Fostering the development of effective person-centered healthcare communication skills: an interprofessional shared learning model.

PubMed

Cavanaugh, James T; Konrad, Shelley Cohen

2012-01-01

To describe the implementation of an interprofessional shared learning model designed to promote the development of person-centered healthcare communication skills. Master of social work (MSW) and doctor of physical therapy (DPT) degree students. The model used evidence-based principles of effective healthcare communication and shared learning methods; it was aligned with student learning outcomes contained in MSW and DPT curricula. Students engaged in 3 learning sessions over 2 days. Sessions involved interactive reflective learning, simulated role-modeling with peer assessment, and context-specific practice of communication skills. The perspective of patients/clients was included in each learning activity. Activities were evaluated through narrative feedback. Students valued opportunities to learn directly from each other and from healthcare consumers. Important insights and directions for future interprofessional learning experiences were gleaned from model implementation. The interprofessional shared learning model shows promise as an effective method for developing person-centered communication skills.

Developing person-centred practice in hip fracture care for older people.

PubMed

Christie, Jane; Macmillan, Maureen; Currie, Colin; Matthews-Smith, Gerardine

2016-12-14

To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

Privacy Practices of Health Social Networking Sites: Implications for Privacy and Data Security in Online Cancer Communities.

PubMed

Charbonneau, Deborah H

2016-08-01

While online communities for social support continue to grow, little is known about the state of privacy practices of health social networking sites. This article reports on a structured content analysis of privacy policies and disclosure practices for 25 online ovarian cancer communities. All of the health social networking sites in the study sample provided privacy statements to users, yet privacy practices varied considerably across the sites. The majority of sites informed users that personal information was collected about participants and shared with third parties (96%, n = 24). Furthermore, more than half of the sites (56%, n = 14) stated that cookies technology was used to track user behaviors. Despite these disclosures, only 36% (n = 9) offered opt-out choices for sharing data with third parties. In addition, very few of the sites (28%, n = 7) allowed individuals to delete their personal information. Discussions about specific security measures used to protect personal information were largely missing. Implications for privacy, confidentiality, consumer choice, and data safety in online environments are discussed. Overall, nurses and other health professionals can utilize these findings to encourage individuals seeking online support and participating in social networking sites to build awareness of privacy risks to better protect their personal health information in the digital age.

Negotiating the transition between different teaching contexts through shared responsibility and shared reflection

NASA Astrophysics Data System (ADS)

Beers, Jennifer S.

2009-06-01

This paper draws on my personal experiences with coteaching and my participation in the research described by Wassell and LaVan (2009). It examines the role of coteaching in the development of structures that afforded opportunities for shared reflection and shared responsibility between stakeholders in the classroom. It also describes how the schema and practices developed through coteaching and cogenerative dialogue helped mediate the transition between my preservice and inservice teaching experiences.

Shared decision making in endocrinology: present and future directions.

PubMed

Rodriguez-Gutierrez, Rene; Gionfriddo, Michael R; Ospina, Naykky Singh; Maraka, Spyridoula; Tamhane, Shrikant; Montori, Victor M; Brito, Juan P

2016-08-01

In medicine and endocrinology, there are few clinical circumstances in which clinicians can accurately predict what is best for their patients. As a result, patients and clinicians frequently have to make decisions about which there is uncertainty. Uncertainty results from limitations in the research evidence, unclear patient preferences, or an inability to predict how treatments will fit into patients' daily lives. The work that patients and clinicians do together to address the patient's situation and engage in a deliberative dialogue about reasonable treatment options is often called shared decision making. Decision aids are evidence-based tools that facilitate this process. Shared decision making is a patient-centred approach in which clinicians share information about the benefits, harms, and burden of different reasonable diagnostic and treatment options, and patients explain what matters to them in view of their particular values, preferences, and personal context. Beyond the ethical argument in support of this approach, decision aids have been shown to improve patients' knowledge about the available options, accuracy of risk estimates, and decisional comfort. Decision aids also promote patient participation in the decision-making process. Despite accumulating evidence from clinical trials, policy support, and expert recommendations in endocrinology practice guidelines, shared decision making is still not routinely implemented in endocrine practice. Additional work is needed to enrich the number of available tools and to implement them in practice workflows. Also, although the evidence from randomised controlled trials favours the use of this shared decision making in other settings, populations, and illnesses, the effect of this approach has been studied in a few endocrine disorders. Future pragmatic trials are needed to explore the effect and feasibility of shared decision making implementation into routine endocrinology and primary care practice. With the available evidence, however, endocrinologists can now start to practice shared decision making, partner with their patients, and use their expertise to formulate treatment plans that reflect patient preferences and are more likely to fit into the context of patients' lives. In this Personal View, we describe shared decision making, the evidence behind the approach, and why and how both endocrinologists and their patients could benefit from this approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reputation management on facebook: awareness is key to protecting yourself, your practice, and the veterinary profession.

PubMed

Weijs, Cynthia A; Coe, Jason B; Muise, Amy; Christofides, Emily; Desmarais, Serge

2014-01-01

From the Social media use by health professionals occurs in a digital environment where etiquette has yet to be solidly defined. The objectives of this study were to explore veterinarians' personal use of Facebook, knowledge of privacy settings, and factors related to sharing personal information online. All American Animal Hospital Association member veterinarians with a valid e-mail address (9469) were invited to complete an online survey about Facebook (e.g., time spent on Facebook, awareness of consequences, types of information posted). Questions assessing personality dimensions including trust, popularity, self-esteem and professional identity were included. The response rate was 17% (1594 of 9469); 72% of respondents (1148 of 1594) had a personal Facebook profile. Veterinarians were more likely to share information on Facebook than they would in general. Trust, need for popularity, and more time spent on Facebook predicted more disclosure of personal information on Facebook. Awareness of consequences and increased veterinary experience predicted lesser disclosure. As veterinary practices use Facebook to improve client services, they need also to manage risks associated with online disclosure by staff. Raising awareness of reputation management and consequences of posting certain types of information to Facebook is integral to protecting the individual, the practice, and the veterinary profession.

Introduction to Positive Psychology in Rehabilitation

ERIC Educational Resources Information Center

Chou, Chih-Chin; Chan, Fong; Phillips, Brian; Chan, Jacob Yui Chung

2013-01-01

Positive psychology has received increasing attention in rehabilitation counseling research and practice. The rehabilitation counseling philosophy shares a similar emphasis of personal assets and strengths, which provides a solid foundation for the integration of positive psychology into the professional practice of rehabilitation counseling. In…

7 CFR 1468.22 - Conservation practice operation and maintenance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... operation and maintenance is occurring. (b) For those persons who are signatories to existing CRP or EQIP contracts, or WRP cost-share agreements, practices will be transferred from EQIP and CRP contracts or WRP... rights and obligations under CRP, EQIP, or WRP will be incorporated into the new CFO contract. Practices...

Thai EFL Online Diaries: Literacy Practice and Self-Expression

ERIC Educational Resources Information Center

Meechai, Jiraporn

2010-01-01

This dissertation aims to expand the definition of literacy beyond its usual text and school-based practice. It studies the online diary as a sociocultural and literacy practice that allows people from various languages and cultures to share their personal experiences and values. The participants are five Thai English as foreign language (EFL)…

Teachers from Five Nations Share Perspectives on Culture and Citizenship

ERIC Educational Resources Information Center

Sunal, Cynthia Szymanski; Christensen, Lois McFadyen; Shwery, Craig S.; Lovorn, Michael; Sunal, Dennis W.

2010-01-01

Online discussions enabled preK-12 teachers (n = 125) from five nations (Brazil, Colombia, Ecuador, Paraguay, and the United States) to share their perspectives of culture and citizenship and the intersections of those concepts. Discussion moved between elements of personal and others' theory into effects of theory on practice. Teachers identified…

Imagining the “open” university: Sharing scholarship to improve research and education

PubMed Central

2017-01-01

Open scholarship, such as the sharing of articles, code, data, and educational resources, has the potential to improve university research and education as well as increase the impact universities can have beyond their own walls. To support this perspective, I present evidence from case studies, published literature, and personal experiences as a practicing open scholar. I describe some of the challenges inherent to practicing open scholarship and some of the tensions created by incompatibilities between institutional policies and personal practice. To address this, I propose several concrete actions universities could take to support open scholarship and outline ways in which such initiatives could benefit the public as well as institutions. Importantly, I do not think most of these actions would require new funding but rather a redistribution of existing funds and a rewriting of internal policies to better align with university missions of knowledge dissemination and societal impact. PMID:29065148

Meaningful Professional Development: A Personal Journey

ERIC Educational Resources Information Center

Shore, Rebecca Ann

2012-01-01

This article shares a personal story of the evolution of professional development in practice in K-12 schools from three states over a 30 year period. The article begins with reference to general subject area life awarded teaching credentials and concludes with the addition of language addressing prekindergarten, specifically the inclusion of…

Initiating and utilizing shared leadership in teams: The role of leader humility, team proactive personality, and team performance capability.

PubMed

Chiu, Chia-Yen Chad; Owens, Bradley P; Tesluk, Paul E

2016-12-01

The present study was designed to produce novel theoretical insight regarding how leader humility and team member characteristics foster the conditions that promote shared leadership and when shared leadership relates to team effectiveness. Drawing on social information processing theory and adaptive leadership theory, we propose that leader humility facilitates shared leadership by promoting leadership-claiming and leadership-granting interactions among team members. We also apply dominance complementary theory to propose that team proactive personality strengthens the impact of leader humility on shared leadership. Finally, we predict that shared leadership will be most strongly related to team performance when team members have high levels of task-related competence. Using a sample composed of 62 Taiwanese professional work teams, we find support for our proposed hypothesized model. The theoretical and practical implications of these results for team leadership, humility, team composition, and shared leadership are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

48 CFR 3.301 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PRACTICES AND PERSONAL CONFLICTS OF INTEREST Reports of Suspected Antitrust Violations 3.301 General. (a..., and sharing of the business. (b) Contracting personnel are an important potential source of...

Attitudes of research participants and the general public towards genomic data sharing: a systematic literature review.

PubMed

Shabani, Mahsa; Bezuidenhout, Louise; Borry, Pascal

2014-11-01

Introducing data sharing practices into the genomic research arena has challenged the current mechanisms established to protect rights of individuals and triggered policy considerations. To inform such policy deliberations, soliciting public and research participants' attitudes with respect to genomic data sharing is a necessity. The main electronic databases were searched in order to retrieve empirical studies, investigating the attitudes of research participants and the public towards genomic data sharing through public databases. In the 15 included studies, participants' attitudes towards genomic data sharing revealed the influence of a constellation of interrelated factors, including the personal perceptions of controllability and sensitivity of data, potential risks and benefits of data sharing at individual and social level and also governance level considerations. This analysis indicates that future policy responses and recruitment practices should be attentive to a wide variety of concerns in order to promote both responsible and progressive research.

Participatory design facilitates Person Centred Nursing in service improvement with older people: a secondary directed content analysis.

PubMed

Wolstenholme, Daniel; Ross, Helen; Cobb, Mark; Bowen, Simon

2017-05-01

To explore, using the example of a project working with older people in an outpatient setting in a large UK NHS Teaching hospital, how the constructs of Person Centred Nursing are reflected in interviews from participants in a Co-design led service improvement project. Person Centred Care and Person Centred Nursing are recognised terms in healthcare. Co-design (sometimes called participatory design) is an approach that seeks to involve all stakeholders in a creative process to deliver the best result, be this a product, technology or in this case a service. Co-design practice shares some of the underpinning philosophy of Person Centred Nursing and potentially has methods to aid in Person Centred Nursing implementation. The research design was a qualitative secondary Directed analysis. Seven interview transcripts from nurses and older people who had participated in a Co-design led improvement project in a large teaching hospital were transcribed and analysed. Two researchers analysed the transcripts for codes derived from McCormack & McCance's Person Centred Nursing Framework. The four most expressed codes were as follows: from the pre-requisites: knowing self; from care processes, engagement, working with patient's beliefs and values and shared Decision-making; and from Expected outcomes, involvement in care. This study describes the Co-design theory and practice that the participants responded to in the interviews and look at how the co-design activity facilitated elements of the Person Centred Nursing framework. This study adds to the rich literature about using emancipatory and transformational approaches to Person Centred Nursing development, and is the first study exploring explicitly the potential contribution of Co-design to this area. Methods from Co-design allow older people to contribute as equals in a practice development project, co-design methods can facilitate nursing staff to engage meaningfully with older participants and develop a shared understanding and goals. The co-produced outputs of Co-design projects embody and value the expressed beliefs and values of staff and older people. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Using personal narrative to deepen emotional awareness of practice.

PubMed

Edwards, Sharon L

2014-08-19

Storytelling is intrinsic to human beings, and stories can explain events, stances taken and actions engaged in. When experience is represented as story it can become more organised and be used for analysis, critique and learning. Experience is important in nursing, as it is in many other practice-based professions, and it can contribute much to nurses' learning. Through a process of sharing and engaging with the author's personal stories, this article encourages nurses to begin to organise their own experiences in story form for use in learning and as part of their personal and professional development.

Creating the Grateful School in Four Phases

ERIC Educational Resources Information Center

Griffith, Owen M.

2018-01-01

Author and educator Owen Griffith shares how leaders can infuse small acts of gratitude to energize their schools and create a positive, thriving culture. Leaders must begin by practicing gratitude personally, then slowly introducing the practice to their faculty and eventually students. With the right attitude and creativity, the acts of…

Seeking and Collecting at Home: Sharing Personal Histories in the Art Room

ERIC Educational Resources Information Center

Bey, Sharif

2012-01-01

Collecting and placing images/objects of inspiration and personal significance is not an uncommon practice for studio artists. Washington based mixed-media/installation artist Renee Stout draws from the collections she displays in her studio and in her home. She is an avid collector of various objects, including vintage perfumes, West African…

The Best Practices for Shaping School Culture for Instructional Leaders

ERIC Educational Resources Information Center

Lewis, Jennifer; Asberry, Jacqueline; DeJarnett, Gregory; King, Gwendolyn

2016-01-01

School culture is the belief and attitude influencing every aspect of how a school functions. Culture shared by all school stakeholders makes the actualization of both short-and long-term objectives easier. In this context, the best practices for shaping school culture for professional educators are personal mastery, team learning, and building a…

Pathway to "Knowing Places"--and Ecojustice--Three Teacher Educators' Experiences

ERIC Educational Resources Information Center

Paige, Kathryn; Lloyd, David; Smith, Richard

2016-01-01

The case study reported here seeks to promote the sharing of successful practice in Education for Sustainability (EfS). It uses literature and three personal and professional autobiographies as background to the development of a set of sustainability educational practices integrated into a primary/middle school teacher education program. The set…

When Personal Tracking Becomes Social: Examining the Use of Instagram for Healthy Eating.

PubMed

Chung, Chia-Fang; Agapie, Elena; Schroeder, Jessica; Mishra, Sonali; Fogarty, James; Munson, Sean A

2017-05-02

Many people appropriate social media and online communities in their pursuit of personal health goals, such as healthy eating or increased physical activity. However, people struggle with impression management, and with reaching the right audiences when they share health information on these platforms. Instagram, a popular photo-based social media platform, has attracted many people who post and share their food photos. We aim to inform the design of tools to support healthy behaviors by understanding how people appropriate Instagram to track and share food data, the benefits they obtain from doing so, and the challenges they encounter. We interviewed 16 women who consistently record and share what they eat on Instagram. Participants tracked to support themselves and others in their pursuit of healthy eating goals. They sought social support for their own tracking and healthy behaviors and strove to provide that support for others. People adapted their personal tracking practices to better receive and give this support. Applying these results to the design of health tracking tools has the potential to help people better access social support.

When Personal Tracking Becomes Social: Examining the Use of Instagram for Healthy Eating

PubMed Central

Chung, Chia-Fang; Agapie, Elena; Schroeder, Jessica; Mishra, Sonali; Fogarty, James; Munson, Sean A.

2017-01-01

Many people appropriate social media and online communities in their pursuit of personal health goals, such as healthy eating or increased physical activity. However, people struggle with impression management, and with reaching the right audiences when they share health information on these platforms. Instagram, a popular photo-based social media platform, has attracted many people who post and share their food photos. We aim to inform the design of tools to support healthy behaviors by understanding how people appropriate Instagram to track and share food data, the benefits they obtain from doing so, and the challenges they encounter. We interviewed 16 women who consistently record and share what they eat on Instagram. Participants tracked to support themselves and others in their pursuit of healthy eating goals. They sought social support for their own tracking and healthy behaviors and strove to provide that support for others. People adapted their personal tracking practices to better receive and give this support. Applying these results to the design of health tracking tools has the potential to help people better access social support. PMID:28516174

Preventing Unintended Disclosure of Personally Identifiable Data Following Anonymisation.

PubMed

Smith, Chris

2017-01-01

Errors and anomalies during the capture and processing of health data have the potential to place personally identifiable values into attributes of a dataset that are expected to contain non-identifiable values. Anonymisation focuses on those attributes that have been judged to enable identification of individuals. Attributes that are judged to contain non-identifiable values are not considered, but may be included in datasets that are shared by organisations. Consequently, organisations are at risk of sharing datasets that unintendedly disclose personally identifiable values through these attributes. This would have ethical and legal implications for organisations and privacy implications for individuals whose personally identifiable values are disclosed. In this paper, we formulate the problem of unintended disclosure following anonymisation, describe the necessary steps to address this problem, and discuss some key challenges to applying these steps in practice.

Thinking together: What makes Communities of Practice work?

PubMed Central

Pyrko, Igor; Dörfler, Viktor; Eden, Colin

2016-01-01

In this article, we develop the founding elements of the concept of Communities of Practice by elaborating on the learning processes happening at the heart of such communities. In particular, we provide a consistent perspective on the notions of knowledge, knowing and knowledge sharing that is compatible with the essence of this concept – that learning entails an investment of identity and a social formation of a person. We do so by drawing richly from the work of Michael Polanyi and his conception of personal knowledge, and thereby we clarify the scope of Communities of Practice and offer a number of new insights into how to make such social structures perform well in professional settings. The conceptual discussion is substantiated by findings of a qualitative empirical study in the UK National Health Service. As a result, the process of ‘thinking together’ is conceptualized as a key part of meaningful Communities of Practice where people mutually guide each other through their understandings of the same problems in their area of mutual interest, and this way indirectly share tacit knowledge. The collaborative learning process of ‘thinking together’, we argue, is what essentially brings Communities of Practice to life and not the other way round. PMID:28232754

The (im)possibilities of returning to work after a stroke.

PubMed

Norstedt, Maria

2017-01-01

What a stroke means for working-age persons has not been sufficiently studied from a sociological perspective. This article uses the empirical material of a larger study to describe and analyze how institutional practices and discourses influence attempts to return to work after a stroke. Semi-structured interviews were conducted with ten persons who have had a stroke and ten civil servants and professionals from the Swedish Public Employment Service, the Social Insurance Agency, and different health care institutions. The qualitative analysis was inspired by institutional ethnography. The analysis shows how persons who have had a stroke and civil servants and professionals in welfare organizations share the same goal: a return to working life for the former. The persons in this study related to, translated, and put into practice discourses of normality and employability in this process. However, there were, at times, conflicting institutional practices between the different organizations. Conflicting institutional practices connected to the discourses of normality and employability contribute to the difficulties that persons who have had a stroke face when trying to return to work after recovery.

A Study to Determine the Most Popular Lifestyle Smartphone Applications and Willingness of the Public to Share Their Personal Data for Health Research.

PubMed

Chen, Juliana; Bauman, Adrian; Allman-Farinelli, Margaret

2016-08-01

Smartphone lifestyle applications (apps) and wearable fitness-tracking devices collect a wealth of data that could provide research insights to support prevention and treatment of obesity and chronic diseases. The aim of this study was to pilot a survey to explore patterns of behavioral tracking using smartphone lifestyle apps and individuals' willingness to share their app-generated data. A cross-sectional Web-based survey was conducted within a university setting. The 35-item survey asked participants about their self-tracking patterns; use of lifestyle apps and wearable devices; how their self-tracked health data could be useful to them; and any restrictions they would impose on sharing personal data. Responses were tabulated and analyzed for trends. The survey was completed by 101 participants. On average, 3.1 (standard deviation [SD] ±1.9) health and fitness apps were installed by current app users (n = 85), with MyFitnessPal, MapMyRun, Nike+, and Fitbit being most popular. Most participants were willing to share their personal health data for research (77%). Those who did not normally share their health-tracking data were more likely than sharers to be concerned about privacy (odds ratio [OR] = 5.93; 95% confidence interval [95% CI] = 2.09-16.78), as were those not identifying with the quantified-self movement compared with those who were (OR = 5.04; 95% CI = 1.64-15.50). Participants were generally willing to share personal data, thus increasing the potential for these data to inform public health research and for use in targeted personalized program and intervention development. Opportunities for partnerships between researchers and commercial app developers or industry could improve public health research and practice.

Whither Rural Education?

ERIC Educational Resources Information Center

Willey, Darrell S.

1981-01-01

Rural education may be entering a renaissance after 60 years of neglect. Improvements include: multidistrict shared services with special attention given to exceptional persons; new delivery systems; more relevant training for school personnel; and effective dissemination of successfully established school practices. (CJ)

The practice of evidence-based medicine involves the care of whole persons.

PubMed

Richardson, W Scott

2017-04-01

In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared. Both clinicians and patients can bring knowledge from several sources into the shared decision making process in the clinical encounter, including evidence from clinical care research. I thank Dr. Fava for expressing legitimate doubts and providing useful criticism, yet I am cautiously optimistic that the model of EBM described here is robust enough to meet the challenges and is not doomed to fail. Copyright © 2017 Elsevier Inc. All rights reserved.

Barriers and enablers to good communication and information-sharing practices in care planning for chronic condition management.

PubMed

Lawn, Sharon; Delany, Toni; Sweet, Linda; Battersby, Malcolm; Skinner, Timothy

2015-01-01

Our aim was to document current communication and information-sharing practices and to identify the barriers and enablers to good practices within the context of care planning for chronic condition management. Further aims were to make recommendations about how changes to policy and practice can improve communication and information sharing in primary health care. A mixed-method approach was applied to seek the perspectives of patients and primary health-care workers across Australia. Data was collected via interviews, focus groups, non-participant observations and a national survey. Data analysis was performed using a mix of thematic, discourse and statistical approaches. Central barriers to effective communication and information sharing included fragmented communication, uncertainty around client and interagency consent, and the unacknowledged existence of overlapping care plans. To be most effective, communication and information sharing should be open, two-way and inclusive of all members of health-care teams. It must also only be undertaken with the appropriate participant consent, otherwise this has the potential to cause patients harm. Improvements in care planning as a communication and information-sharing tool may be achieved through practice initiatives that reflect the rhetoric of collaborative person-centred care, which is already supported through existing policy in Australia. General practitioners and other primary care providers should operationalise care planning, and the expectation of collaborative and effective communication of care that underpins it, within their practice with patients and all members of the care team. To assist in meeting these aims, we make several recommendations.

Stepping across the line: information sharing, truth telling, and the role of the personal carer in the Australian nursing home.

PubMed

Tuckett, Anthony G

2007-04-01

The author draws on an Australian study using multiple qualitative methods to investigate truth telling in aged care. Thematic analysis of data from five nursing homes involving 23 personal care assistants revealed participants' role understanding as influencing their perceptions about truth telling in practice. Five themes emerged: role as the happy comfort carer, division of labor, division of disclosure, role tension and frustration, and managing the division of disclosure. Role emphasis on comfort and happiness and a dominant perception that telling the truth can cause harm mean that disclosure will be withheld, edited, or partial. Participants'role understanding divides labor and disclosure responsibility between the personal carer and registered nurse. Personal carers' strategies for managing the division of disclosure include game playing, obfuscation, lying (denial), and the use of nonverbals. These perceptions about personal carer role, information sharing, and truth telling are paramount for understanding and improving nursing home eldercare.

Human Non-persons, Feticide, and the Erosion of Dignity

PubMed Central

2010-01-01

Feticide, the practice of terminating the life of an otherwise viable fetus in utero, has become an increasingly common practice in obstetric centres around the globe, a concomitant of antenatal screening technologies. This paper examines this expanding practice in light of the concept of human dignity. Although it is assumed from the outset that even viable human fetuses are not persons and as such do not enjoy full membership in the moral community, it is argued that the fact that these are nevertheless human fetuses affords them prima facie moral status. Thus even those who accept a liberal position with regard to therapeutic abortion, should be concerned about these more recent developments. Indeed, how we treat viable human fetuses has implications for our prospective treatment of other human non-persons and could undermine the common human dignity we all share. PMID:21212811

Translating change: the development of a person-centred triage training programme for emergency nurses.

PubMed

McBrien, Barry

2009-01-01

Within health care, there has been a change in practice from an illness-orientated service to one that is more health-focused and person-centred. The concept of person-centredness is frequently espoused by practitioners as being not only a desirable, but a necessary element of health care provision. Indeed, nationally and internationally, person-centred care has underpinned many healthcare documents and policies. Person-centred practice focuses on providing care, utilising a variety of processes that operationalise person-centred nursing and include working with patients' beliefs and values, engagement, presence, sharing decision-making and providing for physical needs. In the field of emergency nursing, the incorporation of person-centred care and its holistic foundation may require a significant shift in practice. There is evidence to suggest that emergency nurses view their role as one, which is predominantly concerned with providing urgent physical care, rather than one, which espouses the theories of holistic healthcare. To this extent, being person-centred in the context of emergency care, requires the nurse to move beyond the traditional notions of his/her role and to embrace the more holistic aspects of patient care. The aim of this article is to critically analyse how a change in nurse-led triage training in one Irish Emergency Department facilitated an improved person-centred approach in practice.

Elaboration of the Gothenburg model of person-centred care.

PubMed

Britten, Nicky; Moore, Lucy; Lydahl, Doris; Naldemirci, Oncel; Elam, Mark; Wolf, Axel

2017-06-01

Person-centred care (PCC) is increasingly advocated as a new way of delivering health care, but there is little evidence that it is widely practised. The University of Gothenburg Centre for Person-Centred Care (GPCC) was set up in 2010 to develop and implement person-centred care in clinical practice on the basis of three routines. These routines are based on eliciting the patient's narrative to initiate a partnership; working the partnership to achieve commonly agreed goals; and using documentation to safeguard the partnership and record the person's narrative and shared goals. In this paper, we aimed to explore professionals' understanding of PCC routines as they implement the GPCC model in a range of different settings. We conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects. Interviewees' accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships. This study illustrates what is needed for health-care professionals to implement PCC in everyday practice: the recognition of the person is as important as the specific practical routines. Interviewees described the need to change the clinical mindset and to develop the ways of integrating people's narratives with clinical practice. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Knowledge into action - supporting the implementation of evidence into practice in Scotland.

PubMed

Davies, Sandra; Herbert, Paul; Wales, Ann; Ritchie, Karen; Wilson, Suzanne; Dobie, Laura; Thain, Annette

2017-03-01

The knowledge into action model for NHS Scotland provides a framework for librarians and health care staff to support getting evidence into practice. Central to this model is the development of a network of knowledge brokers to facilitate identification, use, creation and sharing of knowledge. To translate the concepts described in the model into tangible activities with the intention of supporting better use of evidence in health care and subsequently improving patient outcomes. Four areas of activity were addressed by small working groups comprising knowledge services staff in local and national boards. The areas of activity were as follows: defining existing and required capabilities and developing learning opportunities for the knowledge broker network; establishing national search and summarising services; developing actionable knowledge tools; and supporting person-to-person knowledge sharing. This work presents the development of practical tools and support to translate a conceptual model for getting knowledge into action into a series of activities and outputs to support better use of evidence in health care and subsequently improved patient outcomes. © 2017 Health Libraries Group.

Hospital-based group: ideal practice for the future?

PubMed

Matloff, J M; Denton, T A

1995-11-01

The format for future cardiothoracic surgical practices includes the option of a hospital-based group where provider groups and the hospital share the responsibilities and obligations of clinical care and the cost of that care. Based on personal experience at the Cedars-Sinai Medical Center, Los Angeles, three separate contract relationships during our tenure have reflected the evolution of cardiothoracic surgeons' relationship to our patients and the hospital in which we work. Although other organizational modes may prove equally successful, the hospital-based group practice is a viable structure that supports the preservation of quality in the work performed. This relationship helps to maintain a steady volume of patients enabling research endeavors, which are primarily funded through practice incomes, to continue and it also provides a platform for networking with defined patient referrals, shared services, and bench-marking with other centers.

Approaching confidentiality at a familial level in genomic medicine: a focus group study with healthcare professionals

PubMed Central

Dheensa, Sandi; Fenwick, Angela; Lucassen, Anneke

2017-01-01

Objectives Clinical genetics guidelines from 2011 conceptualise genetic information as confidential to families, not individuals. The normative consequence of this is that the family's interest is the primary consideration and genetic information is shared unless there are good reasons not to do so. We investigated healthcare professionals' (HCPs') views about, and reasoning around, individual and familial approaches to confidentiality and how such views influenced their practice. Method 16 focus groups with 80 HCPs working in/with clinical genetics services were analysed, drawing on grounded theory. Results Participants raised seven problems with, and arguments against, going beyond the individual approach to confidentiality. These problems fell into two overlapping categories: ‘relationships’ and ‘structures’. Most participants had never considered ways to—or thought it was impossible to—treat familial genetic information and personal information differently. They worried that putting the familial approach into practice could disrupt family dynamics and erode patient trust in the health service. They also thought they had insufficient resources to share information and feared that sharing might change the standard of care and make them more vulnerable to liability. Conclusions A familial approach to confidentiality has not been accepted or adopted as a standard, but wider research suggests that some of the problems HCPs perceived are surmountable and sharing in the interest of the family can be achieved. However, further research is needed to explore how personal and familial genetic information can be separated in practice. Our findings are relevant to HCPs across health services who are starting to use genome tests as part of their routine investigations. PMID:28159847

User Expectations for Media Sharing Practices in Open Display Networks

PubMed Central

Jose, Rui; Cardoso, Jorge C. S.; Hong, Jason

2015-01-01

Open Display Networks have the potential to allow many content creators to publish their media to an open-ended set of screen displays. However, this raises the issue of how to match that content to the right displays. In this study, we aim to understand how the perceived utility of particular media sharing scenarios is affected by three independent variables, more specifically: (a) the locativeness of the content being shared; (b) how personal that content is and (c) the scope in which it is being shared. To assess these effects, we composed a set of 24 media sharing scenarios embedded with different treatments of our three independent variables. We then asked 100 participants to express their perception of the relevance of those scenarios. The results suggest a clear preference for scenarios where content is both local and directly related to the person that is publishing it. This is in stark contrast to the types of content that are commonly found in public displays, and confirms the opportunity that open displays networks may represent a new media for self-expression. This novel understanding may inform the design of new publication paradigms that will enable people to share media across the display networks. PMID:26153770

'I try to make a net around each patient': home care nursing as relational practice.

PubMed

Bjornsdottir, Kristin

2018-03-01

As a result of restructuring, home care is increasingly defined in a narrow, task-based way, undermining the holistic nature of practice. Recent practice theories can aid us in articulating the nature of this important, yet often invisible practice. My aim in this article was to enhance our knowledge and understanding of the nature of home care nursing practice. The approach was ethnographic, involving extensive fieldwork and formal interviews with members of five home care nursing teams and 15 older persons receiving care at home in a metropolitan area of Iceland. The study was approved by the National Bioethics Committee. As a net of services, home care was enacted through relational, but often invisible care practices, relating different actors - patient, family and health-care and social-care workers - in doing the work needed for the older persons to live comfortably at home. The work was collective in that it was shared by different actors and motivated by a common understanding that had developed and was preserved in conversations in the teams. Although the findings are limited in that they only reflect home care as practiced in one neighbourhood, they can be seen as providing important insights into what is needed for home care services to work. Home care practice can be understood as relational, aimed at creating a net of needed assistance. This work is a collective accomplishment of the teams and shaped by ideals and values shared among team members. © 2017 Nordic College of Caring Science.

My practice evolution: an appreciation of the discrepancies between the idealism of nursing education and the realities of hospital practice.

PubMed

Perkins, Danielle E K

2010-01-01

Newly graduated registered nurses face a barrage of physical and mental challenges in their first few years of practice, especially in the hospital setting. This article explores discrepancies between student nurse practice and professional nursing practice and the challenges that new nurses face in bridging the gap between idealistic theory and realistic practice. The author's subsequent graduate nursing education and continued practice in the field resulted in a personal evolution of practice that elicited a profound sense of appreciation for the field and a desire to share these experiences with other practicing nurses and students.

Experiential Learning Workshop for Indian Students

ERIC Educational Resources Information Center

Rybak, Christopher J.; Poonawalla, Nishreen P.; Deuskar, Megha U.; Bapat, Radhika S.

2007-01-01

An experiential workshop was offered to graduate psychology students at a major university in India. The workshop combined Western group counseling concepts with Yoga and indigenous peoples' psychological understandings to help students connect theory, practice, and personal understanding in a culturally relevant framework. Students shared their…

JPRS Report, China, Red Flag, Number 23, 1 December 1987

DTIC Science & Technology

1988-03-04

unhealthy tendency of violating laws and abusing power to seek personal gains. Party organizations and the vast numbers of party members should stand...34transition to communism" in production relations, and practiced egalitarianism characterized by "everybody sharing food from the big pot" in distribution...the party from those of the government easily engender the unhealthy tendency of bureaucracy and abusing power for personal gains. It is difficult

Improving the dependability of research in personality and social psychology: recommendations for research and educational practice.

PubMed

Funder, David C; Levine, John M; Mackie, Diane M; Morf, Carolyn C; Sansone, Carol; Vazire, Simine; West, Stephen G

2014-02-01

In this article, the Society for Personality and Social Psychology (SPSP) Task Force on Publication and Research Practices offers a brief statistical primer and recommendations for improving the dependability of research. Recommendations for research practice include (a) describing and addressing the choice of N (sample size) and consequent issues of statistical power, (b) reporting effect sizes and 95% confidence intervals (CIs), (c) avoiding "questionable research practices" that can inflate the probability of Type I error, (d) making available research materials necessary to replicate reported results, (e) adhering to SPSP's data sharing policy, (f) encouraging publication of high-quality replication studies, and (g) maintaining flexibility and openness to alternative standards and methods. Recommendations for educational practice include (a) encouraging a culture of "getting it right," (b) teaching and encouraging transparency of data reporting, (c) improving methodological instruction, and (d) modeling sound science and supporting junior researchers who seek to "get it right."

Employee attitudes towards aggression in persons with dementia: Readiness for wider adoption of person-centered frameworks.

PubMed

Burshnic, V L; Douglas, N F; Barker, R M

2018-04-01

Person-centered care, as compared to standard approaches, is a widely accepted, evidence-based approach for managing aggressive behaviour in persons with dementia. The attitudes, beliefs and values of long-term care and mental health nursing employees are important prerequisites to implementing person-centered practices. Research shows that nursing employees typically support person-centered approaches; however, less is known about the attitudes of non-nursing employee groups. Nurse managers and administrators tended to agree with person-centered approaches for managing aggression in dementia, suggesting some prerequisites are in place to support wider adoption of person-centered frameworks. Employees with more resident contact tended to support person-centered approaches the least, suggesting discipline-specific trainings may not be adequate for preparing frontline staff to use person-centered techniques. Attitudes towards aggressive behaviour may be especially varied and contradictory within certain employee groups, providing implications for facility-wide initiatives. Person-centered values and practices should be monitored and reinforced across the organization. Person-centered trainings should be interdisciplinary in nature and focused on care areas, such as mealtime or bathing. Long-term care facilities should consider allowing nurse management and registered nurses to share the burden of direct resident care with frontline employees on a more regular basis. Introduction Implementing person-centered care requires shared attitudes, beliefs and values among all care employees. Existing research has failed to examine the attitudes of non-nursing employees. Aim This study examined attitudes towards aggression among nursing and non-nursing employees to address gaps in existing research and assess readiness for wider adoption of person-centered frameworks. Method The Management of Aggression in People with Dementia Attitude Questionnaire was used to survey attitudes of employees in Michigan-based nursing homes. Results Overall, employees preferred person-centered over standard approaches. Job title was a significant predictor of paradigm support. Frontline employees were found to support person-centered attitudes the least. Wide-ranging responses were noted within employee groups. Discussion Job title may influence the degree to which an employee supports and utilizes person-centered approaches. Employees with the most contact with persons with dementia may be the least likely to implement person-centered approaches. In contrast to prior studies, years of experience was not a significant predictor of attitude towards aggressive behaviour. Wide-ranging responses indicate that employee attitudes are varied and complex. Implications Person-centered approaches should be trained within care areas rather than individual employee groups. Programs should be interdisciplinary and seek to establish a shared understanding of person-centered beliefs and values. © 2018 John Wiley & Sons Ltd.

The Learning Leader: Reflecting, Modeling, and Sharing

ERIC Educational Resources Information Center

Jacobs, Jacqueline E.; O'Gorman, Kevin L.

2012-01-01

With this book, principals, principals-in-training, and other school leaders get practical, easy-to-implement strategies for professional growth, strengthening relationships with faculty and staff, and making the necessary changes to improve K-12 learning environments. Grounded in specific, real-world examples and personal experiences, "The…

75 FR 72871 - Survey of Information Sharing Practices With Affiliates

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... completed by financial institutions and other persons that are creditors or users of consumer reports. The... by financial institutions, creditors, or users of consumer reports with their affiliates. Type of...), are required jointly to submit a report to the Congress together with any recommendations for...

Practicing Improvisation: Preparing Multicultural Educators

ERIC Educational Resources Information Center

Hull, Karla

2015-01-01

Preparing competent multicultural educators involves a dynamic process requiring constant self-reflection and assisting pre-service teachers to sharpen their cultural vision as they learn to be responsive educators. Reflections on lessons learned as a teacher educator are shared through personal experiences that are identified as keys to prepare…

How Do Astronomers Share Data? Reliability and Persistence of Datasets Linked in AAS Publications and a Qualitative Study of Data Practices among US Astronomers

PubMed Central

Pepe, Alberto; Goodman, Alyssa; Muench, August; Crosas, Merce; Erdmann, Christopher

2014-01-01

We analyze data sharing practices of astronomers over the past fifteen years. An analysis of URL links embedded in papers published by the American Astronomical Society reveals that the total number of links included in the literature rose dramatically from 1997 until 2005, when it leveled off at around 1500 per year. The analysis also shows that the availability of linked material decays with time: in 2011, 44% of links published a decade earlier, in 2001, were broken. A rough analysis of link types reveals that links to data hosted on astronomers' personal websites become unreachable much faster than links to datasets on curated institutional sites. To gauge astronomers' current data sharing practices and preferences further, we performed in-depth interviews with 12 scientists and online surveys with 173 scientists, all at a large astrophysical research institute in the United States: the Harvard-Smithsonian Center for Astrophysics, in Cambridge, MA. Both the in-depth interviews and the online survey indicate that, in principle, there is no philosophical objection to data-sharing among astronomers at this institution. Key reasons that more data are not presently shared more efficiently in astronomy include: the difficulty of sharing large data sets; over reliance on non-robust, non-reproducible mechanisms for sharing data (e.g. emailing it); unfamiliarity with options that make data-sharing easier (faster) and/or more robust; and, lastly, a sense that other researchers would not want the data to be shared. We conclude with a short discussion of a new effort to implement an easy-to-use, robust, system for data sharing in astronomy, at theastrodata.org, and we analyze the uptake of that system to-date. PMID:25165807

How do astronomers share data? Reliability and persistence of datasets linked in AAS publications and a qualitative study of data practices among US astronomers.

PubMed

Pepe, Alberto; Goodman, Alyssa; Muench, August; Crosas, Merce; Erdmann, Christopher

2014-01-01

We analyze data sharing practices of astronomers over the past fifteen years. An analysis of URL links embedded in papers published by the American Astronomical Society reveals that the total number of links included in the literature rose dramatically from 1997 until 2005, when it leveled off at around 1500 per year. The analysis also shows that the availability of linked material decays with time: in 2011, 44% of links published a decade earlier, in 2001, were broken. A rough analysis of link types reveals that links to data hosted on astronomers' personal websites become unreachable much faster than links to datasets on curated institutional sites. To gauge astronomers' current data sharing practices and preferences further, we performed in-depth interviews with 12 scientists and online surveys with 173 scientists, all at a large astrophysical research institute in the United States: the Harvard-Smithsonian Center for Astrophysics, in Cambridge, MA. Both the in-depth interviews and the online survey indicate that, in principle, there is no philosophical objection to data-sharing among astronomers at this institution. Key reasons that more data are not presently shared more efficiently in astronomy include: the difficulty of sharing large data sets; over reliance on non-robust, non-reproducible mechanisms for sharing data (e.g. emailing it); unfamiliarity with options that make data-sharing easier (faster) and/or more robust; and, lastly, a sense that other researchers would not want the data to be shared. We conclude with a short discussion of a new effort to implement an easy-to-use, robust, system for data sharing in astronomy, at theastrodata.org, and we analyze the uptake of that system to-date.

How Do Astronomers Share Data? Reliability and Persistence of Datasets Linked in AAS Publications and a Qualitative Study of Data Practices among US Astronomers

NASA Astrophysics Data System (ADS)

Pepe, Alberto; Goodman, Alyssa; Muench, August; Crosas, Merce; Erdmann, Christopher

2014-08-01

We analyze data sharing practices of astronomers over the past fifteen years. An analysis of URL links embedded in papers published by the American Astronomical Society reveals that the total number of links included in the literature rose dramatically from 1997 until 2005, when it leveled off at around 1500 per year. The analysis also shows that the availability of linked material decays with time: in 2011, 44% of links published a decade earlier, in 2001, were broken. A rough analysis of link types reveals that links to data hosted on astronomers' personal websites become unreachable much faster than links to datasets on curated institutional sites. To gauge astronomers' current data sharing practices and preferences further, we performed in-depth interviews with 12 scientists and online surveys with 173 scientists, all at a large astrophysical research institute in the United States: the Harvard-Smithsonian Center for Astrophysics, in Cambridge, MA. Both the in-depth interviews and the online survey indicate that, in principle, there is no philosophical objection to data-sharing among astronomers at this institution. Key reasons that more data are not presently shared more efficiently in astronomy include: the difficulty of sharing large data sets; over reliance on non-robust, non-reproducible mechanisms for sharing data (e.g. emailing it); unfamiliarity with options that make data-sharing easier (faster) and/or more robust; and, lastly, a sense that other researchers would not want the data to be shared. We conclude with a short discussion of a new effort to implement an easy-to-use, robust, system for data sharing in astronomy, at theastrodata.org, and we analyze the uptake of that system to-date.

The genealogy of personal names: towards a more productive method in historical onomastics.

PubMed

Kotilainen, Sofia

2011-01-01

It is essential to combine genealogical and collective biographical approaches with network analysis if one wants to take full advantage of the evidence provided by (hereditary) personal names in historical and linguistic onomastic research. The naming practices of rural families and clans from the 18th to the 20th century can bring us much fresh information about their enduring attitudes and values, as well as about other mentalities of everyday life. Personal names were cultural symbols that contained socially shared meanings. With the help of genealogical method it is possible to obtain a more nuanced understanding of these past naming practices, for example by comparing the conventions of different communities. A long-term and systematic empirical research also enables us to dispute certain earlier assumptions that have been taken for granted in historical onomastics. Therefore, the genealogical method is crucial in studying the criteria for the choices of personal names in the past.

Evaluating knowledge transfer practices among construction organization in Malaysia

NASA Astrophysics Data System (ADS)

Zaidi, Mohd Azian; Baharuddin, Mohd Nurfaisal; Bahardin, Nur Fadhilah; Yasin, Mohd Fadzil Mat; Nawi, Mohd Nasrun Mohd; Deraman, Rafikullah

2016-08-01

The aims of this paper is to identify a key dimension of knowledge transfer component to improve construction organization performance. It investigates the effectiveness of present knowledge transfer practices currently adopted by the Malaysian construction organizations and examines the relationship between knowledge transfer factors and organizational factors. A survey among 151 respondents including a different contractor registration grade was employed for the study. The survey shows that a seven-teen (17) factors known as creating shared awareness for information sharing, communication, personal skills,individual attitude,training, organizational culture, information technology,motivation, monitoring and supervision, service quality,information accessibility, information supply, socialization process,knowledge tools, coaching and monitoring, staff briefing and information sharing were identify as a key dimension for knowledge transfer success. This finding suggest that through improvement of each factor, the recognition of the whole strategic knowledge transfer process can be increase thus helping to strengthen the Malaysian construction organization for competitive advantages.

