse

    ERIC Educational Resources Information Center

    Banyard, Victoria L.; Williams, Linda M.

    2007-01-01

    Objective: The current study was exploratory and used multiple methods to examine patterns of stability and change in resilient functioning across 7 years of early adulthood. Second, qualitative data were used to examine in greater detail survivors' own narratives about correlates of healing. Method: This study was longitudinal and used both…

  3. Living with systemic lupus erythematosus in the developing world.

    PubMed

    Phuti, A; Schneider, M; Tikly, M; Hodkinson, B

    2018-03-26

    Most of our understanding of SLE and its negative impact originates from developed countries. This review aims to collate existing literature on Health-Related Quality of Life (HRQoL) in SLE patients living in developing countries to identify the gaps for the focus of future research. A narrative literature review was compiled using selected MeSH terms to search EBSCOHOST for articles published between January 1975 and February 2018 pertaining to HRQoL in SLE patients in developing countries. 31 studies from 11 countries were included for analysis. Only one longitudinal, one randomized controlled trial (RCT), one qualitative study, and two intervention studies were found. High disease activity and organ damage were associated with poor functional ability, mental health and low socio-economic status (SES). Poor SES is a recurring theme in developing countries, and worsens all SLE outcomes by reducing access to healthcare, mental, social and emotional support systems. In developing countries, SLE has a globally negative impact on patients' HRQoL, similar to that seen in developed countries. There is an urgent need for more HRQoL studies, and in particular, longitudinal, qualitative and interventional studies in these countries to investigate unmet needs, and to explore novel strategies to improve patient outcomes.

  4. On the Development of Perfectionism: The Longitudinal Role of Academic Achievement and Academic Efficacy.

    PubMed

    Damian, Lavinia E; Stoeber, Joachim; Negru-Subtirica, Oana; Băban, Adriana

    2017-08-01

    Although perfectionism is a prominent personality disposition, only a few longitudinal studies have investigated how perfectionism develops. Theoretical models and qualitative studies have posited that academic success is a developmental antecedent of perfectionism. Yet, quantitative studies tend to interpret the cross-sectional relationships as academic success being an outcome of perfectionism. In light of these gaps in the literature, the present study was the first to investigate the longitudinal relationships between perfectionistic strivings, perfectionistic concerns, academic achievement, and academic efficacy by examining academic success as an antecedent of perfectionism. The study examined 487 adolescents (aged 12-19 years, 54% female) using a cross-lagged longitudinal design with three time points spaced 4-5 months apart. Results showed that academic achievement predicted relative increases in both perfectionistic strivings and perfectionistic concerns, even when including academic efficacy. In addition, academic efficacy predicted relative increases in perfectionistic strivings. This is the first study to show that academic achievement is a common factor in the development of perfectionistic strivings and perfectionistic concerns, whereas academic efficacy plays a role only in the development of perfectionistic strivings. Implications of the findings for the development of perfectionism are discussed. © 2016 Wiley Periodicals, Inc.

  5. Longitudinal Brain Magnetic Resonance Imaging CO2 Stress Testing in Individual Adolescent Sports-Related Concussion Patients: A Pilot Study.

    PubMed

    Mutch, W Alan C; Ellis, Michael J; Ryner, Lawrence N; Morissette, Marc P; Pries, Philip J; Dufault, Brenden; Essig, Marco; Mikulis, David J; Duffin, James; Fisher, Joseph A

    2016-01-01

    Advanced neuroimaging studies in concussion have been limited to detecting group differences between concussion patients and healthy controls. In this small pilot study, we used brain magnetic resonance imaging (MRI) CO2 stress testing to longitudinally assess cerebrovascular responsiveness (CVR) in individual sports-related concussion (SRC) patients. Six SRC patients (three males and three females; mean age = 15.7, range = 15-17 years) underwent longitudinal brain MRI CO2 stress testing using blood oxygen level-dependent (BOLD) MRI and model-based prospective end-tidal CO2 targeting under isoxic conditions. First-level and second-level comparisons were undertaken using statistical parametric mapping (SPM) to score the scans and compare them to an atlas of 24 healthy control subjects. All tests were well tolerated and without any serious adverse events. Anatomical MRI was normal in all study participants. The CO2 stimulus was consistent between the SRC patients and control subjects and within SRC patients across the longitudinal study. Individual SRC patients demonstrated both quantitative and qualitative patient-specific alterations in CVR (p < 0.005) that correlated strongly with clinical findings, and that persisted beyond clinical recovery. Standardized brain MRI CO2 stress testing is capable of providing a longitudinal assessment of CVR in individual SRC patients. Consequently, larger prospective studies are needed to examine the utility of brain MRI CO2 stress testing as a clinical tool to help guide the evaluation, classification, and longitudinal management of SRC patients.

  6. Collaborative Planning and Decision Making in the Elementary School: A Qualitative Study of Contemporary Team Teaching.

    ERIC Educational Resources Information Center

    Riley, John F.

    This longitudinal study examined elementary teachers' perceptions of the collaborative planning and decision-making process and their role in it. Nine teachers participated in grade- level teaming. Teachers ranged in experience from 1-9 years, with 3 teachers new to the team and 5 in their first or second year of teaching. Participants completed…

  7. Multicompetence in L2 Language Play: A Longitudinal Case Study

    ERIC Educational Resources Information Center

    Bell, Nancy; Skalicky, Stephen; Salsbury, Tom

    2014-01-01

    Humor and language play have been recognized as important aspects of second language (L2) development. Qualitative studies that have documented the forms and functions of language play for adult and child L2 users have taken place largely in classroom settings. In order to gain a fuller understanding of such creative manipulations by L2 users, it…

  8. Site Selection in School District Research: A Measure of Effectiveness Using Hierarchical Longitudinal Growth Models of Performance

    ERIC Educational Resources Information Center

    Bowers, Alex J.

    2015-01-01

    School districts in the USA are an active area of study in education research as findings have shown that some districts find success in certain contexts while others struggle. However, the research domain has had few actionable methods for site selection for in-depth qualitative studies. This study analyses all districts in the state of Ohio (n =…

  9. Teaching Approaches of Beginning Teachers for Jewish Studies in Israeli "Mamlachti" Schools: A Case Study of a Jewish Education Teachers' Training Program for Outstanding Students

    ERIC Educational Resources Information Center

    Katzin, Ori

    2015-01-01

    This article presents findings from a longitudinal qualitative study that examined teaching approaches of neophyte teachers in Israel during their 4-year exclusive teachers' training program for teaching Jewish subjects and first two years of teaching. The program wanted to promote change in secular pupils' attitudes toward Jewish subjects. We…

  10. Parallel realities: exploring poverty dynamics using mixed methods in rural Bangladesh.

    PubMed

    Davisa, Peter; Baulch, Bob

    2011-01-01

    This paper explores the implications of using two methodological approaches to study poverty dynamics in rural Bangladesh. Using data from a unique longitudinal study, we show how different methods lead to very different assessments of socio-economic mobility. We suggest five ways of reconciling these differences: considering assets in addition to expenditures, proximity to the poverty line, other aspects of well-being, household division, and qualitative recall errors. Considering assets and proximity to the poverty line along with expenditures resolves three-fifths of the qualitative and quantitative differences. Use of such integrated mixed-methods can therefore improve the reliability of poverty dynamics research.

  11. Examining First-Year Non-Dominant Students' Experiences as Academic Writers: An Identity Perspective

    ERIC Educational Resources Information Center

    Panayotova, Dora Marinova

    2013-01-01

    This dissertation reports on a study investigating the identity of first-year university students as writers. The longitudinal project explored how students from educationally disadvantaged backgrounds construct their identities as undergraduates and as academic writers in their first year. The research was qualitative and interpretative, and used…

  12. Enhancing, Inhibiting, and Maintaining Voice: An Examination of Student Affairs Graduate Students' Self-Authorship Journeys

    ERIC Educational Resources Information Center

    Perez, Rosemary J.

    2017-01-01

    In this longitudinal qualitative study I explored the development of self-authorship among 21 student affairs master's candidates at 2 institutions. The findings suggest that growth, regression, and stasis in newcomers' developmental capacities for self-authorship occurred as they matriculated, and that these developmental trajectories reflected…

  13. The Development of Individual Learners in an L2 Listening Strategies Course

    ERIC Educational Resources Information Center

    Yeldham, Michael; Gruba, Paul

    2016-01-01

    This study examined the idiosyncratic development of second language (L2) learners in a listening strategies course. The progress of four Taiwanese EFL learners was examined longitudinally through a variety of quantitative and qualitative techniques as the learners participated in a course combining direct instruction of strategies with their…

  14. Bidirectional Cross-Linguistic Influence in Cantonese-English Bilingual Children: The Case of Right-Dislocation

    ERIC Educational Resources Information Center

    Ge, Haoyan; Matthews, Stephen; Cheung, Lawrence Yam-leung; Yip, Virginia

    2017-01-01

    This corpus-based study demonstrates a case of bidirectional cross-linguistic influence in the acquisition of right-dislocation by Cantonese-English bilingual children and interprets the results in relation to Hulk and Müller's hypothesis for cross-linguistic influence. Longitudinal data reveal qualitative and quantitative differences between…

  15. How Do Disadvantaged Parents View Tensions in Their Relationships? Insights for Relationship Longevity among At-Risk Couples

    ERIC Educational Resources Information Center

    Waller, Maureen R.

    2008-01-01

    Drawing on longitudinal, qualitative interviews with parents in the Fragile Families Study, this paper examines the narrative frames through which partners in stable and unstable unions viewed tensions over economic issues, domestic responsibilities, personal problems, communication, trust, and their family and social networks. These interviews…

  16. Early Career Researcher Challenges: Substantive and Methods-Based Insights

    ERIC Educational Resources Information Center

    McAlpine, Lynn; Amundsen, Cheryl

    2015-01-01

    Navigating academic work as well as career possibilities during and post-Ph.D. is challenging. To better understand these challenges, since 2010, we have investigated the experiences of early career scientists longitudinally using a range of qualitative data collection formats. For this study, we examined the experiences of four students and four…

  17. Students' Imaginings of Spaces of Learning in Outdoor and Environmental Education

    ERIC Educational Resources Information Center

    Preston, Lou

    2014-01-01

    In this article, I interrogate students' stories about the spaces and places in a tertiary Outdoor and Environmental Education course that support and shape their environmental ethics. Drawing on a longitudinal qualitative study, I explore the ways in which particular sites of learning (outdoor, practical learning) are privileged and how…

  18. Trajectories of Youthful Antisocial Behavior: Categories or Continua?

    ERIC Educational Resources Information Center

    Walters, Glenn D.; Ruscio, John

    2013-01-01

    The purpose of this study was to determine whether qualitatively distinct trajectories of antisocial behavior could be identified in 1,708 children (843 boys, 865 girls) from the 1979 National Longitudinal Survey of Youth-Child Data (NLSY-C). Repeated ratings were made on the Behavior Problems Index (BPI: Peterson and Zill "Journal of Marriage and…

  19. Successful Students' Negotiation of Township Schooling in Contemporary South Africa

    ERIC Educational Resources Information Center

    Kapp, Rochelle; Badenhorst, Elmi; Bangeni, Bongi; Craig, Tracy S.; van Rensburg, Viki Janse; Le Roux, Kate; Prince, Robert; Pym, June; van Pletzen, Ermien

    2014-01-01

    This article draws on data from a larger longitudinal qualitative case study which is tracking the progress of students over the course of their undergraduate degrees at a South African university. For this paper, we used background questionnaires and semi-structured interviews with 62 first-year students from working-class, township schools who…

  20. Critical Methods in Longitudinal Research with Latino Immigrant Families

    ERIC Educational Resources Information Center

    Díaz, Yethzèll; Denner, Jill; Ortiz, Eloy

    2017-01-01

    We have an ethical and a scientific imperative to do research that reflects the views and learning experiences of historically marginalized groups. Most studies that use a critical methodological approach rely on qualitative data. This article describes how a critical approach to recruitment, data collection, and retention can help to ensure that…

  1. Gaining Insight into Hispanic Students' Postsecondary Plans

    ERIC Educational Resources Information Center

    Brown, Neel A.

    2012-01-01

    While the growth of the Hispanic population in the United States is outpacing other ethnicities, college enrollment and graduation rates of Hispanic students continue to lag behind other groups. This longitudinal, qualitative case study explored when, how, and why a sample of Hispanic high school seniors at a large high school in North Central…

  2. Mental health pre-registration nursing students' experiences of group clinical supervision: a UK longitudinal qualitative study.

    PubMed

    Carver, Neil; Clibbens, Nicola; Ashmore, Russell; Sheldon, Julie

    2014-03-01

    There is widespread international interest in the use of clinical supervision in nursing as well as recognition of the need to introduce nursing students to its concepts and value. This article reports on a three-year longitudinal qualitative focus group study which explored students' views and experiences of a group clinical supervision initiative. Students attended supervision groups facilitated by teaching staff over their three year pre-registration mental health nursing course, with a main aim of developing skills, knowledge and attitudes as supervisees. The findings showed that students derived benefit from the experience, gained greater awareness of the nature of supervision and became active supervisees within their groups. These benefits took time to emerge and were not universal however. While the findings support the value of exposing students to the experience of group clinical supervision educators wishing to implement such a programme need to address a host of issues. These include; the preparation of students, structural and resource concerns, and issues relating to group dynamics. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Women's experiences of participating in a prospective, longitudinal postpartum depression study: insights for perinatal mental health researchers.

    PubMed

    Andrighetti, Heather J; Semaka, Alicia; Austin, Jehannine C

    2017-08-01

    Barriers to recruitment for research on mental illness include participant distrust of researchers and social stigma. Though these issues may be acutely important in perinatal mental health research, they remain unexplored in this context. In order to inform strategies to more fully engage women in perinatal mental health research, we explored the motivations and experiences of women with a history of major depressive disorder who participated in a prospective longitudinal research study on postpartum depression (PPD). Sixteen women with a history of depression who had either completed or recently made a decision about participation in a longitudinal research study about PPD were interviewed by telephone. Qualitative, semi-structured interviews explored participants' decision-making about, and experiences of, participation. Interviews were audio-recorded, transcribed, and qualitatively analyzed using elements of grounded theory methodology. Follow-up interviews were conducted with four participants to refine and clarify preliminary results. Foundational elements necessary for women to consider participating in PPD research included personal acceptance of illness and trust in the research team/institution. Other main motivators included perceived personal relevance, anticipated benefits (including access to support/resources, learning opportunities, and improved self-worth), altruism, and accessible study procedures. Our data suggest that participating in perinatal mental health research may help women make meaning of their mental illness experience and is perceived as providing support. The findings-particularly around the importance of participant-researcher rapport and accessibility of study design-may inform strategies that improve participation rates, decrease attrition, and maximize participant benefits in perinatal mental health research.

  4. What Happens to a Nursing Home Chain When Private Equity Takes Over? A Longitudinal Case Study

    PubMed Central

    Bos, Aline; Harrington, Charlene

    2017-01-01

    We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5 different data sources. Results show that private equity owners continued and reinforced several strategies that were already put in place before the takeover, including a focus on keeping staffing levels low; the new owners added restructuring, rebranding, and investment strategies such as establishing new companies, where the nursing home chain served as an essential “launch customer.” PMID:29161948

  5. Longitudinal Trajectories of Ketamine Use among Young Injection Drug Users

    PubMed Central

    Lankenau, Stephen E.; Bloom, Jennifer Jackson; Shin, Charles

    2010-01-01

    Background Ketamine is a dissociative anesthetic that became increasing popular in the club and rave scene in the 1980s and 1990s. Reports surfaced in the late 1990s indicating that ketamine was being injected in several U.S. cities by young injection drug users (IDUs). Since all studies on ketamine injection were cross-sectional, a longitudinal study was undertaken in 2005 to determine: characteristics of young IDUs who continue to inject ketamine; frequency of ketamine injection over an extended time period; risks associated with ongoing ketamine injection; and environmental factors that impact patterns of ketamine use. Methods Young IDUs aged 16 to 29 with a history of injecting ketamine (n=101) were recruited from public locations in Los Angeles and followed during a two-year longitudinal study. A semi-structured instrument captured quantitative and qualitative data on patterns of ketamine injection and other drug use. A statistical model sorted IDUs who completed three or more interviews (n=66) into three groups based upon patterns of ketamine injection at baseline and follow-up. Qualitative analysis focused on detailed case studies within each group. Results IDUs recruited at baseline were typically in their early 20s, male, heterosexual, white, and homeless. Longitudinal injection trajectories included: “Moderates,” who injected ketamine several times per year (n=5); “Occasionals,” who injected ketamine approximately once per year (n=21); and “Abstainers,” who did not inject any ketamine during follow-up (n=40). Findings suggest that ketamine is infrequently injected compared to other drugs such as heroin, cocaine, and methamphetamine. Most IDUs who begin injecting ketamine will stop or curb use due to: negative or ambivalent experiences associated with ketamine; an inability to find the drug due to declining supply; or maturing out of injecting drugs more generally. Conclusion Reducing ketamine injection among young IDUs may best be accomplished by targeting particular groups of IDUs identified in this study, such as homeless youth and homeless travelers. PMID:20138747

  6. Revisiting typhoid fever surveillance in low and middle income countries: lessons from systematic literature review of population-based longitudinal studies.

    PubMed

    Mogasale, Vittal; Mogasale, Vijayalaxmi V; Ramani, Enusa; Lee, Jung Seok; Park, Ju Yeon; Lee, Kang Sung; Wierzba, Thomas F

    2016-01-29

    The control of typhoid fever being an important public health concern in low and middle income countries, improving typhoid surveillance will help in planning and implementing typhoid control activities such as deployment of new generation Vi conjugate typhoid vaccines. We conducted a systematic literature review of longitudinal population-based blood culture-confirmed typhoid fever studies from low and middle income countries published from 1(st) January 1990 to 31(st) December 2013. We quantitatively summarized typhoid fever incidence rates and qualitatively reviewed study methodology that could have influenced rate estimates. We used meta-analysis approach based on random effects model in summarizing the hospitalization rates. Twenty-two papers presented longitudinal population-based and blood culture-confirmed typhoid fever incidence estimates from 20 distinct sites in low and middle income countries. The reported incidence and hospitalizations rates were heterogeneous as well as the study methodology across the sites. We elucidated how the incidence rates were underestimated in published studies. We summarized six categories of under-estimation biases observed in these studies and presented potential solutions. Published longitudinal typhoid fever studies in low and middle income countries are geographically clustered and the methodology employed has a potential for underestimation. Future studies should account for these limitations.

  7. Experiences of disability consumer-directed care users in Australia: results from a longitudinal qualitative study.

    PubMed

    Ottmann, Goetz; Laragy, Carmel; Haddon, Michelle

    2009-09-01

    The rapidly growing body of literature suggests that Consumer-directed Care (CDC) has the potential to empower consumers and improve the flexibility and quality of care. However, reports highlighting quality and risk concerns associated with CDC focusing on a longer time frame have been few. This paper presents the findings from a qualitative longitudinal evaluation of an Australian CDC programme. Focusing on the period between 2003 and 2008, it reports on the experiences of 12 families caring for a dependent family member. It is based on two external evaluations completed 6 and 36 months after enrollment, and one internal evaluation completed 48 months after enrollment. The findings were triangulated with internal memos, reports and minutes of meetings, as well as with the theoretical literature. The study demonstrates that CDC harbours considerable benefits for people with disabilities and their carers. However, the study also suggests that, over time, carers may experience an increased sense of isolation and lack of support as a result of their involvement in the CDC programme. The paper argues that the development of safeguards addressing these weaknesses is crucial for the sustainability of CDC programmes in contexts where risk cannot be simply transferred onto consumers.

  8. Types of lay health influencers in tobacco cessation: a qualitative study.

    PubMed

    Yuan, Nicole P; Wind, Steven; Nichter, Mimi; Nichter, Mark; Castañeda, Heide; Carruth, Lauren; Muramoto, Myra

    2010-01-01

    To identify types of health influencers in tobacco cessation based on the frequency and characteristics of brief intervention activities. Longitudinal qualitative interviews were completed with 28 individuals posttraining. Four individuals were categorized as Rarely Active, 5 as Active With Family and Friends, 9 as Active in the Workplace, and 10 as Proactive in Multiple Settings. Unique motivators, intervention behaviors, and barriers were documented. Some individuals displayed high levels of self-efficacy necessary for expanding the reach of community-based interventions. Training programs need to address the impact of contextual factors on initiating and sustaining intervention activities.

  9. How socioeconomic inequalities impact pathways of care for coronary artery disease among elderly patients: study protocol for a qualitative longitudinal study.

    PubMed

    Schröder, Sara L; Fink, Astrid; Schumann, Nadine; Moor, Irene; Plehn, Alexander; Richter, Matthias

    2015-11-09

    Several studies have identified that socioeconomic inequalities in coronary artery disease (CAD) morbidity and mortality lead to a disadvantage in patients with low socioeconomic status (SES). International studies have shown that socioeconomic inequalities also exist in terms of access, utilisation and quality of cardiac care. The aim of this qualitative study is to provide information on the impact of socioeconomic inequalities on the pathway of care for CAD, and to establish which factors lead to socioeconomic inequality of care to form and expand existing scientific theories. A longitudinal qualitative study with 48 patients with CAD, aged 60-80 years, is being conducted. Patients have been recruited consecutively at the University Hospital in Halle/Saale, Germany, and will be followed for a period of 6 months. Patients are interviewed two times face-to-face using semistructured interviews. Data are transcribed and analysed based on grounded theory. Only participants who have been informed and who have signed a declaration of consent have been included in the study. The study complies rigorously with data protection legislation. Approval of the Ethical Review Committee at the Martin-Luther University Halle-Wittenberg, Germany was obtained. The results of the study will be presented at several congresses, and will be published in high-quality peer-reviewed international journals. This study has been registered with the German Clinical Trials Register and assigned DRKS00007839. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. I Want to Be a Scientist/A Teacher: Students' Perceptions of Career Decision-Making in Gender-Typed, Non-Traditional Areas of Work

    ERIC Educational Resources Information Center

    Buschor, Christine Bieri; Kappler, Christa; Keck Frei, Andrea; Berweger, Simone

    2014-01-01

    The study examines the career decision-making of Swiss academic high school students opting for a career in a non-traditional, gender-typed area of work during the transition to higher education. Based on a longitudinal study, a qualitative study with 11 female students in Science, Technology, Engineering and Mathematics (STEM) and 13 male student…

  11. Gendered Transitions, Career Identities and Possible Selves: The Case of Engineering Graduates

    ERIC Educational Resources Information Center

    Papafilippou, Vanda; Bentley, Laura

    2017-01-01

    This article, drawing upon the Paired Peers project, a longitudinal qualitative study (n = 90), examines how seven UK engineering graduates, four women and three men, construct their career identities during the transitionary period from university to work. It explores how gender and the occupational cultures that reside within the sector, and the…

  12. Peer Production for Collaboration between Academics and Practitioners

    ERIC Educational Resources Information Center

    Ponti, Marisa

    2013-01-01

    The purpose of this article is to suggest commons-based peer production as a form of work that can help bridge the gap between research and practice in LIS. The research design is based on two in-depth and longitudinal qualitative case studies of collaborative projects involving LIS academics and practitioners in Italy. Analysis of interviews and…

  13. Cooperation Structures in Preservice Teacher Education Programmes and Their Effects on Beginning Teachers' Classroom Performance.

    ERIC Educational Resources Information Center

    Brouwer, Niels

    In this paper the first descriptive results of a longitudinal study of organization and learning effects of 24 preservice teacher education programs are reported. Between August 1982 and November 1986 different kinds of qualitative as well as quantitative data were collected among 357 students and their 31 university supervisors and 128…

  14. Educating with Prezi: A New Presentation Paradigm for Teaching, Learning, and Leading in the Digital Age

    ERIC Educational Resources Information Center

    Safar, Ammar H.

    2015-01-01

    This longitudinal descriptive qualitative evaluation action research case study explored the reflections/experiences (i.e., their perceptions, attitudes, and feelings) of 450 pre-service teachers in the College of Education (COE) at Kuwait University (KU) over three academic years regarding the use of Prezi as a facilitative storytelling…

  15. Moving from Technical and Further Education to University: An Australian Study of Mature Students

    ERIC Educational Resources Information Center

    Abbott-Chapman, Joan

    2006-01-01

    Longitudinal research, conducted between 1999 and 2002, tracked the academic progress of a small sample of mature students entering the University of Tasmania, Australia, from a disadvantaged region of Tasmania to pursue degrees in accounting and education. Both quantitative and qualitative methods were used to examine the impact of alternative…

  16. An Outdoor and Environmental Education Community of Practice: Self Stylisation or Normalisation?

    ERIC Educational Resources Information Center

    Preston, Lou

    2012-01-01

    In this article, I draw on a qualitative longitudinal study to explore the influence of a tertiary Outdoor and Environmental Education (OEE) course on the formation of environmental ethics among students. In this task, I bring together Lave & Wenger (1991) and Wenger's (1998) concept of "communities of practice" and Michel Foucault's later work on…

  17. Parental Choice of Infant Feeding Behaviours in South West Sydney: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Arora, A.; Gay, M.; Thirukumar, D.

    2012-01-01

    Objective: The purpose of this study was to test a research instrument that could possibly be used for longitudinal research on infant feeding and to report on the preliminary results from the data collected. Design: Mixed methods approach--cross-sectional survey and qualitative research. Setting: Mother-infant dyads in South West Sydney,…

  18. Teaching or Service?: The Site-Based Realities of Teach for America Teachers in Poor, Urban Schools

    ERIC Educational Resources Information Center

    Veltri, Barbara Torre

    2008-01-01

    "Business Week" and "Fortune Magazine" suggest that Teach for America (TFA) is a beneficial postgraduation option for corps members, who teach for a finite commitment in low-socioeconomic status urban school districts. This longitudinal qualitative study examines the complex issues that surround TFA through the voices of TFA corps members,…

  19. 2B or Not 2B Plurilingual? Navigating Languages Literacies, and Plurilingual Competence in Postsecondary Education in Canada

    ERIC Educational Resources Information Center

    Marshall, Steve; Moore, Danièle

    2013-01-01

    In this article, the researchers employ the framework of plurilingualism and plurilingual competence in a field that has traditionally been dominated by reified conceptualizations of multilingualism that view bi/multilingualism as balanced and complete competence in discrete codes. They present data from a qualitative, longitudinal study of the…

  20. Child Custody Loss among Women with Persistent Severe Mental Illness

    ERIC Educational Resources Information Center

    Hollingsworth, Leslie Doty

    2004-01-01

    The author analyzed quantitative data from an NIMH-funded longitudinal study of 322 women with persistent severe mental illness (SMI) and qualitative data from semistructured interviews with 82 of the women who ever lost custody of a child. The purpose was to test the hypothesis, derived from human ecology theory, that individual and environmental…

  1. Orderly Change in a Stable World: The Antisocial Trait as a Chimera.

    ERIC Educational Resources Information Center

    Patterson, Gerald R.

    1993-01-01

    Used longitudinal data from Oregon Youth Study to examine quantitative and qualitative change. Used latent growth models to demonstrate changes in form and systematic changes in mean level for subgroup of boys. Factor analyses carried out at three ages showed that, over time, changes in form and addition of new problems were quantifiable and thus…

  2. Images of Childhood in Mothers' Accounts of Contemporary Childrearing

    ERIC Educational Resources Information Center

    Murphy, Elizabeth

    2007-01-01

    This article examines how a sample of first-time mothers in the UK constitute childhood in general, and their own children in particular, in and through their talk about the mundane practices of childcare. The data analysed are drawn from a longitudinal qualitative interview study that followed a sample of mothers from late pregnancy until their…

  3. Women's Later Life Career Development: Looking through the Lens of the Kaleidoscope Career Model

    ERIC Educational Resources Information Center

    August, Rachel A.

    2011-01-01

    This study explores the relevance of the Kaleidoscope Career Model (KCM) to women's later life career development. Qualitative interview data were gathered from 14 women in both the "truly" late career and bridge employment periods using a longitudinal design. The relevance of authenticity, balance, and challenge--central parameters in the KCM--is…

  4. Beyond Quantitative Decline: Conceptual Shifts in Adolescents' Development of Interest in Mathematics

    ERIC Educational Resources Information Center

    Frenzel, Anne C.; Pekrun, Reinhard; Dicke, Anna-Lena; Goetz, Thomas

    2012-01-01

    Research has shown that the average values for academic interest decrease during adolescence. Looking beyond such quantitative decline, we explored qualitative change of interest in the domain of mathematics across adolescence. Study 1 was based on a longitudinal data set (annual assessments from Grade 5 to Grade 9; N = 3,193). Latent variable…

  5. Sequential Bimodal Bilingual Acquisition: Mediation Using a Cochlear Implant as a Tool

    ERIC Educational Resources Information Center

    Cramér-Wolrath, Emelie

    2013-01-01

    Most deaf children are born to hearing families. During the last twenty years deaf children, in increasing numbers and at an early age, receive a cochlear implant, a highly technological hearing device. The aim of this qualitative, longitudinal, single-case study was to explore and describe critical changes in naturalistic, video-observed…

  6. The Relationship between Basic Skills and Operational Effectiveness in the British Army

    ERIC Educational Resources Information Center

    Swain, Jon

    2015-01-01

    This paper draws on data that formed part of a major three-year longitudinal study (2008-2011), which set out to investigate basic skills (BS) provision and needs in the British army and its relationship to operational effectiveness. Using mixed methods, the findings draw on qualitative data from 60 semi-structured interviews with 26 young…

  7. Why Do First-Year Students of German Lose Motivation during their First Year at University?

    ERIC Educational Resources Information Center

    Busse, Vera

    2013-01-01

    This article explores motivational changes of first-year students enrolled on German degree courses at two major UK universities. It reports on the qualitative data obtained by a longitudinal mixed-methods study, and focuses on the interplay between students' motivation and the higher education learning environment. In particular, the article aims…

  8. How Do I Love Thee? Let Me Count the Ways: Parenting during Adolescence, Attachment Styles, and Romantic Narratives in Emerging Adulthood

    ERIC Educational Resources Information Center

    Nosko, Amanda; Tieu, Thanh-Thanh; Lawford, Heather; Pratt, Michael W.

    2011-01-01

    In this longitudinal study, a quantitative and qualitative examination of the associations among parent-child relations, adult attachment styles, and relationship quality and theme in romantic narratives was conducted. Parenting and adult attachment style were assessed through questionnaires, whereas overall quality of romantic relationships…

  9. Vulnerability and Resilience: Working Lives and Motivation of Four Novice EFL Secondary School Teachers in Japan

    ERIC Educational Resources Information Center

    Kumazawa, Masako

    2011-01-01

    This study is a longitudinal, qualitative, interpretive inquiry into the work motivation of four novice EFL teachers at public secondary schools in Japan. I employed constructivism as my philosophical framework and narrative inquiry as my primary methodological tool, and attempted to capture the four young teachers' changing motivation as embedded…

  10. Understanding resilience in same-sex parented families: the work, love, play study

    PubMed Central

    2010-01-01

    Background While families headed by same-sex couples have achieved greater public visibility in recent years, there are still many challenges for these families in dealing with legal and community contexts that are not supportive of same-sex relationships. The Work, Love, Play study is a large longitudinal study of same-sex parents. It aims to investigate many facets of family life among this sample and examine how they change over time. The study focuses specifically on two key areas missing from the current literature: factors supporting resilience in same-sex parented families; and health and wellbeing outcomes for same-sex couples who undergo separation, including the negotiation of shared parenting arrangements post-separation. The current paper aims to provide a comprehensive overview of the design and methods of this longitudinal study and discuss its significance. Methods/Design The Work, Love, Play study is a mixed design, three wave, longitudinal cohort study of same-sex attracted parents. The sample includes lesbian, gay, bisexual and transgender parents in Australia and New Zealand (including single parents within these categories) caring for any children under the age of 18 years. The study will be conducted over six years from 2008 to 2014. Quantitative data are to be collected via three on-line surveys in 2008, 2010 and 2012 from the cohort of parents recruited in Wave1. Qualitative data will be collected via interviews with purposively selected subsamples in 2012 and 2013. Data collection began in 2008 and 355 respondents to Wave One of the study have agreed to participate in future surveys. Work is currently underway to increase this sample size. The methods and survey instruments are described. Discussion This study will make an important contribution to the existing research on same-sex parented families. Strengths of the study design include the longitudinal method, which will allow understanding of changes over time within internal family relationships and social supports. Further, the mixed method design enables triangulation of qualitative and quantitative data. A broad recruitment strategy has already enabled a large sample size with the inclusion of both gay men and lesbians. PMID:20211027

  11. Understanding resilience in same-sex parented families: the work, love, play study.

    PubMed

    Power, Jennifer J; Perlesz, Amaryll; Schofield, Margot J; Pitts, Marian K; Brown, Rhonda; McNair, Ruth; Barrett, Anna; Bickerdike, Andrew

    2010-03-09

    While families headed by same-sex couples have achieved greater public visibility in recent years, there are still many challenges for these families in dealing with legal and community contexts that are not supportive of same-sex relationships. The Work, Love, Play study is a large longitudinal study of same-sex parents. It aims to investigate many facets of family life among this sample and examine how they change over time. The study focuses specifically on two key areas missing from the current literature: factors supporting resilience in same-sex parented families; and health and wellbeing outcomes for same-sex couples who undergo separation, including the negotiation of shared parenting arrangements post-separation. The current paper aims to provide a comprehensive overview of the design and methods of this longitudinal study and discuss its significance. The Work, Love, Play study is a mixed design, three wave, longitudinal cohort study of same-sex attracted parents. The sample includes lesbian, gay, bisexual and transgender parents in Australia and New Zealand (including single parents within these categories) caring for any children under the age of 18 years. The study will be conducted over six years from 2008 to 2014. Quantitative data are to be collected via three on-line surveys in 2008, 2010 and 2012 from the cohort of parents recruited in Wave1. Qualitative data will be collected via interviews with purposively selected subsamples in 2012 and 2013. Data collection began in 2008 and 355 respondents to Wave One of the study have agreed to participate in future surveys. Work is currently underway to increase this sample size. The methods and survey instruments are described. This study will make an important contribution to the existing research on same-sex parented families. Strengths of the study design include the longitudinal method, which will allow understanding of changes over time within internal family relationships and social supports. Further, the mixed method design enables triangulation of qualitative and quantitative data. A broad recruitment strategy has already enabled a large sample size with the inclusion of both gay men and lesbians.

  12. An Investigation of GeoBase Mission Data Set Design, Implementation, and Usage Within Air Force Civil Engineer Electrical and Utilities Work Centers

    DTIC Science & Technology

    2005-03-01

    ethnography , grounded theory , phenomenological , case study , and content analysis. As ethnography is based upon a longitudinal study in...a qualitative methodology consisting of a case study strategy is warranted for this research project. Yin (2003) lists five components of research ...systems. Journal of End User Computing, 12(3), 14. Yin, R. K. (2003). Case Study Research : Design and

  13. Residents' perceptions of an integrated longitudinal curriculum: a qualitative study.

    PubMed

    Lubitz, Rebecca; Lee, Joseph; Hillier, Loretta M

    2015-01-01

    The purpose of this study was to explore family medicine residents' perceptions of a newly restructured integrated longitudinal curriculum. A purposeful sample of 16 family medicine residents participated in focus group interviews conducted from a grounded theory perspective to identify the characteristics of this training model that contribute to and that challenge learning. Eight key themes were identified: continuity of care, relevance to family medicine, autonomy, program-focused preparation, professional development as facilitated by role modeling, patient volume, clarity of expectations for learners, and logistics. Positive learning experiences were marked by high levels of autonomy, continuity, and relevance to family medicine. Less favorable learning experiences were characterized by limited opportunities for continuity of care, limited relevance to family medicine practice and unclear expectations for the resident's role. Family physician-led learning experiences contributed to residents' understanding of the full scope of family medicine practice, more so than specialist-led experiences. The logistics of implementing the integrated block were challenging and negatively impacted continuity and learning. This study suggests that an integrated longitudinalized family medicine block training model has the potential to support the principles of a longitudinal integrated competency-based curriculum to effectively prepare residents for family medicine practice.

  14. Paucity of qualitative research in general medical and health services and policy research journals: analysis of publication rates.

    PubMed

    Gagliardi, Anna R; Dobrow, Mark J

    2011-10-12

    Qualitative research has the potential to inform and improve health care decisions but a study based on one year of publications suggests that it is not published in prominent health care journals. A more detailed, longitudinal analysis of its availability is needed. The purpose of this study was to identify, count and compare the number of qualitative and non-qualitative research studies published in high impact health care journals, and explore trends in these data over the last decade. A bibliometric approach was used to identify and quantify qualitative articles published in 20 top general medical and health services and policy research journals from 1999 to 2008. Eligible journals were selected based on performance in four different ranking systems reported in the 2008 ISI Journal Citation Reports. Qualitative and non-qualitative research published in these journals were identified by searching MEDLINE, and validated by hand-searching tables of contents for four journals. The total number of qualitative research articles published during 1999 to 2008 in ten general medical journals ranged from 0 to 41, and in ten health services and policy research journals from 0 to 39. Over this period the percentage of empirical research articles that were qualitative ranged from 0% to 0.6% for the general medical journals, and 0% to 6.4% for the health services and policy research journals. This analysis suggests that qualitative research it is rarely published in high impact general medical and health services and policy research journals. The factors that contribute to this persistent marginalization need to be better understood.

  15. Non-volumetric echocardiographic indices and qualitative assessment of right ventricular systolic function in Ebstein's anomaly: comparison with CMR-derived ejection fraction in 49 patients.

    PubMed

    Kühn, Andreas; Meierhofer, Christian; Rutz, Tobias; Rondak, Ina-Christine; Röhlig, Christoph; Schreiber, Christian; Fratz, Sohrab; Ewert, Peter; Vogt, Manfred

    2016-08-01

    Ebstein's anomaly (EA) is often associated with right ventricular (RV) dysfunction. Data on echocardiographic quantification of RV function are, however, rare. The aim of this study was to determine how non-volumetric echocardiographic indices and qualitative assessment of global systolic RV function correlate with cardiovascular magnetic resonance (CMR)-derived RV ejection fraction (EF). We compared six echocardiographic indices and qualitative assessment of RV function with the gold standard CMR. A total of 49 unoperated patients with EA and a mean age of 32 ± 18 years were examined. Tricuspid annular plane systolic excursion, tissue Doppler myocardial velocities (peak S and IVA) and 2D strain and strain rate measures for the RV were compared with CMR-derived EF. Only 2D global longitudinal strain (2D-GLS), out of the six parameters investigated, showed a weak, although statistically significant correlation with CMR-derived RVEF (R = -0.4, P = 0.01). Using a cut-off value of -20.15, 2D-GLS sensitivity (77%) and specificity (46%) in detecting patients with a CMR-derived EF of <50% were comparable with qualitative assessment (sensitivity 77%, specificity 45%). Overall echocardiographic parameters of RV function correlate poorly with CMR-derived EF in patients with EA. Only 2D global longitudinal RV strain correlated weakly with CMR-derived RVEF. However, the sensitivity and specificity for detecting RV dysfunction using 2D strain imaging were comparable with qualitative RV functional assessment. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  16. A longitudinal interprofessional simulation curriculum for critical care teams: Exploring successes and challenges.

    PubMed

    Leclair, Laurie W; Dawson, Mary; Howe, Alison; Hale, Sue; Zelman, Eric; Clouser, Ryan; Garrison, Garth; Allen, Gilman

    2018-05-01

    Interprofessional care teams are the backbone of intensive care units (ICUs) where severity of illness is high and care requires varied skills and experience. Despite this care model, longitudinal educational programmes for such workplace teams rarely include all professions. In this article, we report findings on the initial assessment and evaluation of an ongoing, longitudinal simulation-based curriculum for interprofessional workplace critical care teams. The study had two independent components, quantitative learner assessment and qualitative curricular evaluation. To assess curriculum effectiveness at meeting learning objectives, participant-reported key learning points identified using a self-assessment tool administered immediately following curricular participation were mapped to session learning objectives. To evaluate the curriculum, we conducted a qualitative study using a phenomenology approach involving purposeful sampling of nine curricular participants undergoing recorded semi-structured interviews. Verbatim transcripts were reviewed by two independent readers to derive themes further subdivided into successes and barriers. Learner self-assessment demonstrated that the majority of learners, across all professions, achieved at least one intended learning objective with senior learners more likely to report team-based objectives and junior learners more likely to report knowledge/practice objectives. Successes identified by curricular evaluation included authentic critical care curricular content, safe learning environment, and team comradery from shared experience. Barriers included unfamiliarity with the simulation environment and clinical coverage for curricular participation. This study suggests that a sustainable interprofessional curriculum for workplace ICU critical care teams can achieve the desired educational impact and effectively deliver authentic simulated work experiences if barriers to educational engagement and participation can be overcome.

  17. Understanding the relationship transitions and associated end of life clinical needs of young adults with life-limiting illnesses: A triangulated longitudinal qualitative study

    PubMed Central

    Johnston, Bridget; Jindal-Snape, Divya; Pringle, Jan; Gold, Libby; Grant, Jayne; Dempsey, Raymond; Scott, Ros; Carragher, Pat

    2016-01-01

    Background: Care of young adults with life-limiting illnesses can often be complex due to the fact that they are growing and developing within the continuing presence of their illness. There is little research conducted nationally and internationally, which has examined the life issues of young adults or taken a longitudinal approach to understand such issues over a period of time. Aim: To gain clear understanding of one particular and pertinent life issue—relationship transition—occurring in the context of being a young adult with a life-limiting illness and the clinical needs arising from this. Design: This was a triangulated, longitudinal, qualitative study involving young adults with life-limiting illnesses and their significant others, namely, family members and healthcare professionals. Semi-structured interviews were conducted with participants and analysed using thematic analysis. Clinical case note reviews were also carried out. Setting/participants: A total of 12 young adults (aged between 17 and 23 years) from 2 hospices and 22 nominated significant others participated in a total of 58 interviews. Results: Thematic analysis revealed 4 main themes and 11 subthemes. The main themes were ‘Dependence dichotomy’, ‘In it together’, ‘Biographical uncertainty’, and ‘Conserving integrity’. These themes helped to establish the nature of relationship transitions that the young adult participants from the study experienced and additionally allowed insight into their possible needs at their end of life. Conclusion: This study has identified the nature of relationship transitions pertinent to young adults and has highlighted associated end of life clinical needs. This study can influence further research into the transitions and end of life needs of this particular patient group receiving palliative care, while informing the lacking evidence base which exists internationally. PMID:27781097

  18. Young People's Everyday Romance and Sexual Experiences in Relation to Sex-Related Conversations with Parents: A Diary Study in the Netherlands

    ERIC Educational Resources Information Center

    Dalenberg, Wieke G.; Timmerman, Margaretha C.; Kunnen, E. Saskia; Van Geert, Paul L. C.

    2016-01-01

    This study builds on existing research into how young people's emergent sexual development is connected to parent-child sex-related communication through avoidance vs. disclosure. Over the course of one year, a total of 21 young people (age range 12-17.5) reported in longitudinal qualitative diaries their (1) everyday sexual experiences and (2)…

  19. A Preliminary Assessment of the Change Recipients' Perceptions of the "4+4+4 Reform Initiative": Has Anything Changed?

    ERIC Educational Resources Information Center

    Summak, M. Semih

    2016-01-01

    The purpose of the present study was to assess change recipients' perceptions of 4+4+4 reform initiative put in effect in Turkish education system and to explore if anything has changed within the one-year interval. This research is a qualitative longitudinal case study conducted in 2013 and 2014 in a large city in Southeastern Turkey. Pragmatist…

  20. Generation of longitudinal vibrations in piano strings: From physics to sound synthesis

    NASA Astrophysics Data System (ADS)

    Bank, Balázs; Sujbert, László

    2005-04-01

    Longitudinal vibration of piano strings greatly contributes to the distinctive character of low piano notes. In this paper a simplified modal model is developed, which describes the generation of phantom partials and longitudinal free modes jointly. The model is based on the simplification that the coupling from the transverse vibration to the longitudinal polarization is unidirectional. The modal formulation makes it possible to predict the prominent components of longitudinal vibration as a function of transverse modal frequencies. This provides a qualitative insight into the generation of longitudinal vibration, while the model is still capable of explaining the empirical results of earlier works. The semi-quantitative agreement with measurement results implies that the main source of phantom partials is the transverse to longitudinal coupling, while the string termination and the longitudinal to transverse coupling have only small influence. The results suggest that the longitudinal component of the tone can be treated as a quasi-harmonic spectrum with formantlike peaks at the longitudinal modal frequencies. The model is further simplified and applied for the real-time synthesis of piano sound with convincing sonic results. .

  1. Maternal Influences on Asian American-Pacific Islander Adolescents' Perceived Maternal Sexual Expectations and Their Sexual Initiation

    ERIC Educational Resources Information Center

    Kao, Tsui-Sui Annie; Loveland-Cherry, Carol; Guthrie, Barbara

    2010-01-01

    Maternal influences on adolescents' sexual initiation have been examined over two time points in 433 Asian American-Pacific Islander (AAPI) adolescents in a secondary analysis of the Add Health data set using structural equation modeling. A longitudinal model built on a preliminary qualitative study is used to examine the fit between data and…

  2. The Sustainability of Comprehensive School Reform Models in Changing District and State Contexts

    ERIC Educational Resources Information Center

    Datnow, Amanda

    2005-01-01

    This article addresses the sustainability of comprehensive school reform (CSR) models in the face of turbulent district and state contexts. It draws on qualitative data gathered in a longitudinal case study of six CSR models implemented in 13 schools in one urban district. Why do reforms sustain in some schools and not in others? How do changing…

  3. Multiple, Relational and Emotional Mobilities: Understanding Student Mobilities in Higher Education as More than "Staying Local" and "Going Away"

    ERIC Educational Resources Information Center

    Finn, Kirsty

    2017-01-01

    This paper advances theorising around student geographies in higher education (HE). It extends recent work, which has problematised the primacy of social class and binary thinking about student mobilities, and presents local/non-local experiences and im/mobility as a defining dualism. Drawing on a qualitative longitudinal study of women's…

  4. Negotiating the Complementarian Gender Ideology of an Evangelical Student Subculture: Further Evidence from Women's Narratives

    ERIC Educational Resources Information Center

    Bryant, Alyssa N.

    2009-01-01

    This study is based on a longitudinal, qualitative investigation of a burgeoning evangelical student organisation on a university campus in the USA. In addition to four months of observation, in-depth interviews were conducted with students in their first and third years of college to understand the gender climate and ideology that characterised…

  5. Becoming Teachers: Examining How Preservice Elementary Teachers Use Language to Construct Professional Identities, Learn within Relationships, and Take Risks in the Classroom

    ERIC Educational Resources Information Center

    Ticknor, Anne Swenson

    2010-01-01

    This longitudinal qualitative study examined how four preservice elementary teachers used language to construct professional identities, learn within relationships, and take risks in the classroom during their final three semesters in teacher education coursework and field experiences. My female participants were former students of mine in the…

  6. "We're Still Here . . . We're Not Giving Up": Black and Latino Men's Narratives of Transition to Community College

    ERIC Educational Resources Information Center

    Bukoski, Beth E.; Hatch, Deryl K.

    2016-01-01

    Objective: This study examines masculinity in a manner commensurate with established feminist frameworks to deconstruct a patriarchal system that ill-serves both men and women. Method: We utilized standpoint theory and narrative analysis to examine longitudinal, qualitative data from first-year Black and Latino males as they transition into…

  7. Becoming a Teacher: Tracing Changes in Pre-Service English as a Foreign Language Teachers' Sense of Efficacy

    ERIC Educational Resources Information Center

    Yüksel, H. Gülru

    2014-01-01

    This longitudinal study aimed to trace changes in Turkish pre-service English as a foreign language teachers' self-efficacy over a year, and to detect possible sources of information influencing their efficacy. Utilizing concurrent mixed model design of Creswell (2003) both qualitative and quantitative data was collected. A total of 40 pre-service…

  8. Exploring the Occurrence of Team Learning Behaviours in Project Teams over Time

    ERIC Educational Resources Information Center

    Raes, Elisabeth; Boon, Anne; Kyndt, Eva; Dochy, Filip

    2017-01-01

    The aim of this qualitative longitudinal study is to create a more in-depth picture of the emergence of team learning behaviours throughout the lifespan of temporary project teams. In order to grasp the emergence of these behaviours, three project teams were followed from the start until the end of their project during a period of three months.…

  9. "A Foundation for Something Bigger": Community College Students' Experience of Remediation in the Context of a Learning Community

    ERIC Educational Resources Information Center

    Schnee, Emily

    2014-01-01

    This longitudinal, qualitative study explores developmental English students' experience of remediation in the context of a first-semester learning community (LC). Conducted at an urban community college in the Northeast, data were collected through semi-structured interviews conducted over a 3-year period with a cohort of 15 students who were…

  10. Types of Lay Health Influencers in Tobacco Cessation: A Qualitative Study

    PubMed Central

    Yuan, Nicole P.; Wind, Steven; Nichter, Mimi; Nichter, Mark; Castañeda, Heide; Carruth, Lauren; Muramoto, Myra L.

    2014-01-01

    Objective To identify types of health influencers in tobacco cessation based on the frequency and characteristics of brief intervention activities. Methods Longitudinal qualitative interviews were completed with 28 individuals post-training. Results Four individuals were categorized as Rarely Active, 5 as Active with Family and Friends, 9 as Active in the Workplace, and 10 as Proactive in Multiple Settings. Unique motivators, intervention behaviors, and barriers were documented. Some individuals displayed high levels of self-efficacy necessary for expanding the reach of community-based interventions. Conclusion Training programs need to address the impact of contextual factors on initiating and sustaining intervention activities. PMID:20524890

  11. Manifestations of Surface States in the Longitudinal Magnetoresistance of an Array of Bi Nanowires

    NASA Astrophysics Data System (ADS)

    Latyshev, Yu. I.; Frolov, A. V.; Volkov, V. A.; Wade, T.; Prudkoglyad, V. A.; Orlov, A. P.; Pudalov, V. M.; Konczykowski, M.

    2018-04-01

    The longitudinal magnetoresistance of the array of parallel-oriented bismuth nanowires each 100 nm in diameter grown by electrochemical deposition in nanopores of an Al2O3 membrane has been studied in magnetic fields up to 14 T and at temperatures down to 0.3 K. The resistance increases with the field and reaches a broad maximum in fields about 10 T. An anomalous increase in the resistance in weak fields is qualitatively consistent with the suppression of the antilocalization correction to the resistance, and the maximum is qualitatively associated with the classical size effect. Near the maximum at temperatures below 0.8 K, manifestations of reproducible magneto-oscillations of the resistance, which are periodic in field, have been detected. The period of these oscillations is close to a value corresponding to the passage of the flux quantum hc/ e through the section of a nanowire. The Fourier analysis also confirms that the oscillations are periodic. This result is similar to the manifestation the Aharonov-Bohm effect caused by conducting surface states of Dirac fermions occupying L-valleys of bismuth.

  12. Changes in Health and Antiretroviral Adherence Among HIV-Infected Adults in Kenya: Qualitative Longitudinal Findings from a Livelihood Intervention.

    PubMed

    Weiser, Sheri D; Hatcher, Abigail M; Hufstedler, Lee L; Weke, Elly; Dworkin, Shari L; Bukusi, Elizabeth A; Burger, Rachel L; Kodish, Stephen; Grede, Nils; Butler, Lisa M; Cohen, Craig R

    2017-02-01

    This longitudinal qualitative study sought to understand how and why a livelihood intervention affected the health and health behaviors of HIV-infected Kenyan adults. The intervention included a microfinance loan, agricultural and financial training, and a human-powered water pump. In-depth interviews were conducted at two time points with intervention and control participants and program staff. We double coded interviews (n = 117) and used thematic content analysis of transcripts following an integrative inductive-deductive approach. Intervention participants described improvements in HIV health, including increased CD4 counts and energy, improved viral suppression, and fewer HIV-related symptoms. Better health was linked to improved clinic attendance and ART adherence through several mechanisms: (1) reductions in food insecurity and abject hunger; (2) improved financial stability; (3) improved productivity which enhanced social support; (4) better control over work situations; and, (5) renewed desire to prioritize their own health. Livelihood interventions may improve health by influencing upstream determinants of health behavior including food security and poverty.

  13. Changes in Health and Antiretroviral Adherence Among HIV-Infected Adults in Kenya: Qualitative Longitudinal Findings from a Livelihood Intervention

    PubMed Central

    Hatcher, Abigail M.; Hufstedler, Lee L.; Weke, Elly; Dworkin, Shari L.; Bukusi, Elizabeth A.; Burger, Rachel L.; Kodish, Stephen; Grede, Nils; Butler, Lisa M.; Cohen, Craig R.

    2018-01-01

    This longitudinal qualitative study sought to understand how and why a livelihood intervention affected the health and health behaviors of HIV-infected Kenyan adults. The intervention included a microfinance loan, agricultural and financial training, and a human-powered water pump. In-depth interviews were conducted at two time points with intervention and control participants and program staff. We double coded interviews (n = 117) and used thematic content analysis of transcripts following an integrative inductive–deductive approach. Intervention participants described improvements in HIV health, including increased CD4 counts and energy, improved viral suppression, and fewer HIV-related symptoms. Better health was linked to improved clinic attendance and ART adherence through several mechanisms: (1) reductions in food insecurity and abject hunger; (2) improved financial stability; (3) improved productivity which enhanced social support; (4) better control over work situations; and, (5) renewed desire to prioritize their own health. Livelihood interventions may improve health by influencing upstream determinants of health behavior including food security and poverty. PMID:27637497

  14. Paucity of qualitative research in general medical and health services and policy research journals: analysis of publication rates

    PubMed Central

    2011-01-01

    Background Qualitative research has the potential to inform and improve health care decisions but a study based on one year of publications suggests that it is not published in prominent health care journals. A more detailed, longitudinal analysis of its availability is needed. The purpose of this study was to identify, count and compare the number of qualitative and non-qualitative research studies published in high impact health care journals, and explore trends in these data over the last decade. Methods A bibliometric approach was used to identify and quantify qualitative articles published in 20 top general medical and health services and policy research journals from 1999 to 2008. Eligible journals were selected based on performance in four different ranking systems reported in the 2008 ISI Journal Citation Reports. Qualitative and non-qualitative research published in these journals were identified by searching MEDLINE, and validated by hand-searching tables of contents for four journals. Results The total number of qualitative research articles published during 1999 to 2008 in ten general medical journals ranged from 0 to 41, and in ten health services and policy research journals from 0 to 39. Over this period the percentage of empirical research articles that were qualitative ranged from 0% to 0.6% for the general medical journals, and 0% to 6.4% for the health services and policy research journals. Conclusions This analysis suggests that qualitative research it is rarely published in high impact general medical and health services and policy research journals. The factors that contribute to this persistent marginalization need to be better understood. PMID:21992238

  15. Choice and Constraint in the Negotiation of the Grandparent Role: A Mixed-Methods Study.

    PubMed

    McGarrigle, Christine A; Timonen, Virpi; Layte, Richard

    2018-01-01

    Few studies have examined how the allocation and consequences of grandchild care vary across different socioeconomic groups. We analyze qualitative data alongside data from The Irish Longitudinal Study on Ageing (TILDA), in a convergent mixed-methods approach. Regression models examined characteristics associated with grandchild care, and the relationship between grandchild care and depressive symptoms and well-being. Qualitative data shed light on processes and choices that explain patterns of grandchild care provision. Tertiary-educated grandparents provided less intensive grandchild care compared with primary educated. Qualitative data indicated that this pattern stems from early boundary-drawing among higher educated grandparents while lower socioeconomic groups were constrained and less able to say no. Intensive grandchild care was associated with more depressive symptoms and lower well-being and was moderated by participation in social activities and level of education attainment. The effect of grandchild care on well-being of grandparents depends on whether it is provided by choice or obligation.

  16. Choice and Constraint in the Negotiation of the Grandparent Role: A Mixed-Methods Study

    PubMed Central

    McGarrigle, Christine A.; Timonen, Virpi; Layte, Richard

    2018-01-01

    Few studies have examined how the allocation and consequences of grandchild care vary across different socioeconomic groups. We analyze qualitative data alongside data from The Irish Longitudinal Study on Ageing (TILDA), in a convergent mixed-methods approach. Regression models examined characteristics associated with grandchild care, and the relationship between grandchild care and depressive symptoms and well-being. Qualitative data shed light on processes and choices that explain patterns of grandchild care provision. Tertiary-educated grandparents provided less intensive grandchild care compared with primary educated. Qualitative data indicated that this pattern stems from early boundary-drawing among higher educated grandparents while lower socioeconomic groups were constrained and less able to say no. Intensive grandchild care was associated with more depressive symptoms and lower well-being and was moderated by participation in social activities and level of education attainment. The effect of grandchild care on well-being of grandparents depends on whether it is provided by choice or obligation. PMID:29372176

  17. 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.

  18. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine.

    PubMed

    Forero, Roberto; Nahidi, Shizar; De Costa, Josephine; Mohsin, Mohammed; Fitzgerald, Gerry; Gibson, Nick; McCarthy, Sally; Aboagye-Sarfo, Patrick

    2018-02-17

    The main objective of this methodological manuscript was to illustrate the role of using qualitative research in emergency settings. We outline rigorous criteria applied to a qualitative study assessing perceptions and experiences of staff working in Australian emergency departments. We used an integrated mixed-methodology framework to identify different perspectives and experiences of emergency department staff during the implementation of a time target government policy. The qualitative study comprised interviews from 119 participants across 16 hospitals. The interviews were conducted in 2015-2016 and the data were managed using NVivo version 11. We conducted the analysis in three stages, namely: conceptual framework, comparison and contrast and hypothesis development. We concluded with the implementation of the four-dimension criteria (credibility, dependability, confirmability and transferability) to assess the robustness of the study, RESULTS: We adapted four-dimension criteria to assess the rigour of a large-scale qualitative research in the emergency department context. The criteria comprised strategies such as building the research team; preparing data collection guidelines; defining and obtaining adequate participation; reaching data saturation and ensuring high levels of consistency and inter-coder agreement. Based on the findings, the proposed framework satisfied the four-dimension criteria and generated potential qualitative research applications to emergency medicine research. We have added a methodological contribution to the ongoing debate about rigour in qualitative research which we hope will guide future studies in this topic in emergency care research. It also provided recommendations for conducting future mixed-methods studies. Future papers on this series will use the results from qualitative data and the empirical findings from longitudinal data linkage to further identify factors associated with ED performance; they will be reported separately.