Just Research in Contentious Times: Widening the Methodological Imagination

ERIC Educational Resources Information Center

Fine, Michelle

2017-01-01

In this intensely powerful and personal new text, Michelle Fine widens the methodological imagination for students, educators, scholars, and researchers interested in crafting research with communities. Fine shares her struggles over the course of 30 years to translate research into policy and practice that can enhance the human condition and…

Intellectual Engagement: A Search for Practical Meaning

ERIC Educational Resources Information Center

Milton, Penny; Kennedy, Robert

2011-01-01

Three authors, writing from different perspectives in different time periods, share the view that students' sense of personal agency is fundamental to their intellectual engagement and deep understanding. The learner's imagination leads to powerful questions that grow when exposed to processes of productive inquiry and social interaction and when…

Philosophy Rediscovered: Exploring the Connections between Teaching Philosophies, Educational Philosophies, and Philosophy

ERIC Educational Resources Information Center

Beatty, Joy E.; Leigh, Jennifer S. A.; Dean, Kathy Lund

2009-01-01

Teaching philosophy statements reflect our personal values, connect us to those with shared values in the larger teaching community, and inform our classroom practices. In this article, we explore the often-overlooked foundations of teaching philosophies, specifically philosophy and historical educational philosophies. We review three elements of…

The Personal Intelligences: Promoting Social and Emotional Learning.

ERIC Educational Resources Information Center

Ellison, Launa

This book blends two of the multiple intelligences (intrapersonal and interpersonal) with current research on the brain and learning to create a new foundation for K-8 classrooms. It shares a teacher's classroom practices linking brain functions with the development of interpersonal and intrapersonal intelligence. Nine chapters include (1)…

A 2e Parent's Journey: Persistence, Partnership, and the Provision of Unconditional Love

ERIC Educational Resources Information Center

Brownstein, Michelle

2015-01-01

I have four children, three of whom are twice exceptional in the context of the new Community of Practice (2e CoP) definition highlighted in this issue. I share a personal story of a parent's journey in persistence, partnerships, and the provision of unconditional love.

What You Know, What You Do, and How You Feel: Cultural Competence, Cultural Consonance, and Psychological Distress

PubMed Central

Dressler, William W.; Balieiro, Mauro C.; dos Santos, José E.

2018-01-01

Describing the link between culture (as a phenomenon pertaining to social aggregates) and the beliefs and behaviors of individuals has eluded satisfactory resolution; however, contemporary cognitive culture theory offers hope. In this theory, culture is conceptualized as cognitive models describing specific domains of life that are shared by members of a social group. It is sharing that gives culture its aggregate properties. There are two aspects to these cultural models at the level of the individual. Persons have their own representations of the world that correspond incompletely to the shared model—this is their ‘cultural competence.’ Persons are also variable in the degree to which they can put cultural models into practice in their own lives—this is their ‘cultural consonance.’ Low cultural consonance is a stressful experience and has been linked to higher psychological distress. The relationship of cultural competence per se and psychological distress is less clear. In the research reported here, cultural competence and cultural consonance are measured on the same sample and their associations with psychological distress are examined using multiple regression analysis. Results indicate that, with respect to psychological distress, while it is good to know the cultural model, it is better to put it into practice. PMID:29379460

The impact of services that offer individualised funds, shared management, person-centred relationships, and self-direction on the lived experiences of consumers with mental illness.

PubMed

Peterson, Sunila; Buchanan, Angus; Falkmer, Torbjorn

2014-01-01

Mental health service providers across Australia, including Western Australia (WA), have begun to offer individualised funds, shared management, person-centred and self-directed (SPS) services. No research exists on the impact of SPS services on the lived experiences of these particular consumers. This study explored the impact of a SPS service offered for the first time in WA to consumers with mental illness. Data on sixteen consumers' lived experiences were analysed using an abbreviated grounded theory approach. These data had been developed by the consumers, Guides (staff) and an independent evaluator, and most of it had been collected in the past prior to the commencement of the study. Three over-arching categories, and related subcategories, emerged indicating that 1) access to individualised funds enabled practical and psychological benefits to consumers; 2) consistent contact in shared management and person-centred relationships enhanced the provision of timely and meaningful staff support to consumers; and 3) high quality shared management and person-centred relationships with staff and the opportunity to self-direct enabled consumers' change and growth. SPS services enhanced consumers' lived experiences and enabled staff to provide and consumers to experience timely access to recovery resources, consistent contact, responsive and high quality support, and self-direction of services. In this, consumers changed, grew and achieved desired recovery experiences. The overall impact of the SPS service seemed to be founded on the goodness of fit between person characteristics of staff and consumers, which enabled rich support that provided for corrective emotional experiences. This enabled consumers to build meaningful and hopeful lives where they started to live with, and beyond, their mental illness.

Why undertake a pilot in a qualitative PhD study? Lessons learned to promote success.

PubMed

Wray, Jane; Archibong, Uduak; Walton, Sean

2017-01-23

Background Pilot studies can play an important role in qualitative studies. Methodological and practical issues can be shaped and refined by undertaking pilots. Personal development and researchers' competence are enhanced and lessons learned can inform the development and quality of the main study. However, pilot studies are rarely published, despite their potential to improve knowledge and understanding of the research. Aim To present the main lessons learned from undertaking a pilot in a qualitative PhD study. Discussion This paper draws together lessons learned when undertaking a pilot as part of a qualitative research project. Important methodological and practical issues identified during the pilot study are discussed including access, recruitment, data collection and the personal development of the researcher. The resulting changes to the final study are also highlighted. Conclusion Sharing experiences of and lessons learned in a pilot study enhances personal development, improves researchers' confidence and competence, and contributes to the understanding of research. Implications for practice Pilots can be used effectively in qualitative studies to refine the final design, and provide the researcher with practical experience to enhance confidence and competence.

Personal responsibility in oral health: ethical considerations.

PubMed

Albertsen, Andreas

2012-11-30

Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people responsible by introducing measures that decrease their share of available resources. Introducing personal responsibility in oral health also has limitations of a more practical nature. Knowledge, social status and other diseases affect the degree to which people can be said to be responsible for their poor oral health. These factors affect people's oral health and their ability to take care of it. Both the conceptual and practical issues at stake are not reasons to abandon the idea of personal responsibility in oral health, but they do affect what the notion means and when it is reasonable to hold people responsible. They also commit people who support the idea of personal responsibility in oral health to supporting the idea of societal responsibility for mitigating the effects of factors that diminish people's responsibility and increase the available information and knowledge in the population.

Data sharing as social dilemma: Influence of the researcher’s personality

PubMed Central

2017-01-01

It is widely acknowledged that data sharing has great potential for scientific progress. However, so far making data available has little impact on a researcher’s reputation. Thus, data sharing can be conceptualized as a social dilemma. In the presented study we investigated the influence of the researcher's personality within the social dilemma of data sharing. The theoretical background was the appropriateness framework. We conducted a survey among 1564 researchers about data sharing, which also included standardized questions on selected personality factors, namely the so-called Big Five, Machiavellianism and social desirability. Using regression analysis, we investigated how these personality domains relate to four groups of dependent variables: attitudes towards data sharing, the importance of factors that might foster or hinder data sharing, the willingness to share data, and actual data sharing. Our analyses showed the predictive value of personality for all four groups of dependent variables. However, there was not a global consistent pattern of influence, but rather different compositions of effects. Our results indicate that the implications of data sharing are dependent on age, gender, and personality. In order to foster data sharing, it seems advantageous to provide more personal incentives and to address the researchers’ individual responsibility. PMID:28817642

The Implementation of Professional Learning Communites in West Tennessee Secondary Schools and Their Influence on Teacher Job Satisfaction

ERIC Educational Resources Information Center

Jones, Eric Thomas

2016-01-01

Of the six PLC dimensions theorized by Hord, the 307 respondents in this study suggested that two such dimension--namely, "Shared Personal Practice" and "Supportive Conditions: Structures"--tended systematically to be underrepresented at their schools: irrespective of their schools' categorization as either high- or…

Don't Divorce Us! Kids' Advice to Divorcing Parents.

ERIC Educational Resources Information Center

Sommers-Flanagan, Rita; Elander, Chelsea; Sommers-Flanagan, John

This book examines the divorce experience firsthand-through the eyes and voices of children and adult children of divorce. People from various ages, ethnic groups, and backgrounds share artwork, essays, and their personal stories of divorce. The book contains practical suggestions for coping with the challenges of double-households, long-distance…

Teaching Sensitive Issues: Feminist Pedagogy and the Practice of Advocacy-Based Counseling

ERIC Educational Resources Information Center

Durfee, Alesha; Rosenberg, Karen

2009-01-01

In the authors' experience, most instructors have dealt with a student "crisis" in some form. When a paper is late, an assignment incomplete, an exam missed, or a lecture skipped, students seeking special accommodations from instructors frequently share (often unsolicited) intimate details about their personal lives. College instructors…

School Counselors Share Their Favorite Classroom Guidance Activities: Guide to Planning, Conducting, and Processing

ERIC Educational Resources Information Center

DeLucia-Waack, J., Ed.; Mercurio, M., Ed.; Colvin, F., Ed.; Korta, S., Ed.; Maertin, K., Ed.; Martin, E., Ed.; Zawadski, L., Ed.

2014-01-01

In this book, practicing school counselors have provided more than 60 classroom guidance activities that are presented across the three major ASCA areas in the National Standards for Students: Academic Skills, Personal/Social Skills, and Career Development/College Preparation. Activities are designed to integrate the ASCA Model, Response to…

Personalized Thematic Kits

ERIC Educational Resources Information Center

Bontrager, Sharon

2010-01-01

Teaching Spanish at the K-5 level is a passion of mine, and the author would like to share some of the practical applications that she finds most rewarding and effective. She has found enthusiastic response to the creation of detailed language learning kits that are rooted in storytelling, but expanded to include home-made board games,…

Positive Psychology Theory, Research, and Practice: A Primer for Rehabilitation Counseling Professionals

ERIC Educational Resources Information Center

Chou, Chih-Chin; Chan, Fong; Chan, Jacob Yui Chung; Phillips, Brian; Ditchman, Nicole; Kaseroff, Ashley

2013-01-01

Positive psychology is a scientific study that explores what makes life most worth living and applies psychological theory to understand the human strengths that are important for enhancing overall well-being and happiness. The rehabilitation counseling philosophy shares a similar emphasis on personal strengths and the importance of enhancing what…

Sites of Possibility: Applied Theatre and Digital Storytelling with Youth

ERIC Educational Resources Information Center

Alrutz, Megan

2013-01-01

As a process for engaging marginalised voices in the social/cultural economy of the media, digital storytelling has garnered much attention from media artists, community organisers and scholars since the early 1990s. The practice of digital storytelling, or the making and sharing of personal narratives through recorded voice-overs, digital…

Ethics in Health, Physical Education, Recreation, and Dance. ERIC Digest.

ERIC Educational Resources Information Center

Fain, Gerald S.

This digest addresses the importance to professional practice of ethics and shared values, focusing on the fields of health, physical education, recreation, and dance (HPRD). Practitioners in these fields routinely deal with situations that call upon moral reasoning and the articulation of values such as instruction about personal health, sexual…

32 CFR 806b.43 - Placing personal information on shared drives.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Placing personal information on shared drives... shared drives. Personal information should never be placed on shared drives for access by groups of... official purposes to reduce the number of people with access to such personal information. Commanders and...

32 CFR 806b.43 - Placing personal information on shared drives.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Placing personal information on shared drives... shared drives. Personal information should never be placed on shared drives for access by groups of... official purposes to reduce the number of people with access to such personal information. Commanders and...

32 CFR 806b.43 - Placing personal information on shared drives.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Placing personal information on shared drives... shared drives. Personal information should never be placed on shared drives for access by groups of... official purposes to reduce the number of people with access to such personal information. Commanders and...

32 CFR 806b.43 - Placing personal information on shared drives.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Placing personal information on shared drives... shared drives. Personal information should never be placed on shared drives for access by groups of... official purposes to reduce the number of people with access to such personal information. Commanders and...

Attitudes towards Social Networking and Sharing Behaviors among Consumers of Direct-to-Consumer Personal Genomics

PubMed Central

Lee, Sandra Soo-Jin; Vernez, Simone L.; Ormond, K.E.; Granovetter, Mark

2013-01-01

Little is known about how consumers of direct-to-consumer personal genetic services share personal genetic risk information. In an age of ubiquitous online networking and rapid development of social networking tools, understanding how consumers share personal genetic risk assessments is critical in the development of appropriate and effective policies. This exploratory study investigates how consumers share personal genetic information and attitudes towards social networking behaviors. Methods: Adult participants aged 23 to 72 years old who purchased direct-to-consumer genetic testing from a personal genomics company were administered a web-based survey regarding their sharing activities and social networking behaviors related to their personal genetic test results. Results: 80 participants completed the survey; of those, 45% shared results on Facebook and 50.9% reported meeting or reconnecting with more than 10 other individuals through the sharing of their personal genetic information. For help interpreting test results, 70.4% turned to Internet websites and online sources, compared to 22.7% who consulted their healthcare providers. Amongst participants, 51.8% reported that they believe the privacy of their personal genetic information would be breached in the future. Conclusion: Consumers actively utilize online social networking tools to help them share and interpret their personal genetic information. These findings suggest a need for careful consideration of policy recommendations in light of the current ambiguity of regulation and oversight of consumer initiated sharing activities. PMID:25562728

Attitudes towards Social Networking and Sharing Behaviors among Consumers of Direct-to-Consumer Personal Genomics.

PubMed

Lee, Sandra Soo-Jin; Vernez, Simone L; Ormond, K E; Granovetter, Mark

2013-10-14

Little is known about how consumers of direct-to-consumer personal genetic services share personal genetic risk information. In an age of ubiquitous online networking and rapid development of social networking tools, understanding how consumers share personal genetic risk assessments is critical in the development of appropriate and effective policies. This exploratory study investigates how consumers share personal genetic information and attitudes towards social networking behaviors. Adult participants aged 23 to 72 years old who purchased direct-to-consumer genetic testing from a personal genomics company were administered a web-based survey regarding their sharing activities and social networking behaviors related to their personal genetic test results. 80 participants completed the survey; of those, 45% shared results on Facebook and 50.9% reported meeting or reconnecting with more than 10 other individuals through the sharing of their personal genetic information. For help interpreting test results, 70.4% turned to Internet websites and online sources, compared to 22.7% who consulted their healthcare providers. Amongst participants, 51.8% reported that they believe the privacy of their personal genetic information would be breached in the future. Consumers actively utilize online social networking tools to help them share and interpret their personal genetic information. These findings suggest a need for careful consideration of policy recommendations in light of the current ambiguity of regulation and oversight of consumer initiated sharing activities.

Seeing through the glass darkly? A qualitative exploration of GPs' drinking and their alcohol intervention practices.

PubMed

Kaner, Eileen; Rapley, Tim; May, Carl

2006-08-01

Brief alcohol intervention is influenced by patients' personal characteristics as well as their clinical risk. Risk-drinkers from higher social-status groups are less likely to receive brief intervention from GPs than those from lower social-status groups. Thus GPs' perception of social similarity or distance may influence brief intervention. To explore the role that GPs' drinking behaviour plays in their recognition of alcohol-related risk in patients. A qualitative interview study with 29 GPs recruited according to maximum variation sampling. All interviews were audio-recorded and transcribed verbatim. Analysis was inductive with constant comparison within and between themes plus deviant case analysis. Analysis developed until category saturation was reached. GPs described a range of personal drinking practices that broadly mirrored population drinking patterns. Many saw themselves as part of mainstream society, sharing in culturally sanctioned behaviour. For some GPs, shared drinking practices could increase empathy for patients who drank, and facilitate discussion about alcohol. However, several GPs regarded themselves as distinct from 'others', separating their own drinking from that of patients. Several GPs described a form of bench-marking, wherein only patients who drank more, or differently, to themselves were felt to be 'at risk'. Alcohol is clearly a complex and emotive health and social issue and GPs are not immune to its effects. For some GPs' shared drinking behaviour can act as a window of opportunity enabling insight on alcohol issues and facilitating discussion. However, other GPs may see through the glass more darkly and selectively recognize risk only in those patients who are least like them.

Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care.

PubMed

Gabrielsson, Sebastian; Sävenstedt, Stefan; Olsson, Malin

2016-10-01

Therapeutic nurse-patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values. © 2016 Australian College of Mental Health Nurses Inc.

Young Drivers: Reckless or Unprepared?

ERIC Educational Resources Information Center

Waller, Patricia F.

Because it is a well-accepted fact that young persons have more than their share of automobile crashes and because the task of driving is a complex one that requires practice to be mastered, it is proposed that a careful human factors analysis of the task of driving be undertaken based on empirically demonstrated differences among driver groups.…

Qualitative Researchers in the Blogosphere: Using Blogs as Diaries and Data

ERIC Educational Resources Information Center

Chenail, Ronald J.

2011-01-01

Weblogs or blogs for short can be personal diaries shared by individuals giving readers a sometimes voyeuristic view into the lives and minds of these virtual authors. The ability for readers to find and promote weblogs makes the practice of blogging appealing for parties wanting to market their products and services. The popularity and the…

Joy and the "Smart Kids": Competing Ways of Being and Believing

ERIC Educational Resources Information Center

Majors, Yolanda J.

2014-01-01

Through a sharing of personal experience, this article aims to draw attention to the language of schooling--a language, both simple and sophisticated, that many schools, as institutions, devise to communicate with insiders and outsiders. The author argues that there is a mismatch between assumed best practices embedded in this language and the…

Records of Practice and the Development of Collective Professional Knowledge

ERIC Educational Resources Information Center

Ball, Deborah Loewenberg; Ben-Peretz, Miriam; Cohen, Rhonda B.

2014-01-01

Although recent years have seen an increase in professional learning communities, use of video and lesson study groups, most teachers still work and learn in isolation. What they know is personal and remains private; little opportunity exists for most teachers to develop shared knowledge or language. The scale of the teaching force, and the rapid…

Opting into a Faculty Scholarship Community: Benefiting Productivity and Personal Well-Being

ERIC Educational Resources Information Center

Francis, Dawn M.; Colbry, Stephanie L.; Hoyle, Amy Gratch; Ratmansky, Lisa A.; Sheety, Alia S.; Szpara, Michelle Yvonne

2017-01-01

A Faculty Scholarship Community (FSC) is a community of practice whose members share an interest in scholarly productivity. This descriptive study examines key factors that enabled a small group of non-tenured faculty, new to their institution, to form a thriving FSC. Members employed autoethnography as the method for examining the impact of the…

Considering Culture in the Selection of Teaching Approaches for Adults. ERIC Digest.

ERIC Educational Resources Information Center

Ziegahn, Linda

Cultural differences, including the personal cultures of learners and educators and the culture of the larger social-political environment, are relevant to adult learning. Culture includes those values, beliefs, and practices shared by a group of people. Cultures tend to vary along a number of dimensions, and the following dimensions are among…

Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers.

PubMed

Klein, Dawn M; Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

2015-08-18

Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients' ability to view, print, and download their health records. The aim of this study was to characterize (1) patients' use of Blue Button, an online information-sharing tool in VA's patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients' use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of providers.

Barriers and facilitators to the implementation of person-centred care in different healthcare contexts.

PubMed

Moore, Lucy; Britten, Nicky; Lydahl, Doris; Naldemirci, Öncel; Elam, Mark; Wolf, Axel

2017-12-01

To empower patients and improve the quality of care, policy-makers increasingly adopt systems to enhance person-centred care. Although models of person-centredness and patient-centredness vary, respecting the needs and preferences of individuals receiving care is paramount. In Sweden, as in other countries, healthcare providers seek to improve person-centred principles and address gaps in practice. Consequently, researchers at the University of Gothenburg Centre for Person-Centred Care are currently delivering person-centred interventions employing a framework that incorporates three routines. These include eliciting the patient's narrative, agreeing a partnership with shared goals between patient and professional, and safeguarding this through documentation. To explore the barriers and facilitators to the delivery of person-centred care interventions, in different contexts. Qualitative interviews were conducted with a purposeful sample of 18 researchers from seven research studies across contrasting healthcare settings. Interviews were transcribed, translated and thematically analysed, adopting some basic features of grounded theory. The ethical code of conduct was followed and conformed to the ethical guidelines adopted by the Swedish Research Council. Barriers to the implementation of person-centred care covered three themes: traditional practices and structures; sceptical, stereotypical attitudes from professionals; and factors related to the development of person-centred interventions. Facilitators included organisational factors, leadership and training and an enabling attitude and approach by professionals. Trained project managers, patients taking an active role in research and adaptive strategies by researchers all helped person-centred care delivery. At the University of Gothenburg, a model of person-centred care is being initiated and integrated into practice through research. Knowledgeable, well-trained professionals facilitate the routines of narrative elicitation and partnership. Strong leadership and adaptive strategies are important for overcoming existing practices, routines and methods of documentation. This study provides guidance for practitioners when delivering and adapting person-centred care in different contexts. © 2016 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Affording to exchange: social capital and online information sharing.

PubMed

Maksl, Adam; Young, Rachel

2013-08-01

The potential harm and benefit associated with sharing personal information online is a topic of debate and discussion. Using survey methods (n=872), we explore whether attainment of social capital online relates to greater comfort with sharing personal information. We found that perceptions of bridging and bonding social capital earned from using Facebook are significant predictors of overall comfort levels with sharing personal information. This research raises timely questions about how the perceived benefits of social networking sites influence how personal information is shared online.

Group practice--trend for the future.

PubMed

Furumoto, H H

1983-11-01

Group practices in various forms and combinations appear to set the trend for small animal practice management. By pooling their financial resources, energies, and talents, veterinarians can share the burden of increasing overhead costs and enjoy the benefits of specialization, new technologies, continuing education, consultations and referrals, peer review, applied research and publication, and fringe benefits such as paid vacation and sick leave, profit sharing, and pension. Group practices preserve ownership continuity at fair market value and afford opportunities for the utilization of expert business consultants. There are prerequisites to establishing a successful group practice: An adequate personal income base, a sufficient pet population, and business associates with compatible practice philosophy. Special considerations must be given to the social, economic, and psychological forces at work in a group practice environment. Professional and personal interactions can make or break a group practice. The group concept, MIP treatment of clients and their pets, and personalized appointments are important features which must be emphasized. The law of supply and demand and the law of diminishing returns must be kept in focus at all times. In tandem, they dictate the fortunes of all business enterprises and group practices can be particularly vulnerable to them. Long-term business commitment is a condition of group practice ownership and may pose a conflict with other interests. A predetermined buy-sell agreement and deferred compensation plan may provide the answer in case of dissolution, termination, or early retirement. A system of animal and material transport and transfer of business transactions and medical records must be set up between satellite clinics and the base hospital. A hospital-owned-and-operated shuttle service appears to offer the greatest flexibility and convenience. Cost-effectiveness of a shuttle service depends on the volume of referral cases generated for the base hospital. Computers may provide the answer to rapid and reliable transfer of data between satellite clinics and central or base hospitals in the near future. New approaches to small animal medicine and practice management must be explored and adopted. Prepaid pet medical insurance seems to be the answer to rapidly growing sophistication and escalating cost of small animal patient care. Human and companion animal interactions have been given a fresh impetus by veterinary educators, clinical psychologists, psychiatrists, humane societies, organizations for the mentally and physically handicapped, gerontologic centers, and others.(ABSTRACT TRUNCATED AT 400 WORDS)

International comparisons of health system performance among OECD countries: opportunities and data privacy protection challenges.

PubMed

Oderkirk, Jillian; Ronchi, Elettra; Klazinga, Niek

2013-09-01

Health data constitute a significant resource in most OECD countries that could be used to improve health system performance. Well-intended policies to allay concerns about breaches of confidentiality and to reduce potential misuse of personal health information may be limiting data use. A survey of 20 OECD countries explored the extent to which countries have developed and use personal health data and the reasons why data use may be problematic in some. Countries are divided, with one-half engaged regularly in national data linkage studies to monitor health care quality. Country variation is linked to risk management in granting an exemption to patient consent requirements; in sharing identifiable data among government authorities; and in project approvals and granting access to data. The resources required to comply with data protection requirements is a secondary problem. The sharing of person-level data across borders for international comparisons is rarely reported and there were few examples of studies of health system performance. Laws and policies enabling data sharing and data linkage are needed to strengthen national information infrastructure. To develop international studies comparing health care quality and health system performance, actions are needed to address heterogeneity in data protection practices. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.

PubMed

Buch, Martin Sandberg; Edwards, Adrian; Eriksson, Tina

2009-01-01

The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes. Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project. General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes. Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.

Designing, Supporting, and Sustaining an Online Community of Practice: NASA EPO Workspace as an Ongoing Exploration of the Value of Community

NASA Astrophysics Data System (ADS)

Davey, B.; Davis, H. B.

2015-12-01

Increasingly, geographically diverse organizations, like NASA's Science Mission Directorate Education and Public Outreach personnel (SMD EPO), are looking for ways to facilitate group interactions in meaningful ways while limiting costs. Towards this end, of particular interest, and showing great potential are communities of practice. Communities of practice represent relationships in real-time between and among people sharing a common practice. They facilitate the sharing of information, building collective knowledge, and growing of the principles of practice. In 2010-11, SMD EPO established a website to support EPO professionals, facilitate headquarters reporting, and foster a community of practice. The purpose of this evaluation is to examine the design and use of the workspace and the value created for both individual community members and SMD EPO, the sponsoring organization. The online workspace was launched in 2010-11 for the members of NASA's SMDEPO community. The online workspace was designed to help facilitate the efficient sharing of information, be a central repository for resources, help facilitate and support knowledge creation, and ultimately lead to the development of an online community of practice. This study examines the role of the online workspace component of a community in the work of a community of practice. Much has been studied revealing the importance of communities of practice to organizations, project success, and knowledge management and some of these same successes hold true for virtual communities of practice. Additionally, we look at the outcomes of housting the online community for these past years in respect to knowledge building and personal and organizational value, the affects on professional dvelopment opportunities, how community members have benefited, and how the workspace has evolved to better serve the community.

Now for Me, Later for Us? Effects of Group Context on Temporal Discounting

PubMed Central

Charlton, Shawn R.; Yi, Richard; Porter, Caitlin; Carter, Anne E.; Bickel, Warren; Rachlin, Howard

2013-01-01

Delayed rewards are less valuable than immediate rewards. This well-established finding has focused almost entirely on individual outcomes. However, are delayed rewards similarly discounted if they are shared by a group? The current article reports on three experiments exploring the effect of group context on delay discounting. Results indicate that discount rates of individual and group rewards were highly correlated, but that respondents were more willing to wait (decreased discounting) for shared outcomes than for individual outcomes. An explanatory model is proposed suggesting that decreased discount rates in group contexts may be due to the way the effects of both delay and social discounting are combined. That is, in a group context, a person values both a future reward (discounted by delay) and a present reward to another person (discounted by the social distance between them). The results are explained by a combined discount function containing a delay factor and a factor representing the social distance between the decision maker and group members. Practical implications of the fact that shared consequences can increase individual self-control are also discussed. PMID:23641123

32 CFR 806b.43 - Placing personal information on shared drives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Placing personal information on shared drives... shared drives. Personal information should never be placed on shared drives for access by groups of... supervisors should give consideration to those individuals with unlisted phone numbers, who do not want their...

The Circle of Trust[R] Approach and a Counselor Training Program: A Hand in Glove Fit

ERIC Educational Resources Information Center

Goodell, Judith A.

2012-01-01

The Circle of Trust[R] approach (www.couragerenewal.org) is dedicated to principles and practices that support exploration of the inner landscape of one's life. Participants share time in a trustworthy environment, connect with inner wisdom, and seek harmony in their personal and professional selves. In this chapter, the author describes her…

The Relationship of Personality Traits to Satisfaction with the Team: A Study of Interdisciplinary Teacher Teams in Rhode Island Middle Schools

ERIC Educational Resources Information Center

Humbyrd, Michele

2010-01-01

A shift toward shared practice in schools has emerged and teachers are moving from isolation to collaboration (Hindin, Morocco, Mott, & Aguilar, 2007). One of the structures that supports collaboration is the collaborative team. Teams have great potential, however, their failure can impact the organization's progress and the team members'…

The Ethical and Practical Implications of Systems Architecture on Identity in Networked Learning: A Constructionist Perspective

ERIC Educational Resources Information Center

Koole, Marguerite L.; Parchoma, Gale

2012-01-01

Through relational dialogue, learners shape their identities by sharing information about the world and how they see themselves in it. As learners interact, they receive feedback from both the environment and other learners which, in turn, helps them assess and adjust their self-presentations. Although learners retain choice and personal agency,…

The Couple that Prays Together: Race and Ethnicity, Religion, and Relationship Quality among Working-Age Adults

ERIC Educational Resources Information Center

Ellison, Christopher G.; Burdette, Amy M.; Wilcox, W. Bradford

2010-01-01

A substantial body of research has shown that relationship quality tends to be (a) lower among racial and ethnic minorities and (b) higher among more religious persons and among couples in which partners share common religious affiliations, practices, and beliefs. However, few studies have examined the interplay of race or ethnicity and religion…

Sharing the Focus: Engaging with Support Workers to Include People with Communication Needs in Research

ERIC Educational Resources Information Center

Lutz, Deborah; Fisher, Karen R.; Robinson, Sally

2016-01-01

Inclusive research is an increasing expectation to value and include people's voice in research and evaluations intended to benefit them. The active participation of people with communication support needs can be difficult due to the practical constraints of evaluations. One technique is to engage with workers who are familiar with the person, but…

[Shared decision-making and individualized goal setting - a pilot trial using PRISM (Pictorial Representation of Illness and Self Measure) in psychiatric inpatients].

PubMed

Büchi, S; Straub, S; Schwager, U

2010-12-01

Although there is much talk about shared decision making and individualized goal setting, there is a lack of knowledge and knowhow in their realization in daily clinical practice. There is a lack in tools for easy applicable tools to ameliorate person-centred individualized goal setting processes. In three selected psychiatric inpatients the semistructured, theory driven use of PRISM (Pictorial Representation of Illness and Self Measure) in patients with complex psychiatric problems is presented and discussed. PRISM sustains a person-centred individualized process of goal setting and treatment and reinforces the active participation of patients. The process of visualisation and synchronous documentation is validated positively by patients and clinicians. The visual goal setting requires 30 to 45 minutes. In patients with complex psychiatric illness PRISM was used successfully to ameliorate individual goal setting. Specific effects of PRISM-visualisation are actually evaluated in a randomized controlled trial.

Counseling women with early pregnancy failure: utilizing evidence, preserving preference.

PubMed

Wallace, Robin R; Goodman, Suzan; Freedman, Lori R; Dalton, Vanessa K; Harris, Lisa H

2010-12-01

To apply principles of shared decision-making to EPF management counseling. To present a patient treatment priority checklist developed from review of available literature on patient priorities for EPF management. Review of evidence for patient preferences; personal, emotional, physical and clinical factors that may influence patient priorities for EPF management; and the clinical factors, resources, and provider bias that may influence current practice. Women have strong and diverse preferences for EPF management and report higher satisfaction when treated according to these preferences. However, estimates of actual treatment patterns suggest that current practice does not reflect the evidence for safety and acceptability of all options, or patient preferences. Multiple practice barriers and biases exist that may be influencing provider counseling about options for EPF management. Choosing management for EPF is a preference-sensitive decision. A patient-centered approach to EPF management should incorporate counseling about all treatment options. Providers can integrate a counseling model into EPF management practice that utilizes principles of shared decision-making and an organized method for eliciting patient preferences, priorities, and concerns about treatment options. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A qualitative analysis of beginning mindfulness experiences for women with post-traumatic stress disorder and a history of intimate partner violence.

PubMed

Bermudez, Diana; Benjamin, Michelle T; Porter, Sarah E; Saunders, Pamela A; Myers, Neely Anne Laurenzo; Dutton, Mary Ann

2013-05-01

This article presents the beginning mindfulness experiences of low income, minority women with a history of intimate partner violence. Ten women participated in a Mindfulness-Based Stress Reduction group, three interviews and a focus group over 15 months. Using an interpretive phenomenological analysis approach, we derived the following themes: struggles to practice meditation; a vision of growing and helping; personal improvements, and interpersonal improvements. We share recommendations for clinical practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Representational Approach: A Conceptual Framework to Guide Patient Education Research and Practice.

PubMed

Arida, Janet A; Sherwood, Paula R; Flannery, Marie; Donovan, Heidi S

2016-11-01

Illness representations are cognitive structures that individuals rely on to understand and explain their illnesses and associated symptoms. The Representational Approach (RA) to patient education offers a theoretically based, clinically useful model that can support oncology nurses to develop a shared understanding of patients' illness representations to collaboratively develop highly personalized plans for symptom management and other important self-management behaviors. This article discusses theoretical underpinnings, practical applications, challenges, and future directions for incorporating illness representations and the RA in clinical and research endeavors.

Person-like intelligent systems architectures for robotic shared control and automated operations

NASA Technical Reports Server (NTRS)

Erickson, Jon D.; Aucoin, Paschal J., Jr.; Ossorio, Peter G.

1992-01-01

An approach to rendering robotic systems as 'personlike' as possible to achieve needed capabilities is outlined. Human characteristics such as knowledge, motivation, know-how, performance, achievement and individual differences corresponding to propensities and abilities can be supplied, within limits, with computing software and hardware to robotic systems provided with sufficiently rich sensory configurations. Pushing these limits is the developmental path for more and more personlike robotic systems. The portions of the Person Concept that appear to be most directly relevant to this effort are described in the following topics: reality concepts (the state-of-affairs system and descriptive formats, behavior as intentional action, individual persons (person characteristics), social patterns of behavior (social practices), and boundary conditions (status maxims). Personlike robotic themes and considerations for a technical development plan are also discussed.

Strategies and Exemplars for Public Outreach Events: Planning, Implementation, Evaluation

NASA Astrophysics Data System (ADS)

Cobb, W. H.; Buxner, S.; Shipp, S. S.; Shebby, S.

2015-12-01

IntroductionEach year the National Aeronautics and Space Administration (NASA) sponsors a variety of public outreach events to share information with educators, students, and the general public. These events are designed to increase interest in and awareness of the mission and goals of NASA. Planning and implementation best practices gleaned from the NASA SMD Education's review of large-scale events, "Best Practices in Outreach Events" will be shared. Outcomes from an event, i C Ceres, celebrating the Dawn mission's arrival at dwarf planet Ceres that utilized these strategies will be shared. Best practices included can be pertinent for all event organizers and evaluators regardless of event size. BackgroundThe literature review focused on identifying evaluations of large-scale public outreach events—and, within these evaluations, identifying best practices. The following criteria for identifying journal articles and reports to potentially include: Public, science-related events open to adults and children. Events with more than 1,000 attendees. Events that occurred during the last 5 years. Evaluations that included information on data collected from visitors and/or volunteers. Evaluations that specified the type of data collected, methodology, and associated results. Planning and Implementation Best PracticesThe literature review revealed key considerations for planning and of large-scale events implementing events. A summary of related best practices is presented below. 1) Advertise the event 2) Use and advertise access to scientists 3) Recruit scientists using these findings 4) Ensure that the event is group and particularly child friendly 5) Target specific event outcomes Best Practices Informing Real-world Planning, Implementation and EvaluationDawn mission's collaborative design of a series of events, i C Ceres, including in-person, interactive events geared to families and live presentations will be shared. Outcomes and lessons learned will be imparted rising from these events and their evaluation. There will be a focus on the family event, in particular the evidence that scientist participation was a particular driver for the event's impact and success.

Voices from the heart: the use of digital story telling in education.

PubMed

Matthews, Jackie

2014-01-01

Digital storytelling has emerged as a powerful teaching and learning tool, which presents personal narratives, images and music to create a unique and sometimes emotional snapshot into another person's experience. By offering a platform for sharing and understanding such narratives, professionals may gain insight into a perceived experience and construct their role accordingly. Used effectively, they can engage the listener and offer opportunity to reflect and consider the impact of their professional role on the storyteller. This article looks at how digital storytelling can enhance professional practice and enable vulnerable voices to be heard.

Beginning with Our Voices

PubMed Central

Acoose, Sharon; Blunderfield, Debbie; Dell, Colleen Anne; Desjarlais, Val

2013-01-01

The purpose of this paper is to review how the experiential stories of First Nations women contribute to a national research project. The project focuses on how women’s healing is impacted by their views about themselves as - and the stigma associated with being - a drug user, involved in crime and an Aboriginal woman. Our project began with three First Nations women on our research team documenting the role of stigma and self-identity in their personal healing journeys from problematically using drugs and being in conflict with the law. In this paper we discuss how key components of feminist research practices, Aboriginal methodology and community-based research helped us position the women’s experiential stories in authoritative, recognized and celebrated ways in our study. We illustrate how the women’s stories uniquely contributed to the creation of our interview questions and the research project in general. We also discuss how the women personally benefited from writing about and sharing their experiences. Key benefits include the women discovering the impact of the written word, promotion of their healing, personal recognition of their ability to offer hope to women in need, increased self-esteem, and increased appreciation of the importance of sharing their lived experiences with others. Our method of research differs from a conventional western scientific approach to understanding, and as such made important contributions to both the project itself and the women who shared their experiential stories. PMID:24795760

Nurse managers' strategies for feeling less drained by their work: an action research and reflection project for developing emotional intelligence.

PubMed

Taylor, Bev; Roberts, Sue; Smyth, Therese; Tulloch, Moira

2015-10-01

To raise nurse managers' critical awareness of practice problems; uncover practice constraints and improve work effectiveness. Nurse management requires skills and knowledge, underscored by emotional intelligence. The research improved participants' practice and personal insights. Purposive sampling targeted nurse managers interested in improving their practice. Three experienced female nurse managers met fortnightly in a group, for 1 hour, for 10 meetings. The methods included: writing and sharing de-identified journal reflections; critically analysing practice stories; identifying a thematic concern; generating action strategies; and instituting and revising the action plan. Phase One resulted in the identification of the issue of 'being drained by the intensity of nurse managers' work'. The participants adopted five strategies: debriefing problematic situations; deflecting multiple requests; diffusing issues; naming dysfunctional behaviours; and regrouping. In Phase Two, participants implemented and revised the action plan strategies, which resulted in them feeling less drained by their work. Strategies can lessen nurse managers' sense of personal depletion. However, strategies cannot guarantee success every time because the emotional intelligence is integral to nurse management. Action research and reflection assist nurse managers to improve their practice and develop their emotional intelligence. © 2014 John Wiley & Sons Ltd.

Addressing narcissistic personality features in the context of medical care: integrating diverse perspectives to inform clinical practice.

PubMed

Magidson, J F; Collado-Rodriguez, A; Madan, A; Perez-Camoirano, N A; Galloway, S K; Borckardt, J J; Campbell, W K; Miller, J D

2012-04-01

Narcissistic personality disorder (NPD) is characterized by an unrealistic need for admiration, lack of empathy toward others, and feelings of superiority. NPD presents a unique and significant challenge in clinical practice, particularly in medical settings with limited provider contact time, as health professionals treat individuals who often require excessive admiration and have competing treatment needs. This practice review highlights real case examples across three distinct medically oriented clinical settings (inpatient and outpatient behavioral medicine and a Level I trauma center) to demonstrate the difficult and compromising situations that providers face when treating patients with general medical conditions and comorbid narcissistic personality features. The main goal of this article is to discuss the various challenges and obstacles associated with these cases in medical settings and discuss some strategies that may prove successful. A second goal is to bridge diverse conceptualizations of narcissism/NPD through the discussion of theoretical and empirical perspectives that can inform understanding of the clinical examples. Despite differing perspectives regarding the underlying motivation of narcissistic behavior, this practice review highlights that these paradigms can be integrated when sharing the same ultimate goal: to improve delivery of care across medically oriented clinical settings for patients with narcissistic features.

Preserving the person: The ethical imperative of recovery-oriented practices.

PubMed

Atterbury, Kendall

2014-03-01

For more than a decade the principles of mental health recovery have been promoted as an alternative to traditional models of care. Recovery-oriented practices are those that recognize the strengths of service users and empower them within the mental health system. In contrast to a more hierarchical model of care in which service providers make decisions with a pronounced absence of input from service users, recovery-oriented practices emphasize shared decision-making, respect for service user goals, and the recognition of the full humanity of all persons in care relationships. Recovery-oriented care has yet to be embraced by the majority of service providers, however. There are several reasons for this failure but among them is the lack of attention given to the ethical ground of recovery. This article seeks to bring recovery into conversation with moral philosophy by arguing that recovery-oriented care is essentially linked to fundamental rights and values of personhood within a liberal democracy. By joining together a conception of personhood rooted in essential vulnerability and a Rawlsian perspective on justice, this article argues that recovery is not only a desirable approach to mental health practice but that it is ethically necessary. It argues that recovery practices are not exceptional interventions to be reserved for a few but that a recovery-orientation entails fundamental elements of justice and respect to which all persons are entitled.

Identification of genetic loci shared between schizophrenia and the Big Five personality traits.

PubMed

Smeland, Olav B; Wang, Yunpeng; Lo, Min-Tzu; Li, Wen; Frei, Oleksandr; Witoelar, Aree; Tesli, Martin; Hinds, David A; Tung, Joyce Y; Djurovic, Srdjan; Chen, Chi-Hua; Dale, Anders M; Andreassen, Ole A

2017-05-22

Schizophrenia is associated with differences in personality traits, and recent studies suggest that personality traits and schizophrenia share a genetic basis. Here we aimed to identify specific genetic loci shared between schizophrenia and the Big Five personality traits using a Bayesian statistical framework. Using summary statistics from genome-wide association studies (GWAS) on personality traits in the 23andMe cohort (n = 59,225) and schizophrenia in the Psychiatric Genomics Consortium cohort (n = 82,315), we evaluated overlap in common genetic variants. The Big Five personality traits neuroticism, extraversion, openness, agreeableness and conscientiousness were measured using a web implementation of the Big Five Inventory. Applying the conditional false discovery rate approach, we increased discovery of genetic loci and identified two loci shared between neuroticism and schizophrenia and six loci shared between openness and schizophrenia. The study provides new insights into the relationship between personality traits and schizophrenia by highlighting genetic loci involved in their common genetic etiology.

Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers

PubMed Central

Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

2015-01-01

Background Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients’ ability to view, print, and download their health records. Objective The aim of this study was to characterize (1) patients’ use of Blue Button, an online information-sharing tool in VA’s patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Methods Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients’ use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Results Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Conclusions Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of providers. PMID:26286139

Rasch Analysis of the 9-Item Shared Decision Making Questionnaire in Women With Breast Cancer.

PubMed

Wu, Tzu-Yi; Chen, Cheng-Te; Huang, Yi-Jing; Hou, Wen-Hsuan; Wang, Jung-Der; Hsieh, Ching-Lin

2018-04-19

Shared decision making (SDM) is a best practice to help patients make optimal decisions by a process of healthcare, especially for women diagnosed with breast cancer and having heavy burden in long-term treatments. To promote successful SDM, it is crucial to assess the level of perceived involvement in SDM in women with breast cancer. The aims of this study were to apply Rasch analysis to examine the construct validity and person reliability of the 9-item Shared Decision Making Questionnaire (SDM-Q-9) in women with breast cancer. The construct validity of SDM-Q-9 was confirmed when the items fit the Rasch model's assumptions of unidimensionality: (1) infit and outfit mean square ranged from 0.6 to 1.4; (2) the unexplained variance of the first dimension of the principal component analysis was less than 20%. Person reliability was calculated. A total of 212 participants were recruited in this study. Item 1 did not fit the model's assumptions and was deleted. The unidimensionality of the remaining 8 items (SDM-Q-8) was supported with good item fit (infit and outfit mean square ranging from 0.6 to 1.3) and very low unexplained variance of the first dimension (5.3%) of the principal component analysis. The person reliability of the SDM-Q-8 was 0.90. The SDM-Q-8 was unidimensional and had good person reliability in women with breast cancer. The SDM-Q-8 has shown its potential for assessing the level of perceived involvement in SDM in women with breast cancer for both research and clinical purposes.

Science Teacher Beliefs and Classroom Practice Related to Constructivism in Different School Settings

NASA Astrophysics Data System (ADS)

Savasci, Funda; Berlin, Donna F.

2012-02-01

Science teacher beliefs and classroom practice related to constructivism and factors that may influence classroom practice were examined in this cross-case study. Data from four science teachers in two schools included interviews, demographic questionnaire, Classroom Learning Environment Survey (preferred/perceived), and classroom observations and documents. Using an inductive analytic approach, results suggested that the teachers embraced constructivism, but classroom observations did not confirm implementation of these beliefs for three of the four teachers. The most preferred constructivist components were personal relevance and student negotiation; the most perceived component was critical voice. Shared control was the least preferred, least perceived, and least observed constructivist component. School type, grade, student behavior/ability, curriculum/standardized testing, and parental involvement may influence classroom practice.

Systems of meaning and transference: Implicit significant-other activation evokes shared reality.

PubMed

Przybylinski, Elizabeth; Andersen, Susan M

2015-10-01

Evidence shows that representations of significant others (SOs) are used in interpersonal relations-for example, in the social-cognitive process of transference (see Andersen & Chen, 2002), a process that is assumed to serve meaning-making functions (Glassman & Andersen, 1999b). Five studies tested the more specific notion that implicit activation of an SO representation in transference should indirectly activate the worldview shared with the SO, leading to its active pursuit, validation, and protection. Shared worldviews were assessed beforehand, both idiographically, as values (Studies 1 and 4), and nomothetically, as political ideology or religious beliefs (Studies 2, 3, and 5). In each experiment, participants learned about new persons, one subtly resembling their own SO. Transference was assessed (memory bias; positive evaluation; see Andersen, Reznik, & Manzella, 1996) and, crucially, as predicted, when considering the new person resembling their SO (vs. the control persons), participants showed faster response latencies in a lexical decision task to words reflecting the worldview shared with the SO (vs. held only personally, Studies 1-3, or only by the SO, Study 3). With this person, they also anticipated a more meaningful interaction and actively socially tuned to the SO-shared worldview, selecting conversation topics reflecting the SO-shared worldview (vs. personally held or SO-held topics, Studies 1-3). Finally, threatening the SO-shared worldview with this person (vs. threatening personally held, SO-held, or irrelevant worldviews) prompted goal activation to restore the disrupted meaning (Studies 4 and 5), assessed by response latency in a lexical decision task. Transference thus evokes shared meaning systems and serves epistemic functions. (c) 2015 APA, all rights reserved).

Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.

PubMed

Yue, Xiao; Wang, Huiju; Jin, Dawei; Li, Mingqiang; Jiang, Wei

2016-10-01

Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

Shared environmental influences on personality: A combined twin and adoption approach

PubMed Central

Matteson, Lindsay K.; McGue, Matt; Iacono, William G.

2013-01-01

In the past, shared environmental influences on personality traits have been found to be negligible in behavior genetic studies (e.g., Bouchard & McGue, 2003). However, most studies have been based on biometrical modeling of twins only. Failure to meet key assumptions of the classical twin design could lead to biased estimates of shared environmental effects. Alternative approaches to the etiology of personality are needed. In the current study we estimated the impact of shared environmental factors on adolescent personality by simultaneously modeling both twin and adoption data. We found evidence for significant shared environmental influences on Multidimensional Personality Questionnaire (MPQ) Absorption (15% variance explained), Alienation (10%), Harm Avoidance (14%), and Traditionalism (26%) scales. Additionally, we found that in most cases biometrical models constraining parameter estimates to be equal across study type (twins versus adoptees) fit no worse than models allowing these parameters to vary; this suggests that results converge across study design despite the potential (sometimes opposite) biases of twin and adoption studies. Thus, we can be more confident that our findings represent the true contribution of shared environmental variance to personality development. PMID:24065564

Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study.

PubMed

Sjögren, Karin; Lindkvist, Marie; Sandman, Per-Olof; Zingmark, Karin; Edvardsson, David

2017-01-01

Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics. A cross-sectional design was used. Residents ( n  = 1460) and staff ( n  = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents . Descriptive and comparative statistics, independent samples t-test, Chi 2 test, Eta Squared and Phi coefficient were used to analyse data. Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care. It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

The role of social media in reducing stigma and discrimination.

PubMed

Betton, Victoria; Borschmann, Rohan; Docherty, Mary; Coleman, Stephen; Brown, Mark; Henderson, Claire

2015-06-01

This editorial explores the implications of social media practices whereby people with mental health problems share their experiences in online public spaces and challenge mental health stigma. Social media enable individuals to bring personal experience into the public domain with the potential to affect public attitudes and mainstream media. We draw tentative conclusions regarding the use of social media by campaigning organisations. © The Royal College of Psychiatrists 2015.

Developing Grit in Our Students: Why Grit Is Such a Desirable Trait, and Practical Strategies for Teachers and Schools

ERIC Educational Resources Information Center

Bashant, Jennifer

2014-01-01

Why do most individuals make use of only a small percentage of their resources, whereas a few exceptional individuals push themselves to their limits? Why do some individuals accomplish more than others of equal intelligence? One personal quality that is shared by most high achieving and successful people is grit. Grit may be the quality that sets…

Voices from Left of the Dial:* Reflections of Practice-Based Researchers

PubMed Central

Fagnan, Lyle J.; Handley, Margaret A.; Rollins, Nancy; Mold, James

2010-01-01

Background Purpose Practice-Based Research Networks (PBRNs) provide an important approach to implementing primary care research at the community level, thus increasing the relevance and utility of research findings for routine primary care practices. PBRNs expend considerable time and energy in the recruitment, engagement, and retention of network clinicians and practices to establish this community-based primary care research laboratory. This study assessed factors motivating PBRN clinicians to participate and stay involved in practice-based research in their primary care office setting. Methods We invited practicing clinicians across the United States who are affiliated with a PBRN to share their stories regarding motivations to participate in practice-based research. Using qualitative methods, we categorized the stories into the main motivation for participation and the perceived impact of participation. Results We collected 37 stories from clinicians affiliated with 12 PBRNS located in 14 states. Motivations for participation in practice-based research included themes associated with personal satisfaction, improving local clinic-based care, and contributing to community and system level improvements. Sources of personal satisfaction corresponded to the three psychological needs postulated by Deci's and Ryan's Self-Determination Theory: competence, autonomy, and relatedness. Conclusions These PBRN clinician stories describe the values, motivations and unique paths that clinicians took as they chose to participate and stay active in a practice-based research network. Their voices have the potential to influence others to participate in practice-based research. PMID:20616286

Partnerships in medical business: a framework for choosing the right key players.

PubMed

Dhawan, Naveen

2013-01-01

At a time when more and more physicians are opting for shared practices and embarking on business ventures, partnerships play a key role. The fate of a medical business is largely contingent upon the success of the partnership. In this article, the author introduces a practical framework for deciding whether to take on a partnership. The model considers six critical factors: financial compensation, special skill set, goal alignment, personality assessment, overall strengths and weaknesses, and trustworthiness. It also provides an evaluation of financial incentives. The paper also provides several action items for physicians.

Digital health and the biopolitics of the Quantified Self

PubMed Central

Ajana, Btihaj

2017-01-01

Recent years have witnessed an intensive growth of systems of measurement and an increasing integration of data processes into various spheres of everyday life. From smartphone apps that measure our activity and sleep, to digital devices that monitor our health and performance at the workplace, the culture of measurement is currently on the rise. Encouraged by movements such as the Quantified Self, whose motto is ‘self knowledge through numbers’, a growing number of people across the globe are embracing practices of self-quantification and tracking in the spirit of improving their wellbeing and productivity or charting their fitness progress. In this article, I examine the biopolitical aspects of the Quantified Self practices, exploring some of the ideologies and rationalities underlying self-tracking culture. I argue that such practices represent an instantiation of a ‘biopolitics of the self’ whereby the body is made amenable to management and monitoring techniques that often echo the ethos of neoliberalism. Rather than being restricted to an individualized form, self-tracking practices are also becoming part of a biosocial and communal phenomenon in which individuals are incited to share with others information about their physical activities and biodata. In exploring some examples of this data sharing culture, I critically address the extent to which the sharing of personal physical data can be seen as a ‘solidaristic’ act that can contribute to a larger Big Data ecosystem and inform the wider medical community and healthcare research and policy. I link this discussion to debates on ‘data philanthropy’, highlighting the emerging tension between philanthropic discourses of data sharing and issues of privacy. From here, I go on to discuss further ethical and political concerns, particularly in relation to data security and the marked shifts in healthcare responsibilities.

The Development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): A Large-Scale Data Sharing Initiative

PubMed Central

Lutomski, Jennifer E.; Baars, Maria A. E.; Schalk, Bianca W. M.; Boter, Han; Buurman, Bianca M.; den Elzen, Wendy P. J.; Jansen, Aaltje P. D.; Kempen, Gertrudis I. J. M.; Steunenberg, Bas; Steyerberg, Ewout W.; Olde Rikkert, Marcel G. M.; Melis, René J. F.

2013-01-01

Introduction In 2008, the Ministry of Health, Welfare and Sport commissioned the National Care for the Elderly Programme. While numerous research projects in older persons’ health care were to be conducted under this national agenda, the Programme further advocated the development of The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) which would be integrated into all funded research protocols. In this context, we describe TOPICS data sharing initiative (www.topics-mds.eu). Materials and Methods A working group drafted TOPICS-MDS prototype, which was subsequently approved by a multidisciplinary panel. Using instruments validated for older populations, information was collected on demographics, morbidity, quality of life, functional limitations, mental health, social functioning and health service utilisation. For informal caregivers, information was collected on demographics, hours of informal care and quality of life (including subjective care-related burden). Results Between 2010 and 2013, a total of 41 research projects contributed data to TOPICS-MDS, resulting in preliminary data available for 32,310 older persons and 3,940 informal caregivers. The majority of studies sampled were from primary care settings and inclusion criteria differed across studies. Discussion TOPICS-MDS is a public data repository which contains essential data to better understand health challenges experienced by older persons and informal caregivers. Such findings are relevant for countries where increasing health-related expenditure has necessitated the evaluation of contemporary health care delivery. Although open sharing of data can be difficult to achieve in practice, proactively addressing issues of data protection, conflicting data analysis requests and funding limitations during TOPICS-MDS developmental phase has fostered a data sharing culture. To date, TOPICS-MDS has been successfully incorporated into 41 research projects, thus supporting the feasibility of constructing a large (>30,000 observations), standardised dataset pooled from various study protocols with different sampling frameworks. This unique implementation strategy improves efficiency and facilitates individual-level data meta-analysis. PMID:24324716

Content Sharing Based on Personal Information in Virtually Secured Space

NASA Astrophysics Data System (ADS)

Sohn, Hosik; Ro, Yong Man; Plataniotis, Kostantinos N.

User generated contents (UGC) are shared in an open space like social media where users can upload and consume contents freely. Since the access of contents is not restricted, the contents could be delivered to unwanted users or misused sometimes. In this paper, we propose a method for sharing UGCs securely based on the personal information of users. With the proposed method, virtual secure space is created for contents delivery. The virtual secure space allows UGC creator to deliver contents to users who have similar personal information and they can consume the contents without any leakage of personal information. In order to verify the usefulness of the proposed method, the experiment was performed where the content was encrypted with personal information of creator, and users with similar personal information have decrypted and consumed the contents. The results showed that UGCs were securely shared among users who have similar personal information.

Caring teaching practices in multiethnic mathematics classrooms: attending to health and well-being

NASA Astrophysics Data System (ADS)

Averill, Robin

2012-06-01

Factors that contribute to strong teacher-student relationships are vital to understand because of the influence these relationships have on achievement and motivation, particularly for minority group students. This article draws from a substantial quantity of empirical data, grounded in a wide theoretical and cultural base, regarding aspects of caring teacher practice to discuss mathematics teacher behaviours in relation to an existing model of health and well-being that encompasses cognitive, social, spiritual, and physical dimensions. Drawing from 100 Year 10 mathematics lesson observations involving six teachers and their classes across three urban schools, evidence emerged that for many indigenous (Māori), New Zealand Pacific, and New Zealand European students, caring teacher behaviours important for student engagement and achievement both include, and range beyond, traditional teaching practices. Examples include capitalising on student reactions and shared endeavours within the context of mathematics learning, expecting mathematical progress, showing respect for students and for their mathematics learning, being explicit about practice and expectations, incorporating one-to-one interactions, making opportunities within mathematics learning for sharing personal identities, and incorporating movement. This research illustrates how mathematics educators can attend to the specific and holistic mathematical learning needs of their students, including those often marginalised.

The inadvertent breach of confidentiality.

PubMed

Erlen, J A

1998-01-01

Patients believe that personal information that they share with their health care providers will be kept strictly confidential. Safeguarding a confidence has been and continues to be an expected professional behavior. Yet, a common ethical problem that nurses face in their everyday practice is the inadvertent disclosure of private information about particular patients to individuals who have no need for this information. This article discusses the inadvertent breach of confidentiality and its related ethical concepts: privacy, respect for persons, trust and fidelity, and the potential for harm or injury. Recommendations are provided to enable nurses to avoid and manage situations that involve an inadvertent breach of confidentiality.

About Personal Protective Equipment (PPE)

MedlinePlus

... Equipment for Infection Control Questions About Personal Protective Equipment (PPE) Share Tweet Linkedin Pin it More sharing ... Print Q1. How do manufacturers ensure personal protective equipment (PPE) is safe and effective? A1. To help ...

How Do Personality Traits Shape Information-Sharing Behaviour in Social Media? Exploring the Mediating Effect of Generalized Trust

ERIC Educational Resources Information Center

Deng, Shengli; Lin, Yanqing; Liu, Yong; Chen, Xiaoyu; Li, Hongxiu

2017-01-01

Introduction: Personality and trust have been found to be important precursors of information-sharing behaviour, but little is known about how these factors interact with each other in shaping information-sharing behaviour. By integrating both trust and user personality into a unified research framework, this study examines how trust mediates the…

Protecting posted genes: social networking and the limits of GINA.

PubMed

Soo-Jin Lee, Sandra; Borgelt, Emily

2014-01-01

The combination of decreased genotyping costs and prolific social media use is fueling a personal genetic testing industry in which consumers purchase and interact with genetic risk information online. Consumers and their genetic risk profiles are protected in some respects by the 2008 federal Genetic Information Nondiscrimination Act (GINA), which forbids the discriminatory use of genetic information by employers and health insurers; however, practical and technical limitations undermine its enforceability, given the everyday practices of online social networking and its impact on the workplace. In the Web 2.0 era, employers in most states can legally search about job candidates and employees online, probing social networking sites for personal information that might bear on hiring and employment decisions. We examine GINA's protections for online sharing of genetic information as well as its limitations, and propose policy recommendations to address current gaps that leave employees' genetic information vulnerable in a Web-based world.

‘The kind of mildly curious sort of science interested person like me’: Science bloggers’ practices relating to audience recruitment

PubMed Central

Ranger, Mathieu; Bultitude, Karen

2014-01-01

With at least 150 million professional and amateur blogs on the Internet, blogging offers a potentially powerful tool for engaging large and diverse audiences with science. This article investigates science blogging practices to uncover key trends, including bloggers’ self-perceptions of their role. Interviews with seven of the most popular science bloggers revealed them to be driven by intrinsic personal motivations. Wishing to pursue their love of writing and share their passion for science, they produce content suitable for niche audiences of science enthusiasts, although they do not assume background scientific knowledge. A content analysis of 1000 blog posts and comparison with the most popular blogs on the Internet further confirmed this result and additionally identified key factors that affect science blog popularity, including update frequency, topic diversity and the inclusion of non-text elements (especially images and video). PMID:25361791

'The kind of mildly curious sort of science interested person like me': Science bloggers' practices relating to audience recruitment.

PubMed

Ranger, Mathieu; Bultitude, Karen

2016-04-01

With at least 150 million professional and amateur blogs on the Internet, blogging offers a potentially powerful tool for engaging large and diverse audiences with science. This article investigates science blogging practices to uncover key trends, including bloggers' self-perceptions of their role. Interviews with seven of the most popular science bloggers revealed them to be driven by intrinsic personal motivations. Wishing to pursue their love of writing and share their passion for science, they produce content suitable for niche audiences of science enthusiasts, although they do not assume background scientific knowledge. A content analysis of 1000 blog posts and comparison with the most popular blogs on the Internet further confirmed this result and additionally identified key factors that affect science blog popularity, including update frequency, topic diversity and the inclusion of non-text elements (especially images and video). © The Author(s) 2014.

Toward patient-centered, personalized and personal decision support and knowledge management: a survey.

PubMed

Leong, T-Y

2012-01-01

This paper summarizes the recent trends and highlights the challenges and opportunities in decision support and knowledge management for patient-centered, personalized, and personal health care. The discussions are based on a broad survey of related references, focusing on the most recent publications. Major advances are examined in the areas of i) shared decision making paradigms, ii) continuity of care infrastructures and architectures, iii) human factors and system design approaches, iv) knowledge management innovations, and v) practical deployment and change considerations. Many important initiatives, projects, and plans with promising results have been identified. The common themes focus on supporting the individual patients who are playing an increasing central role in their own care decision processes. New collaborative decision making paradigms and information infrastructures are required to ensure effective continuity of care. Human factors and usability are crucial for the successful development and deployment of the relevant systems, tools, and aids. Advances in personalized medicine can be achieved through integrating genomic, phenotypic and other biological, individual, and population level information, and gaining useful insights from building and analyzing biological and other models at multiple levels of abstraction. Therefore, new Information and Communication Technologies and evaluation approaches are needed to effectively manage the scale and complexity of biomedical and health information, and adapt to the changing nature of clinical decision support. Recent research in decision support and knowledge management combines heterogeneous information and personal data to provide cost-effective, calibrated, personalized support in shared decision making at the point of care. Current and emerging efforts concentrate on developing or extending conventional paradigms, techniques, systems, and architectures for the new predictive, preemptive, and participatory health care model for patient-centered, personalized medicine. There is also an increasing emphasis on managing complexity with changing care models, processes, and settings.

Psychological reality and the role of the teacher in early-education sharing time

NASA Astrophysics Data System (ADS)

Alsafi, Abdullah T.

1994-01-01

The study of children's language development has been strongly influenced since the 1950s by linguistic research. How well, however, has the education of young children incorporated the concept of psychological reality, which interrelates the child's perceptual and cognitive development with linguistic and non-linguistic events in his/her environment? In reply to this question, the paper concentrates on"sharing time", known also as"show and tell", which has both affective and cognitive value. Although sharing time is a student-centered activity, the teacher plays a pivotal role in establishing its context, structure and norms. Feedback from the teacher and peers promotes language development, and the growth of curiosity and inquisitiveness. The article is derived from experience in teaching kindergarten teachers to conduct sharing time periods in Saudi Arabia. Practical suggestions are made for the implementation of the activity, in the interests of encouraging spontaneous and personalized language rather than focusing on evaluation of students' competence in the formal aspects of language development.

Beginning with Our Voices: How the Experiential Stories of First Nations Women Contribute to a National Research Project.

PubMed

Acoose, Sharon; Blunderfield, Debbie; Dell, Colleen Anne; Desjarlais, Val

2009-12-01

The purpose of this paper is to review how the experiential stories of First Nations women contribute to a national research project. The project focuses on how women's healing is impacted by their views about themselves as - and the stigma associated with being - a drug user, involved in crime and an Aboriginal woman. Our project began with three First Nations women on our research team documenting the role of stigma and self-identity in their personal healing journeys from problematically using drugs and being in conflict with the law. In this paper we discuss how key components of feminist research practices, Aboriginal methodology and community-based research helped us position the women's experiential stories in authoritative, recognized and celebrated ways in our study. We illustrate how the women's stories uniquely contributed to the creation of our interview questions and the research project in general. We also discuss how the women personally benefited from writing about and sharing their experiences. Key benefits include the women discovering the impact of the written word, promotion of their healing, personal recognition of their ability to offer hope to women in need, increased self-esteem, and increased appreciation of the importance of sharing their lived experiences with others. Our method of research differs from a conventional western scientific approach to understanding, and as such made important contributions to both the project itself and the women who shared their experiential stories.

[A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

PubMed

Petrini, Carlo

2015-01-01

The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

How HEXACO Personality Traits Predict Different Selfie-Posting Behaviors among Adolescents and Young Adults

PubMed Central

Baiocco, Roberto; Chirumbolo, Antonio; Bianchi, Dora; Ioverno, Salvatore; Morelli, Mara; Nappa, Maria R.

2017-01-01

Selfies are self-portrait photos shared on Social Networks. Previous literature has investigated how personality traits, and specifically narcissism, are associated with selfie-posting behaviors. In this contribution we investigated how selfie-posting behaviors are predicted by the six HEXACO personality traits, controlling for age, gender and sexual orientation. The Kinsey scale, three questions about the frequency of own selfies, group selfies and selfies with partner, and 60-item HEXACO Personality Inventory-Revised were administered to 750 young people from 13 to 30 years. Females, adolescents and not-exclusively heterosexual people posted more own selfies, and adolescents posted also more group selfies and selfies with partner. Moreover, lower Honesty/Humility, lower Conscientiousness, higher Emotionality and higher Extraversion significantly predict own selfies and group selfies. Finally, only lower Honesty/Humility and higher Emotionality predict selfies with partner. Theoretical and practical implications are provided. PMID:28119662

openPDS: protecting the privacy of metadata through SafeAnswers.

PubMed

de Montjoye, Yves-Alexandre; Shmueli, Erez; Wang, Samuel S; Pentland, Alex Sandy

2014-01-01

The rise of smartphones and web services made possible the large-scale collection of personal metadata. Information about individuals' location, phone call logs, or web-searches, is collected and used intensively by organizations and big data researchers. Metadata has however yet to realize its full potential. Privacy and legal concerns, as well as the lack of technical solutions for personal metadata management is preventing metadata from being shared and reconciled under the control of the individual. This lack of access and control is furthermore fueling growing concerns, as it prevents individuals from understanding and managing the risks associated with the collection and use of their data. Our contribution is two-fold: (1) we describe openPDS, a personal metadata management framework that allows individuals to collect, store, and give fine-grained access to their metadata to third parties. It has been implemented in two field studies; (2) we introduce and analyze SafeAnswers, a new and practical way of protecting the privacy of metadata at an individual level. SafeAnswers turns a hard anonymization problem into a more tractable security one. It allows services to ask questions whose answers are calculated against the metadata instead of trying to anonymize individuals' metadata. The dimensionality of the data shared with the services is reduced from high-dimensional metadata to low-dimensional answers that are less likely to be re-identifiable and to contain sensitive information. These answers can then be directly shared individually or in aggregate. openPDS and SafeAnswers provide a new way of dynamically protecting personal metadata, thereby supporting the creation of smart data-driven services and data science research.

openPDS: Protecting the Privacy of Metadata through SafeAnswers

PubMed Central

de Montjoye, Yves-Alexandre; Shmueli, Erez; Wang, Samuel S.; Pentland, Alex Sandy

2014-01-01

The rise of smartphones and web services made possible the large-scale collection of personal metadata. Information about individuals' location, phone call logs, or web-searches, is collected and used intensively by organizations and big data researchers. Metadata has however yet to realize its full potential. Privacy and legal concerns, as well as the lack of technical solutions for personal metadata management is preventing metadata from being shared and reconciled under the control of the individual. This lack of access and control is furthermore fueling growing concerns, as it prevents individuals from understanding and managing the risks associated with the collection and use of their data. Our contribution is two-fold: (1) we describe openPDS, a personal metadata management framework that allows individuals to collect, store, and give fine-grained access to their metadata to third parties. It has been implemented in two field studies; (2) we introduce and analyze SafeAnswers, a new and practical way of protecting the privacy of metadata at an individual level. SafeAnswers turns a hard anonymization problem into a more tractable security one. It allows services to ask questions whose answers are calculated against the metadata instead of trying to anonymize individuals' metadata. The dimensionality of the data shared with the services is reduced from high-dimensional metadata to low-dimensional answers that are less likely to be re-identifiable and to contain sensitive information. These answers can then be directly shared individually or in aggregate. openPDS and SafeAnswers provide a new way of dynamically protecting personal metadata, thereby supporting the creation of smart data-driven services and data science research. PMID:25007320

Supporting Aphasics for Capturing, Organizing and Sharing Personal Experiences

NASA Astrophysics Data System (ADS)

Al Mahmud, Abdullah

When a person, due to brain injury or another disease, suffers in his or her ability to speak, it becomes inherently cumbersome to share needs, emotions, and experiences through personal stories and social interaction. This paper describes the aim and progress of the author’s dissertation, which focuses on designing a support system to share daily experiences for people suffering from expressive aphasia.

Phases of "pre-engagement" capacity building: discovery, exploration, and trial alliance.

PubMed

Campbell-Voytal, Kimberly

2010-01-01

Academic prevention researchers who engage limited-resource communities may find that organizational or community capacity for prevention is low. Community organizations, neighborhoods, and academic partners may lack shared issue awareness, mutual interests, and interactive skills necessary for collaborative intervention. Existing capacity building models either ignore a 'pre-engagement' phase or acknowledge it without offering strategic detail. An exploratory or developmental phase before active engagement can be achieved through co-located work in a community setting. The construct, "ecology of practice," provides conceptual background for examining how "shared work" introduces and prepares partners for future collaboration consistent with community-based participatory research (CBPR) principles. This paper presents two case studies where pre-engagement capacity building involved partners who were initially unaware, disinterested, or unable to engage in preventive interventions. These cases illustrate how mutual participation in shared "ecologies of practice" enabled an exchange of cultural knowledge, skill, and language that laid the groundwork for future preventive intervention. A trajectory of developmental work in each case occurred over 5 years. Historical timelines, interviews, and personal communications between community and academic leaders were reviewed and common themes identified. A model of "pre-capacity building" emerged. Capacity-building models that detail strategies for developing equitable engagement in under-resourced settings will more effectively move best practices into vulnerable communities. Preventive interventions must be translated equitably if health disparities are to be reduced.

26 CFR 1.6039-1 - Returns required in connection with certain options.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the person; (v) The exercise price per share; (vi) The date the option was exercised by the person...) The actual exercise price paid per share; (vi) The exercise price per share determined as if the... exercise price per share is not fixed or determinable on the date the option was granted); (vii) The date...

The Intersections of Science and Practice: Examples From FitnessGram® Programming.

PubMed

Welk, Gregory J

2017-12-01

The FitnessGram® program has provided teachers with practical tools to enhance physical education programming. A key to the success of the program has been the systematic application of science to practice. Strong research methods have been used to develop assessments and standards for use in physical education, but consideration has also been given to ensure that programming meets the needs of teachers, students, parents, and other stakeholders. This essay summarizes some of these complex and nuanced intersections between science and practice with the FitnessGram® program. The commentaries are organized into 5 brief themes: science informing practice; practice informing science; balancing science and practice; promoting evidence-based practice; and the integration of science and practice. The article draws on personal experiences with the FitnessGram® program and is prepared based on comments shared during the 37th Annual C. H. McCloy Research Lecture at the 2017 SHAPE America - Society of Health and Physical Educators Convention.

[Employment of People with Mental Disorders in Terms of the Policies Developed by the European and International Institutions].

PubMed

Joly, Laurène

Objectives The aim of this article is to present an overview of the reflections led by various European and international organizations on the employment of people with mental disorders.Methods This study is based on data from websites of international organizations and interviews taken place with a disability specialist at the International Labour Organisation (ILO) and members of the European Commission.Results Unlike the French law of 11 February 2005 which refers expressly to psychic disability, this notion is not explicitly dedicated by various European and international legal rules. However, these standards like the United Nations Convention on the Rights of Persons with Disabilities have adopted the contemporary model which presents disability as the result of an interaction between person and environment. Thus they acknowledge that disabled people include people suffering from mental disorders because in the person's environment, a psychiatric impairment could lead to limitations of activities or restrictions of social participation that constitute a situation of disability of psychiatric origin. Therefore, the legal mechanisms often do not provide appropriate answers to the characteristics of psychiatric disability.Besides, negative attitudes, stereotypes and discrimination towards people with a psychiatric disability are still observed in the workplace, in spite of intensified anti-discrimination legislation.This study inventories the different proposals to remedy to substantial barriers to the employment of people with a psychiatric condition. In the European Union's strategy for increasing the employment of these persons, particular consideration is given to put forward a series of key recommendations to improve practices of reasonable accommodation in the workplace. Nonetheless, it must be emphasized that it is necessary to conceive adequate measures in order to take into account the changeability and the unpredictability of mental disorders. Indeed, situations of psychiatric disability require flexibility and reactivity more than any other situation of disability. The discrimination experienced by people with a psychiatric disability is likely to continue as long as specific responses are not implemented. In this perspective, ILO highlights a number of best practices addressing the challenges of psychiatric disabled people's employment. That is why a disability network was created to share knowledge. The great added value of this network is the opportunity to share best practices between companies, best practices between countries in order to increase the ability to include people with mental disorders. Focus is put on strategies to combat discrimination in employment, by raising awareness, exploring measures and good practices to improve mental health in the workplace.Conclusion Finally, this study shows similar challenges in the prevention of the mental health and the issue of the psychiatric handicap, including to remedy to the insufficient attention paid to provide reasonable accommodation to persons with mental disorders.

Individualised patient care: a framework for guidelines.

PubMed

Redfern, S

It is assumed that individualised patient care (IPC) benefits both patients and nurses. This study set out to clarify what IPC means to nurses and how they practise it, as well as how it is experienced by patients. With some exceptions, IPC was not practised widely in the seven wards used as case studies. Even in the wards where it was more common, there were some examples of bad practice. Factors that facilitated IPC were: the personal qualities of the nurses; a shared understanding among the ward team of the goals of nursing care and what constitutes good practice; levels of staffing and skill mix; effective leadership and management of nursing work.

Crafting a Social Context for Medical Informatics Networks

NASA Astrophysics Data System (ADS)

Patel, Salil H.

Effective healthcare delivery is increasingly predicated upon the availability, accuracy, and integrity of personal health information. Tracking and analysis of medical information throughout its lifeeycle may be viewed through the lenses of both physical network architecture and the broader social context in which such information is gathered and applied. As information technology and evidence-based practice models evolve in tandem, the development of interlinked multimodal and multidimensional databases has shown great promise for improving public health. To this end. providers, regulators, payers, and individual patients each share rights and responsibilities in creating a milieu which both, fosters and protects the practice and promise of medical information.

Barriers and Promoters to Participation in the Era of Shared Treatment Decision-Making.

PubMed

McCarter, Sarah P; Tariman, Joseph D; Spawn, Nadia; Mehmeti, Enisa; Bishop-Royse, Jessica; Garcia, Ima; Hartle, Lisa; Szubski, Katharine

2016-10-01

This study aimed to identify the barriers and promoters for participation in cancer treatment decision in the era of shared decision-making (SDM) process. A qualitative design was utilized. Nineteen nurses and 11 nurse practitioners from oncology inpatient and outpatient settings participated in semi-structured interviews. Data were analyzed using directed content analysis. The findings include practice barrier, patient barrier, institutional policy barrier, professional barrier, scope of practice barrier, insurance coverage barrier, and administrative barrier. Multidisciplinary team approach, having a nursing voice during SDM, high level of knowledge of the disease and treatment, and personal valuation of SDM participation were perceived as promoters. Oncology nurses and nurse practitioners face many barriers to their participation during SDM. Organizational support and system-wide culture of SDM are essential to achieve better cancer treatment decisions outcome. Additional studies are needed to determine the factors that can promote more participation among nurses and nurse practitioners. © The Author(s) 2016.

A Qualitative Analysis of Real-Time Continuous Glucose Monitoring Data Sharing with Care Partners: To Share or Not to Share?

PubMed

Litchman, Michelle L; Allen, Nancy A; Colicchio, Vanessa D; Wawrzynski, Sarah E; Sparling, Kerri M; Hendricks, Krissa L; Berg, Cynthia A

2018-01-01

Little research exists regarding how real-time continuous glucose monitoring (RT-CGM) data sharing plays a role in the relationship between patients and their care partners. To (1) identify the benefits and challenges related to RT-CGM data sharing from the patient and care partner perspective and (2) to explore the number and type of individuals who share and follow RT-CGM data. This qualitative content analysis was conducted by examining publicly available blogs focused on RT-CGM and data sharing. A thematic analysis of blogs and associated comments was conducted. A systematic appraisal of personal blogs examined 39 blogs with 206 corresponding comments. The results of the study provided insight about the benefits and challenges related to individuals with diabetes sharing their RT-CGM data with a care partner(s). The analysis resulted in three themes: (1) RT-CGM data sharing enhances feelings of safety, (2) the need to communicate boundaries to avoid judgment, and (3) choice about sharing and following RT-CGM data. RT-CGM data sharing occurred within dyads (n = 46), triads (n = 15), and tetrads (n = 2). Adults and children with type 1 diabetes and their care partners are empowered by the ability to share and follow RT-CGM data. Our findings suggest that RT-CGM data sharing between an individual with diabetes and their care partner can complicate relationships. Healthcare providers need to engage patients and care partners in discussions about best practices related to RT-CGM sharing and following to avoid frustrations within the relationship.

Cyberinfrastructure for Open Science at the Montreal Neurological Institute

PubMed Central

Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S.; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M.; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D. Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A.; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C.

2017-01-01

Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing the vision of Open Science at the Montreal Neurological Institute will be a concerted undertaking that seeks to facilitate data sharing for the global research community. Our goal is to utilize the years of experience in multi-site collaborative research infrastructure to implement the technical requirements to achieve this level of public data sharing in a practical yet robust manner, in support of accelerating scientific discovery. PMID:28111547

Cyberinfrastructure for Open Science at the Montreal Neurological Institute.

PubMed

Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C

2016-01-01

Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing the vision of Open Science at the Montreal Neurological Institute will be a concerted undertaking that seeks to facilitate data sharing for the global research community. Our goal is to utilize the years of experience in multi-site collaborative research infrastructure to implement the technical requirements to achieve this level of public data sharing in a practical yet robust manner, in support of accelerating scientific discovery.

Perceived non-shared environment, personality traits, family factors and developmental experiences in bulimia nervosa.

PubMed

Lehoux, Pascale M; Howe, Nina

2007-03-01

The role of perceived non-shared environmental influences and personality traits in the risk of developing bulimia nervosa (BN) was compared in 40 women with BN and their non-eating disordered sisters. The two sisters were compared for (a) eating pathology, (b) perceived non-shared environmental factors (differential family relationships, developmental teasing, traumatic experiences), (c) personality traits (impulsivity, affective instability, narcissism), and (d) psychopathology (anxiety, depression). Specific perceived non-shared risk factors (e.g. perceptions of teasing), nonspecific non-shared risk factors (e.g. insecure paternal attachment) and personality traits (e.g. narcissism) distinguished women with BN from sisters. In the final logistic regression, insecure paternal attachment predicted the risk for BN, while trends were apparent for narcissism and developmental teasing after controlling for psychopathology. Our correlational cross-sectional design does not allow for investigation of direction of effects. However, it is an important first step in identifying possible perceived non-shared environmental influences and personality traits that may constitute vulnerability factors predisposing individuals to the development of BN. Findings are discussed in the light of existing models of risk factors for the etiology of BN.

International academic mobility in nursing education: an experience report.

PubMed

Guskuma, Erica Mayumi; Dullius, Aline Alves Dos Santos; Godinho, Mônica La Salette da Costa; Costa, Maria Silvana Totti; Terra, Fábio de Souza

2016-01-01

report the experience of international academic mobility in Ireland through the program Science Without Borders during undergraduate education in nursing. a report of experience presented in chronological order, with a descriptive nature. the opportunity to know and be able to discuss questions regarding health and nursing in Ireland allowed the review of concepts and a more reflective perspective regarding nursing practices. Additionally, the exchange promoted personal strengthening regarding the confrontation and solution of problems, development of technical and scientific abilities, improvement of linguistic competences and construction of personality, independence and maturity. regarding such constructive and enriching experience that this mobility provides to students, to the governing authorities, to the population and to Brazilian nursing, sharing this experience is expected to serve as encouragement for those who search for new horizons, with the objective of adding knowledge for their personal and professional life.

Psychopathic personality traits in 5 year old twins: the importance of genetic and shared environmental influences.

PubMed

Tuvblad, Catherine; Fanti, Kostas A; Andershed, Henrik; Colins, Olivier F; Larsson, Henrik

2017-04-01

There is limited research on the genetic and environmental bases of psychopathic personality traits in children. In this study, psychopathic personality traits were assessed in a total of 1189 5-year-old boys and girls drawn from the Preschool Twin Study in Sweden. Psychopathic personality traits were assessed with the Child Problematic Traits Inventory, a teacher-report measure of psychopathic personality traits in children ranging from 3 to 12 years old. Univariate results showed that genetic influences accounted for 57, 25, and 74 % of the variance in the grandiose-deceitful, callous-unemotional, and impulsive-need for stimulation dimensions, while the shared environment accounted for 17, 48 and 9 % (n.s.) in grandiose-deceitful and callous-unemotional, impulsive-need for stimulation dimensions, respectively. No sex differences were found in the genetic and environmental variance components. The non-shared environment accounted for the remaining 26, 27 and 17 % of the variance, respectively. The three dimensions of psychopathic personality were moderately correlated (0.54-0.66) and these correlations were primarily mediated by genetic and shared environmental factors. In contrast to research conducted with adolescent and adult twins, we found that both genetic and shared environmental factors influenced psychopathic personality traits in early childhood. These findings indicate that etiological models of psychopathic personality traits would benefit by taking developmental stages and processes into consideration.

Online communities of practice as a communication resource for community health nurses working with homeless persons.

PubMed

Valaitis, Ruta K; Akhtar-Danesh, Noori; Brooks, Fiona; Binks, Sally; Semogas, Dyanne

2011-06-01

This study explored community health nurses' viewpoints about a Canadian online community of practice to support their practice with homeless or under-housed populations. Community health nurses who specifically work with homeless and marginally housed populations often report feelings of isolation and stress in managing complex problems in resource constraints. To strengthen intra-professional ties and enhance information access, an online community of practice was designed, implemented and evaluated by and for them. Q-methodology was used. Sixty-six statements about the community of practice were collected from an online survey and focus groups, refined and reduced to 44 statements. In 2009, sixteen participants completed the Q-sort activity, rating each statement relative to the others. Scores for each participant were subjected to by-person factor analysis. Respondents fell into two groups -tacit knowledge warriors and tacit knowledge communicators. Warriors strongly believed that the community of practice could combat stigma associated with homelessness and promote awareness of homelessness issues, and valued its potential to validate and improve practice. Communicators would have used the community of practice more with increased discussion, facilitation and prompt responses. Generally, nurses viewed the community of practice as a place to share stories, validate practice and adapt best practices to their work context. Online communities of practice can be valuable to nurses in specialized fields with limited peer support and access to information resources. Tacit knowledge development is important to nurses working with homeless populations: this needs to be valued in conjunction with scientifically based knowledge. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

SHARED, NOT UNIQUE, COMPONENTS OF PERSONALITY AND PSYCHOSOCIAL FUNCTIONING PREDICT DEPRESSION SEVERITY AFTER ACUTE-PHASE COGNITIVE THERAPY

PubMed Central

Clark, Lee Anna; Vittengl, Jeffrey R.; Kraft, Dolores; Jarrett, Robin B.

2005-01-01

In a sample of 100 patients with recurrent major depression, we collected depression severity data early and late in acute-phase cognitive therapy, plus a wide range of psychosocial variables that have been studied extensively in depression research, including measures of interpersonal, cognitive, and social functioning, and personality traits using an inventory that is linked with the Big-Three tradition in personality assessment theory. By assessing this broad range of variables in a single study, we could examine the extent to which relations of these variables with depression were due to (a) a common factor shared across this diverse set of constructs, (b) factors shared among each type of construct (personality vs. psychosocial measures), or (c) specific aspects of the individual measures. Only the most general factor shared across the personality and psychosocial variables predicted later depression. PMID:14632375

"The story God is weaving us into": narrativizing grief, faith, and infant loss in US evangelical women's blog communities

NASA Astrophysics Data System (ADS)

Whitehead, Deborah

2015-04-01

This case study explores how US evangelical Christian "mommy blog" communities constitute spaces for the collective memorialization of infant loss. Personal religious blogs feature a rich combination of esthetics, narrative structure, description of religious practices and beliefs, reader interaction, and linked networks. Using a textual approach, I illustrate distinctive features in how pregnancy and infant loss and grief are experienced, shared and memorialized in US women's evangelical blogging communities. I argue that the blog format allows for a (re)narrativization of the devastating experience of infant loss as grieving mothers situate their traumatic personal experiences within the context of an ongoing religious narrative in which blog readers also come to participate. As the blogger tells the story of her own loss to a listening public, it becomes a larger shared story, so that it is not just the child's story but also the author's story, their family's story, and "our story" inclusive of the blog community of readers, "the story God is weaving us into," post by post, day by day. Personal religious blogs and their reading publics, therefore, can provide a medium for the ongoing creation of meaning, faith and community in the context of infant loss.

[Precision Nursing: Individual-Based Knowledge Translation].

PubMed

Chiang, Li-Chi; Yeh, Mei-Ling; Su, Sui-Lung

2016-12-01

U.S. President Obama announced a new era of precision medicine in the Precision Medicine Initiative (PMI). This initiative aims to accelerate the progress of personalized medicine in light of individual requirements for prevention and treatment in order to improve the state of individual and public health. The recent and dramatic development of large-scale biologic databases (such as the human genome sequence), powerful methods for characterizing patients (such as genomics, microbiome, diverse biomarkers, and even pharmacogenomics), and computational tools for analyzing big data are maximizing the potential benefits of precision medicine. Nursing science should follow and keep pace with this trend in order to develop empirical knowledge and expertise in the area of personalized nursing care. Nursing scientists must encourage, examine, and put into practice innovative research on precision nursing in order to provide evidence-based guidance to clinical practice. The applications in personalized precision nursing care include: explanations of personalized information such as the results of genetic testing; patient advocacy and support; anticipation of results and treatment; ongoing chronic monitoring; and support for shared decision-making throughout the disease trajectory. Further, attention must focus on the family and the ethical implications of taking a personalized approach to care. Nurses will need to embrace the paradigm shift to precision nursing and work collaboratively across disciplines to provide the optimal personalized care to patients. If realized, the full potential of precision nursing will provide the best chance for good health for all.

Personal responsibility or shared responsibility: What is the appropriate role of the law in obesity prevention?

PubMed

Brooks, Benjamin

2015-09-01

Sensitive to allegations of "nanny state" paternalism, Australian governments support the doctrine that combating obesity is a matter of personal responsibility. Policy-makers endorse the "holistic" approach to obesity prevention, with a view to managing both sides of the nutritional energy equation. This paradigm allows the food and drinks industry to deflect its contributory responsibility for the epidemic and to avoid more stringent regulatory intervention beyond existing self-regulatory and corporate social responsibility regimes. This article argues that the industry must bear shared responsibility for the extent of the obesity crisis, although it cannot bear sole responsibility It defends the public interest case for more invasive, government-led regulation, reframing the crisis as one of public not individual burdens. Mindful of the political risk associated with unfocused calls for regulatory intervention, it articulates a set of regulatory principles to ensure that the interests of consumers and industry are properly acknowledged prior to further regulatory intervention. Finally, the article clarifies the subject, object and content of possible regulatory initiatives, offering an evaluation of their efficacy, practicality and fairness.

A Twin Study of Normative Personality and DSM-IV Personality Disorder Criterion Counts: Evidence for Separate Genetic Influences.

PubMed

Czajkowski, Nikolai; Aggen, Steven H; Krueger, Robert F; Kendler, Kenneth S; Neale, Michael C; Knudsen, Gun Peggy; Gillespie, Nathan A; Røysamb, Espen; Tambs, Kristian; Reichborn-Kjennerud, Ted

2018-03-21

Both normative personality and DSM-IV personality disorders have been found to be heritable. However, there is limited knowledge about the extent to which the genetic and environmental influences underlying DSM personality disorders are shared with those of normative personality. The aims of this study were to assess the phenotypic similarity between normative and pathological personality and to investigate the extent to which genetic and environmental influences underlying individual differences in normative personality account for symptom variance across DSM-IV personality disorders. A large population-based sample of adult twins was assessed for DSM-IV personality disorder criteria with structured interviews at two waves spanning a 10-year interval. At the second assessment, participants also completed the Big Five Inventory, a self-report instrument assessing the five-factor normative personality model. The proportion of genetic and environmental liabilities unique to the individual personality disorder measures, and hence not shared with the five Big Five Inventory domains, were estimated by means of multivariate Cholesky twin decompositions. The median percentage of genetic liability to the 10 DSM-IV personality disorders assessed at wave 1 that was not shared with the Big Five domains was 64%, whereas for the six personality disorders that were assessed concurrently at wave 2, the median was 39%. Conversely, the median proportions of unique environmental liability in the personality disorders for wave 1 and wave 2 were 97% and 96%, respectively. The results indicate that a moderate-to-sizable proportion of the genetic influence underlying DSM-IV personality disorders is not shared with the domain constructs of the Big Five model of normative personality. Caution should be exercised in assuming that normative personality measures can serve as proxies for DSM personality disorders when investigating the etiology of these disorders.

7 CFR 1210.601 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... watermelons, including any person who owns or shares the ownership and risk of loss of such watermelon crop. A person who shares the ownership and risk of loss includes a person who: (1) Owns and farms land, resulting in ownership, by said producer, of the watermelons produced thereon; (2) Rents and farms land...

Drug addiction and diabetes: South Asian action.

PubMed

Singh Balhara, Yatan Pal; Kalra, Sanjay

2017-06-01

Both diabetes and drug addiction are common phenomena across the world. Drug abuse impacts glycaemic control in multiple ways. It becomes imperative, therefore, to share guidance on drug deaddiction in persons with diabetes. The South Asian subcontinent is home to specific forms and patterns of drug abuse. Detailed study is needed to ensure good clinical practice regarding the same. This communication provides a simple and pragmatic framework to address this issue, while calling for concerted action on drug deaddiction in South Asia.