  19. Developing a Medical School Curriculum for Psychological, Moral, and Spiritual Wellness: Student and Faculty Perspectives

    PubMed Central

    Mitchell, Christine M.; Epstein-Peterson, Zachary D.; Bandini, Julia; Amobi, Ada; Cahill, Jonathan; Enzinger, Andrea; Noveroske, Sarah; Peteet, John; Balboni, Tracy; Balboni, Michael J.

    2017-01-01

    Context Although many studies have addressed the integration of a religion and/or spirituality curriculum into medical school training, few describe the process of curriculum development based on qualitative data from students and faculty. Objectives The aim of this study is to explore the perspectives of medical students and chaplaincy trainees regarding the development of a curriculum to facilitate reflection on moral and spiritual dimensions of caring for the critically ill and to train students in self-care practices that promote professionalism. Methods Research staff conducted semiscripted and one-on-one interviews and focus groups. Respondents also completed a short and self-reported demographic questionnaire. Participants included 44 students and faculty members from Harvard Medical School and Harvard Divinity School, specifically senior medical students and divinity school students who have undergone chaplaincy training. Results Two major qualitative themes emerged: curriculum format and curriculum content. Inter-rater reliability was high (kappa = 0.75). With regard to curriculum format, most participants supported the curriculum being longitudinal, elective, and experiential. With regard to curriculum content, five subthemes emerged: personal religious and/or spiritual (R/S) growth, professional integration of R/S values, addressing patient needs, structural and/or institutional dynamics within the health care system, and controversial social issues. Conclusion Qualitative findings of this study suggest that development of a future medical school curriculum on R/S and wellness should be elective, longitudinal, and experiential and should focus on the impact and integration of R/S values and self-care practices within self, care for patients, and the medical team. Future research is necessary to study the efficacy of these curricula once implemented. PMID:27693904

  20. Leaders or Led? A Qualitative Analysis of How Young People Explore Express and Experiment via New Media in an Irish Higher Education Context

    ERIC Educational Resources Information Center

    Judge, Miriam; Tuite, Declan

    2017-01-01

    This paper provides a systematic review of students' multimedia projects and reveals how a complex web of institutional, local, global and gender issues influence the process of digital media creation by young adults. The significance of this research for this Special Issue lies in the study's longitudinal nature, which examined students'…

  1. The "Exceptional" Physics Girl: A Sociological Analysis of Multimethod Data from Young Women Aged 10-16 to Explore Gendered Patterns of Post-16 Participation

    ERIC Educational Resources Information Center

    Archer, Louise; Moote, Julie; Francis, Becky; DeWitt, Jennifer; Yeomans, Lucy

    2017-01-01

    Female underrepresentation in postcompulsory physics is an ongoing issue for science education research, policy, and practice. In this article, we apply Bourdieusian and Butlerian conceptual lenses to qualitative and quantitative data collected as part of a wider longitudinal study of students' science and career aspirations age 10-16. Drawing on…

  2. Children Who Desperately Want To Read, But Are Not Working at Grade Level: Use Movement Patterns as "Windows" To Discover Why.

    ERIC Educational Resources Information Center

    Corso, Marjorie

    A qualitative longitudinal study, first of four parts, compared developmental movement levels and academic learning levels in young children. Subjects were 28 children of various ages who were not working up to grade level but who did not qualify for learning disability services. Parents completed a detailed demographic survey and a neurological…

  3. Does a Baby Help Young Women Transition out of Homelessness? Motivation, Coping, and Parenting

    ERIC Educational Resources Information Center

    Ruttan, Lia; Laboucane-Benson, Patricia; Munro, Brenda

    2012-01-01

    Homeless young women experience high levels of stress, challenges to mental health, substance use and abuse, and a lack of housing or of secure housing. This article explores one of the findings from a longitudinal qualitative study designed to follow homeless young women for a 2-year period as they make efforts to transition out of homelessness.…

  4. Recovering from a stroke: a longitudinal, qualitative study of older Norwegian women.

    PubMed

    Eilertsen, Grethe; Kirkevold, Marit; Bjørk, Ida Torunn

    2010-07-01

    To illuminate older women's experiences and the characteristics of the recovery process following a stroke. Patients with stroke face serious challenges related to bodily changes, existential aspects and daily life after stroke. Few qualitative longitudinal studies have examined the recovery process from the perspective of the patient. Knowledge about older women's experiences in coping with life after a stroke is limited. Prospective, longitudinal, case-study design. Six women aged 68-83 suffering from first-time stroke were recruited from two stroke units. Each participant was interviewed in-depth 12-14 times during the first two years post stroke. The interviews addressed how they experienced their body, their self-understanding, daily life and how this had changed over time. Most interviews took place in the participants' homes. Gadamer's philosophical hermeneutics informed the analyses. Post stroke recovery was slow and complex and evolved through four distinct phases. In the first phase (0-2 months post stroke), the participants' main concerns were their bodily changes; in the second phase (2-6 months), activities of daily life; in the third phase (6-12 months), self-understanding and in the fourth phase (12-24 months), going on with life. The transition between phases was gradual. Recovery from stroke evolves over time through four distinct phases, which differ depending on significant experiences and associated meanings. Psychological and social resources are equally critical in the women's process of recovery. The four phases of rehabilitation suggest at what points various concerns require increased therapeutic attention. Psychological and social resources must be vitalised at an early phase similar to bodily resources. This knowledge may assist professionals in offering adequate help throughout the recovery process even beyond the established rehabilitation period. © 2010 Blackwell Publishing Ltd.

  5. Longitudinal Analysis of Mouse SDOCT Volumes

    PubMed Central

    Antony, Bhavna J.; Carass, Aaron; Lang, Andrew; Kim, Byung-Jin; Zack, Donald J.; Prince, Jerry L.

    2017-01-01

    Spectral-domain optical coherence tomography (SDOCT), in addition to its routine clinical use in the diagnosis of ocular diseases, has begun to find increasing use in animal studies. Animal models are frequently used to study disease mechanisms as well as to test drug efficacy. In particular, SDOCT provides the ability to study animals longitudinally and non-invasively over long periods of time. However, the lack of anatomical landmarks makes the longitudinal scan acquisition prone to inconsistencies in orientation. Here, we propose a method for the automated registration of mouse SDOCT volumes. The method begins by accurately segmenting the blood vessels and the optic nerve head region in the scans using a pixel classification approach. The segmented vessel maps from follow-up scans were registered using an iterative closest point (ICP) algorithm to the baseline scan to allow for the accurate longitudinal tracking of thickness changes. Eighteen SDOCT volumes from a light damage model study were used to train a random forest utilized in the pixel classification step. The area under the curve (AUC) in a leave-one-out study for the retinal blood vessels and the optic nerve head (ONH) was found to be 0.93 and 0.98, respectively. The complete proposed framework, the retinal vasculature segmentation and the ICP registration, was applied to a secondary set of scans obtained from a light damage model. A qualitative assessment of the registration showed no registration failures. PMID:29138527

  6. Longitudinal analysis of mouse SDOCT volumes

    NASA Astrophysics Data System (ADS)

    Antony, Bhavna J.; Carass, Aaron; Lang, Andrew; Kim, Byung-Jin; Zack, Donald J.; Prince, Jerry L.

    2017-03-01

    Spectral-domain optical coherence tomography (SDOCT), in addition to its routine clinical use in the diagnosis of ocular diseases, has begun to fund increasing use in animal studies. Animal models are frequently used to study disease mechanisms as well as to test drug efficacy. In particular, SDOCT provides the ability to study animals longitudinally and non-invasively over long periods of time. However, the lack of anatomical landmarks makes the longitudinal scan acquisition prone to inconsistencies in orientation. Here, we propose a method for the automated registration of mouse SDOCT volumes. The method begins by accurately segmenting the blood vessels and the optic nerve head region in the scans using a pixel classification approach. The segmented vessel maps from follow-up scans were registered using an iterative closest point (ICP) algorithm to the baseline scan to allow for the accurate longitudinal tracking of thickness changes. Eighteen SDOCT volumes from a light damage model study were used to train a random forest utilized in the pixel classification step. The area under the curve (AUC) in a leave-one-out study for the retinal blood vessels and the optic nerve head (ONH) was found to be 0.93 and 0.98, respectively. The complete proposed framework, the retinal vasculature segmentation and the ICP registration, was applied to a secondary set of scans obtained from a light damage model. A qualitative assessment of the registration showed no registration failures.

  7. Comparison of qualitative and quantitative CT and MRI parameters for monitoring of longitudinal spine involvement in patients with multiple myeloma.

    PubMed

    Horger, M; Fritz, J; Thaiss, W M; Ditt, H; Weisel, K; Haap, M; Kloth, Christopher

    2018-03-01

    To compare qualitative and quantitative computed tomography (CT) and magnetic resonance imaging (MRI) parameters for longitudinal disease monitoring of multiple myeloma (MM) of the axial skeleton. We included 31 consecutive patients (17 m; mean age 59.20 ± 8.08 years) with MM, who underwent all baseline (n = 31) and at least one or more (n = 47) follow-up examinations consisting of multi-parametric non-enhanced whole-body MRI ( WB MRI) and non-enhanced whole-body reduced-dose thin-section MDCT (NEWBMDCT) between 06/2013 and 09/2016. We classified response according to qualitative CT criteria into progression (PD), stable(SD), partial/very good partial (PR/VGPR) and complete response(CR), grouping the latter three together for statistical analysis because CT cannot reliably assess PR and CR. Qualitative MR-response criteria were defined and grouped similarly to CT using longitudinal quantification of signal-intensity changes on T1w/STIR/ T2*w and calculating ADC-values. Standard of reference was the hematological laboratory (M-gradient). Hematological response categories were CR (14/47, 29.7%), PR (2/47, 4.2%), SD (16/47, 34.0%) and PD (15/47, 29.9%). Qualitative-CT-evaluation showed PD in 12/47 (25.5%) and SD/PR/VGPR/CR in 35/47 (74.5%) cases. These results were confirmed by quantitative-CT in all focal lytic lesions (p < 0.001). Quantitative-CT at sites with diffuse bone involvement showed significant increase of maximum bone attenuation (p < 0.001*) and significant decrease of minimal bone (p < 0.002*) in the SD/PR/VGPR/CR group. Qualitative MRI showed PD in 14/47 (29.7%) and SD/PR/VGPR/CR in 33/47 (70.3%). Quantitative MRI diagnosis showed a statistically significant decrease in signal intensity on short tau inversion recovery sequences (STIR) in bone marrow in patients with diffuse bone marrow involvement achieving SD/PR/VGPR/CR (p < 0.001*). Imaging response monitoring using MRI is superior to CT only if qualitative parameters are used, whereas there was no definite benefit from using quantitative parameters with either CT or MRI.

  8. The Australian Longitudinal Study on Women's Health: Using Focus Groups to Inform Recruitment

    PubMed Central

    2016-01-01

    Background Recruitment and retention of participants to large-scale, longitudinal studies can be a challenge, particularly when trying to target young women. Qualitative inquiries with members of the target population can prove valuable in assisting with the development of effective recruiting techniques. Researchers in the current study made use of focus group methodology to identify how to encourage young women aged 18-23 to participate in a national cohort online survey. Objective Our objectives were to gain insight into how to encourage young women to participate in a large-scale, longitudinal health survey, as well as to evaluate the survey instrument and mode of administration. Methods The Australian Longitudinal Study on Women’s Health used focus group methodology to learn how to encourage young women to participate in a large-scale, longitudinal Web-based health survey and to evaluate the survey instrument and mode of administration. Nineteen groups, involving 75 women aged 18-23 years, were held in remote, regional, and urban areas of New South Wales and Queensland. Results Focus groups were held in 2 stages, with discussions lasting from 19 minutes to over 1 hour. The focus groups allowed concord to be reached regarding survey promotion using social media, why personal information was needed, strategies to ensure confidentiality, how best to ask sensitive questions, and survey design for ease of completion. Recruitment into the focus groups proved difficult: the groups varied in size between 1 and 8 participants, with the majority conducted with 2 participants. Conclusions Intense recruitment efforts and variation in final focus group numbers highlights the “hard to reach” character of young women. However, the benefits of conducting focus group discussions as a preparatory stage to the recruitment of a large cohort for a longitudinal Web-based health survey were upheld. PMID:26902160

  9. Why do drivers become safer over the first three months of driving? A longitudinal qualitative study.

    PubMed

    Day, Marianne R; Thompson, Andrew R; Poulter, Damian R; Stride, Christopher B; Rowe, Richard

    2018-08-01

    Drivers are at high crash risk when they begin independent driving, with liability decreasing steeply over the first three months. Their behavioural development, and other changes underlying improved safety are not well understood. We adopted an innovative longitudinal qualitative design, with thirteen newly qualified drivers completing a total of 36 semi-structured interviews, one, two and three months after acquiring a full UK driving license. The interviews probed high-risk factors for new drivers, as well as allowing space for generating novel road safety issues. Analysis adopted a dual deductive and inductive interpretative thematic approach, identifying three super-ordinate themes: (1) Improvements in car control skills and situation awareness; (2) A reduction in the thrill of taking risks when driving against a background of generally increasing driving speed; (3) Early concerns about their social status in the eyes of other road users during the early stages of driving, which may put pressure on them to drive faster than they felt comfortable with. The study provides important new leads towards understanding how novice driving becomes safer over the first few months of driving, including how well-studied concepts of driving skill and style may change during development of independent driving, and bringing the less rigorously studied concept of social status into focus. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Medical School Factors That Prepare Students to Become Leaders in Medicine.

    PubMed

    Arnold, Louise; Cuddy, Paul G; Hathaway, Susan B; Quaintance, Jennifer L; Kanter, Steven L

    2018-02-01

    To identify medical school factors graduates in major leadership positions perceive as contributing to their leadership development. Using a phenomenological, qualitative approach, in August-November 2015 the authors conducted semistructured interviews with 48 medical leaders who were 1976-1999 baccalaureate-MD graduates of the University of Missouri-Kansas City School of Medicine (UMKC). At UMKC, they participated in longitudinal learning communities, the centerpiece for learning professional values and behaviors plus clinical skills, knowledge, and judgment, but received no formal leadership instruction. The authors subjected interview comments to directed, largely qualitative content analysis with iterative coding cycles. Most graduates said their experiences and the people at UMKC positively influenced their leadership growth. Medical school factors that emerged as contributing to that growth were the longitudinal learning communities including docents, junior-senior partners, and team experiences; expectations set for students to achieve; a clinically oriented but integrated curriculum; admission policies seeking students with academic and nonacademic qualifications; supportive student-student and student-faculty relationships; and a positive overall learning environment. Graduates viewed a combination of factors as best preparing them for leadership and excellence in clinical medicine; together these factors enabled them to assume leadership opportunities after graduation. This study adds medical leaders' perspective to the leadership development literature and offers guidance from theory and practice for medical schools to consider in shaping leadership education: Namely, informal leadership preparation coupled with extensive longitudinal clinical education in a nurturing, authentic environment can develop students effectively for leadership in medicine.

  11. Findings from the Harvard Medical School Cambridge Integrated Clerkship, a Year-Long Longitudinal Psychiatry Experience.

    PubMed

    Cheng, Elisa; Hirsh, David; Gaufberg, Elizabeth; Griswold, Todd; Wesley Boyd, J

    2018-06-01

    The Harvard Medical School Cambridge Integrated Clerkship is a longitudinal integrated clerkship that has provided an alternative clinical model for medical education in psychiatry since its inception in 2004. This study was undertaken in an effort to better understand the student experience of the Cambridge Integrated Clerkship and how it may have impacted students' perceptions of and interest in psychiatry, as well as performance. Qualitative surveys were sent via e-mail to the first 11 student cohorts who had completed the Cambridge Integrated Clerkship (from 2004 to 2014) and for whom we had e-mail addresses (N = 100), and the free-text responses were coded thematically. All available standardized scoring data and residency match data for Cambridge Integrated Clerkship graduates were obtained. From 2006 to 2014, 12 out of 73 Cambridge Integrated Clerkship students who entered the match chose a psychiatry residency (16.4%), four times more than students in traditional clerkships at Harvard Medical School (3.8% of 1355 students) or the national average (4.1% of 146,066 US applicants). Thirty of the 100 surveyed Cambridge Integrated Clerkship graduates (30%) responded to the qualitative survey with free-text remarks on a number of themes. Cambridge Integrated Clerkship students compared positively to their classmates in terms of standardized test performance. Their fourfold higher match rate into psychiatry compared to other students raises intriguing questions as to what role a longitudinal clerkship might have played in developing interest in psychiatry as a career.

  12. Developing an Inclusive Learning Environment for Students with Visual Impairment in Higher Education: Progressive Mutual Accommodation and Learner Experiences in the United Kingdom

    ERIC Educational Resources Information Center

    Hewett, Rachel; Douglas, Graeme; McLinden, Michael; Keil, Sue

    2017-01-01

    Drawing on the findings of a unique longitudinal qualitative study, this article investigates the experiences of 32 young people with visual impairment (VI) in higher education (HE) in the United Kingdom (UK) to explore how well they were able to participate on their courses. We propose and apply a Bioecological Model of Inclusive HE to interpret…

  13. Older Adults' Experiences of Sexual Difficulties: Qualitative Findings From the English Longitudinal Study on Ageing (ELSA).

    PubMed

    Hinchliff, Sharron; Tetley, Josie; Lee, David; Nazroo, James

    2018-02-01

    There is a growing body of evidence demonstrating that sexual activity is important to the quality of life of older adults, and that it can be influenced by physical, psychological, and social factors. However, older adults' experiences of sexual difficulties remain relatively unexplored. This article draws on qualitative data collected as part of the English Longitudinal Study of Ageing (ELSA). Participants answered a Sexual Relationships and Activities Questionnaire (SRA-Q), which included an open comment box for further details, 1,084 (1/7) of which were completed. These data were analyzed using Template Analysis, and findings on the experiences of sexual difficulties are presented in this article. Sexual difficulties were contextualized within the couple relationship and could be detrimental to the relationship, particularly if the partner would not seek professional help. Participants reported that sexual difficulties could also have a negative impact on psychological well-being, described mainly as frustration, depression, and sadness. For some participants the supportive nature of their relationship buffered these impacts. Few had sought professional help; those who had reported helpful and unhelpful experiences. These findings add to the limited evidence base and have implications for health care in the context of global aging and a growing recognition of older adults' sexual rights.

  14. Choices and changes: Eccles' Expectancy-Value model and upper-secondary school students' longitudinal reflections about their choice of a STEM education

    NASA Astrophysics Data System (ADS)

    Lykkegaard, Eva; Ulriksen, Lars

    2016-03-01

    During the past 30 years, Eccles' comprehensive social-psychological Expectancy-Value Model of Motivated Behavioural Choices (EV-MBC model) has been proven suitable for studying educational choices related to Science, Technology, Engineering and/or Mathematics (STEM). The reflections of 15 students in their last year in upper-secondary school concerning their choice of tertiary education were examined using quantitative EV-MBC surveys and repeated qualitative interviews. This article presents the analyses of three cases in detail. The analytical focus was whether the factors indicated in the EV-MBC model could be used to detect significant changes in the students' educational choice processes. An important finding was that the quantitative EV-MBC surveys and the qualitative interviews gave quite different results concerning the students' considerations about the choice of tertiary education, and that significant changes in the students' reflections were not captured by the factors of the EV-MBC model. This questions the validity of the EV-MBC surveys. Moreover, the quantitative factors from the EV-MBC model did not sufficiently explain students' dynamical educational choice processes where students in parallel considered several different potential educational trajectories. We therefore call for further studies of the EV-MBC model's use in describing longitudinal choice processes and especially in investigating significant changes.

  15. An account from the inside: Examining the emotional impact of qualitative research through the lens of "insider" research.

    PubMed

    Ross, Lori E

    2017-11-01

    The benefits and challenges of insider positionality have been much written about in relation to qualitative research. However, the specific emotional implications of insider research have been little explored. In this manuscript, I aim to bring the literature on insider positionality to the study of emotion in qualitative research through a reflection on my experiences as a "total insider" conducting interviews for a longitudinal qualitative study examining mental health during the transition to parenthood among sexual minority women. On the basis of this experience, I highlight emotion-related benefits and challenges of my insider positionality, as they pertain both to the quality of the research and to my personal experiences as a qualitative researcher. In particular, I examine the potential benefits of my insider positioning for establishing rapport and my capacity for empathy, and the personal emotional growth and learning that my insider positioning made possible for me. With respect to challenges, I examine how my emotional investment in the researcher-participant relationship influenced my role as a research instrument, and discuss the difficulties I encountered in managing appropriately boundaried relationships and making decisions about self-disclosure. I close by highlighting promising avenues for further exploration of the emotional implications of insider research, from the perspectives of both researchers and participants.

  16. Experimental study of the laminar-turbulent transition of a concave wall in a parallel flow

    NASA Technical Reports Server (NTRS)

    Bippes, H.

    1978-01-01

    The instability of the laminar boundary layer flow along a concave wall was studied. Observations of these three-dimensional boundary layer phenomena were made using the hydrogen-bubble visualization technique. With the application of stereo-photogrammetric methods in the air-water system it was possible to investigate the flow processes qualitatively and quantitatively. In the case of a concave wall of sufficient curvature, a primary instability occurs first in the form of Goertler vortices with wave lengths depending upon the boundary layer thickness and the wall curvature. At the onset the amplification rate is in agreement with the linear theory. Later, during the non-linear amplification stage, periodic spanwise vorticity concentrations develop in the low velocity region between the longitudinal vortices. Then a meandering motion of the longitudinal vortex streets subsequently ensues, leading to turbulence.

  17. Spirituality: a cultural strength for African American mothers with HIV.

    PubMed

    Polzer Casarez, Rebecca L; Miles, Margaret Shandor

    2008-05-01

    The purpose of this study was to describe how spirituality affected the lives of African American mothers with Human Immunodeficiency Virus (HIV) in the context of coping. This qualitative descriptive study used secondary data of interviews from a larger longitudinal study of parental caregiving of infants seropositive for HIV. Participants were 38 African American mothers with HIV. Data from longitudinal semi-structured interviews were analyzed using content analysis. The women dealt with the stresses of HIV through a relationship with God. Two domains explain this relationship: God in control and God requires participation. The benefits of their relationship with God were a decrease in stress and worry about their own health and that of their infants. It is important for nurses working with mothers with HIV to acknowledge their spirituality and assess how spirituality helps them cope with and manage their illness.

  18. Desert plains classification based on Geomorphometrical parameters (Case study: Aghda, Yazd)

    NASA Astrophysics Data System (ADS)

    Tazeh, mahdi; Kalantari, Saeideh

    2013-04-01

    This research focuses on plains. There are several tremendous methods and classification which presented for plain classification. One of The natural resource based classification which is mostly using in Iran, classified plains into three types, Erosional Pediment, Denudation Pediment Aggradational Piedmont. The qualitative and quantitative factors to differentiate them from each other are also used appropriately. In this study effective Geomorphometrical parameters in differentiate landforms were applied for plain. Geomorphometrical parameters are calculable and can be extracted using mathematical equations and the corresponding relations on digital elevation model. Geomorphometrical parameters used in this study included Percent of Slope, Plan Curvature, Profile Curvature, Minimum Curvature, the Maximum Curvature, Cross sectional Curvature, Longitudinal Curvature and Gaussian Curvature. The results indicated that the most important affecting Geomorphometrical parameters for plain and desert classifications includes: Percent of Slope, Minimum Curvature, Profile Curvature, and Longitudinal Curvature. Key Words: Plain, Geomorphometry, Classification, Biophysical, Yazd Khezarabad.

  19. End of life care for frail older patients in family practice (ELFOP)--protocol of a longitudinal qualitative study on needs, appropriateness and utilisation of services.

    PubMed

    Müller-Mundt, Gabriele; Bleidorn, Jutta; Geiger, Karin; Klindtworth, Katharina; Pleschberger, Sabine; Hummers-Pradier, Eva; Schneider, Nils

    2013-05-03

    Frail elderly people represent a major patient group in family practice. Little is known about the patients' needs, and how their needs evolve over time with increasing frailty towards the end of life. This study will address end-of-life care needs, service utilisation, and experiences of frail elderly patients and their informal caregivers, with regard to family practice. This paper aims to introduce the research protocol. The study uses a multiple perspective approach qualitative design. The first study part consists of serial six-monthly in-depth interviews with 30 community-dwelling elderly patients (≥70 years) with moderate to severe frailty and their key informal caregivers, over a period of 18 months. Additionally, semi-structured interviews with the patients' family physician will be conducted. The serial interviews will be analysed with grounded theory and narrative approaches. Special attention will be paid to the comparison of distinct views of the patients', informal caregivers', and family physicians' as well as on chronological aspects. In the second study part, five focus groups with experts in family medicine, geriatrics, palliative medicine, and nursing will be conducted. Finally, the implications for family practice and health care policy will be discussed in an expert workshop. To our knowledge, this is the first prospective, longitudinal qualitative study on the needs of elderly patients with advanced frailty towards the end of life in German family practice, which integrates the perspectives of patients, informal caregivers, family physicians and other health professionals. The study will contribute to the understanding of the clinical, psychosocial and information needs of patients and their caregivers, and of respective changes of experiences and needs along the illness/frailty trajectory including the last phase of life. It will provide an empirical basis for improving patient-centred care for this increasingly relevant target group.

  20. Longitudinal evaluation of corticospinal tract in patients with resected brainstem cavernous malformations using high-definition fiber tractography and diffusion connectometry analysis: preliminary experience.

    PubMed

    Faraji, Amir H; Abhinav, Kumar; Jarbo, Kevin; Yeh, Fang-Cheng; Shin, Samuel S; Pathak, Sudhir; Hirsch, Barry E; Schneider, Walter; Fernandez-Miranda, Juan C; Friedlander, Robert M

    2015-11-01

    Brainstem cavernous malformations (CMs) are challenging due to a higher symptomatic hemorrhage rate and potential morbidity associated with their resection. The authors aimed to preoperatively define the relationship of CMs to the perilesional corticospinal tracts (CSTs) by obtaining qualitative and quantitative data using high-definition fiber tractography. These data were examined postoperatively by using longitudinal scans and in relation to patients' symptomatology. The extent of involvement of the CST was further evaluated longitudinally using the automated "diffusion connectometry" analysis. Fiber tractography was performed with DSI Studio using a quantitative anisotropy (QA)-based generalized deterministic tracking algorithm. Qualitatively, CST was classified as being "disrupted" and/or "displaced." Quantitative analysis involved obtaining mean QA values for the CST and its perilesional and nonperilesional segments. The contralateral CST was used for comparison. Diffusion connectometry analysis included comparison of patients' data with a template from 90 normal subjects. Three patients (mean age 22 years) with symptomatic pontomesencephalic hemorrhagic CMs and varying degrees of hemiparesis were identified. The mean follow-up period was 37.3 months. Qualitatively, CST was partially disrupted and displaced in all. Direction of the displacement was different in each case and progressively improved corresponding with the patient's neurological status. No patient experienced neurological decline related to the resection. The perilesional mean QA percentage decreases supported tract disruption and decreased further over the follow-up period (Case 1, 26%-49%; Case 2, 35%-66%; and Case 3, 63%-78%). Diffusion connectometry demonstrated rostrocaudal involvement of the CST consistent with the quantitative data. Hemorrhagic brainstem CMs can disrupt and displace perilesional white matter tracts with the latter occurring in unpredictable directions. This requires the use of tractography to accurately define their orientation to optimize surgical entry point, minimize morbidity, and enhance neurological outcomes. Observed anisotropy decreases in the perilesional segments are consistent with neural injury following hemorrhagic insults. A model using these values in different CST segments can be used to longitudinally monitor its craniocaudal integrity. Diffusion connectometry is a complementary approach providing longitudinal information on the rostrocaudal involvement of the CST.

  1. Caring: the socialisation of pre-registration student nurses: a longitudinal qualitative descriptive study.

    PubMed

    Mackintosh, Carolyn

    2006-11-01

    This study explores the impact of the process of socialisation on pre-registration student nurses views about care, and their personal ability to cope with becoming a nurse. It aims to identify the effect time has on participants attitudes and views of care and becoming a nurse, during pre-registration nurse training, by using a descriptive longitudinal qualitative design. Data collection took place within the School of Health or on student's clinical placement areas, using a random sample of 16 pre-registration student nurses obtained from a convenience sample of 52 volunteers. Participants were involved in two semi-structured in depth interviews, the first 6-9 months after entering nurse training and the second 6-9 months prior to completion. Interviews were tape recorded, transcribed verbatim and analysed using Morse and Field's (1996) four stages of analysis. Identified changes between data collection stages suggest socialisation results in a loss of idealism about care within nursing, as well as the identification of negative aspects of care. Loss of care is linked to increased abilities to cope with the nursing role, although this is not uniform and some participants clearly discriminate and reject negative exposures. In conclusion this study identifies an under recognised dichotomy between the caring ethos of professional nursing and the professional socialisation processes student nurses are subject to, which directly mitigate against the individual nurses abilities to care.

  2. Readiness for Delivering Digital Health at Scale: Lessons From a Longitudinal Qualitative Evaluation of a National Digital Health Innovation Program in the United Kingdom

    PubMed Central

    Lennon, Marilyn R; Bouamrane, Matt-Mouley; Devlin, Alison M; O'Connor, Siobhan; O'Donnell, Catherine; Chetty, Ula; Agbakoba, Ruth; Bikker, Annemieke; Grieve, Eleanor; Finch, Tracy; Watson, Nicholas; Wyke, Sally

    2017-01-01

    Background Digital health has the potential to support care delivery for chronic illness. Despite positive evidence from localized implementations, new technologies have proven slow to become accepted, integrated, and routinized at scale. Objective The aim of our study was to examine barriers and facilitators to implementation of digital health at scale through the evaluation of a £37m national digital health program: ‟Delivering Assisted Living Lifestyles at Scale” (dallas) from 2012-2015. Methods The study was a longitudinal qualitative, multi-stakeholder, implementation study. The methods included interviews (n=125) with key implementers, focus groups with consumers and patients (n=7), project meetings (n=12), field work or observation in the communities (n=16), health professional survey responses (n=48), and cross program documentary evidence on implementation (n=215). We used a sociological theory called normalization process theory (NPT) and a longitudinal (3 years) qualitative framework analysis approach. This work did not study a single intervention or population. Instead, we evaluated the processes (of designing and delivering digital health), and our outcomes were the identified barriers and facilitators to delivering and mainstreaming services and products within the mixed sector digital health ecosystem. Results We identified three main levels of issues influencing readiness for digital health: macro (market, infrastructure, policy), meso (organizational), and micro (professional or public). Factors hindering implementation included: lack of information technology (IT) infrastructure, uncertainty around information governance, lack of incentives to prioritize interoperability, lack of precedence on accountability within the commercial sector, and a market perceived as difficult to navigate. Factors enabling implementation were: clinical endorsement, champions who promoted digital health, and public and professional willingness. Conclusions Although there is receptiveness to digital health, barriers to mainstreaming remain. Our findings suggest greater investment in national and local infrastructure, implementation of guidelines for the safe and transparent use and assessment of digital health, incentivization of interoperability, and investment in upskilling of professionals and the public would help support the normalization of digital health. These findings will enable researchers, health care practitioners, and policy makers to understand the current landscape and the actions required in order to prepare the market and accelerate uptake, and use of digital health and wellness services in context and at scale. PMID:28209558

  3. ‘Well London’ and the benefits of participation: results of a qualitative study nested in a cluster randomised trial

    PubMed Central

    Derges, Jane; Clow, Angela; Lynch, Rebecca; Jain, Sumeet; Phillips, Gemma; Petticrew, Mark; Renton, Adrian; Draper, Alizon

    2014-01-01

    Background Well London is a multicomponent community engagement and coproduction programme designed to improve the health of Londoners living in socioeconomically deprived neighbourhoods. To evaluate outcomes of the Well London interventions, a cluster randomised trial (CRT) was conducted that included a longitudinal qualitative component, which is reported here. The aim is to explore in depth the nature of the benefits to residents and the processes by which these were achieved. Methods The 1-year longitudinal qualitative study was nested within the CRT. Purposive sampling was used to select three intervention neighbourhoods in London and 61 individuals within these neighbourhoods. The interventions comprised activities focused on: healthy eating, physical exercise and mental health and well-being. Interviews were conducted at the inception and following completion of the Well London interventions to establish both if and how they had participated. Transcripts of the interviews were coded and analysed using Nvivo. Results Positive benefits relating to the formal outcomes of the CRT were reported, but only among those who participated in project activities. The extent of benefits experienced was influenced by factors relating to the physical and social characteristics of each neighbourhood. The highest levels of change occurred in the presence of: (1) social cohesion, not only pre-existing but also as facilitated by Well London activities; (2) personal and collective agency; (3) involvement and support of external organisations. Where the physical and social environment remained unchanged, there was less participation and fewer benefits. Conclusions These findings show interaction between participation, well-being and agency, social interactions and cohesion and that this modulated any benefits described. Pathways to change were thus complex and variable, but personal well-being and local social cohesion emerged as important mediators of change. PMID:24694622

  4. Facilitators and barriers of participation in a longitudinal research on migrant families in Badalona (Spain): A qualitative approach.

    PubMed

    Hernando, Cristina; Sabidó, Meritxell; Casabona, Jordi

    2018-01-01

    Migrant populations are under-represented in health research. We conducted a community-based qualitative study with the aim to examine the willingness, barriers, facilitators and reasons for participating in longitudinal health research among migrants. In Badalona and Santa Coloma de Gramanet (Barcelona) from May to November 2014, 26 individual interviews and 8 discussion groups were conducted with a convenience sample of 76 migrants born in Colombia, Peru, Ecuador, Bolivia, Morocco, Pakistan and China; and 9 key informants. Grounded Theory methods and thematic analysis was used to analyse the data. Atlas-ti(R) software was used. Participants were willing to participate in health surveys and biological samples testing, and agreed to be re-contacted after 12 months. Participants agreed to the same participation for their children. Participants reported that undertaking biological samples and knowledge of the health status of their children were the greatest benefits of participation in health research. Barriers to participation reported by participants were language difficulties, time constraints and mobility issues. Facilitators of participation included offering complete and understandable information about the study objectives and procedures; offering interviewers with the same migrant background, gender, country of origin and socioeconomic status as participants; building trust through ensuring proximity, privacy and confidentiality; respecting cultural relationships; and receiving monetary compensation and test results. Focusing on migrant families instead of individuals may facilitate participation in the study. Despite being beneficial in general, receipt of monetary compensation, inclusion of questions related to sexual and reproductive health, and blood sample testing resulted in distrust for a small number of participants. The simultaneous use of several Internet tools was the most recommended tool for re-contact. Those with higher risk of mobility, greater language barriers and less Internet use were more difficult to re-contact. Study findings will help to improve participation and retention of migrants in longitudinal research. © 2017 John Wiley & Sons Ltd.

  5. Challenges and strategies for quantitative and qualitative field research in the United Arab Emirates.

    PubMed

    Aw, Tar-Ching; Zoubeidi, Taoufik; Al-Maskari, Fatma; Blair, Iain

    2011-01-01

    Clinical and public health research depends on factors including national systems, socio-cultural influences, and access to organisations and individuals. As a 'new' country, the United Arab Emirates (UAE) has yet to develop strong support for population research. However, there is interest in research. The challenges for quantitative and qualitative research include the varied composition and mobility of the UAE population, with limited health records and disease registries. Long-term follow-up of patients, and tracing foreign workers who may only be in the UAE for a few years, are two major obstacles for longitudinal studies. There can also be a reluctance shown by parts of the population to participate in studies, especially those that require responding to what is perceived as sensitive questions. Successful execution of population research in the UAE requires an understanding of socio-cultural aspects of the study population, and good communication between researchers and participants.

  6. Early visual language exposure and emergent literacy in preschool deaf children: findings from a national longitudinal study.

    PubMed

    Allen, Thomas E; Letteri, Amy; Choi, Song Hoa; Dang, Daqian

    2014-01-01

    Brief review is provided of recent research on the impact of early visual language exposure on a variety of developmental outcomes, including literacy, cognition, and social adjustment. This body of work points to the great importance of giving young deaf children early exposure to a visual language as a critical precursor to the acquisition of literacy. Four analyses of data from the Visual Language and Visual Learning (VL2) Early Education Longitudinal Study are summarized. Each confirms findings from previously published laboratory findings and points to the positive effects of early sign language on, respectively, letter knowledge, social adaptability, sustained visual attention, and cognitive-behavioral milestones necessary for academic success. The article concludes with a consideration of the qualitative similarity hypothesis and a finding that the hypothesis is valid, but only if it can be presented as being modality independent.

  7. Systematic literature review of determinants of sedentary behaviour in older adults: a DEDIPAC study.

    PubMed

    Chastin, Sebastien F M; Buck, Christoph; Freiberger, Ellen; Murphy, Marie; Brug, Johannes; Cardon, Greet; O'Donoghue, Grainne; Pigeot, Iris; Oppert, Jean-Michel

    2015-10-06

    Older adults are the most sedentary segment of society and high sedentary time is associated with poor health and wellbeing outcomes in this population. Identifying determinants of sedentary behaviour is a necessary step to develop interventions to reduce sedentary time. A systematic literature review was conducted to identify factors associated with sedentary behaviour in older adults. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between 2000 and May 2014. The search strategy was based on four key elements: (a) sedentary behaviour and its synonyms; (b) determinants and its synonyms (e.g. correlates, factors); (c) types of sedentary behaviour (e.g. TV viewing, sitting, gaming) and (d) types of determinants (e.g. environmental, behavioural). Articles were included in the review if specific information about sedentary behaviour in older adults was reported. Studies on samples identified by disease were excluded. Study quality was rated by means of QUALSYST. The full review protocol is available from PROSPERO (PROSPERO 2014: CRD42014009823). The analysis was guided by the socio-ecological model framework. Twenty-two original studies were identified out of 4472 returned by the systematic search. These included 19 cross-sectional, 2 longitudinal and 1 qualitative studies, all published after 2011. Half of the studies were European. The study quality was generally high with a median of 82 % (IQR 69-96 %) using Qualsyst tool. Personal factors were the most frequently investigated with consistent positive association for age, negative for retirement, obesity and health status. Only four studies considered environmental determinants suggesting possible association with mode of transport, type of housing, cultural opportunities and neighbourhood safety and availability of places to rest. Only two studies investigated mediating factors. Very limited information was available on contexts and sub-domains of sedentary behaviours. Few studies have investigated determinants of sedentary behaviour in older adults and these have to date mostly focussed on personal factors, and qualitative studies were mostly lacking. More longitudinal studies are needed as well as inclusion of a broader range of personal and contextual potential determinants towards a systems-based approach, and future studies should be more informed by qualitative work.

  8. A one-year longitudinal qualitative study of peer support services in a non-Western context: The perspectives of peer support workers, service users, and co-workers.

    PubMed

    Tse, Samson; Mak, Winnie W S; Lo, Iris W K; Liu, Lucia L; Yuen, Winnie W Y; Yau, Sania; Ho, Kimmy; Chan, Sau-Kam; Wong, Stephen

    2017-09-01

    This study explored the changing views of key stakeholders (peer support workers, their co-workers, and service users) about peer support services in a non-Western community, using a longitudinal qualitative approach. Five trainee peer support workers (PSWs), 15 service users, and 14 co-workers were interviewed over a 12-month period, under the auspices of the Peer Support Workers Project (also known as the Mindset project) in Hong Kong. A total of 77 interviews were transcribed and thematic analyses were conducted across the participant groups at three different time points (training, work placements, and employment). During the initial implementation of the services, uncertainty about the role of the PSWs were reported. However, trusting and beneficial relationships with service users were gradually built, showing growing resilience and confidence over time. The participants realized that PSWs' experiences of mental illnesses were a unique asset that could help service users to alleviate their own somatic symptoms and improve their connections with others. Our findings highlight that the perceptions of peer support services changed from confusion to viewing PSWs as an asset, to an awareness of the importance of family support, and to the belief that implementing such a program will benefit both service users and PSWs. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  9. Applying the ICF framework to study changes in quality-of-life for youth with chronic conditions

    PubMed Central

    McDougall, Janette; Wright, Virginia; Schmidt, Jonathan; Miller, Linda; Lowry, Karen

    2011-01-01

    Objective The objective of this paper is to describe how the ICF framework was applied as the foundation for a longitudinal study of changes in quality-of-life (QoL) for youth with chronic conditions. Method This article will describe the study’s aims, methods, measures and data analysis techniques. It will point out how the ICF framework was used—and expanded upon—to provide a model for studying the impact of factors on changes in QoL for youth with chronic conditions. Further, it will describe the instruments that were chosen to measure the components of the ICF framework and the data analysis techniques that will be used to examine the impact of factors on changes in youths’ QoL. Conclusions Qualitative and longitudinal designs for studying QoL based on the ICF framework can be useful for unraveling the complex ongoing inter-relationships among functioning, contextual factors and individuals’ perceptions of their QoL. PMID:21034288

  10. Longitudinal comparative evaluation of the equivalence of an integrated peer-support and clinical staffing model for residential mental health rehabilitation: a mixed methods protocol incorporating multiple stakeholder perspectives.

    PubMed

    Parker, Stephen; Dark, Frances; Newman, Ellie; Korman, Nicole; Meurk, Carla; Siskind, Dan; Harris, Meredith

    2016-06-02

    A novel staffing model integrating peer support workers and clinical staff within a unified team is being trialled at community based residential rehabilitation units in Australia. A mixed-methods protocol for the longitudinal evaluation of the outcomes, expectations and experiences of care by consumers and staff under this staffing model in two units will be compared to one unit operating a traditional clinical staffing. The study is unique with regards to the context, the longitudinal approach and consideration of multiple stakeholder perspectives. The longitudinal mixed methods design integrates a quantitative evaluation of the outcomes of care for consumers at three residential rehabilitation units with an applied qualitative research methodology. The quantitative component utilizes a prospective cohort design to explore whether equivalent outcomes are achieved through engagement at residential rehabilitation units operating integrated and clinical staffing models. Comparative data will be available from the time of admission, discharge and 12-month period post-discharge from the units. Additionally, retrospective data for the 12-month period prior to admission will be utilized to consider changes in functioning pre and post engagement with residential rehabilitation care. The primary outcome will be change in psychosocial functioning, assessed using the total score on the Health of the Nation Outcome Scales (HoNOS). Planned secondary outcomes will include changes in symptomatology, disability, recovery orientation, carer quality of life, emergency department presentations, psychiatric inpatient bed days, and psychological distress and wellbeing. Planned analyses will include: cohort description; hierarchical linear regression modelling of the predictors of change in HoNOS following CCU care; and descriptive comparisons of the costs associated with the two staffing models. The qualitative component utilizes a pragmatic approach to grounded theory, with collection of data from consumers and staff at multiple time points exploring their expectations, experiences and reflections on the care provided by these services. It is expected that the new knowledge gained through this study will guide the adaptation of these and similar services. For example, if differential outcomes are achieved for consumers under the integrated and clinical staffing models this may inform staffing guidelines.

  11. A qualitative study of participants' views on re-consent in a longitudinal biobank.

    PubMed

    Dixon-Woods, Mary; Kocman, David; Brewster, Liz; Willars, Janet; Laurie, Graeme; Tarrant, Carolyn

    2017-03-23

    Biomedical research increasingly relies on long-term studies involving use and re-use of biological samples and data stored in large repositories or "biobanks" over lengthy periods, often raising questions about whether and when a re-consenting process should be activated. We sought to investigate the views on re-consent of participants in a longitudinal biobank. We conducted a qualitative study involving interviews with 24 people who were participating in a longitudinal biobank. Their views were elicited using a semi-structured interview schedule and scenarios based on a hypothetical biobank. Data analysis was based on the constant comparative method. What participants identified as requiring new consent was not a straightforward matter predictable by algorithms about the scope of the consent, but instead was contingent. They assessed whether proposed new research implied a fundamental alteration in the underlying character of the biobank and whether specific projects were within the scope of the original consent. What mattered most to them was that the cooperative bargain into which they had entered was maintained in good faith. They saw re-consent as one important safeguard in this bargain. In determining what required re-consent, they deployed two logics. First, they used a logic of boundaries, where they sought to detect any possible rupture with their existing framework of cooperation. Second, they used a logic of risk, where they assessed proposed research for any potential threats for them personally or the research endeavour. When they judged that a need for re-consent had been activated, participants saw the process as way of re-actualising and renewing the cooperative bargain. Participants' perceptions of research as a process of mutual co-operation between volunteer and researcher were fundamental to their views on consent. Consenting arrangements for biobanks should respect the cooperative values that are important to participants, recognise the two logics used by research volunteers, and avoid rigidity. Agility may be favoured by tiered consent combined with strong oversight mechanisms; this approach requires evaluation.

  12. Longitudinal qualitative study describing family physicians’ experiences with attempting to integrate physical activity prescriptions in their practice: ‘It’s not easy to change habits’

    PubMed Central

    Bélanger, Mathieu; Phillips, Emily Wolfe; O’Rielly, Connor; Mallet, Bertin; Aubé, Shane; Doucet, Marylène; Couturier, Jonathan; Mallet, Maxime; Martin, Jessica; Gaudet, Christine; Murphy, Nathalie; Brunet, Jennifer

    2017-01-01

    Objective Physical activity (PA) prescriptions provided by family physicians can promote PA participation among patients, but few physicians regularly write PA prescriptions. The objective of this study was to describe family physicians’ experiences of trying to implement written PA prescriptions into their practice. Design Longitudinal qualitative study where participants were interviewed four times during a 12-month period. After the first interview, they were provided with PA prescription pads. Data were analysed using thematic analysis. Setting Family medicine clinics in New Brunswick, Canada. Participants Family physicians (n=11) with no prior experience writing PA prescriptions, but who expressed interest in changing their practice to implement written PA prescriptions. Results Initially, participants exhibited confidence in their ability to write PA prescriptions in the future and intended to write prescriptions. However, data from the follow-up interviews indicated that the rate of implementation was lower than anticipated by participants and prescriptions were not part of their regular practice. Two themes emerged as factors explaining the gap between their intentions and behaviours: (1) uncertainty about the effectiveness of written PA prescription, and (2) practical concerns (eg, changing well-established habits, time constraints, systemic institutional barriers). Conclusion It may be effective to increase awareness among family physicians about the effectiveness of writing PA prescriptions and address barriers related to how their practice is organised in order to promote written PA prescription rates. PMID:28710228

  13. The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives.

    PubMed

    Ridd, Matthew; Shaw, Alison; Lewis, Glyn; Salisbury, Chris

    2009-04-01

    The patient-doctor relationship is an important but poorly defined topic. In order to comprehensively assess its significance for patient care, a clearer understanding of the concept is required. To derive a conceptual framework of the factors that define patient-doctor relationships from the perspective of patients. Systematic review and thematic synthesis of qualitative studies. Medline, EMBASE, PsychINFO and Web of Science databases were searched. Studies were screened for relevance and appraised for quality. The findings were synthesised using a thematic approach. From 1985 abstracts, 11 studies from four countries were included in the final synthesis. They examined the patient-doctor relationship generally (n = 3), or in terms of loyalty (n = 3), personal care (n = 2), trust (n = 2), and continuity (n = 1). Longitudinal care (seeing the same doctor) and consultation experiences (patients' encounters with the doctor) were found to be the main processes by which patient-doctor relationships are promoted. The resulting depth of patient-doctor relationship comprises four main elements: knowledge, trust, loyalty, and regard. These elements have doctor and patient aspects to them, which may be reciprocally related. A framework is proposed that distinguishes between dynamic factors that develop or maintain the relationship, and characteristics that constitute an ongoing depth of relationship. Having identified the different elements involved, future research should examine for associations between longitudinal care, consultation experiences, and depth of patient-doctor relationship, and, in turn, their significance for patient care.

  14. Longitudinal qualitative exploration of cancer information-seeking experiences across the disease trajectory: the INFO-SEEK protocol.

    PubMed

    Germeni, Evi; Bianchi, Monica; Valcarenghi, Dario; Schulz, Peter J

    2015-10-06

    Α substantial corpus of literature has sought to describe the information-seeking behaviour of patients with cancer. Yet, available evidence comes mainly from cross-sectional studies, which provide 'snapshots' of patients' information needs and information-seeking styles at a single time point. Only a few longitudinal studies currently exist; however, these are quantitative in nature and, despite successfully documenting changes in patients' information needs throughout the clinical course of cancer, they have failed to provide an evidence-based interpretation of the causes and consequences of change. The goal of this study is threefold: First, we wish to provide a holistic understanding of how cancer information-seeking behaviour may evolve across different stages of the patient journey. Second, we will seek to elucidate the contextual and intervening conditions that may affect possible changes in information seeking. Third, we will attempt to identify what the consequences of these changes are, while heightening their implications for clinical practice and policy. We will carry out a longitudinal qualitative study, based on face-to-face, in-depth interviews with approximately 25 individuals diagnosed with cancer. Patients will be recruited from 2 oncology hospitals located in Ticino, Switzerland, and will be interviewed at 3 different time points: (1) within 2 weeks after receiving the cancer diagnosis; (2) within 2 weeks after their initial treatment; and (3) 6 months after their initial treatment. All interviews will be recorded and transcribed verbatim. A grounded theory approach will be used for the analysis of the data. The study protocol has been approved by the Ethics Committee of Canton Ticino (CE 2813). Participation in the study will be voluntary, and confidentiality and anonymity ensured. Prior to study participation, patients will be asked to provide signed informed consent. Findings will be disseminated in international peer-reviewed journals and presented in relevant conferences. 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.

  15. Retail food environments research in Canada: A scoping review.

    PubMed

    Minaker, Leia M; Shuh, Alanna; Olstad, Dana L; Engler-Stringer, Rachel; Black, Jennifer L; Mah, Catherine L

    2016-06-09

    The field of retail food environments research is relatively new in Canada. The objective of this scoping review is to provide an overview of retail food environments research conducted before July 2015 in Canada. Specifically, this review describes research foci and key findings, identifies knowledge gaps and suggests future directions for research. A search of published literature concerning Canadian investigations of retail food environment settings (food stores, restaurants) was conducted in July 2015 using PubMed, Web of Science, Scopus, PsychInfo and ERIC. Studies published in English that reported qualitative or quantitative data on any aspect of the retail food environment were included, as were conceptual papers and commentaries. Eighty-eight studies were included in this review and suggest that the field of retail food environments research is rapidly expanding in Canada. While only 1 paper was published before 2005, 66 papers were published between 2010 and 2015. Canadian food environments research typically assessed either the socio-economic patterning of food environments (n = 28) or associations between retail food environments and diet, anthropometric or health outcomes (n = 33). Other papers profiled methodological research, qualitative studies, intervention research and critical commentaries (n = 27). Key gaps in the current literature include measurement inconsistency among studies and a lack of longitudinal and intervention studies. Retail food environments are a growing topic of research, policy and program development in Canada. Consistent methods (where appropriate), longitudinal and intervention research, and close partnerships between researchers and key stakeholders would greatly advance the field of retail food environments research in Canada.

  16. A case of woman abuse: gender ideologies, power paradoxes, and unresolved conflict.

    PubMed

    Rosen, K H; Bird, K

    1996-09-01

    This paper describes some of the complex individual and relationship processes that occurred in an intimate relationship where love and violence coexisted. It presents a longitudinal, qualitative study of a premarital relationship in which the man had been repeatedly violent towards his female partner. It describes how gender role ideologies, the distribution of power between partners, and unresolved conflict are related to each other and to the emergence of violence and maintenance of couple bonds. A grounded theory approach was used to collect and analyze data for this single case and qualitative study in which both partners were interviewed several times each over the course of 1.5 years. Overall, it was found that intimate relationships that become contexts for expressions of love and violence are indeed complex, and the flexibility to consider the complexities that are involved provide a context for developing creative solutions.

  17. [Effect of work and organizational characteristics on workers in call centers: longitudinal study in an information service company].

    PubMed

    Tei, Maki; Yamazaki, Yoshihiko

    2005-09-01

    To investigate the effect of work and organizational characteristics on workers' health status, with job dissatisfaction and intentions to leave as "organizational health", we conducted a longitudinal study using a questionnaire survey in call centers of an information service company from July to August in 2001 and 2002. The response rates were 96.2% and 92.0%, respectively. For the statistical analysis, the completed data of 296 technical support staff, which was more than 80% of the data, was used. We identified seven subscales composed of 29 items of work and organizational characteristics as scales of "organizational characteristics" and "work and workplace characteristics". The results of hierarchical multiple regression analysis showed quantitative and qualitative job-overload influenced psychological health status and poor supervisor support influenced all outcome variables. Moreover, "organizational characteristics" influenced cumulative fatigue and job dissatisfaction, showing an indirect effect with poor supervisor support and coworker support. This study suggests that measures of work and organizational characteristics are useful interventions for "organizational health".

  18. A qualitative study of relationships among parenting strategies, social capital, the juvenile justice system, and mental health care for at-risk African American male youth.

    PubMed

    Richardson, Joseph B; Brakle, Mischelle Van

    2011-10-01

    For many poor, African American families living in the inner city, the juvenile justice system has become a de facto mental health service provider. In this article, longitudinal, ethnographic study methods were used to examine how resource-deprived, inner-city parents in a New York City community relied on the juvenile justice system to provide their African American male children with mental health care resources. The results of three case studies indicate that this strategy actually contributed to an escalation in delinquency among the youth.

  19. Readiness for Delivering Digital Health at Scale: Lessons From a Longitudinal Qualitative Evaluation of a National Digital Health Innovation Program in the United Kingdom.

    PubMed

    Lennon, Marilyn R; Bouamrane, Matt-Mouley; Devlin, Alison M; O'Connor, Siobhan; O'Donnell, Catherine; Chetty, Ula; Agbakoba, Ruth; Bikker, Annemieke; Grieve, Eleanor; Finch, Tracy; Watson, Nicholas; Wyke, Sally; Mair, Frances S

    2017-02-16

    Digital health has the potential to support care delivery for chronic illness. Despite positive evidence from localized implementations, new technologies have proven slow to become accepted, integrated, and routinized at scale. The aim of our study was to examine barriers and facilitators to implementation of digital health at scale through the evaluation of a £37m national digital health program: ‟Delivering Assisted Living Lifestyles at Scale" (dallas) from 2012-2015. The study was a longitudinal qualitative, multi-stakeholder, implementation study. The methods included interviews (n=125) with key implementers, focus groups with consumers and patients (n=7), project meetings (n=12), field work or observation in the communities (n=16), health professional survey responses (n=48), and cross program documentary evidence on implementation (n=215). We used a sociological theory called normalization process theory (NPT) and a longitudinal (3 years) qualitative framework analysis approach. This work did not study a single intervention or population. Instead, we evaluated the processes (of designing and delivering digital health), and our outcomes were the identified barriers and facilitators to delivering and mainstreaming services and products within the mixed sector digital health ecosystem. We identified three main levels of issues influencing readiness for digital health: macro (market, infrastructure, policy), meso (organizational), and micro (professional or public). Factors hindering implementation included: lack of information technology (IT) infrastructure, uncertainty around information governance, lack of incentives to prioritize interoperability, lack of precedence on accountability within the commercial sector, and a market perceived as difficult to navigate. Factors enabling implementation were: clinical endorsement, champions who promoted digital health, and public and professional willingness. Although there is receptiveness to digital health, barriers to mainstreaming remain. Our findings suggest greater investment in national and local infrastructure, implementation of guidelines for the safe and transparent use and assessment of digital health, incentivization of interoperability, and investment in upskilling of professionals and the public would help support the normalization of digital health. These findings will enable researchers, health care practitioners, and policy makers to understand the current landscape and the actions required in order to prepare the market and accelerate uptake, and use of digital health and wellness services in context and at scale. ©Marilyn R Lennon, Matt-Mouley Bouamrane, Alison M Devlin, Siobhan O'Connor, Catherine O'Donnell, Ula Chetty, Ruth Agbakoba, Annemieke Bikker, Eleanor Grieve, Tracy Finch, Nicholas Watson, Sally Wyke, Frances S Mair. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.02.2017.

  20. Perceived classism and its relation with socioeconomic status, health, health behaviours and perceived inferiority: the Dutch Longitudinal Internet Studies for the Social Sciences (LISS) panel.

    PubMed

    Simons, Audrey M W; Koster, Annemarie; Groffen, Daniëlle A I; Bosma, Hans

    2017-05-01

    Classism might be the downside of the prevailing ideologies of individual responsibility for success. However, since studies into perceived classism have mainly been qualitative, little is known about its association with socioeconomic status, health, health behaviours and perceived inferiority, especially in more egalitarian countries. This study, therefore, examined the associations of perceived classism with socioeconomic status, health, health behaviours and perceived inferiority. We used cross-sectional data (2012/2013) from the Dutch Longitudinal Internet Studies for the Social Sciences (LISS) (n = 1540; age 16-90; 46.9 % men). We found that classism was perceived by 18.2 % of the participants, with the lowest income and occupation group most likely to perceive classism (22.0 and 27.5 %, respectively). Perceived classism was significantly associated with poor health (e.g. self-rated health OR = 2.44, 95 % CI = 1.76-3.38) and feelings of inferiority (e.g. shame OR = 4.64, 95 % CI = 3.08-6.98). No significant associations were found with health behaviours. To further examine the role of perceived classism for socioeconomic differences in health and its association with country-level socioeconomic inequalities, prevailing ideologies, and objective opportunities for social mobility, we recommend more longitudinal and international studies with comparable measures of perceived classism.