The UNC-CH MCH Leadership Training Consortium: building the capacity to develop interdisciplinary MCH leaders.

PubMed

Dodds, Janice; Vann, William; Lee, Jessica; Rosenberg, Angela; Rounds, Kathleen; Roth, Marcia; Wells, Marlyn; Evens, Emily; Margolis, Lewis H

2010-07-01

This article describes the UNC-CH MCH Leadership Consortium, a collaboration among five MCHB-funded training programs, and delineates the evolution of the leadership curriculum developed by the Consortium to cultivate interdisciplinary MCH leaders. In response to a suggestion by the MCHB, five MCHB-funded training programs--nutrition, pediatric dentistry, social work, LEND, and public health--created a consortium with four goals shared by these diverse MCH disciplines: (1) train MCH professionals for field leadership; (2) address the special health and social needs of women, infants, children and adolescents, with emphasis on a public health population-based approach; (3) foster interdisciplinary practice; and (4) assure competencies, such as family-centered and culturally competent practice, needed to serve effectively the MCH population. The consortium meets monthly. Its primary task to date has been to create a leadership curriculum for 20-30 master's, doctoral, and post-doctoral trainees to understand how to leverage personal leadership styles to make groups more effective, develop conflict/facilitation skills, and identify and enhance family-centered and culturally competent organizations. What began as an effort merely to understand shared interests around leadership development has evolved into an elaborate curriculum to address many MCH leadership competencies. The collaboration has also stimulated creative interdisciplinary research and practice opportunities for MCH trainees and faculty. MCHB-funded training programs should make a commitment to collaborate around developing leadership competencies that are shared across disciplines in order to enhance interdisciplinary leadership.

Making Each Other’s Daily Life: Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes

PubMed Central

James, Inger; Fredriksson, Carin; Wahlström, Catrin; Kihlgren, Annica; Blomberg, Karin

2014-01-01

Background: In a larger action research project, guidelines were generated for how a meaningful daily life could be developed for older persons. In this study, we focused on the nurse assistants’ (NAs) perspectives, as their knowledge is essential for a well-functioning team and quality of care. The aim was to learn from NAs’ experiences and knowledge about how to develop a meaningful daily life for older persons in nursing homes and the meaning NAs ascribe to their work. Methods: The project is based on Participatory and Appreciative Action and Reflection. Data were generated through interviews, participating observations and informal conversations with 27 NAs working in nursing homes in Sweden, and a thematic analysis was used. Result: NAs developed a meaningful daily life by sensing and finding the “right” way of being (Theme 1). They sense and read the older person in order to judge how the person was feeling (Theme 2). They adapt to the older person (Theme 3) and share their daily life (Theme 4). NAs use emotional involvement to develop a meaningful daily life for the older person and meaning in their own work (Theme 5), ultimately making each other’s daily lives meaningful. Conclusion: It was obvious that NAs based the development of a meaningful daily life on different forms of knowledge: the oreticaland practical knowledge, and practical wisdom, all of which are intertwined. These results could be used within the team to constitute a meaningful daily life for older persons in nursing homes. PMID:25246997

Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: a Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians.

PubMed

Palummieri, Antonio; De Carli, Gabriella; Rosenthal, Éric; Cacoub, Patrice; Mussini, Cristina; Puro, Vincenzo

2017-11-28

Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in Italy, a significant number of PLWHA were aware of it, and approximately 10% reported PrEP use in their close circle, although they rarely shared their ARVs with uninfected people for this purpose. Official policies and PrEP availability, along with implementation programs, could avoid risks from uncontrolled PrEP procurement and self-administration practices.

Stakeholders' views of shared learning models in general practice: a national survey.

PubMed

van de Mortel, Thea; Silberberg, Peter; Ahern, Christine; Pit, Sabrina

2014-09-01

The number of learners requiring general practice placements creates supervisory capacity constraints. This research examined how a shared learning model may affect training capacity. The number of learners requiring general practice placements creates supervisory capacity constraints. This research examined how a shared learning model may affect training capacity. A total of 1122 surveys were completed: 75% of learners had participated in shared learning; 25% of multi-level learner practices were not using shared learning. Learners were positive about shared learning (4.3-4.4/5), considering it an effective way to learn that created training capacity (4.1-4.2/5). 79-88% of learners preferred a mixture of one-to-one teaching and shared learning. Supervisors thought shared learning was more cost- and time-efficient, and created training capacity (4.3-4.4/5). Shared learning models have the potential to increase GP training capacity. Many practices are not utilising shared learning, representing capacity loss. Regional training providers should emphasise positive aspects of shared learning to facilitate uptake.

Gods, daemons and banshees on the journey to the magic scroll: the use of myth as a framework for reflective practice in nurse education.

PubMed

Morgan, S

1996-04-01

This paper reports the use of a mythic journey scenario within a student nurse groupwork session. This approach was introduced as a means to facilitate personal and interpersonal sharing and self-knowledge. These processes are held as important for the development of critical reflective process as a cornerstone of contemporary nursing practice. The use of myth invoked a coherent and supportive student environment within which previously reticent students appeared confident enough to contribute and explore their educational experience in nursing. The mythic allegoric process also identified some poignant themes and enemies, common across the student body. Monsters no less!

Provision of Personal Healthcare Services by Local Health Departments: 2008-2013.

PubMed

Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

2015-09-01

The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, p<0.001). A lower share of revenue from personal healthcare services is associated with lower per capita expenditures. LHDs, especially those serving <25,000 people, are highly dependent on personal healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Community Nurses' Experiences Regarding the Meaning and Promotion of Healthy Aging in Northeastern Thailand.

PubMed

Manasatchakun, Pornpun; Choowattanapakorn, Tassana; Roxberg, Åsa; Asp, Margareta

2018-03-01

Describe community nurses' experiences regarding the meaning and promotion of healthy aging in northeastern Thailand. Data were collected through five focus group interviews with 36 community nurses in northeastern Thailand. Latent content analysis was conducted to analyze the data. Healthy aging was characterized by the interconnection of older persons, older persons' family members, and the community. Healthy aging was associated with two themes: "being strong" and "being a supporter and feeling supported." The nurses' experiences in promoting healthy aging were described by the themes "providing health assessment," "sharing knowledge," and "having limited resources." The findings of this study provide a deeper understanding of the meaning of healthy aging from a holistic viewpoint. Community nurses must pay attention to older persons and their surroundings when planning how to promote healthy aging. Person-centeredness should be applied in practice to promote healthy aging. The current findings contribute useful information that should help policy makers develop healthy aging strategies in Thailand.

Ethical considerations of research policy for personal genome analysis: the approach of the Genome Science Project in Japan.

PubMed

Minari, Jusaku; Shirai, Tetsuya; Kato, Kazuto

2014-12-01

As evidenced by high-throughput sequencers, genomic technologies have recently undergone radical advances. These technologies enable comprehensive sequencing of personal genomes considerably more efficiently and less expensively than heretofore. These developments present a challenge to the conventional framework of biomedical ethics; under these changing circumstances, each research project has to develop a pragmatic research policy. Based on the experience with a new large-scale project-the Genome Science Project-this article presents a novel approach to conducting a specific policy for personal genome research in the Japanese context. In creating an original informed-consent form template for the project, we present a two-tiered process: making the draft of the template following an analysis of national and international policies; refining the draft template in conjunction with genome project researchers for practical application. Through practical use of the template, we have gained valuable experience in addressing challenges in the ethical review process, such as the importance of sharing details of the latest developments in genomics with members of research ethics committees. We discuss certain limitations of the conventional concept of informed consent and its governance system and suggest the potential of an alternative process using information technology.

[Hygiene practices in a street market in the city of Salvador, Bahia State].

PubMed

Minnaert, Ana Cláudia de Sá Teles; Freitas, Maria do Carmo Soares

2010-06-01

The main objective of this research is to understand the meaning of the practices concerning food hygiene in a street market in Salvador, the capital of Bahia State in Brazil. The ethnographic study presents two main categories for symbolic production related to hygiene practices: cleanliness as order and dirtiness as disorder. These cultural codes make correspondence with the studies of Mary Douglas and Nobert Elias. The codes present particularities to decode everyday life, in which concept and hygiene practices are aspects normalized, in daily activity, for persons who share the space of street market: vendors, consumers, street cleaners and official inspectors. The techno-scientific knowledge and sanitary legislation are strange to the symbolic system of street market vendors. The laws are ineffective and their influence is of little importance in the creation of hygiene practices. Official inspectors' attitudes are coercive and punitive and do not take into account any cultural values when enforcing new hygiene practices.

Reflective education for professional practice: discovering knowledge from experience.

PubMed

Lyons, J

1999-01-01

To continually develop as a discipline, a profession needs to generate a knowledge base that can evolve from education and practice. Midwifery reflective practitioners have the potential to develop clinical expertise directed towards achieving desirable, safe and effective practice. Midwives are 'with woman', providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice. Midwife educators and practitioners can assist students and enhance their learning by expanding the scope of practice, encouraging self-assessment and the development of reflective and professional skills. This paper explores journal writing as a learning strategy for the development of reflective skills within midwifery and explores its value for midwifery education. It also examines, through the use of critical social theory and adult learning principles, how midwives can assist and thus enhance students learning through the development of professional and reflective skills for midwifery practice.

How contextual issues can distort shared decision making.

PubMed

Gartlehner, Gerald; Matyas, Nina

2016-12-01

Shared decision making in medicine has become a widely promoted approach. The goal is for patients and physicians to reach a mutual, informed decision by taking into consideration scientific evidence, clinical experience, and the patient's personal values or preferences. Shared decision making, however, is not a straightforward process. In practice, it might fall short of what it promises and might even be misused to whitewash monetary motives. In this article, which summarizes a presentation given at the 17 th Annual Conference of the German Network Evidence-based Medicine on March 4 th , 2016 in Cologne, Germany, we discuss three contextual factors that in our opinion can have a tremendous impact on any informed decision making: 1) opinions and convictions of physicians or other clinicians; 2) uncertainty of the evidence regarding benefits and harms; 3) uncertainty of patients about their own values and preferences. But despite barriers and shortcomings, modern medicine currently does not have an alternative to shared decision making. Shared decision making has become a central theme in good quality health care because it has a strong ethical component. Advocates of shared decision making, however, must realize that not all patients prefer to participate in decision making. For those who do, however, we must ensure that shared decisions can be made in a neutral environment as free of biases and conflicts of interest as possible. Copyright © 2016. Published by Elsevier GmbH.

Interprofessional educator ambassadors: An empirical study of motivation and added value.

PubMed

Anderson, Elizabeth Susan; Thorpe, Lucy Nicola

2010-01-01

Interprofessional education (IPE) is being led by a driving force of teaches who advocate for the importance of this learning within health and social care professional curriculum. Many of these leaders have additional uni professional teaching responsibilities. This study aimed to explore the impact of leading an IPE curriculum on teachers, who were at the forefront of establishing a new IPE curriculum in the east midlands, UK. The prospective study used the principles of grounded theory to analyse the educator's experiences. The study included teachers who work from academic university posts and those who teach from within practice. These IPE leaders were identified through their involvement in the design and delivery of the local IPE initiatives. They were invited to share their experiences at either a mixed-discipline focus group, a one-to-one interview or by completing a postal/e questionnaire. During analysis the views from each data set were triangulated. A total of 58 educators shared their experiences. All benefitted from being part of the planning and teaching teams. They were driven by a strong belief that IPE had the potential to improve patient care and that future healthcare practice would remain team based. Engagement had brought additional benefits to their teaching and career development in particular through forming new relationships with colleagues from other caring professions. They were concerned about educators teaching interprofessional student groups with little prior experience of IPE. The data suggest educators who take on a leading developmental role in designing and delivering an interprofessional curriculum benefit personally and professionally through working relationships with colleagues in other professions and through teaching wider networks of students. These new insights strengthen personal practice and research and in turn have the potential to influence and improve the quality of faculty teaching.

A Drupal-Based Collaborative Framework for Science Workflows

NASA Astrophysics Data System (ADS)

Pinheiro da Silva, P.; Gandara, A.

2010-12-01

Cyber-infrastructure is built from utilizing technical infrastructure to support organizational practices and social norms to provide support for scientific teams working together or dependent on each other to conduct scientific research. Such cyber-infrastructure enables the sharing of information and data so that scientists can leverage knowledge and expertise through automation. Scientific workflow systems have been used to build automated scientific systems used by scientists to conduct scientific research and, as a result, create artifacts in support of scientific discoveries. These complex systems are often developed by teams of scientists who are located in different places, e.g., scientists working in distinct buildings, and sometimes in different time zones, e.g., scientist working in distinct national laboratories. The sharing of these specifications is currently supported by the use of version control systems such as CVS or Subversion. Discussions about the design, improvement, and testing of these specifications, however, often happen elsewhere, e.g., through the exchange of email messages and IM chatting. Carrying on a discussion about these specifications is challenging because comments and specifications are not necessarily connected. For instance, the person reading a comment about a given workflow specification may not be able to see the workflow and even if the person can see the workflow, the person may not specifically know to which part of the workflow a given comments applies to. In this paper, we discuss the design, implementation and use of CI-Server, a Drupal-based infrastructure, to support the collaboration of both local and distributed teams of scientists using scientific workflows. CI-Server has three primary goals: to enable information sharing by providing tools that scientists can use within their scientific research to process data, publish and share artifacts; to build community by providing tools that support discussions between scientists about artifacts used or created through scientific processes; and to leverage the knowledge collected within the artifacts and scientific collaborations to support scientific discoveries.

Balancing Benefits and Risks of Immortal Data: Participants' Views of Open Consent in the Personal Genome Project.

PubMed

Zarate, Oscar A; Brody, Julia Green; Brown, Phil; Ramirez-Andreotta, Mónica D; Perovich, Laura; Matz, Jacob

2016-01-01

An individual's health, genetic, or environmental-exposure data, placed in an online repository, creates a valuable shared resource that can accelerate biomedical research and even open opportunities for crowd-sourcing discoveries by members of the public. But these data become "immortalized" in ways that may create lasting risk as well as benefit. Once shared on the Internet, the data are difficult or impossible to redact, and identities may be revealed by a process called data linkage, in which online data sets are matched to each other. Reidentification (re-ID), the process of associating an individual's name with data that were considered deidentified, poses risks such as insurance or employment discrimination, social stigma, and breach of the promises often made in informed-consent documents. At the same time, re-ID poses risks to researchers and indeed to the future of science, should re-ID end up undermining the trust and participation of potential research participants. The ethical challenges of online data sharing are heightened as so-called big data becomes an increasingly important research tool and driver of new research structures. Big data is shifting research to include large numbers of researchers and institutions as well as large numbers of participants providing diverse types of data, so the participants' consent relationship is no longer with a person or even a research institution. In addition, consent is further transformed because big data analysis often begins with descriptive inquiry and generation of a hypothesis, and the research questions cannot be clearly defined at the outset and may be unforeseeable over the long term. In this article, we consider how expanded data sharing poses new challenges, illustrated by genomics and the transition to new models of consent. We draw on the experiences of participants in an open data platform-the Personal Genome Project-to allow study participants to contribute their voices to inform ethical consent practices and protocol reviews for big-data research. © 2015 The Hastings Center.

Crafting a positive professional digital profile to augment your practice

PubMed Central

Kraakevik, Jeff

2016-01-01

Abstract A digital profile is the sum content about a person on the Internet. A digital profile can be composed of personal or professional information shared on public Web sites posted personally or by others. One of the most effective ways to build a positive professional digital profile is through social media. It is increasingly important to maintain a positive digital profile as others mine the Internet to find out about a professional prior to meeting him or her. As the digital environment continues to grow, it will become increasingly difficult to neglect a professional digital profile without potential negative consequences. There are many benefits to creating a digital presence and using the tools available to learn about neurology and interact with other professionals and patients in ways that were not possible in the past. The spread of social media to a large part of the population makes it unlikely to go away. PMID:29443275

What does media use reveal about personality and mental health? An exploratory investigation among German students.

PubMed

Brailovskaia, Julia; Margraf, Jürgen

2018-01-01

The present study aimed to investigate the relationship between personality traits, mental health variables and media use among German students. The data of 633 participants were collected. Results indicate a positive association between general Internet use, general use of social platforms and Facebook use, on the one hand, and self-esteem, extraversion, narcissism, life satisfaction, social support and resilience, on the other hand. Use of computer games was found to be negatively related to these personality and mental health variables. The use of platforms that focus more on written interaction (Twitter, Tumblr) was assumed to be negatively associated with positive mental health variables and significantly positively with depression, anxiety, and stress symptoms. In contrast, Instagram use, which focuses more on photo-sharing, correlated positively with positive mental health variables. Possible practical implications of the present results for mental health, as well as the limitations of the present work are discussed.

Current Situation of Postmenopausal Grandmothers Raising Their Grandchildren

PubMed Central

Jin, Jang Yong

2015-01-01

As the average life expectancy of women increases, the family and social roles of postmenopausal women have become more important. With the growing number of dual-income households, postmenopausal grandmothers occupy a large role in child-rearing. Postmenopausal women mainly experience social changes as a family member along with personal changes. Postmenopausal women face changes in physical and mental aspects due to drastic hormonal changes. Grandmothers sharing the burden of raising children are actually encountering a number of challenges while dealing with hardships to adapt to physical and mental changes at the same time. It is thought to be important to understand the impact of raising grandchildren on physical and mental conditions among grandmothers experiencing hardships between social reality and personal changes from medical perspective based on sociological studies. Focusing mainly on studies on related fields, this study aims to investigate personal and social supports from medical perspective and to device practical measures. PMID:26355272

Crafting a positive professional digital profile to augment your practice.

PubMed

Kraakevik, Jeff

2016-02-01

A digital profile is the sum content about a person on the Internet. A digital profile can be composed of personal or professional information shared on public Web sites posted personally or by others. One of the most effective ways to build a positive professional digital profile is through social media. It is increasingly important to maintain a positive digital profile as others mine the Internet to find out about a professional prior to meeting him or her. As the digital environment continues to grow, it will become increasingly difficult to neglect a professional digital profile without potential negative consequences. There are many benefits to creating a digital presence and using the tools available to learn about neurology and interact with other professionals and patients in ways that were not possible in the past. The spread of social media to a large part of the population makes it unlikely to go away.

Privacy policies for health social networking sites.

PubMed

Li, Jingquan

2013-01-01

Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data.

Exposing Compassion Fatigue and Burnout Syndrome in a Trauma Team: A Qualitative Study.

PubMed

Berg, Gina M; Harshbarger, Jenni L; Ahlers-Schmidt, Carolyn R; Lippoldt, Diana

2016-01-01

Compassion fatigue (CF) and burnout syndrome (BOS) are identified in trauma, emergency, and critical care nursing practices. The purpose of this qualitative study was to measure CF and BOS in a trauma team and allow them to share perceptions of related stress triggers and coping strategies. Surveys to measure CF and BOS and a focus group allowed a trauma team (12 practitioners) to share perceptions of related stress triggers and coping strategies. More than half scored at risk for CF and BOS. Stress triggers were described as situation (abuse, age of patient) versus injury-related. Personal coping mechanisms were most often reported. Both CF and BOS can be assessed with a simple survey tool. Strategies for developing a program culturally sensitive to CF and BOS are provided.

Privacy policies for health social networking sites

PubMed Central

Li, Jingquan

2013-01-01

Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data. PMID:23599228

Why do identical twins differ in personality: shared environment reconsidered.

PubMed

Torgersen, Anne Mari; Janson, Harald

2002-02-01

While heritability studies show that most of the variance in adult personality can be attributed to genetic or so-called nonshared environmental influence, this does not mean that shared events lack importance for the development of later personality differences. We studied the relationship between Big Five personality differences in monozygotic (MZ) twins at age 29, and life stressors at age 6 to 15, using prospective data from 26 MZ pairs studied from birth onwards. A positive significant correlation was found between stressors in childhood and early adolescence, and intrapair personality differences in Agreeableness, Openness, Conscientiousness, and five-factor profiles. We note that the effects of shared events are labeled "nonshared" environment when the effect is to make siblings more different. Case examples illustrate the relationship between stress and personality differences, and provide hypotheses for further studies in larger samples.

Study on Personality Types of Dentists in different Disciplines of Dentistry.

PubMed

Al-Dlaigan, Yousef H; Alahmari, Albatool S; Almubarak, Sara H; Alateeq, Sahar A; Anil, Sukumaran

2017-07-01

The purpose of this study was to determine the most common personality type among dentists in seven selected clinical dentistry specialties using the Myers-Briggs Type Indicator (MBTI) and to compare between these different types of personalities. A survey containing the MBTI and demographic and practice questions was used to assess the personality styles of 243 dental specialists in Riyadh, Saudi Arabia. The survey results were analyzed using descriptive statistics. The results of the MBTI for 243 specialist dentists revealed, generally, a higher percentage of scoring for introversion (I) with an average of 65% than extroversion (E). The study identified 10 common personality types among these specialists: ISTJ, ISFJ, INFJ, ISTP, INFP, INTP, ENFP, ENTP, ENFJ, and ENTJ (extraversion-introversion (E-I), sensing-intuition (S-N), thinking-feeling (T-F), and judging-perception (J-P)). The dominant personality type in all seven clinical specialties in dentistry was ISTJ, with an average of 54%. The personality types showed variation among the seven clinical dentistry specialties. However, among these seven clinician's specialties in dentistry, more than 50% of the individuals shared one common type of personality (ISTJ). The identification of the personality type might help in their association with coworkers, students, and patients as well as knowing the individual preferences toward different specialties in dentistry.

Celebrating indigenous communities compassionate traditions.

PubMed

Prince, Holly

2018-01-01

Living in a compassionate community is not a new practice in First Nations communities; they have always recognized dying as a social experience. First Nations hold extensive traditional knowledge and have community-based practices to support the personal, familial, and community experiences surrounding end-of-life. However, western health systems were imposed and typically did not support these social and cultural practices at end of life. In fact, the different expectations of western medicine and the community related to end of life care has created stress and misunderstanding for both. One solution is for First Nations communities to develop palliative care programs so that people can receive care at home amongst their family, community and culture. Our research project "Improving End-of-Life Care in First Nations Communities" (EOLFN) was funded by the Canadian Institutes of Health Research [2010-2015] and was conducted in partnership with four First Nations communities in Canada (see www.eolfn.lakeheadu.ca). Results included a community capacity development approach to support Indigenous models of care at end-of-life. The workshop will describe the community capacity development process used to develop palliative care programs in First Nations communities. It will highlight the foundation to this approach, namely, grounding the program in community values and principles, rooted in individual, family, community and culture. Two First Nations communities will share stories about their experiences developing their own palliative care programs, which celebrated cultural capacity in their communities while enhancing medical palliative care services in a way that respected and integrated with their community cultural practices. This workshop shares the experiences of two First Nations communities who developed palliative care programs by building upon community culture, values and principles. The underlying model guiding development is shared.

Participatory Action Research in Public Mental Health and a School of Nursing: Qualitative Findings from an Academic-Community Partnership

PubMed Central

Mahone, Irma H.; Farrell, Sarah P.; Hinton, Ivora; Johnson, Robert; Moody, David; Rifkin, Karen; Moore, Kenneth; Becker, Marcia; Barker, Margaret

2011-01-01

Summary An academic-community partnership between a school of nursing (SON) at a public university (the University of Virginia, or UVA) and a public mental health clinic developed around a shared goal of finding an acceptable shared decision making (SDM) intervention targeting medication use by persons with serious mental illness. The planning meetings of the academic-community partnership were recorded and analyzed. Issues under the partnership process included 1) clinic values and priorities, 2) research agenda, 3) ground rules, and 4) communication. Issues under the SDM content included: 1) barriers, 2) information exchange, 3) positive aspects of shared decision making, and 4) technology. Using participatory-action research (PAR), the community clinic was able to raise questions and concerns throughout the process, be actively involved in research activities (such as identifying stakeholders and co-leading focus groups), participate in the reflective activities on the impact of SDM on practice and policy, and feel ownership of the SDM intervention. PMID:22163075

An Inter-Personal Information Sharing Model Based on Personalized Recommendations

NASA Astrophysics Data System (ADS)

Kamei, Koji; Funakoshi, Kaname; Akahani, Jun-Ichi; Satoh, Tetsuji

In this paper, we propose an inter-personal information sharing model among individuals based on personalized recommendations. In the proposed model, we define an information resource as shared between people when both of them consider it important --- not merely when they both possess it. In other words, the model defines the importance of information resources based on personalized recommendations from identifiable acquaintances. The proposed method is based on a collaborative filtering system that focuses on evaluations from identifiable acquaintances. It utilizes both user evaluations for documents and their contents. In other words, each user profile is represented as a matrix of credibility to the other users' evaluations on each domain of interests. We extended the content-based collaborative filtering method to distinguish other users to whom the documents should be recommended. We also applied a concept-based vector space model to represent the domain of interests instead of the previous method which represented them by a term-based vector space model. We introduce a personalized concept-base compiled from each user's information repository to improve the information retrieval in the user's environment. Furthermore, the concept-spaces change from user to user since they reflect the personalities of the users. Because of different concept-spaces, the similarity between a document and a user's interest varies for each user. As a result, a user receives recommendations from other users who have different view points, achieving inter-personal information sharing based on personalized recommendations. This paper also describes an experimental simulation of our information sharing model. In our laboratory, five participants accumulated a personal repository of e-mails and web pages from which they built their own concept-base. Then we estimated the user profiles according to personalized concept-bases and sets of documents which others evaluated. We simulated inter-personal recommendation based on the user profiles and evaluated the performance of the recommendation method by comparing the recommended documents to the result of the content-based collaborative filtering.

Best practices for basic and advanced skills in health care service recovery: a case study of a re-admitted patient.

PubMed

Hayden, Anna C; Pichert, James W; Fawcett, Jodi; Moore, Ilene N; Hickson, Gerald B

2010-07-01

Service recovery refers to an organizations entire process for facilitating resolution of dissatisfactions, whether or not visible to patients and families. Patients are an important resource for reporting miscommunications, provider inattention, rudeness, or delays, especially if they perceive a connection to misdiagnosis or failed treatment. Health systems that encourage patients to be "the eyes and ears" of individual and team performance capitalize on a rich source of data for quality improvement and risk prevention. Effective service recovery requires organizations (1) to learn about negative perceptions and experiences and (2) to create an infrastructure that supports staff's ability to respond. Service recovery requires the exercise of both basic and advanced skills. We term certain skills as advanced because of the significant variation in their use or endorsement among 30 health care organizations in the United States. On the basis of our work with the 30 organizations, a mnemonic, HEARD, incorporates best practices for basic service recovery processes: Hearing the person's concern; Empathizing with the person raising the issue; Acknowledging, expressing appreciation to the person for sharing, and Apologizing when warranted; Responding to the problem, setting time lines and expectations for follow-up; and Documenting or Delegating the documentation to the appropriate person. Impartiality, chain of command, setting boundaries, and Documentation represent four advanced service recovery skills critical for addressing challenging situations. Using best practices in service recovery enables the organization to do its best to make right what patients and family members experience as wrong.

Assessing Knowledge Sharing Among Academics: A Validation of the Knowledge Sharing Behavior Scale (KSBS).

PubMed

Ramayah, T; Yeap, Jasmine A L; Ignatius, Joshua

2014-04-01

There is a belief that academics tend to hold on tightly to their knowledge and intellectual resources. However, not much effort has been put into the creation of a valid and reliable instrument to measure knowledge sharing behavior among the academics. To apply and validate the Knowledge Sharing Behavior Scale (KSBS) as a measure of knowledge sharing behavior within the academic community. Respondents (N = 447) were academics from arts and science streams in 10 local, public universities in Malaysia. Data were collected using the 28-item KSBS that assessed four dimensions of knowledge sharing behavior namely written contributions, organizational communications, personal interactions, and communities of practice. The exploratory factor analysis showed that the items loaded on the dimension constructs that they were supposed to represent, thus proving construct validity. A within-factor analysis revealed that each set of items representing their intended dimension loaded on only one construct, therefore establishing convergent validity. All four dimensions were not perfectly correlated with each other or organizational citizenship behavior, thereby proving discriminant validity. However, all four dimensions correlated with organizational commitment, thus confirming predictive validity. Furthermore, all four factors correlated with both tacit and explicit sharing, which confirmed their concurrent validity. All measures also possessed sufficient reliability (α > .70). The KSBS is a valid and reliable instrument that can be used to formally assess the types of knowledge artifacts residing among academics and the degree of knowledge sharing in relation to those artifacts. © The Author(s) 2014.

Social Sharing of Bereavement Experience by Chinese Bereaved Persons in Hong Kong

ERIC Educational Resources Information Center

Chow, Amy Y. M.; Chan, Cecilia L. W.; Ho, Samuel M. Y.

2007-01-01

Contrary to the belief that the Chinese do not share emotionally intense experiences, findings from a cross-sectional study of 292 respondents who lost either a spouse or a parent in the previous 2 years in Hong Kong indicated that only 10% did not share their bereavement experiences with another person. The physical health and emotional state of…

The inadvertent disclosure of personal health information through peer-to-peer file sharing programs

PubMed Central

Neri, Emilio; Jonker, Elizabeth; Sokolova, Marina; Peyton, Liam; Neisa, Angelica; Scassa, Teresa

2010-01-01

Objective There has been a consistent concern about the inadvertent disclosure of personal information through peer-to-peer file sharing applications, such as Limewire and Morpheus. Examples of personal health and financial information being exposed have been published. We wanted to estimate the extent to which personal health information (PHI) is being disclosed in this way, and compare that to the extent of disclosure of personal financial information (PFI). Design After careful review and approval of our protocol by our institutional research ethics board, files were downloaded from peer-to-peer file sharing networks and manually analyzed for the presence of PHI and PFI. The geographic region of the IP addresses was determined, and classified as either USA or Canada. Measurement We estimated the proportion of files that contain personal health and financial information for each region. We also estimated the proportion of search terms that return files with personal health and financial information. We ascertained and discuss the ethical issues related to this study. Results Approximately 0.4% of Canadian IP addresses had PHI, as did 0.5% of US IP addresses. There was more disclosure of financial information, at 1.7% of Canadian IP addresses and 4.7% of US IP addresses. An analysis of search terms used in these file sharing networks showed that a small percentage of the terms would return PHI and PFI files (ie, there are people successfully searching for PFI and PHI on the peer-to-peer file sharing networks). Conclusion There is a real risk of inadvertent disclosure of PHI through peer-to-peer file sharing networks, although the risk is not as large as for PFI. Anyone keeping PHI on their computers should avoid installing file sharing applications on their computers, or if they have to use such tools, actively manage the risks of inadvertent disclosure of their, their family's, their clients', or patients' PHI. PMID:20190057

Children with Down Syndrome Sharing Past Personal Event Narratives with Their Teacher Aides: A Pilot Study

ERIC Educational Resources Information Center

van Bysterveldt, Anne K.; Westerveld, Marleen F.

2017-01-01

Personal narrative ability is crucial for social-emotional well-being and classroom participation. This study investigated the ability of 10 school-age participants with Down syndrome to share past personal experiences with their teacher aides in their school environment. To participate, children were required to speak in short sentences and be…

Personal Information Sharing Behaviors of College Students via the Internet and Online Social Networks: A Case Study

ERIC Educational Resources Information Center

Flinn, Michael Bradley

2009-01-01

With privacy concerns growing on a daily basis, it is important to understand how college students guard their personally identifiable information. Despite the students' perceived readiness and several studies on the topic, it is not fully understood what personally identifiable information college students are sharing via online social networks…

Physician consideration of patients' out-of-pocket costs in making common clinical decisions.

PubMed

Pham, Hoangmai H; Alexander, G Caleb; O'Malley, Ann S

2007-04-09

Patients face growing cost-sharing through higher deductibles and other out-of-pocket (OP) expenses, with uncertain effects on clinical decision making. We analyzed data on 6628 respondents to the nationally representative 2004-2005 Community Tracking Study Physician Survey to examine how frequently physicians report considering their insured patients' OP expenses when prescribing drugs, selecting diagnostic tests, and choosing inpatient vs outpatient care settings. Responses were dichotomized as always/usually vs sometimes/rarely/never. In separate multivariate logistic regressions, we examined associations between physicians' reported frequency of considering OP costs for each type of decision and characteristics of individual physicians and their practices. Seventy-eight percent of physicians reported routinely considering OP costs when prescribing drugs, while 51.2% reported doing so when selecting care settings, and 40.2% when selecting diagnostic tests. In adjusted analyses, primary care physicians were more likely than medical specialists to consider patients' OP costs in choosing prescription drugs (85.3% vs 74.5%) (P<.001), care settings (53.9% vs 43.1%) (P<.001), and diagnostic tests (46.3% vs 29.9%) (P<.001). Physicians working in large groups or health maintenance organizations were more likely to consider OP costs in prescribing generic drugs (P<.001 for comparisons with solo and 2-person practices), but those in solo or 2-person practices were more likely to do so in choosing tests and care settings (P<.05 for all comparisons with other practice types). Physicians providing at least 10 hours of charity care a month were more likely than those not providing any to consider OP costs in both diagnostic testing (40.7% vs 35.8%) (P<.001) and care setting decisions (51.4% vs 47.6%) (P<.005). Cost-sharing arrangements targeting patients are likely to have limited effects in safely reducing health care spending because physicians do not routinely consider patients' OP costs when making decisions regarding more expensive medical services.

Why geriatrics? Academic geriatricians' perceptions of the positive, attractive aspects of geriatrics.

PubMed

Cravens, D D; Campbell, J D; Mehr, D R

2000-01-01

Recruitment of geriatrics trainees has been poor, and the current shortage of academic geriatricians is expected to worsen. Although barriers to entering geriatrics practice have been identified, a review of the literature found few studies about why people choose to enter geriatrics. We used qualitative methods to investigate the positive, attractive aspects of geriatrics. Long interviews with six academic geriatricians were taped and transcribed. Transcripts were entered into a textual database computer program and reviewed independently by two investigators. Six themes emerged: 1) traditional learning experiences, 2) value on personal relationships, 3) a perception of distinctive differences, 4) a desire to feel needed personally and societally, 5) prefer democracy versus autocracy, and 6) desire intellectual challenges. Academic geriatrics, therefore, is particularly attractive to people who value enduring relationships, see challenges in complexity, practice social responsibility, prefer working within a multidisciplinary team, and derive satisfaction from making seemingly small but nonetheless important changes in peoples' lives. If further studies validate these findings, they could promote geriatrics as a career, by, for example, identifying students and family practice and internal medicine residents who share these values, beliefs, and attitudes and encouraging them to consider this important field.

Financial and quality impacts of the Medicare physician group practice demonstration.

PubMed

Pope, Gregory; Kautter, John; Leung, Musetta; Trisolini, Michael; Adamache, Walter; Smith, Kevin

2014-01-01

To examine the impact of the Medicare Physician Group Practice (PGP) demonstration on expenditure, utilization, and quality outcomes. Secondary data analysis of 2001-2010 Medicare claims for 1,776,387 person years assigned to the ten participating provider organizations and 1,579,080 person years in the corresponding local comparison groups. We used a pre-post comparison group observational design consisting of four pre-demonstration years (1/01-12/04) and five demonstration years (4/05-3/10). We employed a propensity-weighted difference-in-differences regression model to estimate demonstration effects, adjusting for demographics, health status, geographic area, and secular trends. The ten demonstration sites combined saved $171 (2.0%) per assigned beneficiary person year (p<0.001) during the five-year demonstration period. Medicare paid performance bonuses to the participating PGPs that averaged $102 per person year. The net savings to the Medicare program were $69 (0.8%) per person year. Demonstration savings were achieved primarily from the inpatient setting. The demonstration improved quality of care as measured by six of seven claims-based process quality indicators. The PGP demonstration, which used a payment model similar to the Medicare Accountable Care Organization (ACO) program, resulted in small reductions in Medicare expenditures and inpatient utilization, and improvements in process quality indicators. Judging from this demonstration experience, it is unlikely that Medicare ACOs will initially achieve large savings. Nevertheless, ACOs paid through shared savings may be an important first step toward greater efficiency and quality in the Medicare fee-for-service program.

Qualitative Data Sharing Practices in Social Sciences

ERIC Educational Resources Information Center

Jeng, Wei

2017-01-01

Social scientists have been sharing data for a long time. Sharing qualitative data, however, has not become a common practice, despite the context of e-Research, information growth, and funding agencies' mandates on research data archiving and sharing. Since most systematic and comprehensive studies are based on quantitative data practices, little…

Leveraging medical taxonomies to improve knowledge management within online communities of practice: The knowledge maps system.

PubMed

Stewart, Samuel Alan; Abidi, Syed Sibte Raza

2017-05-01

Online communities of practice contain a wealth of information, stored in the free text of shared communications between community members. The Knowledge Maps (KMaps) system is designed to facilitate Knowledge Translation in online communities through multi-level analyses of the shared messages of these communications. Using state-of-the-art semantic mapping technologies (Metamap) the contents of the messages shared within an online community are mapped to terms from the MeSH medical lexicon, providing a multi-level topic-specific summary of the knowledge being shared within the community. Using the inherent hierarchical structure of the lexicon important insights can be found within the community. The KMaps system was applied to two medical mailing lists, the PPML (archives from 2009-02 to 2013-02) and SURGINET (archives from 2012-01 to 2013-04), identifying 27,924 and 50,597 medical terms respectively. KMaps identified content areas where both communities found interest, specifically around Diseases, 22% and 24% of the total terms, while also identifying field-specific areas that were more popular: SURGINET expressed an interest in Anatomy (14% vs 4%) while the PPML was more interested in Drugs (19% vs 9%). At the level of the individual KMaps identified 6 PPML users and 9 SURGINET users that had noticeably more contributions to the community than their peers, and investigated their personal areas of interest. The KMaps system provides valuable insights into the structure of both communities, identifying topics of interest/shared content areas and defining content-profiles for individual community members. The system provides a valuable addition to the online KT process. Copyright © 2017 Elsevier B.V. All rights reserved.

Developing facilitation skills--a narrative.

PubMed

Newton, Jennifer M

2003-07-01

Effective facilitation has been identified in the literature as one of three elements, along with context and evidence, that have a dynamic and coexisting relationship to enable the successful uptake of evidence into practice. This paper presents an overview of the concept of facilitation within the context of practice development, ahead of a personal and professional reflective account of a 'developing facilitator'. In the summer of 2001, the author was instrumental in organising the first Practice Development School in Melbourne. Thrown in at the deep end, she found herself co-facilitating with an experienced practice developer from the United Kingdom. Having never facilitated in the arena of an action learning group, nor worked in the field of practice development, there was initially a sense of impending overload and drowning in the new knowledge and skills that needed to be acquired. Drawing upon the work of narrative inquiry the author shares her experiences in the anticipation that in telling her story it will assist others in their journey of becoming a facilitator.

Aggregate exposure modelling of zinc pyrithione in rinse-off personal cleansing products using a person-orientated approach with market share refinement.

PubMed

Tozer, Sarah A; Kelly, Seamus; O'Mahony, Cian; Daly, E J; Nash, J F

2015-09-01

Realistic estimates of chemical aggregate exposure are needed to ensure consumer safety. As exposure estimates are a critical part of the equation used to calculate acceptable "safe levels" and conduct quantitative risk assessments, methods are needed to produce realistic exposure estimations. To this end, a probabilistic aggregate exposure model was developed to estimate consumer exposure from several rinse off personal cleansing products containing the anti-dandruff preservative zinc pyrithione. The model incorporates large habits and practices surveys, containing data on frequency of use, amount applied, co-use along with market share, and combines these data at the level of the individual based on subject demographics to better estimate exposure. The daily-applied exposure (i.e., amount applied to the skin) was 3.79 mg/kg/day for the 95th percentile consumer. The estimated internal dose for the 95th percentile exposure ranged from 0.01-1.29 μg/kg/day after accounting for retention following rinsing and dermal penetration of ZnPt. This probabilistic aggregate exposure model can be used in the human safety assessment of ingredients in multiple rinse-off technologies (e.g., shampoo, bar soap, body wash, and liquid hand soap). In addition, this model may be used in other situations where refined exposure assessment is required to support a chemical risk assessment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Human Milk Handling and Storage Practices Among Peer Milk-Sharing Mothers.

PubMed

Reyes-Foster, Beatriz M; Carter, Shannon K; Hinojosa, Melanie Sberna

2017-02-01

Peer milk sharing, the noncommercial sharing of human milk from one parent or caretaker directly to another for the purposes of feeding a child, appears to be an increasing infant-feeding practice. Although the U.S. Food and Drug Administration has issued a warning against the practice, little is known about how people who share human milk handle and store milk and whether these practices are consistent with clinical safety protocols. Research aim: This study aimed to learn about the milk-handling practices of expressed human milk by milk-sharing donors and recipient caretakers. In this article, we explore the degree to which donors and recipients adhere to the Academy of Breastfeeding Medicine clinical recommendations for safe handling and storage. Online surveys were collected from 321 parents engaged in peer milk sharing. Univariate descriptive statistics were used to describe the safe handling and storage procedures for milk donors and recipients. A two-sample t-test was used to compare safety items common to each group. Multivariate ordinary least squares regression analysis was used to examine sociodemographic correlates of milk safety practices within the sample group. Findings indicate that respondents engaged in peer milk sharing report predominantly positive safety practices. Multivariate analysis did not reveal any relationship between safety practices and sociodemographic characteristics. The number of safe practices did not differ between donors and recipients. Parents and caretakers who participate in peer human milk sharing report engaging in practices that should reduce risk of bacterial contamination of expressed peer shared milk. More research on this particular population is recommended.

Perception of intelligibility and qualities of non-native accented speakers.

PubMed

Fuse, Akiko; Navichkova, Yuliya; Alloggio, Krysteena

To provide effective treatment to clients, speech-language pathologists must be understood, and be perceived to demonstrate the personal qualities necessary for therapeutic practice (e.g., resourcefulness and empathy). One factor that could interfere with the listener's perception of non-native speech is the speaker's accent. The current study explored the relationship between how accurately listeners could understand non-native speech and their perceptions of personal attributes of the speaker. Additionally, this study investigated how listeners' familiarity and experience with other languages may influence their perceptions of non-native accented speech. Through an online survey, native monolingual and bilingual English listeners rated four non-native accents (i.e., Spanish, Chinese, Russian, and Indian) on perceived intelligibility and perceived personal qualities (i.e., professionalism, intelligence, resourcefulness, empathy, and patience) necessary for speech-language pathologists. The results indicated significant relationships between the perception of intelligibility and the perception of personal qualities (i.e., professionalism, intelligence, and resourcefulness) attributed to non-native speakers. However, these findings were not supported for the Chinese accent. Bilingual listeners judged the non-native speech as more intelligible in comparison to monolingual listeners. No significant differences were found in the ratings between bilingual listeners who share the same language background as the speaker and other bilingual listeners. Based on the current findings, greater perception of intelligibility was the key to promoting a positive perception of personal qualities such as professionalism, intelligence, and resourcefulness, important for speech-language pathologists. The current study found evidence to support the claim that bilinguals have a greater ability in understanding non-native accented speech compared to monolingual listeners. The results, however, did not confirm an advantage for bilingual listeners sharing the same language backgrounds with the non-native speaker over other bilingual listeners. Copyright © 2017 Elsevier Inc. All rights reserved.

Parents Reading with Their Toddlers: The Role of Personalization in Book Engagement

ERIC Educational Resources Information Center

Kucirkova, Natalia; Messer, David; Whitelock, Denise

2013-01-01

The aim of this study was to investigate the effects of personalized books on parents' and children's engagement during shared book reading. Seven native English parents and their children aged between 12 and 33 months were observed at home when sharing a book made specifically for the child (i.e. a personalized book), a comparable book with no…

Mixed methods pilot study of sharing behaviors among waterpipe smokers of rural Lao PDR: implications for infectious disease transmission.

PubMed

Martin, Robyn; Safaee, Sahar D; Somsamouth, Khamphithoune; Mounivong, Boualoy; Sinclair, Ryan; Bansal, Shweta; Singh, Pramil N

2013-05-24

To date, the sharing behaviors associated with the homemade tobacco waterpipe used in rural areas of the Western Pacific Region have not been studied. Evidence from studies of manufactured waterpipes raises the possibility of infectious disease transmission due to waterpipe sharing. The objective of our pilot study in rural Lao People's Democratic Republic (PDR) was to identify and measure the prevalence of waterpipe sharing behaviors. We first conducted ethnographic studies to investigate waterpipe-smoking behaviors. These findings were then used to develop an interviewer-administered household survey that was used in a sampling of waterpipe smokers from three villages of the Luang Namtha province of Lao PDR (n = 43). Sampled waterpipe smokers were predominantly male (90.7%), older (mean age 49, SD 13.79), married (95.4%), farmers (78.6%), and had completed no primary education. Pipes were primarily made from bamboo (92.9%). Almost all (97.6%) smokers were willing to share their pipe with others. At the last time they smoked, smokers shared a pipe with at least one other person (1.2 ± 0.5 persons). During the past week, they had shared a pipe with five other persons (5.2 ± 3.8 persons). The high prevalence of sharing behaviors among waterpipe smokers in rural Southeast Asia raises the possibility that this behavior provides important and unmeasured social network pathways for the transmission of infectious agents.

An Examination of Preschool Teachers' Shared Book Reading Practices in Spanish: Before and after Instructional Guidance

ERIC Educational Resources Information Center

Pollard-Durodola, Sharolyn D.; Gonzalez, Jorge E.; Simmons, Deborah C.; Taylor, Aaron B.; Davis, Matthew J.; Simmons, Leslie; Nava-Walichowski, Miranda

2012-01-01

Shared book reading is a prominent practice in preschools; however, limited research has examined this practice in classrooms with English language learners (ELLs). This study investigated the shared book reading practices of seven preschool teachers of Spanish-speaking ELLs to describe their vocabulary instructional practices before and after…

The Genetic and Environmental Sources of Resemblance Between Normative Personality and Personality Disorder Traits.

PubMed

Kendler, K S; Aggen, S H; Gillespie, Nathan; Neale, M C; Knudsen, G P; Krueger, R F; Czajkowski, Nikolai; Ystrom, Eivind; Reichborn-Kjennerud, T

2017-04-01

Recent work has suggested a high level of congruence between normative personality, most typically represented by the "big five" factors, and abnormal personality traits. In 2,293 Norwegian adult twins ascertained from a population-based registry, the authors evaluated the degree of sharing of genetic and environmental influences on normative personality, assessed by the Big Five Inventory (BFI), and personality disorder traits (PDTs), assessed by the Personality Inventory for DSM-5-Norwegian Brief Form (PID-5-NBF). For four of the five BFI dimensions, the strongest genetic correlation was observed with the expected PID-5-NBF dimension (e.g., neuroticism with negative affectivity [+], conscientiousness with disinhibition [-]). However, neuroticism, conscientiousness, and agreeableness had substantial genetic correlations with other PID-5-NBF dimensions (e.g., neuroticism with compulsivity [+], agreeableness with detachment [-]). Openness had no substantial genetic correlations with any PID-5-NBF dimension. The proportion of genetic risk factors shared in aggregate between the BFI traits and the PID-5-NBF dimensions was quite high for conscientiousness and neuroticism, relatively robust for extraversion and agreeableness, but quite low for openness. Of the six PID-5-NBF dimensions, three (negative affectivity, detachment, and disinhibition) shared, in aggregate, most of their genetic risk factors with normative personality traits. Genetic factors underlying psychoticism, antagonism, and compulsivity were shared to a lesser extent, suggesting that they are influenced by etiological factors not well indexed by the BFI.

Social but safe? Quality and safety of diabetes-related online social networks.

PubMed

Weitzman, Elissa R; Cole, Emily; Kaci, Liljana; Mandl, Kenneth D

2011-05-01

To foster informed decision-making about health social networking (SN) by patients and clinicians, the authors evaluated the quality/safety of SN sites' policies and practices. Multisite structured observation of diabetes-focused SN sites. Measurements 28 indicators of quality and safety covering: (1) alignment of content with diabetes science and clinical practice recommendations; (2) safety practices for auditing content, supporting transparency and moderation; (3) accessibility of privacy policies and the communication and control of privacy risks; and (4) centralized sharing of member data and member control over sharing. Quality was variable across n=10 sites: 50% were aligned with diabetes science/clinical practice recommendations with gaps in medical disclaimer use (30% have) and specification of relevant glycosylated hemoglobin levels (0% have). Safety was mixed with gaps in external review approaches (20% used audits and association links) and internal review approaches (70% use moderation). Internal safety review offers limited protection: misinformation about a diabetes 'cure' was found on four moderated sites. Of nine sites with advertising, transparency was missing on five; ads for unfounded 'cures' were present on three. Technological safety was poor with almost no use of procedures for secure data storage and transmission; only three sites support member controls over personal information. Privacy policies' poor readability impedes risk communication. Only three sites (30%) demonstrated better practice. Limitations English-language diabetes sites only. The quality/safety of diabetes SN is variable. Observed better practice suggests improvement is feasible. Mechanisms for improvement are recommended that engage key stakeholders to balance autonomy, community ownership, conditions for innovation, and consumer protection.

An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice.

PubMed

Mun, Mi Suk

2010-02-01

The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.

What Once Was Old Is New Again

PubMed Central

Hotelling, Barbara A.

2010-01-01

Through seminars and continuing educational opportunities, recently certified Lamaze childbirth educators beginning their teaching careers have learned of the changes in birth practices over the past 50 years. However, they may not have heard the personal stories about the locations and conditions in which Lamaze educators first taught. In this column, five childbirth educators share their memories of the birthing climate, teaching strategies, class populations, and other aspects of Lamaze childbirth education 50 years ago and how the “old ways” compare with today's classes. Their stories not only provide an important, historical perspective to build on the past and improve future educational opportunities for expectant women and their families but also illustrate Lamaze's ongoing efforts to promote natural, safe, and healthy birth practices. PMID:21629390

A story: nursing-damaged lives.

PubMed

Fenwick, J

1999-12-01

This paper presents a story that captures forever a 'difficult', 'horrible' but in many respects totally 'normal' nursing moment. It is a short story of only one person's reality. On that fateful night in which many lives were changed forever, there were, of course, many realities, all of which hold their own truth. This tale is offered in the spirit of sharing and in the hope that others may find it useful. I believe that 'story telling' allows us to revisit and review our practice. In doing so, stories facilitate the discovery of nursing knowledge and the self. Ultimately this contributes to the development of expert practice. Nursing stories, then, become an excellent medium for nursing inquiry, from both an academic and a clinical perspective.

Global Perspectives on Cancer Health Disparities: Impact, Utility, and Implications for Cancer Nursing

PubMed Central

So, Winnie K. W.; Chan, Raymond Javan; Truant, Tracy; Trevatt, Paul; Bialous, Stella Aguinaga; Barton-Burke, Margaret

2016-01-01

This paper examines cancer health disparities and contributing factors at national, regional, and international levels. The authors all live in different countries and regions with different health-care systems and practices. Despite the shared cancer nursing perspective, each country or global region approaches cancer disparities differently. With globalization the world is becoming smaller, and in turn becoming interconnected and interdependent. This article focuses on cancer health disparities and global cancer nursing, exemplifying these concepts about the impact and implications of person-centered care. PMID:28083548

Effective professional networking.

PubMed

Goolsby, Mary Jo; Knestrick, Joyce M

2017-08-01

The reasons for nurse practitioners to develop a professional network are boundless and are likely to change over time. Networking opens doors and creates relationships that support new opportunities, personal development, collaborative research, policy activism, evidence-based practice, and more. Successful professional networking involves shared, mutually beneficial interactions between individuals and/or individuals and groups, regardless of whether it occurs face to face or electronically. This article combines nuggets from the literature with guidance based on the authors' combined experience in networking activities at the local, national, and international levels. ©2017 American Association of Nurse Practitioners.

Sharing of Needles and Syringes among Men Who Inject Drugs: HIV Risk in Northwest Bangladesh.

PubMed

Pasa, M Kamal; Alom, Kazi Robiul; Bashri, Zubaida; Vermund, Sten H

2016-01-01

Injection drug use is prevalent in northwestern Bangladesh. We sought to explore the context of needle/syringe sharing among persons who inject drugs (PWID), examining risk exposures to blood-borne infections like the human immunodeficiency virus (HIV) and hepatitis in a region where these dual epidemics are likely to expand. We used a qualitative research approach to learn about injection practices, conducting 60 in-depth interviews among PWID. We then conducted 12 focus group discussions (FGDs) that generated a checklist of salient issues, and followed up with personal observations of typical days at the drug-use venues. Content and interpretative frameworks were used to analyze qualitative information and socio-demographic information, using SPSS software. We found that needle/syringe-sharing behaviours were integrated into the overall social and cultural lives of drug users. Sharing behaviours were an central component of PWID social organization. Sharing was perceived as an inherent element within reciprocal relationships, and sharing was tied to beliefs about drug effects, economic adversity, and harassment due to their drug user status. Carrying used needles/syringes to drug-use venues was deemed essential since user-unfriendly needle-syringe distribution schedules of harm reduction programmes made it difficult to access clean needles/syringes in off-hours. PWID had low self-esteem. Unequal power relationships were reported between the field workers of harm reduction programmes and PWID. Field workers expressed anti-PWID bias and judgmental attitudes, and also had had misconceptions about HIV and hepatitis transmission. PWID were especially disturbed that no assistance was forthcoming from risk reduction programme staff when drug users manifested withdrawal symptoms. Interventions must take social context into account when scaling up programmes in diverse settings. The social organization of PWID include values that foster needle-syringe sharing. Utilization and impact of risk reduction programmes might be improved with expanded clean needle/syringe distribution at times and venues convenient for PWID, better trained and non-judgmental staff, and medical assistance for health problems, including drug withdrawal symptoms.

Establishing an online and social media presence for your IBCLC practice.

PubMed

McCann, Amber D; McCulloch, Jeanette E

2012-11-01

Women of childbearing age, especially in industrialized nations, are using social media in record numbers and are seeking information about pregnancy, birth, and breastfeeding online. Social media is a form of communication that enables online communities to share ideas, information, and personal messages. Those providing support to breastfeeding mothers are uniquely equipped to share information, guidance, and encouragement with new mothers. Lactation professionals, advocates, and volunteers should be aware that mothers are using Web-based communication to gain information about breastfeeding. Those who support breastfeeding mothers can also learn to use these methods to engage with the breastfeeding community online. Regardless of the chosen platform, social media is most successful when it promotes engagement with a target audience. Facebook, Twitter, blogs, and Pinterest are identified as useful platforms for connecting with breastfeeding mothers.

XplOit: An Ontology-Based Data Integration Platform Supporting the Development of Predictive Models for Personalized Medicine.

PubMed

Weiler, Gabriele; Schwarz, Ulf; Rauch, Jochen; Rohm, Kerstin; Lehr, Thorsten; Theobald, Stefan; Kiefer, Stephan; Götz, Katharina; Och, Katharina; Pfeifer, Nico; Handl, Lisa; Smola, Sigrun; Ihle, Matthias; Turki, Amin T; Beelen, Dietrich W; Rissland, Jürgen; Bittenbring, Jörg; Graf, Norbert

2018-01-01

Predictive models can support physicians to tailor interventions and treatments to their individual patients based on their predicted response and risk of disease and help in this way to put personalized medicine into practice. In allogeneic stem cell transplantation risk assessment is to be enhanced in order to respond to emerging viral infections and transplantation reactions. However, to develop predictive models it is necessary to harmonize and integrate high amounts of heterogeneous medical data that is stored in different health information systems. Driven by the demand for predictive instruments in allogeneic stem cell transplantation we present in this paper an ontology-based platform that supports data owners and model developers to share and harmonize their data for model development respecting data privacy.

Intoxigenic digital spaces? Youth, social networking sites and alcohol marketing.

PubMed

Griffiths, Richard; Casswell, Sally

2010-09-01

To examine how young people in New Zealand engage with alcohol and reproduce alcohol marketing messages and alcohol-related branding in 'Bebo', a popular social networking site (SNS) on the Internet. Data are drawn from information posted on approximately 150 Bebo Web pages and analysed by way of textual analysis and cyberspace ethnography. Social networking sites, such as Bebo, provide young people with a digital space in which to share a range of alcohol marketing messages via peer-to-peer transmission. Bebo also enables youth to communicate to one another how they consume alcohol and their views of alcohol marketing messages. The information being shared by young people who use Bebo is openly provided in the form of personal information, forum comments, digital photographs and answering quizzes about their engagement with alcohol. Through this sharing of information in the digital Internet environment, young people are creating 'intoxigenic social identities' as well as 'intoxigenic digital spaces' that further contribute towards the normalisation of youth consumption of alcohol. A better understanding of how youth are using the Internet to share their experiences with alcohol and engagement with alcohol-related messages is crucial to public health research as alcohol marketing practices rapidly evolve.

Rehabilitation living lab in the mall community of practice: learning together to improve rehabilitation, participation and social inclusion for people living with disabilities.

PubMed

Mazer, Barbara; Kairy, Dahlia; Guindon, Andréanne; Girard, Michel; Swaine, Bonnie; Kehayia, Eva; Labbé, Delphine

2015-04-22

Communities of practice (CoP) can facilitate collaboration between people who share a common interest, but do not usually work together. A CoP was initiated and developed including stakeholders from clinical, research, community and governmental backgrounds involved in a large multidisciplinary and multi-sectorial project: the Rehabilitation Living Lab in a Mall (RehabMaLL). This study aimed to evaluate the structure, process and outcomes of this CoP. A single case-study, using mixed-methods, evaluated the RehabMaLL CoP initiative after one year, based on Donabedian's conceptual evaluation model. Forty-three participants took part in the RehabMaLL CoP with 60.5% (n = 26) participating at least once on the online platform where 234 comments were posted. Four in-person meetings were held. Members expressed satisfaction regarding the opportunity to share knowledge with people from diverse backgrounds and the usefulness of the CoP for the RehabMaLL project. Collaboration led to concrete outcomes, such as a sensitization activity and a research project. Common challenges included lack of time and difficulty finding common objectives. A CoP can be a useful strategy to facilitate knowledge sharing on disability issues. Future research is necessary to determine strategies of increasing knowledge creation between members.

Rehabilitation Living Lab in the Mall Community of Practice: Learning Together to Improve Rehabilitation, Participation and Social Inclusion for People Living with Disabilities

PubMed Central

Mazer, Barbara; Kairy, Dahlia; Guindon, Andréanne; Girard, Michel; Swaine, Bonnie; Kehayia, Eva; Labbé, Delphine

2015-01-01

Communities of practice (CoP) can facilitate collaboration between people who share a common interest, but do not usually work together. A CoP was initiated and developed including stakeholders from clinical, research, community and governmental backgrounds involved in a large multidisciplinary and multi-sectorial project: the Rehabilitation Living Lab in a Mall (RehabMaLL). This study aimed to evaluate the structure, process and outcomes of this CoP. A single case-study, using mixed-methods, evaluated the RehabMaLL CoP initiative after one year, based on Donabedian’s conceptual evaluation model. Forty-three participants took part in the RehabMaLL CoP with 60.5% (n = 26) participating at least once on the online platform where 234 comments were posted. Four in-person meetings were held. Members expressed satisfaction regarding the opportunity to share knowledge with people from diverse backgrounds and the usefulness of the CoP for the RehabMaLL project. Collaboration led to concrete outcomes, such as a sensitization activity and a research project. Common challenges included lack of time and difficulty finding common objectives. A CoP can be a useful strategy to facilitate knowledge sharing on disability issues. Future research is necessary to determine strategies of increasing knowledge creation between members. PMID:25913187

Shared Decision-Making in the Management of Congenital Vascular Malformations.

PubMed

Horbach, Sophie E R; Ubbink, Dirk T; Stubenrouch, Fabienne E; Koelemay, Mark J W; van der Vleuten, Carine J M; Verhoeven, Bas H; Reekers, Jim A; Schultze Kool, Leo J; van der Horst, Chantal M A M

2017-03-01

In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular malformations, for which preference-sensitive decision-making seems obvious. The authors investigated preferences regarding decision-making and current shared decision-making behavior during physician-patient encounters. In two Dutch university hospitals, adults and children with congenital vascular malformations facing a treatment-related decision were enrolled. Before the consultation, patients (or parents of children) expressed their preference regarding decision-making (Control Preferences Scale). Afterward, participants completed shared decision-making-specific questionnaires (nine-item Shared Decision-Making Questionnaire, CollaboRATE, and satisfaction), and physicians completed the Shared Decision-Making Questionnaire-Physician questionnaire. Consultations were audiotaped and patient involvement was scored by two independent researchers using the five-item Observing Patient Involvement instrument. All questionnaire results were expressed on a scale of 0 to 100 (optimum shared decision-making). Fifty-five participants (24 parents and 31 adult patients) were included. Two-thirds preferred the shared decision-making approach (Control Preferences Scale). Objective five-item Observing Patient Involvement scores were low (mean ± SD, 31 ± 15), whereas patient and physician Shared Decision-Making Questionnaire scores were high, with means of 68 ± 18 and 68 ± 19, respectively. The median CollaboRATE score was 93. There was no clear relationship between shared decision-making and satisfaction scores. Although adults and parents of children with vascular malformations express a strong desire for shared decision-making, objective shared decision-making behavior is still lacking, most likely because of poor awareness of the shared decision-making concept among patients, parents, and physicians. To improve shared decision-making practice, targeted interventions (e.g., decision aids, staff training) are essential.

Shared meanings of success, happiness, and health among adults with cerebral palsy and physiotherapists: implications for practice and research.

PubMed

Gannotti, Mary E; Blanchard, Yvette; Blumberg, Lisa; LaRocco, Diana

2018-01-25

To describe shared meanings of success, happiness, and health of adults with cerebral palsy and physiotherapists. Ethnography employed open ended/semi-structured interviews and structured questionnaires (Satisfaction with Life Scale, Beck Depression Inventory-II ® , Oxford Happiness Questionnaire, Life Habits Questionnaire, Medical Outcomes Study-Social Support Survey, and PROMIS ® Pain Interference Scale). Content analysis of qualitative data and principal components analysis of questionnaire responses identified shared meanings. Fourteen adults with cerebral palsy and 15 physiotherapists (median age 46) had similar levels of education. For both groups, social achievements, personal goals, employment, and supporting a family defined success. Adults with cerebral palsy more frequently identified tenacity and persistence as important for success. Both groups described happiness as spending time with loved ones, recreational activities, and having purpose in life. Adults with cerebral palsy identified the importance of self-acceptance for happiness. For both, health included self-care of mind/spirit, cardiovascular and musculoskeletal wellness, and physical fitness (the ability to perform physical tasks). Analysis of questionnaire responses identified shared meanings (eigenvalue 41, 95% explained variance). Adults with cerebral palsy and physiotherapists share similar experiences, behaviors, and feelings about success, happiness, and health. This knowledge may improve communication, enhance evidence-based practice, and foster services to support wellbeing. Implications for rehabilitation Cerebral palsy is a life-long condition, but we know little about social and physical outcomes for adults with cerebral palsy. Lack of understanding about meanings of success, happiness, and health may be a barrier for consumers accessing and for providers delivering evidence-based services. Physiotherapists and adults with cerebral palsy share similar meanings (feelings, experiences, beliefs, behaviors) of success, happiness, and health- or wellbeing. Knowledge of this common ground may result in improved communication between providers and consumers, and foster more relevant and meaningful services to support the wellbeing of adults with cerebral palsy.

Shared learning in general practice--facilitators and barriers.

PubMed

van de Mortel, Thea; Silberberg, Peter; Ahern, Christine

2013-03-01

Capacity for teaching in general practice clinics is limited. Shared learning sessions are one form of vertically integrated teaching that may ameliorate capacity constraints. This study sought to understand the perceptions of general practitioner supervisors, learners and practice staff of the facilitators of shared learning in general practice clinics. Using a grounded theory approach, semistructured interviews were conducted and analysed to generate a theory about the topic. Thirty-five stakeholders from nine general practices participated. Facilitators of shared learning included enabling factors such as small group facilitation skills, space, administrative support and technological resources; reinforcing factors such as targeted funding, and predisposing factors such as participant attributes. Views from multiple stakeholders suggest that the implementation of shared learning in general practice clinics would be supported by an ecological approach that addresses all these factors.

Spousal caregivers and persons with dementia: Increasing participation in shared leisure activities among hospital-based dementia support program participants.

PubMed

DiLauro, Michelle; Pereira, Amanda; Carr, Jennifer; Chiu, Mary; Wesson, Virginia

2015-02-20

Spousal caregivers of persons with dementia often have difficulty engaging persons with dementia in leisure activities. This qualitative descriptive study identifies how caregivers perceive their spouses' participation in leisure activities since dementia onset and the professional guidance caregivers require to increase persons with dementia participation in shared leisure activities. Nine spousal caregivers from a hospital-based caregiver intervention attended one of three focus groups. Using symbolic interactionism and selective optimization with compensation theory as guiding frameworks, thematic content analysis was performed. Three major themes were identified: Recognizing and acknowledging changes, Making sense of changes and conflicts, and Embracing changes and forging ahead. Findings can be used by healthcare providers to better understand caregivers' needs for engaging persons with dementia in shared leisure activities, and inform development of feedback protocols to enhance caregiver interventions. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Turkish students' perceptions of professionalism at the beginning and at the end of medical education: a cross-sectional qualitative study.

PubMed

Kavas, Mustafa Volkan; Demirören, Meral; Koşan, Ayşen Melek Aytuğ; Karahan, Süleyman Tuna; Yalim, Neyyire Yasemin

2015-01-01

Medical students' perceptions of professionalism might reflect the impact of the current educational processes on their professional identity development. This study focuses on Ankara University Faculty of Medicine students' perceptions of 'good doctor' along with the factors effective on the formation of these perceptions. Six focus groups with 59 medical students from Grade-1 and Grade-6 were held. The transcripts of discussions were analyzed thematically. Results regarding 'being a good physician' mostly mirrored the findings of previous studies framing the medical professionalism concept. The thematic pattern of the discussions on the relation between professional development and medical education suggests that students suffer from a gradual erosion of perception during medical education. That the education cannot either change the person for the better or might downgrade the person instead of improving her/him were shared by participants from both grades. Students consider clinical practice and role models two main variables determining the person's qualification as a professional. The formal and hidden programs determine the quality and efficacy of the professional education together. Attempts to restructure medical education must recognize the reciprocal dynamics between these two components and, thus, should carefully work out the practical aspect of the educational processes.

Turkish students’ perceptions of professionalism at the beginning and at the end of medical education: a cross-sectional qualitative study

PubMed Central

Kavas, Mustafa Volkan; Demirören, Meral; Koşan, Ayşen Melek Aytuğ; Karahan, Süleyman Tuna; Yalim, Neyyire Yasemin

2015-01-01

Aim Medical students’ perceptions of professionalism might reflect the impact of the current educational processes on their professional identity development. This study focuses on Ankara University Faculty of Medicine students’ perceptions of ‘good doctor’ along with the factors effective on the formation of these perceptions. Method Six focus groups with 59 medical students from Grade-1 and Grade-6 were held. The transcripts of discussions were analyzed thematically. Results Results regarding ‘being a good physician’ mostly mirrored the findings of previous studies framing the medical professionalism concept. The thematic pattern of the discussions on the relation between professional development and medical education suggests that students suffer from a gradual erosion of perception during medical education. That the education cannot either change the person for the better or might downgrade the person instead of improving her/him were shared by participants from both grades. Students consider clinical practice and role models two main variables determining the person's qualification as a professional. Conclusions The formal and hidden programs determine the quality and efficacy of the professional education together. Attempts to restructure medical education must recognize the reciprocal dynamics between these two components and, thus, should carefully work out the practical aspect of the educational processes. PMID:25795382

Developing nursing practice through work-based learning.

PubMed

Clarke, David J; Copeland, Lisa

2003-12-01

Developing nursing practice in any area demands skills, knowledge, support and a long term commitment to the achievement of best practice. It is easy to become overwhelmed by the competing demands for client care and service delivery. It is not always easy to see how good ideas, clinical concerns and professionally led objectives, can be realised in practice. Ongoing professional development activities, including formal educational programmes can contribute to individual staff members' ability to take on practice development projects. Too often however, educational programmes are seen as making little real difference to clinical practice. Work-based learning, a relatively new approach in higher education in the United Kingdom, presents opportunities for Universities and healthcare providers to work in partnership to realise the shared aims of developing nursing practice. Specific examples, drawn from the personal experiences of one of the authors, will examine the contribution of a work-based learning approach to integrating learning and developing practice in the field of cancer care. The work-based learning approach can bring about tangible benefits for patients, practitioners and organisations, but only if the organisational and contextual factors which impact on practice and its development are properly considered and managed through effective partnerships.

Shifting and Sharing: Academic Physicians' Strategies for Navigating Underperformance and Failure.

PubMed

LaDonna, Kori A; Ginsburg, Shiphra; Watling, Christopher

2018-05-22

Medical practice is uncertain and complex. Consequently, even outstanding performers will inevitably experience moments of underperformance and failure. Coping relies on insight and resilience. However, how physicians develop and use these skills to navigate struggle remains underexplored. A better understanding may reveal strategies to support both struggling learners and stressed practitioners. In 2015, 28 academic physicians were interviewed about their experiences with underperformance or failure. Constructivist grounded theory informed data collection and analysis. Participants' experiences with struggle ranged from patient errors and academic failures to frequent, smaller moments of interpersonal conflict and work-life imbalance. To buffer impact, participants sometimes shifted their focus to an aspect of their identity where they felt successful. Additionally, while participants perceived that insight develops by acknowledging and reflecting on error, they sometimes deflected blame for performance gaps. More often, participants seemed to accept personal responsibility while simultaneously sharing accountability for underperformance or failure with external forces. Paradoxically, participants perceived learners who used these strategies as lacking in insight. Participants demonstrated the protective and functional value of distributing responsibility for underperformance and failure. Shifting and sharing may be an element of reflection and resilience; recognizing external factors may provide a way to gain perspective and to preserve the self. However, this strategy challenges educators' assumptions that learners who deflect are avoiding personal responsibility. The authors' findings raise questions about what it means to be resilient, and how assumptions about learners' responses to failure may affect strategies to support underperforming learners.

Personal characteristics and experiences of long-term allied health professionals in rural and northern British Columbia.

PubMed

Manahan, Candice M; Hardy, Cindy L; MacLeod, Martha L P

2009-01-01

Health sciences programs are being designed to attract students who are likely to stay and practice in rural and northern Canada. Consequently, student recruitment and screening are increasingly including assessment of suitability for rural practice. Although retention factors among rural physicians and nurses have been investigated, little is known about factors that contribute to the retention of other healthcare professionals who work in rural areas. The primary objective of this project was to identify the personal characteristics and experiences of allied health professionals who have worked long term in northern British Columbia (BC), Canada. The study used a qualitative descriptive approach. Six speech language pathologists, four psychologists, four occupational therapists, eight social workers, and four physiotherapists practicing long term in northern BC were recruited, using a convenience sample and the snowball technique, to participate in semi-structured telephone interviews. The interviews were audiotaped and transcribed verbatim. A thematic content analysis identified the motivations for their decision to begin or stay working in northern communities, the reasons for choosing rural or northern education and key themes concerning personal characteristics and experiences. A process of member checking and an external audit validated the analysis and findings. There were two major themes for choosing rural and northern education. For some, selection of rural or northern training was based on accessibility to health education programs; all participants who chose rural and northern education had already decided that they were going to practice rurally. Generally, participants identified past positive experiences and rural background as influencing their practice location decision. Participants named the community's need for healthcare professionals, career advancement opportunities, welcoming employers, peer support, as well as promises of continuing education and interprofessional teamwork as key to their decision. Professional preferences for variety, challenges, and trying new aspects of the job such as teaching also impacted their decision. Also identified were individual factors and personal preferences such as the need for adventure, wilderness, and outdoor recreation, and community factors (eg people's friendliness and the slow pace). Such factors also influenced retention; however, retention was also affected by factors such as job satisfaction, and some community factors were only associated with retention. The analysis revealed a number of personal characteristics and experiences shared by long-term healthcare professionals, and that there is not one particular factor that determines duration of practice in rural and northern communities. The findings imply a combination of varying personal values impact the decision to come or stay in rural and northern communities. Personal characteristics and experiences help to shape these personal values. Over time and depending on stage of life, personal values change. Age and stage of life, rural background, and location of family members also have bearing on personal values, which in turn impact recruitment and retention. An explicit identification of values that have emerged out of personal characteristics and experiences may be useful in the selection of students for rural health education programs, as well as the recruitment and retention of healthcare professionals in rural and northern areas.

Discourses of dementia: a call for an ethnographic, action research approach to care in linguistically and culturally diverse environments.

PubMed

Müller, Nicole; Guendouzi, Jacqueline A

2009-08-01

The methods of ethnography and action research have much to offer to the field of speech-language pathology, particularly as our clinical populations are becoming increasingly diverse. We suggest that practicing speech-language pathologists and students, as well as researchers, will benefit from strategies that use the methods of participatory action research and ethnography as guiding principles to their work. Ethnography seeks to discover meaningful structures in a culture from the perspective of those whose culture it is. Action research, which shares a methodological basis with ethnography, is undertaken with the aim of improving the functioning of the social institution, practice, or structure investigated for the benefit of those most closely involved with that institution or practice. By way of illustration, we use data collected during fieldwork in Louisiana, involving persons with dementia from linguistically and culturally diverse backgrounds.

Effective management of construction company in terms of linguistic communication

NASA Astrophysics Data System (ADS)

Shirina, Elena; Gaybarian, Olga; Myasischev, Georg

2017-10-01

The research presented here has been made over the years in the field of increasing the effectiveness of management in a construction company in terms of applied linguistics. The aim of this work is to share with the scientific community some practical findings of applying the technology of process management of the company, in particular the methods of linguistic efficiency considering the factors of the linguistic personality of the employee. The study deals with the description of applied linguistic and managerial models, views, practical results of their application in the applied field in order to assess production sustainability and minimize losses. The authors applied the developed technology to practical use, and the article presents the results of this application. The authors continue the research in this direction aiming at improving the production effectiveness of the proposed technologies and eliminating some identified drawback.

The power of nursing: An innovative course in values clarification and self-discovery.

PubMed

Day, Lisa; Ziehm, Scott R; Jessup, Martha A; Amedro, Pattie; Dawson-Rose, Carol; Derouin, Anne; Kennedy, Betsy Babb; Manahan, Sally; Parish, Abby Luck; Remen, Rachel Naomi

Teaching for a practice is more than the dissemination of knowledge and information to the learner. Professional nursing education requires teachers to facilitate students' self-reflection and awareness and assimilation of core professional and personal values in order for the new nurse to anchor and internalize these values as part of a professional identity. To achieve this, nursing educators recognize the importance of learning opportunities centered in the affective domain and the importance of teaching for professional formation that supports nursing students' commitment to the values of their chosen community of practice. This paper describes the development, implementation and evaluation of a learning innovation for pre-RN students. The Power of Nursing: Embracing the Healer's Art, a five-session, 15-hour discovery model course that uses guided reflection and personal sharing is described, as are course outcomes for 68 students from four nursing schools in the U.S. Overall students' reports were strongly favorable and the learning experience was valued and identified as unique within the nursing curriculum. Copyright © 2017 Elsevier Inc. All rights reserved.

A study of science leadership and science standards in exemplary standards-based science programs

NASA Astrophysics Data System (ADS)

Carpenter, Wendy Renae

The purpose for conducting this qualitative study was to explore best practices of exemplary standards-based science programs and instructional leadership practices in a charter high school and in a traditional high school. The focus of this study included how twelve participants aligned practices to National Science Education Standards to describe their science programs and science instructional practices. This study used a multi-site case study qualitative design. Data were obtained through a review of literature, interviews, observations, review of educational documents, and researcher's notes collected in a field log. The methodology used was a multi-site case study because of the potential, through cross analysis, for providing greater explanation of the findings in the study (Merriam, 1988). This study discovered six characteristics about the two high school's science programs that enhance the literature found in the National Science Education Standards; (a) Culture of expectations for learning-In exemplary science programs teachers are familiar with a wide range of curricula. They have the ability to examine critically and select activities to use with their students to promote the understanding of science; (b) Culture of varied experiences-In exemplary science programs students are provided different paths to learning, which help students, take in information and make sense of concepts and skills that are set forth by the standards; (c) Culture of continuous feedback-In exemplary science programs teachers and students work together to engage students in ongoing assessments of their work and that of others as prescribed in the standards; (d) Culture of Observations-In exemplary science programs students, teachers, and principals reflect on classroom instructional practices; teachers receive ongoing evaluations about their teaching and apply feedback towards improving practices as outlined in the standards; (e) Culture of continuous learning-In exemplary science programs teachers value continuous personal development, teachers are provided on-going science professional development opportunities to improve instructional practices, teachers reflect and share professional practices, and teachers establish professional learning communities within their classrooms; and (f) Culture of shared leadership-In exemplary science programs instructional leadership purposes and values are consistently shared among all stakeholders which are outlined in the standards. These results are potentially useful for understanding exemplary standards-based science programs and science instructional leadership practices as a model for science programs trying to improve science education so that all students can have a true scientific learning experience.

Student attitudes towards socially acceptable and unacceptable group working practices.

PubMed

Underwood, Jean D M

2003-08-01

While there is much support for co-operative learning among learning theorists, not all learners exhibit the same enthusiasm for groupwork. A number of factors such as sex, group size and ability mix, subject domain, task type and organization have been shown to influence the effectiveness of co-operative and collaborative learning. This study established learners' attitudes to various shared working scenarios. In this mixed design, 140 post-graduate teacher trainees were asked to imagine their responses to seven groupwork scenarios presented as a series of short vignettes. The vignettes varied on the degree of co-operation required; the sex of the prospective co-worker(s) including single and mixed-sex groups; type of assessment, including no assessment at all; and on academically acceptable and unacceptable 'shared' working practices. Anticipated attitudinal and behavioural responses of the students were assessed by questionnaire. On the whole, students were cautiously willing to be involved in groupwork. There were caveats, however. Factors such as the characteristics of the group members, the level and type of assessment procedures in operation, and individual differences, including sex and self-reported social deviance, also governed their responses. There was very limited agreement to be involved in socially undesirable collaborative group activities at a personal level or to condone such activities by others. Those students who showed a tendency towards mild anti-social behaviour were more willing to take direct punitive action against non-contributors than their peers. Female students were more willing to invoke the help of the tutor than their male counterparts, but only if the anti-social behaviour impacted on them personally.

Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: a cross-sectional study.

PubMed

Mubarak, Mohammad Yousuf; Wagner, Abram L; Asami, Mari; Carlson, Bradley F; Boulton, Matthew L

2016-08-31

Sustained civil and military conflict, resulting in large numbers of internally displaced persons (IDP), in combination with rapid urbanization has strained public health and sanitation within cities in Afghanistan. In order to examine the association between preventive sanitary behaviors and diarrhea within two high risk settings located within Kabul, Afghanistan, this study aimed to evaluate the prevalence of hygienic practices and diarrheal illness in an IDP camp and an urban slum. In this cross sectional study, a convenience sample of residents of an IDP camp and an urban slum in Kabul, Afghanistan, was used. Participants were asked to describe their hygienic practices and interviewers independently documented household sanitation. The knowledge and attitudes about and practice of hygienic activities to prevent diarrhea were compared between the two settings. Two hundred participants, 100 from each setting, were enrolled. Knowledge, attitudes, and practices regarding hygienic activities to prevent diarrhea were greater among the slum dwellers than the IDP. Fewer than half of participants washed their hands with soap before eating or after eating: 31 % of slum dwellers washed before eating compared to 11 % of IDPs (P = 0.0050), and 25 % of slum dwellers washed after defecating compared to 4 % of IDPs (P = 0.0020). The IDPs were more likely to share a latrine (P = 0.0144) and less likely to disinfect their latrine than slum dwellers. Diarrhea in the household within the past 3 months was more common in the IDP camp (54 %) than the slum (20 %) (P = 0.0020). Even though certain sanitary and hygienic practices were more common among slum dwellers than IDPs, the lack of hygienic activities in both setting indicates that interventions to change behavior, like increasing the availability of soap and encouraging hand washing, are needed. Any initiative will have to be developed in the context of pervasive illiteracy among persons in both of these settings.

Knowledge and experience sharing practices among health professionals in hospitals under the Addis Ababa health bureau, Ethiopia.

PubMed

Asemahagn, Mulusew Andualem

2014-09-24

Health professionals need updated health information from credible sources to improve their knowledge and provide evidence based health care services. Various types of medical errors have occurred in resource-limited countries because of poor knowledge and experience sharing practices among health professionals. The aim of this study was to assess knowledge-sharing practices and determinants among health professionals in Addis Ababa, Ethiopia. An institutional based cross-sectional study was conducted among 320 randomly selected health professionals from August12-25/2012. A pretested, self-administered questionnaire was used to collect data about different variables. Data entry and analysis were done using Epi-Info version 3.5.4 and SPSS version20 respectively. Descriptive statistics and multivariate regression analyses were applied to describe study objectives and identify the determinants of knowledge sharing practices respectively. Odds ratio at 95% CI was used to describe the strength of association between the study and outcome variables. Most of the respondents approved the need of knowledge and experience sharing practices in their routine activities. Nearly half, 152 (49.0%) of the study participants had knowledge and experience sharing practices. A majority, 219 (70.0%) of the respondents showed a willingness to share their knowledge and experiences. Trust on others' knowledge, motivation, supportive leadership, job satisfaction, awareness, willingness and resource allocation are the determinants of knowledge and experience sharing practices. Supportive leadership, resources, and trust on others' knowledge can enhance knowledge and experience sharing by OR = 3.12, 95% CI = [1.89 - 5.78], OR = 2.3, 95% CI = [1.61- 4.21] and OR = 2.78, 95% CI = [1.66 - 4.64] times compared with their counterparts respectively. Even though most of the respondents knew the importance of knowledge and experience sharing practices, only a limited number of respondents practiced it. Individual, organizational and resource related issues are the major determinants of low knowledge sharing practices. Improving management, proper resource allocation, motivating staffs, and accessing health information sources are important interventions to improve the problem in the study area.

Elbow Room for Best Practice? Montgomery, Patients' values, and Balanced Decision-Making in Person-Centred Clinical Care.

PubMed

Herring, Jonathan; Fulford, Kmw; Dunn, Michael; Handa, Ashoki

2017-11-01

The UK Supreme Court Montgomery judgment marks a decisive shift in the legal test of duty of care in the context of consent to treatment, from the perspective of the clinician (as represented by Bolam rules) to that of the patient. A majority of commentators on Montgomery have focused on the implications of the judgment for disclosure of risk. In this article, we set risk disclosure in context with three further elements of the judgment: benefits, options, and dialogue. These elements, we argue, taken together with risk disclosure, reflect the origins of the Montgomery ruling in a model of consent based on autonomy of patient choice through shared decision-making with their doctor. This model reflects recent developments in both law and medicine and is widely regarded (by the General Medical Council and others) as representing best practice in contemporary person-centred medicine. So understood, we suggest, the shift marked by Montgomery in the basis of duty of care is a shift in underpinning values: it is a shift from the clinician's interpretation about what would be best for patients to the values of (to what is significant or matters from the perspective of) the particular patient concerned in the decision in question. But the values of the particular patient do not thereby become paramount. The Montgomery test of duty of care requires the values of the particular patient to be balanced alongside the values of a reasonable person in the patient's position. We illustrate some of the practical challenges arising from the balance of considerations required by Montgomery with examples from surgical care. These examples show the extent to which Montgomery, in mirroring the realities of clinical decision-making, provides elbowroom for best practice in person-centred clinical care. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

"Understanding my ALS". Experiences and reflections of persons with amyotrophic lateral sclerosis and relatives on participation in peer group rehabilitation.

PubMed

Madsen, Louise Sofia; Jeppesen, Jørgen; Handberg, Charlotte

2018-01-26

The aim of this study was to gain insight into experiences and reflections of persons with amyotrophic lateral sclerosis and relatives concerning the peer group rehabilitation programme "More Life - Less Illness". This qualitative study used the Interpretive Description methodology with Symbolic Interactionism as the analytical framework. Eighteen programme participants representing persons with amyotrophic lateral sclerosis (n = 8) and relatives (n = 10) were included. Data consisted of individual interviews and participant observation. The analysis revealed two categorical themes, "Sense of Community Building" and "Understanding my ALS", which represented the participants' experiences and reflections on peer group rehabilitation. Through the analysis, it became apparent that "Sense of Community Building" gave rise to an increased and personalised understanding of amyotrophic lateral sclerosis among the participants. As a part of the continuous processing of the knowledge gained, "Facing Facts" and "Retaining Normality" appeared as subthemes regarding the participants' ability to live a less dependent and more meaningful life. This study of peer group rehabilitation for persons with amyotrophic lateral sclerosis and relatives indicates that programme participation leads to positive experiences in terms of living a shared meaningful life despite severe disability. The findings may guide practice to develop longitudinal peer group rehabilitation programmes with joint inclusion of persons with amyotrophic lateral sclerosis and relatives. Implications for Rehabilitation Peer group rehabilitation may facilitate an increased and personalised understanding of what it means to live with amyotrophic lateral sclerosis. A programme design with six months of sequential sessions enables a continuous processing of shared experiences and gained knowledge. Joint participation of persons with amyotrophic lateral sclerosis and their relatives supports both their internal relationship and social networking. Peer group rehabilitation in amyotrophic lateral sclerosis should help overcome obstacles concerning the needs of participants, accessibility, and geographical distance.

An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India.

PubMed

Phukan, Sanjib Kumar; Medhi, Gajendra Kumar; Mahanta, Jagadish; Adhikary, Rajatashuvra; Thongamba, Gay; Paranjape, Ramesh S; Akoijam, Brogen S

2017-07-03

Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur. A total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes. The average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors. Because of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users for enriching the HIV prevention in this region.

Listening to and Sharing of Self in Psychoanalytic Supervision: The Supervisor's Self-Perspective.

PubMed

Watkins, C Edward

2016-08-01

Just as the analyst's self-perspective is critical to effective analytic process, the supervisor's self-perspective is accordingly critical to effective supervision process. But the supervisor's self-perspective has received virtually no attention as a listening/experiencing perspective in the psychoanalytic supervision literature. In this paper, the author defines the supervisor's self-perspective and considers five ways by which it contributes to an effective supervisory process: (1) sharing one's own impressions of/reactions to patients; (2) sharing personal disclosures about the supervisee-patient relationship; (3) sharing personal disclosures about the supervisee as a developing analytic therapist; (4) sharing personal disclosures about the supervisor-supervisee relationship; and (5) using one's own self-reflection as a check and balance for supervisory action. The supervisor's self-perspective provides the missing supervisory voice in the triadic complement of subject-other-self, has the potential to be eminently educative across the treatment/supervision dyads, and serves as a prototype for the supervisee's own development and use of analytic (or analyst) self-perspective.

The increasing labor force participation of older workers and its effect on the income of the aged.

PubMed

Leonesio, Michael V; Bridges, Benjamin; Gesumaria, Robert; Del Bene, Linda

2012-01-01

The labor force participation rates of men and women aged 62-79 have notably increased since the mid-1990s. The result is a dramatic increase in the share of total money income attributable to earnings. For persons aged 65-69, the earnings share of total income increased from 28 percent in 1980 to 42 percent in 2009. For this age group in the late 1980s and early 1990s, Social Security benefits and earnings were roughly equal shares of total money income (about 30 percent); the earnings share is now more than 12 percentage points larger. When we focus on aged persons who receive Social Security benefits, earnings shares have increased markedly throughout the 62-79 age range since the early 1990s. We show that for aged persons with labor market earnings, those earnings have a large effect on their relative position in the distribution of annual money income of older Americans.

Design Considerations for Today's Online Learners: A Study of Personalized, Relationship-Based Social Awareness Information

ERIC Educational Resources Information Center

Heo, Misook

2009-01-01

This article examined online learners' preferences in personalized, relationship-based social awareness information sharing in course management systems. Three hundred seventy-seven online learners' willingness to share social awareness information was measured through a national survey. Results indicated that today's online learners are open…

What does media use reveal about personality and mental health? An exploratory investigation among German students

PubMed Central

Margraf, Jürgen

2018-01-01

The present study aimed to investigate the relationship between personality traits, mental health variables and media use among German students. The data of 633 participants were collected. Results indicate a positive association between general Internet use, general use of social platforms and Facebook use, on the one hand, and self-esteem, extraversion, narcissism, life satisfaction, social support and resilience, on the other hand. Use of computer games was found to be negatively related to these personality and mental health variables. The use of platforms that focus more on written interaction (Twitter, Tumblr) was assumed to be negatively associated with positive mental health variables and significantly positively with depression, anxiety, and stress symptoms. In contrast, Instagram use, which focuses more on photo-sharing, correlated positively with positive mental health variables. Possible practical implications of the present results for mental health, as well as the limitations of the present work are discussed. PMID:29370275

Support Seeking or Familial Obligation: An Investigation of Motives for Disclosing Genetic Test Results.