  1. Perceptions of coping with non-disease-related life stress for women with osteoarthritis: a qualitative analysis

    PubMed Central

    Harris, Melissa L; Byles, Julie E; Townsend, Natalie; Loxton, Deborah

    2016-01-01

    Objective Coping with arthritis-related stress has been extensively studied. However, limited evidence exists regarding coping with stress extraneous to the disease (life stress). This study explored life stress and coping in a subset of older women with osteoarthritis from a larger longitudinal study. Setting An Australian regional university. Design This qualitative study involved semistructured telephone interviews. Potential participants were mailed a letter of invitation/participant information statement by the Australian Longitudinal Study on Women's Health (ALSWH). Invitations were sent out in small batches (primarily 10). Interviews were conducted until data saturation was achieved using a systematic process (n=19). Digitally recorded interviews were transcribed verbatim and deidentified. Data were thematically analysed. Participants Women who indicated being diagnosed or treated for arthritis in the previous 3 years in the fifth survey of the ALSWH (conducted in 2007) provided the sampling frame. Potential participants were randomly sampled by a blinded data manager using a random number generator. Results Coping with life stress involved both attitudinal coping processes developed early in life (ie, stoicism) and transient cognitive and support-based responses. Women also described a dualistic process involving a reduction in the ability to cope with ongoing stress over time, coupled with personal growth. Conclusions This is the first study to examine how individuals cope with non-arthritis-related stress. The findings add to the current understanding of stress and coping, and have implications regarding the prevention of arthritis in women. Importantly, this study highlighted the potential detrimental impact of persistent coping patterns developed early in life. Public health campaigns aimed at stress mitigation and facilitation of adaptive coping mechanisms in childhood and adolescence may assist with arthritis prevention. PMID:27188808

  2. To track or not to track: user reactions to concepts in longitudinal health monitoring.

    PubMed

    Beaudin, Jennifer S; Intille, Stephen S; Morris, Margaret E

    2006-01-01

    Advances in ubiquitous computing, smart homes, and sensor technologies enable novel, longitudinal health monitoring applications in the home. Many home monitoring technologies have been proposed to detect health crises, support aging-in-place, and improve medical care. Health professionals and potential end users in the lay public, however, sometimes question whether home health monitoring is justified given the cost and potential invasion of privacy. The aim of the study was to elicit specific feedback from health professionals and laypeople about how they might use longitudinal health monitoring data for proactive health and well-being. Interviews were conducted with 8 health professionals and 26 laypeople. Participants were asked to evaluate mock data visualization displays that could be generated by novel home monitoring systems. The mock displays were used to elicit reactions to longitudinal monitoring in the home setting as well as what behaviors, events, and physiological indicators people were interested in tracking. Based on the qualitative data provided by the interviews, lists of benefits of and concerns about health tracking from the perspectives of the practitioners and laypeople were compiled. Variables of particular interest to the interviewees, as well as their specific ideas for applications of collected data, were documented. Based upon these interviews, we recommend that ubiquitous "monitoring" systems may be more readily adopted if they are developed as tools for personalized, longitudinal self-investigation that help end users learn about the conditions and variables that impact their social, cognitive, and physical health.

  3. Disability and poverty – Reflections on research experiences in Africa and beyond

    PubMed Central

    Ingstad, Benedicte

    2013-01-01

    Background Whilst broadly agreed in the literature that disability and poverty are closely interlinked, the empirical basis for this knowledge is relatively weak. Objectives To describe and discuss the current state of knowledge and to suggest the need for further generation of knowledge on disability and poverty. Method Two recent attempts at statistically analysing the situation for disabled people and a series of qualitative studies on disability and poverty are applied in a discussion on the state of current knowledge. Results Firstly, the surveys confirm substantial gaps in access to services, and a systematic pattern of lower levels of living amongst individuals with disability as compared to non-disabled. Existing surveys are however not originally set up to study the disability – poverty relationship and thus have some important limitations. Secondly, the qualitative studies have shown the relevance of cultural, political and structural phenomena in relation to poverty and disability, but also the complexity and the contextual character of these forces that may sometimes provide or create opportunities either at the individual or the collective level. Whilst not establishing evidence as such, the qualitative studies contribute to illustrating some of the mechanisms that bring individuals with disability into poverty and keep them there. Conclusions A longitudinal design including both quantitative and qualitative methods and based on the current conceptual understanding of both disability and poverty is suggested to pursue further knowledge generation on the relationship between disability and poverty. PMID:28729985

  4. How and why do patients with Type 1 diabetes sustain their use of flexible intensive insulin therapy? A qualitative longitudinal investigation of patients' self-management practices following attendance at a Dose Adjustment for Normal Eating (DAFNE) course.

    PubMed

    Rankin, D; Cooke, D D; Clark, M; Heller, S; Elliott, J; Lawton, J

    2011-05-01

    Conventional insulin therapy requires patients with Type 1 diabetes to adhere to rigid dietary and insulin injection practices. Recent trends towards flexible intensive insulin therapy enable patients to match insulin to dietary intake and lifestyle; however, little work has examined patients' experiences of incorporating these practices into real-life contexts. This qualitative longitudinal study explored patients' experiences of using flexible intensive insulin therapy to help inform the development of effective long-term support. Semi-structured interviews were conducted with 30 adult patients with Type 1 diabetes following participation in a structured education programme on using flexible intensive insulin therapy, and 6 and 12 months post-course. Longitudinal data analysis used an inductive, thematic approach. Patients consistently reported feeling committed to and wanting to sustain flexible intensive insulin therapy. This regimen was seen as a logical and effective method of self-management, as patients experienced improved blood glucose readings and/or reported feeling better. Implementing and sustaining flexible intensive insulin therapy was enhanced when patients had stable routines, with more challenges reported by those working irregular hours and during weekends/holidays. Some patients re-crafted their lives to make this approach work for them; for instance, by creating dietary routines or adjusting dietary choices. Clinical data have shown that flexible intensive insulin therapy can lead to improvement in glycaemic control. This study, drawing on patients' perspectives, provides further endorsement for flexible intensive insulin therapy by demonstrating patients' liking of, and their motivation to sustain, this approach over time. To help patients implement and sustain flexible intensive insulin therapy, follow-up support should encourage them to identify routines to better integrate this regimen into their lives. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  5. Do Project Pedagogies Make a Difference?

    ERIC Educational Resources Information Center

    Simeone, James; Shaw, Greg M.

    2017-01-01

    Community-based action research (CBAR) encourages students to view internships and other civic-engagement opportunities as the first steps in collaborative projects that build long-term relationships with community partners and model how democracy works. We marshal longitudinal data, qualitative and quantitative, on both attitudes and behaviors to…

  6. Asset Depletion, Chronic Financial Stress, and Mortgage Trouble Among Older Female Homeowners.

    PubMed

    Castro Baker, Amy; West, Stacia; Wood, Anna

    2017-09-08

    The Great Recession disproportionately impacted older adults and women of color, suggesting that women may be entering retirement without adequate assets. However, the current literature lacks a detailed account of women's experiences of mortgage trouble and foreclosure, as well as a longitudinal view of how these experiences impacted their overall financial assets. Grounded in cumulative inequality theory, this mixed methods study employed a QUAL→quan approach to gather qualitative data from a sample of 21 older adult women regarding their experiences of mortgage trouble. Quantitative longitudinal data was gathered for a subsample of the Early Baby Boomer Cohort using the Health and Retirement Study. Qualitative findings indicated women approaching retirement experienced chronic underemployment, wage stagnation, and financial volatility as contributors to asset depletion and eventual mortgage default or foreclosure. Quantitative results indicated asset depletion both during and post-Recession was considerably more pronounced among older adult women of color compared to older adult White men. These findings suggest that a lifetime of financial disadvantage coupled with macroeconomic instability situates older adult women, particularly women of color, in a financially vulnerable position for retirement. The ways in which 2017 attacks on the Consumer Financial Protection Bureau, Dodd-Frank, and the Fiduciary rule carry potential to further destabilize this population are also discussed. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Young registered nurses' intention to leave the profession and professional turnover in early career: a qualitative case study.

    PubMed

    Flinkman, Mervi; Isopahkala-Bouret, Ulpukka; Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29-32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process.

  8. The Qualitative Interview Study of Persistent and Nonpersistent Substance Use in the MTA: Sample Characteristics, Frequent Use, and Reasons for Use.

    PubMed

    Swanson, James M; Wigal, Timothy; Jensen, Peter S; Mitchell, John T; Weisner, Thomas S; Murray, Desiree; Arnold, L Eugene; Hechtman, Lily; Molina, Brooke S G; Owens, Elizabeth B; Hinshaw, Stephen P; Belendiuk, Katherine; Howard, Andrea; Wigal, Sharon B; Sorensen, Page; Stehli, Annamarie

    2017-10-01

    To evaluate participants' perceptions about frequent use and reasons for substance use (SU) in the qualitative interview study, an add-on to the multimodal treatment study of ADHD (MTA). Using the longitudinal MTA database, 39 ADHD cases and 19 peers with Persistent SU, and 86 ADHD cases and 39 peers without Persistent SU were identified and recruited. In adulthood, an open-ended interview was administered, and SU excerpts were indexed and classified to create subtopics (frequent use and reasons for use of alcohol, marijuana, and other drugs). For marijuana, the Persistent compared with Nonpersistent SU group had a significantly higher percentage of participants describing frequent use and giving reasons for use, and the ADHD group compared with the group of peers had a significantly higher percentage giving "stability" as a reason for use. Motivations for persistent marijuana use may differ for adults with and without a history of ADHD.

  9. Children's voices: living with HIV.

    PubMed

    Mawn, Barbara Ellen

    2011-01-01

    To present the findings from a qualitative study that explored living with pediatric HIV from the children's perspectives. The researcher conducted face-to-face interviews with seven HIV-positive children in this nested, phenomenological study. The children's parents were enrolled at the same time in a longitudinal qualitative study, which focused on raising a child with HIV. The children, ages 9 to 13, were interviewed once in the context of their homes. The researcher identified themes based on interview transcriptions. Four major themes emerged: a positive self-perception; varying levels of understanding about HIV; a lack of concern and/or memory about the disclosure process; and an awareness to keep the diagnosis private. Nurses who counsel children living with HIV should be aware that the self-perception of these children varies and may not be focused on their chronic illness. The interpretation of the disclosure process and the understanding of the diagnosis itself may be impacted by memory and developmental changes over time.

  10. You Can Teach an Old Dog New Tricks: A Qualitative Analysis of How Residents of Senior Living Communities May Use the Web to Overcome Spatial and Social Barriers*

    PubMed Central

    Winstead, Vicki; Anderson, William A.; Yost, Elizabeth A.; Cotten, Shelia R.; Warr, Amanda; Berkowsky, Ronald W.

    2017-01-01

    For adults in senior living communities, information and communication technologies, (ICTs) can be used to increase and expand communication for a population that is often spatially and socially separated from the general public. Using qualitative observational data from a longitudinal study of the impact of ICT usage on the quality of life among residents in assisted and independent living communities, we examine whether ICTs can mitigate the effects of social and spatial barriers. We find that ICTs have the potential to allow individuals to transcend social and spatial barriers, providing residents with the ability to maintain and enhance social networks as well as provide a greater sense of connection to the world at large. PMID:25474761

  11. The Nun Study and Alzheimer's disease: Quality of vocation as a potential protective factor?

    PubMed

    Keohane, Kieran; Balfe, Myles

    2017-01-01

    Data from the Nun Study, the most famous longitudinal epidemiology of Alzheimer's disease to date, are analyzed and reformulated in terms of Max Weber's discussion of the centrality of beruf - "calling" - fulfilling a life task in pursuit of a vocation. Qualitative differences in the Nuns' vocations are uncovered, which are correlated to their resilience to dementia. Extrapolating, we argue that Alzheimer's disease and the dementia reputed to it should be understood as a social pathology of contemporary civilization related to the loss of moral foundations from which coherent, meaningful life-projects can be conducted.

  12. Professional development utilizing an oncology summer nursing internship.

    PubMed

    Mollica, Michelle; Hyman, Zena

    2016-01-01

    The aim of this study was to examine the effect of an oncology student nursing internship on role socialization and professional self-concept. This mixed-methods study utilized a convergent parallel approach that incorporated a quasi-experimental and qualitative design. Data was collected through pre and post-survey and open-ended questions. Participants were 11 baccalaureate nursing students participating in a summer oncology student nursing internship between their junior and senior years. Investigators completed a content analysis of qualitative questionnaires resulted in categories of meaning, while the Wilcoxon signed-ranks test was used to compare pre and post internship scores. Aggregated mean scores from all instruments showed an increase in professionalism, role socialization, and sense of belonging from pre to post-internship, although no differences were significant. Qualitative data showed participants refined their personal philosophy of nursing and solidified their commitment to the profession. Participants did indicate, however, that the internship, combined with weekly debriefing forums and conferences, proved to have a positive impact on the students' role socialization and sense of belonging. Despite quantitative results, there is a need for longitudinal research to confirm the effect of nursing student internships on the transition from student to professional. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. “This is a kind of betrayal”: a qualitative study of disability after breast cancer

    PubMed Central

    Thomas–MacLean, R.; Towers, A.; Quinlan, E.; Hack, T.F.; Kwan, W.; Miedema, B.; Tilley, A.; Graham, P.

    2009-01-01

    Objective We proposed to document the effect of arm morbidity and disability in 40 Canadian women who were 12–24 months post breast cancer surgery. Methods We completed 40 qualitative interviews as one component of a multidisciplinary national longitudinal study of arm morbidity after breast cancer (n = 745) involving four research sites (Fredericton/Saint John, Montreal, Winnipeg, Surrey). During semi-structured interviews, participants who had reported arm morbidity and disability in earlier surveys were asked to discuss the effects of these conditions on everyday life. Results The interviewees reported making major adjustments to paid and unpaid work, which often involved the assistance of family members, thus demonstrating the effect of disability. Interview data resulted in the creation of a model that addresses arm morbidity and disability, and that holds implications for health care professionals. Conclusions Based on the interview findings, we conclude that a robust measure of disability after breast cancer should be developed. In the absence of a validated measure of the effect of disability, evaluating qualitative responses to questions about everyday activities could provide the impetus for provision of physical therapy and emotional support. PMID:19526082

  14. Strain rate, temperature, and humidity on strength and moduli of a graphite/epoxy composite

    NASA Technical Reports Server (NTRS)

    Lifshitz, J. M.

    1981-01-01

    Results of an experimental study of the influence of strain rate, temperature and humidity on the mechanical behavior of a graphite/epoxy fiber composite are presented. Three principal strengths (longitudinal, transverse and shear) and four basic moduli (E1, E2, G12 and U12) of a unidirectional graphite/epoxy composite were followed as a function of strain rate, temperature and humidity. Each test was performed at a constant tensile strain rate in an environmental chamber providing simultaneous temperature and humidity control. Prior to testing, specimens were given a moisture preconditioning treatment at 60 C. Values for the matrix dominated moduli and strength were significantly influenced by both environmental and rate parameters, whereas the fiber dominated moduli were not. However, the longitudinal strength was significantly influenced by temperature and moisture content. A qualitative explanation for these observations is presented.

  15. Central nervous system antiretroviral efficacy in HIV infection: a qualitative and quantitative review and implications for future research.

    PubMed

    Cysique, Lucette A; Waters, Edward K; Brew, Bruce J

    2011-11-22

    There is conflicting information as to whether antiretroviral drugs with better central nervous system (CNS) penetration (neuroHAART) assist in improving neurocognitive function and suppressing cerebrospinal fluid (CSF) HIV RNA. The current review aims to better synthesise existing literature by using an innovative two-phase review approach (qualitative and quantitative) to overcome methodological differences between studies. Sixteen studies, all observational, were identified using a standard citation search. They fulfilled the following inclusion criteria: conducted in the HAART era; sample size > 10; treatment effect involved more than one antiretroviral and none had a retrospective design. The qualitative phase of review of these studies consisted of (i) a blind assessment rating studies on features such as sample size, statistical methods and definitions of neuroHAART, and (ii) a non-blind assessment of the sensitivity of the neuropsychological methods to HIV-associated neurocognitive disorder (HAND). During quantitative evaluation we assessed the statistical power of studies, which achieved a high rating in the qualitative analysis. The objective of the power analysis was to determine the studies ability to assess their proposed research aims. After studies with at least three limitations were excluded in the qualitative phase, six studies remained. All six found a positive effect of neuroHAART on neurocognitive function or CSF HIV suppression. Of these six studies, only two had statistical power of at least 80%. Studies assessed as using more rigorous methods found that neuroHAART was effective in improving neurocognitive function and decreasing CSF viral load, but only two of those studies were adequately statistically powered. Because all of these studies were observational, they represent a less compelling evidence base than randomised control trials for assessing treatment effect. Therefore, large randomised trials are needed to determine the robustness of any neuroHAART effect. However, such trials must be longitudinal, include the full spectrum of HAND, ideally carefully control for co-morbidities, and be based on optimal neuropsychology methods.

  16. Clustering and switching processes in semantic verbal fluency in the course of Alzheimer's disease subjects: results from the PAQUID longitudinal study.

    PubMed

    Raoux, Nadine; Amieva, Hélène; Le Goff, Mélanie; Auriacombe, Sophie; Carcaillon, Laure; Letenneur, Luc; Dartigues, Jean-François

    2008-10-01

    Reduced semantic fluency performances have been reported in the preclinical phase of Alzheimer's disease (AD). To investigate the cognitive processes underlying this early deficit, this study analyzed the verbal production of predemented subjects for the animals category with the qualitative parameters related to clustering (i.e. the ability to generate words belonging to semantic subcategories of animals) and switching (i.e. the ability to shift from one subcategory to another) proposed by Troyer. This qualitative analysis was applied to the PAQUID (Personnes Agées QUID) cohort, a 17-year longitudinal population-based study. The performances on the animal verbal fluency task of 51 incident cases of possible and probable AD were analyzed at the onset of dementia, 2 years and 5 years before dementia onset. Each case was matched for age, sex and education to two control subjects leading to a sample of 153 subjects. The mean cluster size and the raw number of switches were compared in the two samples. The results revealed a significantly lower switching index in the future AD subjects than in the elderly controls including 5 years before dementia incidence. A significant decline in this parameter was evidenced all along the prodromal phase until the clinical diagnosis of dementia. In contrast, the mean cluster size could not discriminate the two groups. Therefore the results support the hypothesis that impaired shifting abilities - rather than semantic memory storage degradation - could explain the early decline in semantic fluency performance occurring in the predementia phase of AD.

  17. Longitudinal qualitative study describing family physicians' experiences with attempting to integrate physical activity prescriptions in their practice: 'It's not easy to change habits'.

    PubMed

    Bélanger, Mathieu; Phillips, Emily Wolfe; O'Rielly, Connor; Mallet, Bertin; Aubé, Shane; Doucet, Marylène; Couturier, Jonathan; Mallet, Maxime; Martin, Jessica; Gaudet, Christine; Murphy, Nathalie; Brunet, Jennifer

    2017-07-13

    Physical activity (PA) prescriptions provided by family physicians can promote PA participation among patients, but few physicians regularly write PA prescriptions. The objective of this study was to describe family physicians' experiences of trying to implement written PA prescriptions into their practice. Longitudinal qualitative study where participants were interviewed four times during a 12-month period. After the first interview, they were provided with PA prescription pads. Data were analysed using thematic analysis. Family medicine clinics in New Brunswick, Canada. Family physicians (n=11) with no prior experience writing PA prescriptions, but who expressed interest in changing their practice to implement written PA prescriptions. Initially, participants exhibited confidence in their ability to write PA prescriptions in the future and intended to write prescriptions. However, data from the follow-up interviews indicated that the rate of implementation was lower than anticipated by participants and prescriptions were not part of their regular practice. Two themes emerged as factors explaining the gap between their intentions and behaviours: (1) uncertainty about the effectiveness of written PA prescription, and (2) practical concerns (eg, changing well-established habits, time constraints, systemic institutional barriers). It may be effective to increase awareness among family physicians about the effectiveness of writing PA prescriptions and address barriers related to how their practice is organised in order to promote written PA prescription rates. © 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.

  18. Exploring and comparing the experience and coping behaviour of men and women with colorectal cancer after chemotherapy treatment: a qualitative longitudinal study.

    PubMed

    McCaughan, Eilis; Prue, Gillian; Parahoo, Kader; McIlfatrick, Sonja; McKenna, Hugh

    2012-01-01

    Men have higher incidence and mortality rates for nearly all cancers. They are less likely than women to utilise cancer information services and other social support services. The aim of this study was to explore and compare the experience and coping behaviour of men and women after treatment for colorectal cancer (CRC). A longitudinal qualitative study was conducted involving 38 individuals (24 men and 14 women) with CRC. Data were generated using semi-structured interviews at four time points over an 18-month period, post-diagnosis. Interviews focused on participant's experience of CRC and on how gender affected their coping. This paper reports the findings of interviews 3 and 4 which examined the participant's experience after chemotherapy. Three themes emerged from the interviews ('new normal', living with uncertainty and support needs). Many men and women reacted similarly; however, there was some variation evident between and within sexes. The main difference was with regard to the long-term physical side effects of the illness. Many women admitted to still experiencing side effects, whereas many men indicated that they had no problems. These men engaged in practices that aligned with their gender identity and view of masculinity. It must be noted that some men and women were still experiencing an impact. Recovery from the physical and psychological effects of CRC does not occur simultaneously. Healthcare professionals should be aware that not all men (or women) conform to the social stereotypes of masculinity (or femininity). Copyright © 2010 John Wiley & Sons, Ltd.

  19. International Service and Public Health Learning Objectives for Medical Students

    ERIC Educational Resources Information Center

    Block, Robert C.; Duron, Vincent; Creigh, Peter; McIntosh, Scott

    2013-01-01

    Objective: We aimed to improve the education of medical students involved in a longitudinal perinatal health improvement project in Gowa, Malawi. Design: We conducted qualitative interviews with students who participated in the project, reviewed their quantitative reports, and assessed the application of methodologies consonant with the learning…

  20. Enhancing Student Learning through Scaffolded Client Projects

    ERIC Educational Resources Information Center

    Tomlinson, Elizabeth

    2017-01-01

    This article reports on the current status of client projects (CPs) in business communication courses, provides a scaffolded model for implementing CP, and assesses student learning in CPs. Using a longitudinal mixed method research design, survey data and qualitative materials from six semesters are presented. The instructor survey indicated need…

  1. Young People with Health Conditions and the Inclusive Education Problematic

    ERIC Educational Resources Information Center

    Yates, Lyn

    2014-01-01

    This article revisits debates about inclusive education from the perspective of the "Keeping Connected" project, a qualitative longitudinal research project focusing on young people with health-related disrupted experiences of schooling. Drawing on findings from this project, three main arguments are advanced and illustrated in relation…

  2. Music Acquisition of Children in Rural Zimbabwe: A Longitudinal Observation.

    ERIC Educational Resources Information Center

    Kreutzer, Natalie Jones

    2001-01-01

    This article provides qualitative description of behaviors that bring children to musical competence by age 5 in Nharira Communal Lands in Zimbabwe. Based on observation of three villages comprised of multiple extended family groups, the narrative focuses on area demographics, the community's people, musical influences, musical interactions of…

  3. Reaching Resisters in a Teaching Assistant Training Program

    ERIC Educational Resources Information Center

    Brown, Carolyn I.

    2016-01-01

    In the past decade, there has been limited longitudinal qualitative research examining the effects of training programs on graduate students' teaching performance. One gap in this research is a discussion of Teaching Assistants (TAs) who resist such programs and an examination of strategies for overcoming this resistance. This action research…

  4. The Texas saltwater angler population: a longitudinal perspective (1989-2005)

    Treesearch

    Yung-Ping (Emilio) Tseng; Robert B. Ditton

    2007-01-01

    This paper focuses on selected human dimensions indicators of the Texas recreational fishery using the Index of Qualitative Variation (IQV) and Spearman Rank-Order Correlation Coefficient. Minority (Hispanic, Spanish, and females) participation and the overall participation rate in saltwater fishing did not keep pace with a dramatic population...

  5. Longitudinal spiritual coping with trauma in people with HIV: implications for health care.

    PubMed

    Kremer, Heidemarie; Ironson, Gail

    2014-03-01

    This 10-year study (N=177) examines how people with HIV use spirituality to cope with life's trauma on top of HIV-related stress (e.g., facing death, stigma, poverty, limited healthcare) usual events. Spirituality, defined as a connection to a higher presence, is independent from religion (institutionalized spirituality). As a dynamic adaptive process, coping requires longitudinal studying. Qualitative content-analysis of interviews/essays yielded a coding of specific aspects and a longitudinal rating of overall spiritual coping. Most participants were rated as spiritual, using spiritual practices, about half experienced comfort, empowerment, growth/transformation, gratitude, less than one-third meaning, community, and positive reframing. Up to one-fifth perceived spiritual conflict, struggle, or anger, triggering post-traumatic stress, which sometimes converted into positive growth/transformation later. Over time, 65% used spiritual coping positively, 7% negatively, and 28% had no significant use. Spirituality was mainly beneficial for women, heterosexuals, and African Americans (p<0.05). Results suggest that spirituality is a major source of positive and occasionally negative coping (e.g., viewing HIV as sin). We discuss how clinicians can recognize and prevent when spirituality is creating distress and barriers to HIV treatment, adding a literature review on ways of effective spiritual assessment. Spirituality may be a beneficial component of coping with trauma, considering socio-cultural contexts.

  6. A longitudinal medical Spanish program at one US medical school.

    PubMed

    Reuland, Daniel S; Frasier, Pamela Y; Slatt, Lisa M; Alemán, Marco A

    2008-07-01

    Policymakers have recommended recruiting or training (or both) more US physicians who can provide care in Spanish. Few longitudinal medical Spanish programs have been described and evaluated. This study aims to describe development and evaluation of the preclinical phase of a 4-y program designed to graduate physicians who can provide language-concordant care in Spanish. Study was done in one public medical school in southeastern USA. The program targeted intermediate/advanced Spanish speakers. Standardized fluency assessments were used to determine eligibility and evaluate participants' progress. Curriculum included didactic coursework, simulated patients, socio-cultural seminars, clinical skills rotations at sites serving Latinos, service-learning, and international immersion. For the first two cohorts (n = 45) qualitative evaluation identified program improvement opportunities and found participants believed the program helped them maintain their Spanish skills. Mean interim (2-y) speaking proficiency scores were unchanged from baseline: 9.0 versus 8.7 at baseline on 12-point scale (p = 0.15). Mean interim listening comprehension scores (second cohort only, n = 25) increased from a baseline of 77 to 86% (p = 0.003). Proportions "passing" the listening comprehension test increased from 72 to 92% (p = 0.06). We describe development of a longitudinal Spanish program within a medical school. Participation was associated with improved Spanish listening comprehension and no change in speaking proficiency.

  7. When mixed methods produce mixed results: integrating disparate findings about miscarriage and women's wellbeing.

    PubMed

    Lee, Christina; Rowlands, Ingrid J

    2015-02-01

    To discuss an example of mixed methods in health psychology, involving separate quantitative and qualitative studies of women's mental health in relation to miscarriage, in which the two methods produced different but complementary results, and to consider ways in which the findings can be integrated. We describe two quantitative projects involving statistical analysis of data from 998 young women who had had miscarriages, and 8,083 who had not, across three waves of the Australian Longitudinal Study on Women's Health. We also describe a qualitative project involving thematic analysis of interviews with nine Australian women who had had miscarriages. The quantitative analyses indicate that the main differences between young women who do and do not experience miscarriage relate to social disadvantage (and thus likelihood of relatively early pregnancy) and to a lifestyle that makes pregnancy likely: Once these factors are accounted for, there are no differences in mental health. Further, longitudinal modelling demonstrates that women who have had miscarriages show a gradual increase in mental health over time, with the exception of women with prior diagnoses of anxiety, depression, or both. By contrast, qualitative analysis of the interviews indicates that women who have had miscarriages experience deep emotional responses and a long and difficult process of coming to terms with their loss. A contextual model of resilience provides a possible framework for understanding these apparently disparate results. Considering positive mental health as including the ability to deal constructively with negative life events, and consequent emotional distress, offers a model that distinguishes between poor mental health and the processes of coping with major life events. In the context of miscarriage, women's efforts to struggle with difficult emotions, and search for meaning, can be viewed as pathways to resilience rather than to psychological distress. Statement of contribution What is already known on this subject? Quantitative research shows that women who miscarry usually experience moderate depression and anxiety, which persists for around 6 months. Qualitative research shows that women who miscarry frequently experience deep grief, which can last for years. What does this study add? We consider ways in which these disparate findings might triangulate. The results suggest a need to distinguish between poor mental health and the experience of loss and grief. Adjusting to miscarriage is often emotionally challenging but not always associated with poor mental health. © 2014 The British Psychological Society.

  8. A Qualitative Analysis of Narrative Preclerkship Assessment Data to Evaluate Teamwork Skills.

    PubMed

    Dolan, Brigid M; O'Brien, Celia Laird; Cameron, Kenzie A; Green, Marianne M

    2018-04-16

    Construct: Students entering the health professions require competency in teamwork. Although many teamwork curricula and assessments exist, studies have not demonstrated robust longitudinal assessment of preclerkship students' teamwork skills and attitudes. Assessment portfolios may serve to fill this gap, but it is unknown how narrative comments within portfolios describe student teamwork behaviors. We performed a qualitative analysis of narrative data in 15 assessment portfolios. Student portfolios were randomly selected from 3 groups stratified by quantitative ratings of teamwork performance gathered from small-group and clinical preceptor assessment forms. Narrative data included peer and faculty feedback from these same forms. Data were coded for teamwork-related behaviors using a constant comparative approach combined with an identification of the valence of the coded statements as either "positive observation" or "suggestion for improvement." Eight codes related to teamwork emerged: attitude and demeanor, information facilitation, leadership, preparation and dependability, professionalism, team orientation, values team member contributions, and nonspecific teamwork comments. The frequency of codes and valence varied across the 3 performance groups, with students in the low-performing group receiving more suggestions for improvement across all teamwork codes. Narrative data from assessment portfolios included specific descriptions of teamwork behavior, with important contributions provided by both faculty and peers. A variety of teamwork domains were represented. Such feedback as collected in an assessment portfolio can be used for longitudinal assessment of preclerkship student teamwork skills and attitudes.

  9. Qualitative simulation of bathymetric changes due to reservoir sedimentation: A Japanese case study

    PubMed Central

    Dai, Wenhong; Larson, Magnus; Beebo, Qaid Naamo; Xie, Qiancheng

    2017-01-01

    Sediment-dynamics modeling is a useful tool for estimating a dam’s lifespan and its cost–benefit analysis. Collecting real data for sediment-dynamics analysis from conventional field survey methods is both tedious and expensive. Therefore, for most rivers, the historical record of data is either missing or not very detailed. Available data and existing tools have much potential and may be used for qualitative prediction of future bathymetric change trend. This study shows that proxy approaches may be used to increase the spatiotemporal resolution of flow data, and hypothesize the river cross-sections and sediment data. Sediment-dynamics analysis of the reach of the Tenryu River upstream of Sakuma Dam in Japan was performed to predict its future bathymetric changes using a 1D numerical model (HEC-RAS). In this case study, only annually-averaged flow data and the river’s longitudinal bed profile at 5-year intervals were available. Therefore, the other required data, including river cross-section and geometry and sediment inflow grain sizes, had to be hypothesized or assimilated indirectly. The model yielded a good qualitative agreement, with an R2 (coefficient of determination) of 0.8 for the observed and simulated bed profiles. A predictive simulation demonstrated that the useful life of the dam would end after the year 2035 (±5 years), which is in conformity with initial detailed estimates. The study indicates that a sediment-dynamic analysis can be performed even with a limited amount of data. However, such studies may only assess the qualitative trends of sediment dynamics. PMID:28384361

  10. Qualitative simulation of bathymetric changes due to reservoir sedimentation: A Japanese case study.

    PubMed

    Bilal, Ahmed; Dai, Wenhong; Larson, Magnus; Beebo, Qaid Naamo; Xie, Qiancheng

    2017-01-01

    Sediment-dynamics modeling is a useful tool for estimating a dam's lifespan and its cost-benefit analysis. Collecting real data for sediment-dynamics analysis from conventional field survey methods is both tedious and expensive. Therefore, for most rivers, the historical record of data is either missing or not very detailed. Available data and existing tools have much potential and may be used for qualitative prediction of future bathymetric change trend. This study shows that proxy approaches may be used to increase the spatiotemporal resolution of flow data, and hypothesize the river cross-sections and sediment data. Sediment-dynamics analysis of the reach of the Tenryu River upstream of Sakuma Dam in Japan was performed to predict its future bathymetric changes using a 1D numerical model (HEC-RAS). In this case study, only annually-averaged flow data and the river's longitudinal bed profile at 5-year intervals were available. Therefore, the other required data, including river cross-section and geometry and sediment inflow grain sizes, had to be hypothesized or assimilated indirectly. The model yielded a good qualitative agreement, with an R2 (coefficient of determination) of 0.8 for the observed and simulated bed profiles. A predictive simulation demonstrated that the useful life of the dam would end after the year 2035 (±5 years), which is in conformity with initial detailed estimates. The study indicates that a sediment-dynamic analysis can be performed even with a limited amount of data. However, such studies may only assess the qualitative trends of sediment dynamics.

  11. Protocol for a longitudinal qualitative study: survivors of childhood critical illness exploring long-term psychosocial well-being and needs—The SCETCH Project

    PubMed Central

    Manning, Joseph C; Hemingway, Pippa; Redsell, Sarah A

    2014-01-01

    Introduction Life-threatening critical illness affects over a quarter of a million children and adolescents (0–18 years old) annually in the USA and the UK. Death from critical illness is rare; however, survivors and their families can be exposed to a complex array of negative physical, psychological and social problems. Currently, within the literature, there is a distinct paucity of child and adolescent survivor self-reports, thus limiting our understanding of how survivors perceive this adversity and subsequently cope and grow in the long-term following their critical illness. This study aims to explore and understand psychosocial well-being and needs of critical illness survivors, 6–20 months post paediatric intensive care admission. Methods and analysis A longitudinal, qualitative approach will provide a platform for a holistic and contextualised exploration of outcomes and mechanisms at an individual level. Up to 80 participants, including 20 childhood critical illness survivors and 60 associated family members or health professionals/teachers, will be recruited. Three interviews, 7–9 weeks apart, will be conducted with critical illness survivors, allowing for the exploration of psychosocial well-being over time. A single interview will be conducted with the other participants enabling the exploration of contextual information and how psychosocial well-being may inter-relate between critical illness survivors and themselves. A ‘tool box’ of qualitative methods (semi-structured interviews, draw and tell, photo-elicitation, graphic-elicitation) will be used to collect data. Narrative analysis and pattern matching will be used to identify emergent themes across participants. Ethics and dissemination This study will provide an insight and understanding of participants’ experiences and perspectives of surviving critical illness in the long term with specific relation to their psychosocial well-being. Multiple methods will be used to ensure that the findings are effectively disseminated to service users, clinicians, policy and academic audiences. The study has full ethical approval from the East Midlands Research Ethics Committee and has received National Health Service (NHS) governance clearance. PMID:24435896

  12. The real-world problem of care coordination: a longitudinal qualitative study with patients living with advanced progressive illness and their unpaid caregivers.

    PubMed

    Daveson, Barbara A; Harding, Richard; Shipman, Cathy; Mason, Bruce L; Epiphaniou, Eleni; Higginson, Irene J; Ellis-Smith, Clare; Henson, Lesley; Munday, Dan; Nanton, Veronica; Dale, Jeremy R; Boyd, Kirsty; Worth, Allison; Barclay, Stephen; Donaldson, Anne; Murray, Scott

    2014-01-01

    To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. Three cases from contrasting primary, secondary and tertiary settings within Britain. Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients' and caregivers' needs, preferences, circumstances and abilities. Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients' and caregivers' views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding oversimplification can help with the development, evaluation and implementation of real-world coordination interventions for patients and their unpaid caregivers in the future.

  13. Effect of drug law enforcement on drug market violence: a systematic review.

    PubMed

    Werb, Dan; Rowell, Greg; Guyatt, Gordon; Kerr, Thomas; Montaner, Julio; Wood, Evan

    2011-03-01

    Violence is amongst the primary concerns of communities around the world and research has demonstrated links between violence and the illicit drug trade, particularly in urban settings. Given the growing emphasis on evidence-based policy-making, and the ongoing severe drug market violence in Mexico and other settings, we conducted a systematic review to examine the impacts of drug law enforcement on drug market violence. We conducted a systematic review using Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Specifically, we undertook a search of English language electronic databases (Academic Search Complete, PubMed, PsycINFO, EMBASE, Web of Science, Sociological Abstracts, Social Service Abstracts, PAIS International and Lexis-Nexis), the Internet (Google, Google Scholar), and article reference lists, from database inception to January 24, 2011. Overall, 15 studies were identified that evaluated the impact of drug law enforcement on drug market violence, including 11 (73%) longitudinal analyses using linear regression, 2 (13%) mathematical drug market models, and 2 (13%) qualitative studies. Fourteen (93%) studies reported an adverse impact of drug law enforcement on levels of violence. Ten of the 11 (91%) studies employing longitudinal qualitative analyses found a significant association between drug law enforcement and drug market violence. Our findings suggest that increasing drug law enforcement is unlikely to reduce drug market violence. Instead, the existing evidence base suggests that gun violence and high homicide rates may be an inevitable consequence of drug prohibition and that disrupting drug markets can paradoxically increase violence. In this context, and since drug prohibition has not meaningfully reduced drug supply, alternative regulatory models will be required if drug supply and drug market violence are to be meaningfully reduced. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Understanding why people do or do not engage in activities following total joint replacement: a longitudinal qualitative study.

    PubMed

    Webster, F; Perruccio, A V; Jenkinson, R; Jaglal, S; Schemitsch, E; Waddell, J P; Venkataramanan, V; Bytautas, J; Davis, A M

    2015-06-01

    Numerous studies report large and significant improvements in basic mobility and activities of daily living following total hip or knee replacement (TJR). Nevertheless, quantitative research has shown minimal increase in participation in activities that benefit overall health. This study explored why people do or do not engage in activities following hip or knee TJR. This was a longitudinal qualitative study. Sampling was guided by constructivist grounded theory and data collected using open-ended, semi-structured interviews. Participants were recruited using maximum variation sampling based on age, sex and joint replaced (hip or knee). Data were analysed using a constant comparative approach and coded for thematic patterns and relationships from which overarching themes were constructed. Twenty-nine patients participated in interviews prior to, and 8 and 18 months post following TJR. A high degree of variability with regard to participants' return to activities was found and five emergent themes were identified that accounted for this variability. These themes highlight the importance of issues beyond medical factors alone, such as socio-cultural factors that partially determine participants' participation in activity following TJR. Findings suggest that multi-faceted experiences impact participation in activity following TJR. These experiences include changes in identity and lifestyle that preclude a 'return to normal'. There is an urgent need for supports to increase people's activity post-TJR in order to facilitate enhancement of post-surgery levels of engagement. Approaches that take into consideration more personalized interventions may be critical to promoting healthy aging in people with TJR. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  15. Intervention for aggressive victims of school bullying in Hong Kong: a longitudinal mixed-methods study.

    PubMed

    Fung, Annis Lai-Chu

    2012-08-01

    The distinction between aggressive and passive victims of school bullying is well documented. Aggressive victims exhibit restlessness and hot-temperedness, are easily provoked, and take revenge when irritated, whereas passive victims are quiet and timid when attacked or insulted and withdraw rather than retaliate. To date, there has been no evidence-based evaluative study examining interventions designed specifically to reduce aggressive victimization, and neither has there been an inclusive assessment screening of high-risk aggressive victims prior to intervention. This study addressed these research gaps by employing multi-stage assessment procedures and a mixed-mode methodology in a one-year longitudinal design. Data were collected from student self-reports, parent and teacher rating scales, and individual structured interviews with students, parents and teachers. A total of 269 potential high-risk aggressive victims were identified from among 5,089 schoolchildren, 68 of whom were screened out and randomly assigned to 10 treatment groups, with 39 completing a one-year follow-up study. Multivariate analysis of variance identified significant improvements in physical and verbal victimization (F(2,47, 93.99) = 10.73, p < 0.01), verbal victimization (F(2.74, 104.14) = 12.80, p < 0.01) and social exclusion scores at the three follow-up assessments compared to the pre-treatment scores, and the qualitative results were consistent, showing participants' cognition, emotion, and behavior to have been positively reconstructed by the group intervention. The consistent quantitative and qualitative results confirm that the cognitive-behavioral group therapy program reported herein is effective in reducing aggressive victims' anxious and depressed emotions and reactive cognition. © 2012 The Author. Scandinavian Journal of Psychology © 2012 The Scandinavian Psychological Associations.

  16. X-ray magneto-optic KERR effect studies of spring magnet heterostructures.

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

    Kortright, J. B.; Kim, S.-K.; Fullerton, E. E.

    2000-11-01

    The complex 3-dimensional magnetization reversal behavior of Sin-Co/Fe exchange spring films is used to test the sensitivity of different resonant soft x-ray magneto-optical Kerr effect (MOKE) measurements to changes in longitudinal and transverse moments within the SOIIFe layer and to changes in these moments in depth within the Fe layer. As in the visible MOKE, changes in longitudinal and net transverse moments are resolved by measuring both Kerr rotation and intensity loops in the near the Fe 2p core resonance. These x-ray MOKE signals measured using linear incident polarization are more directly interpreted in terms of longitudinal and transverse momentsmore » than are the same signals measured using elliptical polarization. Varying photon energy near the Fe L3line is shown to be an effective means of resolving distinctly different reversal behavior at the top and bottom of the 20 nm thick Fe layer resulting from the strong exchange coupling at the Sin-Co/Fe interface. Measured x-ray MOKE spectra and signals are in qualitative agreement with those calculated using standard magneto-optical formalisms incorporating interference between different layers and measured helicity-dependent magneto-optical constants for Fe.« less

  17. Interpersonal social responsibility model of service learning: A longitudinal study.

    PubMed

    Lahav, Orit; Daniely, Noa; Yalon-Chamovitz, Shira

    2018-01-01

    Service-learning (SL) is commonly used in Occupational Therapy (OT) programs worldwide as a community placement educational strategy. However, most SL models are not clearly defined in terms of both methodology and learning outcomes. This longitudinal study explores a structured model of Service-Learning (Interpersonal Social Responsibility-Service Learning: ISR-SL) aimed towards the development of professional identity among OT students. Based on OT students experiences from the end of the course through later stages as mature students and professionals. A qualitative research design was used to explore the perceptions and experiences of 150 first, second, and third-year OT students and graduates who have participated in ISR-SL during their first academic year. Our findings suggest that the structured, long-term relationship with a person with a disability in the natural environment, which is the core of the ISR-SL, allowed students to develop a professional identity based on seeing the person as a whole and recognizing his/her centrality in the therapeutic relationship. This study suggests ISR-SL as future direction or next step for implementing SL in OT and other healthcare disciplines programs.

  18. The Design, Development, and Evaluation of a Qualitative Data Collection Application for Pregnant Women.

    PubMed

    Keedle, Hazel; Schmied, Virginia; Burns, Elaine; Dahlen, Hannah

    2018-01-01

    This article explores the development and evaluation of a smartphone mobile software application (app) to collect qualitative data. The app was specifically designed to capture real-time qualitative data from women planning a vaginal birth after caesarean delivery. This article outlines the design and development of the app to include funding, ethics, and the recruitment of an app developer, as well as the evaluation of using the app by seven participants. Data collection methods used in qualitative research include interviews and focus groups (either online, face-to-face, or by phone), participant diaries, or observations of interactions. This article identifies an alternative data collection methodology using a smartphone app to collect real-time data. The app provides real-time data and instant access to data alongside the ability to access participants from a variety of locations. This allows the researcher to gain insight into the experiences of participants through audio or video recordings in longitudinal studies without the need for constant interactions or interviews with participants. Using smartphone applications can allow researchers to access participants who are traditionally hard to reach and access their data in real time. Evaluating these apps before use in research is invaluable. © 2017 Sigma Theta Tau International.

  19. Explaining Antiretroviral Therapy Adherence Success Among HIV-Infected Children in Rural Uganda: A Qualitative Study

    PubMed Central

    Olds, Peter K.; Kiwanuka, Julius P.; Ware, Norma C.; Tsai, Alexander C.

    2014-01-01

    High adherence is critical for achieving clinical benefits of HIV antiretroviral therapy (ART) and particularly challenging for children. We conducted 35 qualitative interviews with caregivers of HIV-infected Ugandan children who were followed in a longitudinal study of real-time ART adherence monitoring; 18 participants had undetectable HIV RNA, while 17 had detectable virus. Interviews blinded to viral suppression status elicited information on adherence experiences, barriers and facilitators to adherence, and social support. Using an inductive content analytic approach, we identified ‘lack of resources,’ ‘Lazarus effect,’ ‘caregiver's sense of obligation and commitment,’ and ‘child's personal responsibility’ as categories of influence on adherence, and defined types of caregiver social support. Among children with viral suppression, high hopes for the child's future and ready access to private instrumental support appeared particularly important. These findings suggest clinical counseling should explore caregivers' views of their children's futures and ability to access support in overcoming adherence barriers. PMID:25323679

  20. 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.

  1. Planning for Sustainability of an Evidence-Based Mental Health Promotion Program in Canadian Elementary Schools.

    PubMed

    Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena

    2015-09-01

    Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.

  2. Understanding Persistent Food Insecurity: A Paradox of Place and Circumstance

    ERIC Educational Resources Information Center

    Mammen, Sheila; Bauer, Jean W.; Richards, Leslie

    2009-01-01

    Survey data from a U.S. Department of Agriculture funded multi-state longitudinal project revealed a paradox where rural low-income families from states considered prosperous were persistently more food insecure than similar families from less prosperous states. An examination of quantitative and qualitative data found that families in the food…

  3. Fitness, Fatness and Healthism Discourse: Girls Constructing 'Healthy' Identities in School

    ERIC Educational Resources Information Center

    Clark, Sheryl Laura

    2018-01-01

    Drawing on longitudinal, qualitative research into girls' participation in physical activity and sport in the UK, this article will explore girls' embodied constructions of 'healthy' identities. My research with girls (aged 10-13) found that over the transition to secondary school, classed and gendered healthism discourses had come to powerfully…

  4. Retirement and Learning: A Longitudinal Qualitative Approach

    ERIC Educational Resources Information Center

    Tam, Maureen

    2018-01-01

    This paper discusses retirement as a learning process, where learning, be it formal or informal, enables retirees to adjust to the transition from work to retirement. Such discussion is important given the fact that the world population is aging and that more people are retiring in the next few decades. Moreover, people are experiencing an…

  5. Trouble with ataxia: A longitudinal qualitative study of the diagnosis and medical management of a group of rare, progressive neurological conditions

    PubMed Central

    Ealing, John; Greenfield, Julie; Kingston, Helen; Sanders, Caroline; Payne, Katherine

    2013-01-01

    Objectives: An exploratory investigation of diagnosis and management in progressive ataxias: rare neurological conditions usually affecting balance, mobility and speech. Methods: A longitudinal qualitative study into the experiences of people with ataxia and neurologists. Thematic analysis and follow-up interviews were used to determine diagnosis and management issues over time. Results: People with ataxia recruited via two hospital departments and Ataxia UK were interviewed at baseline (n = 38) and 12-month follow-up (n = 31). Eight consultant neurologists were interviewed once. Patient accounts were diverse, but many expressed frustration at having an incurable condition and dissatisfaction with service outcomes. At follow-up, there was variation in their contact and satisfaction with helping agencies. Service issues regarding continuity of care and the primary/secondary care interface were evident. Neurologists’ accounts also varied. One-half reported that there is nothing that can be done, and one-half favoured specialist referral to increase the likelihood of finding an underlying aetiology within budget constraints. Conclusions: Diagnostic uncertainties existing at baseline remained for patients at follow-up interviews, although some had learned to deal with the uncertainties brought by the diagnosis of a largely untreatable condition. Care pathways only seemed to operate in the case of defined conditions, such as Friedreich’s Ataxia, the most commonly inherited cause. The findings point to a need to develop the evidence base to inform the relative utility of diagnostic procedures in the context of finite resources for patient care and support. PMID:26770684

  6. Caregiver responses to early cleft palate care: A mixed method approach.

    PubMed

    Sischo, Lacey; Clouston, Sean A P; Phillips, Ceib; Broder, Hillary L

    2016-05-01

    This study sought to understand caregivers' (CGs') responses to early cleft lip/palate care for their infants. A prospective, mixed methods multicenter longitudinal study was conducted among CGs (N = 118) seeking treatment for their infants' cleft lip and palate or cleft lip only at 1 of 6 cleft treatment centers in the United States. Participants were in 1 of 2 treatment groups: traditional care only or nasoalveolar molding (NAM) plus traditional care. The CGs completed semistructured interviews and standardized questionnaires assessing psychosocial well-being and family impact at 3 time points: the beginning of treatment (∼1 month of age), prelip surgery (∼3-5 months of age), and postpalate surgery (∼12-13 months of age). Multilevel modeling was used to longitudinally assess CGs' psychosocial outcomes. Although the first year was demanding for all CGs, NAM onset and the child's lip surgery were particularly stressful times. CGs used optimism, problem-solving behavior, and social support to cope with this stress. Qualitatively, CGs' ability to balance cleft treatment demands with their psychosocial resources and coping strategies influenced family adaptation. Qualitative and quantitative results indicated CGs of NAM-treated infants experienced more rapid declines in anxiety and depressive symptoms and better coping skills over time than CGs whose infants had traditional care. CGs of NAM-treated infants experienced more positive psychosocial outcomes than CGs whose infants had traditional care. Results from the mixed model support the family adjustment and adaptation response model as used in pediatric chronic condition research. (c) 2016 APA, all rights reserved).

  7. The formal support experiences of mothers of adolescents with intellectual disabilities in Edinburgh, UK: a longitudinal qualitative design.

    PubMed

    Lin, Mei-Chun; Macmillan, Maureen; Brown, Norrie

    2010-03-01

    In the United Kingdom, healthcare provision for children with intellectual disabilities (ID) has shifted away from institutions to the community. Today, family members most often assume the primary caregiver role and look after care recipients in the home. The support needs of caregivers, therefore, represent an important area of research that should help caregivers enhance their quality of life. The aim of this study was to understand the received formal support perceptions of mothers of ID adolescents over time. This study used a longitudinal qualitative method in three phases. Semistructured interviews were conducted with seven mothers at three points in time (initial, at 6 months, and at 18 months). Constant comparative analysis was conducted on transcribed interviews. The three themes that emerged from research included (1) the process of complex emotions, (2) the perception of received support, and (3) the process of fighting reactions. Mothers expressed different levels of satisfaction and dissatisfaction with the range of support received. Respite care was, overall, a beneficial intervention for participants. However, some mothers felt health professionals to be insensitive, showing lack of understanding and empathy, diminished personhood, and perceived lack of respect for the human value of their children with ID. The "fighting process" experienced when applying for financial help from the social welfare system was also pointed out as stressful. Further exploration of the professional support needs of mothers is important to support effectively their effective caregiving role. Professionals should increase their awareness of caregiver sensitivities and be respectful of individual responses by providing empathy and understanding from the caregivers' point of view.

  8. The effect of unemployment on self-reported health and mental health in Greece from 2008 to 2013: a longitudinal study before and during the financial crisis.

    PubMed

    Drydakis, Nick

    2015-03-01

    The current study uses six annual waves of the Longitudinal Labor Market Study (LLMS) covering the 2008-2013 period to obtain longitudinal estimations suggesting statistically significant negative effects from unemployment on self-reported health and mental health in Greece. The specifications suggest that unemployment results in lower health and the deterioration of mental health during the 2008-2009 period compared with the 2010-2013 period, i.e., a period in which the country's unemployment doubled as a consequence of the financial crisis. Unemployment seems to be more detrimental to health/mental health in periods of high unemployment, suggesting that the unemployment crisis in Greece is more devastating as it concerns more people. Importantly, in all specifications, comparable qualitative patterns are found by controlling for unemployment due to firm closure, which allows us to minimize potential bias due to unemployment-health related reverse causality. Moreover, in all cases, women are more negatively affected by unemployment in relation to their health and mental health statuses than are men. Greece has been more deeply affected by the financial crisis than any other EU country, and this study contributes by offering estimates for before and during the financial crisis and considering causality issues. Because health and mental health indicators increase more rapidly in a context of higher surrounding unemployment, policy action must place greater emphasis on unemployment reduction and supporting women's employment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. The Longitudinal STEM Identity Trajectories of Middle School Girls who Participated in a Single-Sex Informal STEM Education Program

    NASA Astrophysics Data System (ADS)

    Hughes, Roxanne

    2014-03-01

    This study examined the longitudinal effects of participation in an all-girls STEM summer camp on young women's interest in STEM fields and motivation to pursue these fields. The SciGirls camp has been in existence since 2006, with its goal of providing a safe space for young women to explore STEM careers and strengthen their interest in these careers. Over 166 middle school age girls have participated in the program since it began in 2006. Of those participants, 60 responded to at least one of the follow up surveys that are sent every three years - 2009 and 2012. The surveys attempt to determine participants' level of interest in STEM. The survey was qualitative in nature and asked open ended questions. Results indicated that the camp had a positive effect on participants' perceptions of scientists and their work. This study adds to the literature that looks at the longitudinal impacts of informal STEM educational programs that expose young women to female scientist role models and mentors. This study supports the research that claims that exposing young women at an early age to science role models can positively alter their perception of science careers which can eventually increase the number of women who pursue these careers. This increase is important at a time when men still outnumber women in many science and engineering fields. This study was funded in part by the National Science Foundation Division of Materials Research through DMR 0654118.

  10. Young Registered Nurses' Intention to Leave the Profession and Professional Turnover in Early Career: A Qualitative Case Study

    PubMed Central

    Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29–32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process. PMID:24027640

  11. Exploring the experience of sleep and fatigue in male and female adults over the 2 years following traumatic brain injury: a qualitative descriptive study.

    PubMed

    Theadom, Alice; Rowland, Vickie; Levack, William; Starkey, Nicola; Wilkinson-Meyers, Laura; McPherson, Kathryn

    2016-04-08

    To explore the experience of fatigue and sleep difficulties over the first 2 years after traumatic brain injury (TBI). Longitudinal qualitative descriptive analysis of interviews completed as part of a larger longitudinal study of recovery following TBI. Data relating to the experience of fatigue and/or sleep were extracted and coded by two independent researchers. Community-based study in the Hamilton and Auckland regions of New Zealand. 30 adult participants who had experienced mild, moderate or severe brain injury within the past 6 months (>16 years of age). 15 participants also nominated significant others to take part. Interviews were completed at 6, 12 and 24 months postinjury. Participants described feeling unprepared for the intensity, impact and persistent nature of fatigue and sleep difficulties after injury. They struggled to learn how to manage their difficulties by themselves and to adapt strategies in response to changing circumstances over time. Four themes were identified: (1) Making sense of fatigue and sleep after TBI; (2) accepting the need for rest; (3) learning how to rest and; (4) need for rest impacts on ability to engage in life. Targeted support to understand, accept and manage the sleep and fatigue difficulties experienced may be crucial to improve recovery and facilitate engagement in everyday life. Advice needs to be timely and revised for relevance over the course of recovery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study

    PubMed Central

    Eisingerich, Andreas B

    2016-01-01

    Background Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. Objective The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. Methods We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Conclusions Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond. PMID:27777216

  13. Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study.

    PubMed

    El-Hilly, Abdulrahman Abdulla; Iqbal, Sheeraz Syed; Ahmed, Maroof; Sherwani, Yusuf; Muntasir, Mohammed; Siddiqui, Sarim; Al-Fagih, Zaid; Usmani, Omar; Eisingerich, Andreas B

    2016-10-24

    Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond.

  14. Obese women experience multiple challenges with breastfeeding that are either unique or exacerbated by their obesity: discoveries from a longitudinal, qualitative study.

    PubMed

    Garner, Christine D; McKenzie, Shanice A; Devine, Carol M; Thornburg, Loralei L; Rasmussen, Kathleen M

    2017-07-01

    Obese women are at risk for shorter breastfeeding duration, but little is known about how obese women experience breastfeeding. The aim of this study was to understand obese women's breastfeeding experiences. We enrolled pregnant women in upstate New York, who were either obese [n = 13; body mass index (BMI) ≥30 kg/m 2 ] or normal weight (n = 9; BMI 18.5-24.9 kg/m 2 ) before conception and intended to breastfeed. A longitudinal, qualitative study was conducted from February 2013 through August 2014 with semi-structured interviews during pregnancy and at specific times post-partum through 3 months. Interviews were audio recorded, transcribed and analyzed using content analysis. Themes that emerged in analysis were compared between obese and normal-weight women. Differences were identified and described. Prenatally, obese women expressed less confidence about breastfeeding than normal-weight women. Post-partum, obese women and their infants had more health issues that affected breastfeeding, such as low infant blood glucose. Compared with normal-weight women, they also experienced more challenges with latching and positioning their infants. Breastfeeding required more time, props and pillows, which limited where obese women could breastfeed. Obese women also experienced more difficulty finding nursing bras and required more tangible social support than normal-weight women. In conclusion, obese women experienced more challenges than women of normal weight; some challenges were similar to those of normal-weight women but were experienced to a greater degree or a longer duration. Other challenges were unique. Obese women could benefit from targeted care prenatally and during the hospital stay as well as continued support post-partum to improve breastfeeding outcomes. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

  15. Food parenting measurement issues: working group consensus report.

    PubMed

    Hughes, Sheryl O; Frankel, Leslie A; Beltran, Alicia; Hodges, Eric; Hoerr, Sharon; Lumeng, Julie; Tovar, Alison; Kremers, Stef

    2013-08-01

    Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent-child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models.

  16. Food Parenting Measurement Issues: Working Group Consensus Report

    PubMed Central

    Frankel, Leslie A.; Beltran, Alicia; Hodges, Eric; Hoerr, Sharon; Lumeng, Julie; Tovar, Alison; Kremers, Stef

    2013-01-01

    Abstract Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent–child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models. PMID:23944928

  17. The Experience of Being a Guide Dog Puppy Raiser Volunteer: A Longitudinal Qualitative Collective Case Study

    PubMed Central

    Chur-Hansen, Anna; Werner, Lucy-Kate; McGuiness, Clare E.; Hazel, Susan

    2014-01-01

    Simple Summary Guide dogs are important service animals. They cannot be trained without the input of volunteer puppy raisers, who serve as custodians for the animals for around 12 months. To date very little research has considered the experience of being a guide dog puppy raiser, including the costs and benefits to psychological, physical and social health. In this study one litter of puppies and their raisers were followed from before the animal arrived until one year had passed. Overall, less positive experiences were reported than more negative ones. This has implications for the organisations that seek volunteers to raise service animals. Abstract There are no published studies that consider the experiences of guide dog puppy raisers. As these people are volunteers, their continued willingness to participate in the training of dogs for assisting the vision impaired and blind is essential for the viability of guide dog schools around the world. Using a qualitative, longitudinal methodology, data were collected from nine guide dog puppy raisers at four time points: before receiving the puppy, one week, then three months after the puppy arrived, and 13 months after the puppy arrived (at which time all puppies had left the raisers). Participants reported more challenges than benefits in raising the puppies. Volunteering to be a guide dog puppy raiser may not be the pleasant experience that is anticipated when community members first offer their services. Understanding what it is like to be a puppy raiser and working towards ways in which to address problems is essential, given that, without volunteers to train and care for puppies, vision impaired and blind people would not have access to guide dogs. PMID:26479133

  18. A qualitative exploration of student perceptions of the impact of progress tests on learning and emotional wellbeing.