PubMed

Greenberg, Marisa; Smith, Rachel A

2016-01-01

Genetic test results reveal not only personal information about a person's likelihood of certain medical conditions but also information about the person's genetic relatives. Given the familial nature of genetic information, one's obligation to protect family members may be a motive for disclosing genetic test results, but this claim has not been methodically tested. Existing models of disclosure decision making presume self-interested motives, such as seeking social support, instead of other-interested motives, like familial obligation. This study investigated young adults' (N = 173) motives to share a genetic-based health condition, alpha-1 antitrypsin deficiency, after reading a hypothetical vignette. Results show that social support and familial obligation were both reported as motives for disclosure. In fact, some participants reported familial obligation as their primary motivator for disclosure. Finally, stronger familial obligation predicted increased likelihood of disclosing hypothetical genetic test results. Implications of these results were discussed in reference to theories of disclosure decision-making models and the practice of genetic disclosures.

Age rationing, the virtues, and wanting more life.

PubMed

Purviance, Susan M

1993-01-01

The goal of this paper is to show that Callahan's reasons for withholding life extending care cannot be made out exclusively in terms of contemporary notions of distributive justice and fair allocation. I argue that by relying on a notion of justice which links the merit of the individual with the fairness of a social pattern of shares, Callahan imputes vice to the elderly as he denies them eligibility for life-prolonging care. Aristotle's doctrine of the mean is a useful tool for character evaluation. One can speak meaningfully of a proper disposition of a person of a certain type (an elderly person) with respect to the good of continued life. I claim that the mean of one's disposition with respect to the good of continued life would be relative to one's age group, and would be determined by that principle by which an elderly person of practical wisdom would determine it. This leads to very different conclusions than those drawn by Callahan.

Bridging the digital divide in HIV care: a pilot study of an iPod personal health record.

PubMed

Luque, Amneris E; Corales, Roberto; Fowler, Richard J; DiMarco, Jamie; van Keken, Adjuah; Winters, Paul; Keefer, Michael C; Fiscella, Kevin

2013-01-01

Persons living with HIV (PLWH) need practical tools to self-manage their condition. We conducted a proof-of-concept study among PLWH to assess whether patients could learn to use a personal health record (PHR) on a hand-held device (iPod Touch) to manage their condition. We began individual trainings and later adapted this to group training. We assessed usability, acceptability and also effects on self-efficacy for treatment adherence using the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES). Nine PLWH participated in the individual training and 29 participated in the group sessions. The participants were largely middle aged, low-income and of racial/ethnic minorities. The sessions were well attended and participants fully engaged in tasks and shared learning. Most participants stated they intended to use the PHR and reported improved self-efficacy in treatment adherence (P = .05) particularly on the integration of treatment adherence into one's routine (P < .02). Training PLWH in use of a handheld PHR shows promise.

Factors associated with the practice of nursing staff sharing information about patients' nutritional status with their colleagues in hospitals.

PubMed

Kawasaki, Y; Tamaura, Y; Akamatsu, R; Sakai, M; Fujiwara, K

2018-01-01

Nursing staff have an important role in patients' nutritional care. The aim of this study was to demonstrate how the practice of sharing a patient's nutritional status with colleagues was affected by the nursing staff's attitude, knowledge and their priority to provide nutritional care. The participants were 492 nursing staff. We obtained participants' demographic data, the practice of sharing patients' nutritional information and information about participants' knowledge, attitude and priority of providing nutritional care by the questionnaire. We performed partial correlation analyses and linear regression analyses to describe the relationship between the total scores of the practice of sharing patients' nutritional information based on their knowledge, attitude and priority to provide nutritional care. Among the 492 participants, 396 nursing staff (80.5%) completed the questionnaire and were included in analyses. Mean±s.d. of total score of the 396 participants was 8.4±3.1. Nursing staff shared information when they had a high nutritional knowledge (r=0.36, P<0.01) and attitude (r=0.13, P<0.05); however, their correlation coefficients were low. In the linear regression analyses, job categories (β=-0.28, P<0.01), knowledge (β=0.33, P<0.01) and attitude (β=0.10, P<0.05) were independently associated with the practice of sharing information. Nursing staff's priority to provide nutritional care practice was not significantly associated with the practice of sharing information. Knowledge and attitude were independently associated with the practice of sharing patients' nutrition information with colleagues, regardless of their priority to provide nutritional care. An effective approach should be taken to improve the practice of providing nutritional care practice.

Infant Sleep Location and Breastfeeding Practices in the United States, 2011-2014.

PubMed

Smith, Lauren A; Geller, Nicole L; Kellams, Ann L; Colson, Eve R; Rybin, Denis V; Heeren, Timothy; Corwin, Michael J

2016-08-01

To describe the prevalence of breastfeeding and sleep location practices among US mothers and the factors associated with these behaviors, including advice received regarding these practices. A nationally representative sample of 3218 mothers who spoke English or Spanish were enrolled at a sample of 32 US birth hospitals between January 2011 and March 2014. Exclusive breastfeeding was reported by 30.5% of mothers, while an additional 29.5% reported partial breastfeeding. The majority of mothers, 65.5%, reported usually room sharing without bed sharing, while 20.7% reported bed sharing. Compared to mothers who room shared without bed sharing, mothers who bed shared were more likely to report exclusive breastfeeding (adjusted odds ratio 2.46, 95% confidence interval 1.76, 3.45) or partial breastfeeding (adjusted odds ratio 1.75, 95% confidence interval 1.33, 2.31). The majority of mothers reported usually room sharing without bed sharing regardless of feeding practices, including 58.2% of exclusively breastfeeding mothers and 70.0% of nonbreastfeeding mothers. Receiving advice regarding sleep location or breastfeeding increased adherence to recommendations in a dose response manner (the adjusted odds of room sharing without bed sharing and exclusive breastfeeding increased as the relevant advice score increased); however, receiving advice regarding sleep location did not affect feeding practices. Many mothers have not adopted the recommended infant sleep location or feeding practices. Receiving advice from multiple sources appears to promote adherence in a dose response manner. Many women are able to both breastfeed and room share without bed sharing, and advice to adhere to both of these recommendations did not decrease breastfeeding rates. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Finding A Seat at the Table Together: Recommendations for Improving Collaboration between Social Work and Bioethics.

PubMed

Brazg, Tracy; Dotolo, Danae; Blacksher, Erika

2015-06-01

Social work and bioethics are fields deeply committed to cross-disciplinary collaboration to do their respective work. While scholars and practitioners from both fields share a commitment to social justice and to respecting the dignity, integrity and the worth of all persons, the overlap between the fields, including shared values, has received little attention. The purpose of this article is to describe the ways in which greater collaboration between the two fields can broaden their scope, enrich their scholarship, and better ground their practice. We describe the potential for realizing such benefits in two areas - health care ethics consultation and social inequalities in health - arguing that the fields both complement and challenge one another, making them ideal partners for the interdisciplinary inquiry and problem-solving so often called for today in health and health care. © 2014 John Wiley & Sons Ltd.

Does international family nursing need a professional organization?

PubMed

Curry, Donna Miles

2007-11-01

An International Family Nursing Conference has been held on a periodic basis since the 1980s. It started with several nursing professionals with a common interest: wanting to meet to share research and practice ideas. The organization of these conferences has been completely voluntary and sponsored by some very benevolent individuals and an institution of higher education. The fact that any of these conferences came off is attributed to considerable personal financial support and an untold number of volunteer hours. A group met in 2005 at the 7th International Family Nursing Conference in Victoria, British Columbia, Canada, to discuss whether there was any interest in forming a professional organization for family nursing. This article explores the cost/ benefits of such an endeavor. Input from other small newly created professional nursing organizations is shared. Conclusions provide summative questions related to development of a formal international professional nursing organization that family nurses must address.

A socio-emotional approach to couple therapy: linking social context and couple interaction.

PubMed

Knudson-Martin, Carmen; Huenergardt, Douglas

2010-09-01

This paper introduces Socio-Emotional Relationship Therapy (SERT), an approach designed to intervene in socio-cultural processes that limit couples' ability to develop mutually supportive relationships, especially within heterosexual relationships. SERT integrates recent advances in neurobiology and the social context of emotion with social constructionist assumptions regarding the fluid and contextual nature of gender, culture, personal identities, and relationship patterns. It advances social constructionist practice through in-session experiential work focused on 4 conditions foundational to mutual support--mutual influence, shared vulnerability, shared relationship responsibility, and mutual attunement. In contrast to couple therapy models that mask power issues, therapist neutrality is not considered possible or desirable. Instead, therapists position themselves to counteract social inequalities. The paper illustrates how empathic engagement of a socio-culturally attuned therapist sets the stage for new socio-cultural experience as it is embodied neurologically and physically in the relationship and discusses therapy as societal intervention. 2010 © FPI, Inc.

Sensory experiences of children with autism spectrum disorder: In their own words

PubMed Central

Kirby, Anne V; Dickie, Virginia A; Baranek, Grace T

2015-01-01

First-person perspectives of children with autism spectrum disorder (ASD) are rarely included in research, yet their voices may help more clearly illuminate their needs. This study involved phenomenological interviews with children with ASD (n=12, ages 4-13) used to gain insights about their sensory experiences. This article addresses two study aims: determining the feasibility of interviewing children with ASD and exploring how they share information about their sensory experiences during the qualitative interview process. With the described methods, children as young as four and across a broad range of autism severity scores successfully participated in the interviews. The manner with which children shared information about their sensory experiences included themes of normalizing, storytelling, and describing responses. The interviews also revealed the importance of context and the multisensory nature of children's experiences. These findings contribute strategies for understanding the sensory experiences of children with ASD with implications for practice and future research. PMID:24519585

The relationship between diversion-related attitudes and sharing and selling buprenorphine.

PubMed

Kenney, Shannon R; Anderson, Bradley J; Bailey, Genie L; Stein, Michael D

2017-07-01

Buprenorphine medication-assisted treatment (B-MAT) is an efficacious and popular outpatient treatment for opioid use disorder. However, the likelihood of buprenorphine diversion is a public health concern. We examined the relationship between attitudes toward diversion as predictors of both sharing and selling buprenorphine. Participants (n=476) were patients undergoing short-term inpatient opioid detoxification. Multinomial logistic regression was used to estimate the adjusted association of sharing and selling buprenorphine with demographics, substance use behaviors, and attitudes toward sharing and selling buprenorphine. Among the two hundred persons who had ever been prescribed buprenorphine (73.4% male, 89% heroin users), 50.5% reported they had shared buprenorphine and 28.0% reported they had sold buprenorphine. Controlling for other covariates, the odds of sharing buprenorphine were 3.17 (95% CI 1.21; 8.32) times higher for persons who agreed that it was "right to share buprenorphine with dope sick friends" than for those who did not agree with this attitude. Attitudes toward selling (OR 2.92; 95% CI 1.35; 6.21) and sharing (OR 4.12; 95% CI 1.64; 10.32) buprenorphine were the only significant correlates of selling, with the odds of selling exponentially greater among persons with favorable attitudes toward sharing or selling buprenorphine. Although considered diversion, sharing B-MAT is normative among B-MAT patients. Assessing B-MAT patients' attitudes about diversion may help identify patients requiring enhanced oversight, education, or intervention aimed at modifying attitudes to reduce their likelihood to share or sell buprenorphine. Copyright © 2017 Elsevier Inc. All rights reserved.

On the different "worlds" of intra-organizational knowledge management: Understanding idiosyncratic variation in MNC cross-site knowledge-sharing practices.

PubMed

Kasper, Helmut; Lehrer, Mark; Mühlbacher, Jürgen; Müller, Barbara

2013-02-01

This qualitative field study investigated cross-site knowledge sharing in a small sample of multinational corporations in three different MNC business contexts (global, multidomestic, transnational). The results disclose heterogeneous "worlds" of MNC knowledge sharing, ultimately raising the question as to whether the whole concept of MNC knowledge sharing covers a sufficiently unitary phenomenon to be meaningful. We derive a non-exhaustive typology of MNC knowledge-sharing practices: self-organizing knowledge sharing, technocratic knowledge sharing, and best practice knowledge sharing. Despite its limitations, this typology helps to elucidate a number of issues, including the latent conflict between two disparate theories of MNC knowledge sharing, namely "sender-receiver" and "social learning" theories (Noorderhaven & Harzing, 2009). More generally, we develop the term "knowledge contextualization" to highlight the way that firm-specific organizational features pre-define which knowledge is considered to be of special relevance for intra-organizational sharing.

Networking to improve end of life care.

PubMed

McGivern, Gerry

2009-01-01

Network organisations are increasingly common in healthcare. This paper describes an example of clinically led networking, which improved end of life care (EOLC) in care homes, differentiating between a 'network' as a formal entity and the more informal process of 'networking'. The paper begins with a brief discussion of networks and their development in healthcare, then an overview of EOLC policy, the case setting and methods. The paper describes four key features of this networking; (1) how it enabled discussions and implemented processes to help people address difficult taboos about dying; (2) how personal communication and 'distributed leadership' facilitated learning; (3) how EOLC occasionally lapsed during the handover of patient care, where personal relationship and communication were weaker; and (4) how successful learning and sharing of best practice was fragile and could be potentially undermined by wider financial pressures in the NHS.

Challenges in educating patients and parents about differences in sex development.

PubMed

McCauley, Elizabeth

2017-06-01

This article reviews practical approaches to talking with parents and youth about Differences in Sex Development (DSD) which are conditions that affect chromosomal, gonadal, or anatomic sexual development, one of the most personal, and in our society, private areas of life. Talking with parents and patients about these conditions can be challenging given the complexity of sexual development and the sensitive nature of the information being shared. Changing approaches to disclosing or communicating information about conditions, such as DSD are reviewed as well as factors leading to revision in the diagnostic nomenclature. Building on these developments, strategies used by an established DSD team to enhance shared decision making and partnership with families and patients are presented followed by examples of how some particularly challenging, but not uncommon clinical situations were approached. The paper concludes by endorsing the importance of understanding the social and cultural needs and beliefs of the parents and patients with DSD to set the stage for effective disclosure of medical facts. To be most useful to parents and youth, medical disclosure needs to include discussion of practical implications and strategies to help families and patients digest, understand, and work with the information provided. © 2017 Wiley Periodicals, Inc.

"Negotiorum Gestio" in Family Medicine, Informed Consent Obtainment, and Disciplinary Responsibility.

PubMed

Birkeland, Søren

2016-01-01

Introduction. Negotiorum gestio (NG) denotes an action where a person well intendedly acts on behalf of another without obtaining the latter's prior consent. In broad terms, NG-like actions have played a considerable role in health care provision. In some settings, health care delivery with only little or presumed patients' consent has been the rule rather than the exception. However, bioethical principles regarding patient autonomy and obtainment of the patient's informed consent (IC) before intervention are now increasingly materialized in the law of many countries. Aim. To study legal consequences of NG in family medicine and IC handling options. Methods. Case law examination. Results. A disciplinary board case is described concerning a family doctor conducting unlawful NG by not coming up to legal IC requirements. Discussion and Conclusion. The practical and legal implications of IC and possible role of novel Shared Decision-Making approaches in coming up to regulation and bioethical demands are discussed. It is concluded that a doctor may run an unnecessary legal risk when conducting NG in decision-competent patients and furthermore it is suggested that novel Shared Decision-Making approaches could help in obtaining a rightful and practicable IC.

Primary Health Care as a Foundation for Strengthening Health Systems in Low- and Middle-Income Countries.

PubMed

Bitton, Asaf; Ratcliffe, Hannah L; Veillard, Jeremy H; Kress, Daniel H; Barkley, Shannon; Kimball, Meredith; Secci, Federica; Wong, Ethan; Basu, Lopa; Taylor, Chelsea; Bayona, Jaime; Wang, Hong; Lagomarsino, Gina; Hirschhorn, Lisa R

2017-05-01

Primary health care (PHC) has been recognized as a core component of effective health systems since the early part of the twentieth century. However, despite notable progress, there remains a large gap between what individuals and communities need, and the quality and effectiveness of care delivered. The Primary Health Care Performance Initiative (PHCPI) was established by an international consortium to catalyze improvements in PHC delivery and outcomes in low- and middle-income countries through better measurement and sharing of effective models and practices. PHCPI has developed a framework to illustrate the relationship between key financing, workforce, and supply inputs, and core primary health care functions of first-contact accessibility, comprehensiveness, coordination, continuity, and person-centeredness. The framework provides guidance for more effective assessment of current strengths and gaps in PHC delivery through a core set of 25 key indicators ("Vital Signs"). Emerging best practices that foster high-performing PHC system development are being codified and shared around low- and high-income countries. These measurement and improvement approaches provide countries and implementers with tools to assess the current state of their PHC delivery system and to identify where cross-country learning can accelerate improvements in PHC quality and effectiveness.

Coevolution of Information Sharing and Implementation of Evidence-Based Practices Among North American Tobacco Cessation Quitlines

PubMed Central

Saul, Jessie E.; Lemaire, Robin H.; Valente, Thomas W.; Leischow, Scott J.

2015-01-01

Objectives. We examined the coevolution of information sharing and implementation of evidence-based practices among US and Canadian tobacco cessation quitlines within the North American Quitline Consortium (NAQC). Methods. Web-based surveys were used to collect data from key respondents representing each of 74 participating funders of NAQC quitlines during the summer and fall of 2009, 2010, and 2011. We used stochastic actor-based models to estimate changes in information sharing and practice implementation in the NAQC network. Results. Funders were more likely to share information within their own country and with funders that contracted with the same service provider. Funders contracting with larger service providers shared less information but implemented significantly more practices. Funders connected to larger numbers of tobacco control researchers more often received information from other funders. Intensity of ties to the NAQC network administrative organization did not influence funders’ decisions to share information or implement practices. Conclusions. Our findings show the importance of monitoring the NAQC network over time. We recommend increased cross-border information sharing and sharing of information between funders contracting with different and smaller service providers. PMID:26180993

Improving Communication Skills in Early Career Scientists

NASA Astrophysics Data System (ADS)

Saia, S. M.

2013-12-01

The AGU fall meeting is a time for scientists to share what we have been hard at work on for the past year, to share our trials and tribulations, and of course, to share our science (we hope inspirational). In addition to sharing, the AGU fall meeting is also about collaboration as it brings old and new colleagues together from diverse communities across the planet. By sharing our ideas and findings, we build new relationships with the potential to cross boundaries and solve complex and pressing environmental issues. With ever emerging and intensifying water scarcity, extreme weather, and water quality issues across the plant, it is especially important that scientists like us share our ideas and work together to put these ideas into action. My vision of the future of water sciences embraces this fact. I believe that better training is needed to help early career scientists, like myself, build connections within and outside of our fields. First and foremost, more advanced training in effective storytelling concepts and themes may improve our ability to provide context for our research. Second, training in the production of video for internet-based media (e.g. YouTube) may help us bring our research to audiences in a more personalized way. Third, opportunities to practice presenting at highly visible public events such as the AGU fall meeting, will serve to prepare early career scientists for a variety of audiences. We hope this session, ';Water Sciences Pop-Ups', will provide the first steps to encourage and train early career scientists as they share and collaborate with scientists and non-scientists around the world.

Levels of Social Sharing and Clinical Implications for Severe Social Withdrawal in Patients with Personality Disorders.

PubMed

Colle, Livia; Pellecchia, Giovanni; Moroni, Fabio; Carcione, Antonino; Nicolò, Giuseppe; Semerari, Antonio; Procacci, Michele

2017-01-01

Social sharing capacities have attracted attention from a number of fields of social cognition and have been variously defined and analyzed in numerous studies. Social sharing consists in the subjective awareness that aspects of the self's experience are held in common with other individuals. The definition of social sharing must take a variety of elements into consideration: the motivational element, the contents of the social sharing experience, the emotional responses it evokes, the behavioral outcomes, and finally, the circumstances and the skills which enable social sharing. The primary objective of this study is to explore some of the diverse forms of human social sharing and to classify them according to levels of complexity. We identify four different types of social sharing, categorized according to the nature of the content being shared and the complexity of the mindreading skills required. The second objective of this study is to consider possible applications of this graded model of social sharing experience in clinical settings. Specifically, this model may support the development of graded, focused clinical interventions for patients with personality disorders characterized by severe social withdrawal.

When science meets capitalism

NASA Astrophysics Data System (ADS)

Parker, Greg

2008-03-01

When I joined the University of Southampton's microelectronics group in 1987 after spending 10 years in industry, I shared some of my commercial ideas for advancing the group into the 21st century with my academic colleagues. To say that my personal vision of paradise was close to their vision of hell is probably a pretty accurate observation. Two decades on, I now understand why they felt that way. Science for Sale contains a lot of information that explains this vast difference in perception, and the book also does a good job of highlighting how academia and industry differ on practical and ethical levels.

PET imaging for receptor occupancy: meditations on calculation and simplification.

PubMed

Zhang, Yumin; Fox, Gerard B

2012-03-01

This invited mini-review briefly summarizes procedures and challenges of measuring receptor occupancy with positron emission tomography. Instead of describing the detailed analytic procedures of in vivo ligand-receptor imaging, the authors provide a pragmatic approach, along with personal perspectives, for conducting positron emission tomography imaging for receptor occupancy, and systematically elucidate the mathematics of receptor occupancy calculations in practical ways that can be understood with elementary algebra. The authors also share insights regarding positron emission tomography imaging for receptor occupancy to facilitate applications for the development of drugs targeting receptors in the central nervous system.

PET imaging for receptor occupancy: meditations on calculation and simplification

PubMed Central

Zhang, Yumin; Fox, Gerard B.

2012-01-01

This invited mini-review briefly summarizes procedures and challenges of measuring receptor occupancy with positron emission tomography. Instead of describing the detailed analytic procedures of in vivo ligand-receptor imaging, the authors provide a pragmatic approach, along with personal perspectives, for conducting positron emission tomography imaging for receptor occupancy, and systematically elucidate the mathematics of receptor occupancy calculations in practical ways that can be understood with elementary algebra. The authors also share insights regarding positron emission tomography imaging for receptor occupancy to facilitate applications for the development of drugs targeting receptors in the central nervous system. PMID:23554733

Designing for health in school buildings: between research and practice.

PubMed

Kirkeby, Inge Mette; Jensen, Bjarne Bruun; Larsen, Kristian; Kural, René

2015-05-01

To investigate the kinds of knowledge practitioners use when planning and designing for health in school buildings. Twelve semi-structured qualitative interviews were conducted with architects, teachers and officials to investigate use of knowledge in the making of school buildings. Practitioners drew on many kinds and sources of knowledge, but in particular they made use of concepts, examples or pictures or thought-provoking knowledge. However, the interviews indicate a number of hurdles for efficient knowledge sharing between research and practice: (1) a considerable discrepancy between kinds of knowledge used by practice and knowledge traditionally produced by research; (2) research-knowledge and practice-knowledge form two circuits and the flow from one circuit to the other is weak; (3) practitioners' knowledge was often based on experience and therefore person-dependent. It makes the knowledge vulnerable. Special attention has to be paid by research to concepts and principles to guide the decision-making in practice. Further is recommended to consider new kinds of collaboration between researchers and practitioners. © 2015 the Nordic Societies of Public Health.

The layered learning practice model: Lessons learned from implementation.

PubMed

Pinelli, Nicole R; Eckel, Stephen F; Vu, Maihan B; Weinberger, Morris; Roth, Mary T

2016-12-15

Pharmacists' views about the implementation, benefits, and attributes of a layered learning practice model (LLPM) were examined. Eligible and willing attending pharmacists at the same institution that had implemented an LLPM completed an individual, 90-minute, face-to-face interview using a structured interview guide developed by the interdisciplinary study team. Interviews were digitally recorded and transcribed verbatim without personal identifiers. Three researchers independently reviewed preliminary findings to reach consensus on emerging themes. In cases where thematic coding diverged, the researchers discussed their analyses until consensus was reached. Of 25 eligible attending pharmacists, 24 (96%) agreed to participate. The sample was drawn from both acute and ambulatory care practice settings and all clinical specialty areas. Attending pharmacists described several experiences implementing the LLPM and perceived benefits of the model. Attending pharmacists identified seven key attributes for hospital and health-system pharmacy departments that are needed to design and implement effective LLPMs: shared leadership, a systematic approach, good communication, flexibility for attending pharmacists, adequate resources, commitment, and evaluation. Participants also highlighted several potential challenges and obstacles for organizations to consider before implementing an LLPM. According to attending pharmacists involved in an LLPM, successful implementation of an LLPM required shared leadership, a systematic approach, communication, flexibility, resources, commitment, and a process for evaluation. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

"Developing culturally sensitive affect scales for global mental health research and practice: Emotional balance, not named syndromes, in Indian Adivasi subjective well-being".

PubMed

Snodgrass, Jeffrey G; Lacy, Michael G; Upadhyay, Chakrapani

2017-08-01

We present a perspective to analyze mental health without either a) imposing Western illness categories or b) adopting local or "native" categories of mental distress. Our approach takes as axiomatic only that locals within any culture share a cognitive and verbal lexicon of salient positive and negative emotional experiences, which an appropriate and repeatable set of ethnographic procedures can elicit. Our approach is provisionally agnostic with respect to either Western or native nosological categories, and instead focuses on persons' relative frequency of experiencing emotions. Putting this perspective into practice in India, our ethnographic fieldwork (2006-2014) and survey analysis (N = 219) resulted in a 40-item Positive and Negative Affect Scale (PANAS), which we used to assess the mental well-being of Indigenous persons (the tribal Sahariya) in the Indian states of Rajasthan and Madhya Pradesh. Generated via standard cognitive anthropological procedures that can be replicated elsewhere, measures such as this possess features of psychiatric scales favored by leaders in global mental health initiatives. Though not capturing locally named distress syndromes, our scale is nonetheless sensitive to local emotional experiences, frames of meaning, and "idioms of distress." By sharing traits of both global and also locally-derived diagnoses, approaches like ours can help identify synergies between them. For example, employing data reduction techniques such as factor analysis-where diagnostic and screening categories emerge inductively ex post facto from emotional symptom clusters, rather than being deduced or assigned a priori by either global mental health experts or locals themselves-reveals hidden overlaps between local wellness idioms and global ones. Practically speaking, our perspective, which assesses both emotional frailty and also potential sources of emotional resilience and balance, while eschewing all named illness categories, can be deployed in mental health initiatives in ways that minimize stigma and increase both the acceptability and validity of assessment instruments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improving Health Care for Critically Ill Patients Using an Evidence-Based Collaborative Approach to ABCDEF Bundle Dissemination and Implementation.

PubMed

Barnes-Daly, Mary Ann; Pun, Brenda T; Harmon, Lori A; Byrum, Diane G; Kumar, Vishakha K; Devlin, John W; Stollings, Joanna L; Puntillo, Kathleen A; Engel, Heidi J; Posa, Patricia J; Barr, Juliana; Schweickert, William D; Esbrook, Cheryl L; Hargett, Ken D; Carson, Shannon S; Aldrich, J Matthew; Ely, E Wesley; Balas, Michele C

2018-06-01

Patients admitted to intensive care units (ICUs) often experience pain, oversedation, prolonged mechanical ventilation, delirium, and weakness. These conditions are important in that they often lead to protracted physical, neurocognitive, and mental health sequelae now termed postintensive care syndrome. Changing current ICU practice will not only require the adoption of evidence-based interventions but the development of effective and reliable teams to support these new practices. To build on the success of bundled care and bridge an ongoing evidence-practice gap, the Society of Critical Care Medicine (SCCM) recently launched the ICU Liberation ABCDEF Bundle Improvement Collaborative. The Collaborative aimed to foster the bedside application of the SCCM's Pain, Agitation, and Delirium Guidelines via the ABCDEF bundle. The purpose of this paper is to describe the history of the Collaborative, the evidence-based implementation strategies used to foster change and teamwork, and the performance and outcome metrics used to monitor progress. Collaborative participants were required to attend four in-person meetings, monthly colearning calls, database training sessions, an e-Community listserv, and select in-person site visits. Teams submitted patient-level data and completed pre- and postimplementation questionnaires focused on the assessment of teamwork and collaboration, work environment, and overall ICU care. Faculty shared the evidence used to derive each bundle element as well as team-based implementation strategies for improvement and sustainment. Retention in the Collaborative was high, with 67 of 69 adult and eight of nine pediatric ICUs fully completing the program. Baseline and prospective data were collected on over 17,000 critically ill patients. A variety of evidence-based professional behavioral change interventions and novel implementation techniques were utilized and shared among Collaborative members. Hospitals and health systems can use the Collaborative structure, strategies, and tools described in this paper to help successfully implement the ABCDEF bundle in their ICUs. © 2018 Sigma Theta Tau International.

Risk-sharing agreements, present and future

PubMed Central

Gonçalves, Francisco R; Santos, Susana; Silva, Catarina; Sousa, Gabriela

2018-01-01

Risk-sharing agreements between pharmaceutical companies and payers stand out as a recent practice, the use of which has been increasing in the case of innovative medicines, particularly in the field of oncology, which aims to ensure better budgetary control and a lower risk of spending on medicinal products without full evidence of clinical benefit. In this article, the authors discuss the types of existing agreements, as well as those used in Portugal, their advantages, disadvantages and future challenges of implementation, as well as their potential role in access to therapeutic innovation, namely medicines for cancer treatment. For this purpose, a nonsystematic review of indexed and nonconventional literature was carried out. There is a tendency for the risk-sharing agreements established between payers and pharmaceutical companies to include a component of monitoring the use of medicines and outcomes measurement, involving real life data collection. Portugal is no exception and, although most agreements are still financial in nature, there is already a strong desire for other agreements, in particular clinical outcomes based. It is concluded that there is not yet a gold standard methodology in relation to the type of agreements to be practiced. Moreover, its opportunity cost, including the cost of implementation, remains to be scrutinised. However, regardless of the type of agreement, the advantages of adopting these agreements are well known, inevitably related with challenges of implementation. The need for an infrastructure to support information sharing is undisputed and urgent. The future of therapeutic innovation and increased pressure on health budgets will require alternative, more flexible models, personalized reimbursement models that allow alignment of medicines prices with the value they deliver in treating the several diseases. PMID:29743943

Comparativism and the Grounds for Person-Centered Care and Shared Decision Making.

PubMed

Herlitz, Anders

2017-01-01

This article provides a new argument and a new value-theoretical ground for person-centered care and shared decision making that ascribes to it the role of enabling rational choice in situations involving clinical choice. Rather than referring to good health outcomes and/or ethical grounds such as patient autonomy, it argues that a plausible justification and ground for person-centered care and shared decision making is preservation of rationality in the face of comparative non-determinacy in clinical settings. Often, no alternative treatment will be better than or equal to every other alternative. In the face of such comparative non-determinacy, Ruth Chang has argued that we can make rational decisions by invoking reasons that are created through acts of willing. This article transfers this view to clinical decision making and argues that shared decision making provides a solution to non-determinacy problems in clinical settings. This view of the role of shared decision making provides a new understanding of its nature, and it also allows us to better understand when caregivers should engage in shared decision making and when they should not. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

The Value of Sharing Information: A Neural Account of Information Transmission.

PubMed

Baek, Elisa C; Scholz, Christin; O'Donnell, Matthew Brook; Falk, Emily B

2017-07-01

Humans routinely share information with one another. What drives this behavior? We used neuroimaging to test an account of information selection and sharing that emphasizes inherent reward in self-reflection and connecting with other people. Participants underwent functional MRI while they considered personally reading and sharing New York Times articles. Activity in neural regions involved in positive valuation, self-related processing, and taking the perspective of others was significantly associated with decisions to select and share articles, and scaled with preferences to do so. Activity in all three sets of regions was greater when participants considered sharing articles with other people rather than selecting articles to read themselves. The findings suggest that people may consider value not only to themselves but also to others even when selecting news articles to consume personally. Further, sharing heightens activity in these pathways, in line with our proposal that humans derive value from self-reflection and connecting to others via sharing.

Shared decision making in chronic care in the context of evidence based practice in nursing.

PubMed

Friesen-Storms, Jolanda H H M; Bours, Gerrie J J W; van der Weijden, Trudy; Beurskens, Anna J H M

2015-01-01

In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient's values. The shared decision-making model seems to be helpful in the integration of the individual patient's values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient's willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making—integrated with evidence-based practice—can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence-based practice to deliver patient-centred care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Maximizing gait and balance: behaviors and decision-making processes of persons with multiple sclerosis and physical therapists.

PubMed

Held Bradford, Elissa; Finlayson, Marcia; White Gorman, Andrea; Wagner, Joanne

2018-05-01

To describe the behavioral decisions used by persons with multiple sclerosis (MS) and physical therapists to maximize gait and balance following outpatient physical therapy. A multi-method case series with seven matched pairs (persons with MS-physical therapists). Quota sampling maximized variability among persons with MS (disease steps score range 3-6). Three of the four physical therapists were MS or neurology certified. Persons with MS completed a phone survey, follow-up interview, and standardized questionnaires. Physical therapists completed an interview. Data were collected 2-8 weeks following discharge. Content and constant comparison analyses were used for thematic development and triangulation. Core themes arose exemplifying the decision-making processes and actions of persons with MS (challenging self by pushing but respecting limits) and physical therapists (finding the right fit). One overarching theme, keeping their lived world large, or participation in valued life roles, emerged integrating both perspectives driving decision-making. Participants have a shared goal of maximizing gait and balance so persons with MS can participate in valued life roles. Understanding the differences in the behavioral decisions and optimizing skill sets in shared decision-making and self-management may enhance the therapeutic partnership and engagement in gait- and balance-enhancing behaviors. Implications for Rehabilitation Persons with MS and physical therapists have a shared goal of maximizing gait and balance so persons with MS can participate in valued activities and life roles, or more poetically, keep their lived world large. Knowledge that persons with MS aim to challenge themselves by pushing but respecting limits can provide physical therapists with greater insight in helping persons with MS resolve uncertainty, set meaningful goals, and build the routines and resilience needed for engagement in gait- and balance-enhancing behaviors. Enriching skill sets in shared decision-making, behavior change and self-management may optimize the physical therapist toolbox.

Towards a consumer-informed research agenda for aphasia: preliminary work.

PubMed

Hinckley, Jacqueline; Boyle, Erika; Lombard, Diane; Bartels-Tobin, Lori

2014-01-01

Person-centeredness in clinical practice incorporates the values of clients into a shared decision-making approach. The values of person-centeredness can be extended into the realm of research when the views of consumers towards relevant and important research topics are sought. Work in other health domains has shown the importance of gathering consumer views on health care research, which ultimately extends into health care policy and practice. The purpose of this paper is to report methods used successfully to gather the views of individuals living with aphasia on research topics they view as important. The project is founded on principles of community-based participatory research. Using a modified nominal group technique, members of an aphasia support group generated a list of research topics. The Aphasia Support Group identified twenty-two potential research questions. Although a majority (59%) of the research questions generated by persons with aphasia could be addressed with accumulated scientific evidence, the remainder of the generated questions has not been addressed in the research literature. This project demonstrates that consumers with aphasia can participate as stakeholders in the discussion of research needs in aphasia. Additional work is needed to fully develop a consumer-informed research agenda for aphasia. The perspectives of individuals with post-stroke aphasia on research needs can be successfully collected using nominal group techniques. Consumer input to research agendas and priorities can help to address potential research biases. Clinicians and researchers can use these techniques and other communication supports to foster collaborative, patient-centered care in their practice and work.

Organizational Culture as Determinant of Knowledge Sharing Practices of Teachers Working in Higher Education Sector

ERIC Educational Resources Information Center

Areekkuzhiyil, Santhosh

2016-01-01

The current study aims to explore the influence of organisational culture on the knowledge sharing practices of teachers working in higher education sector. The study hypothesized the impact of various aspects of organisational culture on the knowledge sharing practices of teachers working in higher education sector. The data required for the…

Impact of Organisational Factors on the Knowledge Sharing Practice of Teachers Working in Higher Education Sector

ERIC Educational Resources Information Center

Areekkuzhiyil, Santhosh

2016-01-01

The current study aims to explore the various organizational factors that influence the knowledge sharing practices of teachers working in higher education sector. The study hypothesized the impact of various organizational factors on the knowledge sharing practices of teachers working in higher education sector. The data required for the study…

Integration of Learning and Practice for Job Sharing Partnerships

ERIC Educational Resources Information Center

Dixon-Krausse, Pamela Marie

2007-01-01

This paper explores the forces that support the proliferation of the flexible work arrangement called job sharing. Moreover, the paper will illuminate the need for integrating learning and practice as a way to develop and support job sharing partners, or "Partners in Practice" (PiPs). The author puts forth a model derived from learning in…

Physician response to the United Mine Workers' cost-sharing program: the other side of the coin.

PubMed Central

Fahs, M C

1992-01-01

The effect of cost sharing on health services utilization is analyzed from a new perspective, that is, its effects on physician response to cost sharing. A primary data set was constructed using medical records and billing files from a large multispecialty group practice during the three-year period surrounding the introduction of cost sharing to the United Mine Workers Health and Retirement Fund. This same group practice also served an equally large number of patients covered by United Steelworkers' health benefit plans, for which similar utilization data were available. The questions addressed in this interinsurer study are: (1) to what extent does a physician's treatment of medically similar cases vary, following a drop in patient visits as a result of cost sharing? and (2) what is the impact, if any, on costs of care for other patients in the practice (e.g., "spillover effects" such as cost shifting)? Answers to these kinds of questions are necessary to predict the effects of cost sharing on overall health care costs. A fixed-effects model of physician service use was applied to data on episodes of treatment for all patients in a private group practice. This shows that the introduction of cost sharing to some patients in a practice does, in fact, increase the treatment costs to other patients in the same practice who remain under stable insurance plans. The analysis demonstrates that when the economic effects of cost sharing on physician service use are analyzed for all patients within a physician practice, the findings are remarkably different from those of an analysis limited to those patients directly affected by cost sharing. PMID:1563952

Willingness to share personal health record data for care improvement and public health: a survey of experienced personal health record users.

PubMed

Weitzman, Elissa R; Kelemen, Skyler; Kaci, Liljana; Mandl, Kenneth D

2012-05-22

Data stored in personally controlled health records (PCHRs) may hold value for clinicians and public health entities, if patients and their families will share them. We sought to characterize consumer willingness and unwillingness (reticence) to share PCHR data across health topics, and with different stakeholders, to advance understanding of this issue. Cross-sectional 2009 Web survey of repeat PCHR users who were patients over 18 years old or parents of patients, to assess willingness to share their PCHR data with an-out-of-hospital provider to support care, and the state/local public health authority to support monitoring; the odds of reticence to share PCHR information about ten exemplary health topics were estimated using a repeated measures approach. Of 261 respondents (56% response rate), more reported they would share all information with the state/local public health authority (63.3%) than with an out-of-hospital provider (54.1%) (OR 1.5, 95% CI 1.1, 1.9; p = .005); few would not share any information with these parties (respectively, 7.9% and 5.2%). For public health sharing, reticence was higher for most topics compared to contagious illness (ORs 4.9 to 1.4, all p-values < .05), and reflected concern about anonymity (47.2%), government insensitivity (41.5%), discrimination (24%). For provider sharing, reticence was higher for all topics compared to contagious illness (ORs 6.3 to 1.5, all p-values < .05), and reflected concern for relevance (52%), disclosure to insurance (47.6%) and/or family (20.5%). Pediatric patients and their families are often willing to share electronic health information to support health improvement, but remain cautious. Robust trust models for PCHR sharing are needed.

Knowledge displays: Soliciting clients to fill knowledge gaps and to reconcile knowledge discrepancies in therapeutic interaction.

PubMed

Pino, Marco

2016-06-01

To examine knowledge displays (KDs), a practice by which Therapeutic Community (TC) professionals exhibit previous knowledge about their clients' circumstances and experiences. Conversation analysis is used to examine 12 staff-led meetings recorded in Italy (8 in a drug addiction TC; 4 in a mental health TC). The TC professionals use KDs within broader sequences of talk where they solicit their clients to share personal information and where the clients provide insufficient or inconsistent responses. In these circumstances, the staff members employ KDs to pursue responses that redress emerging knowledge gaps and discrepancies regarding the clients' experiences or circumstances. KDs allow the staff members to achieve a balance between respecting their clients' right to report their own experiences and influencing the ways in which they report them. KDs help to reinforce the culture of openness that is central to many forms of therapeutic interaction, to forward the therapeutic agenda and to expand the staff members' knowledge of the clients' experiences and circumstances. KDs can be used to solicit clients to share personal information. This paper illustrates core features that underlie the function of KDs (where they are used and how they are constructed). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

SU-E-P-26: Oncospace: A Shared Radiation Oncology Database System Designed for Personalized Medicine, Decision Support, and Research

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

Bowers, M; Robertson, S; Moore, J

Purpose: Advancement in Radiation Oncology (RO) practice develops through evidence based medicine and clinical trial. Knowledge usable for treatment planning, decision support and research is contained in our clinical data, stored in an Oncospace database. This data store and the tools for populating and analyzing it are compatible with standard RO practice and are shared with collaborating institutions. The question is - what protocol for system development and data sharing within an Oncospace Consortium? We focus our example on the technology and data meaning necessary to share across the Consortium. Methods: Oncospace consists of a database schema, planning and outcomemore » data import and web based analysis tools.1) Database: The Consortium implements a federated data store; each member collects and maintains its own data within an Oncospace schema. For privacy, PHI is contained within a single table, accessible to the database owner.2) Import: Spatial dose data from treatment plans (Pinnacle or DICOM) is imported via Oncolink. Treatment outcomes are imported from an OIS (MOSAIQ).3) Analysis: JHU has built a number of webpages to answer analysis questions. Oncospace data can also be analyzed via MATLAB or SAS queries.These materials are available to Consortium members, who contribute enhancements and improvements. Results: 1) The Oncospace Consortium now consists of RO centers at JHU, UVA, UW and the University of Toronto. These members have successfully installed and populated Oncospace databases with over 1000 patients collectively.2) Members contributing code and getting updates via SVN repository. Errors are reported and tracked via Redmine. Teleconferences include strategizing design and code reviews.3) Successfully remotely queried federated databases to combine multiple institutions’ DVH data for dose-toxicity analysis (see below – data combined from JHU and UW Oncospace). Conclusion: RO data sharing can and has been effected according to the Oncospace Consortium model: http://oncospace.radonc.jhmi.edu/ . John Wong - SRA from Elekta; Todd McNutt - SRA from Elekta; Michael Bowers - funded by Elekta.« less

Social Identity, Social Ties and Social Capital: A Study in Gaming Context

ERIC Educational Resources Information Center

Jiang, Hao

2012-01-01

This work will focus on how different social relationships, namely shared identity and personal tie, will impact cooperative behavior, a form of social capital. I designed and conducted an economic game study to show that shared identity and personal ties work differently on cooperation among people and resource flow in social groups. Many factors…

Social Networking Privacy Control: Exploring University Variables Related to Young Adults' Sharing of Personally Identifiable Information

ERIC Educational Resources Information Center

Zimmerman, Melisa S.

2014-01-01

The growth of the Internet, and specifically social networking sites (SNSs) like Facebook, create opportunities for individuals to share private and identifiable information with a closed or open community. Internet crime has been on the rise and research has shown that criminals are using individuals' personal information pulled from social…

Teachers' Orientation to Kindergartners' Different Interactional Competences: Telling Personal Experiences during Shared Readings of Picture Books

ERIC Educational Resources Information Center

Gosen, Myrte N.

2015-01-01

This paper is centered around 106 tellings of personal experiences during shared readings of picture books in kindergarten classrooms. It is shown that teachers orient to different interactional storytelling competences of their pupils. Teachers are found to contribute to pupils' tellings by inviting them, by showing recipiency, by asking…

Online and in-person networking among women in the Earth Sciences Women's Network at www.ESWNonline.org

NASA Astrophysics Data System (ADS)

Kontak, R.; Adams, A. S.; De Boer, A. M.; Hastings, M. G.; Holloway, T.; Marin-Spiotta, E.; Steiner, A. L.; Wiedinmyer, C.