    PubMed

    Yielder, Jill; Wearn, Andy; Chen, Yan; Henning, Marcus A; Weller, Jennifer; Lillis, Steven; Mogol, Vernon; Bagg, Warwick

    2017-08-29

    Progress testing was introduced to the MBChB programme at the University of Auckland in 2013. As there has been a focus in published literature on aspects relating to the format or function of progress tests, the purpose of this study was to explore a qualitative student perspective on the introduction of progress testing and its impact on approaches to learning and perceived stress. This article presents the qualitative aspects of a longitudinal evaluation study. The qualitative data were derived from eight focus groups of Year 2-5 medical students in the University of Auckland medical programme. Two themes, 'Impact on Learning' and 'Emotional Wellbeing' and their subthemes offered insight into student perceptions and behaviour. Students described a variety of learning responses to progress testing that clustered around the employment of a range of learning strategies based on their experience of sitting progress tests and their individualised feedback. A range of emotional responses were also expressed, with some finding progress tests stressful, while others enjoyed not needing to intensively cram before the tests. Progress tests appear to influence the approach of students to their learning. They employ a mix of learning strategies, shaped by their performance, individualised feedback and the learning environment. While students expressed some stress and anxiety with respect to sitting progress tests, this form of testing was viewed by these students as no worse, and sometimes better than traditional assessments.

  19. Effectiveness of a systematic approach to promote intersectoral collaboration in comprehensive school health promotion-a multiple-case study using quantitative and qualitative data.

    PubMed

    Pucher, Katharina K; Candel, Math J J M; Krumeich, Anja; Boot, Nicole M W M; De Vries, Nanne K

    2015-07-05

    We report on the longitudinal quantitative and qualitative data resulting from a two-year trajectory (2008-2011) based on the DIagnosis of Sustainable Collaboration (DISC) model. This trajectory aimed to support regional coordinators of comprehensive school health promotion (CSHP) in systematically developing change management and project management to establish intersectoral collaboration. Multilevel analyses of quantitative data on the determinants of collaborations according to the DISC model were done, with 90 respondents (response 57 %) at pretest and 69 respondents (52 %) at posttest. Nvivo analyses of the qualitative data collected during the trajectory included minutes of monthly/bimonthly personal/telephone interviews (N = 65) with regional coordinators, and documents they produced about their activities. Quantitative data showed major improvements in change management and project management. There were also improvements in consensus development, commitment formation, formalization of the CSHP, and alignment of policies, although organizational problems within the collaboration increased. Content analyses of qualitative data identified five main management styles, including (1) facilitating active involvement of relevant parties; (2) informing collaborating parties; (3) controlling and (4) supporting their task accomplishment; and (5) coordinating the collaborative processes. We have contributed to the fundamental understanding of the development of intersectoral collaboration by combining qualitative and quantitative data. Our results support a systematic approach to intersectoral collaboration using the DISC model. They also suggest five main management styles to improve intersectoral collaboration in the initial stage. The outcomes are useful for health professionals involved in similar ventures.

  20. Alcohol-specific parenting, adolescents' self-control, and alcohol use: a moderated mediation model.

    PubMed

    Koning, Ina M; van den Eijnden, Regina J J M; Vollebergh, Wilma A M

    2014-01-01

    There is convincing evidence that parental rules about alcohol are important in curbing adolescents' alcohol use. However, little is known about the mechanisms through which the direct link between alcohol-specific parenting and alcohol use is obtained. In this study, we investigated the mediating effect of adolescent self-control on the relationship between alcohol-specific rules and adolescents' drinking behavior and whether this mediation effect depends on the level of quality of communication. A total of 883 adolescents participated in this longitudinal study at ages 13, 14, and 15 years. Strict rules predicted lower rates of drinking, but no direct effect of the quality of communication on adolescents' alcohol use was found. A higher level of self-control was related to lower rates of drinking in adolescents. The indirect effect of rules about alcohol through adolescents' self-control was statistically significant, yet only in adolescents with high qualitative parent-child communication about alcohol. In adolescents with low quality of parent-child communication, self-control was not related to drinking. These findings imply that strict rule setting in combination with qualitative parent-child communication is an important target for prevention. In addition, findings point at the importance of high qualitative parent-child communication for adolescents' motivation to engage in self-control to avoid drinking.

  1. Longitudinal variability of complexities associated with equatorial electrojet

    NASA Astrophysics Data System (ADS)

    Rabiu, A. B.; Ogunjo, S. T.; Fuwape, I. A.

    2017-12-01

    Equatorial electrojet indices obtained from ground based magnetometers at 6 representative stations across the magnetic equatorial belt for the year 2009 (mean annual sunspot number Rz = 3.1) were treated to nonlinear time series analysis technique to ascertain the longitudinal dependence of the chaos/complexities associated with the phenomena. The selected stations were along the magnetic equator in the South American (Huancayo, dip latitude -1.80°), African (Ilorin, dip latitude -1.82°; Addis Ababa, dip latitude - 0.18°), and Philippine (Langkawi, dip latitude -2.32°; Davao, dip latitude -1.02°; Yap, dip latitude -1.49°) sectors. The non-linear quantifiers engaged in this work include: Recurrence rate, determinism, diagonal line length, entropy, laminarity, Tsallis entropy, Lyapunov exponent and correlation dimension. Ordinarily the EEJ was found to undergo variability from one longitudinal representative station to another, with the strongest EEJ of about 192.5 nT at the South American axis at Huancayo. The degree of complexity in the EEJ was found to vary qualitatively from one sector to another. Probable physical mechanisms responsible for longitudinal variability of EEJ strength and its complexities were highlighted.

  2. A novel approach to studying co-evolution of understanding and research: Family bereavement and the potential for organ donation as a case study

    PubMed Central

    Dicks, Sean G; Ranse, Kristen; Northam, Holly; van Haren, Frank MP; Boer, Douglas P

    2018-01-01

    A novel approach to data extraction and synthesis was used to explore the connections between research priorities, understanding and practice improvement associated with family bereavement in the context of the potential for organ donation. Conducting the review as a qualitative longitudinal study highlighted changes over time, and extraction of citation-related data facilitated an analysis of the interaction in this field. It was found that lack of ‘communication’ between researchers contributes to information being ‘lost’ and then later ‘rediscovered’. It is recommended that researchers should plan early for dissemination and practice improvement to ensure that research contributes to change. PMID:29399367

  3. Mood and anxiety problems in perinatal Indigenous women in Australia, New Zealand, Canada, and the United States: a critical review of the literature.

    PubMed

    Bowen, Angela; Duncan, Vicky; Peacock, Shelley; Bowen, Rudy; Schwartz, Laura; Campbell, Diane; Muhajarine, Nazeem

    2014-02-01

    We conducted a review of research literature related to anxiety, depression, and mood problems in Indigenous women in Canada, the United States (including Hawaii), Australia, and New Zealand. Quantitative and qualitative research studies published between 1980 and March 2010 were reviewed. The initial search revealed 396 potential documents, and after being checked for relevance by two researchers, data were extracted from 16 quantitative studies, one qualitative research article, and one dissertation. Depression is a common problem in Indigenous pregnant and postpartum women; however, the prevalence and correlates of anxiety and mood disorders are understudied. The review identified four key areas where further research is needed: (a) longitudinal, population-based studies; (b) further validation and modification of appropriate screening tools; (c) exploration of cultural diversity and meaning of the lived experiences of antenatal and postpartum depression, anxiety, and mood disorders; and (d) development of evidence-informed practices for researchers and practitioners through collaborations with Aboriginal communities to better understand and improve mental health of women of childbearing age.

  4. Longitudinal Spiritual Coping with Trauma in People with HIV: Implications for Health Care

    PubMed Central

    Ironson, Gail

    2014-01-01

    Abstract This 10-year study (N=177) examines how people with HIV use spirituality to cope with life's trauma on top of HIV-related stress (e.g., facing death, stigma, poverty, limited healthcare) usual events. Spirituality, defined as a connection to a higher presence, is independent from religion (institutionalized spirituality). As a dynamic adaptive process, coping requires longitudinal studying. Qualitative content-analysis of interviews/essays yielded a coding of specific aspects and a longitudinal rating of overall spiritual coping. Most participants were rated as spiritual, using spiritual practices, about half experienced comfort, empowerment, growth/transformation, gratitude, less than one-third meaning, community, and positive reframing. Up to one-fifth perceived spiritual conflict, struggle, or anger, triggering post-traumatic stress, which sometimes converted into positive growth/transformation later. Over time, 65% used spiritual coping positively, 7% negatively, and 28% had no significant use. Spirituality was mainly beneficial for women, heterosexuals, and African Americans (p<0.05). Results suggest that spirituality is a major source of positive and occasionally negative coping (e.g., viewing HIV as sin). We discuss how clinicians can recognize and prevent when spirituality is creating distress and barriers to HIV treatment, adding a literature review on ways of effective spiritual assessment. Spirituality may be a beneficial component of coping with trauma, considering socio-cultural contexts. PMID:24601735

  5. Numerical evaluation of longitudinal motions of Wigley hulls advancing in waves by using Bessho form translating-pulsating source Green'S function

    NASA Astrophysics Data System (ADS)

    Xiao, Wenbin; Dong, Wencai

    2016-06-01

    In the framework of 3D potential flow theory, Bessho form translating-pulsating source Green's function in frequency domain is chosen as the integral kernel in this study and hybrid source-and-dipole distribution model of the boundary element method is applied to directly solve the velocity potential for advancing ship in regular waves. Numerical characteristics of the Green function show that the contribution of local-flow components to velocity potential is concentrated at the nearby source point area and the wave component dominates the magnitude of velocity potential in the far field. Two kinds of mathematical models, with or without local-flow components taken into account, are adopted to numerically calculate the longitudinal motions of Wigley hulls, which demonstrates the applicability of translating-pulsating source Green's function method for various ship forms. In addition, the mesh analysis of discrete surface is carried out from the perspective of ship-form characteristics. The study shows that the longitudinal motion results by the simplified model are somewhat greater than the experimental data in the resonant zone, and the model can be used as an effective tool to predict ship seakeeping properties. However, translating-pulsating source Green function method is only appropriate for the qualitative analysis of motion response in waves if the ship geometrical shape fails to satisfy the slender-body assumption.

  6. Investigating Student Perceptions of Knowledge Acquisition within a Role-Play Simulation of the Convention on Biological Diversity

    ERIC Educational Resources Information Center

    Schnurr, Matthew A.; De Santo, Elizabeth M.; Green, Amanda D.; Taylor, Alanna

    2015-01-01

    This article investigates the particular mechanisms through which a role-play simulation impacts student perceptions of knowledge acquisition. Longitudinal data were mobilized in the form of quantitative and qualitative surveys to examine whether the simulation succeeded in increasing knowledge around both content and skills. It then delves deeper…

  7. Envisioning World Citizens? Self-Presentations of an International School in Germany and Related Orientations of Its Pupils

    ERIC Educational Resources Information Center

    Keßler, Catharina; Krüger, Heinz-Hermann; Schippling, Anne; Otto, Ariane

    2015-01-01

    Against the backdrop of changes in global education, the German education system has undergone immense diversification. Many private schools are being founded, among them international schools catering both to an international clientele and to growing numbers of Germans. This article presents results from part of a qualitative longitudinal study…

  8. Notes on phase transitions and the role of spin fluctuations

    NASA Astrophysics Data System (ADS)

    Stishov, S. M.

    2016-09-01

    The physical properties of two chiral systems with localized and delocalized magnetic moments, {\\text{Cu}}2{\\text{OSeO}}3 and MnSi, are reviewed. It is concluded that the longitudinal fluctuations of magnetic moments have no strong effect on the qualitative picture of phase transitions and the magnetic phase diagrams of chiral systems.

  9. Legal Outcomes of Sexually Abused Children Evaluated at the Philippine General Hospital Child Protection Unit

    ERIC Educational Resources Information Center

    Sugue-Castillo, Mariella

    2009-01-01

    Objectives: To describe the legal outcomes and factors associated with case reaching court and conviction for sexual abuse of children seen at the Philippine General Hospital Child Protection Unit (PGH-CPU) from 1997 to 2000. Methods: Mixed transdisciplinary research design combined longitudinal cohort with qualitative methods. Data were obtained…

  10. To Stay or to Go? Narratives of Early-Stage Sociologists about Persisting in Academia

    ERIC Educational Resources Information Center

    Wöhrer, Veronika

    2014-01-01

    Based on analyses of life course questionnaires, semi-structured qualitative interviews and focus group interviews carried out with early-stage sociologists over a period of 8 years, this paper presents analyzes of continuity and change in the decisions made by early-stage researchers in regard to their work and careers. The longitudinal approach…

  11. Doing Well vs. Feeling Well: Understanding Family Dynamics and the Psychological Adjustment of Chinese Immigrant Adolescents

    ERIC Educational Resources Information Center

    Qin, Desiree Baolian

    2008-01-01

    Despite their average high levels of educational achievement, Asian American students often report poor psychological and social adjustment, suggesting an achievement/adjustment paradox. Yet, the reasons for this paradox remain unclear. Drawing on 5-year longitudinal qualitative interview data, this paper compares the family dynamics of two groups…

  12. From Further to Higher Education: Transition as an On-Going Process

    ERIC Educational Resources Information Center

    Tett, Lyn; Cree, Viviene E; Christie, Hazel

    2017-01-01

    This paper argues that transition is not a one-off event that occurs when students first enter universities but is an on-going process that is repeated over time. We draw on qualitative data from a longitudinal project on "non-traditional" students who entered a research-intensive university in Scotland direct from further education…

  13. Exploring the use of a gamified intervention for encouraging physical activity in adolescents: a qualitative longitudinal study in Northern Ireland

    PubMed Central

    Corepal, Rekesh; Best, Paul; O’Neill, Roisin; Tully, Mark A; Edwards, Mark; Jago, Russell; Miller, Sarah J; Kee, Frank; Hunter, Ruth F

    2018-01-01

    Objective To explore the temporal changes of adolescents’ views and experiences of participating in a gamified intervention to encourage physical activity behaviour and associated processes of behaviour change. Design A qualitative longitudinal design was adopted whereby focus groups were conducted with the same participants in each intervention school (n=3) at four time-points (baseline, end of each of two intervention phases and 1-year follow-up). The framework method was used to thematically analyse the data. Setting Secondary schools (n=3), Belfast (Northern Ireland). Participants A subsample (n=19 at four time-points) of individuals aged 12–14 years who participated in the StepSmart Challenge, a gamified intervention involving a pedometer competition and material rewards to encourage physical activity behaviour change. Results Three core themes were identified: (1) competition; (2) incentives and (3) influence of friends. Participants indicated that a pedometer competition may help initiate physical activity but suggested that there were a number of barriers such as participants finding it ‘boring’, and feeling as though they had a remote chance of ‘winning’. ‘Incentives’ were viewed favourably, although there were participants who found not winning a prize ‘annoying’. Friends were a motivator to be more physically active, particularly for girls who felt encouraged to walk more when with a friend. Conclusions The intervention in general and specific gamified elements were generally viewed positively and deemed acceptable. Results suggest that gamification may have an important role to play in encouraging adolescents to engage in physical activity and in creating interventions that are fun and enjoyable. The longitudinal approach added additional depth to the analysis as themes were refined and tested with participants over time. The findings also suggest that gamified Behaviour Change Techniques align well with core concepts of Self-determination Theory and that various game elements may require tailoring for specific populations, for example, different genders. Trial registration number NCT02455986; Pre-results. PMID:29678971

  14. Solidarity and ambivalence: comparing two perspectives on intergenerational relations using longitudinal panel data.

    PubMed

    Hogerbrugge, Martijn J A; Komter, Aafke E

    2012-05-01

    Research on family relations has extensively used the intergenerational solidarity model proposed by Bengtson and colleagues. Recently, the relevance of this model for explaining changes in family relations has been questioned, and the concept of intergenerational ambivalence has been proposed as a relevant addition to the model, supposedly acting as a catalyst, and thus serving as an explanation for changes in family relations. This study tests both the viability of the intergenerational solidarity model and the hypothesized effect of ambivalence employing longitudinal data. We use data from 2 waves of the Netherlands' Kinship Panel Study on parent-adult child relationships to estimate latent variable structural equation models. Affection, association, and support between family members are core, mutually reinforcing dimensions of solidarity. The hypothesis that ambivalence is a catalyst for change in family relations was not confirmed. Adding conflict separately revealed that it only affects the core solidarity dimensions but is itself, like normative and structural solidarity, not influenced by them. The relevance of the concept of intergenerational ambivalence for studying changes in family relations can be questioned. The viability of the intergenerational solidarity model is, however, confirmed. The concept of intergenerational ambivalence might be further explored in qualitative studies on family change.

  15. A longitudinal study of conversations with parents about sex and dating during college.

    PubMed

    Morgan, Elizabeth M; Thorne, Avril; Zurbriggen, Eileen L

    2010-01-01

    Emerging adulthood is a time of sexual and romantic relationship development as well as change in the parent-child relationship. This study provides a longitudinal analysis of 30 young adults' (17 women, 13 men) sexual experiences, attitudes about sexuality and dating, and reported conversations with parents about sexuality and dating from the 1st and 4th years of college. Self-report questionnaires revealed increases in general closeness with parents, increases in sexual and dating experiences, and more sexually permissive as well as more gender stereotyped attitudes. Qualitative analyses of individual interviews indicated a movement from unilateral and restrictive sex-based topics to more reciprocal and relationship-focused conversations over time. Gender analyses revealed that young women reported more restrictive sex messages and young men more positive sex messages. Participants also described increased openness and comfort in talking about sexual topics with both mothers and fathers from the 1st to 4th year of college. Overall, the results suggest that prior findings of increased mutuality with parents during the college years extend to the traditionally taboo topic of sexuality. Copyright 2009 APA, all rights reserved.

  16. Perceptions of coping with non-disease-related life stress for women with osteoarthritis: a qualitative analysis.

    PubMed

    Harris, Melissa L; Byles, Julie E; Townsend, Natalie; Loxton, Deborah

    2016-05-17

    Coping with arthritis-related stress has been extensively studied. However, limited evidence exists regarding coping with stress extraneous to the disease (life stress). This study explored life stress and coping in a subset of older women with osteoarthritis from a larger longitudinal study. An Australian regional university. This qualitative study involved semistructured telephone interviews. Potential participants were mailed a letter of invitation/participant information statement by the Australian Longitudinal Study on Women's Health (ALSWH). Invitations were sent out in small batches (primarily 10). Interviews were conducted until data saturation was achieved using a systematic process (n=19). Digitally recorded interviews were transcribed verbatim and deidentified. Data were thematically analysed. Women who indicated being diagnosed or treated for arthritis in the previous 3 years in the fifth survey of the ALSWH (conducted in 2007) provided the sampling frame. Potential participants were randomly sampled by a blinded data manager using a random number generator. Coping with life stress involved both attitudinal coping processes developed early in life (ie, stoicism) and transient cognitive and support-based responses. Women also described a dualistic process involving a reduction in the ability to cope with ongoing stress over time, coupled with personal growth. This is the first study to examine how individuals cope with non-arthritis-related stress. The findings add to the current understanding of stress and coping, and have implications regarding the prevention of arthritis in women. Importantly, this study highlighted the potential detrimental impact of persistent coping patterns developed early in life. Public health campaigns aimed at stress mitigation and facilitation of adaptive coping mechanisms in childhood and adolescence may assist with arthritis prevention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Factors Important for Work Participation Among Older Workers with Depression, Cardiovascular Disease, and Osteoarthritis: A Mixed Method Study.

    PubMed

    Boot, Cécile R L; de Kruif, Anja Th C M; Shaw, William S; van der Beek, Allard J; Deeg, Dorly J; Abma, Tineke

    2016-06-01

    Purpose The aim of this study was to gain insight into differences and similarities in factors important for work participation in older (58-65 years) workers among three different chronic diseases: depression (D), cardiovascular disease (C), and osteoarthritis (O). Methods A mixed method design was used, with a qualitative part (in-depth interviews) with 14 patients with D, C or O and a quantitative part based on the 2002-2003 cohort of the Longitudinal Aging Study Amsterdam. We analysed and compared 3-year (response 93 %) predictors of paid work in 239 participants with D, C, or O using regression analyses. The qualitative findings were integrated with the quantitative findings aiming at complementarity. Results Common factors important for work participation were: working at baseline; male gender; lower age; partner with paid work; better physical and mental health; and higher mastery scores. The qualitative analyses added autonomy in work and provided contextual information regarding the perceived importance of working as factors important for participation in paid work. For D and C, work gave purpose in life and enhanced social contacts. Participation in work was perceived as necessary to structure life only for D. Conclusion Most factors important for work participation were similar for D, C, and O. However, the interviews revealed that for D, the context and the meaning attributed to these factors differed.

  18. Using theatre to address mental illness stigma: a knowledge translation study in bipolar disorder.

    PubMed

    Michalak, Erin E; Livingston, James D; Maxwell, Victoria; Hole, Rachelle; Hawke, Lisa D; Parikh, Sagar V

    2014-01-01

    Reduction of the stigma of mental illness is an international priority; arts- and contact-based approaches represent a promising mode of intervention. This project was designed to explore the impact of a one-woman theatrical performance on attitudes towards bipolar disorder (BD) on people with BD and healthcare providers. A playwright and actress who lives with BD developed a stage performance - 'That's Just Crazy Talk' - targeting stigmatizing attitudes towards BD. Prospective, longitudinal and sequential mixed methods were used to assess the impact of the performance on people with BD (n = 80) and healthcare providers (n = 84). Qualitative interviews were conducted with 33 participants (14 people with BD and 19 healthcare providers). Quantitatively, healthcare providers showed significantly improved attitudes immediately post-performance, but this change was not maintained over time; people with BD showed little quantitative change. Qualitatively, both people with BD and BD healthcare providers showed enduring and broadly positive changes. A theatrical presentation designed to reduce stigma produced immediate impact on healthcare providers quantitatively and significant qualitative impact on people with BD and healthcare providers. Additionally, the utility of using mixed-method approaches in mental health research was demonstrated.

  19. Measurement of the degree of cure in epoxies with ultrasonic velocity

    NASA Technical Reports Server (NTRS)

    Winfree, W. P.; Parker, F. R.

    1986-01-01

    The use of ultrasonic longitudinal velocity values to measure the degree of cure (defined for an epoxide system as the concentration of epoxide/amine bonds divided by the initial epoxide concentration) in epoxy resins is investigated. The experimental setup used to measure the changes in longitudinal velocity with time is described, together with the technique used to calculate the degree of cure from the acoustic data, using the principle of additive module. Measurements were done with diglycidyl ether of bisphenol A epoxy resin cured with an amine adduct agent. Good qualitative agreement was shown between the time dependence of the acoustically measured degree of cure and the predicted rate of reaction.

  20. Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study)

    PubMed Central

    Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise

    2014-01-01

    Objective To explore views of service providers caring for injured people on: the extent to which services meet patients’ needs and their perspectives on factors contributing to any identified gaps in service provision. Design Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers’ views were elicited through semistructured interviews. Data were analysed using thematic analysis. Setting Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. Participants 40 service providers from a range of disciplines. Results Service providers described two distinct models of trauma care: an ‘ideal’ model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a ‘real’ model based on the realities of National Health Service (NHS) practice. Participants’ ‘ideal’ model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, ‘real’ care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients’ needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Conclusions Service providers envisage an ‘ideal’ model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between ‘real’ and ‘ideal’ care. Using service provider views to inform service design and delivery could enhance the quality, patient experience and outcomes of care. PMID:25005598

  1. [What do we know about participation in cultural activities and health?].

    PubMed

    Knudtsen, Margunn Skjei; Holmen, Jostein; Håpnes, Odd

    2005-12-15

    Knowledge of the association between health status and lifestyle factors, such as food habits, smoking and physical activity, is abundant. Other lifestyle factors, such as participation in cultural activities, have attained less attention. The article is based on studies of the literature. Reference lists in key articles have been used as well as references given by research colleagues. The survey shows an association between participation in cultural activities, cultural experiences and health status, also when measured by differing methods. Further population studies, longitudinal studies and controlled studies are needed in order to expand our knowledge of the relationship between participation in cultural activities and health status. There is a need for multidisciplinary cooperation and increased use of combined quantitative and qualitative methods.

  2. Bouncing forward of young refugees: a perspective on resilience research directions

    PubMed Central

    Sleijpen, Marieke; June ter Heide, F. Jackie; Mooren, Trudy; Boeije, Hennie R.; Kleber, Rolf J.

    2013-01-01

    While studies on the consequences of trauma and forced migration on young refugees have focused mainly on their pathology, a focus on resilience in young refugees is needed to adequately represent their response to adversity and to help understand their needs. The aim of this article is to present a proposed study of resilience in young refugees which has been informed by an overview of achievements and challenges in the field of resilience. In order to advance the field of resilience, several topics need clarification: definition and assessment of resilience, the relation of resilience to other constructs and the underlying biological and external factors influencing resilience. With respect to young refugees, the cross-cultural applicability of resilience has to be examined. Qualitative research, mixed method designs, comparative studies, and longitudinal studies seem especially promising in furthering this goal. The proposed study compares refugee adolescents with Dutch adolescents. Data from qualitative evidence synthesis, interviews, questionnaires, experiments, and DNA analysis will be combined to provide a multifaceted picture of factors contributing to resilience, resulting in a better understanding and efficient use of “resilience” to meet the needs of traumatised youth. PMID:23671759

  3. Using longitudinal mixed methods to study the development of professional behaviours during pharmacy work-based training.

    PubMed

    Jee, Samuel D; Schafheutle, Ellen I; Noyce, Peter R

    2017-05-01

    Recent longitudinal investigations of professional socialisation and development of professional behaviours during work-based training are lacking. Using longitudinal mixed methods, this study aimed to explore the development of professional behaviours during a year of intensive work-based (pre-registration) training in pharmacy. Twenty trainee pharmacists and their tutors completed semi-structured interview and professional behaviour questionnaires at four time points during 2011/2012: months 1, 4 and 9 during training and 4 months after registration; tutors participated in months 1 and 9. Interviews were analysed thematically using template analysis, and questionnaires were analysed using ANOVA and t-tests. Self-assessed (trainee) and tutor ratings of all elements of professional behaviours measured in questionnaires (appearance, interpersonal/social skills, responsibility, communication skills) increased significantly from the start of pre-registration training to post-registration. Some elements, for example, communication skills, showed more change over time compared with others, such as appearance, and continued to improve post-registration. Qualitative findings highlighted the changing roles of trainees and learning experiences that appeared to facilitate the development of professional behaviours. Trainees' colleagues, and particularly tutors, played an essential part in trainees' development through offering support and role modelling. Trainees noted that they would have benefited from more responsibilities during training to ease the transition into practising as a responsible pharmacist. Longitudinal mixed methods can unpack the way in which professional behaviours develop during work-based training and allow researchers to examine changes in the demonstration of professional behaviours and how they occur. Identifying areas less prone to change allows for more focus to be given to supporting trainees in areas where there is a development need, such as communication skills and holding increasing responsibility. © 2016 John Wiley & Sons Ltd.

  4. Undergraduate medical education programme renewal: a longitudinal context, input, process and product evaluation study.

    PubMed

    Mirzazadeh, Azim; Gandomkar, Roghayeh; Hejri, Sara Mortaz; Hassanzadeh, Gholamreza; Koochak, Hamid Emadi; Golestani, Abolfazl; Jafarian, Ali; Jalili, Mohammad; Nayeri, Fatemeh; Saleh, Narges; Shahi, Farhad; Razavi, Seyed Hasan Emami

    2016-02-01

    The purpose of this study was to utilize the Context, Input, Process and Product (CIPP) evaluation model as a comprehensive framework to guide initiating, planning, implementing and evaluating a revised undergraduate medical education programme. The eight-year longitudinal evaluation study consisted of four phases compatible with the four components of the CIPP model. In the first phase, we explored the strengths and weaknesses of the traditional programme as well as contextual needs, assets, and resources. For the second phase, we proposed a model for the programme considering contextual features. During the process phase, we provided formative information for revisions and adjustments. Finally, in the fourth phase, we evaluated the outcomes of the new undergraduate medical education programme in the basic sciences phase. Information was collected from different sources such as medical students, faculty members, administrators, and graduates, using various qualitative and quantitative methods including focus groups, questionnaires, and performance measures. The CIPP model has the potential to guide policy makers to systematically collect evaluation data and to manage stakeholders' reactions at each stage of the reform in order to make informed decisions. However, the model may result in evaluation burden and fail to address some unplanned evaluation questions.

  5. A longitudinal study of independent scholar-published open access journals.

    PubMed

    Björk, Bo-Christer; Shen, Cenyu; Laakso, Mikael

    2016-01-01

    Open Access (OA) is nowadays increasingly being used as a business model for the publishing of scholarly peer reviewed journals, both by specialized OA publishing companies and major, predominantly subscription-based publishers. However, in the early days of the web OA journals were mainly founded by independent academics, who were dissatisfied with the predominant print and subscription paradigm and wanted to test the opportunities offered by the new medium. There is still an on-going debate about how OA journals should be operated, and the volunteer model used by many such 'indie' journals has been proposed as a viable alternative to the model adopted by big professional publishers where publishing activities are funded by authors paying expensive article processing charges (APCs). Our longitudinal quantitative study of 250 'indie' OA journals founded prior to 2002, showed that 51% of these journals were still in operation in 2014 and that the median number of articles published per year had risen from 11 to 18 among the survivors. Of these surviving journals, only 8% had started collecting APCs. A more detailed qualitative case study of five such journals provided insights into how such journals have tried to ensure the continuity and longevity of operations.

  6. A longitudinal study of independent scholar-published open access journals

    PubMed Central

    Björk, Bo-Christer; Laakso, Mikael

    2016-01-01

    Open Access (OA) is nowadays increasingly being used as a business model for the publishing of scholarly peer reviewed journals, both by specialized OA publishing companies and major, predominantly subscription-based publishers. However, in the early days of the web OA journals were mainly founded by independent academics, who were dissatisfied with the predominant print and subscription paradigm and wanted to test the opportunities offered by the new medium. There is still an on-going debate about how OA journals should be operated, and the volunteer model used by many such ‘indie’ journals has been proposed as a viable alternative to the model adopted by big professional publishers where publishing activities are funded by authors paying expensive article processing charges (APCs). Our longitudinal quantitative study of 250 ‘indie’ OA journals founded prior to 2002, showed that 51% of these journals were still in operation in 2014 and that the median number of articles published per year had risen from 11 to 18 among the survivors. Of these surviving journals, only 8% had started collecting APCs. A more detailed qualitative case study of five such journals provided insights into how such journals have tried to ensure the continuity and longevity of operations. PMID:27190709

  7. Should First-Year Doctoral Students Be Supervised Collectively or Individually? Effects on Thesis Completion and Time to Completion

    ERIC Educational Resources Information Center

    Agné, Hans; Mörkenstam, Ulf

    2018-01-01

    Whether supervision of doctoral students is best pursued individually or collectively is a recurring but unresolved question in debates on higher education. The rarity of longitudinal data and the common usage of qualitative methods to analyse a limited number of cases have left the effectiveness of either model largely untested. To assist with…

  8. Outcome of a Tobacco Use Cessation Randomized Trial with High-School Students

    PubMed Central

    BURTON, Dee; CHAKRAVORTY, B.; WEEKS, K.; FLAY, B. R.; DENT, C.; STACY, A.; SUSSMAN, S.

    2009-01-01

    This study analyzed quantitative data on tobacco use and dependency for 3,589 high-school students, qualitative data for 448 students, and outcome data for a randomized trial comparing the efficacy of two cessation interventions and a control condition for 337 students. Data were collected from 1988 through 1992 in California and Illinois as part of a larger longitudinal study. Smokeless tobacco users, but not smokers, were more likely than controls to maintain cessation for 4 months: biochemically validated cessation at 4 months was 6.5% versus 3.2% for smokers and 14.3% versus 0.0% for smokeless tobacco users. Implications and limitations are discussed. PMID:19938938

  9. Capitals diminished, denied, mustered and deployed. A qualitative longitudinal study of women's four year trajectories after acute health crisis, Burkina Faso

    PubMed Central

    Murray, Susan F.; Akoum, Mélanie S.; Storeng, Katerini T.

    2012-01-01

    Accumulating evidence indicates that health crises can play a key role in precipitating or exacerbating poverty. For women of reproductive age in low-income countries, the complications of pregnancy are a common cause of acute health crisis, yet investigation of longer-term dynamics set in motion by such events, and their interactions with other aspects of social life, is rare. This article presents findings from longitudinal qualitative research conducted in Burkina Faso over 2004–2010. Guided by an analytic focus on patterns of continuity and change, and drawing on recent discussions on the notion of ‘resilience’, and the concepts of ‘social capital’ and ‘bodily capital’, we explore the trajectories of 16 women in the aftermath of costly acute healthcare episodes. The synthesis of case studies shows that, in conditions of structural inequity and great insecurity, an individual's social capital ebbs and flow over time, resulting in a trajectory of multiple adaptations. Women's capacity to harness or exploit bodily capital in its various forms (beauty, youthfulness, physical strength, fertility) to some extent determines their ability to confront and overcome adversities. With this, they are able to further mobilise social capital without incurring excessive debt, or to access and accumulate significant new social capital. Temporary self-displacement, often to the parental home, is also used as a weapon of negotiation in intra-household conflict and to remind others of the value of one's productive and domestic labour. Conversely, diminished bodily capital due to the physiological impact of an obstetric event or its complications can lead to reduced opportunities, and to further disadvantage. PMID:23063215

  10. A singing choir: Understanding the dynamics of hope, hopelessness, and despair in palliative care patients. A longitudinal qualitative study.

    PubMed

    Olsman, Erik; Leget, Carlo; Duggleby, Wendy; Willems, Dick

    2015-12-01

    Hope, despair, and hopelessness are dynamic in nature; however, they have not been explored over time. The objective of the present study was to describe hope, hopelessness, and despair over time, as experienced by palliative care patients. We employed a qualitative longitudinal method based on narrative theories. Semistructured interviews with palliative care patients were prospectively conducted, recorded, and transcribed. Data on hope, hopelessness and despair were thematically analyzed, which led to similarities and differences between these concepts. The concepts were then analyzed over time in each case. During all stages, the researchers took a reflexive stance, wrote memos, and did member checking with participants. A total of 29 palliative care patients (mean age, 65.9 years; standard deviation, 14.7; 14 females) were included, 11 of whom suffered from incurable cancer, 10 from severe chronic obstructive pulmonary disease, and 8 from severe heart failure. They were interviewed a maximum of three times. Participants associated hope with gains in the past or future, such as physical improvement or spending time with significant others. They associated hopelessness with past losses, like loss of health, income, or significant others, and despair with future losses, which included the possibility of losing the future itself. Over time, the nature of their hope, hopelessness, and despair changed when their condition changed. These dynamics could be understood as voices in a singing choir that can sing together, alternate with each other, or sing their own melody. Our findings offer insight into hope, hopelessness, and despair over time, and the metaphor of a choir helps to understand the coexistence of these concepts. The findings also help healthcare professionals to address hope, hopelessness, and despair during encounters with patients, which is particularly important when the patients' physical condition has changed.

  11. Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study.

    PubMed

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

    2013-01-01

    Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. To investigate if and how nursing home residents' personal dignity changes over the course of time, and what contributes to this. A longitudinal qualitative study. Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1) finding a way to cope with one's situation; 2) getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3) physical improvement (with or without an electric wheelchair); 4) being socially involved with nursing home staff, other residents and relatives; and 5) being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. Although the direction in which a resident's personal dignity develops is also dependent on one's character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person.

  12. Evolution of Pediatric Chronic Disease Treatment Decisions: A Qualitative, Longitudinal View of Parents' Decision-Making Process.

    PubMed

    Lipstein, Ellen A; Britto, Maria T

    2015-08-01

    In the context of pediatric chronic conditions, patients and families are called upon repeatedly to make treatment decisions. However, little is known about how their decision making evolves over time. The objective was to understand parents' processes for treatment decision making in pediatric chronic conditions. We conducted a qualitative, prospective longitudinal study using recorded clinic visits and individual interviews. After consent was obtained from health care providers, parents, and patients, clinic visits during which treatment decisions were expected to be discussed were video-recorded. Parents then participated in sequential telephone interviews about their decision-making experience. Data were coded by 2 people and analyzed using framework analysis with sequential, time-ordered matrices. 21 families, including 29 parents, participated in video-recording and interviews. We found 3 dominant patterns of decision evolution. Each consisted of a series of decision events, including conversations, disease flares, and researching of treatment options. Within all 3 patterns there were both constant and evolving elements of decision making, such as role perceptions and treatment expectations, respectively. After parents made a treatment decision, they immediately turned to the next decision related to the chronic condition, creating an iterative cycle. In this study, decision making was an iterative process occurring in 3 distinct patterns. Understanding these patterns and the varying elements of parents' decision processes is an essential step toward developing interventions that are appropriate to the setting and that capitalize on the skills families may develop as they gain experience with a chronic condition. Future research should also consider the role of children and adolescents in this decision process. © The Author(s) 2015.

  13. After critical care: patient support after critical care. A mixed method longitudinal study using email interviews and questionnaires.

    PubMed

    Pattison, Natalie; O'Gara, Geraldine; Rattray, Janice

    2015-08-01

    To explore experiences and needs over time, of patients discharged from ICU using the Intensive Care Experience (ICE-q) questionnaire, Hospital Anxiety and Depression Scale (HADS) and EuroQoL (EQ-5D), associated clinical predictors (APACHE II, TISS, Length of stay, RIKER scores) and in-depth email interviewing. A mixed-method, longitudinal study of patients with >48hour ICU stays at 2 weeks, 6 months, 12 months using the ICE-q, HADS, EQ-5D triangulated with clinical predictors, including age, gender, length of stay (ICU and hospital), APACHE II and TISS. In-depth qualitative email interviews were completed at 1 month and 6 months. Grounded Theory analysis was applied to interview data and data were triangulated with questionnaire and clinical data. Data was collected from January 2010 to March 2012 from 77 participants. Both mean EQ-5D visual analogue scale, utility scores and HADS scores improved from 2 weeks to 6 months, (p=<0.001; p=<0.001), but between 6 and 12 months, no change was found in data from either questionnaire, suggesting improvements level off. These variations were reflected in qualitative data themes: rehabilitation/recovery in the context of chronic illness; impact of critical care; emotional and psychological needs (including sub-themes of: information needs and relocation anxiety). The overarching, core theme related to adjustment of normality. Patient recovery in this population appears to be shaped by ongoing illness and treatment. Email interviews offer a convenient method of gaining in-depth interview data and could be used as part of ICU follow-up. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  14. 'I think my body has become addicted to those tablets'. Chronic heart failure patients' understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda.

    PubMed

    Namukwaya, Elizabeth; Murray, Scott A; Downing, Julia; Leng, Mhoira; Grant, Liz

    2017-01-01

    Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients' understanding of their illness and their beliefs influence their health related behaviour. The study aimed to explore the beliefs of patients with heart failure, their understanding of their illness and its treatment, and how this influenced their health related behaviour to inform future health education programs, information and palliative care services. Serial qualitative in-depth interviews were conducted with Heart Failure patients who were purposively sampled and recruited in Mulago National Referral Hospital until thematic saturation was reached. In-depth interviews were conducted at three time points over the course of their illness with intervals of 3 months between interviews. A grounded theory approach was used in data analysis. The University of Edinburgh ethics committee, Mulago Hospital Research Ethics committee and the Uganda National Council of Science and Technology (Reference numbers D/GC/178; MREC 33, SS 3083 respectively) approved the research. A total of 40 face to face qualitative longitudinal interviews (36-patient alone, 4 paired-patient and family carer), were conducted with 21 patients. The findings revealed that heart failure patients were unaware of the symptoms of the illness and their definition of illness differed from that of health professionals. Patients understood their diagnosis, cause of illness, prognosis and the importance of the medicines differently from health professionals, and had insufficient information on self-care. Lay beliefs were used to explain many aspects of the illness and treatments. All these influenced where patients sought care and their adherence to treatment, self-care and follow up leading to uncontrolled disease. There is a high level of health illiteracy among heart failure patients in Uganda. Patients rely on lay beliefs to make health decisions and medical information is often miscomprehended. There is an urgent need for health education using culturally appropriate information.

  15. ‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda

    PubMed Central

    Murray, Scott A.; Downing, Julia; Leng, Mhoira; Grant, Liz

    2017-01-01

    Background Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients’ understanding of their illness and their beliefs influence their health related behaviour. The study aimed to explore the beliefs of patients with heart failure, their understanding of their illness and its treatment, and how this influenced their health related behaviour to inform future health education programs, information and palliative care services. Methods Serial qualitative in-depth interviews were conducted with Heart Failure patients who were purposively sampled and recruited in Mulago National Referral Hospital until thematic saturation was reached. In-depth interviews were conducted at three time points over the course of their illness with intervals of 3 months between interviews. A grounded theory approach was used in data analysis. The University of Edinburgh ethics committee, Mulago Hospital Research Ethics committee and the Uganda National Council of Science and Technology (Reference numbers D/GC/178; MREC 33, SS 3083 respectively) approved the research. Results A total of 40 face to face qualitative longitudinal interviews (36-patient alone, 4 paired-patient and family carer), were conducted with 21 patients. The findings revealed that heart failure patients were unaware of the symptoms of the illness and their definition of illness differed from that of health professionals. Patients understood their diagnosis, cause of illness, prognosis and the importance of the medicines differently from health professionals, and had insufficient information on self-care. Lay beliefs were used to explain many aspects of the illness and treatments. All these influenced where patients sought care and their adherence to treatment, self-care and follow up leading to uncontrolled disease. Conclusion There is a high level of health illiteracy among heart failure patients in Uganda. Patients rely on lay beliefs to make health decisions and medical information is often miscomprehended. There is an urgent need for health education using culturally appropriate information. PMID:28957338

  16. Evaluating the comparative effectiveness of different demand side interventions to increase maternal health service utilization and practice of birth spacing in South Kivu, Democratic Republic of Congo: an innovative, mixed methods approach.

    PubMed

    Dumbaugh, Mari; Bapolisi, Wyvine; van de Weerd, Jennie; Zabiti, Michel; Mommers, Paula; Balaluka, Ghislain Bisimwa; Merten, Sonja

    2017-07-03

    In this protocol we describe a mixed methods study in the province of South Kivu, Democratic Republic of Congo evaluating the effectiveness of different demand side strategies to increase maternal health service utilization and the practice of birth spacing. Conditional service subsidization, conditional cash transfers and non-monetary incentives aim to encourage women to use maternal health services and practice birth spacing in two different health districts. Our methodology will comparatively evaluate the effectiveness of different approaches against each other and no intervention. This study comprises four main research activities: 1) Formative qualitative research to determine feasibility of planned activities and inform development of the quantitative survey; 2) A community-based, longitudinal survey; 3) A retrospective review of health facility records; 4) Qualitative exploration of intervention acceptability and emergent themes through in-depth interviews with program participants, non-participants, their partners and health providers. Female community health workers are engaged as core members of the research team, working in tandem with female survey teams to identify women in the community who meet eligibility criteria. Female community health workers also act as key informants and community entry points during methods design and qualitative exploration. Main study outcomes are completion of antenatal care, institutional delivery, practice of birth spacing, family planning uptake and intervention acceptability in the communities. Qualitative methods also explore decision making around maternal health service use, fertility preference and perceptions of family planning. The innovative mixed methods design allows quantitative data to inform the relationships and phenomena to be explored in qualitative collection. In turn, qualitative findings will be triangulated with quantitative findings. Inspired by the principles of grounded theory, qualitative analysis will begin while data collection is ongoing. This "conversation" between quantitative and qualitative data will result in a more holistic, context-specific exploration and understanding of research topics, including the mechanisms through which the interventions are or are not effective. In addition, engagement of female community health workers as core members of the research team roots research methods in the realities of the community and provides teams with key informants who are simultaneously implicated in the health system, community and target population.

  17. Peer workers' perceptions and experiences of barriers to implementation of peer worker roles in mental health services: A literature review.

    PubMed

    Vandewalle, Joeri; Debyser, Bart; Beeckman, Dimitri; Vandecasteele, Tina; Van Hecke, Ann; Verhaeghe, Sofie

    2016-08-01

    To identify peer workers' perceptions and experiences of barriers to implementation of peer worker roles in mental health services. Review of qualitative and quantitative studies. A comprehensive electronic database search was conducted between October 2014 and December 2015 in PubMed, CINAHL, Web of Science, The Cochrane Library, and PsycARTICLES. Additional articles were identified through handsearch. All articles were assessed on quality. A thematic analysis informed by a multi-level approach was adopted to identify and discuss the main themes in the individual studies. Reporting was in line with the 'Enhancing transparency in reporting the synthesis of qualitative research' statement. Eighteen articles met the inclusion criteria. All studies adopted qualitative research methods, of which three studies used additional quantitative methods. Peer workers' perceptions and experiences cover a range of themes including the lack of credibility of peer worker roles, professionals' negative attitudes, tensions with service users, struggles with identity construction, cultural impediments, poor organizational arrangements, and inadequate overarching social and mental health policies. This review can inform policy, practice and research from the unique perspective of peer workers. Mental health professionals and peer workers should enter into an alliance to address barriers in the integration of peer workers and to enhance quality of service delivery. Longitudinal research is needed to determine how to address barriers in the implementation of peer worker roles. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. [Everyday life and solidarity in north-east German rural communities - first qualitative results of the Rural Health Study].

    PubMed

    Nebelung, C; Forkel, J A; Elkeles, T

    2010-03-01

    There have been increasing discussions in the health sciences in recent years about socio-spatial influences on health activities. The starting point has been the growing territorial inequality in spatial development resources, which has an effect on the participatory chances of people in structurally weak regions. The concept of "peripherisation" is used to describe this change. Empirical investigations of socio-spatial resources at the local level are rare, because the theoretical preconditions have not been elaborated sufficiently for the theoretical modelling to be recognised for hypothesis-based empirical investigations. At the centre of this theorisation are analyses of the "social capital" of every-day actions. As part of the Rural Health Study 2008 at the University of Applied Science Neubrandenburg (involving a longitudinal analysis with quantitative surveys in 14 rural communities in north-eastern Germany 1973, 1994, 2008), a qualitative approach was also adopted with case and community studies. The first results are compared with the state of the literature. Case studies are presented showing strategies for adaptation and improvement of the individual's situation, and also the daily solidarity of people in villages. Development potentials are outlined. Georg Thieme Verlag KG Stuttgart. New York.

  19. Obesity interventions for people with a learning disability: an integrative literature review.

    PubMed

    Jinks, Annette; Cotton, Angela; Rylance, Rebecca

    2011-03-01

    This paper is a review of the effectiveness of non-surgical, non-pharmaceutical interventions designed to promote weight loss in people with a learning disability and how qualitative evidence on people's experiences and motivations can help understanding of the quantitative research outcomes. The health risks of obesity underline the importance of effective evidence-based weight loss interventions for people with learning disabilities as they are at increased risk of being overweight. Papers published from 1998 to 2009 were identified through searches of the Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), PSYCHINFO databases, and the Cochrane Library. An integrative review method was used. Studies included were non-surgical or non-pharmaceutical interventions aimed at weight reduction for people with a learning disability. Synthesis of the findings related to study design, participants, types of interventions, outcome measures and participant perspectives. Twelve studies met the inclusion criteria. The most common research design was quasi-experimental pretest and post-test. Few researchers used a clinical trial approach, and there was only one predominantly qualitative study. Interventions were mainly focused on energy intake, energy expenditure or health promotion. Only a few studies incorporated behaviour modification approaches. Nurses who work with clients with learning disabilities have a key role to play in the management of obesity. Future research needs to focus on qualitative studies of the perceptions of clients and their families, controlled trials investigating the effectiveness of interventions and their costs and sustainability, and longitudinal studies examining weight loss over time. © 2010 Blackwell Publishing Ltd.

  20. How do veterinary students' motivation and study practices relate to academic success?

    PubMed

    Mikkonen, Johanna; Ruohoniemi, Mirja

    2011-01-01

    The aim of the present study was to explore the factors associated with veterinary students' study success. All veterinary students who began their studies at the University of Helsinki in 2005 participated in this qualitative longitudinal study (N=52). The data consisted of assignments that the students completed at the beginning of their studies and again after three years of studying. The focus was on differences in motivation and study practices as well as possible changes in these over the three-year period. The students were divided into three groups according to their study success (grade point average and study progress). These groups were compared according to group-level differences in the categorized data. The most successful students already described themselves using more positive words than other students at the beginning of their veterinary studies. In addition, they seemed more adaptive in relation to the study's demands. However, there were drops in both the most and least successful students' motivation during their studies. The findings suggest that it is possible to predict forthcoming study problems by analyzing students' study practices and their own descriptions of themselves as learners. In addition, the results show that veterinary students' high motivation cannot be taken for granted. The comparative and longitudinal perspective of the present study can be useful in the development of curricula and in student support.

  1. Comparing professional values and authentic leadership dimensions in baccalaureate nursing students: a longitudinal study.

    PubMed

    Dever, Kathleen H; Roman, Tammy C; Smith, Charlene M; Bowllan, Nancy M; Dollinger, Marilyn L; Blaine, Bruce Evan

    2015-06-01

    A series of three baccalaureate Nursing Leadership and Patient-Centered Care (NLPCC) courses were developed to strengthen students' perceptions and preparation as leaders in the delivery of patient-centered care through more effective professional socialization. A mixed-methods design was used, administering two surveys to students at the start of the junior year and the end of their senior year, plus two qualitative questions were administered after the second-semester junior and senior years. Qualitative data reflected a growing awareness of the professional nurse's role and responsibilities beyond the bedside. Graduating senior students demonstrated a heightened awareness for the socialization and realities of practice and a growing sense of readiness and empowerment to embrace the professional role of an RN. Through role modeling, scripted conversations, and focused dialogue, the infusion of knowledge, skills, and attitudes from the Quality and Safety Education for Nurses competencies allowed students to hone their socialization skills prior to entering the workforce. Copyright 2015, SLACK Incorporated.

  2. Lifestyle in Multiple Myeloma - a longitudinal cohort study protocol.

    PubMed

    Heinrich, M; Fisher, A; Paton, B; McCourt, O; Beeken, R J; Hackshaw, A; Wardle, J; Yong, K

    2016-07-04

    Deterioration in bone health is one of the presenting symptoms of Multiple Myeloma (MM), a cancer of plasma cells. As a consequence of this condition, patients suffer bone pain and bone damage and report cancer-related fatigue, resulting in deterioration in their quality of life. Evidence in patients with solid tumours shows promise for the positive effects of physical activity on quality of life. However, in the case of patients with MM a better understanding of the association between physical fitness and quality of life factors is still required. Therefore, this cohort study aims to objectively and longitudinally assess activity and fitness levels in patients with MM in order to explore their role in bone health, fatigue and quality of life for this patient population. The study is a prospective cohort study of MM patients in remission to assess physical activity, fatigue and bone health. Clinical markers of health, self-reported measures of psychological and physical well-being, and lifestyle behaviours are assessed at baseline, 3, 6 and 12 months. At each time point, patients complete cardiopulmonary exercise testing (CPET) along with a series of objective tests to assess physical fitness (eg accelerometry) and a number of self-report measures. A complementary qualitative study will be carried out in order to explore patients' desire for lifestyle advice and when in their cancer journey they deem such advice to be useful. This study will be the first to prospectively and longitudinally explore associations between physical fitness and well-being, bone health, and fatigue (along with a number of other physical and clinical outcomes) in a cohort of patients with MM with the use of objective measures. The findings will also help to identify time points within the MM pathway at which physical activity interventions may be introduced for maximum benefit.

  3. Analysis of the vector magnetic fields of complex sunspots

    NASA Technical Reports Server (NTRS)

    Patty, S. R.

    1981-01-01

    An analysis of the vector magnetic field in the delta-configurations of two complex sunspot groups is presented, noting several characteristics identified in the delta-configurations. The observations of regions 2469 (S12E80) and 2470 (S21E83) took place in May, 1980 with a vector magnetograph, verified by optical viewing. Longitudinal magnetic field plots located the delta-configurations in relation to the transverse field neutral line. It is shown that data on the polarization yields qualitative information on the magnetic field strengths, while the azimuth of the transverse field can be obtained from the relative intensities of linear polarization measurements aligned with respect to the magnetograph analyses axis at 0 and 90 deg, and at the plus and minus 45 deg positions. Details of the longitudinal fields are discussed. A strong, sheared transverse field component is found to be a signature of strong delta. A weak delta is accompanied by a weak longitudinal gradient with an unsheared transverse component of variable strength.

  4. Quantitative assessment of isolated rapid eye movement (REM) sleep without atonia without clinical REM sleep behavior disorder: clinical and research implications.

    PubMed

    Sasai-Sakuma, Taeko; Frauscher, Birgit; Mitterling, Thomas; Ehrmann, Laura; Gabelia, David; Brandauer, Elisabeth; Inoue, Yuichi; Poewe, Werner; Högl, Birgit

    2014-09-01

    Rapid eye movement (REM) sleep without atonia (RWA) is observed in some patients without a clinical history of REM sleep behavior disorder (RBD). It remains unknown whether these patients meet the refined quantitative electromyographic (EMG) criteria supporting a clinical RBD diagnosis. We quantitatively evaluated EMG activity and investigated its overnight distribution in patients with isolated qualitative RWA. Fifty participants with an incidental polysomnographic finding of RWA (isolated qualitative RWA) were included. Tonic, phasic, and 'any' EMG activity during REM sleep on PSG were quantified retrospectively. Referring to the quantitative cut-off values for a polysomnographic diagnosis of RBD, 7/50 (14%) and 6/50 (12%) of the patients showed phasic and 'any' EMG activity in the mentalis muscle above the respective cut-off values. No patient was above the cut-off value for tonic EMG activity or phasic EMG activity in the anterior tibialis muscles. Patients with RWA above the cut-off value showed higher amounts of RWA during later REM sleep periods. This is the first study showing that some subjects with incidental RWA meet the refined quantitative EMG criteria for a diagnosis of RBD. Future longitudinal studies must investigate whether this subgroup with isolated qualitative RWA is at an increased risk of developing fully expressed RBD and/or neurodegenerative disease. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Refugees, asylum-seekers and undocumented migrants and the experience of parenthood: a synthesis of the qualitative literature.

    PubMed

    Merry, Lisa; Pelaez, Sandra; Edwards, Nancy C

    2017-09-19

    To synthesize the recent qualitative literature and identify the integrative themes describing the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We searched seven online databases for the period January 2006 to February 2017. We included English and French published peer-reviewed articles and graduate-level dissertations, which qualitatively examined the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We summarized study characteristics and performed a thematic analysis across the studies. One hundred thirty eight studies met inclusion criteria. All but three were conducted in high-income countries, mainly in the US. Migrants studied were mostly undocumented from Latin America and refugees from Sub-Saharan Africa. Almost all studies (93%) included mothers; about half (47%) included fathers; very few (5%) included extended family members. We identified three integrative themes: 1) experiencing hardship and/or loss in the context of precarious migration and past traumas; 2) building resilience and strength by bridging language, norms and expectations; and 3) living transnationally: obligations, challenges and resources. Each theme contributed to shaping the parenthood experience; the transnationalism theme intersected with the themes on hardship and loss and resilience and strength. More research is needed with fathers, extended family members, asylum-seekers and in the LMIC context. A transnational lens needs to be applied to programs, policies and future research for refugee, asylum-seeker and undocumented migrant parents. Addressing transnational concerns (family separation and reunification), acknowledging transnational resources, fostering a transnational family identity and conducting transnational and longitudinal studies are potentially pivotal approaches for this sub-population of parents.

  6. The Real-World Problem of Care Coordination: A Longitudinal Qualitative Study with Patients Living with Advanced Progressive Illness and Their Unpaid Caregivers

    PubMed Central

    Daveson, Barbara A.; Harding, Richard; Shipman, Cathy; Mason, Bruce L.; Epiphaniou, Eleni; Higginson, Irene J.; Ellis-Smith, Clare; Henson, Lesley; Munday, Dan; Nanton, Veronica; Dale, Jeremy R.; Boyd, Kirsty; Worth, Allison; Barclay, Stephen; Donaldson, Anne; Murray, Scott

    2014-01-01

    Objectives To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. Design A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. Methods Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. Participants Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. Settings Three cases from contrasting primary, secondary and tertiary settings within Britain. Results Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients’ and caregivers’ needs, preferences, circumstances and abilities. Conclusions Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients’ and caregivers’ views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding oversimplification can help with the development, evaluation and implementation of real-world coordination interventions for patients and their unpaid caregivers in the future. PMID:24788451

  7. A place to call home: study protocol for a longitudinal, mixed methods evaluation of two housing first adaptations in Sydney, Australia.

    PubMed

    Whittaker, Elizabeth; Swift, Wendy; Flatau, Paul; Dobbins, Timothy; Schollar-Root, Olivia; Burns, Lucinda

    2015-04-09

    This protocol describes a study evaluating two 'Housing First' programs, Platform 70 and Common Ground, presently being implemented in the inner-city region of Sydney, Australia. The Housing First approach prioritises housing individuals who are homeless in standard lease agreement tenancies as rapidly as possible to lock in the benefits from long-term accommodation, even where the person may not be seen as 'housing ready'. The longitudinal, mixed methods evaluation utilises both quantitative and qualitative data collected at baseline and 12-month follow-up time points. For the quantitative component, clients of each program were invited to complete client surveys that reported on several factors associated with chronic homelessness and were hypothesised to improve under stable housing, including physical and mental health status and treatment rates, quality of life, substance use patterns, and contact with the health and criminal justice systems. Semi-structured interviews with clients and stakeholders comprised the qualitative component and focused on individual experiences with, and perceptions of, the two programs. In addition, program data on housing stability, rental subsidies and support levels provided to clients by agencies was collected and will be used in conjunction with the client survey data to undertake an economic evaluation of the two programs. This study will systematically evaluate the efficacy of a scatter site model (Platform 70) and a congregated model (Common Ground) of the Housing First approach; an examination that has not yet been made either in Australia or internationally. A clear strength of the study is its timing. It was designed and implemented as the programs in question themselves were introduced. Moreover, the programs were introduced when the Australian Government, with State and Territory support, began a more focused, coordinated response to homelessness and funded rapid expansion of innovative homelessness programs across the country, including Common Ground supportive housing developments.