2012-12-01

The Earth Science Women's Network is an international peer-mentoring network of women in the Earth Sciences, many of whom are in the early stages of their careers. Membership is free and has grown through "word of mouth," and includes upper-level undergraduates, graduate students, professionals in a range of environmental fields, scientists working in public and private institutions. Our mission is to promote career development, build community, provide informal mentoring and support, and facilitate professional collaborations. Since 2002 we have accomplished this trough online networking, including over email and a listserv, on facebook, in-person networking events, and professional development workshops. Now in our 10th year, ESWN is debuting a new web-center that creates an online space exclusively for women in any discipline of the Earth (including planetary) sciences. ESWN members can connect and create an online community of support and encouragement for themselves as women in a demanding career. Many women in Earth Science fields feel isolated and are often the only woman in their department or work environments. ESWN is a place to meet others, discuss issues faced in creating work-life balance and professional success and share best practices through peer mentoring. Now on ESWN's new web-center, members can create and personalize their profiles and search for others in their field, nearby, or with similar interests. Online discussions in the members-only area can also be searched. Members can create groups for discussion or collaboration, with document sharing and password protection. Publicly, we can share gained knowledge with a broader audience, like lessons learned at our professional development workshops and collected recommendations from members. The new web center allows for more connectivity among other online platforms used by our members, including linked-in, facebook, and twitter. Built in Wordpress with a Buddpress members-only section, the new ESWN website is supported by AGU and a NSF ADVANCE grant.;

On the different “worlds” of intra-organizational knowledge management: Understanding idiosyncratic variation in MNC cross-site knowledge-sharing practices

PubMed Central

Kasper, Helmut; Lehrer, Mark; Mühlbacher, Jürgen; Müller, Barbara

2013-01-01

This qualitative field study investigated cross-site knowledge sharing in a small sample of multinational corporations in three different MNC business contexts (global, multidomestic, transnational). The results disclose heterogeneous “worlds” of MNC knowledge sharing, ultimately raising the question as to whether the whole concept of MNC knowledge sharing covers a sufficiently unitary phenomenon to be meaningful. We derive a non-exhaustive typology of MNC knowledge-sharing practices: self-organizing knowledge sharing, technocratic knowledge sharing, and best practice knowledge sharing. Despite its limitations, this typology helps to elucidate a number of issues, including the latent conflict between two disparate theories of MNC knowledge sharing, namely “sender–receiver” and “social learning” theories (Noorderhaven & Harzing, 2009). More generally, we develop the term “knowledge contextualization” to highlight the way that firm-specific organizational features pre-define which knowledge is considered to be of special relevance for intra-organizational sharing. PMID:27087759

Human milk sharing practices in the U.S.

PubMed

Palmquist, Aunchalee E L; Doehler, Kirsten

2016-04-01

The primary objective of this study is to describe human milk sharing practices in the U.S. Specifically, we examine milk sharing social networks, donor compensation, the prevalence of anonymous milk sharing interactions, recipients' concerns about specific milk sharing risks, and lay screening behaviors. Data on human milk sharing practices were collected via an online survey September 2013-March 2014. Chi-square analyses were used to test the association between risk perception and screening practices. A total of 867 (661 donors, 206 recipients) respondents were included in the analyses. Most (96.1%) reported sharing milk face-to-face. Only 10% of respondents reported giving or receiving milk through a non-profit human milk bank, respectively. There were no reports of anonymous purchases of human milk. A small proportion of recipients (4.0%) reported that their infant had a serious medical condition. Screening of prospective donors was common (90.7%) but varied with social relationship and familiarity. Likewise, concern about specific milk sharing risks was varied, and risk perception was significantly associated (P-values = 0.01 or less) with donor screening for all risk variables except diet. Understanding lay perceptions of milk sharing risk and risk reduction strategies that parents are using is an essential first step in developing public health interventions and clinical practices that promote infant safety. © 2015 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Are person-related and socio-structural factors associated with nurses' self-management support behavior? A correlational study.

PubMed

Duprez, Veerle; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann

2018-02-01

To explore nurses' self-perceived behavior of supporting patients' self-management, and its association with person-related and socio-structural factors. Correlational study in a sample of nurses from nine general hospitals, three community healthcare organizations, and six private community practices. Nurses with >50% of their patients living with a chronic condition were eligible to participate. Data were collected at two time-points. Self-management support behavior was measured by the SEPSS-36 instrument. The person-related and socio-structural associated factors were derived from behavioral theories and measured by validated questionnaires. Nurses (N=477) scored overall low on self-management support behavior. Nurses lacked mainly competencies in collaborative goalsetting, shared decision making and organizing follow-up. Factors predicting nurses' behavior in supporting patients' self-management were self-efficacy, priority, perceived supervisor support and training in self-management support. This model explained 51.7% of the variance in nurses' behavior. To date, nurses do not optimally fulfil their role in supporting patients' self-management. Self-management support is practiced from a narrow medical point of view and primarily consists of informing patients, which is the lowest level of patient participation. It is essential to better prepare and support nurses - and by extend all healthcare professionals - for the challenges of supporting patients' self-management. Copyright © 2017 Elsevier B.V. All rights reserved.

What's your strategy for managing knowledge?

PubMed

Hansen, M T; Nohria, N; Tierney, T

1999-01-01

The rise of the computer and the increasing importance of intellectual assets have compelled executives to examine the knowledge underlying their businesses and how it is used. Because knowledge management as a conscious practice is so young, however, executives have lacked models to use as guides. To help fill that gap, the authors recently studied knowledge management practices at management consulting firms, health care providers, and computer manufacturers. They found two very different knowledge management strategies in place. In companies that sell relatively standardized products that fill common needs, knowledge is carefully codified and stored in databases, where it can be accessed and used--over and over again--by anyone in the organization. The authors call this the codification strategy. In companies that provide highly customized solutions to unique problems, knowledge is shared mainly through person-to-person contacts; the chief purpose of computers is to help people communicate. They call this the personalization strategy. A company's choice of knowledge management strategy is not arbitrary--it must be driven by the company's competitive strategy. Emphasizing the wrong approach or trying to pursue both can quickly undermine a business. The authors warn that knowledge management should not be isolated in a functional department like HR or IT. They emphasize that the benefits are greatest--to both the company and its customers--when a CEO and other general managers actively choose one of the approaches as a primary strategy.

Sharing resources: opportunities for smaller primary care practices to increase their capacity for patient care. Findings from the 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

PubMed

Fryer, Ashley-Kay; Doty, Michelle M; Audet, Anne-Marie J

2011-03-01

Most Americans get their health care in small physician practices. Yet, small practice settings are often unable to provide the same range of services or partici­pate in quality improvement initiatives as large practices because they lack the staff, infor­mation technology, and office systems. One promising strategy is to share clinical sup­port services and information systems with other practices. New findings from the 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians suggest smaller practices that share resources are more likely than those without shared resources to have advanced electronic medical records and health information technology, routinely track and manage patient information, have after-hours care arrangements, and engage in quality monitoring and benchmarking. This issue brief highlights strategies that can increase resources among small- and medium-sized practices and efforts supported by states, the private sector, and the Affordable Care Act that encourage the expansion of shared-resource models.

Personal protective equipment

MedlinePlus

... medlineplus.gov/ency/patientinstructions/000447.htm Personal protective equipment To use the sharing features on this page, please enable JavaScript. Personal protective equipment is special equipment you wear to create a ...

Can only one person be right? The development of objectivism and social preferences regarding widely shared and controversial moral beliefs.

PubMed

Heiphetz, Larisa; Young, Liane L

2017-10-01

Prior work has established that children and adults distinguish moral norms (e.g., hitting is wrong) from conventional norms (e.g., wearing pajamas to school is wrong). Specifically, moral norms are generally perceived as universal across time and space, similar to objective facts. We examined preschoolers' and adults' perceptions of moral beliefs alongside facts and opinions by asking whether only one person could be right in the case of disagreements. We also compared perceptions of widely shared moral beliefs (e.g., whether it is better to pull someone's hair or share with someone) and controversial moral beliefs (e.g., whether it is better to help someone with a project or make cookies for someone). In Studies 1 and 2, preschoolers and adults were more likely to judge that only one person could be right in the case of widely shared versus controversial moral beliefs, treating the former as more objective or fact-like. Children were also more likely than adults to say that only one person could be right in a moral disagreement. Study 2 additionally revealed that adults were more likely than children to report preferring individuals who shared their controversial moral beliefs. Study 3 replicated these patterns using a different sample of widely shared beliefs (e.g., whether it is okay to mock a poor classmate) and controversial moral beliefs (e.g., whether it is okay to tell small, prosocial lies). While some aspects of moral cognition may depend on abundant social learning and cognitive development, the perception that disagreements about widely shared moral beliefs have only one right answer while disagreements about controversial moral beliefs do not emerges relatively early. We discuss implications for moral learning and social preferences. Copyright © 2016 Elsevier B.V. All rights reserved.

"Life Within the Person Comes to The Fore": Pastoral Workers' Practice Wisdom on Using Arts in Palliative Care.

PubMed

O'Callaghan, Clare; Byrne, Libby; Cokalis, Eleni; Glenister, David; Santilli, Margaret; Clark, Rose; McCarthy, Therese; Michael, Natasha

2018-07-01

Pastoral care (also chaplaincy, spiritual care) assists people to find meaning, personal resources, and connection with self, others, and/or a higher power. Although essential in palliative care, there remains limited examination of what pastoral workers do. This study examined how pastoral workers use and consider the usefulness of art-based modalities. Qualitative research was used to examine the practice wisdom (tacit practice knowledge) of pastoral workers experienced in using visual arts and music in palliative care. Two focus groups were conducted. Thematic analysis was informed by grounded theory. Six pastoral workers shared information. Three themes emerged. First, pastoral workers use arts as "another tool" to extend scope of practice by assisting patients and families to symbolically and more deeply contemplate what they find "sacred." Second, pastoral workers' art affinities inform their aims, assessments, and interactions. Third, pastoral workers perceive that art-based modalities can validate, enlighten, and transform patients and families through enabling them to "multisensorially" (through many senses) feel recognized, accepted, empowered, and/or close to God. Key elements involved in the work's transformative effects include enabling beauty, ritual, and the sense of "home" being heard, and legacy creation. Pastoral workers interpret that offering art-based modalities in palliative care can help patients and families to symbolically deal with painful memories and experiences, creatively engage with that deemed significant, and/or encounter a sense of transcendence. Training in generalist art-based care needs to be offered in pastoral education.

Implementation and Evaluation of Two Educational Strategies to Improve Screening for Eating Disorders in Pediatric Primary Care.

PubMed

Gooding, Holly C; Cheever, Elizabeth; Forman, Sara F; Hatoun, Jonathan; Jooma, Farah; Touloumtzis, Currie; Vernacchio, Louis

2017-05-01

Routine screening for disordered eating or body image concerns is recommended by the American Academy of Pediatrics. We evaluated the ability of two educational interventions to increase screening for eating disorders in pediatric primary care practice, predicting that the "active-learning" group would have an increase in documented screening after intervention. We studied 303 practitioners in a large independent practice association located in the northeastern United States. We used a quasi-experimental design to test the effect of printed educational materials ("print-learning" group, n = 280 participants) compared with in-person shared learning followed by on-line spaced education ("active-learning" group, n = 23 participants) on documented screening of adolescents for eating disorder symptoms during preventive care visits. A subset of 88 participants completed additional surveys regarding knowledge of eating disorders, comfort screening for, diagnosing, and treating eating disorders, and satisfaction with their training regarding eating disorders. During the preintervention period, 4.5% of patients seen by practitioners in both the print-learning and active-learning groups had chart documentation of screening for eating disorder symptoms or body image concerns. This increased to 22% in the active-learning group and 5.7% in the print-learning group in the postintervention period, a statistically significant result. Compared with print-learning participants, active-learning group participants had greater eating disorder knowledge scores, increases in comfort diagnosing eating disorders, and satisfaction with their training in this area. In-person shared learning followed by on-line spaced education is more effective than print educational materials for increasing provider documentation of screening for eating disorders in primary care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Refinement and dissemination of a digital platform for sharing transportation education materials.

DOT National Transportation Integrated Search

2015-07-01

National agencies have called for more widespread adoption of best practices in engineering education. To facilitate this sharing of practices a : web-based system framework used by transportation engineering educators to share curricular materials a...

Borderline personality disorder

MedlinePlus

... this page: //medlineplus.gov/ency/article/000935.htm Borderline personality disorder To use the sharing features on this page, please enable JavaScript. Borderline personality disorder (BPD) is a mental condition in which ...

Shared decision-making and patient autonomy.

PubMed

Sandman, Lars; Munthe, Christian

2009-01-01

In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.

Getting connected: Both associative and semantic links structure semantic memory for newly learned persons.

PubMed

Wiese, Holger; Schweinberger, Stefan R

2015-01-01

The present study examined whether semantic memory for newly learned people is structured by visual co-occurrence, shared semantics, or both. Participants were trained with pairs of simultaneously presented (i.e., co-occurring) preexperimentally unfamiliar faces, which either did or did not share additionally provided semantic information (occupation, place of living, etc.). Semantic information could also be shared between faces that did not co-occur. A subsequent priming experiment revealed faster responses for both co-occurrence/no shared semantics and no co-occurrence/shared semantics conditions, than for an unrelated condition. Strikingly, priming was strongest in the co-occurrence/shared semantics condition, suggesting additive effects of these factors. Additional analysis of event-related brain potentials yielded priming in the N400 component only for combined effects of visual co-occurrence and shared semantics, with more positive amplitudes in this than in the unrelated condition. Overall, these findings suggest that both semantic relatedness and visual co-occurrence are important when novel information is integrated into person-related semantic memory.

One Big Happy Family? Unraveling the Relationship between Shared Perceptions of Team Psychological Contracts, Person-Team Fit and Team Performance.

PubMed

Gibbard, Katherine; Griep, Yannick; De Cooman, Rein; Hoffart, Genevieve; Onen, Denis; Zareipour, Hamidreza

2017-01-01

With the knowledge that team work is not always associated with high(er) performance, we draw from the Multi-Level Theory of Psychological Contracts, Person-Environment Fit Theory, and Optimal Distinctiveness Theory to study shared perceptions of psychological contract (PC) breach in relation to shared perceptions of complementary and supplementary fit to explain why some teams perform better than other teams. We collected three repeated survey measures in a sample of 128 respondents across 46 teams. After having made sure that we met all statistical criteria, we aggregated our focal variables to the team-level and analyzed our data by means of a longitudinal three-wave autoregressive moderated-mediation model in which each relationship was one-time lag apart. We found that shared perceptions of PC breach were directly negatively related to team output and negatively related to perceived team member effectiveness through a decrease in shared perceptions of supplementary fit. However, we also demonstrated a beneficial process in that shared perceptions of PC breach were positively related to shared perceptions of complementary fit, which in turn were positively related to team output. Moreover, best team output appeared in teams that could combine high shared perceptions of complementary fit with modest to high shared perceptions of supplementary fit. Overall, our findings seem to indicate that in terms of team output there may be a bright side to perceptions of PC breach and that perceived person-team fit may play an important role in this process.

One Big Happy Family? Unraveling the Relationship between Shared Perceptions of Team Psychological Contracts, Person-Team Fit and Team Performance

PubMed Central

Gibbard, Katherine; Griep, Yannick; De Cooman, Rein; Hoffart, Genevieve; Onen, Denis; Zareipour, Hamidreza

2017-01-01

With the knowledge that team work is not always associated with high(er) performance, we draw from the Multi-Level Theory of Psychological Contracts, Person-Environment Fit Theory, and Optimal Distinctiveness Theory to study shared perceptions of psychological contract (PC) breach in relation to shared perceptions of complementary and supplementary fit to explain why some teams perform better than other teams. We collected three repeated survey measures in a sample of 128 respondents across 46 teams. After having made sure that we met all statistical criteria, we aggregated our focal variables to the team-level and analyzed our data by means of a longitudinal three-wave autoregressive moderated-mediation model in which each relationship was one-time lag apart. We found that shared perceptions of PC breach were directly negatively related to team output and negatively related to perceived team member effectiveness through a decrease in shared perceptions of supplementary fit. However, we also demonstrated a beneficial process in that shared perceptions of PC breach were positively related to shared perceptions of complementary fit, which in turn were positively related to team output. Moreover, best team output appeared in teams that could combine high shared perceptions of complementary fit with modest to high shared perceptions of supplementary fit. Overall, our findings seem to indicate that in terms of team output there may be a bright side to perceptions of PC breach and that perceived person-team fit may play an important role in this process. PMID:29170648

Reflecting on patient-centred care in pharmacy through an illness narrative.

PubMed

Dowse, Ros

2015-08-01

Patient-centred care (PCC) is rapidly adopting a central position in discussions on the quality of healthcare, with patient-centredness deemed essential to transforming the healthcare system. PCC speaks to the quality of patient-provider relationships and has been defined as an approach to providing care that is respectful of and responsive to individual patient preferences, needs, and values, while ensuring that patient values guide all clinical decisions. However its place within pharmacy practice is unclear and is as yet undefined, particularly in relation to pharmaceutical care. Through my personal illness narrative, I briefly explore the visibility and evidence of PCC in the pharmacy literature as well as from personal experience of pharmacy care, and find it lacking. I conclude that an integrated, seamless understanding of PCC and the use of shared language within the health professions is essential in successful teamwork with both the patient and with other health professions.

Sorting It Out: Cultural Competency and Healthcare Literacy in the World Today.

PubMed

Karnick, Paula M

2016-04-01

Healthcare literacy and cultural competence are necessary components in keeping patients informed. Nurses are the foundation of healthcare and pivotal in creating trusting relationships with patients by sharing information. Respect is key in developing a tailored approach to individuals' healthcare literacy and nurses' cultural competence. In practice, the consequence of understanding healthcare literacy and being culturally competent should not be understated. Whether on a mission trip to another country or working in a clinic in the United States, diverse cultures abound. While a person from a particular culture may have some of the same beliefs of others in a culture, the breadth of expression of culture, personal beliefs, and worldview may be vastly different. Humans express themselves in unique ways even within cultures. Seeking ways to understand one another is vital not only in healthcare but in all aspects of life. © The Author(s) 2016.

Pro-environmental behavior: rational choice meets moral motivation.

PubMed

Turaga, Rama Mohana R; Howarth, Richard B; Borsuk, Mark E

2010-01-01

The determinants of individual behaviors that provide shared environmental benefits are a longstanding theme in social science research. Alternative behavioral models yield markedly different predictions and policy recommendations. This paper reviews and compares the literatures from two disciplines that appear to be moving toward a degree of convergence. In social psychology, moral theories of pro-environmental behavior have focused on the influence of personal moral norms while recognizing that external factors, such as costs and incentives, ultimately limit the strength of the norm-behavior relationship. Rational choice models, such as the theory of planned behavior in social psychology and the theories of voluntary provision of public goods in economics, have sought to incorporate the effects of personal norms and to measure their importance in explaining behaviors, such as recycling and the demand for green products. This paper explores the relationship between these approaches and their implications for the theory and practice of ecological economics.

Wake Vortex Wingtip-Turbine Powered Circulation Control High-Lift System

NASA Technical Reports Server (NTRS)

Moore, Mark D.

2005-01-01

NASA s Vehicle Systems Program is investing in aeronautics technology development across six vehicle sectors, in order to improve future air travel. These vehicle sectors include subsonic commercial transports, supersonic vehicles, Uninhabited Aerial Vehicles (UAVs), Extreme Short Takeoff and Landing (ESTOL) vehicles, Rotorcraft, and Personal Air Vehicles (PAVs). While the subsonic transport is firmly established in U.S. markets, the other vehicle sectors have not developed a sufficient technology or regulatory state to permit widespread, practical use. The PAV sector has legacy products in the General Aviation (GA) market, but currently only accounts for negligible revenue miles, sales, or market share of personal travel. In order for PAV s to ever capture a significant market, these small aircraft require technologies that permit them to be less costly, environmentally acceptable, safer, easier to operate, more efficient, and less dependent on large support infrastructures.

Aesthetics and ethics in engineering: insights from Polanyi.

PubMed

Dias, Priyan

2011-06-01

Polanyi insisted that scientific knowledge was intensely personal in nature, though held with universal intent. His insights regarding the personal values of beauty and morality in science are first enunciated. These are then explored for their relevance to engineering. It is shown that the practice of engineering is also governed by aesthetics and ethics. For example, Polanyi's three spheres of morality in science--that of the individual scientist, the scientific community and the wider society--has parallel entities in engineering. The existence of shared values in engineering is also demonstrated, in aesthetics through an example that shows convergence of practitioner opinion to solutions that represent accepted models of aesthetics; and in ethics through the recognition that many professional engineering institutions hold that the safety of the public supersedes the interests of the client. Such professional consensus can be seen as justification for studying engineering aesthetics and ethics as inter-subjective disciplines.

Networking to improve end of life care

PubMed Central

2009-01-01

Network organisations are increasingly common in healthcare. This paper describes an example of clinically led networking, which improved end of life care (EOLC) in care homes, differentiating between a ‘network’ as a formal entity and the more informal process of ‘networking’. The paper begins with a brief discussion of networks and their development in healthcare, then an overview of EOLC policy, the case setting and methods. The paper describes four key features of this networking; (1) how it enabled discussions and implemented processes to help people address difficult taboos about dying; (2) how personal communication and ‘distributed leadership’ facilitated learning; (3) how EOLC occasionally lapsed during the handover of patient care, where personal relationship and communication were weaker; and (4) how successful learning and sharing of best practice was fragile and could be potentially undermined by wider financial pressures in the NHS. PMID:25949588

Strategies for Information Retrieval and Virtual Teaming to Mitigate Risk on NASA's Missions

NASA Technical Reports Server (NTRS)

Topousis, Daria; Williams, Gregory; Murphy, Keri

2007-01-01

Following the loss of NASA's Space Shuttle Columbia in 2003, it was determined that problems in the agency's organization created an environment that led to the accident. One component of the proposed solution resulted in the formation of the NASA Engineering Network (NEN), a suite of information retrieval and knowledge sharing tools. This paper describes the implementation of this set of search, portal, content management, and semantic technologies, including a unique meta search capability for data from distributed engineering resources. NEN's communities of practice are formed along engineering disciplines where users leverage their knowledge and best practices to collaborate and take informal learning back to their personal jobs and embed it into the procedures of the agency. These results offer insight into using traditional engineering disciplines for virtual teaming and problem solving.

The diagnosis and neuropsychological assessment of adult attention deficit/hyperactivity disorder. Scientific study and practical guidelines.

PubMed

Gallagher, R; Blader, J

2001-06-01

The recognition of attention deficit/hyperactivity disorder (ADHD) in adults is a well documented, but relatively new development. Investigations of the disorder have indicated that disturbances in behavior and adjustment are common. These disturbances may be linked to poorly developed executive functions. This paper reviews the neuropsychological studies that have compared persons with ADHD to normal controls and to psychiatric controls. The review indicates that persons with ADHD share many neuropsychological characteristics with other persons with serious psychiatric conditions, although those with ADHD may have a particular profile of slowed performance in tasks of sustained attention and set shifting, and their use of working memory may be particularly impaired. The implications of research for clinical assessment are discussed. We contend that a neuropsychological orientation is necessary for making the diagnosis and gaining a full understanding of adult ADHD. A model for clinical assessment is proposed which utilizes a neuropsychological orientation and the targeted administration of neuropsychological instruments. The careful use of neuropsychological measures is warranted in providing an elaborate picture of a person's functioning, although the use of neuropsychological tests is not necessary to make the diagnosis.

Holistic nurses' stories of personal healing.

PubMed

Smith, Marlaine C; Zahourek, Rothlyn; Hines, Mary Enzman; Engebretson, Joan; Wardell, Diane Wind

2013-09-01

The purpose of this study was to uncover the nature, experiences, and meaning of personal healing for holistic nurses through their narrative accounts. The study employed a qualitative descriptive design with methods of narrative and story inquiry. Participants were nurse attendees at an American Holistic Nurses' Association conference who volunteered for the study. They were invited to share a story about healing self or another. Twenty-five stories were collected; seven were about personal healing, and these are the focus of this analysis. Data were analyzed using a hybrid approach from narrative and story inquiry methods. Eleven themes were clustered under three story segments. The themes within the Call to the Healing Encounter are the following: recognition of the need to resolve a personal or health crisis, knowledge of or engagement in self-care practices, and reliance on intuitive knowing. Themes under the Experience of Healing are the following: connections; profound sensations, perceptions, and events; awareness of the reciprocal nature of healing; inner resolution: forgiveness, awakening, and acceptance; use of multiple holistic approaches; and witnessing manifestations of healing. The themes for Insights are the following: gratitude and appreciation and ongoing journey. A metastory synthesizing the themes is presented, and findings are related to existing literature on healing.

Levels of Social Sharing and Clinical Implications for Severe Social Withdrawal in Patients with Personality Disorders

PubMed Central

Colle, Livia; Pellecchia, Giovanni; Moroni, Fabio; Carcione, Antonino; Nicolò, Giuseppe; Semerari, Antonio; Procacci, Michele

2017-01-01

Social sharing capacities have attracted attention from a number of fields of social cognition and have been variously defined and analyzed in numerous studies. Social sharing consists in the subjective awareness that aspects of the self’s experience are held in common with other individuals. The definition of social sharing must take a variety of elements into consideration: the motivational element, the contents of the social sharing experience, the emotional responses it evokes, the behavioral outcomes, and finally, the circumstances and the skills which enable social sharing. The primary objective of this study is to explore some of the diverse forms of human social sharing and to classify them according to levels of complexity. We identify four different types of social sharing, categorized according to the nature of the content being shared and the complexity of the mindreading skills required. The second objective of this study is to consider possible applications of this graded model of social sharing experience in clinical settings. Specifically, this model may support the development of graded, focused clinical interventions for patients with personality disorders characterized by severe social withdrawal. PMID:29255430

Racial differences in attitudes toward personalized medicine.

PubMed

Diaz, V A; Mainous, A G; Gavin, J K; Wilson, D

2014-01-01

Patient concerns regarding personalized medicine may limit its use. This study assesses racial differences in attitudes toward personalized medicine, evaluating variables that may influence these attitudes. A convenience sample of 190 adults (≥18 years) from an academic primary care practice was surveyed regarding awareness and acceptance of personalized medicine, plus concerns and benefits regarding its use. Logistic regressions predicting awareness, acceptance and concerns were performed, controlling for race, gender, marital status, education, children, internet use, and self-reported discrimination. The sample was 35% non-Hispanic white (NHW) and 34.7% male. More NHW participants expressed acceptance of personalized medicine than non-Hispanic black (NHB) participants (94.4 vs. 81.9%, p = 0.0190). More NHBs were concerned about the use of genes without consent (57.3 vs. 20.6%, p < 0.0001), sharing genetic information without consent (65.0 vs. 35.6%, p < 0.0001), discrimination based on genes (62.4 vs. 34.3%, p = 0.0002), and lack of access due to cost (75.0 vs. 48.0%, p = 0.0002). In logistic regressions, NHBs (OR = 7.46, 95% CI = 3.04-18.32) and those self-reporting discrimination (OR = 2.87, 95% CI = 1.22-6.78) had more concerns about the misuse of genes and costs associated with personalized medicine. Racial differences exist in attitudes toward personalized medicine and may be influenced by self-reported discrimination. Further study to understand factors influencing the acceptance of personalized medicine could help encourage its use.

Mother-child bed-sharing trajectories and psychiatric disorders at the age of 6 years.

PubMed

Santos, Iná S; Barros, Aluísio Jd; Barros, Fernando C; Munhoz, Tiago N; Da Silva, Bianca Del Ponte; Matijasevich, Alicia

2017-01-15

Little is known about the effect of bed-sharing with the mother over the child mental health. Population-based birth cohort conducted in Pelotas, Brazil. Children were enrolled at birth (n=4231) and followed-up at 3 months and at 1, 2, 4, and 6 years of age. Bed-sharing was defined as "habitual sharing of the bed between the child and the mother, for sleeping, for part of the night or the whole night". Trajectories of bed sharing between 3 months and 6 years of age were calculated. Mental health was assessed at the age of 6 years using the Development and Well-Being Assessment instrument that generates psychiatric diagnosis according to ICD-10 and DSM-IV criteria. Odds ratios (OR) with 95% confidence intervals were obtained by multivariate logistic regression. 3583 children were analyzed. Four trajectories were identified: non bed-sharers (44.4%), early-only (36.2%), late-onset (12.0%), and persistent bed-sharers (7.4%). In the adjusted analyses persistent bed-sharers were at increased odds of presenting any psychiatric disorder (OR=1.7; 1.2-2.5) and internalizing problems (OR=2.1; 1.4-3.1), as compared to non bed-sharers. Among the early-only bed-sharers OR for any psychiatric disorder was 1.4 (1.1-1.8) and for internalizing problems 1.6 (1.2-2.1). Although the effect of bed-sharing was adjusted for several covariates including the family socio-economic status, maternal mental health and excessive crying, there was no information on maternal personal reasons for bed-sharing. Mothers that bed-share intentionally and those that bed-share in reaction to a child sleep problem may have a different interpretation of their children behavior that may bias the study results. Bed-sharing is a common practice in our setting and is associated with impaired child mental health at the age of six years. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness.

PubMed

Kacel, Elizabeth L; Ennis, Nicole; Pereira, Deidre B

2017-01-01

Narcissistic Personality Disorder (NPD) is characterized by a persistent pattern of grandiosity, fantasies of unlimited power or importance, and the need for admiration or special treatment. Individuals with NPD may experience significant psychological distress related to interpersonal conflict and functional impairment. Research suggests core features of the disorder are associated with poor prognosis in therapy, including slow progress to behavioral change, premature patient-initiated termination, and negative therapeutic alliance. The current manuscript will explore challenges of working with NPD within the context of life-limiting illness for two psychotherapy patients seen in a behavioral health clinic at a large academic health science center. The ways in which their personality disorder affected their illness-experience shared significant overlap characterized by resistance to psychotherapeutic change, inconsistent adherence to medical recommendations, and volatile relationships with providers. In this manuscript we will (1) explore the ways in which aspects of narcissistic personality disorder impacted the patients' physical health, emotional well-being, and healthcare utilization; (2) describe psychotherapeutic methods that may be useful for optimizing psychosocial, behavioral, and physical well-being in individuals with co-morbid NPD and life-limiting disease; and (3) review conceptualizations of NPD from the DSM-5 alternative model for assessing personality function via trait domains.

Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness

PubMed Central

Kacel, Elizabeth L.; Ennis, Nicole; Pereira, Deidre B.

2018-01-01

Narcissistic Personality Disorder (NPD) is characterized by a persistent pattern of grandiosity, fantasies of unlimited power or importance, and the need for admiration or special treatment. Individuals with NPD may experience significant psychological distress related to interpersonal conflict and functional impairment. Research suggests core features of the disorder are associated with poor prognosis in therapy, including slow progress to behavioral change, premature patient-initiated termination, and negative therapeutic alliance. The current manuscript will explore challenges of working with NPD within the context of life-limiting illness for two psychotherapy patients seen in a behavioral health clinic at a large academic health science center. The ways in which their personality disorder affected their illness-experience shared significant overlap characterized by resistance to psychotherapeutic change, inconsistent adherence to medical recommendations, and volatile relationships with providers. In this manuscript we will (1) explore the ways in which aspects of narcissistic personality disorder impacted the patients’ physical health, emotional well-being, and healthcare utilization; (2) describe psychotherapeutic methods that may be useful for optimizing psychosocial, behavioral, and physical well-being in individuals with comorbid NPD and life-limiting disease; and (3) review conceptualizations of NPD from the DSM-5 alternative model for assessing personality function via trait domains. PMID:28767013

Teacher Perspectives of Interdisciplinary Coteaching Relationships in a Clinical Skills Course: A Relational Coordination Theory Analysis.

PubMed

Daniel, Michelle M; Ross, Paula; Stalmeijer, Renée E; de Grave, Willem

2018-01-01

Phenomenon: Interdisciplinary coteaching has become a popular pedagogic model in medical education, yet there is insufficient research to guide effective practices in this context. Coteaching relationships are not always effective, which has the potential to affect the student experience. The purpose of this study was to explore interdisciplinary coteaching relationships between a physician (MD) and social behavioral scientist (SBS) in an undergraduate clinical skills course. We aimed to gain an in-depth understanding of what teachers perceive as influencing the quality of relationships to begin to construct a framework for collaborative teaching in medical education. A qualitative study was conducted consisting of 12 semistructured interviews (6 MD and 6 SBS) and 2 monodisciplinary focus groups. Sampling was purposive and aimed at maximal variation from among 64 possible faculty. The data were analyzed using the constant comparative method to develop a grounded theory. Five major themes resulted from the analysis that outline a framework for interdisciplinary coteaching: respect, shared goals, shared knowledge and understanding, communication, and complementary pairings. Insights: The first 4 themes align with elements of relational coordination theory, an organizational theory of collaborative practice that describes how work roles interact. The complementary pairings extend this theory from work roles to individuals, with unique identities and personal beliefs and values about teaching. Prior studies on coteaching have not provided a clear linkage to theory. The conceptual framework helps suggest future directions for coteaching research and has practical implications for administrative practices and faculty development. These findings contribute to the sparse research in medical education on interdisciplinary coteaching relationships.

Community oncology in an era of payment reform.

PubMed

Cox, John V; Ward, Jeffery C; Hornberger, John C; Temel, Jennifer S; McAneny, Barbara L

2014-01-01

Patients and payers (government and private) are frustrated with the fee-for-service system (FFS) of payment for outpatient health services. FFS rewards volume and highly valued services, including expensive diagnostics and therapeutics, over lesser valued cognitive services. Proposed payment schemes would incent collaboration and coordination of care among providers and reward quality. In oncology, new payment schemes must address the high costs of all services, particularly drugs, while preserving the robust distribution of sites of service available to patients in the United States. Information technology and personalized cancer care are changing the practice of oncology. Twenty-first century oncology will require increasing cognitive work and shared decision making, both of which are not well regarded in the FFS model. A high proportion of health care dollars are consumed in the final months of life. Effective delivery of palliative and end-of-life care must be addressed by practice and by new models of payment. Value-based reimbursement schemes will require oncology practices to change how they are structured. Lessons drawn from the principles of primary care's Patient Centered Medical Home (PCMH) will help oncology practice to prepare for new schemes. PCMH principles place a premium on proactively addressing toxicities of therapies, coordinating care with other providers, and engaging patients in shared decision making, supporting the ideal of value defined in the triple aim-to measurably improve patient experience and quality of care at less cost. Payment reform will be disruptive to all. Oncology must be engaged in policy discussions and guide rational shifts in priorities defined by new payment models.

A French network of bipolar expert centres: a model to close the gap between evidence-based medicine and routine practice.

PubMed

Henry, Chantal; Etain, Bruno; Mathieu, Flavie; Raust, Aurélie; Vibert, Jean-Francois; Scott, Jan; Leboyer, Marion

2011-06-01

Bipolar disorders are a major public health concern. Efforts to provide optimal care by general practitioners and psychiatrists are undermined by the complexity of the disorder and difficulties in applying clinical practice guidelines and new research findings to the spectrum of cases seen in day to day practice. A national network of bipolar expert centres was established. Each centre has established strong links to local health services and provides support to clinicians in delivering personalized care plans derived from systematic case assessments undertaken at the centre. A common set of diagnostic and clinical assessment tools has been adopted at eight centres. Evaluations are undertaken by trained assessors and cross-centre reliability is monitored. A web application, e-bipolar© is used to record data in a common computerized medical file. Anonymized data is entered into a shared national database for use in multi-centre audit and research. Instead of offering treatment advice based on clinical practice guidelines recommendations for selected sub-populations of patients (a 'top-down' approach), the French bipolar network offers systematic, comprehensive, longitudinal, and multi-dimensional assessments of cases representative of general bipolar populations. This 'bottom-up' strategy may offer a more efficient and effective way to transfer knowledge and share expertise as the referrer can appreciate the rationale underpinning suggested treatment protocols and more readily apply such principles and approaches to other cases. The network also builds an infrastructure for clinical cohort and comparative-effectiveness research on more representative patient populations. Copyright © 2010 Elsevier B.V. All rights reserved.

To amend the Fair Housing Act to provide an exemption for any person seeking to enter into a shared living arrangement with a person sharing similar religious opinions or religious beliefs, and for other purposes.

THOMAS, 111th Congress

Rep. Hoekstra, Peter [R-MI-2

2010-11-18

House - 12/20/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Mobile phones carry the personal microbiome of their owners.

PubMed

Meadow, James F; Altrichter, Adam E; Green, Jessica L

2014-01-01

Most people on the planet own mobile phones, and these devices are increasingly being utilized to gather data relevant to our personal health, behavior, and environment. During an educational workshop, we investigated the utility of mobile phones to gather data about the personal microbiome - the collection of microorganisms associated with the personal effects of an individual. We characterized microbial communities on smartphone touchscreens to determine whether there was significant overlap with the skin microbiome sampled directly from their owners. We found that about 22% of the bacterial taxa on participants' fingers were also present on their own phones, as compared to 17% they shared on average with other people's phones. When considered as a group, bacterial communities on men's phones were significantly different from those on their fingers, while women's were not. Yet when considered on an individual level, men and women both shared significantly more of their bacterial communities with their own phones than with anyone else's. In fact, 82% of the OTUs were shared between a person's index and phone when considering the dominant taxa (OTUs with more than 0.1% of the sequences in an individual's dataset). Our results suggest that mobile phones hold untapped potential as personal microbiome sensors.

Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.

PubMed

Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L

2015-07-01

An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as their patients.

Rethinking autonomy in the context of prenatal screening decision-making.

PubMed

García, Elisa; Timmermans, Danielle R M; van Leeuwen, Evert

2008-02-01

Answering the question: Does the offer of prenatal screening impede women in making autonomous choices? Semi-structured interviews with 59 women to whom a prenatal screening test was offered and who were in the process of taking a decision. Women described the offer as confronting but expressed a positive attitude towards screening and considered the offer as an opportunity for making up their minds about testing. Participants stated that they took decisions freely to follow their individual perspectives. Nevertheless, they preferred to share the responsibility of taking decisions, and its consequences for other family members, with their partner and close persons. The active offer of an unsolicited prenatal test need not be considered as an impediment for making an autonomous choice. The moral significance of prenatal testing is inseparably bound with the social context in which it is practiced. Influence from other persons and emotional reactions due to the test offer can be interpreted as supportive for making a choice. In clinical practice, testing should be timely offered in order to give women the opportunity of discussing their views with significant others. Caregivers should care for the emotions experienced by women so as to help them decide according to their values.

Changes in nurse education: delivering the curriculum.

PubMed

Carr, Graham

2008-01-01

The aim of this study is to examine changes in pre-registration nursing education through the personal accounts of nurse teachers. This paper is based on 37 in-depth interviews within a central London Healthcare Faculty. Each interview was subjected to a process of content analysis described by Miles and Huberman. The interviews took place between August 2003 and March 2004 and totalled 34.4 hours or 305,736 words. There were thirty female and seven male participants, who shared 1015 years of nursing experience, averaging at 27.4 years (min 7-max 42). These were supplemented by 552 years of teaching practice, the average being 15 years (min 0.5-max 29). This paper--delivering the nursing curriculum--identifies that the nature of nursing has changed as it has both expanded and contracted. Participants identified three major changes; the nature of nursing, selection of future nurses and the current impact that large cohorts have on our traditional model of person-centred education. The practice placements remain central to nursing education and it is the nursing role that should define the curriculum and the values of higher education should be supportive of this identity.

Strategies to overcome clinical, regulatory, and financial challenges in the implementation of personalized medicine.

PubMed

Tsimberidou, Apostolia M; Ringborg, Ulrik; Schilsky, Richard L

2013-01-01

This article highlights major developments over the last decade in personalized medicine in cancer. Emerging data from clinical studies demonstrate that the use of targeted agents in patients with targetable molecular aberrations improves clinical outcomes. Despite a surge of studies, however, significant gaps in knowledge remain, especially in identifying driver molecular aberrations in patients with multiple aberrations, understanding molecular networks that control carcinogenesis and metastasis, and most importantly, discovering effective targeted agents. Implementation of personalized medicine requires continued scientific and technological breakthroughs; standardization of tumor tissue acquisition and molecular testing; changes in oncology practice and regulatory standards for drug and device access and approval; modification of reimbursement policies by health care payers; and innovative ways to collect and analyze electronic patient information that are linked to prospective clinical registries and rapid learning systems. Informatics systems that integrate clinical, laboratory, radiologic, molecular, and economic data will improve clinical care and will provide infrastructure to enable clinical research. The initiative of the EurocanPlatform aims to overcome the challenges of implementing personalized medicine in Europe by sharing patients, biologic materials, and technological resources across borders. The EurocanPlatform establishes a complete translational cancer research program covering the drug development process and strengthening collaborations among academic centers, pharmaceutical companies, regulatory authorities, health technology assessment organizations, and health care systems. The CancerLinQ rapid learning system being developed by ASCO has the potential to revolutionize how all stakeholders in the cancer community assemble and use information obtained from patients treated in real-world settings to guide clinical practice, regulatory decisions, and health care payment policy.

Challenges in Sharing Information Effectively: Examples from Command and Control

ERIC Educational Resources Information Center

Sonnenwald, Diane H.

2006-01-01

Introduction: The goal of information sharing is to change a person's image of the world and to develop a shared working understanding. It is an essential component of collaboration. This paper examines barriers to sharing information effectively in dynamic group work situations. Method: Three types of battlefield training simulations were…

Shared Semantics and the Use of Organizational Memories for E-Mail Communications.

ERIC Educational Resources Information Center

Schwartz, David G.

1998-01-01

Examines the use of shared semantics information to link concepts in an organizational memory to e-mail communications. Presents a framework for determining shared semantics based on organizational and personal user profiles. Illustrates how shared semantics are used by the HyperMail system to help link organizational memories (OM) content to…

Decision-making in Swiss home-like childbirth: A grounded theory study.

PubMed

Meyer, Yvonne; Frank, Franziska; Schläppy Muntwyler, Franziska; Fleming, Valerie; Pehlke-Milde, Jessica

2017-12-01

Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth. To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions. The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births. The central phenomenon that arose from the data was "defining/redefining decision as a joint commitment to healthy childbirth". The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife's decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman's decision, making an informed decision or taking the necessary decision. To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Intellectual property rights, benefit-sharing and development of "improved traditional medicines": A new approach.

PubMed

Willcox, Merlin; Diallo, Drissa; Sanogo, Rokia; Giani, Sergio; Graz, Bertrand; Falquet, Jacques; Bodeker, Gerard

2015-12-24

Protection of intellectual property rights and benefit-sharing are key issues for all ethnopharmacological research. The International Society of Ethnobiology has produced helpful guidelines on access and benefit-sharing which are widely viewed as a "gold standard" but the question remains how best to apply these guidelines in practice. Difficult questions include ownership of traditional knowledge, making appropriate agreements, and how appropriately to share benefits. We present the case study of the development of an "improved traditional medicine" for malaria in Mali and we report how benefit-sharing was applied in this case. The knowledge about the selected plant came independently from several families and traditional healers. The IPR approach was to recognise that this traditional knowledge belongs to the people of Mali and was used for their benefit in developing a new "improved traditional medicine" (ITM). The traditional healer whose method of preparation was used, and who collaborated in clinical trials, did not request any financial reward but asked for the ITM to be named after him. The most sustainable benefit for the community was sharing the results of which preparation of which medicinal plant seemed to be the most effective for treating malaria. Attempts at providing a health centre and training a health worker for the village did not prove to be sustainable. Respect for intellectual property rights and benefit-sharing are possible even in a context where the knowledge is not owned by a clearly identified person or group of people. The most sustainable benefits are intangible rather than material: namely recognition, improved knowledge about which traditional treatment is the best and how to prepare and take it. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Qualitative Study Examining Experiences and Dilemmas in Concealment and Disclosure of People Living With Serious Mental Illness.

PubMed

Bril-Barniv, Shani; Moran, Galia S; Naaman, Adi; Roe, David; Karnieli-Miller, Orit

2017-03-01

People with mental illnesses face the dilemma of whether to disclose or conceal their diagnosis, but this dilemma was scarcely researched. To gain in-depth understanding of this dilemma, we interviewed 29 individuals with mental illnesses: 16 with major depression/bipolar disorders and 13 with schizophrenia. Using a phenomenological design, we analyzed individuals' experiences, decision-making processes, and views of gains and costs regarding concealment and disclosure of mental illness. We found that participants employed both positive and negative disclosure/concealment practices. Positive practices included enhancing personal recovery, community integration, and/or supporting others. Negative practices occurred in forced, uncontrolled situations. We also identified various influencing factors, including familial norms of sharing, accumulated experiences with disclosure, and ascribed meaning to diagnosis. Based on these findings, we deepen the understanding about decision-making processes and the consequences of disclosing or concealing mental illness. We discuss how these finding can help consumers explore potential benefits and disadvantages of mental illness disclosure/concealment occurrences.

[Medical professionals on the subject of their core values: the importance of practice-based stories and intrinsic motivation].

PubMed

Witman, Yolande; van den Kerkhof, Peter C M; Braat, Didi D M

2013-01-01

In the current system for guaranteeing quality of care, emphasis is placed firmly on external control of professionals. We looked for a way to appeal to the intrinsic motivation of medical professionals and to discover what they mean by 'good work'. This was achieved with the aid of reflective sessions using the toolkit 'Good Work': in four sessions three different groups of medical professionals (medical department chairs, residents and interns) from a Dutch university hospital reflected on the topics 'excellence', 'moral responsibility' and 'personal engagement'. The participants exchanged practice-based stories during the sessions. The most important theme was moral responsibility, with its accompanying dilemmas. The sessions gave rise to feelings of mutual acknowledgement, recognition, inspiration and motivation. Sharing meaningful practice-based stories can be considered as a 'moment of learning', strengthening professional identity and stimulating intrinsic motivation. More space for this form of reflection might restore the balance with external control systems.