  8. A longitudinal qualitative study examining the factors impacting on the ability of persons with T1DM to assimilate the Dose Adjustment for Normal Eating (DAFNE) principles into daily living and how these factors change over time

    PubMed Central

    2011-01-01

    Background The literature reveals that structured education programmes, such as DAFNE, result in many positive outcomes for people with Type 1 diabetes including a decrease in HbA1c levels and reductions in hypoglycaemia. While there is evidence that some of these outcomes are maintained we do not know at present what factors are most important over time. The study aim was to identify the key factors impacting on persons with Type 1 diabetes ability to assimilate the Dose Adjustment For Normal Eating (DAFNE) DAFNE principles into their daily lives and how these factors change over time. Methods This is a longitudinal descriptive qualitative study. Interviews were undertaken with 40 participants who had attended DAFNE in one of 5 study sites across the Island of Ireland, at 6 weeks, 6 and 12 months after completion of the programme. The interviews lasted from 30 to 60 minutes and were transcribed verbatim. Data were analysed in three ways, a within time analysis, a cross sectional analysis for each participant and a thematic analysis which focused on examining changes over time Results Four themes that influenced participants' ability to assimilate DAFNE into their daily lives over time were identified. These were: embedded knowledge, continued responsive support, enduring motivation and being empowered. Support at the 6 month period was found to be crucial to continued motivation. Conclusions Understanding the factors that influence people's ability to assimilate DAFNE principles over time into their daily lives can help health professionals give focused responsive support that helps people with diabetes become more empowered. Understanding that continued support matters, particularly around 6 months, is important as health professionals can influence good management by providing appropriate support and enhancing motivation. Trial registration ISRCTN79759174 PMID:21878104

  9. A Livelihood Intervention to Reduce the Stigma of HIV in Rural Kenya: Longitudinal Qualitative Study.

    PubMed

    Tsai, Alexander C; Hatcher, Abigail M; Bukusi, Elizabeth A; Weke, Elly; Lemus Hufstedler, Lee; Dworkin, Shari L; Kodish, Stephen; Cohen, Craig R; Weiser, Sheri D

    2017-01-01

    The scale-up of effective treatment has partially reduced the stigma attached to HIV, but HIV still remains highly stigmatized throughout sub-Saharan Africa. Most studies of anti-HIV stigma interventions have employed psycho-educational strategies such as information provision, counseling, and testimonials, but these have had varying degrees of success. Theory suggests that livelihood interventions could potentially reduce stigma by weakening the instrumental and symbolic associations between HIV and premature morbidity, economic incapacity, and death, but this hypothesis has not been directly examined. We conducted a longitudinal qualitative study among 54 persons with HIV participating in a 12-month randomized controlled trial of a livelihood intervention in rural Kenya. Our study design permitted assessment of changes over time in the perspectives of treatment-arm participants (N = 45), as well as an understanding of the experiences of control arm participants (N = 9, interviewed only at follow-up). Initially, participants felt ashamed of their seropositivity and were socially isolated (internalized stigma). They also described how others in the community discriminated against them, labeled them as being "already dead," and deemed them useless and unworthy of social investment (perceived and enacted stigma). At follow-up, participants in the treatment arm described less stigma and voiced positive changes in confidence and self-esteem. Concurrently, they observed that other community members perceived them as active, economically productive, and contributing citizens. None of these changes were noted by participants in the control arm, who described ongoing and continued stigma. In summary, our findings suggest a theory of stigma reduction: livelihood interventions may reduce internalized stigma among persons with HIV and also, by targeting core drivers of negative attitudes toward persons with HIV, positively change attitudes toward persons with HIV held by others. Further research is needed to formally test these hypotheses, assess the extent to which these changes endure over the long term, and determine whether this class of interventions can be implemented at scale.

  10. A livelihood intervention to reduce the stigma of HIV in rural Kenya: longitudinal qualitative study

    PubMed Central

    Tsai, Alexander C.; Hatcher, Abigail M.; Bukusi, Elizabeth A.; Weke, Elly; Hufstedler, Lee Lemus; Dworkin, Shari L.; Kodish, Stephen; Cohen, Craig R.; Weiser, Sheri D.

    2017-01-01

    The scale-up of effective treatment has partially reduced the stigma attached to HIV, but HIV still remains highly stigmatized throughout sub-Saharan Africa. Most studies of anti-HIV stigma interventions have employed psycho-educational strategies such as information provision, counseling, and testimonials, but these have had varying degrees of success. Theory suggests that livelihood interventions could potentially reduce stigma by weakening the instrumental and symbolic associations between HIV and premature morbidity, economic incapacity, and death, but this hypothesis has not been directly examined. We conducted a longitudinal qualitative study among 54 persons with HIV participating in a 12-month randomized controlled trial of a livelihood intervention in rural Kenya. Our study design permitted assessment of changes over time in the perspectives of treatment-arm participants (N=45), as well as an understanding of the experiences of control arm participants (N=9, interviewed only at follow-up). Initially, participants felt ashamed of their seropositivity and were socially isolated (internalized stigma). They also described how others in the community discriminated against them, labeled them as being “already dead,” and deemed them useless and unworthy of social investment (perceived and enacted stigma). At follow-up, participants in the treatment arm described less stigma and voiced positive changes in confidence and self-esteem. Concurrently, they observed that other community members perceived them as active, economically productive, and contributing citizens. Participants in the control arm described continued stigma with none of these changes. In summary, our findings suggest a theory of stigma reduction: livelihood interventions may reduce internalized stigma among persons with HIV and also, by targeting core drivers of negative attitudes toward persons with HIV, positively change attitudes toward persons with HIV held by others. Further research is needed to formally test these hypotheses, assess the extent to which these changes endure over the long term, and determine whether this class of interventions can be implemented at scale. PMID:26767535

  11. Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

    PubMed

    Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

    2017-01-01

    Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

  12. Use of the videophone to collect quality of life data from burn patients

    PubMed Central

    Yoder, Linda H; McFall, D Curk; Cancio, Leopoldo C

    2012-01-01

    Collecting quality of life (QOL) data longitudinally from burn survivors is difficult; especially if they live in geographically distant areas from the burn center. Although mailed surveys can be used, response rates to these surveys may be low. The purpose of this feasibility study was to examine the use of the videophone to collect QOL data from burn patients over 5 time points after discharge from the U.S. Army Institute of Surgical Research Burn Center. Twenty-five patients agreed to participate, using the Starview 2000 Pro II videophone. Participant satisfaction with the technology was measured using the Telemedicine Perception Questionnaire. Qualitative comments from participants and the researchers conducting the videophone data collection sessions also were collected. Military participants were approximately 20 years younger than civilian participants. Most burns were from a thermal cause and civilian patients had a slightly shorter length of stay in the burn center than military participants. The majority of participants were relatively happy with the telehealth technology, rating it with a mean score of 61.84 out of a possible total score of 85. Qualitative comments also reflected a positive attitude about the use of the videophone for research data collection; 60% of the participants said they remained in the study because they were allowed to use the videophone rather than using only the telephone or a mailed survey. The researchers collecting the data also commented about the ease of using the videophone. Negative comments were related to dropped calls or lack of audio or video at certain times. Findings from this study are consistent with the two other studies that reported use of telemedicine to clinically evaluate burn patients. With the rapid advancement of technology, QOL research data could be collected longitudinally from burn patients by using laptops with high resolution, portable video cameras. PMID:23272295

  13. In-hospital experiences of families of potential organ donors: A systematic review and qualitative synthesis

    PubMed Central

    Dicks, Sean Glenton; Ranse, Kristen; van Haren, Frank MP; Boer, Douglas P

    2017-01-01

    Information and compassion assist families of potential organ donors to make informed decisions. However, psychological implications of the in-hospital process are not well described with past research focusing on decision-making. To enhance understanding and improve service delivery, a systematic review was conducted. Inductive analysis and synthesis utilised Grounded Theory Methodology within a systems theory framework and contributed to a model proposing that family and staff form a System of Systems with shared responsibility for process outcomes. This model can guide evaluation and improvement of care and will be tested by means of a longitudinal study of family experiences. PMID:28680696

  14. Open adoption of infants: adoptive parents' feelings seven years later.

    PubMed

    Siegel, Deborah H

    2003-07-01

    Adoptions today increasingly include contact between adoptive and birth families. What do these "open adoptions" look like? How do the participants feel about them? This article, based on part of a longitudinal study that first examined adoptive parents' perceptions of their infants' open adoptions seven years ago, explores the parents' reactions now that their children are school age. This qualitative descriptive research revealed changes in the openness in the adoptions over time and identified four dimensions along which open adoptions vary. Findings showed parents' enthusiasm for the openness in their adoptions, regardless of the type and extent of openness. Implications for social work practice, education, and policy are explored.

  15. 'Distributed health literacy': longitudinal qualitative analysis of the roles of health literacy mediators and social networks of people living with a long-term health condition.

    PubMed

    Edwards, Michelle; Wood, Fiona; Davies, Myfanwy; Edwards, Adrian

    2015-10-01

    The role of one's social network in the process of becoming health literate is not well understood. We aim to explain the 'distributed' nature of health literacy and how people living with a long-term condition draw on their social network for support with health literacy-related tasks such as managing their condition, interacting with health professionals and making decisions about their health. This paper reports a longitudinal qualitative interview and observation study of the development and practice of health literacy in people with long-term health conditions, living in South Wales, UK. Participants were recruited from health education groups (n = 14) and community education venues (n = 4). The 44 interview transcripts were analysed using the 'Framework' approach. Health literacy was distributed through family and social networks, and participants often drew on the health literacy skills of others to seek, understand and use health information. Those who passed on their health literacy skills acted as health literacy mediators and supported participants in becoming more health literate about their condition. The distribution of health literacy supported participants to manage their health, become more active in health-care decision-making processes, communicate with health professionals and come to terms with living with a long-term condition. Participants accessed health literacy mediators through personal and community networks. Distributed health literacy is a potential resource for managing one's health, communicating with health professionals and making health decisions. © 2013 John Wiley & Sons Ltd.

  16. Vulnerability and access to care for South Asian Sikh and Muslim patients with life limiting illness in Scotland: prospective longitudinal qualitative study

    PubMed Central

    Worth, Allison; Irshad, Tasneem; Bhopal, Raj; Brown, Duncan; Lawton, Julia; Grant, Elizabeth; Murray, Scott; Kendall, Marilyn; Adam, James; Gardee, Rafik

    2009-01-01

    Objectives To examine the care experiences of South Asian Sikh and Muslim patients in Scotland with life limiting illness and their families and to understand the reasons for any difficulties with access to services and how these might be overcome. Design Prospective, longitudinal, qualitative design using in-depth interviews. Setting Central Scotland. Participants 25 purposively selected South Asian Sikh and Muslim patients, 18 family carers, and 20 key health professionals. Results 92 interviews took place. Most services struggled to deliver responsive, culturally appropriate care. Barriers to accessing effective end of life care included resource constrained services; institutional and, occasionally, personal racial and religious discrimination; limited awareness and understanding among South Asian people of the role of hospices; and difficulty discussing death. The most vulnerable patients, including recent migrants and those with poor English language skills, with no family advocate, and dying of non-malignant diseases were at particularly high risk of inadequate care. Conclusions Despite a robust Scottish diversity policy, services for South Asian Sikh and Muslim patients with life limiting illness were wanting in many key areas. Active case management of the most vulnerable patients and carers, and “real time” support, from where professionals can obtain advice specific to an individual patient and family, are the approaches most likely to instigate noticeable improvements in access to high quality end of life care. Improving access to palliative care for all, particularly those with non-malignant illnesses, as well as focusing on the specific needs of ethnic minority groups, is required. PMID:19190015

  17. Community mapping and respondent-driven sampling of gay and bisexual men’s communities in Vancouver, Canada

    PubMed Central

    Forrest, Jamie I; Stevenson, Benjamin; Rich, Ashleigh; Michelow, Warren; Pai, Jayaram; Jollimore, Jody; Raymond, H. Fisher; Moore, David; Hogg, Robert S; Roth, Eric A

    2014-01-01

    Literature suggests formative research is vital for those using respondent-driven sampling (RDS) to study hidden populations of interest. However, few authors have described in detail how different qualitative methodologies can address the objectives of formative research for understanding the social network properties of the study population, selecting seeds, and adapting survey logistics to best fit the population. In this paper we describe the use of community mapping exercises as a tool within focus groups to collect data on social and sexual network characteristics of gay and bisexual men in the metropolitan area of Vancouver, Canada. Three key themes emerged from analyzing community maps along with other formative research data: (a) connections between physical spaces and social networks of gay and bisexual men, (b) diversity in communities, and (c) substance use connected with formation of sub-communities. We discuss how these themes informed the planning and operations of a longitudinal epidemiological cohort study recruited by RDS. We argue that using community mapping within formative research is a valuable qualitative tool for characterizing network structures of a diverse and differentiated population of gay and bisexual men in a highly developed urban setting. PMID:24512070

  18. Acceptability and Feasibility of Cash Transfers for HIV Prevention among Adolescent South African Women

    PubMed Central

    MacPhail, Catherine; Adato, Michelle; Kahn, Kathleen; Selin, Amanda; Twine, Rhian; Khoza, Samson; Rosenberg, Molly; Nguyen, Nadia; Becker, Elizabeth; Pettifor, Audrey

    2013-01-01

    Women are at increased risk of HIV infection in much of sub-Saharan Africa. Longitudinal and cross-sectional studies have found an association between school attendance and reduced HIV risk. We report feasibility and acceptability results from a pilot of a cash transfer intervention conditional on school attendance paid to young women and their families in rural Mpumalanga, South Africa for the prevention of HIV infection. Twenty-nine young women were randomised to intervention or control and a cash payment based on school attendance made over a 2 month period. Quantitative (survey) and qualitative (focus group and interview) data collection was undertaken with young women, parents, teachers and young men in the same school. Qualitative analysis was conducted in Atlas.ti using a framework approach and basic descriptive analysis in Excel was conducted on the quantitative data. Results indicate it was both feasible and acceptable to introduce such an intervention among this population in rural South Africa. There was good understanding of the process of randomisation and the aims of the study, although some rumours developed in the study community. We address some of the changes necessary to ensure acceptability and feasibility of the main trial. PMID:23435698

  19. Anal heterosex among young people and implications for health promotion: a qualitative study in the UK

    PubMed Central

    Marston, C; Lewis, R

    2014-01-01

    Objective To explore expectations, experiences and circumstances of anal sex among young people. Design Qualitative, longitudinal study using individual and group interviews. Participants 130 men and women aged 16–18 from diverse social backgrounds. Setting 3 contrasting sites in England (London, a northern industrial city, rural southwest). Results Anal heterosex often appeared to be painful, risky and coercive, particularly for women. Interviewees frequently cited pornography as the ‘explanation’ for anal sex, yet their accounts revealed a complex context with availability of pornography being only one element. Other key elements included competition between men; the claim that ‘people must like it if they do it’ (made alongside the seemingly contradictory expectation that it will be painful for women); and, crucially, normalisation of coercion and ‘accidental’ penetration. It seemed that men were expected to persuade or coerce reluctant partners. Conclusions Young people's narratives normalised coercive, painful and unsafe anal heterosex. This study suggests an urgent need for harm reduction efforts targeting anal sex to help encourage discussion about mutuality and consent, reduce risky and painful techniques and challenge views that normalise coercion. PMID:25122073

  20. Twenty-four/seven: a mixed-method systematic review of the off-shift literature

    PubMed Central

    de Cordova, Pamela B.; Phibbs, Ciaran S.; Bartel, Ann P.; Stone, Patricia W.

    2012-01-01

    Aim This article is a report of a review that aimed to synthesize qualitative and quantitative evidence of ‘off-shifts’ (nights, weekends and/or holidays) on quality and employee outcomes in hospitals. Background Healthcare workers provide 24-hour-a-day, 7-day-a-week service. Quality and employee outcomes may differ on off-shifts as compared to regular hours. Data sources Searches for studies occurred between the years 1985–2011 using computerized databases including Business Source Complete, EconLit, ProQuest, PubMed and MEDLINE. Review design and methods Design was a mixed-method systematic review with quantitative and qualitative studies. To be included, studies met the following criteria: (1) the independent variable was an off-shift; (2) the article was a research study and peer-reviewed; (3) the article could be obtained in English; and (4) the article pertained to health care. Studies were not excluded on design. Results Sixty studies were included. There were 37 quality outcome, 19 employee outcome and four qualitative studies. In the quality outcome studies, researchers often used quantitative, longitudinal study designs with large sample sizes. Researchers found important differences between patients admitted on weekends and mortality. Important differences were also found between nighttime birth and mortality and rotating night work and fatigue, stress and low mental well-being. Most studies (9 of 12) did not find an important association between patients admitted at night and mortality. Conclusion Patient outcomes on weekends and employee outcomes at night are worse than during the day. It is important to further investigate why care on off-shifts differs from weekly day shifts. PMID:22905343

  1. Effects of music therapy and music-based interventions in the treatment of substance use disorders: A systematic review

    PubMed Central

    Hohmann, Louisa; Bradt, Joke; Stegemann, Thomas; Koelsch, Stefan

    2017-01-01

    Music therapy (MT) and music-based interventions (MBIs) are increasingly used for the treatment of substance use disorders (SUD). Previous reviews on the efficacy of MT emphasized the dearth of research evidence for this topic, although various positive effects were identified. Therefore, we conducted a systematic search on published articles examining effects of music, MT and MBIs and found 34 quantitative and six qualitative studies. There was a clear increase in the number of randomized controlled trials (RCTs) during the past few years. We had planned for a meta-analysis, but due to the diversity of the quantitative studies, effect sizes were not computed. Beneficial effects of MT/ MBI on emotional and motivational outcomes, participation, locus of control, and perceived helpfulness were reported, but results were inconsistent across studies. Furthermore, many RCTs focused on effects of single sessions. No published longitudinal trials could be found. The analysis of the qualitative studies revealed four themes: emotional expression, group interaction, development of skills, and improvement of quality of life. Considering these issues for quantitative research, there is a need to examine social and health variables in future studies. In conclusion, due to the heterogeneity of the studies, the efficacy of MT/ MBI in SUD treatment still remains unclear. PMID:29141012

  2. Distress in significant others of patients with chronic fatigue syndrome: A systematic review of the literature.

    PubMed

    Harris, Kamelia; Band, Rebecca J; Cooper, Hazel; Macintyre, Vanessa G; Mejia, Anilena; Wearden, Alison J

    2016-11-01

    The objective of this study was to systematically review existing empirical research assessing levels and correlates of distress in significant others of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Systematic searches in CINAHL, Web of Science and PsycINFO were conducted in August 2014. The search was repeated in January 2015 to check for newly published articles. Studies published in English with quantitative, qualitative, or mixed designs exploring distress, poor subjective health, poor mental health, reduced quality of life and well-being, and symptoms of depression and anxiety in significant others (>18 years) of children and adults with CFS/ME were included. Quality appraisal of included studies was carried out. Quantitative and qualitative studies were summarized separately. Six articles met eligibility criteria. Two quantitative studies with significant others of adult patients, and one quantitative and two mixed-methods studies with significant others of child patients showed moderate to high levels of distress. One qualitative study (adult patients) found minimal evidence of distress and that acceptance of CFS/ME was related to better adjustment. In the quantitative and mixed-methods studies, significant others who attributed some level of responsibility for symptoms to the patient, or who were female, or whose partners had poorer mental health, had higher levels of distress. The small number of studies to date, the contrary evidence from a qualitative study, and the limited data available on levels of distress in significant others of patients with CFS/ME mean that our conclusion that distress levels are elevated is provisional. We recommend that future qualitative studies focus on this particular topic. Further longitudinal studies exploring correlates of distress within the context of a predictive theoretical model would be helpful. Statement of contribution What is already known on this subject? Chronic fatigue syndrome (CFS/ME) entails considerable economic, social, and personal costs. Uncertainties exist around diagnosis and management. This may lead to particular difficulties for significant others trying to support patients. What does this study add? Few studies have examined distress and its correlates in significant others of people with CFS/ME. Significant others report elevated levels of distress on quantitative measures. © 2016 The British Psychological Society.

  3. A Qualitative Study of the Development of Health Literacy Capacities of Participants Attending a Community-Based Cardiovascular Health Programme.

    PubMed

    McKenna, Verna B; Sixsmith, Jane; Barry, Margaret M

    2018-06-02

    Health literacy is a critical determinant of health, which can empower individuals and lead to engagement in collective health promotion action and is also a crucial component in the self-management of illness. The current study moves beyond a focus on functional health literacy and presents findings from a longitudinal qualitative (LQ) study consisting of three phases. This paper presents findings from the second phase of the study, which assessed the development of health literacy capacities of individuals attending a structured cardiovascular risk reduction programme in Ireland. The study objectives were to: explore perceptions of changes in interactions and information exchange within health consultations; identify the facilitators associated with changes in health literacy capacities; assess developments in engagement with broader contexts for health literacy capacities. A LQ study design was undertaken, which employed repeat interview methodology with 19 participants (aged 36⁻76 years) 12 weeks after beginning a structured cardiovascular risk reduction programme. Health literacy levels were assessed using the HLS-EU 47 item instrument in phase 1 (68% limited health literacy (HL), 32% adequate health literacy). A semi-structured interview guide, (informed by Sørensen's conceptual model of health literacy), was used to explore the development of health literacy and to identify changes in knowledge, attitudes and experiences over time. Thematic analysis was used, informed by aspects of Saldaña's framework for longitudinal qualitative data analysis. All participants reported having acquired increased understanding of issues relevant to their health and self-care. Participants described health literacy capacities that incorporate aspects of all levels of health literacy (functional, interactive and critical). Core themes were identified corresponding to changes in these levels: re-engagement with health information and increased understanding of risk and protective factors (changes in functional health literacy); changes in interactions with healthcare providers (HCP) (changes in interactive health literacy); enhanced psychological insights and understanding the broader determinants of health (changes in critical health literacy). Findings support the development of health literacy capacities across the functional, interactive and critical health literacy domains. Participants are capable of locating responsibility for health beyond the individual level and are making sense of knowledge within their own social contexts. Individuals, regardless of their initial health literacy levels, are capable of engaging with broader issues that can impact on their health and can be supported to develop these critical health literacy capacities.

  4. When Educational Material Is Delivered: A Mixed Methods Content Validation Study of the Information Assessment Method

    PubMed Central

    2017-01-01

    Background The Information Assessment Method (IAM) allows clinicians to report the cognitive impact, clinical relevance, intention to use, and expected patient health benefits associated with clinical information received by email. More than 15,000 Canadian physicians and pharmacists use the IAM in continuing education programs. In addition, information providers can use IAM ratings and feedback comments from clinicians to improve their products. Objective Our general objective was to validate the IAM questionnaire for the delivery of educational material (ecological and logical content validity). Our specific objectives were to measure the relevance and evaluate the representativeness of IAM items for assessing information received by email. Methods A 3-part mixed methods study was conducted (convergent design). In part 1 (quantitative longitudinal study), the relevance of IAM items was measured. Participants were 5596 physician members of the Canadian Medical Association who used the IAM. A total of 234,196 ratings were collected in 2012. The relevance of IAM items with respect to their main construct was calculated using descriptive statistics (relevance ratio R). In part 2 (qualitative descriptive study), the representativeness of IAM items was evaluated. A total of 15 family physicians completed semistructured face-to-face interviews. For each construct, we evaluated the representativeness of IAM items using a deductive-inductive thematic qualitative data analysis. In part 3 (mixing quantitative and qualitative parts), results from quantitative and qualitative analyses were reviewed, juxtaposed in a table, discussed with experts, and integrated. Thus, our final results are derived from the views of users (ecological content validation) and experts (logical content validation). Results Of the 23 IAM items, 21 were validated for content, while 2 were removed. In part 1 (quantitative results), 21 items were deemed relevant, while 2 items were deemed not relevant (R=4.86% [N=234,196] and R=3.04% [n=45,394], respectively). In part 2 (qualitative results), 22 items were deemed representative, while 1 item was not representative. In part 3 (mixing quantitative and qualitative results), the content validity of 21 items was confirmed, and the 2 nonrelevant items were excluded. A fully validated version was generated (IAM-v2014). Conclusions This study produced a content validated IAM questionnaire that is used by clinicians and information providers to assess the clinical information delivered in continuing education programs. PMID:28292738

  5. Reconsidering the effects of poverty and social support on health: a 5-year longitudinal test of the stress-buffering hypothesis.

    PubMed

    Moskowitz, David; Vittinghoff, Eric; Schmidt, Laura

    2013-02-01

    Prior research in the general population has found that social support can buffer the adverse effects of stressors on health. However, both stressors and social support may be qualitatively different for those living in urban poverty. We examined the effects of social support and poverty-specific stressors on self-rated health. We used data from the Welfare Client Longitudinal Survey (WCLS), a 5-year longitudinal study of 718 public aid recipients. We measured received social support and "net social support," defined as the difference between support received and that given to others. We used restricted cubic splines to model the stress-buffering effects of social support on self-rated health as a function of stressful life events and neighborhood disorder. Increased exposure to stressors was associated with poorer self-rated health. Evidence of stress buffering was confined to those with the heaviest exposure to stressors, and its effects decreased across increasing levels of social support. Analyses using net social support had generally more modest effects than those using received social support. Social support does not buffer the effects of stressors on health uniformly for individuals living in conditions of urban poverty. Researchers and policymakers should be cautious in overestimating the beneficial effects that social support may have on health for marginalized populations.

  6. Systematic study of charged-pion and kaon femtoscopy in Au + Au collisions at √{sNN}=200 GeV

    NASA Astrophysics Data System (ADS)

    Adare, A.; Afanasiev, S.; Aidala, C.; Ajitanand, N. N.; Akiba, Y.; Al-Bataineh, H.; Alexander, J.; Alfred, M.; Aoki, K.; Apadula, N.; Aramaki, Y.; Asano, H.; Atomssa, E. T.; Averbeck, R.; Awes, T. C.; Azmoun, B.; Babintsev, V.; Bai, M.; Baksay, G.; Baksay, L.; Bandara, N. S.; Bannier, B.; Barish, K. N.; Bassalleck, B.; Basye, A. T.; Bathe, S.; Baublis, V.; Baumann, C.; Bazilevsky, A.; Beaumier, M.; Beckman, S.; Belikov, S.; Belmont, R.; Bennett, R.; Berdnikov, A.; Berdnikov, Y.; Bickley, A. A.; Blau, D. S.; Bok, J. S.; Boyle, K.; Brooks, M. L.; Bryslawskyj, J.; Buesching, H.; Bumazhnov, V.; Bunce, G.; Butsyk, S.; Camacho, C. M.; Campbell, S.; Chen, C.-H.; Chi, C. Y.; Chiu, M.; Choi, I. J.; Choi, J. B.; Choudhury, R. K.; Christiansen, P.; Chujo, T.; Chung, P.; Chvala, O.; Cianciolo, V.; Citron, Z.; Cole, B. A.; Connors, M.; Constantin, P.; Csanád, M.; Csörgő, T.; Dahms, T.; Dairaku, S.; Danchev, I.; Danley, D.; Das, K.; Datta, A.; Daugherity, M. S.; David, G.; Deblasio, K.; Dehmelt, K.; Denisov, A.; Deshpande, A.; Desmond, E. J.; Dietzsch, O.; Dion, A.; Diss, P. B.; Do, J. H.; Donadelli, M.; Drapier, O.; Drees, A.; Drees, K. A.; Durham, J. M.; Durum, A.; Dutta, D.; Edwards, S.; Efremenko, Y. V.; Ellinghaus, F.; Engelmore, T.; Enokizono, A.; En'yo, H.; Esumi, S.; Fadem, B.; Feege, N.; Fields, D. E.; Finger, M.; Finger, M.; Fleuret, F.; Fokin, S. L.; Fraenkel, Z.; Frantz, J. E.; Franz, A.; Frawley, A. D.; Fujiwara, K.; Fukao, Y.; Fusayasu, T.; Gal, C.; Gallus, P.; Garg, P.; Garishvili, I.; Ge, H.; Giordano, F.; Glenn, A.; Gong, H.; Gonin, M.; Goto, Y.; Granier de Cassagnac, R.; Grau, N.; Greene, S. V.; Grosse Perdekamp, M.; Gunji, T.; Gustafsson, H.-Å.; Hachiya, T.; Haggerty, J. S.; Hahn, K. I.; Hamagaki, H.; Hamblen, J.; Hamilton, H. F.; Han, R.; Han, S. Y.; Hanks, J.; Hartouni, E. P.; Hasegawa, S.; Haseler, T. O. S.; Hashimoto, K.; Haslum, E.; Hayano, R.; He, X.; Heffner, M.; Hemmick, T. K.; Hester, T.; Hill, J. C.; Hohlmann, M.; Hollis, R. S.; Holzmann, W.; Homma, K.; Hong, B.; Horaguchi, T.; Hornback, D.; Hoshino, T.; Hotvedt, N.; Huang, J.; Huang, S.; Ichihara, T.; Ichimiya, R.; Ide, J.; Ikeda, Y.; Imai, K.; Inaba, M.; Iordanova, A.; Isenhower, D.; Ishihara, M.; Isobe, T.; Issah, M.; Isupov, A.; Ivanishchev, D.; Jacak, B. V.; Jezghani, M.; Jia, J.; Jiang, X.; Jin, J.; Johnson, B. M.; Joo, K. S.; Jouan, D.; Jumper, D. S.; Kajihara, F.; Kametani, S.; Kamihara, N.; Kamin, J.; Kanda, S.; Kang, J. H.; Kapustinsky, J.; Karatsu, K.; Kawall, D.; Kawashima, M.; Kazantsev, A. V.; Kempel, T.; Key, J. A.; Khachatryan, V.; Khanzadeev, A.; Kijima, K. M.; Kim, B. I.; Kim, C.; Kim, D. H.; Kim, D. J.; Kim, E.; Kim, E.-J.; Kim, G. W.; Kim, M.; Kim, S. H.; Kim, Y.-J.; Kimelman, B.; Kinney, E.; Kiriluk, K.; Kiss, Á.; Kistenev, E.; Kitamura, R.; Klatsky, J.; Kleinjan, D.; Kline, P.; Koblesky, T.; Kochenda, L.; Komkov, B.; Konno, M.; Koster, J.; Kotchetkov, D.; Kotov, D.; Kozlov, A.; Král, A.; Kravitz, A.; Kunde, G. J.; Kurita, K.; Kurosawa, M.; Kwon, Y.; Kyle, G. S.; Lacey, R.; Lai, Y. S.; Lajoie, J. G.; Lebedev, A.; Lee, D. M.; Lee, J.; Lee, K.; Lee, K. B.; Lee, K. S.; Lee, S.; Lee, S. H.; Leitch, M. J.; Leite, M. A. L.; Leitner, E.; Lenzi, B.; Li, X.; Liebing, P.; Lim, S. H.; Linden Levy, L. A.; Liška, T.; Litvinenko, A.; Liu, H.; Liu, M. X.; Love, B.; Luechtenborg, R.; Lynch, D.; Maguire, C. F.; Makdisi, Y. I.; Makek, M.; Malakhov, A.; Malik, M. D.; Manion, A.; Manko, V. I.; Mannel, E.; Mao, Y.; Masui, H.; Matathias, F.; McCumber, M.; McGaughey, P. L.; McGlinchey, D.; McKinney, C.; Means, N.; Meles, A.; Mendoza, M.; Meredith, B.; Miake, Y.; Mignerey, A. C.; Mikeš, P.; Miki, K.; Milov, A.; Mishra, D. K.; Mishra, M.; Mitchell, J. T.; Miyasaka, S.; Mizuno, S.; Mohanty, A. K.; Montuenga, P.; Moon, T.; Morino, Y.; Morreale, A.; Morrison, D. P.; Moukhanova, T. V.; Murakami, T.; Murata, J.; Mwai, A.; Nagamiya, S.; Nagashima, K.; Nagle, J. L.; Naglis, M.; Nagy, M. I.; Nakagawa, I.; Nakagomi, H.; Nakamiya, Y.; Nakamura, T.; Nakano, K.; Nattrass, C.; Netrakanti, P. K.; Newby, J.; Nguyen, M.; Niida, T.; Nishimura, S.; Nouicer, R.; Novak, T.; Novitzky, N.; Nyanin, A. S.; O'Brien, E.; Oda, S. X.; Ogilvie, C. A.; Oka, M.; Okada, K.; Onuki, Y.; Orjuela Koop, J. D.; Osborn, J. D.; Oskarsson, A.; Ouchida, M.; Ozawa, K.; Pak, R.; Pantuev, V.; Papavassiliou, V.; Park, I. H.; Park, J.; Park, J. S.; Park, S.; Park, S. K.; Park, W. J.; Pate, S. F.; Patel, M.; Pei, H.; Peng, J.-C.; Pereira, H.; Perepelitsa, D. V.; Perera, G. D. N.; Peresedov, V.; Peressounko, D. Yu.; Perry, J.; Petti, R.; Pinkenburg, C.; Pinson, R.; Pisani, R. P.; Proissl, M.; Purschke, M. L.; Purwar, A. K.; Qu, H.; Rak, J.; Rakotozafindrabe, A.; Ramson, B. J.; Ravinovich, I.; Read, K. F.; Reygers, K.; Reynolds, D.; Riabov, V.; Riabov, Y.; Richardson, E.; Rinn, T.; Roach, D.; Roche, G.; Rolnick, S. D.; Rosati, M.; Rosen, C. A.; Rosendahl, S. S. E.; Rosnet, P.; Rowan, Z.; Rubin, J. G.; Rukoyatkin, P.; Ružička, P.; Sahlmueller, B.; Saito, N.; Sakaguchi, T.; Sakashita, K.; Sako, H.; Samsonov, V.; Sano, S.; Sarsour, M.; Sato, S.; Sato, T.; Sawada, S.; Schaefer, B.; Schmoll, B. K.; Sedgwick, K.; Seele, J.; Seidl, R.; Semenov, A. Yu.; Sen, A.; Seto, R.; Sett, P.; Sexton, A.; Sharma, D.; Shein, I.; Shibata, T.-A.; Shigaki, K.; Shimomura, M.; Shoji, K.; Shukla, P.; Sickles, A.; Silva, C. L.; Silvermyr, D.; Silvestre, C.; Sim, K. S.; Singh, B. K.; Singh, C. P.; Singh, V.; Slunečka, M.; Snowball, M.; Soltz, R. A.; Sondheim, W. E.; Sorensen, S. P.; Sourikova, I. V.; Sparks, N. A.; Stankus, P. W.; Stenlund, E.; Stepanov, M.; Stoll, S. P.; Sugitate, T.; Sukhanov, A.; Sumita, T.; Sun, J.; Sziklai, J.; Takagui, E. M.; Taketani, A.; Tanabe, R.; Tanaka, Y.; Tanida, K.; Tannenbaum, M. J.; Tarafdar, S.; Taranenko, A.; Tarján, P.; Themann, H.; Thomas, T. L.; Tieulent, R.; Timilsina, A.; Todoroki, T.; Togawa, M.; Toia, A.; Tomášek, L.; Tomášek, M.; Torii, H.; Towell, C. L.; Towell, R.; Towell, R. S.; Tserruya, I.; Tsuchimoto, Y.; Vale, C.; Valle, H.; van Hecke, H. W.; Vazquez-Zambrano, E.; Veicht, A.; Velkovska, J.; Vértesi, R.; Vinogradov, A. A.; Virius, M.; Vrba, V.; Vznuzdaev, E.; Wang, X. R.; Watanabe, D.; Watanabe, K.; Watanabe, Y.; Watanabe, Y. S.; Wei, F.; Wei, R.; Wessels, J.; White, A. S.; White, S. N.; Winter, D.; Wood, J. P.; Woody, C. L.; Wright, R. M.; Wysocki, M.; Xia, B.; Xie, W.; Xue, L.; Yalcin, S.; Yamaguchi, Y. L.; Yamaura, K.; Yang, R.; Yanovich, A.; Ying, J.; Yokkaichi, S.; Yoo, J. H.; Yoon, I.; You, Z.; Young, G. R.; Younus, I.; Yu, H.; Yushmanov, I. E.; Zajc, W. A.; Zelenski, A.; Zhang, C.; Zhou, S.; Zolin, L.; Zou, L.; Phenix Collaboration

    2015-09-01

    We present a systematic study of charged-pion and kaon interferometry in Au +Au collisions at √{s NN}=200 GeV. The kaon mean source radii are found to be larger than pion radii in the outward and longitudinal directions for the same transverse mass; this difference increases for more central collisions. The azimuthal-angle dependence of the radii was measured with respect to the second-order event plane and similar oscillations of the source radii were found for pions and kaons. Hydrodynamic models qualitatively describe the similar oscillations of the mean source radii for pions and kaons, but they do not fully describe the transverse-mass dependence of the oscillations.

  7. Long-term Quality of Life After Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Pseudomyxoma Peritonei: A Prospective Longitudinal Study.

    PubMed

    Stearns, Adam T; Malcomson, Lee; Punnett, Grant; Abudeeb, Haytham; Aziz, Omer; Selvasekar, Chelliah R; Fulford, Paul E; Wilson, Malcolm S; Renehan, Andrew G; O'Dwyer, Sarah T

    2018-04-01

    Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are an established treatment for pseudomyxoma peritonei (PMP), but it is a major surgical procedure and may be associated with long-term morbidity. To date, health-related quality-of-life (HRQL) data among survivors are lacking. A two-period qualitative study investigated patients undergoing CRS-HIPEC for PMP at a national peritoneal tumor center between 2003 and 2011. First, the European Organization for Research and Treatment (EORTC)-QLQ C30 HRQL questionnaire was used longitudinally preoperatively and at postoperative months 3, 6, 9, 12, 18, and 24, then yearly thereafter. Second, it was updated in 2016 as a cross-sectional study. Both studies were compared with age- and sex-matched reference populations (one-way t tests). A total of 553 longitudinal HRQL questionnaires were completed for 137 patients, truncated at 60 months. In the 2016 update, 85 responses were received from 103 survivors (mean follow-up period, 8.11 years). Patients' physical, role, and social function scores were impaired until 12 months postoperatively, after which the scores did not differ significantly from those of with reference populations. Similarly, fatigue, appetite loss, insomnia, and financial difficulties worsened significantly compared with reference populations in the first 12-months and then normalized. In contrast, impaired cognitive function (82.3 vs 88.5; P = 0.017), constipation (13.7 vs 7.3; P = 0.032), and diarrheal symptoms (15.1 vs 4.9; P = 0.0006) persisted through both periods. Global health scores did not differ significantly from those of the reference population. Beyond 12 months postoperatively, CRS-HIPEC for PMP is associated with a good quality of life except for some cognitive functional impairment and bowel disturbances.

  8. On the structure of viscous flow about the afterbody of hull

    NASA Astrophysics Data System (ADS)

    Yoshida, Osamu; Zhu, Ming; Miyata, Hideaki

    1993-09-01

    A finite-volume method is applied to a flow about full ship models in the curvilinear coordinate system. Simulations are carried out for SR196 frame-line series. The simulated results show the difference of the wake and the longitudinal vorticity between the different hull forms. The comparisons between simulated and measured results show qualitative agreements in the wake distributions near the propeller disk circumference.

  9. Implementation of the guidelines for targeted temperature management after cardiac arrest: a longitudinal qualitative study of barriers and facilitators perceived by hospital resuscitation champions.

    PubMed

    Kim, Young-Min; Lee, Seung Joon; Jo, Sun Jin; Park, Kyu Nam

    2016-01-05

    To identify the barriers to and facilitators of implementing guidelines for targeted temperature management (TTM) after cardiac arrest perceived by hospital resuscitation champions and to investigate the changes in their perceptions over the early implementation period. A longitudinal qualitative study (up to 2 serial semistructured interviews over 1 year and focus groups). The individual interviews and focus groups were transcribed and coded by 2 independent assessors. Contents were analysed thematically; group interaction was also examined. 21 hospitals, including community and tertiary care centres in South Korea. 21 hospital champions (14 acting champions and 7 managerial champions). The final data set included 40 interviews and 2 focus groups. The identified barriers and facilitators could be classified into 3 major themes: (1) healthcare professionals' perceptions of the guidelines and protocols, (2) interdisciplinary and interprofessional collaboration and (3) organisational resources. Lack of resources was the most commonly agreed on barrier for the acting champions, whereas lack of interdisciplinary collaboration was the most common barrier for the managerial champions. Educational activities and sharing successfully treated cases were the most frequently identified facilitators. Most of the participants identified and agreed that cooling equipment was an important barrier as well as a facilitator of successful TTM implementation. Perception of the guidelines and protocols has improved with the accumulation of clinical experience over the study period. Healthcare professionals' internal barriers to TTM implementation may be influenced by new guidelines and can be changed with the accumulation of successful clinical experiences during the early implementation period. Promoting interprofessional and interdisciplinary collaboration through educational activities and the use of cooling equipment with an automated feedback function can improve adherence to guidelines in hospitals with limited human resources in critical care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Women's lived experiences of learning to live with osteoporosis: a longitudinal qualitative study.

    PubMed

    Hansen, Carrinna A; Abrahamsen, Bo; Konradsen, Hanne; Pedersen, Birthe D

    2017-03-09

    A vast amount of literature exists concerning pharmaceutical adherence in osteoporosis. However, the process of learning to live with osteoporosis over time remains largely unknown. The purpose of this study was to gain a deeper understanding of the continued process of how women learn to live with osteoporosis. Our objective was to explore what characterizes women's experiences of living with osteoporosis during the first year after diagnosis, when patients are prescribed anti-osteoporotic treatment, without having experienced an osteoporotic fracture. Forty-two narrative qualitative interviews were conducted with fifteen recently diagnosed Danish women. A longitudinal design was chosen since this allows an investigation of the perspective over time. The interviews were conducted in the period of March 2011 to August 2012. Data were analyzed using a phenomenological-hermeneutic interpretation of text. No medical records were available for the researchers. All information with the exception of T-score was self-reported. The participants' experiences could be described in two key themes developed through the analysis: 1) "To become influenced by the medical treatment" which consisted of two sub-themes "taking the medication", and "discontinuing the medication". 2) "Daily life with osteoporosis", which was characterized by three sub-themes: "interpretation of symptoms", "interpretation of the scan results" and "lifestyle reflections". The results highlighted that learning to live with osteoporosis is a multifaceted process that is highly influenced by the medical treatment. In some cases, this is a prolonged process that can take around one year. The results suggest a need for improved support for individual women during the complex process of learning to live with osteoporosis. The study adds new knowledge that can be useful for healthcare professionals taking a health-oriented stance when supporting women in self-management of their illness. Further investigations of lived experiences over time in the field of osteoporosis research are therefore needed.

  11. Implementation of the guidelines for targeted temperature management after cardiac arrest: a longitudinal qualitative study of barriers and facilitators perceived by hospital resuscitation champions

    PubMed Central

    Kim, Young-Min; Lee, Seung Joon; Jo, Sun Jin; Park, Kyu Nam

    2016-01-01

    Objectives To identify the barriers to and facilitators of implementing guidelines for targeted temperature management (TTM) after cardiac arrest perceived by hospital resuscitation champions and to investigate the changes in their perceptions over the early implementation period. Design A longitudinal qualitative study (up to 2 serial semistructured interviews over 1 year and focus groups). The individual interviews and focus groups were transcribed and coded by 2 independent assessors. Contents were analysed thematically; group interaction was also examined. Setting 21 hospitals, including community and tertiary care centres in South Korea. Participants 21 hospital champions (14 acting champions and 7 managerial champions). Results The final data set included 40 interviews and 2 focus groups. The identified barriers and facilitators could be classified into 3 major themes: (1) healthcare professionals’ perceptions of the guidelines and protocols, (2) interdisciplinary and interprofessional collaboration and (3) organisational resources. Lack of resources was the most commonly agreed on barrier for the acting champions, whereas lack of interdisciplinary collaboration was the most common barrier for the managerial champions. Educational activities and sharing successfully treated cases were the most frequently identified facilitators. Most of the participants identified and agreed that cooling equipment was an important barrier as well as a facilitator of successful TTM implementation. Perception of the guidelines and protocols has improved with the accumulation of clinical experience over the study period. Conclusions Healthcare professionals’ internal barriers to TTM implementation may be influenced by new guidelines and can be changed with the accumulation of successful clinical experiences during the early implementation period. Promoting interprofessional and interdisciplinary collaboration through educational activities and the use of cooling equipment with an automated feedback function can improve adherence to guidelines in hospitals with limited human resources in critical care. PMID:26733568

  12. Pictorial Representation of Illness and Self Measure (PRISM): A novel visual instrument to measure quality of life in dermatological inpatients.

    PubMed

    Mühleisen, Beda; Büchi, Stefan; Schmidhauser, Simone; Jenewein, Josef; French, Lars E; Hofbauer, Günther F L

    2009-07-01

    To validate the PRISM (Pictorial Representation of Illness and Self Measure) tool, a novel visual instrument, for the assessment of health-related quality of life in dermatological inpatients compared with the Dermatology Life Quality Index (DLQI) and the Skindex-29 questionnaires and to report qualitative information on PRISM. In an open longitudinal study, PRISM and Skindex-29 and DLQI questionnaires were completed and HRQOL measurements compared. Academic dermatological inpatient ward. The study population comprised 227 sequential dermatological inpatients on admission. Patients completed the PRISM tool and the Skindex-29 and DLQI questionnaires at admission and discharge. PRISM Self-Illness Separation (SIS) score; Skindex-29 and DLQI scores; and qualitative PRISM information by Mayring inductive qualitative context analysis. The PRISM scores correlated well with those from the Skindex-29 (rho = 0.426; P < .001) and DLQI (rho = 0.304; P < .001) questionnaires. Between PRISM and Skindex-29 scores, the highest correlations were for dermatitis (rho = 0.614) and leg ulcer (rho = 0.554), and between PRISM and DLQI scores, the highest correlations were for psoriasis (rho = 0.418) and tumor (rho = 0.399). The PRISM tool showed comparable or higher sensitivity than quality of life questionnaires to assess changes in the burden of suffering during hospitalization. Inductive qualitative context analysis revealed impairment of adjustment and self-image as major aspects. Patients overall expected symptomatic and functional improvement. In patients with psoriasis and leg ulcers, many expected no treatment benefit. The PRISM tool proved to be convenient and reliable for health-related quality of life assessment, applicable for a wide range of skin diseases, and correlated with DLQI and Skindex-29 scores. With the PRISM tool, free-text answers allow for the assessment of individual information and potentially customized therapeutic approaches.

  13. Olfaction preservation after removal of large tuberculum sellae meningiomas via a superior interhemispheric approach. A quantitative and qualitative study.

    PubMed

    Hannequin, P; Paviot, A; Chaussy, O; Gilard, V; Cébula, H; Marie, J-P; Proust, F

    2015-10-01

    We present a prospective series of tuberculum sellae meningioma (TSM) resected via a superior interhemispheric (IH) approach in 10 patients who preoperatively and postoperatively underwent extensive olfaction testing using a standardised test battery. This prospective longitudinal study evaluated the olfactory function after TSM resection. The resection was performed via a superior interhemispheric (IH) approach. The quantitative and qualitative analyses of the olfactory function were assessed with the Biolfa(®) olfactory test (at 6 months). Between November 2009 and April 2012, 10 consecutive patients with symptomatic TSM and preserved olfactory function were operated via a superior IH approach. For the self-evaluation criteria of the olfactory function, the mean preoperative visual analog scale score was 8.8. The mean preoperative total quantitative (/27) scored 18.2 ± 6.3 for this cohort of 10 patients. In the postoperative period, the mean total score decreased non-significantly to 15.8 ± 8.8 (Wilcoxon test, P = 0.085). The mean preoperative qualitative score (/8) was 5.5 ± 1.7 and in the postoperative period decreased, non-significantly, to 4.7 ± 2.6 (Wilcoxon test, P = 0.12). The olfactory function was quantitatively and qualitatively preserved in 6 patients (60%), but a postoperative deterioration occurred in 2 (20%) and an anosmia in 2 (20%). Size and invasive characteristics of the meningioma determined the post-surgical deterioration. Olfaction is an important factor of emotional and social life, which needs to be integrated into the challenge regarding the resection of TSM. The risks of nerve damage are reviewed. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Exploring the use of a gamified intervention for encouraging physical activity in adolescents: a qualitative longitudinal study in Northern Ireland.

    PubMed

    Corepal, Rekesh; Best, Paul; O'Neill, Roisin; Tully, Mark A; Edwards, Mark; Jago, Russell; Miller, Sarah J; Kee, Frank; Hunter, Ruth F

    2018-04-20

    To explore the temporal changes of adolescents' views and experiences of participating in a gamified intervention to encourage physical activity behaviour and associated processes of behaviour change. A qualitative longitudinal design was adopted whereby focus groups were conducted with the same participants in each intervention school (n=3) at four time-points (baseline, end of each of two intervention phases and 1-year follow-up). The framework method was used to thematically analyse the data. Secondary schools (n=3), Belfast (Northern Ireland). A subsample (n=19 at four time-points) of individuals aged 12-14 years who participated in the StepSmart Challenge, a gamified intervention involving a pedometer competition and material rewards to encourage physical activity behaviour change. Three core themes were identified: (1) competition; (2) incentives and (3) influence of friends. Participants indicated that a pedometer competition may help initiate physical activity but suggested that there were a number of barriers such as participants finding it ' boring ', and feeling as though they had a remote chance of ' winning '. 'Incentives' were viewed favourably, although there were participants who found not winning a prize ' annoying '. Friends were a motivator to be more physically active, particularly for girls who felt encouraged to walk more when with a friend. The intervention in general and specific gamified elements were generally viewed positively and deemed acceptable. Results suggest that gamification may have an important role to play in encouraging adolescents to engage in physical activity and in creating interventions that are fun and enjoyable. The longitudinal approach added additional depth to the analysis as themes were refined and tested with participants over time. The findings also suggest that gamified Behaviour Change Techniques align well with core concepts of Self-determination Theory and that various game elements may require tailoring for specific populations, for example, different genders. NCT02455986; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Graduates' Perceptions of Learning Affordances in Longitudinal Integrated Clerkships: A Dual-Institution, Mixed-Methods Study.

    PubMed

    Latessa, Robyn A; Swendiman, Robert A; Parlier, Anna Beth; Galvin, Shelley L; Hirsh, David A

    2017-09-01

    The authors explored affordances that contribute to participants' successful learning in longitudinal integrated clerkships (LICs). This dual-institutional, mixed-methods study included electronic surveys and semistructured interviews of LIC graduates who completed their core clinical (third) year of medical school. These LIC graduates took part in LICs at Harvard Medical School from 2004 to 2013 and the University of North Carolina School of Medicine-Asheville campus from 2009 to 2013. The survey questions asked LIC graduates to rate components of LICs that they perceived as contributing to successful learning. A research assistant interviewed a subset of study participants about their learning experiences. The authors analyzed aggregate data quantitatively and performed a qualitative content analysis on interview data. The graduates reported multiple affordances that they perceive contributed to successful learning in their LIC. The most reported components included continuity and relationships with preceptors, patients, place, and peers, along with integration of and flexibility within the curriculum. As LIC models grow in size and number, and their structures and processes evolve, learners' perceptions of affordances may guide curriculum planning. Further research is needed to investigate to what degree and by what means these affordances support learning in LICs and other models of clinical education.

  16. Childhood chronic-kidney-disease: a longitudinal-qualitative study of families learning to share management early in the trajectory.

    PubMed

    Swallow, Veronica; Lambert, Heather; Clarke, Charlotte; Campbell, Steve; Jacoby, Ann

    2008-11-01

    To explore the ways families learn to share management during the early stages of childhood chronic-kidney-disease. This longitudinal, descriptive study based on the tenets of grounded theory, aimed to derive meaning about family-professional interactions during shared management. Data were obtained from six newly referred families, four renal nurses, four paediatric nephrologists and one dietician through: 36 semi-structured interviews, 21 case-note reviews and four child/parent learning diaries. Three learning stages were identified: dependent (families' understanding was superficial, they lacked underlying knowledge and were totally reliant on professional guidance); co-dependent (families engaged competently in management but still required extensive guidance); independent (families communicated effectively with staff and competently adjusted management within professionally defined parameters). Five families actively shared management from early in the trajectory and progressed to independent learning when, by mutual agreement, professional input to management gradually decreased. The remaining family adopted a passive approach to management, did not progress to independent learning and remained reliant on professional input. Families in this study demonstrated three learning stages in becoming competent at management. Future research is needed to investigate the ways professionals promote family competence early in the trajectory and the factors that can facilitate or hinder families' progression to independent learning.

  17. Maturation of auditory neural processes in autism spectrum disorder - A longitudinal MEG study.

    PubMed

    Port, Russell G; Edgar, J Christopher; Ku, Matthew; Bloy, Luke; Murray, Rebecca; Blaskey, Lisa; Levy, Susan E; Roberts, Timothy P L

    2016-01-01

    Individuals with autism spectrum disorder (ASD) show atypical brain activity, perhaps due to delayed maturation. Previous studies examining the maturation of auditory electrophysiological activity have been limited due to their use of cross-sectional designs. The present study took a first step in examining magnetoencephalography (MEG) evidence of abnormal auditory response maturation in ASD via the use of a longitudinal design. Initially recruited for a previous study, 27 children with ASD and nine typically developing (TD) children, aged 6- to 11-years-old, were re-recruited two to five years later. At both timepoints, MEG data were obtained while participants passively listened to sinusoidal pure-tones. Bilateral primary/secondary auditory cortex time domain (100 ms evoked response latency (M100)) and spectrotemporal measures (gamma-band power and inter-trial coherence (ITC)) were examined. MEG measures were also qualitatively examined for five children who exhibited "optimal outcome", participants who were initially on spectrum, but no longer met diagnostic criteria at follow-up. M100 latencies were delayed in ASD versus TD at the initial exam (~ 19 ms) and at follow-up (~ 18 ms). At both exams, M100 latencies were associated with clinical ASD severity. In addition, gamma-band evoked power and ITC were reduced in ASD versus TD. M100 latency and gamma-band maturation rates did not differ between ASD and TD. Of note, the cohort of five children that demonstrated "optimal outcome" additionally exhibited M100 latency and gamma-band activity mean values in-between TD and ASD at both timepoints. Though justifying only qualitative interpretation, these "optimal outcome" related data are presented here to motivate future studies. Children with ASD showed perturbed auditory cortex neural activity, as evidenced by M100 latency delays as well as reduced transient gamma-band activity. Despite evidence for maturation of these responses in ASD, the neural abnormalities in ASD persisted across time. Of note, data from the five children whom demonstrated "optimal outcome" qualitatively suggest that such clinical improvements may be associated with auditory brain responses intermediate between TD and ASD. These "optimal outcome" related results are not statistically significant though, likely due to the low sample size of this cohort, and to be expected as a result of the relatively low proportion of "optimal outcome" in the ASD population. Thus, further investigations with larger cohorts are needed to determine if the above auditory response phenotypes have prognostic utility, predictive of clinical outcome.

  18. From (Un)Willingness to InvolveMENt: Development of a Successful Study Brand for Recruitment of Diverse MSM to a Longitudinal HIV Research.

    PubMed

    Frew, Paula M; Williams, Victoria A; Shapiro, Eve T; Sanchez, Travis; Rosenberg, Eli S; Fenimore, Vincent L; Sullivan, Patrick S

    2013-11-21

    HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Formative research results indicated that younger Black MSM (18-29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM ( x 2 = 5.92, P = 0.015). Qualitative and quantitative results indicate four prominent themes related to brand development: (1) communication sources (message deliverer), (2) message (impact of public health messaging on perceptions of HIV research), (3) intended audience (underlying issues that influence personal relevance of HIV research), and (4) communication channels (reaching intended audiences). The findings highlight the importance of behavioral communication translational research to effectively engage hard-to-reach populations. Despite reservations, MSM in our formative study expressed a need for active involvement and greater education to facilitate their engagement in HIV prevention research. Thus, the brand concept of "InvolveMENt" emerged.

  19. From (Un)Willingness to InvolveMENt: Development of a Successful Study Brand for Recruitment of Diverse MSM to a Longitudinal HIV Research

    PubMed Central

    Frew, Paula M.; Williams, Victoria A.; Shapiro, Eve T.; Sanchez, Travis; Rosenberg, Eli S.; Fenimore, Vincent L.; Sullivan, Patrick S.

    2014-01-01

    Background HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (x2 = 5.92, P = 0.015). Qualitative and quantitative results indicate four prominent themes related to brand development: (1) communication sources (message deliverer), (2) message (impact of public health messaging on perceptions of HIV research), (3) intended audience (underlying issues that influence personal relevance of HIV research), and (4) communication channels (reaching intended audiences). Conclusion The findings highlight the importance of behavioral communication translational research to effectively engage hard-to-reach populations. Despite reservations, MSM in our formative study expressed a need for active involvement and greater education to facilitate their engagement in HIV prevention research. Thus, the brand concept of “InvolveMENt” emerged. PMID:24639900

  20. Social Network Decay as Potential Recovery from Homelessness: A Mixed Methods Study in Housing First Programming

    PubMed Central

    Golembiewski, Elizabeth; Watson, Dennis P.; Robison, Lisa; Coberg, John W.

    2017-01-01

    The positive relationship between social support and mental health has been well documented, but individuals experiencing chronic homelessness face serious disruptions to their social networks. Housing First (HF) programming has been shown to improve health and stability of formerly chronically homeless individuals. However, researchers are only just starting to understand the impact HF has on residents’ individual social integration. The purpose of the current study was to describe and understand changes in social networks of residents living in a HF program. Researchers employed a longitudinal, convergent parallel mixed method design, collecting quantitative social network data through structured interviews (n = 13) and qualitative data through semi-structured interviews (n = 20). Quantitative results demonstrated a reduction in network size over the course of one year. However, increases in both network density and frequency of contact with network members increased. Qualitative interviews demonstrated a strengthening in the quality of relationships with family and housing providers and a shedding of burdensome and abusive relationships. These results suggest network decay is a possible indicator of participants’ recovery process as they discontinued negative relationships and strengthened positive ones. PMID:28890807

  1. Long title: Protocol for evaluating a Consultation for Suffering at work in French-speaking Switzerland.

    PubMed

    Bontemps, Sophie; Barlet-Ghaleb, Catherine; Mediouni, Zakia; Besse, Christine; Bonsack, Charles; Wild, Pascal; Danuser, Brigitta

    2018-03-01

    Psychosocial suffering entails human, social and economic costs. In Switzerland, 34.4% of workers report chronic work-related stress. Our medical Consultation for Suffering at Work aims to preserve-or restore-the patient's capacity to act and make decisions after a diagnosis of work-related psychological suffering; it also aims to help employees get back to or remain at work. Our hypothesis is that the dynamic of the consultation itself and adherence to its medical advice are active factors of these results. Understand changes in patients' work and health status 12 months after a Consultation for Suffering at Work. Determine the effects of the consultation on health and working status via identified active factors: the consultation dynamic and the ability to adhere to the consultation's advice. Evaluate the consultation's effects qualitatively. This longitudinal, monocentric study with a quasi-experimental design will include patients consulting between 1 January and 31 December 2018. Changes in patients' work and health status will be analysed using data collected via questionnaires at 0, 3 and 12 months. Qualitative data will be collected via a semi-structured telephone interview 3 months after the consultation. The quantitative part will include 150-170 patients; the qualitative part will include 30. This exploratory research project will provide a better understanding of issues of work-related psychological suffering and effective strategies to support patients. The absence of a control group and the impossibility of applying a randomised controlled design are constraints on this study.

  2. Daily hassles, their antecedents and outcomes among professional first responders: A systematic literature review.

    PubMed

    Larsson, Gerry; Berglund, Anna Karin; Ohlsson, Alicia

    2016-08-01

    Occupational groups such as firefighters, military officers, paramedics and police officers are exposed to a combination of acute, severe and accumulated everyday stress. Drawing on the daily hassles perspective on stress, the aim was to synthesize existing research on daily hassles in professional first responder settings into a theoretical model. A systematic mixed studies review with an integrated design was undertaken. The selection process resulted in 40 articles meeting the inclusion criteria. The selected papers represented two literature reviews, one qualitative study, eight longitudinal studies and 29 cross-sectional studies. Five superior categories emerged in the analysis: Individual antecedent and continuously framing factors, Environmental antecedent and continuously framing factors, Appraisal and coping processes, Daily hassles and Outcome. Suggestions for future research are presented. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

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

    Khurgin, Jacob B., E-mail: jakek@jhu.edu; Bajaj, Sanyam; Rajan, Siddharth

    Longitudinal optical (LO) phonons in GaN generated in the channel of high electron mobility transistors (HEMT) are shown to undergo nearly elastic scattering via collisions with hot electrons. The net result of these collisions is the diffusion of LO phonons in the Brillouin zone causing reduction of phonon and electron temperatures. This previously unexplored diffusion mechanism explicates how an increase in electron density causes reduction of the apparent lifetime of LO phonons, obtained from the time resolved Raman studies and microwave noise measurements, while the actual decay rate of the LO phonons remains unaffected by the carrier density. Therefore, themore » saturation velocity in GaN HEMT steadily declines with increased carrier density, in a qualitative agreement with experimental results.« less

  4. Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study).

    PubMed

    Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise

    2014-07-08

    To explore views of service providers caring for injured people on: the extent to which services meet patients' needs and their perspectives on factors contributing to any identified gaps in service provision. Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers' views were elicited through semistructured interviews. Data were analysed using thematic analysis. Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. 40 service providers from a range of disciplines. Service providers described two distinct models of trauma care: an 'ideal' model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a 'real' model based on the realities of National Health Service (NHS) practice. Participants' 'ideal' model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, 'real' care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients' needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Service providers envisage an 'ideal' model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between 'real' and 'ideal' care. Using service provider views to inform service design and delivery could enhance the quality, patient experience and outcomes of care. 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.

  5. Identifying Latent Trajectories of Personality Disorder Symptom Change: Growth Mixture Modeling in the Longitudinal Study of Personality Disorders

    PubMed Central

    Hallquist, Michael N.; Lenzenweger, Mark F.

    2013-01-01

    Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a four-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of Avoidant, Obsessive-Compulsive, or Paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower negative emotionality, and greater positive emotionality and constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower positive emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology. PMID:23231459

  6. Identifying latent trajectories of personality disorder symptom change: growth mixture modeling in the longitudinal study of personality disorders.

    PubMed

    Hallquist, Michael N; Lenzenweger, Mark F

    2013-02-01

    Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a 4-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of avoidant, obsessive-compulsive, or paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower Negative Emotionality, and greater Positive Emotionality and Constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower Positive Emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology. 2013 APA, all rights reserved

  7. Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial.

    PubMed

    Wenham, Aniela; Atkin, Karl; Woodman, Julia; Ballard, Kathleen; MacPherson, Hugh

    2018-05-01

    A large randomised controlled trial found that the provision of either Alexander Technique lessons or acupuncture, for those with chronic neck pain, resulted in significantly increased self-efficacy when compared with usual care alone. In turn, enhanced self-efficacy was associated with significant reductions in neck pain at 6 and 12 months. In this analysis we explore the perspectives of participants within the trial, with the aim of gaining a better understanding of how these interventions had an impact. We used a longitudinal qualitative approach; in-depth interviews, informed by a topic guide, were conducted with a sample of the trial population. Participants were interviewed twice: at around six months (n = 30) and twelve months (n = 26) after trial entry. Analysis was guided by the principles of grounded theory, and key themes were developed. Five key themes emerged: pre-trial experiences of biomedical treatment against which subsequent interventions were compared; emergence of tangible benefits from the interventions; factors that contributed to the observed benefits, notably growing self-care and self-efficacy; a developing sense of embodiment as an integral part of the transformative process; and contribution of these factors to sustaining benefits over the longer term. In-depth interviews revealed a rich array of experiences. They gave insight into the positive impact of the interventions on development of self-care, self-efficacy and embodiment. These findings complement the quantitative trial data, providing a more nuanced understanding of the factors that underpin the previously quantified improvement in self-efficacy and its association with longer-term reductions in pain. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Applications of Doppler ultrasound in clinical vascular disease

    NASA Technical Reports Server (NTRS)

    Barnes, R. W.; Hokanson, D. E.; Sumner, D. S.; Strandness, D. E., Jr.

    1975-01-01

    Doppler ultrasound has become the most useful and versatile noninvasive technique for objective evaluation of clinical vascular disease. Commercially available continuous-wave instruments provide qualitative and quantitative assessment of venous and arterial disease. Pulsed Doppler ultrasound was developed to provide longitudinal and transverse cross-sectional images of the arterial lumen with a resolution approaching that of conventional X-ray techniques. Application of Doppler ultrasound in venous, peripheral arterial, and cerebrovascular diseases is reviewed.

  9. A qualitative investigation of the role of the family in structuring young people’s alcohol use

    PubMed Central

    Jacob, Nina; MacArthur, Georgie J.; Hickman, Matthew

    2016-01-01

    Background: Few qualitative studies have investigated young people’s perspectives around influences on substance use. We aimed to examine young people’s understandings, attitudes and experiences around alcohol, tobacco and cannabis use and factors influencing substance use behaviour. Methods: Qualitative interview study involving 28 young people (13 males and 15 females) aged 18–20 years, recruited purposively on the basis of substance use, who were participating in the Avon Longitudinal Study of Parents and Children. Interviews were conducted at participants’ homes or at local cafés. Audio data were transcribed verbatim, systematically coded and analysed inductively using a constant comparative approach. Results: Parental attitudes and behaviours and the nature of communication emerged as critical factors structuring young people’s alcohol use. Initiation of alcohol use was frequently mediated by parents early in adolescence, with the home recounted as a primary site of early drinking experiences. Later in adolescence, young people perceived a more permissive stance towards alcohol use, with broad acceptance of high levels of consumption and recognition of drinking as a cultural norm during adolescence. In contrast, young people reported a more prohibitive and discouraging stance from their parents towards tobacco and cannabis use, and the use of these substances appeared to be of greater parental concern. Conclusions: Interventions involving parents or guardians have a critical role to play in the prevention of harms arising from alcohol use during adolescence. However, such interventions are needed in conjunction with individual, school, community and environmental interventions to shift cultural norms across the population and to facilitate effective prevention. PMID:26142406

  10. Inquiry practice and identity of beginning secondary science teachers in the online and offline learning community: A longitudinal mixed methods study

    NASA Astrophysics Data System (ADS)

    Bang, Eunjin

    This two-year study explored changes in practices and the emerging identities of beginning secondary science teachers who participated in an online science specific mentoring program. Fourteen beginning secondary science teachers and six experienced secondary science teachers were selected for the study. As a mixed methods study, data were gathered quantitatively and qualitatively. A hierarchical linear modeling was used in order to depict the changes in inquiry-based science practices as a result of content-focused online mentoring program. Qualitative data were collected via monthly semi-structured interviews, pre, post, and follow-up yearly semi-structured interviews, and finally online written dialogues of beginning secondary science teachers and their e-mentors. A mixed method was used that utilized the results of quantitative data, Items for Inquiry-Based Practice (IBP) scores, helped for selecting cases for qualitative analysis. Results indicated that there were no significant differences in IBP scores among the fourteen beginning secondary science teachers; however, three groups were detected: increasing use, no change, and decreasing use in inquiry-based practices. Porsha, who made increasing use, showed four emerging identities throughout two years: watchful-imitator, seeker, collaborator, and junior-leader. Nora, who made no change, showed only two emerging identities: imitator and seeker. Netty, who made decreasing use, showed also two emerging identities: lonely-follower and feeder. Different identities detected in online dialogue, namely Porsha as a whistleblower, Nora as a watchful-imitator, and Netty as a watchful-feeder. The corresponding responses of three beginning secondary science teachers' e-mentors were defender, provider, listener, pusher and umpire. This study provides not only an in-depth picture of the contemporary science education community of practice but also suggest a roadmap to design an effective induction program.

  11. Heart Failure Self-care Within the Context of Patient and Informal Caregiver Dyadic Engagement: A Mixed Methods Study.

    PubMed

    Buck, Harleah G; Hupcey, Judith; Wang, Hsiao-Lan; Fradley, Michael; Donovan, Kristine A; Watach, Alexa

    Recent heart failure (HF) patient and informal caregiver (eg, dyadic) studies have either examined self-care from a qualitative or quantitative perspective. To date, the 2 types of data have not been integrated. The aim of this study was to understand HF self-care within the context of dyadic engagement. This was a cross-sectional, mixed methods (quantitative/qualitative) study. Heart failure self-care was measured with the Self-care of Heart Failure Index (v.6) dichotomized to adequate (≥70) or inadequate (<69). Dyadic symptom management type was assessed with the Dyadic Symptom Management Type scale. Interviews regarding self-care were conducted with both dyad members present. Content analytic techniques were used. Data were integrated using an information matrix and triangulated using Creswell and Plano Clark's methods. Of the 27 dyads, HF participants were 56% men, with a mean age of 77 years. Caregivers were 74% women, with a mean age of 66 years, representing spouses (n = 14) and adult children (n = 7). Quantitatively, few dyads scored as adequate (≥70) in self-care; the qualitative data described the impact of adequacy on the dyads' behavior. Dyads who scored higher, individually or both, on self-care self-efficacy and self-care management were less likely to change from their life course pattern. Either the patient or dyad continued to handle all self-care as they always had, rather than trying new strategies or reaching out for help as the patient's condition deteriorated. Our data suggest links that should be explored between dyadic adequacy and response to patients' symptoms. Future studies should assess dyadic adequacy longitudinally and examine its relationship to event-free survival and health services cost.

  12. Substance Abuse-Specific Knowledge Transfer or Loss? Treatment Program Turnover versus Professional Turnover among Substance Abuse Clinicians

    PubMed Central

    Eby, Lillian T.; Curtis, Sara L.

    2014-01-01

    This longitudinal study investigated the extent to which substance abuse (SA) clinician turnover is associated with SA-specific knowledge loss due to change in professions (professional turnover) versus SA-specific knowledge transfer due to movement from one SA clinical setting to another (treatment program turnover). For this study, clinicians had to voluntarily leave their current treatment program. Eligible clinicians completed a quantitative survey while employed and a qualitative post-employment exit interview 1 year later. Compared to those that exited the SA profession (N = 99), clinicians who changed treatment programs (N = 120) had greater SA-specific formal knowledge and were more likely to be personally in recovery. No differences were found between the two groups in terms of SA-specific practical knowledge. PMID:25115318

  13. Systematic study of charged-pion and kaon femtoscopy in Au+Au collisions at √s NN = 200 GeV

    DOE PAGES

    Adare, A.

    2015-09-23

    We present a systematic study of charged pion and kaon interferometry in Au+Au collisions at √s NN=200 GeV. The kaon mean source radii are found to be larger than pion radii in the outward and longitudinal directions for the same transverse mass; this difference increases for more central collisions. The azimuthal-angle dependence of the radii was measured with respect to the second-order event plane and similar oscillations of the source radii were found for pions and kaons. Hydrodynamic models qualitatively describe the similar oscillations of the mean source radii for pions and kaons, but they do not fully describe themore » transverse-mass dependence of the oscillations.« less

  14. Choosing engineering: Can I succeed and do I want to? A qualitative analysis framed in expectancy-value theory

    NASA Astrophysics Data System (ADS)

    Matusovich, Holly Marie

    Recently published reports call for an increase in the number of engineering graduates and suggest appropriate characteristics that these graduates should embody. Accomplishing either objective requires first understanding why students choose to pursue engineering degrees. This research started addressing this knowledge gap using Eccles' expectancy-value model to qualitatively and longitudinally examine undergraduate student's choices to enroll and persist in engineering majors. Specifically, this study focused on identity within Eccles' model to answer the question: How do students' beliefs about being engineers in the future shape their choices to pursue engineering? Framed in Eccles' model, students' choices to pursue engineering majors are based on beliefs about their engineering-related competence and how much they value succeeding in an engineering major. Eccles posits that identity shapes both competence and value beliefs. This study defined identity as students' self-perceptions as future engineers then examined the roles these self-perceptions in shaping their choices to pursue engineering degrees. Gee's conception of four-interrelated aspects of identity (nature identity, institutional identity, affinity identity, and discourse identity) provided a lens to examine students' self-perceptions as future engineers. Multiple case study methods guided this research with each of ten students (five men and five women) representing a case. Results derive from the inductive analysis of longitudinal interviews triangulated with survey results---all data spanned the students' first through fourth undergraduate years. This study is part of a larger body of work, the Academic Pathways Study (APS), conducted by the Center for Advancement of Engineering Education (CAEE). Results demonstrated that students' self-perceptions as future engineers are connected to both competence and value beliefs and to the choice to persist in engineering. Specifically, the results showed: (1) even in their fourth undergraduate year, three out of ten participants were uncertain about themselves as future engineers; (2) students choosing to pursue an engineering degree because they identify with the types of activities in which engineers engage experience the persistence choice process differently than students who choose engineering for other reasons; and (3) all students ultimately had positive competence beliefs, although two women participants continually renegotiated definitions of competence in engineering.

  15. Making and Maintaining Lifestyle Changes with the Support of a Lay Health Advisor: Longitudinal Qualitative Study of Health Trainer Services in Northern England

    PubMed Central

    Visram, Shelina; Clarke, Charlotte; White, Martin

    2014-01-01

    Objective To explore and document the experiences of those receiving support from a lay health trainer, in order to inform the optimisation and evaluation of such interventions. Design Longitudinal qualitative study with up to four serial interviews conducted over 12 months. Interviews were transcribed and analysed using the constant comparative approach associated with grounded theory. Participants 13 health trainers, 5 managers and 26 clients. Setting Three health trainer services targeting disadvantaged communities in northern England. Results The final dataset comprised 116 interviews (88 with clients and 28 with staff). Discussions with health trainers and managers revealed a high degree of heterogeneity between the local services in terms of their primary aims and activities. However, these were found to converge over time. There was agreement that health trainer interventions are generally ‘person-centred’ in terms of being tailored to the needs of individual clients. This led to a range of self-reported outcomes, including behaviour changes, physical health improvements and increased social activity. Factors impacting on the maintenance of lifestyle changes included the cost and timing of health-promoting activities, ill-health or low mood. Participants perceived a need for ongoing access to low cost facilities to ensure that any lifestyle changes can be maintained in the longer term. Conclusions Health trainers may be successful in terms of supporting people from socio-economically disadvantaged communities to make positive lifestyle changes, as well as achieving other health-related outcomes. This is not a ‘one-size-fits-all’ approach; commissioners and providers should select the intervention models that best meet the needs of their local populations. By delivering holistic interventions that address multiple lifestyle risks and incorporate relapse prevention strategies, health trainers could potentially have a significant impact on health inequalities. However, rigorous, formal outcome and economic evaluation of the range of health trainer delivery models is needed. PMID:24801173

  16. The practice of hope: a longitudinal, multi-perspective qualitative study among South Asian Sikhs and Muslims with life-limiting illness in Scotland.

    PubMed

    Kristiansen, Maria; Irshad, Tasneem; Worth, Allison; Bhopal, Raj; Lawton, Julia; Sheikh, Aziz

    2014-02-01

    We explored the role of faith and religious identities in shaping end of life experiences in South Asian Muslims and Sikhs with life-limiting illnesses. Secondary analysis of data from a longitudinal, multi-perspective qualitative study of the experience of life-limiting illness and access to palliative care services among South Asian Sikhs and Muslims in Scotland. Up to three semi-structured interviews were conducted with 25 participants, 15 family members and 20 health care professionals over a period of 18 months. Analysis was informed by Mattingly's theory on hope. Hope emerged as a central construct in the accounts of illness constructed by the participants as they struggled to make sense of and uphold a meaningful life. Clinical encounters and, for some, religious beliefs served as sources of hope for participants. Hope unfolded as an active process that enabled them to live with the personal and in particular the social ramifications of their illness. Changing images of hope were formulated and reflected as illness progressed or treatments failed. These ranged from hoping for cure, prolonged life, the regaining of lost capabilities needed to fulfil social roles, or at times death when suffering and the consequences for the family became too hard to bear. For those suffering from a life-limiting illness, sustaining hope is a complex challenge. The social character of hope is evident as it focuses on envisioning a life that is worth living, not only for oneself, but most importantly for social relations. Continuity in care at the end of life and a holistic approach is important in order to enable patients to articulate complex and changing notions of hope that at times are silenced within families, and for patients to feel confident in discussing the possible role of religious beliefs in shaping personal notions of hope.

  17. Changes in the Personal Dignity of Nursing Home Residents: A Longitudinal Qualitative Interview Study

    PubMed Central

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

    2013-01-01

    Background Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. Aim To investigate if and how nursing home residents’ personal dignity changes over the course of time, and what contributes to this. Design A longitudinal qualitative study. Methods Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. Results From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1) finding a way to cope with one’s situation; 2) getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3) physical improvement (with or without an electric wheelchair); 4) being socially involved with nursing home staff, other residents and relatives; and 5) being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. Conclusion Although the direction in which a resident’s personal dignity develops is also dependent on one’s character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person. PMID:24069235

  18. Nurses' and community support workers' experience of telehealth: a longitudinal case study.

    PubMed

    Sharma, Urvashi; Clarke, Malcolm

    2014-04-10

    Introduction of telehealth into the healthcare setting has been recognised as a service that might be experienced as disruptive. This paper explores how this disruption is experienced. In a longitudinal qualitative study, we conducted focus group discussions prior to and semi structured interviews post introduction of a telehealth service in Nottingham, U.K. with the community matrons, congestive heart failure nurses, chronic obstructive pulmonary disease nurses and community support workers that would be involved in order to elicit their preconceptions and reactions to the implementation. Users experienced disruption due to the implementation of telehealth as threatening. Three main factors add to the experience of threat and affect the decision to use the technology: change in clinical routines and increased workload; change in interactions with patients and fundamentals of face-to-face nursing work; and change in skills required with marginalisation of clinical expertise. Since the introduction of telehealth can be experienced as threatening, managers and service providers should aim at minimising the disruption caused by taking the above factors on board. This can be achieved by employing simple yet effective measures such as: providing timely, appropriate and context specific training; provision of adequate technical support; and procedures that allow a balance between the use of telehealth and personal visit by nurses delivering care to their patients.

  19. Grief after second-trimester termination for fetal anomaly: a qualitative study

    PubMed Central

    Maguire, Marguerite; Light, Alexis; Kuppermann, Miriam; Dalton, Vanessa K.; Steinauer, Jody E.; Kerns, Jennifer L.

    2015-01-01

    Objectives We aimed to qualitatively evaluate factors that contribute to and alleviate grief associated with termination of a pregnancy for a fetal anomaly and how that grief changes over time. Study design We conducted a longitudinal qualitative study of decision satisfaction, grief and coping among women undergoing termination (dilation and evacuation or induction termination) for fetal anomalies and other complications. We conducted three postprocedure interviews at 1–3 weeks, 3 months and 1 year. We used a generative thematic approach to analyze themes related to grief using NVivo software program. Results Of the 19 women in the overall study, 13 women’s interviews were eligible for analysis of the grief experience. Eleven women completed all three interviews, and two completed only the first interview. Themes that contributed to grief include self-blame for the diagnosis, guilt around the termination decision, social isolation related to discomfort with abortion and grief triggered by reminders of pregnancy. Social support and time are mechanisms that serve to alleviate grief. Conclusions Pregnancy termination in this context is experienced as a significant loss similar to other types of pregnancy loss and is also associated with real and perceived stigma. Women choosing termination for fetal anomalies may benefit from tailored counseling that includes dispelling misconceptions about cause of the anomaly. In addition, efforts to decrease abortion stigma and increase social support may improve women’s experiences and lessen their grief response. Implications The nature and course of grief after second-trimester termination for fetal anomaly are, as of yet, poorly understood. With improved understanding of how women grieve over time, clinicians can better recognize the significance of their patients’ suffering and offer tools to direct their grief toward positive coping. PMID:25499590

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

    DTIC Science & Technology

    2011-03-01

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

  1. When Educational Material Is Delivered: A Mixed Methods Content Validation Study of the Information Assessment Method.

    PubMed

    Badran, Hani; Pluye, Pierre; Grad, Roland

    2017-03-14

    The Information Assessment Method (IAM) allows clinicians to report the cognitive impact, clinical relevance, intention to use, and expected patient health benefits associated with clinical information received by email. More than 15,000 Canadian physicians and pharmacists use the IAM in continuing education programs. In addition, information providers can use IAM ratings and feedback comments from clinicians to improve their products. Our general objective was to validate the IAM questionnaire for the delivery of educational material (ecological and logical content validity). Our specific objectives were to measure the relevance and evaluate the representativeness of IAM items for assessing information received by email. A 3-part mixed methods study was conducted (convergent design). In part 1 (quantitative longitudinal study), the relevance of IAM items was measured. Participants were 5596 physician members of the Canadian Medical Association who used the IAM. A total of 234,196 ratings were collected in 2012. The relevance of IAM items with respect to their main construct was calculated using descriptive statistics (relevance ratio R). In part 2 (qualitative descriptive study), the representativeness of IAM items was evaluated. A total of 15 family physicians completed semistructured face-to-face interviews. For each construct, we evaluated the representativeness of IAM items using a deductive-inductive thematic qualitative data analysis. In part 3 (mixing quantitative and qualitative parts), results from quantitative and qualitative analyses were reviewed, juxtaposed in a table, discussed with experts, and integrated. Thus, our final results are derived from the views of users (ecological content validation) and experts (logical content validation). Of the 23 IAM items, 21 were validated for content, while 2 were removed. In part 1 (quantitative results), 21 items were deemed relevant, while 2 items were deemed not relevant (R=4.86% [N=234,196] and R=3.04% [n=45,394], respectively). In part 2 (qualitative results), 22 items were deemed representative, while 1 item was not representative. In part 3 (mixing quantitative and qualitative results), the content validity of 21 items was confirmed, and the 2 nonrelevant items were excluded. A fully validated version was generated (IAM-v2014). This study produced a content validated IAM questionnaire that is used by clinicians and information providers to assess the clinical information delivered in continuing education programs. ©Hani Badran, Pierre Pluye, Roland Grad. Originally published in JMIR Medical Education (http://mededu.jmir.org), 14.03.2017.

  2. Implementation of infection control best practice in intensive care units throughout Europe: a mixed-method evaluation study.

    PubMed

    Sax, Hugo; Clack, Lauren; Touveneau, Sylvie; Jantarada, Fabricio da Liberdade; Pittet, Didier; Zingg, Walter

    2013-02-19

    The implementation of evidence-based infection control practices is essential, yet challenging for healthcare institutions worldwide. Although acknowledged that implementation success varies with contextual factors, little is known regarding the most critical specific conditions within the complex cultural milieu of varying economic, political, and healthcare systems. Given the increasing reliance on unified global schemes to improve patient safety and healthcare effectiveness, research on this topic is needed and timely. The 'InDepth' work package of the European FP7 Prevention of Hospital Infections by Intervention and Training (PROHIBIT) consortium aims to assess barriers and facilitators to the successful implementation of catheter-related bloodstream infection (CRBSI) prevention in intensive care units (ICU) across several European countries. We use a qualitative case study approach in the ICUs of six purposefully selected acute care hospitals among the 15 participants in the PROHIBIT CRBSI intervention study. For sensitizing schemes we apply the theory of diffusion of innovation, published implementation frameworks, sensemaking, and new institutionalism. We conduct interviews with hospital health providers/agents at different organizational levels and ethnographic observations, and conduct rich artifact collection, and photography during two rounds of on-site visits, once before and once one year into the intervention. Data analysis is based on grounded theory. Given the challenge of different languages and cultures, we enlist the help of local interpreters, allot two days for site visits, and perform triangulation across multiple data sources. Qualitative measures of implementation success will consider the longitudinal interaction between the initiative and the institutional context. Quantitative outcomes on catheter-related bloodstream infections and performance indicators from another work package of the consortium will produce a final mixed-methods report. A mixed-methods study of this scale with longitudinal follow-up is unique in the field of infection control. It highlights the 'Why' and 'How' of best practice implementation, revealing key factors that determine success of a uniform intervention in the context of several varying cultural, economic, political, and medical systems across Europe. These new insights will guide future implementation of more tailored and hence more successful infection control programs.

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

    PubMed

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

    2017-08-01

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

  4. Deeply Virtual Exclusive Processes and Generalized Parton Distributions

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

    ,

    2011-06-01

    The goal of the comprehensive program in Deeply Virtual Exclusive Scattering at Jefferson Laboratory is to create transverse spatial images of quarks and gluons as a function of their longitudinal momentum fraction in the proton, the neutron, and in nuclei. These functions are the Generalized Parton Distributions (GPDs) of the target nucleus. Cross section measurements of the Deeply Virtual Compton Scattering (DVCS) reaction ep {yields} ep{gamma} in Hall A support the QCD factorization of the scattering amplitude for Q^2 {>=} 2 GeV^2. Quasi-free neutron-DVCS measurements on the Deuteron indicate sensitivity to the quark angular momentum sum rule. Fully exclusive H(e,more » e'p{gamma} ) measurements have been made in a wide kinematic range in CLAS with polarized beam, and with both unpolarized and longitudinally polarized targets. Existing models are qualitatively consistent with the JLab data, but there is a clear need for less constrained models. Deeply virtual vector meson production is studied in CLAS. The 12 GeV upgrade will be essential for for these channels. The {rho} and {omega} channels reactions offer the prospect of flavor sensitivity to the quark GPDs, while the {phi}-production channel is dominated by the gluon distribution.« less

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

    PubMed Central

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

    2017-01-01

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

  6. Organizational culture change in U.S. hospitals: a mixed methods longitudinal intervention study.

    PubMed

    Curry, Leslie A; Linnander, Erika L; Brewster, Amanda L; Ting, Henry; Krumholz, Harlan M; Bradley, Elizabeth H

    2015-03-07

    Improving outcomes for patients with acute myocardial infarction (AMI) is a priority for hospital leadership, clinicians, and policymakers. Evidence suggests links between hospital organizational culture and hospital performance; however, few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with AMI. We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL). This manuscript describes the methodology of LSL, a 2-year intervention study using a concurrent mixed methods design, guided by open systems theory and the Assess, Innovate, Develop, Engage, Devolve (AIDED) model of diffusion, implemented in 10 U.S. hospitals and their peer hospital networks. The intervention has three primary components: 1) annual convenings of the ten intervention hospitals; 2) semiannual workshops with guiding coalitions at each hospital; and 3) continuous remote support across all intervention hospitals through a web-based platform. Primary outcomes include 1) shifts in key dimensions of hospital organizational culture associated with lower mortality rates for patients with AMI; 2) use of targeted evidence-based practices associated with lower mortality rates for patients with AMI; and 3) in-hospital AMI mortality. Quantitative data include annual surveys of guiding coalition members in the intervention hospitals and peer network hospitals. Qualitative data include in-person, in-depth interviews with all guiding coalition members and selective observations of key interactions in care for patients with AMI, collected at three time points. Data integration will identify patterns and major themes in change processes across all intervention hospitals over time. LSL is novel in its use of a longitudinal mixed methods approach in a diverse sample of hospitals, its focus on objective outcome measures of mortality, and its examination of changes not only in the intervention hospitals but also in their peer hospital networks over time. This paper adds to the methodological literature for the study of complex interventions to promote hospital organizational culture change.

  7. Factors affecting continuation of clean intermittent catheterisation in people with multiple sclerosis: Results of the COSMOS mixed-methods study.

    PubMed

    McClurg, Doreen; Bugge, Carol; Elders, Andrew; Irshad, Tasneem; Hagen, Suzanne; Moore, Katherine N; Buckley, Brian; Fader, Mandy

    2018-04-01

    Clean intermittent catheterisation (CIC) is often recommended for people with multiple sclerosis (MS). To determine the variables that affect continuation or discontinuation of the use of CIC. A three-part mixed-method study (prospective longitudinal cohort ( n = 56), longitudinal qualitative interviews ( n = 20) and retrospective survey ( n = 456)) was undertaken, which identified the variables that influenced CIC continuation/discontinuation. The potential explanatory variables investigated in each study were the individual's age, gender, social circumstances, number of urinary tract infections, bladder symptoms, presence of co-morbidity, stage of multiple sclerosis and years since diagnosis, as well as CIC teaching method and intensity. For some people with MS the prospect of undertaking CIC is difficult and may take a period of time to accept before beginning the process of using CIC. Ongoing support from clinicians, support at home and a perceived improvement in symptoms such as nocturia were positive predictors of continuation. In many cases, the development of a urinary tract infection during the early stages of CIC use had a significant detrimental impact on continuation. Procedures for reducing the incidence of urinary tract infection during the learning period (i.e. when being taught and becoming competent) should be considered, as well as the development of a tool to aid identification of a person's readiness to try CIC.

  8. Systemic-constructivist couple therapy (SCCT): Description of approach, theoretical advances, and published longitudinal evidence.

    PubMed

    Reid, David W; Doell, Faye K; Dalton, E Jane; Ahmad, Saunia

    2008-12-01

    The systemic-constructivist approach to studying and benefiting couples was derived from qualitative and quantitative research on distressed couples over the past 10 years. Systemic-constructivist couple therapy (SCCT) is the clinical intervention that accompanies the approach. SCCT guides the therapist to work with both the intrapersonal and the interpersonal aspects of marriage while also integrating the social-environmental context of the couple. The theory that underlies SCCT is explained, including concepts such as we-ness and interpersonal processing. The primary components of the therapy are described. Findings described previously in an inaugural monograph containing extensive research demonstrating the long-term utility of SCCT are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  9. The embodied spaces of children with complex care needs: Effects on the social realities and power negotiations of families.

    PubMed

    Woodgate, Roberta L; Zurba, Melanie; Edwards, Marie; Ripat, Jacquie D; Rempel, Gina

    2017-07-01

    This paper presents research findings that advance knowledge around the power and agency families with children with complex care needs (CCN). Our conceptual framework uses concepts from geography towards situating the experiences and social realities of family carers within the 'embodied space of care'. The data originate from a longitudinal qualitative study of Canadian families with children with CCN. Findings reveal that interactions and decision-making processes relating to health and everyday life were complex and socially interconnected, and emphasize the need for provisions for family-based decision-making and enhanced social inclusion of families and the importance of the renegotiation of power. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Quality of life in end stage renal disease patients

    PubMed Central

    Joshi, Veena D

    2014-01-01

    AIM: To understand factors associated with quality of life (QOL), examine types of QOL instruments, and determine need for further improvements in QOL assessment. METHODS: The method used databases (Pubmed, Google scholar) and a bibliographic search using key words QOL, end stage renal disease, Hemodialysis, Peritoneal dialysis, instruments to measure QOL, patients and qualitative/quantitative analysis published during 1990 to June 2014. Each article was assessed for sample size, demographics of participants, study design and type of QOL instruments used. We used WHO definition of QOL. RESULTS: For this review, 109 articles were screened, out of which 65 articles were selected. Out of 65 articles, there were 19 reports/reviews and 12 questionnaire manuals. Of the 34 studies, 82% were quantitative while only 18% were qualitative. QOL instruments measured several phenomenon such as physical/psychological health, effects and burdens of kidney disease, social support etc. those are associated with QOL. Few studies looked at spiritual beliefs, cultural beliefs, personal concerns, as per the WHO definition. Telemedicine and Palliative care have now been successfully used however QOL instruments seldom addressed those in the articles reviewed. Also noticed was that longitudinal studies were rarely conducted. Existing QOL instruments only partially measure QOL. This may limit validity of predictive power of QOL. CONCLUSION: Culture and disease specific QOL instruments that assess patients’ objective and subjective experiences covering most aspects of QOL are urgently needed. PMID:25374827

  11. Impact buckling of thin bars in the elastic range for any end condition

    NASA Technical Reports Server (NTRS)

    Taub, Josef

    1934-01-01

    Following a qualitative discussion of the complicated process involved in a short-period, longitudinal force applied to an originally not quite straight bar, the actual process is substituted by an idealized process for the purpose of analytical treatment. The simplifications are: the assumption of an infinitely high rate of propagation of the elastic longitudinal waves in the bar, limitation to slender bars, disregard of material damping and of rotatory inertia, the assumption of consistently small elastic deformations, the assumption of cross-sectional dimensions constant along the bar axis, the assumption of a shock-load constant in time, and the assumption of eccentricities on one plane. Then follow the mathematical principles for resolving the differential equation of the simplified problem, particularly the developability of arbitrary functions with steady first and second and intermittently steady third and fourth derivatives into one convergent series, according to the natural functions of the homogeneous differential equation.

  12. Consistent and reproducible positioning in longitudinal imaging for phenotyping genetically modified swine

    NASA Astrophysics Data System (ADS)

    Hammond, Emily; Dilger, Samantha K. N.; Stoyles, Nicholas; Judisch, Alexandra; Morgan, John; Sieren, Jessica C.

    2015-03-01

    Recent growth of genetic disease models in swine has presented the opportunity to advance translation of developed imaging protocols, while characterizing the genotype to phenotype relationship. Repeated imaging with multiple clinical modalities provides non-invasive detection, diagnosis, and monitoring of disease to accomplish these goals; however, longitudinal scanning requires repeatable and reproducible positioning of the animals. A modular positioning unit was designed to provide a fixed, stable base for the anesthetized animal through transit and imaging. Post ventilation and sedation, animals were placed supine in the unit and monitored for consistent vitals. Comprehensive imaging was performed with a computed tomography (CT) chest-abdomen-pelvis scan at each screening time point. Longitudinal images were rigidly registered, accounting for rotation, translation, and anisotropic scaling, and the skeleton was isolated using a basic thresholding algorithm. Assessment of alignment was quantified via eleven pairs of corresponding points on the skeleton with the first time point as the reference. Results were obtained with five animals over five screening time points. The developed unit aided in skeletal alignment within an average of 13.13 +/- 6.7 mm for all five subjects providing a strong foundation for developing qualitative and quantitative methods of disease tracking.

  13. Qualitative Literature Review of the Prevalence of Depression in Medical Students Compared to Students in Non-medical Degrees.

    PubMed

    Bacchi, Stephen; Licinio, Julio

    2015-06-01

    The purpose of this study is to review studies published in English between 1 January 2000 and 16 June 2014, in peer-reviewed journals, that have assessed the prevalence of depression, comparing medical students and non-medical students with a single evaluation method. The databases PubMed, Medline, EMBASE, PsycINFO, and Scopus were searched for eligible articles. Searches used combinations of the Medical Subject Headings medical student and depression. Titles and abstracts were reviewed to determine eligibility before full-text articles were retrieved, which were then also reviewed. Twelve studies met eligibility criteria. Non-medical groups surveyed included dentistry, business, humanities, nursing, pharmacy, and architecture students. One study found statistically significant results suggesting that medical students had a higher prevalence of depression than groups of non-medical students; five studies found statistically significant results indicating that the prevalence of depression in medical students was less than that in groups of non-medical students; four studies found no statistically significant difference, and two studies did not report on the statistical significance of their findings. One study was longitudinal, and 11 studies were cross-sectional. While there are limitations to these comparisons, in the main, the reviewed literature suggests that medical students have similar or lower rates of depression compared to certain groups of non-medical students. A lack of longitudinal studies meant that potential common underlying causes could not be discerned, highlighting the need for further research in this area. The high rates of depression among medical students indicate the continuing need for interventions to reduce depression.

  14. Making sense of autism: Progressive engagement with science among parents of young, recently diagnosed autistic children.

    PubMed

    Feinstein, Noah Weeth

    2014-07-01

    This exploratory study examines the significance of science to parents whose children were recently diagnosed with an autism spectrum disorder. It asks: (I) In what manner did science emerge in parents' concerns and resources as they attempted to understand and advocate for their children? (2) Did some parents engage with science in a qualitatively deeper or more intense manner? Using longitudinal data from interviews and a novel data collection strategy called engagement mapping, it shows that parents asked questions and used resources that were strongly associated with science, but these were vastly outnumbered by "near-science" concerns and resources that mingled meanings from science and daily life. Several parents in the study wove together concerns and resources in an iterative pattern referred to here as progressive engagement with science.

  15. An investigation of the predictors of photoprotection and UVR dose to the face in patients with XP: a protocol using observational mixed methods

    PubMed Central

    Walburn, Jessica; Sarkany, Robert; Norton, Sam; Foster, Lesley; Morgan, Myfanwy; Sainsbury, Kirby; Araújo-Soares, Vera; Anderson, Rebecca; Garrood, Isabel; Heydenreich, Jakob; Sniehotta, Falko F; Vieira, Rute; Wulf, Hans Christian; Weinman, John

    2017-01-01

    Introduction Xeroderma pigmentosum (XP) is a rare genetic condition caused by defective nucleotide excision repair and characterised by skin cancer, ocular and neurological involvement. Stringent ultraviolet protection is the only way to prevent skin cancer. Despite the risks, some patients’ photoprotection is poor, with a potentially devastating impact on their prognosis. The aim of this research is to identify disease-specific and psychosocial predictors of photoprotection behaviour and ultraviolet radiation (UVR) dose to the face. Methods and analysis Mixed methods research based on 45 UK patients will involve qualitative interviews to identify individuals’ experience of XP and the influences on their photoprotection behaviours and a cross-sectional quantitative survey to assess biopsychosocial correlates of these behaviours at baseline. This will be followed by objective measurement of UVR exposure for 21 days by wrist-worn dosimeter and daily recording of photoprotection behaviours and psychological variables for up to 50 days in the summer months. This novel methodology will enable UVR dose reaching the face to be calculated and analysed as a clinically relevant endpoint. A range of qualitative and quantitative analytical approaches will be used, reflecting the mixed methods (eg, cross-sectional qualitative interviews, n-of-1 studies). Framework analysis will be used to analyse the qualitative interviews; mixed-effects longitudinal models will be used to examine the association of clinical and psychosocial factors with the average daily UVR dose; dynamic logistic regression models will be used to investigate participant-specific psychosocial factors associated with photoprotection behaviours. Ethics and dissemination This research has been approved by Camden and King’s Cross Research Ethics Committee 15/LO/1395. The findings will be published in peer-reviewed journals and presented at national and international scientific conferences. PMID:28827277

  16. The socio-political context of migration and reproductive health disparities: The case of early sexual initiation among Mexican-origin immigrant young women

    PubMed Central

    Coleman-Minahan, Kate

    2017-01-01

    Prior research often explains the lower risk of early sexual initiation among foreign-born Mexican-origin young women by a patriarchal and sexually conservative “traditional Latino culture.” This definition overlooks structural factors such as exploitation of migrant workers, and conflates gender inequality and sexual expectations. I use an intersectional framework and the theory of gender and power to explore how gender inequality and sexual expectations are both influenced by structural factors and affect reproductive health outcomes. I integrate data from qualitative interviews with 21 first and second generation Mexican-origin women in 2013–2014 with data from discrete time hazard models with 798 Mexican-origin young women in the National Longitudinal Study of Adolescent to Adult Health. Qualitative results demonstrate that gender inequality and sexual expectations in Mexican-origin immigrant households are associated with structural factors. Gender inequality occurs more often in households with family instability, greater poverty, and among parents who migrated independently. Qualitative data also demonstrate that parental gendered expectations are sometimes at odds to what parents are actually doing in the household. Finally, contrary to assumptions that a patriarchal “traditional Latino culture” protects against early sexual initiation, qualitative and multivariate quantitative data suggest that household gender inequality increases risk of early sexual initiation. These findings challenge the utility of a culturalist approach that views culture as determining behavior to explain health disparities among immigrants and demonstrate the need to incorporate an intersectional framework that includes structural factors. This approach may reduce stereotypes and identify meaningful interventions to reduce reproductive health disparities. PMID:28324794

  17. “Having Another Child Would Be a Life or Death Situation for Her”: Understanding Pregnancy Termination Among Couples in Rural Bangladesh

    PubMed Central

    Hindin, Michelle J.

    2008-01-01

    Objectives. We conducted a mixed-method study in rural southwestern Bangladesh, a country in which an estimated 730 000 elective pregnancy terminations occur each year, to explore women's and couples’ motivations to terminate pregnancies. Methods. Quantitative data derived from a 1998 cross-sectional survey and a longitudinal demographic surveillance system (1998–2003) were combined with qualitative data gathered through 84 in-depth interviews conducted with 19 couples during 2004–2005. Results. Quantitative results indicated that 11% of couples reported a pregnancy termination in the study period; the rate was highest among couples who reported in 1998 that they wanted no more children (29%). Both wives’ and husbands’ fertility preferences independently and significantly predicted pregnancy termination. Qualitative findings showed that more than half of the participants had attempted to terminate a pregnancy at least once in their lifetime. Conclusions. Our results highlight the importance of collecting data from both partners and the influence of husbands’ fertility preferences on reproductive decisionmaking. The prevalence of reported pregnancy terminations in our population, along with the use of informal methods in termination attempts, highlights the need for continued provision of contraceptives and access to safe and affordable pregnancy termination services in this setting. PMID:18703439

  18. Understanding patient perceptions of shared decision making.

    PubMed

    Shay, L Aubree; Lafata, Jennifer Elston

    2014-09-01

    This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared. Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis. Patients' conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision. There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of "agreement" may be more important than the actual decision-making process for patients to label a decision as shared. Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM. Published by Elsevier Ireland Ltd.

  19. General practitioners’ experiences using cognitive behavioural therapy in general practice: A qualitative study

    PubMed Central

    Aschim, Bente; Lundevall, Sverre; Martinsen, Egil W.; Frich, Jan C.

    2011-01-01

    Objective To explore GPs’ experiences using cognitive behavioural therapy (CBT), with a focus on factors that promote or limit the use of CBT in general practice. Design Qualitative study using data from written evaluation reports and focus-group interviews. Setting Norwegian general practice. Subjects GPs who participated in a longitudinal CBT course in the continuous medical education (CME) programme for GPs in Norway, of whom 19 filled in evaluation forms and 15 participated in focus-group interviews. Main outcome measures Experiences with the use of CBT in general practice. Results GPs used CBT mainly in the treatment of patients with anxiety disorders and depression. Factors that promoted the use of CBT in general practice were structured supervision and group counselling, receiving feedback on individual video-recorded consultations, and experiencing that one mastered the therapeutic techniques. Limiting factors were that it took some time before one mastered the techniques, lack of eligible patients, constraints related to attending group supervision during office hours, and the lack of financial incentives to use CBT in general practice. Conclusion Tailored training programmes in CBT for GPs may contribute to more frequent use of CBT in general practice. A formal recognition of CBT in the reimbursement scheme for GPs might counter limiting factors to an increased use of CBT in general practice. PMID:21861599

  20. Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments.

    PubMed

    Conners, Erin E; West, Brooke S; Roth, Alexis M; Meckel-Parker, Kristen G; Kwan, Mei-Po; Magis-Rodriguez, Carlos; Staines-Orozco, Hugo; Clapp, John D; Brouwer, Kimberly C

    2016-01-01

    Increasingly, 'place', including physical and geographical characteristics as well as social meanings, is recognized as an important factor driving individual and community health risks. This is especially true among marginalized populations in low and middle income countries (LMIC), whose environments may also be more difficult to study using traditional methods. In the NIH-funded longitudinal study Mapa de Salud, we employed a novel approach to exploring the risk environment of female sex workers (FSWs) in two Mexico/U.S. border cities, Tijuana and Ciudad Juárez. In this paper we describe the development, implementation, and feasibility of a mix of quantitative and qualitative tools used to capture the HIV risk environments of FSWs in an LMIC setting. The methods were: 1) Participatory mapping; 2) Quantitative interviews; 3) Sex work venue field observation; 4) Time-location-activity diaries; 5) In-depth interviews about daily activity spaces. We found that the mixed-methodology outlined was both feasible to implement and acceptable to participants. These methods can generate geospatial data to assess the role of the environment on drug and sexual risk behaviors among high risk populations. Additionally, the adaptation of existing methods for marginalized populations in resource constrained contexts provides new opportunities for informing public health interventions.

  1. Shared decision-making in medical encounters regarding breast cancer treatment: the contribution of methodological triangulation.

    PubMed

    Durif-Bruckert, C; Roux, P; Morelle, M; Mignotte, H; Faure, C; Moumjid-Ferdjaoui, N

    2015-07-01

    The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires (n = 132), longitudinal interviews (n = 47) and observations of consultations (n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available. © 2014 John Wiley & Sons Ltd.

  2. Occupational balance of women with rheumatoid arthritis: a qualitative study.

    PubMed

    Stamm, Tanja; Wright, Jon; Machold, Klaus; Sadlo, Gaynor; Smolen, Josef

    2004-01-01

    Occupational balance has been shown to be an important factor in maintaining health. Rheumatoid arthritis (RA) reduces functional ability and quality of life and may thus reduce occupational balance. The aim of this qualitative pilot study was to explore occupational balance in women who have RA. Nine women with RA with past, but not current, paid work experience, no other confounding neuro-motor disease and with disease duration of 0.75-31 years were selected from an Austrian rheumatology outpatient clinic. Age range of the participants was 28-68 years. A semi-structured interview was conducted with each participant and transcribed verbatim. Data were analysed by the constant comparative method from an occupational perspective. Three main categories emerged: (1) The participants experienced a process of change that affected their occupational balance. (2) This new state of occupational balance was characterized by changed levels of involvement in physical, mental, social and rest occupations and by a certain level of unpredictability of symptoms. (3) Overall, the new state of occupational balance was valued differently: positively, indifferently or negatively. RA was found to have a considerable impact on occupational balance. The experience is not invariably seen as negative as previous literature would suggest. Further research should explore the longitudinal dimension of occupational balance in people with RA. Copyright (c) 2004 Whurr Publishers Ltd.

  3. Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments

    PubMed Central

    Conners, Erin E.; West, Brooke S.; Roth, Alexis M.; Meckel-Parker, Kristen G.; Kwan, Mei-Po; Magis-Rodriguez, Carlos; Staines-Orozco, Hugo; Clapp, John D.; Brouwer, Kimberly C.

    2016-01-01

    Increasingly, ‘place’, including physical and geographical characteristics as well as social meanings, is recognized as an important factor driving individual and community health risks. This is especially true among marginalized populations in low and middle income countries (LMIC), whose environments may also be more difficult to study using traditional methods. In the NIH-funded longitudinal study Mapa de Salud, we employed a novel approach to exploring the risk environment of female sex workers (FSWs) in two Mexico/U.S. border cities, Tijuana and Ciudad Juárez. In this paper we describe the development, implementation, and feasibility of a mix of quantitative and qualitative tools used to capture the HIV risk environments of FSWs in an LMIC setting. The methods were: 1) Participatory mapping; 2) Quantitative interviews; 3) Sex work venue field observation; 4) Time-location-activity diaries; 5) In-depth interviews about daily activity spaces. We found that the mixed-methodology outlined was both feasible to implement and acceptable to participants. These methods can generate geospatial data to assess the role of the environment on drug and sexual risk behaviors among high risk populations. Additionally, the adaptation of existing methods for marginalized populations in resource constrained contexts provides new opportunities for informing public health interventions. PMID:27191846

  4. “We Do Science Here”: Underrepresented Students’ Interactions with Faculty in Different College Contexts

    PubMed Central

    Hurtado, Sylvia; Eagan, M. Kevin; Tran, Minh C.; Newman, Christopher B.; Chang, Mitchell J.; Velasco, Paolo

    2011-01-01

    Faculty members play a key role in the identification and training of the next generation of scientific talent. In the face of the need to advance and diversify the scientific workforce, we examine whether and how specific institutional contexts shape student interactions with faculty. We conducted a mixed methods study to understand institutional contextual differences in the experiences of aspiring scientists. Data from a qualitative five-campus case study and a quantitative longitudinal study of students from over 117 higher education institutions were analyzed to determine how aspiring scientists interact with faculty and gain access to resources that will help them achieve their educational goals. Findings indicate that important structural differences exist between institutions in shaping students’ interactions with faculty. For example, students at more selective institutions typically have less frequent, less personal interactions with faculty whereas Black students at HBCUs report having more support and frequent interactions with faculty. PMID:23503924

  5. Students' perceptions about science: The impact of transition from primary to secondary school

    NASA Astrophysics Data System (ADS)

    Speering, Wendy; Rennie, Léonie

    1996-09-01

    As students move through school, attitudes to school in general, and science in particular, become less positive. This paper reports on a longitudinal study which mapped, from the students' point of view, the transition between primary and secondary school in Western Australia. The study focused on the subject of science, and used both quantitative and qualitative methods. During the transition, there is a considerable change in the organisation of the school, the curriculum and the teacherstudent relationship. Students in this study, especially the girls, were generally disenchanted with the teaching strategies used in their secondary science classrooms, and regretted the loss of the close teacher-student relationship of their primary school years. Their perceptions were that science in secondary school was not what they had expected, and this experience may have long term implications for their subject and career choices.

  6. Emerging adulthood and the perception of parental depression.

    PubMed

    Kaimal, Girija; Beardslee, William R

    2010-09-01

    Few studies have examined children's perceptions of parental depression. This study was a qualitative analysis of the changes in the perception of parental depression between the ages of 17 and 19 years. Archived interview narratives of 16 respondents from a longitudinal, preventive intervention study of depression in families were analyzed. The respondents were purposefully selected to represent both genders as well as higher and lower levels of family adversity. The perceptions of parental depression were found to fall into three categories: self-oriented perspectives (resistance and negativity), ambivalent perspectives, and, other-oriented perspectives (acceptance and compassion). Over time, respondents from the high-adversity families showed shifts from self-orientation to other-orientation, whereas the perspectives of respondents from low-adversity families remained unchanged. Some respondents with depression in both parents and/or siblings revealed changes in perception toward one parent but no change toward other family members with depression.

  7. Fracture mechanics of shear crack propagation and dissection in the healthy bovine descending aortic media.

    PubMed

    Haslach, Henry W; Siddiqui, Ahmed; Weerasooriya, Amanda; Nguyen, Ryan; Roshgadol, Jacob; Monforte, Noel; McMahon, Eileen

    2018-03-01

    This experimental study adopts a fracture mechanics strategy to investigate the mechanical cause of aortic dissection. Inflation of excised healthy bovine aortic rings with a cut longitudinal notch that extends into the media from the intima suggests that an intimal tear may propagate a nearly circumferential-longitudinal rupture surface that is similar to the delamination that occurs in aortic dissection. Radial and 45°-from-radial cut notch orientations, as seen in the thickness surface, produce similar circumferential crack propagation morphologies. Partial cut notches, whose longitudinal length is half the width of the ring, measure the influence of longitudinal material on crack propagation. Such specimens also produce circumferential cracks from the notch root that are visible in the thickness circumferential-radial plane, and often propagate a secondary crack from the base of the notch, visible in the intimal circumferential-longitudinal plane. Inflation of rings with pairs of cut notches demonstrates that a second notch modifies the propagation created in a specimen with a single notch. The circumferential crack propagation is likely a consequence of the laminar medial structure. These fracture surfaces are probably due to non-uniform circumferential shear deformation in the heterogeneous media as the aortic wall expands. The qualitative deformation morphology around the root of the cut notch during inflation is evidence for such shear deformation. The shear apparently results from relative slip in the circumferential direction of collagen fibers. The slip may produce shear in the longitudinal-circumferential plane between medial layers or in the radial-circumferential plane within a medial lamina in an idealized model. Circumferential crack propagation in the media is then a shear mechanical process that might be facilitated by disease of the tissue. An intimal tear of an apparently healthy aortic wall near the aortic arch is life-threatening because it may lead to full rupture or to wall dissection in which delamination of the medial layer extends around most of the aortic circumference. The mechanical events underlying dissection are not definitively established. This experimental fracture mechanics study provides evidence that shear rupture is the main mechanical process underlying aortic dissection. The commonly performed tensile strength tests of aortic tissue are not clinically useful to predict or describe aortic dissection. One implication of the study is that shear tests might produce more fruitful simple assessments of the aortic wall strength. A clinical implication is that when presented with an intimal tear, those who guide care might recommend steps to reduce the shear load on the aorta. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  8. The experiences, unmet needs and outcomes of parents of severely injured children: a longitudinal mixed methods study protocol.

    PubMed

    Foster, Kim; Curtis, Kate; Mitchell, Rebecca; Van, Connie; Young, Alexandra

    2016-09-06

    Being the parent of a severely injured child involves many stressors throughout the trauma journey. Internationally, little is known about the experiences or levels of emotional distress, parenting stress, quality of life, and resilience for parents of injured children. The aim of this study is to investigate the experiences, unmet needs and outcomes of parents of physically injured children 0-12 years over the 2 year period following injury. This is a prospective longitudinal study using an embedded mixed methods design. This design has a primary qualitative strand which incorporates supplementary quantitative data on child quality of life, and parental quality of life, parenting stress, emotional distress, and resilience at four time points; the acute hospitalisation phase, and at 6, 12 and 24 months following injury. The primary sample are parents of injured children 0-12 years hospitalised in the Australian states of New South Wales, Queensland, Victoria and South Australia. Primary data sources are child and parent demographic data; survey data; and semi-structured interview data across a 24 month period. This study aims to address the existing gap in knowledge on the experiences and unmet support needs of parents in the 2 years following child injury to provide guidance for care provision for these families. There is a lack of evidence-based recommendations for supporting parents and families of injured children and strengthening their capacity to address the challenges they face.

  9. Evaluating a Dutch cardiology primary care plus intervention on the Triple Aim outcomes: study design of a practice-based quantitative and qualitative research.

    PubMed

    Quanjel, Tessa C C; Spreeuwenberg, Marieke D; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

    2017-09-06

    In an attempt to deal with the pressures on the health-care system and to guarantee sustainability, changes are needed. This study focuses on a cardiology primary care plus intervention. Primary care plus (PC+) is a new health-care delivery model focused on substitution of specialist care in the hospital setting with specialist care in the primary care setting. The intervention consists of a cardiology PC+ centre in which cardiologists, supported by other health-care professionals, provide consultations in a primary care setting. The PC+ centre aims to improve the health of the population and quality of care as experienced by patients, and reduce the number of referrals to hospital-based outpatient specialist care in order to reduce health-care costs. These aims reflect the Triple Aim principle. Hence, the objectives of the study are to evaluate the cardiology PC+ centre in terms of the Triple Aim outcomes and to evaluate the process of the introduction of PC+. The study is a practice-based, quantitative study with a longitudinal observational design, and an additional qualitative study to supplement, interpret and improve the quantitative study. The study population of the quantitative part will consist of adult patients (≥18 years) with non-acute and low-complexity cardiology-related health complaints, who will be referred to the cardiology PC+ centre (intervention group) or hospital-based outpatient cardiology care (control group). All eligible patients will be asked to complete questionnaires at three different time points consisting of questions about their demographics, health status and experience of care. Additionally, quantitative data will be collected about health-care utilization and related health-care costs at the PC+ centre and the hospital. The qualitative part, consisting of semi-structured interviews, focus groups, and observations, is designed to evaluate the process as well as to amplify, clarify and explain quantitative results. This study will evaluate a cardiology PC+ centre using quantitative and supplementary qualitative methods. The findings of both sub-studies will fill a gap in knowledge about the effects of PC+ and in particular whether PC+ is able to pursue the Triple Aim outcomes. NTR6629 (Data registered: 25-08-2017) (registered retrospectively).

  10. Evolution of phonemic word fluency performance in post-stroke aphasia.

    PubMed

    Sarno, Martha Taylor; Postman, Whitney Anne; Cho, Young Susan; Norman, Robert G

    2005-01-01

    In this longitudinal study, quantitative and qualitative changes in responses of people with aphasia were examined on a phonemic fluency task. Eighteen patients were tested at 3-month intervals on the letters F-A-S while they received comprehensive, intensive treatment from 3 to 12 months post-stroke. They returned for a follow-up evaluation at an average of 10 months post-intervention. Mean group scores improved significantly from beginning to end of treatment, but declined post-intervention. Patients produced a significantly greater number and proportion of modifiers (adjectives and adverbs) between the beginning and end of treatment, with no decline afterwards, implying that they had access to a wider range of grammatical categories over time. Moreover, patients used significantly more phonemic clusters in generating word lists by the end of treatment. These gains may be attributed to the combined effects of time since onset and the linguistic and cognitive stimulation that patients received in therapy. Readers of this paper should (1) gain a better understanding of verbal fluency performance in the assessment of aphasia, (2) recognize the importance of analyzing qualitative aspects of single word production in aphasia, and (3) contribute to their clinical judgment of long term improvement in aphasia.

  11. A qualitative and quantitative study on the enkephalinergic innervation of the pig gastrointestinal tract.

    PubMed

    Porcher, C; Julé, Y; Henry, M

    2000-03-01

    Enkephalins are involved in neural control of digestive functions such as motility, secretion, and absorption. To better understand their role in pigs, we analyzed the qualitative and quantitative distribution of enkephalin immunoreactivity (ENK-IR) in components of the intestinal wall from the esophagus to the anal sphincter. Immunohistochemical labelings were analyzed using conventional fluorescence and confocal microscopy. ENK-IR was compared with the synaptophysin immunoreactivity (SYN-IR). The results show that maximal ENK-IR levels in the entire digestive tract are reached in the myenteric plexuses and, to a lesser extent, in the external submucous plexus and the circular muscle layer. In the longitudinal muscle layer, ENK-IR was present in the esophagus, stomach, rectum, and anal sphincter, whereas it was absent from the duodenum to the distal colon. In the ENK-IR plexuses and muscle layers, more than 60% of the nerve fibers identified by SYN-IR expressed ENK-IR. No ENK-IR was observed in the internal submucous plexus and the mucosa; the latter was found to contain ENK-IR endocrine cells. These results strongly suggest that, in pigs, enkephalins play a major role in the regulatory mechanisms that underlie the neural control of digestive motility.

  12. Simulation workshops with first year midwifery students.

    PubMed

    Catling, Christine; Hogan, Rosemarie; Fox, Deborah; Cummins, Allison; Kelly, Michelle; Sheehan, Athena

    2016-03-01

    Simulated teaching methods enable a safe learning environment that are structured, constructive and reflective. We prepared a 2-day simulation project to help prepare students for their first clinical practice. A quasi-experimental pre-test - post-test design was conducted. Qualitative data from the open-ended survey questions were analysed using content analysis. Confidence intervals and p-values were calculated to demonstrate the changes in participants' levels of understanding/ability or confidence in clinical midwifery skills included in the simulation. 71 midwifery students participated. Students rated their understanding, confidence, and abilities as higher after the simulation workshop, and higher still after their clinical experience. There were five main themes arising from the qualitative data: having a learning experience, building confidence, identifying learning needs, developing communication skills and putting skills into practise. First year midwifery students felt well prepared for the clinical workplace following the simulation workshops. Self-rated understanding, confidence and abilities in clinical midwifery skills were significantly higher following consolidation during clinical placement. Longitudinal studies on the relationship between simulation activities and student's overall clinical experience, their intentions to remain in midwifery, and facility feedback, would be desirable. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Process and Outcome Evaluation of a Community Intervention for Orphan Adolescents in Western Kenya

    PubMed Central

    Hallfors, Denise D.; Cho, Hyunsan; Mbai, Isabella; Milimo, Benson; Itindi, Janet

    2012-01-01

    We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area in rural western Kenya to test whether providing young orphan adolescents with uniforms, school fees, and community visitors improves school retention and reduces HIV risk factors. The trial was a community intervention, limited to one community. In this paper, we examined intervention implementation and its association with outcomes using longitudinal data. We used both quantitative and qualitative methods to evaluate the community-based model for orphan HIV prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE analyses showed null effects after 2 years. Volunteer community visitors, a key element of the intervention, showed little of the expected effect although qualitative reports documented active assistance to prevent orphans' school absence. For future research, we recommend capturing the transition to high school, a larger sample size, and biomarker data to add strength to the research design. We also recommend a school-based intervention approach to improve implementation and reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving school attendance and preventing dropout because of their unique ability to address critical biopsychosocial problems. PMID:22350730

  14. Biomarkers in Prodromal Parkinson Disease: a Qualitative Review.

    PubMed

    Cooper, Christine A; Chahine, Lama M

    2016-11-01

    Over the past several years, the concept of prodromal Parkinson disease (PD) has been increasingly recognized. This term refers to individuals who do not fulfill motor diagnostic criteria for PD, but who have clinical, genetic, or biomarker characteristics suggesting risk of developing PD in the future. Clinical diagnosis of prodromal PD has low specificity, prompting the need for objective biomarkers with higher specificity. In this qualitative review, we discuss objectively defined putative biomarkers for PD and prodromal PD. We searched Pubmed and Embase for articles pertaining to objective biomarkers for PD and their application in prodromal cohorts. Articles were selected based on relevance and methodology. Objective biomarkers of demonstrated utility in prodromal PD include ligand-based imaging and transcranial sonography. Development of serum, cerebrospinal fluid, and tissue-based biomarkers is underway, but their application in prodromal PD has yet to meaningfully occur. Combining objective biomarkers with clinical or genetic prodromal features increases the sensitivity and specificity for identifying prodromal PD. Several objective biomarkers for prodromal PD show promise but require further study, including their application to and validation in prodromal cohorts followed longitudinally. Accurate identification of prodromal PD will likely require a multimodal approach. (JINS, 2016, 22, 956-967).

  15. Process and outcome evaluation of a community intervention for orphan adolescents in western Kenya.

    PubMed

    Hallfors, Denise D; Cho, Hyunsan; Mbai, Isabella; Milimo, Benson; Itindi, Janet

    2012-10-01

    We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area in rural western Kenya to test whether providing young orphan adolescents with uniforms, school fees, and community visitors improves school retention and reduces HIV risk factors. The trial was a community intervention, limited to one community. In this paper, we examined intervention implementation and its association with outcomes using longitudinal data. We used both quantitative and qualitative methods to evaluate the community-based model for orphan HIV prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE analyses showed null effects after 2 years. Volunteer community visitors, a key element of the intervention, showed little of the expected effect although qualitative reports documented active assistance to prevent orphans' school absence. For future research, we recommend capturing the transition to high school, a larger sample size, and biomarker data to add strength to the research design. We also recommend a school-based intervention approach to improve implementation and reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving school attendance and preventing dropout because of their unique ability to address critical biopsychosocial problems.

  16. Inter-observer reliability of high-resolution ultrasonography in the assessment of bone erosions in patients with rheumatoid arthritis: experience of an intensive dedicated training programme.

    PubMed

    Gutierrez, Marwin; Filippucci, Emilio; Ruta, Santiago; Salaffi, Fausto; Blasetti, Patrizia; Di Geso, Luca; Grassi, Walter

    2011-02-01

    The present study was aimed at testing the ability of a rheumatologist without experience in ultrasound (US) who attended an intensive 4-week training programme focused on US assessing bone erosions in the hands and feet in patients with RA. Twenty patients diagnosed with RA according to the ACR criteria were included in the study. All US examinations were performed bilaterally by two investigators (with different experience in the field of musculoskeletal US) at the following sites: the dorsal, lateral and volar aspect of the second metacarpal, ulnar and fifth metatarsal head; and the dorsal and volar aspect of the third metacarpal and second proximal heads. Each quadrant was scanning in longitudinal and transverse scans for assessing the qualitative, semiquantitative and quantitative US findings indicative of bone erosions according the OMERACT preliminary definition. Both κ-values and overall agreement percentages of qualitative and semiquantitative assessments showed moderate to excellent agreement between the two investigators. Similar results were obtained for the quantitative assessment with the concordance correlation coefficient value always significant. The only exception was the volar aspects, in particular those of the fifth metatarsal head. Our study suggests that after a 4-week dedicated training programme, a rheumatologist without experience in US is able to detect and score bone erosions in the hands and feet of patients with RA.

  17. To what extent do site-based training, mentoring, and operational research improve district health system management and leadership in low- and middle-income countries: a systematic review protocol.

    PubMed

    Belrhiti, Zakaria; Booth, Andrew; Marchal, Bruno; Verstraeten, Roosmarijn

    2016-04-27

    District health managers play a key role in the effectiveness of decentralized health systems in low- and middle-income countries. Inadequate management and leadership skills often hamper their ability to improve quality of care and effectiveness of health service delivery. Nevertheless, significant investments have been made in capacity-building programmes based on site-based training, mentoring, and operational research. This systematic review aims to review the effectiveness of site-based training, mentoring, and operational research (or action research) on the improvement of district health system management and leadership. Our secondary objectives are to assess whether variations in composition or intensity of the intervention influence its effectiveness and to identify enabling and constraining contexts and underlying mechanisms. We will search the following databases: MEDLINE, PsycInfo, Cochrane Library, CRD database (DARE), Cochrane Effective Practice and Organisation of Care (EPOC) group, ISI Web of Science, Health Evidence.org, PDQ-Evidence, ERIC, EMBASE, and TRIP. Complementary search will be performed (hand-searching journals and citation and reference tracking). Studies that meet the following PICO (Population, Intervention, Comparison, Outcome) criteria will be included: P: professionals working at district health management level; I: site-based training with or without mentoring, or operational research; C: normal institutional arrangements; and O: district health management functions. We will include cluster randomized controlled trials, controlled before-and-after studies, interrupted time series analysis, quasi-experimental designs, and cohort and longitudinal studies. Qualitative research will be included to contextualize findings and identify barriers and facilitators. Primary outcomes that will be reported are district health management and leadership functions. We will assess risk of bias with the Cochrane Collaboration's tools for randomized controlled trials (RCT) and non RCT studies and Critical Appraisal Skills Programme checklists for qualitative studies. We will assess strength of recommendations with the GRADE tool for quantitative studies, and the CERQual approach for qualitative studies. Synthesis of quantitative studies will be performed through meta-analysis when appropriate. Best fit framework synthesis will be used to synthesize qualitative studies. This protocol paper describes a systematic review assessing the effectiveness of site-based training (with or without mentoring programmes or operational research) on the improvement of district health system management and leadership. PROSPERO CRD42015032351.

  18. Does nailfold capillaroscopy help predict future outcomes in systemic sclerosis? A systematic literature review.

    PubMed

    Paxton, Dolcie; Pauling, John D

    2018-02-14

    Nailfold capillaroscopy (NC) is an important diagnostic tool in systemic sclerosis (SSc). Confirmation of NC as a prognostic factor could facilitate earlier intervention and slow disease progression in SSc. We undertook a systematic literature review to evaluate the prognostic value of NC in predicting SSc disease progression. Standardised searches of EMBASE and MEDLINE were undertaken to identify longitudinal studies of adult subjects with SSc reporting the prognostic value of NC for any aspect of disease progression and/or survival. Non-English, non-original research, animal studies, non-adult studies and non-full length reports were excluded from the analysis (PROSPERO 2017:CRD42017071719). Wide heterogeneity in study design, prognostic factor measurement and study outcomes necessitated a qualitative data synthesis. The "QUality In Prognosis Studies" (QUIPS) risk-of-bias tool was used to assess study quality. Study selection, data extraction and risk-of-bias assessment were each undertaken independently by 2 reviewers and consensus reached where necessary. Of 942 retrieved articles, 18 studies fulfilled the inclusion criteria. The majority of studies (17/18, 94%) reported positive associations between baseline NC appearances (using a variety of qualitative, semi-quantitative and quantitative NC endpoints) and clinical outcomes including digital ulcer (DU) occurrence/healing, survival, disease progression (using domains of Medsger disease severity scale), calcinosis, skin progression, pulmonary arterial hypertension (PAH), and/or a composite analysis of "cardiovascular events". Application of the QUIPS tool identified a moderate-high risk of potential bias in 6/18 studies for study participation, 3/18 studies for study attrition, 10/18 for prognostic factor measurement, 5/18 for outcome measurement, 13/18 for confounders and 13/18 for statistical analyses. Study quality limited the strength of the conclusions drawn from these studies. The most important source of potential bias across the studies was insufficient adjustment for potential confounders; such as existing DU disease in studies evaluating future DU occurrence. Recent work suggests NC evolution is an important predictor of disease progression in SSc. High levels of potential bias relating to study confounding and statistical analysis make it difficult to draw conclusions regarding the prognostic role of NC in SSc. There is strong evidence supporting an association between NC abnormalities (particularly capillary loss) and disease severity (particularly vascular manifestations such as DU, calcinosis and PAH). Evolution of NC appearances may represent a more important predictor of disease progression which could have important implications for the future use of NC in the routine longitudinal assessment and management of SSc. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Healthcare utilization in older patients using personal emergency response systems: an analysis of electronic health records and medical alert data : Brief Description: A Longitudinal Retrospective Analyses of healthcare utilization rates in older patients using Personal Emergency Response Systems from 2011 to 2015.

    PubMed

    Agboola, Stephen; Golas, Sara; Fischer, Nils; Nikolova-Simons, Mariana; Op den Buijs, Jorn; Schertzer, Linda; Kvedar, Joseph; Jethwani, Kamal

    2017-04-18

    Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization. Retrospective, longitudinal analyses of healthcare and PERS utilization records of older patients over a 5-years period from 2011-2015. The primary outcome was to characterize the healthcare utilization of PERS patients. This outcome was assessed by 30-, 90-, and 180-day readmission rates, frequency of principal admitting diagnoses, and prevalence of conditions leading to potentially avoidable admissions based on Centers for Medicare and Medicaid Services classification criteria. The overall 30-day readmission rate was 14.2%, 90-days readmission rate was 34.4%, and 180-days readmission rate was 42.2%. While 30-day readmission rates did not increase significantly (p = 0.16) over the study period, 90-days (p = 0.03) and 180-days (p = 0.04) readmission rates did increase significantly. The top 5 most frequent principal diagnoses for inpatient admissions included congestive heart failure (5.7%), chronic obstructive pulmonary disease (4.6%), dysrhythmias (4.3%), septicemia (4.1%), and pneumonia (4.1%). Additionally, 21% of all admissions were due to conditions leading to potentially avoidable admissions in either institutional or non-institutional settings (16% in institutional settings only). Chronic medical conditions account for the majority of healthcare utilization in older patients using PERS. Results suggest that PERS data combined with electronic medical records data can provide useful insights that can be used to improve health outcomes in older patients.

  20. The impact of a peer counselling scheme to address bullying in an all-girl London secondary school: a short-term longitudinal study.

    PubMed

    Houlston, Catherine; Smith, Peter K

    2009-03-01

    A variety of peer support schemes are now widely used in schools, notably to reduce bullying. However, there has been little systematic investigation of the impact and effectiveness of these approaches. To assess the impact of a peer counselling scheme on peer counsellors and the school community. The research was conducted in a North London all-girls state secondary school. Data were collected from all lower school classes (years 7, 8, and 9) and some staff members, in addition to year 10 peer counsellors and an age equivalent comparison group. A detailed 1-year longitudinal study combined qualitative and quantitative methods of assessment. Peer counsellors benefited from their involvement through an acquisition of transferable communication and interpersonal skills, and, compared to age-matched control pupils, had increased social self-esteem. There were no reductions in self-reported bullying and victimization, but in general pupils believed that there was less bullying in school and that the school was doing more about bullying, with year 7 students showing the most positive changes. Peer-counselling schemes can improve self-esteem of peer supporters, and also impact positively on perceptions of bullying in the school; but impact on actual experiences of bullying is less clear, and there may be problems with the acceptance and use of such programmes by older students.

  1. Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

    PubMed Central

    Cornelis, Shana; Desmet, Mattias; Van Nieuwenhove, Kimberly L. H. D.; Meganck, Reitske; Willemsen, Jochem; Inslegers, Ruth; Feyaerts, Jasper

    2017-01-01

    The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed. PMID:28649214

  2. Changes in commitment to change among leaders in home help services.

    PubMed

    Westerberg, Kristina; Tafvelin, Susanne

    2015-07-06

    The purpose of the this study was to explore the development of commitment to change among leaders in the home help services during organizational change and to study this development in relation to workload and stress. During organizational change initiatives, commitment to change among leaders is important to ensure the implementation of the change. However, little is known of development of commitment of change over time. The study used a qualitative design with semi-structured interviews with ten leaders by the time an organizational change initiative was launched and follow-up one year later. Thematic content analysis was used to analyze the interviews. Commitment to change is not static, but seems to develop over time and during organizational change. At the first interview, leaders had a varied pattern reflecting different dimensions of commitment to change. One year later, the differences between leaders' commitment to change was less obvious. Differences in commitment to change had no apparent relationship with workload or stress. The data were collected from one organization, and the number of participants were small which could affect the results on workload and stress in relation to commitment to change. It is important to support leaders during organizational change initiatives to maintain their commitment. One way to accomplish this is to use management team meetings to monitor how leaders perceive their situation. Qualitative, longitudinal and leader studies on commitment to change are all unusual, and taken together, this study shows new aspects of commitment.

  3. Predictive value of uterine contractility and the serum levels of progesterone and oestrogens with regard to preterm labour.

    PubMed

    Smit, D A; Essed, G G; de Haan, J

    1984-01-01

    A longitudinal investigation regarding the serum concentrations of oestradiol, oestriol and progesterone in relation to uterine activity has been performed in 80 healthy primigravid women during the course of pregnancy up to the 37th week of pregnancy. The frequency of uterine contractions was quantitatively objectivated by means of external toco-dynamometry; simultaneously the uterine activity has been recorded by the pregnant women qualitatively. It appears that there is a gradual increase of all the three mentioned hormones during the course of pregnancy. However, there is a large interindividual spread. There exists no relation between the hormonal serum levels and uterine activity (quantitatively as well as qualitatively recorded). Between these two latter there is a poor relation. It is impossible to predict the occurrence of preterm birth based on hormonal serum changes. This holds for the progesterone-oestradiol ratio.

  4. Grandparent Involvement and Children’s Health Outcomes: The Current State of the Literature

    PubMed Central

    Pulgaron, Elizabeth R.; Marchante, Ashley N.; Agosto, Yaray; Lebron, Cynthia N.; Delamater, Alan M.

    2016-01-01

    Introduction Grandparents are often highly involved as secondary caregivers for their grandchildren and may influence children’s psychological and physical health outcomes. The purpose of the current review was to gather and synthesize research findings on the effects of grandparent involvement on children’s physical health outcomes. Methods PubMed, PsycInfo, and MedLine were searched by three independent reviewers for articles that reported on grandparent involvement and children’s health. Twenty-six articles were included for final review based on selection criteria. Results Relatively few studies have examined the effects of grandparent involvement on children’s health outcomes and therefore the degree of their influence remains unclear. Four categories of children’s health outcomes: disease/illness, weight, eating behaviors, and injury/safety emerged during this review. Results indicated that the majority of studies available reported a negative effect of grandparent involvement on child’s weight status. However, It is important to note that in most of these studies the effects of grandparent involvement were not a primary outcome and the amount of time grandparents spent with their grandchildren was not accounted for. Many studies in this review were qualitative studies, limiting the types of analyses that could be conducted. Additionally, few longitudinal studies have been conducted in this area. Discussion Based on this review, it is clear that grandparents are involved in caretaking for children across many cultures but in order to understand their role in children’s health outcomes, more systematic and longitudinal research needs to be conducted. PMID:27505069

  5. Effective kinetic description of the expanding overoccupied glasma

    DOE PAGES

    Tanji, Naoto; Venugopalan, Raju

    2017-05-19

    Here, we report on a numerical study of the Boltzmann equation including 2↔2 scatterings of gluons and quarks in an overoccupied glasma undergoing longitudinal expansion. We find that when a cascade of gluon number to the infrared occurs, corresponding to an infrared enhancement analogous to a transient Bose-Einstein condensate, gluon distributions qualitatively reproduce the results of classical-statistical simulations for the expanding glasma. These include key features of the distributions that are not anticipated in the “bottom-up” thermalization scenario. We also find that quark distributions, like those of gluons, satisfy self-similar scaling distributions in the overoccupied glasma. We discuss the implicationsmore » of these results for a deeper understanding of the self-similarity and universality of parton distributions in the glasma.« less

  6. Convicted Driving-While-Impaired Offenders’ Views on Effectiveness of Sanctions and Treatment

    PubMed Central

    Lapham, Sandra; England-Kennedy, Elizabeth

    2011-01-01

    In this article we analyze qualitative data from a multiple methods, longitudinal study drawn from 15-year follow-up interviews with a subsample of 82 individuals arrested for driving while intoxicated in a southwestern state (1989–1995). We explore reactions to the arrest and court-mandated sanctions, including legal punishments, mandated interventions, and/or participation in programs aimed at reducing recidivism. Key findings include experiencing certain negative emotional reactions to the arrest, reactions to being jailed, experiencing other court-related sanctions as deterring driving while intoxicated behavior, and generally negative opinions regarding court-mandated interventions. We discuss interviewees’ complex perspectives on treatment and program participation and their effects on lessening recidivism, and we offer suggestions for reducing recidivism based on our findings. PMID:21490294

  7. Integrating Epidemiology, Education, and Organizing for Environmental Justice: Community Health Effects of Industrial Hog Operations

    PubMed Central

    Wing, Steve; Horton, Rachel Avery; Muhammad, Naeema; Grant, Gary R.; Tajik, Mansoureh; Thu, Kendall

    2008-01-01

    The environmental justice movement has stimulated community-driven research about the living and working conditions of people of color and low-income communities. We describe an epidemiological study designed to link research with community education and organizing for social justice. In eastern North Carolina, high-density industrial swine production occurs in communities of low-income people and people of color. We investigated relationships between the resulting pollution and the health and quality of life of the hog operations’ neighbors. A repeat-measures longitudinal design, community involvement in data collection, and integration of qualitative and quantitative research methods helped promote data quality while providing opportunities for community education and organizing. Research could affect policy through its findings and its mobilization of communities. PMID:18556620

  8. Effective kinetic description of the expanding overoccupied glasma

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

    Tanji, Naoto; Venugopalan, Raju

    Here, we report on a numerical study of the Boltzmann equation including 2↔2 scatterings of gluons and quarks in an overoccupied glasma undergoing longitudinal expansion. We find that when a cascade of gluon number to the infrared occurs, corresponding to an infrared enhancement analogous to a transient Bose-Einstein condensate, gluon distributions qualitatively reproduce the results of classical-statistical simulations for the expanding glasma. These include key features of the distributions that are not anticipated in the “bottom-up” thermalization scenario. We also find that quark distributions, like those of gluons, satisfy self-similar scaling distributions in the overoccupied glasma. We discuss the implicationsmore » of these results for a deeper understanding of the self-similarity and universality of parton distributions in the glasma.« less

  9. Living with a Crucial Decision: A Qualitative Study of Parental Narratives Three Years after the Loss of Their Newborn in the NICU

    PubMed Central

    Caeymaex, Laurence; Speranza, Mario; Vasilescu, Caroline; Danan, Claude; Bourrat, Marie-Michèle

    2011-01-01

    Background The importance of involving parents in the end-of-life decision-making-process (EOL DMP) for their child in the neonatal intensive care unit (NICU) is recognised by ethical guidelines in numerous countries. However, studies exploring parents' opinions on the type of involvement report conflicting results. This study sought to explore parents' experience of the EOL DMP for their child in the NICU. Methods The study used a retrospective longitudinal design with a qualitative analysis of parental experience 3 years after the death of their child in four NICUs in France. 53 face-to-face interviews and 80 telephone interviews were conducted with 164 individuals. Semi-structured interviews were conducted to explore how parents perceived their role in the decision process, what they valued about physicians' attitudes in this situation and whether their long-term emotional well being varied according to their perceived role in the EOL DMP. Findings Qualitative analysis identified four types of perceived role in the DMP: shared, medical, informed parental decision, and no decision. Shared DM was the most appreciated by parents. Medical DM was experienced as positive only when it was associated with communication. Informed parental DM was associated with feelings of anxiousness and abandonment. The physicians' attitudes that were perceived as helpful in the long term were explicit sharing of responsibility, clear expression of staff preferences, and respectful care and language toward the child. Interpretation Parents find it valuable to express their opinion in the EOL DMP of their child. Nonetheless, they do need continuous emotional support and an explicit share of the responsibility for the decision. As involvement preferences and associated feelings can vary, parents should be able to decide what role they want to play. However, our study suggests that fully autonomous decisions should be misadvised in these types of tragic choices. PMID:22194873

  10. Parents' experiences and views of caring for a child with a tracheostomy: a literature review.

    PubMed

    Flynn, A P; Carter, B; Bray, L; Donne, A J

    2013-10-01

    To review the published/reported experiences and views of parents' whose child has had a tracheostomy. To date, no review has focused specifically on parents' experiences and views of having a child with a tracheostomy. MEDLINE, CINAHL, PsycINFO and Embase were systematically searched from 1990 to 2012 and a review of reference lists was conducted. The review draws on articles where parents' views of caring for their child's tracheostomy were either the sole focus of the research or where parental views of caring for their child's tracheostomy have been sought as a subsidiary aim. Studies relating to the aims of the review were examined using quality appraisal tools and in line with criteria for inclusion of studies. Studies were excluded if findings were about adults, studies that only focused on children's or sibling's views were not based on empirical work (e.g. literature reviews or expert commentary) or were not published in the English language. Findings were summarised under thematic headings. The systematic database search identified 442 citations of which 10 were eligible for inclusion in the review. Of those 10 studies six were quantitative and four qualitative. Only one paper published qualitative data specifically on parents' experiences about their tracheotomised child. The three main themes identified were parents' experiences of caregiving, their social experiences and experiences of service delivery of having a child with a tracheostomy. Although parents encountered emotional and social challenges, some positive responses to these challenges were reported. This review identifies a lack of qualitative research on parents' views of having a child with a tracheostomy. Issues surrounding parental management of tracheostomy require further investigation. This review has identified the need to elicit parents' longitudinal experiences of having a child with a tracheostomy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Improving the quality of educational strategies in postgraduate dental education using student and graduate feedback: findings from a qualitative study in New Zealand.

    PubMed

    Subramanian, J; Anderson, V R; Morgaine, K C; Thomson, W M

    2013-02-01

    Research suggests that students' perceptions should be considered in any discussion of their education. However, to date, there has been no systematic examination of New Zealand postgraduate dental students' learning processes in both the research and clinical settings. This study aimed to obtain in-depth qualitative insights into student and graduate perspectives of effective and ineffective learning experiences during their postgraduate dental education. Data were collected in 2010 using semi-structured individual interviews. Participants included 2010 final-year students and 2009 graduates of the University of Otago Doctor of Clinical Dentistry programme. Using the Critical Incident Technique, participants were asked to describe at least one effective and one ineffective learning experience in detail. Interview transcripts were analysed using a general inductive approach. Broad themes which emerged included supervisory approaches, characteristics of the learning process and characteristics of the physical learning environment. The focus of this article is to report and discuss the learning processes that participants identified as promoting and precluding effective learning experiences in the clinical and research settings. Students and graduates in the study had largely similar perspectives of learning processes likely to result in effective clinical and research learning. These included self-directed and collaborative learning; timely, constructive and detailed feedback with directions for further improvement; and discreet clinical feedback. Learning processes that precluded effective learning included unsupported and isolated learning, delayed and overly critical/destructive feedback and open criticism in the clinical context. The in-depth findings of this study contribute to the scientific literature that identifies learning process characteristics which facilitate effective learning from New Zealand postgraduate students' and graduates' perspectives. Additional cross-sectional and longitudinal studies (both qualitative and quantitative) would lead to a better understanding of what constitutes effective teaching in postgraduate dental education. © 2012 John Wiley & Sons A/S.

  12. Themes and methods of research presented at European General Practice Research Network conferences.

    PubMed

    Kruschinski, Carsten; Lange, Maaike; Lionis, Christos; van Weel, Chris; Hummers-Pradier, Eva

    2010-08-01

    The World Organization of Family Doctors (Wonca) defined core characteristics of general practice and general practitioners' competencies. It is unclear to which extent research has addressed these issues so far. To determine themes and research methods of general practice research as reflected by presentations at the European General Practice Research Network (EGPRN) meetings. Descriptive and retrospective study. All abstracts presented at each of the 14 EGPRN conferences between June 2001 and October 2007 were analysed for content and study design/methodology. Categories for content were developed inductively; a predefined hierarchical scheme was used for study designs. A total of N=614 abstracts were classified. The main research topics were related to GP/health service issues (n=232), clinical (n=148) and patient-related themes (n=118). Original data (n=558) were mainly derived from cross-sectional designs (38.7%). Intervention studies (11.0%), longitudinal designs including case-control and cohort studies (13.3%) as well as instrumental research (2.2%) were less common. More than one-fourth of all original studies were qualitative studies (27.6%). Stratified analysis revealed that cross-sectional designs were less frequent in the second half of conferences. Analysis by country showed that, in contrast to different quantitative designs, the proportion of qualitative studies was comparable. To test effectiveness of diagnostic and therapeutic interventions under primary care conditions, a higher proportion of experimental studies would be preferable. This could increase the acceptance of general practitioners' specific approaches and provide clear guidance on approaches and procedures, especially in health care systems not predominantly based on primary care.

  13. Explaining governmental involvement in home care across Europe: an international comparative study.

    PubMed

    Genet, Nadine; Kroneman, Madelon; Boerma, Wienke G W

    2013-04-01

    The involvement of governments in the home care sector strongly varies across Europe. This study aims to explain the differences through the conditions for the involvement of informal care and governments in society; wealth and the demographic structure. As this study could combine qualitative data and quantitative data analyses, it could consider larger patterns than previous studies which were often based on ideographic historical accounts. Extensive data were gathered in 30 European countries, between 2008 and 2010. In each country, policy documents were analysed and experts were interviewed. International variation in regulation and governmental funding of personal care and domestic aid are associated with differences in prevailing values on family care, tax burden and wealth in a country. Hence, this study provides evidence for the obstacles - i.e. country differences - for transferring home care policies between countries. However, longitudinal research is needed to establish whether this is indeed the causal relationship we expect. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Is burnout separable from depression in cluster analysis? A longitudinal study.

    PubMed

    Bianchi, Renzo; Schonfeld, Irvin Sam; Laurent, Eric

    2015-06-01

    Whether burnout and depression represent distinct pathologies is unclear. The aim of this study was to examine whether burnout and depressive symptoms manifest themselves separately from each other or are so closely intertwined as to reflect the same phenomenon. A two-wave longitudinal study involving 627 French schoolteachers (73 % female) was conducted. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire. Burnout and depressive symptoms clustered both at baseline and follow-up. Cluster membership at time 1 (T1) predicted cases of burnout and depression at time 2 (T2), controlling for gender, age, length of employment, lifetime history of depression, and antidepressant intake. Changes in burnout and depressive symptoms from T1 to T2 were found to overlap. Teachers with increasing burnout experienced increases in depression and teachers with decreasing burnout experienced decreases in depression. In addition, emotional exhaustion, the core of burnout, was more strongly associated with depression than with depersonalization, the second dimension of burnout, underlining an inconsistency in the conceptualization of the burnout syndrome. Our results are consistent with recent findings showing qualitative and quantitative symptom overlap of burnout with depression. The close interconnection of burnout and depression questions the relevance of a nosological distinction between the two entities. Emotional exhaustion and depersonalization, the two main dimensions of burnout, may be better conceptualized as depressive responses to adverse occupational environments than as components of a separate entity.

  15. Patients With Hepatocellular Carcinoma Near the End of Life: A Longitudinal Qualitative Study of Their Illness Experiences.

    PubMed

    Hansen, Lissi; Rosenkranz, Susan J; Vaccaro, Gina M; Chang, Michael F

    2015-01-01

    In the United States, the incidence of hepatocellular carcinoma (HCC) is rising. For those diagnosed with terminal HCC, there is no curative treatment and duration of survival is typically 1 to 2 years. Research on illness and treatment experiences toward the end of life for patients with terminal HCC is limited. The aim of this study was to explore the illness experiences of patients with terminal HCC as they approached the end of life. This study used a prospective, longitudinal descriptive design. Interview data were collected from 14 patients once a month for up to 6 months, for a total of 45 interviews. Data were analyzed using conventional content analysis. Three major themes (illness perceptions, decision to start treatment, and navigating treatment over time) and 10 subthemes were identified that were reflected across time in all patient experiences. Patients faced challenges with symptom experiences, treatment decisions, and unmet information needs affecting their quality of life. Gaining knowledge about the challenges facing patients with HCC is crucial for designing interventions that optimize their quality of life. Healthcare professionals may improve the quality of life of patients with terminal HCC by eliciting patients' perceptions of their illness and treatment decisions, symptom experiences, and information needs as the disease progresses and providing symptom management and offering information tailored to their needs. Care for patients with HCC who are approaching the end of life should be multidisciplinary and include timely referral to palliative care.

  16. "I started working because I was hungry": The consequences of food insecurity for children's well-being in rural Ethiopia.

    PubMed

    Morrow, Virginia; Tafere, Yisak; Chuta, Nardos; Zharkevich, Ina

    2017-06-01

    Food insecurity, the state of being without reliable access to a sufficient quantity of safe, nutritious food, is a persistent problem in rural Ethiopia. However, little qualitative research has explored how food insecurity affects children over time, from their point of view. What are the effects of economic 'shocks' such as illness, death, loss of livestock, drought and inflation on availability of food, and children's well-being? To what extent do social protection schemes (in this case, the Productive Safety Net Programme) mitigate the long-term effects of food insecurity for children? The paper uses a life-course approach, drawing on analysis of four rounds of qualitative longitudinal research conducted in 2007, 2008, 2011 and 2014, with eight case study children, as part of Young Lives, an ongoing cohort study. Children's descriptions of the importance of food and a varied diet (dietary diversity) in everyday life were expressed in a range of qualitative methods, including interviews, group discussions and creative methods. The paper suggests that while the overall picture of food security in Ethiopia has improved in the past decade, for the poorest rural families, food insecurity remains a major factor influencing decisions about a range of matters - children's time allocation, whether to continue in school, whether to migrate for work, and whether they marry. The paper argues that experiences of food insecurity need to be understood holistically, in relation to other aspects of children's lives, at differing stages of the life-course during childhood. The paper concludes that nutritional support beyond early childhood needs to be a focus of policy and programming. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Problem-based learning at the receiving end: a 'mixed methods' study of junior medical students' perspectives.

    PubMed

    Maudsley, Gillian; Williams, Evelyn M I; Taylor, David C M

    2008-11-01

    Qualitative insights about students' personal experience of inconsistencies in implementation of problem-based learning (PBL) might help refocus expert discourse about good practice. This study explored how junior medical students conceptualize: PBL; good tutoring; and less effective sessions. Participants comprised junior medical students in Liverpool 5-year problem-based, community-orientated curriculum. Data collection and analysis were mostly cross-sectional, using inductive analysis of qualitative data from four brief questionnaires and a 'mixed' qualitative/quantitative approach to data handling. The 1999 cohort (end-Year 1) explored PBL, generated 'good tutor' themes, and identified PBL (dis)advantages (end-Year 1 then mid-Year 3). The 2001 cohort (start-Year 1) described critical incidents, and subsequently (end-Year 1) factors in less effective sessions. These factors were coded using coding-frames generated from the answers about critical incidents and 'good tutoring'. Overall, 61.2% (137), 77.9% (159), 71.0% (201), and 71.0% (198) responded to the four surveys, respectively. Responders perceived PBL as essentially process-orientated, focused on small-groupwork/dynamics and testing understanding through discussion. They described 'good tutors' as knowing when and how to intervene without dominating (51.1%). In longitudinal data (end-Year 1 to mid-Year 3), the main perceived disadvantage remained lack of 'syllabus' (and related uncertainty). For less effective sessions (end-Year 1), tutor transgressions reflected unfulfilled expectations of good tutors, mostly intervening poorly (42.6% of responders). Student transgressions reflected the critical incident themes, mostly students' own lack of work/preparation (54.8%) and other students participating poorly (33.7%) or dominating/being self-centred (31.6%). Compelling individual accounts of uncomfortable PBL experiences should inform improvements in implementation.

  18. Capturing system level activities and impacts of mental health consumer-run organizations.

    PubMed

    Janzen, Rich; Nelson, Geoffrey; Hausfather, Nadia; Ochocka, Joanna

    2007-06-01

    Since the 1970s mental health consumer-run organizations have come to offer not only mutual support, but they have also adopted agendas for broader social change. Despite an awareness of the need for system level efforts that create supportive environments for their members, there has been limited research demonstrating how their system level activities can be documented or their impacts evaluated. The purpose of this paper is to feature a method of evaluating systems change activities and impacts. The paper is based on a longitudinal study evaluating four mental health consumer-run organizations in Ontario, Canada. The study tracked system level activities and impacts using both qualitative and quantitative methodologies. The article begins by describing the development and implementation of these methods. Next it offers a critical analysis of the methods used. It concludes by reflecting on three lessons learned about capturing system level activities and impacts of mental health consumer-run organizations.

  19. Association between financial strain, social network and five-year recovery from first episode psychosis.

    PubMed

    Mattsson, Maria; Topor, Alain; Cullberg, Johan; Forsell, Yvonne

    2008-12-01

    Despite much effort to positively affect long-term outcome in psychosis and schizophrenia many patients are still facing a poor outcome with persistent psychotic symptoms and decline in social functioning. The aim of this study was to examine the relationship between financial strain and social network and five-year outcome of first episode psychosis (FEP). FEP patients were divided into recovered (n = 52) and non-recovered (n = 19). Each person was matched according to age and gender with four persons (n = 284) from a longitudinal population-based study. All persons had answered an extensive questionnaire including social network, quantitative and qualitative, financial strain and mental health. Linear regression analysis showed that both financial strain and social network were associated, and had a unique contribution, to outcome. The results indicate that FEP patients might benefit from interventions that reduce financial strain thus facilitating daily life and cultural and social activities.

  20. Community care for people who are homeless and mentally ill.

    PubMed

    Drury, Lin J

    2003-05-01

    This qualitative longitudinal study documents the experiences of 60 people who are homeless and mentally ill from their state mental hospital discharge through their first two years in community housing. The study explores the personal, cultural, and environmental contexts of life for adults who are homeless and mentally ill and examines the interaction between an individual's needs and community resources. The research identifies forces that perpetuate homelessness and traces the struggles that people who are homeless and mentally ill encounter during the transition from the streets to stable housing. The findings describe a culturally based pattern of mutual avoidance between homeless mentally ill clients and caregivers, which limits delivery of services to the population. Recommendations include development of alternative systems of care delivery, expansion of educational experiences with underserved populations, and increased funding for service or research with people who are homeless and mentally ill.

  1. Effects of Early Childhood Peer Relationships on Adolescent Mental Health: A 6- to 8-Year Follow-Up Study in South Korea.

    PubMed

    Shin, Kyoung Min; Cho, Sun-Mi; Shin, Yun Mi; Park, Kyung Soon

    2016-07-01

    Peer relationships are one of the important factors in children's development. The present study examines the relationship between the effects of early peer relationships and adolescent psychological adjustment. The first survey took place from 1998 to 2000, and a follow-up assessment obtained data in 2006, as the original participants reached 13-15 years of age. The first assessment used the Korean version of the Child Behavior Checklist (K-CBCL) and simple questions about peer relationships to evaluate the participants. The follow-up assessment administered the Korean Youth Self Report (K-YSR). Children's peer relationships have longitudinal effects on mental health and adjustment. Children who had qualitative peer-relation problems were more likely to exhibit internalizing problems as adolescents. Children who have poor peer relationships might become more vulnerable to emotional problems and social adjustment as adolescents.

  2. Stress management and mind-body medicine: a randomized controlled longitudinal evaluation of students' health and effects of a behavioral group intervention at a middle-size German university (SM-MESH).

    PubMed

    Esch, Tobias; Sonntag, Ulrike; Esch, Sonja Maren; Thees, Stefanie

    2013-01-01

    Student life can be stressful. Hence, we started a regular mind-body medical stress management program in 2006. By today, more than 500 students took part and evaluations showed significant results, especially with regard to a reduction of stress warning signals. For further analysis, we now decided to run a randomized controlled longitudinal trial. Participating students at Coburg University were randomized into an intervention (n = 24) or a waitlist control group (n = 19). The intervention group completed 3 sets (pre/post/follow-up) and the control group 2 sets (pre/post) of self-administered questionnaires. The questionnaires included: SF-12 Health Survey, Perceived Stress Scale (PSS), Sense of Coherence (SOC-L9), Visual Analogue Scale (VAS) concerning stress, and the Stress Warning Signs (SWS) scale. Randomly selected participants of the intervention group were also queried in qualitative interviews. The intervention consisted of an 8 week stress management group program (mind-body medical stress reduction - MBMSR). Follow-up measures were taken after 6 months. Virtually, no drop-out occurred. Our study showed significant effects in the intervention group concerning SF-12 Mental Component Scale (p = 0.05), SF-12 Physical Component Scale (p = 0.001), VAS (in general, p = 0.001) and SWS (emotional reactions, p <0.001), underlined by qualitative results, which showed a higher quality of life. The effectiveness of an MBMSR program in a group of supposedly healthy students could be demonstrated. Findings suggest that stress management might be given importance at universities that care for the performance, the quality of life, and stress-health status of their students, acknowledging and accounting for the challenging circumstances of university life, as well as the specific needs of the modern student population. Copyright © 2013 S. Karger AG, Basel.

  3. Health-promoting factors in medical students and students of science, technology, engineering, and mathematics: design and baseline results of a comparative longitudinal study

    PubMed Central

    2014-01-01

    Background The negative impact of medical school on students' general and mental health has often been reported. Compared to students of other subjects, or employed peers, medical students face an increased risk of developing depression, anxiety and burnout. While pathogenetic factors have been studied extensively, less is known about health-promoting factors for medical students' health. This longitudinal study aims to identify predictors for maintaining good general and mental health during medical education. We report here the design of the study and its baseline results. Methods We initiated a prospective longitudinal cohort study at the University of Lübeck, Germany. Two consecutive classes of students, entering the university in 2011 and 2012, were recruited. Participants will be assessed annually for the duration of their course. We use validated psychometric instruments covering health outcomes (general and mental health) and personality traits, as well as self-developed, pre-tested items covering leisure activities and sociodemographic data. Results At baseline, compared to students of STEM (science, technology, engineering, and mathematics) subjects (n = 531; 60.8% response rate), a larger proportion of medical students (n = 350; 93.0% response rate) showed good general health (90.9% vs. 79.7%) and a similar proportion was in good mental health (88.3% vs. 86.3%). Medical students scored significantly higher in the personality traits of extraversion, conscientiousness, openness to experience and agreeableness. Neuroticism proved to be a statistically significant negative predictor for mental health in the logistic regression analyses. Satisfaction with life as a dimension of study-related behaviour and experience predicted general health at baseline. Physical activity was a statistically significant predictor for general health in medical students. Conclusions Baseline data revealed that medical students reported better general and similar mental health compared to STEM students. The annual follow-up questionnaires, combined with qualitative approaches, should clarify wether these differences reflect a higher resilience, a tendency to neglect personal health problems - as has been described for physicians - before entering medical school, or both. The final results may aid decision-makers in developing health-promotion programmes for medical students. PMID:24996637

  4. Health-promoting factors in medical students and students of science, technology, engineering, and mathematics: design and baseline results of a comparative longitudinal study.

    PubMed

    Kötter, Thomas; Tautphäus, Yannick; Scherer, Martin; Voltmer, Edgar

    2014-07-04

    The negative impact of medical school on students' general and mental health has often been reported. Compared to students of other subjects, or employed peers, medical students face an increased risk of developing depression, anxiety and burnout. While pathogenetic factors have been studied extensively, less is known about health-promoting factors for medical students' health. This longitudinal study aims to identify predictors for maintaining good general and mental health during medical education. We report here the design of the study and its baseline results. We initiated a prospective longitudinal cohort study at the University of Lübeck, Germany. Two consecutive classes of students, entering the university in 2011 and 2012, were recruited. Participants will be assessed annually for the duration of their course. We use validated psychometric instruments covering health outcomes (general and mental health) and personality traits, as well as self-developed, pre-tested items covering leisure activities and sociodemographic data. At baseline, compared to students of STEM (science, technology, engineering, and mathematics) subjects (n = 531; 60.8% response rate), a larger proportion of medical students (n = 350; 93.0% response rate) showed good general health (90.9% vs. 79.7%) and a similar proportion was in good mental health (88.3% vs. 86.3%). Medical students scored significantly higher in the personality traits of extraversion, conscientiousness, openness to experience and agreeableness. Neuroticism proved to be a statistically significant negative predictor for mental health in the logistic regression analyses. Satisfaction with life as a dimension of study-related behaviour and experience predicted general health at baseline. Physical activity was a statistically significant predictor for general health in medical students. Baseline data revealed that medical students reported better general and similar mental health compared to STEM students. The annual follow-up questionnaires, combined with qualitative approaches, should clarify wether these differences reflect a higher resilience, a tendency to neglect personal health problems - as has been described for physicians - before entering medical school, or both. The final results may aid decision-makers in developing health-promotion programmes for medical students.

  5. Subject-specific longitudinal shape analysis by coupling spatiotemporal shape modeling with medial analysis

    NASA Astrophysics Data System (ADS)

    Hong, Sungmin; Fishbaugh, James; Rezanejad, Morteza; Siddiqi, Kaleem; Johnson, Hans; Paulsen, Jane; Kim, Eun Young; Gerig, Guido

    2017-02-01

    Modeling subject-specific shape change is one of the most important challenges in longitudinal shape analysis of disease progression. Whereas anatomical change over time can be a function of normal aging, anatomy can also be impacted by disease related degeneration. Anatomical shape change may also be affected by structural changes from neighboring shapes, which may cause non-linear variations in pose. In this paper, we propose a framework to analyze disease related shape changes by coupling extrinsic modeling of the ambient anatomical space via spatiotemporal deformations with intrinsic shape properties from medial surface analysis. We compare intrinsic shape properties of a subject-specific shape trajectory to a normative 4D shape atlas representing normal aging to isolate shape changes related to disease. The spatiotemporal shape modeling establishes inter/intra subject anatomical correspondence, which in turn enables comparisons between subjects and the 4D shape atlas, and also quantitative analysis of disease related shape change. The medial surface analysis captures intrinsic shape properties related to local patterns of deformation. The proposed framework jointly models extrinsic longitudinal shape changes in the ambient anatomical space, as well as intrinsic shape properties to give localized measurements of degeneration. Six high risk subjects and six controls are randomly sampled from a Huntington's disease image database for qualitative and quantitative comparison.

  6. Exploring the beliefs and practices of five preservice secondary science teachers from recruitment through induction in a university preparation program: A longitudinal study

    NASA Astrophysics Data System (ADS)

    Fletcher, Steven Samuel

    This three-year longitudinal study explores the evolving beliefs and practices of five prospective secondary science teachers in a university preparation program from recruitment through their first year in the classroom. As an interpretive qualitative study, the format for data collection and analysis utilizes a case-study methodology with cross-case analysis. Data was collected through semi-structured interviews, collected artifacts, and classroom observations. There are a number of important conclusions from this study. First, the teachers' beliefs about teaching initially shift to a contemporary focus during the program, but ultimately return to a didactic orientation by their first year in the classroom. At the same time, the teachers' beliefs about learning remain consistently more contemporary in nature. Second, the participants believe that they practice teaching science as inquiry at a higher level than are indicated by researcher observations. Third, while participants value advanced content and educational theory coursework, they do not always see the link between these experiences and their development as science teachers. Fourth, the findings from this study reveal that internal and external contextual factors impacted, to varying degrees, the development of the science teachers. The findings from this study contribute to a deeper understanding of the development of science teachers from preservice education to the induction years, which indicates a pattern that is not linear. The findings from this study also reinforce the importance of internal and external contextual factors on the development of science teachers. Ultimately, this study is important to the field of secondary science teacher education as it depicts the complex interactions between the individual, the preparation program, and the school placements that impact the beliefs and practices of preservice and beginning teachers.

  7. Evaluation of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

    PubMed Central

    Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

    2016-01-01

    Objectives To gain insights into the process of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Design Qualitative study alongside a cluster randomised controlled trial. Setting 17 long-term care homes spread across the Netherlands. Participants 34 licensed practical nurses supporting 54 dual sensory impaired older adults. Intervention A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Primary outcomes Nurses’ perceptions on relevance and feasibility of the self-management programme collected from nurses’ semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers’ reports. Results Nurses’ initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults’ autonomy needs. However, nurses’ initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Conclusions Longitudinal data collection enabled exploration of nurses’ changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond ‘protocol thinking’, discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time. Trial registration number NCT01217502, Post-results. PMID:27856482

  8. Evaluation of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study.

    PubMed

    Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

    2016-11-17

    To gain insights into the process of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Qualitative study alongside a cluster randomised controlled trial. 17 long-term care homes spread across the Netherlands. 34 licensed practical nurses supporting 54 dual sensory impaired older adults. A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Nurses' perceptions on relevance and feasibility of the self-management programme collected from nurses' semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers' reports. Nurses' initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults' autonomy needs. However, nurses' initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Longitudinal data collection enabled exploration of nurses' changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond 'protocol thinking', discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time. NCT01217502, Post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Health issues of female foreign domestic workers: a systematic review of the scientific and gray literature.

    PubMed

    Malhotra, Rahul; Arambepola, Chandima; Tarun, Samiksha; de Silva, Vijitha; Kishore, Jugal; Østbye, Truls

    2013-01-01

    Although the number of female foreign domestic workers (FDWs) is increasing worldwide, little is known about their health issues. To systematically review the literature on health issues of female FDWs to ascertain the problems studied, identify limitations, and suggest future research and policy implications. A systematic database (PubMed, EBSCO Host, and Google Scholar) and bibliographic search identified the English-language scientific and gray literature published during 1990-2012 addressing health issues of female FDWs living with the family of the employer, using qualitative and/or quantitative research methods. Studies in which female FDWs constituted less than half of the participants were excluded. The health issues studied and identified were adverse work conditions and associated health problems (such as physical, verbal, and sexual abuse at the workplace, caregiving tasks associated with musculoskeletal strain, and chemical exposure associated with respiratory difficulty), mental health (psychotic, neurotic, and mood disorders), infectious diseases (most of the studies were on intestinal parasitic infections), and health knowledge/attitudes/practices (most of the studies were in context of sexual and reproductive health). Most of the studies were medical record reviews or questionnaire-based surveys utilizing convenience sampling or qualitative interviews/focus group discussions. Female FDWs face numerous health problems. Studies on representative, possibly longitudinal, samples of female FDWs focusing on specific health conditions are needed to better understand the epidemiology of such conditions. Concerted efforts through the governments of both labor-sending and host countries are required to improve the health, work conditions, and safety of this vulnerable group of women.

  10. Drinking, Drug Use, and Related Consequences Among University Students Completing Study Abroad Experiences: A Systematic Review.

    PubMed

    Aresi, Giovanni; Moore, Simon; Marta, Elena

    2016-12-05

    University students who complete study abroad experiences are potentially exposed to behaviors, in particular alcohol and drug use, that place their health at risk. There is a need to identify risk and protective factors and highlight knowledge gaps. A systematic review adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Relevant bibliographic databases and online repositories were systematically searched for both qualitative and quantitative peer-reviewed studies. Eighteen articles were eligible for inclusion. Degree mobility students (DMSs-students pursuing a full bachelor or master degree in a foreign country) and Credit Mobility Students (CMSs-students participating in short term or semester study abroad programmes) show different patterns of at-risk behaviors compared to pre-departure, and to domestic or non-study abroad students. DMSs mostly consumed less alcohol and illicit substances compared to domestic students, but little information on pre-travel behavior and predictors of at-risk behaviors while abroad was available on DMSs. Most studies indicated that CMSs increased their alcohol use while abroad and reduced it when they returned home. However, there is no evidence of an increase in the negative consequences associated with alcohol misuse while abroad. Different pre-departure and abroad factors (e.g., perceptions of peer drinking norms, psychological and sociocultural adjustment abroad) were related to at-risk behaviors in the host country. University students who study abroad are understudied and potentially at risk from alcohol and drug use. Knowledge gaps are discussed in relation to possible future qualitative, mixed methods and longitudinal research.

  11. The experience of international doctoral education in nursing: an exploratory survey of staff and international nursing students in a British university.

    PubMed

    Evans, Catrin

    2007-07-01

    As part of the internationalization of higher education, increasing numbers of international doctoral students are coming to study in British nursing schools. This paper reports on a small-scale exploratory survey that sought to investigate the educational experiences of these students and their supervisors in one British School of Nursing. Both staff and students saw great value in international education. However both groups identified the need for greater support to facilitate adjustment in a number of areas, including: understanding the PhD process, studying in a second language, working within a different academic culture, managing the supervision relationship, and finding a sense of community. This was a small study, but the findings confirm key issues identified in the limited available literature. Recommendations include staff training and the development of additional in-puts for students. Future research should include qualitative, longitudinal and multi-site studies to more thoroughly assess the process and outcomes of international doctoral education in nursing.

  12. Social Factors Influencing Russian Male Alcohol Use over the Life Course: A Qualitative Study Investigating Age Based Social Norms, Masculinity, and Workplace Context.

    PubMed

    Keenan, Katherine; Saburova, Lyudmila; Bobrova, Natalia; Elbourne, Diana; Ashwin, Sarah; Leon, David A

    2015-01-01

    The massive fluctuations occurring in Russian alcohol-related mortality since the mid-1980s cannot be seen outside of the context of great social and economic change. There is a dearth of qualitative studies about Russian male drinking and especially needed are those that address social processes and individual changes in drinking. Conducted as part of a longitudinal study on men's alcohol consumption in Izhevsk, this qualitative study uses 25 semi-structured biographical interviews with men aged 33-60 years to explore life course variation in drinking. The dominant pattern was decreasing binge and frequent drinking as men reached middle age which was precipitated by family building, reductions in drinking with work colleagues, and health concerns. A minority of men described chaotic drinking histories with periods of abstinence and heavy drinking. The results highlight the importance of the blue-collar work environment for conditioning male heavy drinking in young adulthood through a variety of social, normative and structural mechanisms. Post-Soviet changes had a structural influence on the propensity for workplace drinking but the important social function of male drinking sessions remained. Bonding with workmates through heavy drinking was seen as an unavoidable and essential part of young men's social life. With age peer pressure to drink decreased and the need to perform the role of responsible breadwinner put different behavioural demands on men. For some resisting social pressure to drink became an important site of self-determination and a mark of masculine maturity. Over the lifetime the place where masculine identity was asserted shifted from the workplace to the home, which commonly resulted in a reduction in drinking. We contribute to existing theories of Russian male drinking by showing that the performance of age-related social roles influences Russian men's drinking patterns, drinking contexts and their attitudes. Further research should be conducted investigating drinking trajectories in Russian men.

  13. Social Factors Influencing Russian Male Alcohol Use over the Life Course: A Qualitative Study Investigating Age Based Social Norms, Masculinity, and Workplace Context

    PubMed Central

    Keenan, Katherine; Saburova, Lyudmila; Bobrova, Natalia; Elbourne, Diana; Ashwin, Sarah; Leon, David A.

    2015-01-01

    The massive fluctuations occurring in Russian alcohol-related mortality since the mid-1980s cannot be seen outside of the context of great social and economic change. There is a dearth of qualitative studies about Russian male drinking and especially needed are those that address social processes and individual changes in drinking. Conducted as part of a longitudinal study on men’s alcohol consumption in Izhevsk, this qualitative study uses 25 semi-structured biographical interviews with men aged 33–60 years to explore life course variation in drinking. The dominant pattern was decreasing binge and frequent drinking as men reached middle age which was precipitated by family building, reductions in drinking with work colleagues, and health concerns. A minority of men described chaotic drinking histories with periods of abstinence and heavy drinking. The results highlight the importance of the blue-collar work environment for conditioning male heavy drinking in young adulthood through a variety of social, normative and structural mechanisms. Post-Soviet changes had a structural influence on the propensity for workplace drinking but the important social function of male drinking sessions remained. Bonding with workmates through heavy drinking was seen as an unavoidable and essential part of young men’s social life. With age peer pressure to drink decreased and the need to perform the role of responsible breadwinner put different behavioural demands on men. For some resisting social pressure to drink became an important site of self-determination and a mark of masculine maturity. Over the lifetime the place where masculine identity was asserted shifted from the workplace to the home, which commonly resulted in a reduction in drinking. We contribute to existing theories of Russian male drinking by showing that the performance of age-related social roles influences Russian men’s drinking patterns, drinking contexts and their attitudes. Further research should be conducted investigating drinking trajectories in Russian men. PMID:26575847

  14. Illness trajectories in patients with amyotrophic lateral sclerosis: How illness progression is related to life narratives and interpersonal relationships.

    PubMed

    Cipolletta, Sabrina; Gammino, Giorgia Rosamaria; Palmieri, Arianna

    2017-12-01

    To identify illness trajectories in amyotrophic lateral sclerosis by analysing personal, social and functional dimensions related to amyotrophic lateral sclerosis progression. Previous studies have considered some psychological distinct variables that may moderate illness progression, but no research has combined an extensive qualitative understanding of amyotrophic lateral sclerosis patients' psychological characteristics and illness progression. A mixed-methods approach was used to combine quantitative and qualitative measures. Illness progression was assessed through a longitudinal design. Eighteen patients with amyotrophic lateral sclerosis attending a Neurology Department in northern Italy participated in the study. Semi-structured interviews to explore personal experience, and dependency grids to assess the distribution of dependency; ALSFRS-R and neuropsychological screening were, respectively, used to measure physical and cognitive impairment. To assess the progression of the disease, ALSFRS-R was re-administered after 8 months and mortality rate was considered. Data were analysed using the grounded theory approach. Illness progression changed according to the perception of the disease, the trust placed in medical care, self-construction and the distribution of dependency. Based on these categories, cases that had similar experiences were grouped, and four illness trajectories were identified: aggressiveness, threat, constriction and guilt. The findings suggest that it is possible to identify different illness trajectories in amyotrophic lateral sclerosis. Personalised intervention strategies may be construed based on the different trajectories identified. © 2017 John Wiley & Sons Ltd.

  15. Implementation of infection control best practice in intensive care units throughout Europe: a mixed-method evaluation study

    PubMed Central

    2013-01-01

    Background The implementation of evidence-based infection control practices is essential, yet challenging for healthcare institutions worldwide. Although acknowledged that implementation success varies with contextual factors, little is known regarding the most critical specific conditions within the complex cultural milieu of varying economic, political, and healthcare systems. Given the increasing reliance on unified global schemes to improve patient safety and healthcare effectiveness, research on this topic is needed and timely. The ‘InDepth’ work package of the European FP7 Prevention of Hospital Infections by Intervention and Training (PROHIBIT) consortium aims to assess barriers and facilitators to the successful implementation of catheter-related bloodstream infection (CRBSI) prevention in intensive care units (ICU) across several European countries. Methods We use a qualitative case study approach in the ICUs of six purposefully selected acute care hospitals among the 15 participants in the PROHIBIT CRBSI intervention study. For sensitizing schemes we apply the theory of diffusion of innovation, published implementation frameworks, sensemaking, and new institutionalism. We conduct interviews with hospital health providers/agents at different organizational levels and ethnographic observations, and conduct rich artifact collection, and photography during two rounds of on-site visits, once before and once one year into the intervention. Data analysis is based on grounded theory. Given the challenge of different languages and cultures, we enlist the help of local interpreters, allot two days for site visits, and perform triangulation across multiple data sources. Qualitative measures of implementation success will consider the longitudinal interaction between the initiative and the institutional context. Quantitative outcomes on catheter-related bloodstream infections and performance indicators from another work package of the consortium will produce a final mixed-methods report. Conclusion A mixed-methods study of this scale with longitudinal follow-up is unique in the field of infection control. It highlights the ‘Why’ and ‘How’ of best practice implementation, revealing key factors that determine success of a uniform intervention in the context of several varying cultural, economic, political, and medical systems across Europe. These new insights will guide future implementation of more tailored and hence more successful infection control programs. Trial registration Trial number: PROHIBIT-241928 (FP7 reference number) PMID:23421909

  16. The Effects of Mindfulness on Persons with Mild Cognitive Impairment: Protocol for a Mixed-Methods Longitudinal Study.

    PubMed

    Wong, Wee Ping; Hassed, Craig; Chambers, Richard; Coles, Jan

    2016-01-01

    Mild cognitive impairment (MCI) not only negatively impacts upon a person's life, but it is also seen as an intermediate stage on the progression to Alzheimer's Disease (AD), and therefore warrants early intervention. However, there is currently no effective pharmacological treatment approved for MCI. There is a paucity of evidence that non-pharmacological interventions such as cognitive training could result in improvements in the daily activities functioning of persons with MCI. Growing evidence has shown that mindfulness meditation increases gray matter volume and concentration in brain regions such as the hippocampus and prefrontal cortex, strengthens brain functional connectivity, and enhances psychological well-being which could be beneficial to counteract the memory and cognitive decline of MCI. We aim to quantitatively investigate whether mindfulness practice can improve the cognitive function, psychological health, mindfulness and functional abilities in activities of daily living of the MCI participants over time; the relationship between the amount of mindfulness practice and degree of improvement in these health outcomes; and the differential effects and interactions of both formal and informal mindfulness practices. We will also qualitatively address the issues about the MCI participants' and familiar support persons' engagement with the program, the nature of group interactions, their program experience, their perceived effects and expectations of mindfulness practice, and the challenges encountered in practicing mindfulness. Our study is one of the first mixed-methods longitudinal studies with a 1-year follow-up using a pre- and post-intervention design. It involves the MCI participants and their familiar support person in a customized 8-week group-based mindfulness training program. The outcome measures will use the Montreal Cognitive Assessment, Depression Anxiety Stress Scales, Freiburg Mindfulness Inventory and Bayer Activities of Daily Living Scale. The qualitative methods will include participant observation during the program and semi-structured interviews at post-intervention and 1-year follow-up. This customized MCI group mindfulness training program presents as a promising and feasible non-pharmacological therapeutic intervention option for MCI and a possible preventive strategy for Alzheimer's disease. This study has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366695) and allocated the ACTRN12614000820606.

  17. Transverse stresses and modes of failure in tree branches and other beams.

    PubMed

    Ennos, A R; van Casteren, A

    2010-04-22

    The longitudinal stresses in beams subjected to bending also set up transverse stresses within them; they compress the cross section when the beam's curvature is being increased and stretch it when its curvature is being reduced. Analysis shows that transverse stresses rise to a maximum at the neutral axis and increase with both the bending moment applied and the curvature of the beam. These stresses can qualitatively explain the fracture behaviour of tree branches. Curved 'hazard beams' that are being straightened split down the middle because of the low transverse tensile strength of wood. By contrast, straight branches of light wood buckle when they are bent because of its low transverse compressive strength. Branches of denser wood break, but the low transverse tensile strength diverts the crack longitudinally when the fracture has only run half-way across the beam, to produce their characteristic 'greenstick fracture'. The bones of young mammals and uniaxially reinforced composite beams may also be prone to greenstick fracture because of their lower transverse tensile strength.

  18. Transverse single-file diffusion and enhanced longitudinal diffusion near a subcritical bifurcation

    NASA Astrophysics Data System (ADS)

    Dessup, Tommy; Coste, Christophe; Saint Jean, Michel

    2018-05-01

    A quasi-one-dimensional system of repelling particles undergoes a configurational phase transition when the transverse confining potential decreases. Below a threshold, it becomes energetically favorable for the system to adopt one of two staggered raw patterns, symmetric with respect to the system axis. This transition is a subcritical pitchfork bifurcation for short range interactions. As a consequence, the homogeneous zigzag pattern is unstable in a finite zigzag amplitude range [hC 1,hC 2] . We exhibit strong qualitative effects of the subcriticality on the thermal motions of the particles. When the zigzag amplitude is close enough to the limits hC 1 and hC 2, a transverse vibrational soft mode occurs which induces a strongly subdiffusive behavior of the transverse fluctuations, similar to single-file diffusion. On the contrary, the longitudinal fluctuations are enhanced, with a diffusion coefficient which is more than doubled. Conversely, a simple measurement of the thermal fluctuations allows a precise determination of the bifurcation thresholds.

  19. "My favourite subject is maths. For some reason no-one really agrees with me": student perspectives of mathematics teaching and learning in the upper primary classroom

    NASA Astrophysics Data System (ADS)

    Attard, Catherine

    2011-09-01

    The levels of engagement in mathematics experienced by students during the middle years of schooling (Years 5 to 8 in New South Wales) has been of concern in Australia for some years. Lowered engagement in school has been attributed to factors such as inappropriate teaching strategies, curricula that is unchallenging and irrelevant, and cultural and technological conditions that continue to evolve (Sullivan et al. Australian Journal of Education 53(2):176-191, 2009). There is currently a gap in this field of research in terms of a lack of longitudinal studies conducted in an Australian context that feature students' voices and their perceptions of mathematics teaching and learning during the middle years. As part of a qualitative longitudinal case study spanning 3 school years, 20 students in their final year of primary school (aged between 11 and 12 years) were asked to provide their views on mathematics teaching and learning. The aim of the study was to explore the students' perspectives of mathematics teaching and learning to discover pedagogies that engage the students. During focus group discussions and individual interviews the students discussed qualities of a "good" mathematics teacher and aspects of "good" lessons. These were found to resonate well with current Australian quality teaching frameworks. The findings of this study indicate that students in the middle years are critically aware of pedagogies that lead to engagement in mathematics, and existing standards and frameworks should be used as a starting point for quality teaching of mathematics.

  20. Longitudinal trends and subgroup analysis in publication patterns for preclinical data of newly approved drugs.

    PubMed

    Köster, Ursula; Nolte, Ingo; Michel, Martin C

    2016-02-01

    Having observed a large variation in the number and type of original preclinical publications for newly registered drugs, we have explored whether longitudinal trends and/or factors specific for certain drugs or their manufacturers may explain such variation. Our analysis is based on 1954 articles related to 170 newly approved drugs. The number of preclinical publications per compound declined from a median of 10.5 in 1991 to 3 in 2011. A similar trend was observed for the number of in vivo studies in general, but not in the subset of in vivo studies in animal models of disease. The percentage of compounds with studies using isolated human cells or cell lines almost doubled over time from 37 to 72%. Number of publications did not exhibit major differences between compounds intended for human versus veterinary use, therapeutic areas, small molecules versus biologicals, or innovator versus follow-up compounds; however, some companies may publish fewer studies per compound than others. However, there were qualitative differences in the types of models being used depending on the therapeutic area; specifically, compounds for use in oncology very often used isolated cells and cell lines, often from human origin. We conclude that the large variation in number and type of reported preclinical data is not easily explained. We propose that pharmaceutical companies should consistently provide a comprehensive documentation of the preclinical data they generate as part of their development programs in the public domain to enable a better understanding of the drugs they intend to market.

  1. [Effects of anxiety on cardiorespiratory function].

    PubMed

    Dimitriev, D A; Saperova, E V; Dimitriev, A D; Karpenko, Iu D

    2014-01-01

    The present study was undertaken to investigate the effect of anxiety on pulmonary function parameters and respiratory sinus arrhythmia (RSA) in healthy people under real-life conditions. This study consisted of two interrelated parts. During the first stage, eighty healthy students were examined in the following sequence: recording of heart rate variability (HRV) and respiration parameters at rest and shortly before real life stress. In a longitudinal study (the second stage), we assessed the profile of cardiorespiratory activity over 50 days in ten healthy women. Pulmonary function parameters like breath rate, tidal volume, forced expiratory volume in ones (FEV1), peak expiratory flow (PEF), forced expired flow at 25%, 50%, 75% of FVC, forced expired flow from 25-75% of FVC (FEF25-75%) and HRV measures (SDNN, RMSSD, pNN50, LF, HF, HFnorm, LF/HF ratio) of all subjects were tested. State anxiety was measured by Spielberger state anxiety inventory. Higher levels of state anxiety were associated with higher levels of breath rate, tidal volume and reduced HRV parameters, especially indicators of the RSA (HF and HFnorm) at baseline. These changes depend on the category of state anxiety: the group of students with a qualitative increase in state anxiety before examination has increased level of FEV1, PEF, forced expired flow at 25%, 50%, 75% of FVC, FEF25-75%. Less reactive students have no difference in respiratory parameters. We found a strong negative correlation between the level of HF at rest and state anxiety scores before examination. Longitudinal study found a negative correlation between RSA parameters and PEF, positive correlation between state anxiety and PEF of the majority those surveyed, except for two women with low levels of state anxiety and RSA indicators were in a narrow range. The variations of cardiorespiratory parameters during a longitudinal study depend on the changes of state anxiety. The higher level of state anxiety was associated with significant changes in RSA and the respiratory parameters. These results lend strong support to the notion that parasympathetic function is a critical physiological component of emotional processes.

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

    PubMed

    Bierer, S Beth; Dannefer, Elaine F

    2016-11-01

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

  3. A systematic review of factors influencing older adults' decision to accept or decline cancer treatment.

    PubMed

    Puts, Martine T E; Tapscott, Brianne; Fitch, Margaret; Howell, Doris; Monette, Johanne; Wan-Chow-Wah, Doreen; Krzyzanowska, Monika; Leighl, Nathasha B; Springall, Elena; Alibhai, Shabbir M

    2015-02-01

    Cancer is a disease that affects mostly older adults. Older adults often have other chronic health conditions in addition to cancer and may have different health priorities, both of which can impact cancer treatment decision-making. However, no systematic review of factors that influence an older cancer patient's decision to accept or decline cancer treatment has been conducted. Systematic review of the literature published between inception of the databases and February 2013. Dutch, English, French or German articles reporting on qualitative studies, cross-sectional, longitudinal observational or intervention studies describing factors why older adults accepted or declined cancer treatment examining actual treatment decisions were included. Ten databases were used. Two independent reviewers reviewed manuscripts and performed data abstraction using a standardized form and the quality of studies was assessed with the Mixed Methods Appraisal Tool. Of 17,343 abstracts reviewed, a total of 38 studies were included. The majority focused on breast and prostate cancer treatment decisions and most studies used a qualitative design. Important factors for accepting treatment were convenience and success rate of treatment, seeing necessity of treatment, trust in the physician and following the physician's recommendation. Factors important for declining cancer treatment included concerns about the discomfort of the treatments, fear of side effects and transportation difficulties. Although the reasons why older adults with cancer accepted or declined treatment varied considerably, the most consistent determinant was physician recommendation. Further studies using large, representative samples and exploring decision-making incorporating health literacy and comorbidity are needed. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Adherence to yoga and its resultant effects on blood glucose in Type 2 diabetes: A community-based follow-up study.

    PubMed

    Angadi, Praveen; Jagannathan, Aarti; Thulasi, Arun; Kumar, Vinod; Umamaheshwar, K; Raghuram, Nagarathna

    2017-01-01

    To study the adherence to yoga and its effects on blood glucose parameters in patients with Type 2 Diabetes Mellitus. A single group longitudinal study over 6 months was conducted at VASK yoga centre, Bangalore. Fasting Blood Sugar, Post Prandial Blood Sugar Levels and Glycosylated Hemoglobin and qualitative in-depth interview of the participants and therapist was conducted at baseline, end of 3 rd month and end of 6 months; intermediate observations was conducted at the end of every month. Adherence to yoga in the community in Bangalore is around 50% over 6 months. Participants who completed the yoga programme had significantly lower HbA1c (end of 3 rd month). At the end of 6 months yoga adherence was significantly negatively correlated with FBS and stress. Further there was a trend towards those who dropped out having higher FBS, controlling for medication intake, stress levels and diet pattern (OR = 1.027, P = 0.07). Qualitative data revealed that most of the participants joined and completed the yoga programme to help cure their diabetes. Participants who dropped out from the yoga programme gave reasons of travel, ill-health and increased work-load at office. Adherence to yoga has an effect on the blood glucose parameters in diabetes. Hence, strategies to motivate participants to undergo 'lifestyle modification practices' including maximizing adherence to yoga should be the focus to experience any beneficial effects of yoga.

  5. Adherence to yoga and its resultant effects on blood glucose in Type 2 diabetes: A community-based follow-up study

    PubMed Central

    Angadi, Praveen; Jagannathan, Aarti; Thulasi, Arun; Kumar, Vinod; Umamaheshwar, K; Raghuram, Nagarathna

    2017-01-01

    Aim: To study the adherence to yoga and its effects on blood glucose parameters in patients with Type 2 Diabetes Mellitus. Methods: A single group longitudinal study over 6 months was conducted at VASK yoga centre, Bangalore. Fasting Blood Sugar, Post Prandial Blood Sugar Levels and Glycosylated Hemoglobin and qualitative in-depth interview of the participants and therapist was conducted at baseline, end of 3rd month and end of 6 months; intermediate observations was conducted at the end of every month. Results: Adherence to yoga in the community in Bangalore is around 50% over 6 months. Participants who completed the yoga programme had significantly lower HbA1c (end of 3rd month). At the end of 6 months yoga adherence was significantly negatively correlated with FBS and stress. Further there was a trend towards those who dropped out having higher FBS, controlling for medication intake, stress levels and diet pattern (OR = 1.027, P = 0.07). Qualitative data revealed that most of the participants joined and completed the yoga programme to help cure their diabetes. Participants who dropped out from the yoga programme gave reasons of travel, ill-health and increased work-load at office. Conclusions: Adherence to yoga has an effect on the blood glucose parameters in diabetes. Hence, strategies to motivate participants to undergo ‘lifestyle modification practices’ including maximizing adherence to yoga should be the focus to experience any beneficial effects of yoga. PMID:28149065

  6. [Living and dying with frailty : Qualitative interviews with elderly people in the domestic environment].

    PubMed

    Klindtworth, Katharina; Geiger, Karin; Pleschberger, Sabine; Bleidorn, Jutta; Schneider, Nils; Müller-Mundt, Gabriele

    2017-02-01

    Frail older people are becoming an increasingly more important target group in healthcare provision. Little is known about patients' views on frailty and its various impacts, especially towards the end of life. This study was carried out to analyze the needs of frail elderly people at the end of life. A qualitative, longitudinal case study design was applied and included 31 frail older patients (≥ 70 year) with a Canadian study of health and aging (CSHA) clinical frailty scale (CFS) grade 6/7 from urban and rural areas within the region of Lower Saxony. The analysis was based on guided interviews and followed the principles of grounded theory. From the patients' perspective frailty is perceived as a process of increasing complexity of health problems, increased vulnerability and reduced ability to perform tasks. Frailty is experienced as various deficits including the physical, psychological, social and existential dimensions. Living and dying in a familiar environment and maintaining autonomy was identified as a core category. Key determinants were access to and quality of healthcare services as well as various individual and social resources. A palliative biopsychosocial care approach should be established early in the process of frailty, including advance care planning in order to meet the patients' needs of staying in a familiar environment. General practitioners as well as home care nursing personnel have to collaborate in order to balance issues of autonomy with increased care needs and the support of informal carers as key partners towards the end of life.

  7. How has early testicular cancer affected your life? A study of sexual function in men attending active surveillance for stage one testicular cancer.

    PubMed

    Brand, Sue; Williams, Hilary; Braybrooke, Jeremy

    2015-06-01

    Testicular cancer is the most common cancer in young men, it is frequently diagnosed at key times in relationship formation. In early stage disease the vast majority of tumours will be cured by surgery alone with patients being offered active surveillance rather than adjuvant therapies. To date, research has not evaluated how surveillance alone impacts on sexual function. The aim of this quantitative longitudinal study was to ascertain the sexual function of men with stage one disease at 3 and 12 months post diagnosis and to compare with normative data. Additional data was collected on the information men sought regarding sexual function and media they used to access this. This study shows that men's sexual function is altered at diagnosis and improves by 3 months. At 12 months, whilst not statistically significant, sexual function improves but not to the same level as normative data comparison. Men appear to find verbal information useful at 3 months, however men appear to be seeking written and online information at 12 months. The intricacies of sexual function together with the low number of participants may have been best met with a qualitative approach. However, the information data indicates the importance of further research into the effects of early stage testicular cancer on sexual function. Therefore, further qualitative research is recommended to explore the effects of early stage testicular cancer in relation to sexual function. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Barriers to data quality resulting from the process of coding health information to administrative data: a qualitative study.

    PubMed

    Lucyk, Kelsey; Tang, Karen; Quan, Hude

    2017-11-22

    Administrative health data are increasingly used for research and surveillance to inform decision-making because of its large sample sizes, geographic coverage, comprehensivity, and possibility for longitudinal follow-up. Within Canadian provinces, individuals are assigned unique personal health numbers that allow for linkage of administrative health records in that jurisdiction. It is therefore necessary to ensure that these data are of high quality, and that chart information is accurately coded to meet this end. Our objective is to explore the potential barriers that exist for high quality data coding through qualitative inquiry into the roles and responsibilities of medical chart coders. We conducted semi-structured interviews with 28 medical chart coders from Alberta, Canada. We used thematic analysis and open-coded each transcript to understand the process of administrative health data generation and identify barriers to its quality. The process of generating administrative health data is highly complex and involves a diverse workforce. As such, there are multiple points in this process that introduce challenges for high quality data. For coders, the main barriers to data quality occurred around chart documentation, variability in the interpretation of chart information, and high quota expectations. This study illustrates the complex nature of barriers to high quality coding, in the context of administrative data generation. The findings from this study may be of use to data users, researchers, and decision-makers who wish to better understand the limitations of their data or pursue interventions to improve data quality.

  9. The Occupational Transition Process to Upper Secondary School, Further Education and/or Work in Sweden: As Described by Young Adults with Asperger Syndrome and Attention Deficit Hyperactivity Disorder.

    PubMed

    Baric, Vedrana Bolic; Hemmingsson, Helena; Hellberg, Kristina; Kjellberg, Anette

    2017-03-01

    The aim was to describe the occupational transition process to upper secondary school, further education and/or work, and to discover what support influences the process from the perspectives of young adults with Asperger syndrome or attention deficit/hyperactivity disorder. This qualitative study was performed in Sweden and comprised interviews with 15 young adults recruited from community based day centres. Support influencing the process included: occupational transition preparation in compulsory school, practical work experience in a safe environment, and support beyond the workplace. The overall understanding shows that the occupational transition process was a longitudinal one starting as early as in middle school, and continuing until the young adults obtained and were able to remain in employment or further education.

  10. Strategic development in exact calculation: group and individual differences in four achievement subtypes.

    PubMed

    Wylie, Judith; Jordan, Julie-Ann; Mulhern, Gerry

    2012-09-01

    This longitudinal study sought to identify developmental changes in strategy use between 5 and 7 years of age when solving exact calculation problems. Four mathematics and reading achievement subtypes were examined at four time points. Five strategies were considered: finger counting, verbal counting, delayed retrieval, automatic retrieval, and derived fact retrieval. Results provided unique insights into children's strategic development in exact calculation at this early stage. Group analysis revealed relationships between mathematical and/or reading difficulties and strategy choice, shift, and adaptiveness. Use of derived fact retrieval by 7 years of age distinguished children with mathematical difficulties from other achievement subtypes. Analysis of individual differences revealed marked heterogeneity within all subtypes, suggesting (inter alia) no marked qualitative distinction between our two mathematical difficulty subtypes. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Investigating conditions for meaningful feedback in the context of an evidence-based feedback programme.

    PubMed

    Voyer, Stéphane; Cuncic, Cary; Butler, Deborah L; MacNeil, Kimberley; Watling, Christopher; Hatala, Rose

    2016-09-01

    We developed, implemented and evaluated an evidence-based programme of feedback designed to address limitations identified in the current literature. We sought to advance understanding about how and why feedback processes might be more effective in clinical education. Three faculty members and nine first-year internal medicine residents participated in the pilot programme. To counter challenges identified in the literature, feedback was based on direct observation, grounded in longitudinal faculty-resident relationships, and devoid of summative assessment. We used a qualitative case study design to address three research questions: (i) What benefits did the participants describe? (ii) What elements of the programme facilitated these benefits? (iii) What were the limitations and challenges of the programme? Collected data included audiotapes of interactions between faculty members and residents, field notes written during observations, and semi-structured interviews and focus groups with resident participants. Data analysis moved cyclically and iteratively through inductive and deductive analysis. Residents described benefits relating to their ways of working (clinical skills), ways of learning (accountability for learning) and ways of feeling (emotional well-being). According to participants, specific elements of the programme that achieved these benefits included the direct observation of authentic clinical work, the longitudinal relationship with a faculty member and the emergence of feedback as a conversation between the faculty member and learner. We conclude that the conditions established within our pilot feedback programme influenced the learning culture for first-year internal medicine residents by grounding direct observation in authentic clinical work and setting the observations in the context of a longitudinal, non-assessment-based relationship between a faculty member and resident. These conditions appeared to influence residents' participation in the feedback process, their ways of approaching their daily clinical work, their emotional well-being and their engagement in their own learning. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  12. Key Elements of a Family Intervention for Schizophrenia: A Qualitative Analysis of an RCT.

    PubMed

    Grácio, Jaime; Gonçalves-Pereira, Manuel; Leff, Julian

    2018-03-01

    Schizophrenia is a complex biopsychosocial condition in which expressed emotion in family members is a robust predictor of relapse. Not surprisingly, family interventions are remarkably effective and thus recommended in current treatment guidelines. Their key elements seem to be common therapeutic factors, followed by education and coping skills training. However, few studies have explored these key elements and the process of the intervention itself. We conducted a qualitative and quantitative analysis of the records from a pioneering family intervention trial addressing expressed emotion, published by Leff and colleagues four decades ago. Records were analyzed into categories and data explored using descriptive statistics. This was complemented by a narrative evaluation using an inductive approach based on emotional markers and markers of change. The most used strategies in the intervention were addressing needs, followed by coping skills enhancement, advice, and emotional support. Dealing with overinvolvement and reframing were the next most frequent. Single-family home sessions seemed to augment the therapeutic work conducted in family groups. Overall the intervention seemed to promote cognitive and emotional change in the participants, and therapists were sensitive to the emotional trajectory of each subject. On the basis of our findings, we developed a longitudinal framework for better understanding the process of this treatment approach. © 2016 Family Process Institute.

  13. Motivations, concerns and preferences of personal genome sequencing research participants: Baseline findings from the HealthSeq project

    PubMed Central

    Sanderson, Saskia C; Linderman, Michael D; Suckiel, Sabrina A; Diaz, George A; Zinberg, Randi E; Ferryman, Kadija; Wasserstein, Melissa; Kasarskis, Andrew; Schadt, Eric E

    2016-01-01

    Whole exome/genome sequencing (WES/WGS) is increasingly offered to ostensibly healthy individuals. Understanding the motivations and concerns of research participants seeking out personal WGS and their preferences regarding return-of-results and data sharing will help optimize protocols for WES/WGS. Baseline interviews including both qualitative and quantitative components were conducted with research participants (n=35) in the HealthSeq project, a longitudinal cohort study of individuals receiving personal WGS results. Data sharing preferences were recorded during informed consent. In the qualitative interview component, the dominant motivations that emerged were obtaining personal disease risk information, satisfying curiosity, contributing to research, self-exploration and interest in ancestry, and the dominant concern was the potential psychological impact of the results. In the quantitative component, 57% endorsed concerns about privacy. Most wanted to receive all personal WGS results (94%) and their raw data (89%); a third (37%) consented to having their data shared to the Database of Genotypes and Phenotypes (dbGaP). Early adopters of personal WGS in the HealthSeq project express a variety of health- and non-health-related motivations. Almost all want all available findings, while also expressing concerns about the psychological impact and privacy of their results. PMID:26036856

  14. Reconstructing masculinity? A qualitative evaluation of the Stepping Stones and Creating Futures interventions in urban informal settlements in South Africa.

    PubMed

    Gibbs, Andrew; Jewkes, Rachel; Sikweyiya, Yandisa; Willan, Samantha

    2015-01-01

    Evidence shows the importance of working with men to reduce intimate partner violence and HIV-risk. Two claims dominate this work. The first is that interventions 'reconstruct' masculinities--these new formations of masculinity exist in opposition to existing ones and are healthier for men and less harmful for women. The second is that to be successful, such interventions need to address men's exclusion from the economy. Using a qualitative longitudinal cohort study of young men who participated in a gender transformative and livelihood strengthening intervention, as well as dyadic interviews with men's main female partners, we explore these claims. Data suggests men saw some improvements in livelihoods and relationships. However, challenging social contexts, including high rates of unemployment, peer networks and a dominant youth masculinity, limited change. Rather than reconstructing masculinity, a more subtle shift was seen with men moving away from 'harmful' aspects of a dominant youth masculinity towards a form of masculinity whereby male power is buttressed by economic provision and attempting to form and support 'households'. Working with men on their livelihoods at an instrumental level encouraged participation in the intervention. Beyond encouragement, men's improving livelihoods afforded men the opportunity to materially demonstrate the social changes - in the form of shifts in masculinity--they were seeking to enact.

  15. Healthy Aging in Older Women Living with HIV Infection: a Systematic Review of Psychosocial Factors.

    PubMed

    Rubtsova, Anna A; Kempf, Mirjam-Colette; Taylor, Tonya N; Konkle-Parker, Deborah; Wingood, Gina M; Holstad, Marcia McDonnell

    2017-02-01

    Due to life-enhancing effects of antiretroviral therapy, HIV-positive persons have the potential for long life comparable to their uninfected peers. Older women (age 50+) living with HIV (OWLH) are often an under-recognized aging group. We conducted a systematic review to examine psychosocial factors that impact how OWLH live, cope, and age with HIV. Initial key word search yielded 1527 records, and 21 studies met our inclusion criteria of original quantitative or qualitative research published between 2013 and 2016 with results specific to OWLH. These focused on health care and self-management, sexual health and risk, stigma, loneliness, mental health (depression, substance use), and protective factors (coping, social support, well-being). Due to the scarcity of studies on each topic and inconclusive findings, no clear patterns of results emerged. As the number of OWLH continues to grow, more research, including longitudinal studies, is needed to fully characterize the psychosocial factors that impact aging with HIV.

  16. Managing the work-life roller-coaster: private stress or public health issue?

    PubMed

    Bryson, Lois; Warner-Smith, Penny; Brown, Peter; Fray, Leanne

    2007-09-01

    Although research has established the importance for health of a sense of personal control at work, the implications of this for women have not been adequately studied. Using quantitative data from the Australian Longitudinal Study on Women's Health and qualitative data from an associated study, here we examine women's health and sense of control in relation to family and employment commitments. In line with other research, 'demand over-load' is found to be important for sense of control, but both 'over-load' and 'control' prove complex, as illustrated by the finding that good mental health is associated with satisfaction with, rather than actual, hours of employment. In the contemporary western context of longer working hours, increasing time strain, and gender relations shaped within a neo-liberal, individualised social environment, the findings suggest that as life speeds up, 'control' and the health effects of 'busyness', need to be understood not merely as personal matters, but rather as potentially important public health issues.

  17. Integrating Professional and Folk Models of HIV Risk: YMSM’s Perceptions of High-Risk Sex

    PubMed Central

    Kubicek, Katrina; Carpineto, Julie; McDavitt, Bryce; Weiss, George; Iverson, Ellen F.; Au, Chi-Wai; Kerrone, Dustin; Martinez, Miguel; Kipke, Michele D.

    2009-01-01

    Risks associated with HIV are well documented in research literature. While a great deal has been written about high-risk sex, little research has been conducted to examine how young men who have sex with men (YMSM) perceive and define high-risk sexual behavior. In this study, we compare the “professional’ and “folk” models of HIV-risk based on YMSM’s understanding of high-risk sex and where and how they gathered their understanding of HIV-risk behaviors. The findings reported here emerged from the quantitative and qualitative interviews from the Healthy Young Men’s Study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can increase YMSM’s knowledge of sexual behavior and help them build solid foundations of sexual health education to protect them from STI and HIV infection. PMID:18558819

  18. Making Informed Decisions: How Attitudes and Perceptions Affect the Use of Crystal, Cocaine and Ecstasy among Young Men who Have Sex with Men.

    PubMed

    Kubicek, Katrina; McDavitt, Bryce; Carpineto, Julie; Weiss, George; Iverson, Ellen F; Kipke, Michele D

    2007-01-01

    Although the use of illicit substances, particularly those commonly categorized as "club drugs", among men who have sex with men (MSM), is well established in the literature, little is known about the decision making process that is used in deciding whether or not to use a particular substance. In this study, we examine the positive and negative attitudes and perceptions among young men who have sex with men (YMSM) in regards to three specific drugs: crystal methamphetamine, cocaine and ecstasy. The findings reported here emerged from the baseline quantitative interviews and an accompanying qualitative phase of the Healthy Young Men's study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can design new and innovative interventions to prevent young men from initiating substance use.

  19. Improving Latino Youths' Environmental Health Literacy and Leadership Skills Through Participatory Research on Chemical Exposures in Cosmetics: The HERMOSA Study.

    PubMed

    Madrigal, Daniel S; Minkler, Meredith; Parra, Kimberly L; Mundo, Carolina; Gonzalez, Jesus Enrique Cardenas; Jimenez, Ramon; Vera, Carlos; Harley, Kim G

    2016-07-18

    To increase environmental health literacy (EHL) and leadership skills in Latino youth in Salinas, CA., we worked from 2012-2015 with 15 members of the CHAMACOS Youth Community Council (YCC), an outreach arm of a longitudinal study of impacts of environmental chemicals on children's health. The YCC program provided hands-on research experiences related to Endocrine Disrupting Chemicals (EDCs) in cosmetics and their possible health effects. We use participatory research principles and Bloom's Taxonomy of Educational Objectives to describe the development of EHC and leadership in the youth co-researchers. Using data from multiple qualitative sources, we explore the youths' engagement in a wide range of research and action processes. Promising outcomes, including perceptions of improved youth self-esteem, EHL, leadership, and career orientation are discussed, as are challenges, such as time constraints and high priority youth concerns not addressed by the study. Implications for other youth-engaged participatory science and leadership programs are presented. © The Author(s) 2016.

  20. How patient educators help students to learn: An exploratory study.

    PubMed

    Cheng, Phoebe T M; Towle, Angela

    2017-03-01

    Benefits of the active involvement of patients in educating health professionals are well-recognized but little is known about how patient educators facilitate student learning. This exploratory qualitative study investigated the teaching practices and experiences that prepared patient educators for their roles in a longitudinal interprofessional Health Mentors program. Semi-structured interviews were conducted with eleven experienced health mentors. Responses were coded and analyzed for themes related to teaching goals, methods, and prior experiences. Mentors used a rich variety of teaching methods to teach patient-centeredness and interprofessionalism, categorized as: telling my story, stimulating reflection, sharing perspectives, and problem-solving. As educators they drew on a variety of prior experiences with teaching, facilitation or public speaking and long-term interactions with the health-care system. Patient educators use diverse teaching methods, drawing on both individualistic and social perspectives on learning. A peer-support model of training and support would help maintain the authenticity of patients as educators. The study highlights inadequacies of current learning theories to explain how patients help students learn.

  1. Families in the context of macroeconomic crises: A systematic review.

    PubMed

    Fonseca, Gabriela; Cunha, Diana; Crespo, Carla; Relvas, Ana Paula

    2016-09-01

    The present study is a systematic review of empirical literature from the last 35 years on families' responses to economic distress in the context of macroeconomic crises. Thirty-nine studies published between 1983 and 2015 in 12 countries were identified, resulting in 3 main findings. First, economic distress was associated with negative changes in family dynamics, specifically couple relationships and parenting. Second, protective factors were found to buffer the adverse effects of economic distress on family and individual outcomes. Third, the results suggest that individual responses to macroeconomic crises may be moderated by sex. Implications for future research encompass using validated assessment instruments, including participants beyond 2-parent families with adolescent children and conducting both longitudinal and qualitative studies that focus on the processes and meanings of adaptation within this risk context. Conclusions highlighted the need to assist families dealing with macroeconomic crises' demands, encouraging the development and validation of macrosystemic intervention programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Making Informed Decisions: How Attitudes and Perceptions Affect the Use of Crystal, Cocaine and Ecstasy among Young Men who Have Sex with Men

    PubMed Central

    Kubicek, Katrina; McDavitt, Bryce; Carpineto, Julie; Weiss, George; Iverson, Ellen F.; Kipke, Michele D.

    2008-01-01

    Although the use of illicit substances, particularly those commonly categorized as “club drugs”, among men who have sex with men (MSM), is well established in the literature, little is known about the decision making process that is used in deciding whether or not to use a particular substance. In this study, we examine the positive and negative attitudes and perceptions among young men who have sex with men (YMSM) in regards to three specific drugs: crystal methamphetamine, cocaine and ecstasy. The findings reported here emerged from the baseline quantitative interviews and an accompanying qualitative phase of the Healthy Young Men’s study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can design new and innovative interventions to prevent young men from initiating substance use. PMID:18852843

  3. Case Manager Perspectives on the Role of Treatment in Supportive Housing for People with Severe Mental Illness

    PubMed Central

    Stanhope, Victoria; Choy-Brown, Mimi; Tiderington, Emmy; Henwood, Benjamin F.; Padgett, Deborah K.

    2016-01-01

    Objective Growing recognition exists of housing as a social determinant of health, and thus, health care reform initiatives are expanding the reach of health care beyond traditional settings. One result of this expansion is increased Medicaid funds for supportive-housing programs for people with severe mental illnesses. This qualitative study explores the ways in which case managers working in a supportive housing program approach treatment and how their approach is influenced by both program requirements and their beliefs about mental illness. Method The study is part of a longitudinal qualitative study on recovery for people with severe mental illnesses living in supportive housing. Multiple interviews (n = 55) with 24 case managers from a residential-continuum supportive-housing program were conducted over 18 months. To provide an in-depth view of case manager perspectives, the study uses thematic analysis with multiple coders. Results Overall, case managers understand supportive housing as being a treatment program but predominantly characterize treatment as medication management. The following themes emerged: believing medication to be the key to success in the program, persuading residents to take medication, and questioning the utility of the program for residents who were not medication adherent. Conclusions Case managers understand supportive housing to be a treatment program; however, given the external constraints and their own beliefs about mental illness, case managers often equate treatment with taking medication. Study findings demonstrate the need to train case managers about mental health recovery and integrated health care. The findings also have implications for policies that tie housing to services. PMID:28163830

  4. Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function.

    PubMed

    Mulligan, Edward P; Cook, Patrick G

    2013-10-01

    A specific training program emphasizing the neuromuscular recruitment of the plantar intrinsic foot muscles, colloquially referred to as "short foot" exercise (SFE) training, has been suggested as a means to dynamically support the medial longitudinal arch (MLA) during functional tasks. A single-group repeated measures pre- and post-intervention study design was utilized to determine if a 4-week intrinsic foot muscle training program would impact the amount of navicular drop (ND), increase the arch height index (AHI), improve performance during a unilateral functional reaching maneuver, or the qualitative assessment of the ability to hold the arch position in single limb stance position in an asymptomatic cohort. 21 asymptomatic subjects (42 feet) completed the 4-week SFE training program. Subject ND decreased by a mean of 1.8 mm at 4 weeks and 2.2 mm at 8 weeks (p < 0.05). AHI increased from 28 to 29% (p < 0.05). Intrinsic foot muscle performance during a static unilateral balancing activity improved from a grade of fair to good (p < 0.001) and subjects experienced a significant improvement during a functional balance and reach task in all directions with the exception of an anterior reach (p < 0.05). This study offers preliminary evidence to suggest that SFE training may have value in statically and dynamically supporting the MLA. Further research regarding the value of this exercise intervention in foot posture type or pathology specific patient populations is warranted. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Is the Scoutreach Initiative of Boy Scouts of America Linked to Character Development among Socioeconomically, Racially, and Ethnically Diverse Youth?: Initial Explorations.

    PubMed

    Wang, Jun; Champine, Robey B; Ferris, Kaitlyn A; Hershberg, Rachel M; Warren, Daniel J; Burkhard, Brian M; Su, Shaobing; Lerner, Richard M

    2017-10-01

    Youth development programs represent key tools in the work of youth-serving practitioners and researchers who strive to promote character development and other attributes of youth thriving, particularly among youth who may confront structural and social challenges related to their racial, ethnic, and/or economic backgrounds. This article conducts secondary analyses of two previously reported studies of a relatively recent innovation in Boy Scouts of America (BSA) developed for youth from low-income communities, Scoutreach. Our goal is to provide descriptive and admittedly preliminary exploratory information about whether these data sets-one involving a sample of 266 youth of color from socioeconomically impoverished communities in Philadelphia (M age  = 10.54 years, SD = 1.58 years) and the other involving a pilot investigation of 32 youth of color from similar socioeconomic backgrounds in Boston (M age  = 9.97 years, SD = 2.46 years)-provide evidence for a link between program participation and a key indicator of positive development; that is, character development. Across the two data sets, quantitative and qualitative evidence suggested the presence of character development among Scoutreach participants. Limitations of both studies are discussed and implications for future longitudinal research are presented. We suggest that future longitudinal research should test the hypothesis that emotional engagement is key to creating the conditions wherein Scoutreach participation is linked to character development.

  6. An investigation of the predictors of photoprotection and UVR dose to the face in patients with XP: a protocol using observational mixed methods.

    PubMed

    Walburn, Jessica; Sarkany, Robert; Norton, Sam; Foster, Lesley; Morgan, Myfanwy; Sainsbury, Kirby; Araújo-Soares, Vera; Anderson, Rebecca; Garrood, Isabel; Heydenreich, Jakob; Sniehotta, Falko F; Vieira, Rute; Wulf, Hans Christian; Weinman, John

    2017-08-21

    Xeroderma pigmentosum (XP) is a rare genetic condition caused by defective nucleotide excision repair and characterised by skin cancer, ocular and neurological involvement. Stringent ultraviolet protection is the only way to prevent skin cancer. Despite the risks, some patients' photoprotection is poor, with a potentially devastating impact on their prognosis. The aim of this research is to identify disease-specific and psychosocial predictors of photoprotection behaviour and ultraviolet radiation (UVR) dose to the face. Mixed methods research based on 45 UK patients will involve qualitative interviews to identify individuals' experience of XP and the influences on their photoprotection behaviours and a cross-sectional quantitative survey to assess biopsychosocial correlates of these behaviours at baseline. This will be followed by objective measurement of UVR exposure for 21 days by wrist-worn dosimeter and daily recording of photoprotection behaviours and psychological variables for up to 50 days in the summer months. This novel methodology will enable UVR dose reaching the face to be calculated and analysed as a clinically relevant endpoint. A range of qualitative and quantitative analytical approaches will be used, reflecting the mixed methods (eg, cross-sectional qualitative interviews, n-of-1 studies). Framework analysis will be used to analyse the qualitative interviews; mixed-effects longitudinal models will be used to examine the association of clinical and psychosocial factors with the average daily UVR dose; dynamic logistic regression models will be used to investigate participant-specific psychosocial factors associated with photoprotection behaviours. This research has been approved by Camden and King's Cross Research Ethics Committee 15/LO/1395. The findings will be published in peer-reviewed journals and presented at national and international scientific conferences. © 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.

  7. [Design of the general population study NEMESIS-2: Netherlands Mental Health Survey and Incidence Study-2].

    PubMed

    de Graaf, Ron; Ten Have, Margreet; van Dorsselaer, Saskia

    2012-01-01

    The longitudinal epidemiological population study NEMESIS-2 (Netherlands Mental Health Survey and Incidence Study-2) replicates the first study conducted from 1996 to 1999, and expands it by adding new subjects such as impulse-control disorders. To describe the aims and design of nemesis-2, particularly of its first round of measurements, to provide up-to-date figures on prevalence, incidence, course and consequences of mental disorders and associated factors, and to study trends in the mental health of the population aged 18-64 years and the use these people make of psychiatric services. Face-to-face interviews were conducted (November 2007-July 2009) by means of the Composite International Diagnostic Interview 3.0. The response was 65.1% (n = 6646). Respondents were reasonably representative for the population, but young persons were somewhat underrepresented. Two follow-up rounds of measurements are planned with three-year intervals between the rounds. The second round of measurements began in November 2010. A qualitatively good dataset was built up. This will allow several mental health topics to be studied in the future.

  8. The PULSAR Specialist Care protocol: a stepped-wedge cluster randomized control trial of a training intervention for community mental health teams in recovery-oriented practice.

    PubMed

    Shawyer, Frances; Enticott, Joanne C; Brophy, Lisa; Bruxner, Annie; Fossey, Ellie; Inder, Brett; Julian, John; Kakuma, Ritsuko; Weller, Penelope; Wilson-Evered, Elisabeth; Edan, Vrinda; Slade, Mike; Meadows, Graham N

    2017-05-08

    Recovery features strongly in Australian mental health policy; however, evidence is limited for the efficacy of recovery-oriented practice at the service level. This paper describes the Principles Unite Local Services Assisting Recovery (PULSAR) Specialist Care trial protocol for a recovery-oriented practice training intervention delivered to specialist mental health services staff. The primary aim is to evaluate whether adult consumers accessing services where staff have received the intervention report superior recovery outcomes compared to adult consumers accessing services where staff have not yet received the intervention. A qualitative sub-study aims to examine staff and consumer views on implementing recovery-oriented practice. A process evaluation sub-study aims to articulate important explanatory variables affecting the interventions rollout and outcomes. The mixed methods design incorporates a two-step stepped-wedge cluster randomized controlled trial (cRCT) examining cross-sectional data from three phases, and nested qualitative and process evaluation sub-studies. Participating specialist mental health care services in Melbourne, Victoria are divided into 14 clusters with half randomly allocated to receive the staff training in year one and half in year two. Research participants are consumers aged 18-75 years who attended the cluster within a previous three-month period either at baseline, 12 (step 1) or 24 months (step 2). In the two nested sub-studies, participation extends to cluster staff. The primary outcome is the Questionnaire about the Process of Recovery collected from 756 consumers (252 each at baseline, step 1, step 2). Secondary and other outcomes measuring well-being, service satisfaction and health economic impact are collected from a subset of 252 consumers (63 at baseline; 126 at step 1; 63 at step 2) via interviews. Interview-based longitudinal data are also collected 12 months apart from 88 consumers with a psychotic disorder diagnosis (44 at baseline, step 1; 44 at step 1, step 2). cRCT data will be analyzed using multilevel mixed-effects modelling to account for clustering and some repeated measures, supplemented by thematic analysis of qualitative interview data. The process evaluation will draw on qualitative, quantitative and documentary data. Findings will provide an evidence-base for the continued transformation of Australian mental health service frameworks toward recovery. Australian and New Zealand Clinical Trial Registry: ACTRN12614000957695 . Date registered: 8 September 2014.

  9. Helpful and Hindering Factors in Psychodrama Field Training: A Longitudinal Mixed Methods Study of Student Development.

    PubMed

    Azoulay, Bracha; Orkibi, Hod

    2018-01-01

    Although the literature indicates that students in mental health professions start to form their professional identity and competence in graduate school, there are few studies on the in-training experience of creative arts therapies students. This mixed methods study examined how five first-year students in a psychodrama master's degree program in Israel experienced their field training, with the aim of identifying the factors likely to promote or hinder the development of their professional identity and sense of professional ability. Longitudinal data were collected weekly throughout the 20-week field training experience. The students reported qualitatively on helpful and hindering factors and were assessed quantitatively on questionnaires measuring professional identity, perceived demands-abilities fit, client involvement, and therapy session evaluations. A thematic analysis of the students' reports indicated that a clear and defined setting and structure, observing the instructor as a role model, actively leading parts of the session, and observing fellow students were all helpful factors. The hindering factors included role confusion, issues related to coping with client resistance and disciplinary problems, as well as school end-of-year activities that disrupted the continuity of therapy. The quantitative results indicated that students' professional identity did not significantly change over the year, whereas a U-shaped curve trajectory characterized the changes in demands-abilities fit and other measures. Students began their field training with an overstated sense of ability that soon declined and later increased. These findings provide indications of which helping and hindering factors should be maximized and minimized, to enhance students' field training.

  10. Helpful and Hindering Factors in Psychodrama Field Training: A Longitudinal Mixed Methods Study of Student Development

    PubMed Central

    Azoulay, Bracha; Orkibi, Hod

    2018-01-01

    Although the literature indicates that students in mental health professions start to form their professional identity and competence in graduate school, there are few studies on the in-training experience of creative arts therapies students. This mixed methods study examined how five first-year students in a psychodrama master’s degree program in Israel experienced their field training, with the aim of identifying the factors likely to promote or hinder the development of their professional identity and sense of professional ability. Longitudinal data were collected weekly throughout the 20-week field training experience. The students reported qualitatively on helpful and hindering factors and were assessed quantitatively on questionnaires measuring professional identity, perceived demands-abilities fit, client involvement, and therapy session evaluations. A thematic analysis of the students’ reports indicated that a clear and defined setting and structure, observing the instructor as a role model, actively leading parts of the session, and observing fellow students were all helpful factors. The hindering factors included role confusion, issues related to coping with client resistance and disciplinary problems, as well as school end-of-year activities that disrupted the continuity of therapy. The quantitative results indicated that students’ professional identity did not significantly change over the year, whereas a U-shaped curve trajectory characterized the changes in demands-abilities fit and other measures. Students began their field training with an overstated sense of ability that soon declined and later increased. These findings provide indications of which helping and hindering factors should be maximized and minimized, to enhance students’ field training. PMID:29515504

  11. Adherence to a Mediterranean-Style Diet and Effects on Cognition in Adults: A Qualitative Evaluation and Systematic Review of Longitudinal and Prospective Trials.

    PubMed

    Hardman, Roy J; Kennedy, Greg; Macpherson, Helen; Scholey, Andrew B; Pipingas, Andrew

    2016-01-01

    The Mediterranean-style diet (MedDiet) involves substantial intake of fruits, vegetables, and fish, and a lower consumption of dairy, red meat, and sugars. Over the past 15 years, much empirical evidence supports the suggestion that a MedDiet may be beneficial with respect to reducing the incidence of cardiovascular disease, cancer, metabolic syndrome, and dementia. A number of cross-sectional studies that have examined the impact of MedDiet on cognition have yielded largely positive results. The objective of this review is to evaluate longitudinal and prospective trials to gain an understanding of how a MedDiet may impact cognitive processes over time. The included studies were aimed at improving cognition or minimizing of cognitive decline. Studies reviewed included assessments of dietary status using either a food frequency questionnaire or a food diary assessment. Eighteen articles meeting our inclusion criteria were subjected to systematic review. These revealed that higher adherence to a MedDiet is associated with slower rates of cognitive decline, reduced conversion to Alzheimer's disease, and improvements in cognitive function. The specific cognitive domains that were found to benefit with improved Mediterranean Diet Score were memory (delayed recognition, long-term, and working memory), executive function, and visual constructs. The current review has also considered a number of methodological issues in making recommendations for future research. The utilization of a dietary pattern, such as the MedDiet, will be essential as part of the armamentarium to maintain quality of life and reduce the potential social and economic burden of dementia.

  12. Adherence to a Mediterranean-Style Diet and Effects on Cognition in Adults: A Qualitative Evaluation and Systematic Review of Longitudinal and Prospective Trials

    PubMed Central

    Hardman, Roy J.; Kennedy, Greg; Macpherson, Helen; Scholey, Andrew B.; Pipingas, Andrew

    2016-01-01

    The Mediterranean-style diet (MedDiet) involves substantial intake of fruits, vegetables, and fish, and a lower consumption of dairy, red meat, and sugars. Over the past 15 years, much empirical evidence supports the suggestion that a MedDiet may be beneficial with respect to reducing the incidence of cardiovascular disease, cancer, metabolic syndrome, and dementia. A number of cross-sectional studies that have examined the impact of MedDiet on cognition have yielded largely positive results. The objective of this review is to evaluate longitudinal and prospective trials to gain an understanding of how a MedDiet may impact cognitive processes over time. The included studies were aimed at improving cognition or minimizing of cognitive decline. Studies reviewed included assessments of dietary status using either a food frequency questionnaire or a food diary assessment. Eighteen articles meeting our inclusion criteria were subjected to systematic review. These revealed that higher adherence to a MedDiet is associated with slower rates of cognitive decline, reduced conversion to Alzheimer’s disease, and improvements in cognitive function. The specific cognitive domains that were found to benefit with improved Mediterranean Diet Score were memory (delayed recognition, long-term, and working memory), executive function, and visual constructs. The current review has also considered a number of methodological issues in making recommendations for future research. The utilization of a dietary pattern, such as the MedDiet, will be essential as part of the armamentarium to maintain quality of life and reduce the potential social and economic burden of dementia. PMID:27500135

  13. A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis.

    PubMed

    Barr, Andrew J; Campbell, T Mark; Hopkinson, Devan; Kingsbury, Sarah R; Bowes, Mike A; Conaghan, Philip G

    2015-08-25

    Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. PROSPERO registration number: CRD 42013005009.

  14. Collision-induced stimulated photon echoes in ‘strong’ magnetic field

    NASA Astrophysics Data System (ADS)

    Reshetov, V. A.

    2018-05-01

    Collision-induced stimulated photon echoes formed in a gaseous medium on the transition with the angular momentum change Ja=0 → Jb=1 under the action of ‘strong’ longitudinal magnetic field, when the echo pulse becomes unpolarized, are considered with an account of elastic depolarizing collisions. In the case of narrow spectral line the explicit expressions for the echo polarization density matrix and the degree of polarization are obtained. In the case of broad spectral line the results of the numeric calculations reproduce qualitatively the curve obtained in the experiments with ytterbium vapor.

  15. The first year of practice: an investigation of the professional learning and development of promising novice physical therapists.

    PubMed

    Black, Lisa L; Jensen, Gail M; Mostrom, Elizabeth; Perkins, Jan; Ritzline, Pamela D; Hayward, Lorna; Blackmer, Betsy

    2010-12-01

    The goal in studying expertise is not merely to describe ways in which experts excel but also to understand how experts develop in order to better facilitate the development of novices. The study of novice progression helps us to understand what successful versus unsuccessful learning looks like. This understanding is critical, as autonomous practice places increased demands for advanced clinical judgments and the ability to assume professional responsibilities. The purpose of this study was to explore the experiences, learning, and development of promising novice therapists throughout their first year of practice in the United States. A longitudinal, multiple-site qualitative case study method was used for within-case and across-case analysis. A purposive sample of 11 promising new graduates from 4 physical therapist education programs participated. Investigators followed the graduates throughout their first year of practice. Data sources included: (1) semistructured interviews conducted at baseline and every 3 months thereafter for 1 year, (2) reflective journals completed at regular intervals, and (3) review of academic and clinical education records and résumés. Four themes emerged: (1) the clinical environment influenced the novice physical therapists' performance, (2) participants learned through experience and social interaction and learning was primarily directed toward self, (3) growing confidence was directly related to developing communication skills, and (4) therapists were engaged in professional identity formation and role transitions. The findings suggest there are common experiences and themes that emerge as novice physical therapists develop. Although research has been conducted on expertise in physical therapy, few longitudinal investigations have explored the development of therapists across transitions from graduate to novice to expert practitioner. This study explored and described the learning and development of graduates during their first year of practice.

  16. Academic Performance of Language-Minority Students and All-Day Kindergarten: A Longitudinal Study

    ERIC Educational Resources Information Center

    Chang, Mido

    2012-01-01

    This longitudinal study examined the effect of all-day kindergarten programs on the academic achievement of students from racial language minority and low socioeconomic class. The study employed a series of 3-level longitudinal multilevel analyses using a nationally representative database, the Early Childhood Longitudinal Study (ECLS). The study…

  17. Non-linear theory of a cavitated plasma wake in a plasma channel for special applications and control

    NASA Astrophysics Data System (ADS)

    Thomas, Johannes; Kostyukov, Igor Yu.; Pronold, Jari; Golovanov, Anton; Pukhov, Alexander

    2016-05-01

    We introduce a complete semi-analytical model for a cavitated electron wake driven by an electron beam in a radially inhomogeneous plasma. The electron response to the driver, dynamics of electrons in a thin sheath surrounding the cavity, as well as accelerating and focusing fields inside the cavity are calculated in the quasistatic approximation. Our theory holds for arbitrary radial density profiles and reduces to known models in the limit of a homogeneous plasma. A free-propagating blow-out in an evacuated channel experiences longitudinal squeezing, qualitatively the same as observed in particle-in-cell simulations for the laser pulse-driven case [Pukhov et al., Phys. Rev. Lett. 113, 245003 (2014)]. Our model also permits qualitative interpretation of the earlier observed cancellation of the focusing gradient in the cavity [Pukhov et al., Phys. Rev. Lett. 113, 245003 (2014)]. In this work, we show the underlying mechanism that causes the radial fields in the vacuum part of a channel to become defocussing.

  18. Becoming "Undetectable": Longitudinal Narratives of Gay Men's Sex Lives After a Recent HIV Diagnosis.

    PubMed

    Grace, Daniel; Chown, Sarah A; Kwag, Michael; Steinberg, Malcolm; Lim, Elgin; Gilbert, Mark

    2015-08-01

    We explore gay men's sex life narratives following their diagnosis with an acute or recent HIV infection. All participants received an acute (n = 13) or recent (n = 12) HIV diagnosis and completed a series of self-administered questionnaires and in-depth qualitative interviews over a one-year period or longer. Over the course of four qualitative interviews, participants frequently spoke of the role of medications (e.g., decisions to start treatment) and changing viral loads (e.g., discourses of becoming "undetectable") in relation to their sex lives since being diagnosed with HIV. Many men talked about milestones relating to initiating medication and viral load as informing their shifting sexual behaviors and identities as HIV-positive--or "undetectable"--gay men. The narratives of our participants provide insight regarding complex negotiations and processes of decision-making over time related to sex, counseling needs, treatment initiation, viral load, and the significance of undetectability as an emergent identity.

  19. Cervical vertebral maturation as a biologic indicator of skeletal maturity.

    PubMed

    Santiago, Rodrigo César; de Miranda Costa, Luiz Felipe; Vitral, Robert Willer Farinazzo; Fraga, Marcelo Reis; Bolognese, Ana Maria; Maia, Lucianne Cople

    2012-11-01

    To identify and review the literature regarding the reliability of cervical vertebrae maturation (CVM) staging to predict the pubertal spurt. The selection criteria included cross-sectional and longitudinal descriptive studies in humans that evaluated qualitatively or quantitatively the accuracy and reproducibility of the CVM method on lateral cephalometric radiographs, as well as the correlation with a standard method established by hand-wrist radiographs. The searches retrieved 343 unique citations. Twenty-three studies met the inclusion criteria. Six articles had moderate to high scores, while 17 of 23 had low scores. Analysis also showed a moderate to high statistically significant correlation between CVM and hand-wrist maturation methods. There was a moderate to high reproducibility of the CVM method, and only one specific study investigated the accuracy of the CVM index in detecting peak pubertal growth. This systematic review has shown that the studies on CVM method for radiographic assessment of skeletal maturation stages suffer from serious methodological failures. Better-designed studies with adequate accuracy, reproducibility, and correlation analysis, including studies with appropriate sensitivity-specificity analysis, should be performed.

  20. This corrosion: A systematic review of the association between alternative subcultures and the risk of self-harm and suicide.

    PubMed

    Hughes, Mairead Ann; Knowles, Susan Frances; Dhingra, Katie; Nicholson, Hannah Louise; Taylor, Peter James

    2018-03-25

    Rates of self-harm and suicide are increasing in young people. The literature suggests that individuals who identify with alternative subcultures (e.g., Goth) may be at a greater risk. To explore the prevalence of self-harm and suicide in alternative subcultures and the factors that might contribute to this increased risk. Using a systematic strategy, the databases PsycINFO, Scopus, MEDLINE and Web of Science, and the E-Thesis online service (ETHOS) were searched for English language only papers, with no restrictions in terms of date of publication. Papers were selected that included data on the relationship between either alternative subculture identity (e.g., Goth) or preference for alternative music (e.g., Heavy Metal) and self-harm or suicide. Ten quantitative papers were included: seven cross-sectional, two longitudinal and one cross-sectional state-level comparison study. Two qualitative papers were also included. Studies were assessed by two reviewers for risk of bias. The findings indicated that individuals who associated with alternative subcultures were at a greater risk of self-harm and suicide. Whilst qualitative papers identified potential mechanisms (e.g., exposure to self-harm and the way self-harm is presented or normalized), there remains limited support for these mechanisms. More research is required to understand the association between self-harm, suicide and alternative subculture affiliation, and the factors underlying it. Longitudinal studies and studies focusing on mechanism are particularly important. The review supports the suggestion that those who identify as belonging to an alternative subculture may be at a higher risk of self-harm and suicidal behaviour. It also presents preliminary evidence that alternative affiliation predicts self-harm over time, and that this effect holds whilst adjusting for a number of likely confounders. The findings highlight the importance of increasing the awareness of the victimization and potential risk that these groups hold and suggests areas for intervention in health, educational, and social services. The review does not, however, indicate specifically what it is about alternative subculture affiliation (or alternative music preference) that could contribute to the risk of self-harm. Consequently, studies with a greater focus on mechanisms are needed. Methodological limitations (e.g., cross-sectional studies, small sample of 'alternative' participants, westernized samples) restricted the reliability and validity of the results which impacted on the extent to which the findings could be generalized more widely. © 2018 The British Psychological Society.

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