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study.

PubMed

Jackson, Lovie J; White, Catherine Roller; O'Brien, Kirk; DiLorenzo, Paul; Cathcart, Ernie; Wolf, Mary; Bruskas, Delilah; Pecora, Peter J; Nix-Early, Vivian; Cabrera, Jorge

2010-02-01

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14-17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is 'creator' and God is 'love', and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to 'bad or tragic things happening' by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care.

Attending to emotions is sharing of emotions - A multidisciplinary perspective to social attention and emotional sharing. Comment on Zahavi and Rochat (2015).

PubMed

Bader, Oren

2016-05-01

Attending to bodily expression of emotions plays an important role in the human social world. It provides subjects with valuable information, constructs opportunities to act, and importantly, as Daniel Stern pointed out, it is involved in the constitution of the direct experience of others. Whether mutual or one-sided, these direct experiences, in which the subject can share the perspectives and attitudes of other subjects, always comprise one person's bodily expression of emotions that is available to another person. In this article I suggest that attending to other subjects' expressed emotions involves a special (social) mode of attention and emotional sharing. This suggestion challenges Dan Zahavi's view that confines the sharing of emotions solely to reciprocal experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

Living with the label "disability": personal narrative as a resource for responsive and informed practice in biomedicine and bioethics.

PubMed

Bishop, Jeffery; Sunderland, Naomi

2013-01-01

What is it like to live with the label "Disability?" NIB editorial staff and narrative symposium editors, Jeffery Bishop and Naomi Sunderland developed a call for stories, which was sent to several list serves, shared with the 1000 Voices Project community and posted on Narrative Inquiry in Bioethics' website. The request for personal stories from people who identify with the label "disabled" asked them to: consider how the label "disability" interacts with other aspects of their life in health care settings; does the term "disability" reflect their actual embodied experiences of impairment or does it fail to do justice to their particular experience of impairment; describe the kind of experiences that are possible because of the impairment(s); discuss how the label has affected their "authentic voice"; and many other concepts about what effects the label has on their lives. These authors share deeply personal experiences that will help readers understand their world, challenges, and joys. Thirteen stories are found in the print version of the journal and an additional five supplemental stories are published online only through Project MUSE. The stories are complemented by four commentary articles by Elizabeth R. Schiltz; Lorna Hallahan; Nicole Matthews, Kathleen Ellem, and Lesley Chenoweth; and Jeffery Bishop, Rachelle Barina, and Devan Stahl. These scholars come from the disciplines of law, social work, media studies, medicine, and bioethics from Australia and the United States. Together, the symposium's storytellers and commentators offer striking and informative insights into the everydayness of living with disabilities.

Shared decision making and the promise of a respectful and equitable healthcare system in Peru.

PubMed

Málaga, Germán; Romero, Zoila O; Málaga, Ariana S; Cuba-Fuentes, Sofia

2017-06-01

Peru has achieved sustained development in the last two decades. However, despite this achievement, it has not been matched with improvements in the quality of education and health; investment in both sectors is among the lowest in the region. This situation perpetuates huge gaps in infrastructure and also conditions a poor literacy level of the population specifically in health. Currently, there is a fragmented model of patient care, in which the systems are exclusive of each other. They do not cooperate or communicate with each other; and if there is no vertical communication within the system, preventing referral of patients directly from the basic level to the complex level of care when needed. In addition, there has been no progress in the development of an empathetic, respectful or person-centered clinical practice; instead, economic, social and educational differences perpetuate a paternalistic clinical practice. The task of orienting medical training towards the development of humanism is pending. The patient is the center of the medical act and the main objective of doctors' actions. A humanistic care approach will not only empower the person in the clinical encounter - to participate and make decisions related to his/her health care - but it will allow us to move towards an empathetic, caring, respectful and kind model of clinical practice. Copyright © 2017. Published by Elsevier GmbH.

'Do You Practice What You Preach?' A Qualitative Exploration of Therapists' Personal Practice of Compassion Focused Therapy.

PubMed

Gale, Corinne; Schröder, Thomas; Gilbert, Paul

2017-01-01

Therapists' personal practice of therapy techniques can impact on a range of areas, including: empathy for the client, therapeutic understanding, therapist skills and self-awareness. Compassion Focused Therapy (CFT) draws extensively on personal practice during training, and on-going personal practice is encouraged. However, the impact of this has not been examined. To explore therapists' experiences of personal practice in relation to CFT, and the impact this has upon them and their therapeutic work. A qualitative approach was adopted, using inductive thematic analysis. Ten therapists, who had trained in CFT, took part in a semi-structured interview to explore their experiences of personal practice. Five main themes were identified. These highlighted that: (1) experiences of personal practice often felt strange to start with but were surprisingly powerful; (2) with practice, the exercises became more automatic and could be adopted as a 'way of life'; (3) personal practice was felt to increase both self-compassion and compassion for others; (4) personal practice often helped participants to feel more present for their clients; and (5) participants were more aware of what they were bringing to therapy. This exploratory study demonstrated that personal practice is an important part of CFT training and can have a positive impact upon therapists both personally and professionally. It is concluded that the results justify further research in order to establish the applicability of these findings with a larger sample. Copyright © 2015 John Wiley & Sons, Ltd. Personal practice facilitates experiential learning and is an important element of CFT training, which impacts on both personal and professional development. CFT trainers need to ensure that sufficient time is provided for both personal practice and reflection. CFT trainees should be aware that initial reactions to personal practice can be powerful and sometimes unsettling. As for therapy itself, working through fears, blocks and resistances is important. Personal practice is a valuable self-care strategy, and therapists are encouraged to engage in personal practice after training. Copyright © 2015 John Wiley & Sons, Ltd.

Optimizing Radiation Doses for Computed Tomography Across Institutions: Dose Auditing and Best Practices.

PubMed

Demb, Joshua; Chu, Philip; Nelson, Thomas; Hall, David; Seibert, Anthony; Lamba, Ramit; Boone, John; Krishnam, Mayil; Cagnon, Christopher; Bostani, Maryam; Gould, Robert; Miglioretti, Diana; Smith-Bindman, Rebecca

2017-06-01

Radiation doses for computed tomography (CT) vary substantially across institutions. To assess the impact of institutional-level audit and collaborative efforts to share best practices on CT radiation doses across 5 University of California (UC) medical centers. In this before/after interventional study, we prospectively collected radiation dose metrics on all diagnostic CT examinations performed between October 1, 2013, and December 31, 2014, at 5 medical centers. Using data from January to March (baseline), we created audit reports detailing the distribution of radiation dose metrics for chest, abdomen, and head CT scans. In April, we shared reports with the medical centers and invited radiology professionals from the centers to a 1.5-day in-person meeting to review reports and share best practices. We calculated changes in mean effective dose 12 weeks before and after the audits and meeting, excluding a 12-week implementation period when medical centers could make changes. We compared proportions of examinations exceeding previously published benchmarks at baseline and following the audit and meeting, and calculated changes in proportion of examinations exceeding benchmarks. Of 158 274 diagnostic CT scans performed in the study period, 29 594 CT scans were performed in the 3 months before and 32 839 CT scans were performed 12 to 24 weeks after the audit and meeting. Reductions in mean effective dose were considerable for chest and abdomen. Mean effective dose for chest CT decreased from 13.2 to 10.7 mSv (18.9% reduction; 95% CI, 18.0%-19.8%). Reductions at individual medical centers ranged from 3.8% to 23.5%. The mean effective dose for abdominal CT decreased from 20.0 to 15.0 mSv (25.0% reduction; 95% CI, 24.3%-25.8%). Reductions at individual medical centers ranged from 10.8% to 34.7%. The number of CT scans that had an effective dose measurement that exceeded benchmarks was reduced considerably by 48% and 54% for chest and abdomen, respectively. After the audit and meeting, head CT doses varied less, although some institutions increased and some decreased mean head CT doses and the proportion above benchmarks. Reviewing institutional doses and sharing dose-optimization best practices resulted in lower radiation doses for chest and abdominal CT and more consistent doses for head CT.

Medical home capabilities of primary care practices that serve sociodemographically vulnerable neighborhoods.

PubMed

Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Schneider, Eric C

2010-06-14

Under current medical home proposals, primary care practices using specific structural capabilities will receive enhanced payments. Some practices disproportionately serve sociodemographically vulnerable neighborhoods. If these practices lack medical home capabilities, their ineligibility for enhanced payments could worsen disparities in care. Via survey, 308 Massachusetts primary care practices reported their use of 13 structural capabilities commonly included in medical home proposals. Using geocoded US Census data, we constructed racial/ethnic minority and economic disadvantage indices to describe the neighborhood served by each practice. We compared the structural capabilities of "disproportionate-share" practices (those in the most sociodemographically vulnerable quintile on each index) and others. Racial/ethnic disproportionate-share practices were more likely than others to have staff assisting patient self-management (69% vs 55%; P = .003), on-site language interpreters (54% vs 26%; P < .001), multilingual clinicians (80% vs 51%; P < .001), and multifunctional electronic health records (48% vs 29%; P = .01). Similarly, economic disproportionate-share practices were more likely than others to have physician awareness of patient experience ratings (73% vs 65%; P = .03), on-site language interpreters (56% vs 25%; P < .001), multilingual clinicians (78% vs 51%; P < .001), and multifunctional electronic health records (40% vs 31%; P = .03). Disproportionate-share practices were larger than others. After adjustment for practice size, only language capabilities continued to have statistically significant relationships with disproportionate-share status. Contrary to expectations, primary care practices serving sociodemographically vulnerable neighborhoods were more likely than other practices to have structural capabilities commonly included in medical home proposals. Payments tied to these capabilities may aid practices serving vulnerable populations.

Patients' rights in decision making: the case for personalism versus paternalism in health care.

PubMed

Schain, W S

1980-08-15

The purpose of this presentation is to shine a psychological spotlight on the role of the breast cancer patient in the process of her decision making about her medical care and the specific influence that the nature of the physician-patient interaction has on that behavior. The vision of the parental physician as unilateral authority in decisions about health care is dimming. The picture is being supplanted by a new image that promotes a view of personalism and a concept of "shared responsibility." The wave of consumerism is washing the shores of medical practice, and women are establishing their beachhead. Women are demonstrating their knowledge, their competence, and their responsibility in exercising decisions about their medical treatments and the quality of their survival. Therefore, it is essential to educate patients to exhibit informed consumer behavior and encourage physicians to recognize the value of a patient's participation. Such collaborative endeavors could result in increased patient satisfaction, reduced burdens for the physician, and preserved patients' feelings of individuality, autonomy, and sense of personal dignity.

"I am just thankful": the experience of gratitude following traumatic spinal cord injury.

PubMed

Chun, Sanghee; Lee, Youngkhill

2013-01-01

This study explored the experience of gratitude in everyday life following traumatic spinal cord injury (SCI) by applying thematic analysis to personal experience narratives. Fifteen participants including two negative cases with SCI shared individual experiences of gratitude according to five themes: (a) everyday life, (b) family support, (c) new opportunities, (d) positive sense of self, and (e) gratitude to God. The findings demonstrated that participants benefited from their efforts to appraise challenging life experiences as positive. Therapists could apply intentional and guided gratitude interventions so that individuals would practice and embrace gratitude in adjusting, coping, and adapting positively to various life changes following trauma.

[French astronomical journals an interactivity of the scientific world].

PubMed

Vassilieff, Catherine

2014-01-01

Astronomical data issued from observatories find multiple uses on land, as well as on sea. Due to their structure and periodicity, scientific reviews are particularly adapted to peer review and sharing of data between astronomers as well as between astronomers and hobbyists. During the 19(th) century regional observatories first gather together professionals interested in the practical applications of the observations and later, under the influence of personalities such as Camille Flammarion, they bring together a larger non-professional audience. Being the epicentre of scientific exchange, the reviews have in the 20(th) century found their place on the websites of academic institutions as well as users forums.

Reliance on high technology among senior medical students.

PubMed

Merrill, J M; Lorimor, R J; Thornby, J I; Vallbona, C

1998-01-01

To gain a better understanding of senior medical students who perceive high-technology medicine as the desirable form of medical practice, we developed and evaluated a structural equation model. Intolerance to clinical uncertainty, Machiavellianism, and authoritarianism characterized students who scored higher on reliance on high-technology medicine. High scorers also tended to have a negative orientation toward patients' psychological problems and were unlikely to choose careers in primary care medicine. Students who perceive high technology as a panacea in clinical medicine share personal traits and attitudes toward patients that are not conducive to achieving the national goal of a 50:50 ratio between primary and non-primary care physicians.

Validated School Business Practices That Work. Volume III: Sharing Business Success.

ERIC Educational Resources Information Center

Association of School Business Officials of the United States and Canada, Park Ridge, IL. Research Corp.

Seventeen validated school business practices are described in this document. The practices were selected through the Sharing Business Success (SBS) program, in which the Federal Department of Education, 41 state education agencies, and State Associations of School Business Officials cooperate to identify successful school district practices,…

The Shared Superintendency: The Iowa Experience.

ERIC Educational Resources Information Center

Decker, Robert H.; Talbot, Adrian P.

1990-01-01

Based on interviews with almost the entire population of shared superintendents in Iowa, this article discusses the pros and cons of shared superintendencies. Problems arose concerning logistics, decreased administrator visibility, loss of personal control, keeping district policies separate, and favoritism charges. Participants experienced high…

Balancing Benefits and Risks of Immortal Data: Participants’ Views of Open Consent in the Personal Genome Project

PubMed Central

Zarate, Oscar A.; Brody, Julia Green; Brown, Phil; Ramírez-Andreotta, Mónica D.; Perovich, Laura; Matz, Jacob

2016-01-01

The NIH Genomic Data Sharing Policy, effective in January 2015, encourages researchers to obtain broad consent to share data for unspecified biomedical research. The ethics of extensive data sharing depend in part on study participants’ understanding of the risks and benefits. Interviews with participants in the Personal Genome Project show that study participants can readily discuss the risks, including loss of privacy, and are willing to accept risks because they value the opportunity to contribute to health science. They have expansive views of the benefits for science, medicine, and their own health and curiosity. With justice in mind, further exploration is needed to evaluate consent for data sharing among more diverse and vulnerable populations. PMID:26678513

Aging Couples in Dual-Career/Earner Families.

PubMed

Reeves, Joy B; Darville, Ray L

1992-01-01

The authors present results of an empirical study of 611 mature couples in a dual-career or dual-earner famil where at least one spouse is a member of The National Retired Teacher's Association and is retired. We hypothesize that degree of role-sharing will va among mature couples in this special population on the basis of sexcted personal and social characteristics. Through discriminant analysis we identify which personal and social variables best predict whether or not couples currently share roles. We also determine the change in role-sharing over time for these couples. Our hypothesis is confirmed.

Implementing a virtual community of practice for family physician training: a mixed-methods case study.

PubMed

Barnett, Stephen; Jones, Sandra C; Caton, Tim; Iverson, Don; Bennett, Sue; Robinson, Laura

2014-03-12

GP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation. The goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation. The case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation. Step 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%). The 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community shows promise in GP training. Time and technology are barriers that may be overcome by training, technology, and valuable content. In a VCoP, trust can be built online. This has implications for course delivery, particularly in regional areas. VCoPs may also have a specific role assisting overseas trained doctors to interpret their medical knowledge in a new context.

The Evolution of End-of-Life Care: Ethical Implications for Case Management.

PubMed

Fink-Samnick, Ellen

2016-01-01

This article: : Applicable to all health care sectors where case management is practiced. Few topics are more intimate and multifaceted for case managers than engaging with today's culturally diverse patient populations around end-of-life processes. The already prominent focus of this issue has been further elevated by a series of events to receive public attention. These include the Institute of Medicine's 2014 report-Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, rising numbers of patients around the globe requesting to end life on their own terms, and corresponding death with dignity initiatives and legislation.Another vital factor in the end-of-life equation involves how the latest generation of shared decision making influences the management of treatment dialogues among practitioners, patients, as well as insurance companies. Case managers are at the intersection of these complex interactions, working to achieve ethical, as well as legal accountability to the patient, employer, and profession while balancing personal perspectives. Professionals strive to effectively intervene with patients and their support systems facing end-of-life care decisions. It is essential case managers actively consider the intricacies of ethical practice and current contexts including death with dignity legislation, shared decision making, and shifts in regulations and reimbursement for end-of-life care.Case management's ethical envelope will continue to be pushed. To that end amid shifting societal constructs, professionals must have mastery of applicable codes, standards, principles, and rules essential for adherence to ethical practice.

Creating pedagogical spaces for developing doctor professional identity.

PubMed

Clandinin, D Jean; Cave, Marie-Therese

2008-08-01

Working with doctors to develop their identities as technically skilled as well as caring, compassionate and ethical practitioners is a challenge in medical education. One way of resolving this derives from a narrative reflective practice approach to working with residents. We examine the use of such an approach. This paper draws on a 2006 study carried out with four family medicine residents into the potential of writing, sharing and inquiring into parallel charts in order to help develop doctor identity. Each resident wrote 10 parallel charts over 10 weeks. All residents met bi-weekly as a group with two researchers to narratively inquire into the stories told in their charts. One parallel chart and the ensuing group inquiry about the chart are described. In the narrative reflective practice process, one resident tells of working with a patient and, through writing, sharing and inquiry, integrates her practice and how she learned to be a doctor in one cultural setting into another cultural setting; another resident affirms her relational way of practising medicine, and a third resident begins to see the complexity of attending to patients' experiences. The process shows the importance of creating pedagogical spaces to allow doctors to tell and retell, through narrative inquiry, their stories of their experiences. This pedagogical approach creates spaces for doctors to individually develop their own stories by which to live as doctors through narrative reflection on their interwoven personal, professional and cultural stories as they are shaped by, and enacted within, their professional contexts.

26 CFR 1.6039-1 - Returns required in connection with certain options.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) The exercise price per share; (vi) The date the option was exercised by the person; (vii) The fair...) The actual exercise price paid per share; (vi) The exercise price per share determined as if the... exercise price per share is not fixed or determinable on the date the option was granted); (vii) The date...

12 CFR 303.83 - Transactions not requiring prior notice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... increase in ownership of voting shares resulting from a redemption of voting shares by the issuing bank or... acquisiition of additional voting shares of an insured state nonmember bank or a parent company by a person who: (i) Held the power to vote 25 percent or more of any class of voting shares of the institution...

Photography and Social Media Use in Community-Based Participatory Research with Youth: Ethical Considerations.

PubMed

Kia-Keating, Maryam; Santacrose, Diana; Liu, Sabrina

2017-12-01

Community-based participatory researchers increasingly incorporate photography and social media into their work. Despite its relative infancy, social media has created a powerful network that allows individuals to convey messages quickly to a widespread audience. In addition to its potential benefits, the use of social media in research also carries risk, given the fast pace of exchanges, sharing of personal images and ideas in high accessibility, low privacy contexts and continually shifting options and upgrades. This article contributes to the literature examining ethical considerations for photography and social media use in community-based participatory research. We describe three key ethical dilemmas that we encountered during our participatory photography project with Latina/o youth: (a) use and content of images and risk; (b) incentives and coercion; and (c) social media activity and confidentiality. We provide our responses to these challenges, contextualized in theory and practice, and share lessons learned. We raise the question of how to contend with cultural shifts in boundaries and privacy. We propose that evaluating participant vulnerability versus potential empowerment may be more fitting than the standard approach of assessing risks and benefits. Finally, we recommend upholding the principles of participatory research by co-producing ethical practices with one's participants. © Society for Community Research and Action 2017.

Interprofessional simulated learning: short-term associations between simulation and interprofessional collaboration

PubMed Central

2011-01-01

Background Health professions education programs use simulation for teaching and maintaining clinical procedural skills. Simulated learning activities are also becoming useful methods of instruction for interprofessional education. The simulation environment for interprofessional training allows participants to explore collaborative ways of improving communicative aspects of clinical care. Simulation has shown communication improvement within and between health care professions, but the impacts of teamwork simulation on perceptions of others' interprofessional practices and one's own attitudes toward teamwork are largely unknown. Methods A single-arm intervention study tested the association between simulated team practice and measures of interprofessional collaboration, nurse-physician relationships, and attitudes toward health care teams. Participants were 154 post-licensure nurses, allied health professionals, and physicians. Self- and proxy-report survey measurements were taken before simulation training and two and six weeks after. Results Multilevel modeling revealed little change over the study period. Variation in interprofessional collaboration and attitudes was largely attributable to between-person characteristics. A constructed categorical variable indexing 'leadership capacity' found that participants with highest and lowest values were more likely to endorse shared team leadership over physician centrality. Conclusion Results from this study indicate that focusing interprofessional simulation education on shared leadership may provide the most leverage to improve interprofessional care. PMID:21443779

Practices and discourses of ubuntu: Implications for an African model of disability?

PubMed

Berghs, Maria

2017-01-01

Southern African scholars and activists working in disability studies have argued that ubuntu or unhu is a part of their world view. Thinking seriously about ubuntu, as a shared collective humanness or social ethics, means to examine how Africans have framed a struggle for this shared humanity in terms of decolonisation and activism. Three examples of applications of ubuntu are given, with two mainly linked to making explicit umaka. Firstly, ubuntu is linked to making visible the invisible inequalities for a common humanity in South Africa. Secondly, it becomes correlated to the expression of environmental justice in West and East African countries. An African model of disability that encapsulates ubuntu is correlated to how Africans have illustrated a social ethics of a common humanity in their grassroots struggles against oppression and disablement in the 20th century. Ubuntu also locates disability politically within the wider environment and practices of sustainability which are now important to the post-2105 agenda, Convention on the Rights of Persons with Disabilities (CRPD) and the (UN) Sustainable Development Goals linked to climate change. A different kind of political action linked to social justice seems to be evolving in line with ubuntu . This has implications for the future of disability studies.

Photography and Social Media Use in Community-Based Participatory Research with Youth: Ethical Considerations

PubMed Central

Santacrose, Diana; Liu, Sabrina

2017-01-01

Community-based participatory researchers increasingly incorporate photography and social media into their work. Despite its relative infancy, social media has created a powerful network that allows individuals to convey messages quickly to a widespread audience. In addition to its potential benefits, the use of social media in research also carries risk, given the fast pace of exchanges, sharing of personal images and ideas in high accessibility, low privacy contexts and continually shifting options and upgrades. This article contributes to the literature examining ethical considerations for photography and social media use in community-based participatory research. We describe three key ethical dilemmas that we encountered during our participatory photography project with Latina/o youth: (a) use and content of images and risk; (b) incentives and coercion; and (c) social media activity and confidentiality. We provide our responses to these challenges, contextualized in theory and practice, and share lessons learned. We raise the question of how to contend with cultural shifts in boundaries and privacy. We propose that evaluating participant vulnerability versus potential empowerment may be more fitting than the standard approach of assessing risks and benefits. Finally, we recommend upholding the principles of participatory research by co-producing ethical practices with one’s participants. PMID:28944473

Themes in the literature related to cardiovascular disease risk reduction.

PubMed

Cohen, Shannon Munro; Kataoka-Yahiro, Merle

2009-01-01

This article aimed to identify themes in the literature related to patient-healthcare provider beliefs, barriers to adherence, and interventions pertaining to cardiovascular disease risk reduction. Twenty quantitative and qualitative primary research studies including 2 meta-analyses published between 1995 and 2008 were analyzed for themes and practice implications to synthesize existing research on cardiovascular disease risk reduction. Databases searched included EBSCO, CINAHL, MEDLINE, ScienceDirect, HealthSource, and PsychLit using the search terms patient- provider adherence, adherence and shared decision making, adherence and decision support, patient- provider goal setting, and cardiovascular disease risk reduction. The emergent themes found in this literature review included (1) complex medication regimens; (2) risk perception, quality of life, and competing priorities; (3) motivation for change; (4) provider clinical inertia; and (5) goal setting, feedback, and reminders. Studies reporting the highest rates of adherence to cardiovascular disease risk reduction recommendations incorporated patient-provider goal setting and decision support, self-management techniques, and personalized printed communication. Goal setting in cardiovascular disease risk reduction is a relatively unexplored area and is an important component of shared decision making and adherence to cardiovascular disease health recommendations. The following review will address the 5 themes identified in more detail and provide a basis for improved clinical practice.

Practices and discourses of ubuntu: Implications for an African model of disability?

PubMed Central

2017-01-01

Background Southern African scholars and activists working in disability studies have argued that ubuntu or unhu is a part of their world view. Objectives Thinking seriously about ubuntu, as a shared collective humanness or social ethics, means to examine how Africans have framed a struggle for this shared humanity in terms of decolonisation and activism. Method Three examples of applications of ubuntu are given, with two mainly linked to making explicit umaka. Firstly, ubuntu is linked to making visible the invisible inequalities for a common humanity in South Africa. Secondly, it becomes correlated to the expression of environmental justice in West and East African countries. Results An African model of disability that encapsulates ubuntu is correlated to how Africans have illustrated a social ethics of a common humanity in their grassroots struggles against oppression and disablement in the 20th century. Ubuntu also locates disability politically within the wider environment and practices of sustainability which are now important to the post-2105 agenda, Convention on the Rights of Persons with Disabilities (CRPD) and the (UN) Sustainable Development Goals linked to climate change. Conclusion A different kind of political action linked to social justice seems to be evolving in line with ubuntu. This has implications for the future of disability studies. PMID:28730067

The prevalence of carriage of meticillin-resistant staphylococci by veterinary dermatology practice staff and their respective pets.

PubMed

Morris, Daniel O; Boston, Raymond C; O'Shea, Kathleen; Rankin, Shelley C

2010-08-01

It has been shown that people and pets can harbour identical strains of meticillin-resistant (MR) staphylococci when they share an environment. Veterinary dermatology practitioners are a professional group with a high incidence of exposure to animals infected by Staphylococcus spp. The objective of this study was to assess the prevalence of carriage of MR Staphylococcus aureus (MRSA), MR S. pseudintermedius (MRSP) and MR S. schleiferi (MRSS) by veterinary dermatology practice staff and their personal pets. A swab technique and selective media were used to screen 171 veterinary dermatology practice staff and their respective pets (258 dogs and 160 cats). Samples were shipped by over-night carrier. Human subjects completed a 22-question survey of demographic and epidemiologic data relevant to staphylococcal transmission. The 171 human-source samples yielded six MRSA (3.5%), nine MRSP (5.3%) and four MRSS (2.3%) isolates, while 418 animal-source samples yielded eight MRSA (1.9%) 21 MRSP (5%), and two MRSS (0.5%) isolates. Concordant strains (genetically identical by pulsed-field gel electrophoresis) were isolated from human subjects and their respective pets in four of 171 (2.9%) households: MRSA from one person/two pets and MRSP from three people/three pets. In seven additional households (4.1%), concordant strains were isolated from only the pets: MRSA in two households and MRSP in five households. There were no demographic or epidemiologic factors statistically associated with either human or animal carriage of MR staphylococci, or with concordant carriage by person-pet or pet-pet pairs. Lack of statistical associations may reflect an underpowered study. © 2010 The Authors. Journal compilation © 2010 ESVD and ACVD.

Adaptation and innovation: a grounded theory study of procedural variation in the academic surgical workplace.

PubMed

Apramian, Tavis; Watling, Christopher; Lingard, Lorelei; Cristancho, Sayra

2015-10-01

Surgical research struggles to describe the relationship between procedural variations in daily practice and traditional conceptualizations of evidence. The problem has resisted simple solutions, in part, because we lack a solid understanding of how surgeons conceptualize and interact around variation, adaptation, innovation, and evidence in daily practice. This grounded theory study aims to describe the social processes that influence how procedural variation is conceptualized in the surgical workplace. Using the constructivist grounded theory methodology, semi-structured interviews with surgeons (n = 19) from four North American academic centres were collected and analysed. Purposive sampling targeted surgeons with experiential knowledge of the role of variations in the workplace. Theoretical sampling was conducted until a theoretical framework representing key processes was conceptually saturated. Surgical procedural variation was influenced by three key processes. Seeking improvement was shaped by having unsolved procedural problems, adapting in the moment, and pursuing personal opportunities. Orienting self and others to variations consisted of sharing stories of variations with others, taking stock of how a variation promoted personal interests, and placing trust in peers. Acting under cultural and material conditions was characterized by being wary, positioning personal image, showing the logic of a variation, and making use of academic resources to do so. Our findings include social processes that influence how adaptations are incubated in surgical practice and mature into innovations. This study offers a language for conceptualizing the sociocultural influences on procedural variations in surgery. Interventions to change how surgeons interact with variations on a day-to-day basis should consider these social processes in their design. © 2015 John Wiley & Sons, Ltd.

Gender differences in the reasons for participation in spouse sharing among the Okun in Nigeria.

PubMed

Osagbemi, M O; Adepetu, A A

2001-08-01

This report examines the reasons for participation in spouse sharing among the Okun with a view to identifying some factors that may present particular obstacles to women and enhance their vulnerability to the practice. A total of 1029 sexually active respondents in 5 settlements where spouse sharing is being practiced participated in the questionnaire survey aspect of the study, while 82 respondents participated in the focus group discussions. About 65% of respondents reported having ale or alase and were involved in the practice of spouse sharing. Reasons for involvement in spouse sharing include the need for economic support, sexual satisfaction, increased social status, procreation, the problems of separation/divorce and widowhood. The focus group discussions revealed a possible exploitation of the gender-based economic weakness of the women by the men in the initiation and sustenance of the practice in the Okun communities. It is recommended that for any program to achieve a considerable reduction in the practice, differences in the reasons for participation in spouse sharing among the men and women must be documented with a view to solving those problems that compel women to participate.

Combined evaluation of personality, risk and coping in MS patients: A step towards individualized treatment choice - The PeRiCoMS-Study I.

PubMed

Bsteh, G; Monz, E; Zamarian, L; Hagspiel, S; Hegen, H; Auer, M; Wurth, S; Di Pauli, F; Deisenhammer, F; Berger, T

2017-05-15

Multiple sclerosis (MS) is a chronic inflammatory neurological disease requiring disease-modifying treatment (DMT). To provide patients with the optimal individual therapeutic option, treatment recommendations should be based not only on individual disease course and DMT specific benefit-risk estimates, but also on patient's individual characteristics such as personality, risk attitude and coping strategies. However, these characteristics are difficult to objectify in clinical routine practice without the support of appropriate evaluation instruments. To identify and to assemble an objective test battery measuring personality, risk attitude and coping strategies in MS patients. A comprehensive literature search was performed to obtain all questionnaires assessing personality, risk attitude and coping strategies. Availability in German language, validation in a published normative collective and a reliability of >0.70 were required for our purposes. Based on these criteria, we chose the Big-Five-Personality Test, UPPS Impulsive Behaviour Scale, Domain-Specific Risk-Taking scale (DOSPERT), Brief-COPE and Stress & Coping Inventory (SCI). Results were compared to published normative controls of the respective questionnaires. Out of 22 MS patients (7 males, 15 females) participating in this study, 19 (86.4%) completed all questionnaires. The median completion time was 45min (min-max range: 25-60min). The median scores of the MS group were within the average range of published control samples in all questionnaires. We report that traits of personality, risk attitude and coping strategies can be effectively and feasibly tested in MS patients by the instruments used in our exploratory study. There were no differences between MS patients and healthy controls, thus enabling assessment without being influenced by the diagnosis of MS. After validation in a larger cohort the "PeRiCoMS"-battery will be useful as another step towards a more individualized shared-decision-making in every day routine practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Marginalization and social change processes among lesbian, gay, bisexual and transgender persons in Swaziland: implications for HIV prevention.

PubMed

H Logie, Carmen; Perez-Brumer, Amaya; Jenkinson, Jesse; Madau, Veli; Nhlengethwa, Winnie; Baral, Stefan

2018-05-30

Swaziland has among the highest national adult HIV prevalence globally. There is limited knowledge of HIV vulnerabilities and prevention engagement among lesbian, gay, bisexual and transgender (LGBT) persons in the context of Swaziland's criminalization of consensual same-sex practices. This study explored social processes of marginalization to assess how they could potentiate HIV vulnerabilities and limit engagement in HIV prevention services. Additionally, we assessed positive change to better understand existing strategies employed by LGBT persons to challenge these HIV prevention barriers. Guided by community-based research methodology and conducted in Mbabane and Manzini, Swaziland, data were collected by LGBT peer-research assistants (PRA) in collaboration with an LGBT community organization in Manzini. Semi-structured interviews were conducted by trained PRAs and explored HIV prevention, including experiences of stigma and coping. Audio files were transcribed verbatim, translated to English, and analyzed using thematic techniques. Among participants (n = 51; mean age: 26.47, SD: 4.68), 40 self-identifed as gay or lesbian (78.4%), 11 bisexual (22.6%), and 12 (23.5%) identified as transgender. Findings highlighted three primary processes of marginalization and positive change in structural, community, and internal domains. First, structural marginalization, which included criminalization, healthcare discrimination, and a scarcity of LGBT tailored HIV prevention resources was challenged by grassroots networks created to access and share specific HIV resources with LGBT persons and the Ministry of Health. Second, community marginalization included stigma and multi-dimensional forms of violence, however, this was met with LGBT persons providing mutual peer support, including for accessing HIV testing services. Thirdly, internal marginalization comprised of self-stigma and associated sexual risk practices was contrasted with coping strategies focused on self-acceptance, stemming from social support and leading to healthcare utilization. Jointly, these findings can inform the implementation of community-based and rights affirming HIV prevention and care cascade strategies that improve coverage of services with LGBT persons in Swaziland.

Exercise prescription for non-specific chronic low back pain (NSCLBP): a qualitative study of patients' experiences of involvement in decision making.

PubMed

Stenner, Rob; Swinkels, Annette; Mitchell, Theresa; Palmer, Shea

2016-12-01

The culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences. To understand the treatment decision making experiences, information and decision support needs of patients with NSCLBP who have been offered exercise as part of their management plan. A qualitative study using a philosophical hermeneutic approach. Semi-structured interviews with eight patients (including use of brief patient vignettes) was undertaken to explore their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their care. The findings provide a detailed insight into patients' perceptions and experiences of receiving exercise-based management strategies. Four themes were formed from the texts: (1) patients' expectations and patients' needs are not synonymous, (2) information is necessary but often not sufficient, (3) not all decisions need to be shared, and (4) wanting to be treated as an individual. Shared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Inter-ethics: towards an interactive and interdependent bioethics.

PubMed

Abma, Tineke A; Baur, Vivianne E; Molewijk, Bert; Widdershoven, Guy A M

2010-06-01

Since its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice improvement, and from a legal defence of rights towards fostering interdependent practices of responsibility. This article describes these transitions within bioethics in relation to the broader societal and cultural dynamics within Western societies, and traces the implications for the methodologies and changing roles of the bioethicist. The bioethicist we foresee is not just a clever expert but also a relationally sensitive person who engages stakeholders in reciprocal dialogues about their practice of responsibility and helps to integrate various sorts of knowledge (embodied, experiential, visual, and cognitive-scientific). In order to illustrate this new approach, we present a case study. It concerns a project focusing on an innovation in elderly care, based on the participation of various stakeholders, especially older people themselves.

Externalising the autobiographical self: sharing personal memories online facilitated memory retention.

PubMed

Wang, Qi; Lee, Dasom; Hou, Yubo

2017-07-01

Internet technology provides a new means of recalling and sharing personal memories in the digital age. What is the mnemonic consequence of posting personal memories online? Theories of transactive memory and autobiographical memory would make contrasting predictions. In the present study, college students completed a daily diary for a week, listing at the end of each day all the events that happened to them on that day. They also reported whether they posted any of the events online. Participants received a surprise memory test after the completion of the diary recording and then another test a week later. At both tests, events posted online were significantly more likely than those not posted online to be recalled. It appears that sharing memories online may provide unique opportunities for rehearsal and meaning-making that facilitate memory retention.

75 FR 75725 - Survey of Information Sharing Practices With Affiliates

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-06

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Survey of Information Sharing Practices... comments concerning the following information collection. Title of Proposal: Survey of Information Sharing...'') Public Law 108-159, 117 Stat. 1952. The OTS will gather information by means of a Survey to be completed...

36 CFR 230.43 - Cost-share assistance-prohibited practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

36 CFR 230.43 - Cost-share assistance-prohibited practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

36 CFR 230.43 - Cost-share assistance-prohibited practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

36 CFR 230.43 - Cost-share assistance-prohibited practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

Teacher learning from girls' informal science experiences

NASA Astrophysics Data System (ADS)

Birmingham, Daniel J.

School science continues to fail to engage youth from non-dominant communities (Carlone, Huan-Frank & Webb, 2011). However, recent research demonstrates that informal science learning settings support both knowledge gains and increased participation in science among youth from non-dominant communities (Dierking, 2007; Falk et al., 2007; HFRP, 2010). Despite the success, little is known about how teachers can learn from informal science practices to support student engagement in science. In this study, I examine the impact informal science experiences has for the teaching and learning of science in school contexts. This study is focused on eliciting girls' stories of informal science learning experiences and sharing these stories with science teachers to examine what they notice and make meaning of in connection with their classroom practices (van Es & Sherin, 2002). I co-constructed cases of informal science experiences with middle school females who participate in an after school science program in an urban area. These cases consisted of the girls' written stories, their explicit messages to science teachers, examples of actions taken when investigating community based science issues and transcripts of conversations between the girls and researchers. These cases were shared with local science teachers in order to investigate what they "notice" (van Es & Sherin, 2002) regarding girls' participation in informal science learning, how they make meaning of youths' stories and whether the stories influence their classroom practices. I found that the girls' use their cases to share experiences of how, where and why science matters, to express hope for school science and to critique stereotypical views that young, female, students of color from lower SES backgrounds are not interested or capable of making contributions to scientific investigations. Additionally, I found that teachers noticed powerful messages within and across the girls' cases. The messages include; 1) students' desire to be active participants in science investigations, 2) the need to provide spaces for students to leverage their strengths when learning and doing science, 3) the importance of building connections between science and community, and 4) expanding the outcomes of scientific investigations beyond traditional school measures. However, their individual meaning making was influenced by tensions between what they found powerful in the cases, the institutional narratives that often guide practice in schools and the societal and personal narratives connected to participation of girls from non dominant communities in science. Thus, each of the three teachers took different pathways as they implemented new science learning experiences based upon what each found most salient in the girls' stories as well as the influence of institutional, societal and personal narratives, resulting in varied learning experiences for their students.

Improving the Quality of Palliative Care Through National and Regional Collaboration Efforts.

PubMed

Kamal, Arif H; Harrison, Krista L; Bakitas, Marie; Dionne-Odom, J Nicholas; Zubkoff, Lisa; Akyar, Imatullah; Pantilat, Steven Z; O'Riordan, David L; Bragg, Ashley R; Bischoff, Kara E; Bull, Janet

2015-10-01

The measurement and reporting of the quality of care in the field of palliation has become a required task for many health care leaders and specialists in palliative care. Such efforts are aided when organizations collaborate together to share lessons learned. The authors reviewed examples of quality-improvement collaborations in palliative care to understand the similarities, differences, and future directions of quality measurement and improvement strategies in the discipline. Three examples were identified that showed areas of robust and growing quality-improvement collaboration in the field of palliative care: the Global Palliative Care Quality Alliance, Palliative Care Quality Network, and Project Educate, Nurture, Advise, Before Life Ends. These efforts exemplify how shared-improvement activities can inform improved practice for organizations participating in collaboration. National and regional collaboratives can be used to enhance the quality of palliative care and are important efforts to standardize and improve the delivery of palliative care for persons with serious illness, along with their friends, family, and caregivers.

[Design of a communicative model from a social perspective oriented toward physical activity].

PubMed

Prieto-Rodríguez, Adriana; Moreno-Angarita, Marisol; Cardozo-Vásquez, Yency S

2006-12-01

A communication model was designed and put into practice, in the form of a Network throughout three regions in Colombia; Bogotá, Antioquia and Quindío. Based on a macro-intentional model, this network was aimed at strengthening understanding around the subject of physical activity among those people affected by the issue, from a multidimensional perspective. The test population was defined and working groups were formed around three strategies: social production, transmission and democratization, during a three-month period. RESULTS Messages were developed based around the ideas of the community producers themselves; the initial concepts were widened to include the body, self care, physical activity and health. Communication models related to health, aimed at developing personal skills including the ability to communicate and build shared experience, can be assimilated and incorporated into broadcasts on health issues. This model serves as a communication strategy which strengthens the building of shared broadcasts on health issues. This kind of focus requires the development of local activity and capacity-building within the community.

A Large-Scale Initiative Inviting Patients to Share Personal Fitness Tracker Data with Their Providers: Initial Results

PubMed Central

Pevnick, Joshua M.; Fuller, Garth; Duncan, Ray; Spiegel, Brennan M. R.

2016-01-01

Background Personal fitness trackers (PFT) have substantial potential to improve healthcare. Objective To quantify and characterize early adopters who shared their PFT data with providers. Methods We used bivariate statistics and logistic regression to compare patients who shared any PFT data vs. patients who did not. Results A patient portal was used to invite 79,953 registered portal users to share their data. Of 66,105 users included in our analysis, 499 (0.8%) uploaded data during an initial 37-day study period. Bivariate and regression analysis showed that early adopters were more likely than non-adopters to be younger, male, white, health system employees, and to have higher BMIs. Neither comorbidities nor utilization predicted adoption. Conclusion Our results demonstrate that patients had little intrinsic desire to share PFT data with their providers, and suggest that patients most at risk for poor health outcomes are least likely to share PFT data. Marketing, incentives, and/or cultural change may be needed to induce such data-sharing. PMID:27846287

Personality disorders as maladaptive, extreme variants of normal personality: borderline personality disorder and neuroticism in a substance using sample.

PubMed

Samuel, Douglas B; Carroll, Kathleen M; Rounsaville, Bruce J; Ball, Samuel A

2013-10-01

Although the current diagnostic manual conceptualizes personality disorders (PDs) as categorical entities, an alternative perspective is that PDs represent maladaptive extreme versions of the same traits that describe normal personality. Existing evidence indicates that normal personality traits, such as those assessed by the five-factor model (FFM), share a common structure and obtain reasonably predictable correlations with the PDs. However, very little research has investigated whether PDs are more extreme than normal personality traits. Utilizing item-response theory analyses, the authors of the current study extend previous research to demonstrate that the diagnostic criterion for borderline personality disorder and FFM neuroticism could be fit along a single latent dimension. Furthermore, the authors' findings indicate that the borderline criteria assessed the shared latent trait at a level that was more extreme (d = 1.11) than FFM neuroticism. This finding provides further evidence for dimensional understanding of personality pathology and suggests that a trait model in DSM-5 should span normal and abnormal personality functioning, but focus on the extremes of these common traits.

Impact of Maine's Medicaid drug formulary change on non-Medicaid markets: spillover effects of a restrictive drug formulary.

PubMed

Wang, Y Richard; Pauly, Mark V; Lin, Y Aileen

2003-10-01

Market penetration of HMOs affect physician practice styles for non-HMO patients. To study the impact of a restrictive Medicaid drug formulary on prescribing patterns for other patients, ie, so-called spillover effects. A before-and-after, 3-state comparison study. On January 1, 2001, Maine's Medicaid program implemented a restrictive drug formulary for the proton pump inhibitor class, with pantoprazole as the only preferred drug. The Medicaid and non-Medicaid market shares of pantoprazole in Maine (vs New Hampshire and Vermont and among Maine physicians with different Medicaid share of practice. After 3 months, the market share of pantoprazole in Maine (vs 2 control states) increased 79% among Medicaid prescriptions (vs 1%-2%), 10% among cash prescriptions (vs 3%), and 7% among other third-party payer prescriptions (vs 1%). The market shares increased more among Maine physicians with a higher Medicaid share of practice (high vs middle vs low [market]: 16% vs 8% vs 5% [cash]; 11% vs 5% vs 4% [other third-party payers]). Linear regression results indicate that practicing medicine in Maine leads to a 72% increase in pantoprazole share among Medicaid prescriptions (P < .001). In addition, for each 10% Medicaid share of practice in Maine, the share of pantoprazole increases 1.8% among cash prescriptions (P = .01) and 1.4% among other third-party payer prescriptions (P < .001). Maine's Medicaid drug formulary generated spillover effects in cash and other third-party payer markets, with somewhat stronger effects in the cash market.

How can clinical practice guidelines be adapted to facilitate shared decision making? A qualitative key-informant study.

PubMed

van der Weijden, Trudy; Pieterse, Arwen H; Koelewijn-van Loon, Marije S; Knaapen, Loes; Légaré, France; Boivin, Antoine; Burgers, Jako S; Stiggelbout, Anne M; Faber, Marjan; Elwyn, Glyn

2013-10-01

To explore how clinical practice guidelines can be adapted to facilitate shared decision making. This was a qualitative key-informant study with group discussions and semi-structured interviews. First, 75 experts in guideline development or shared decision making participated in group discussions at two international conferences. Next, health professionals known as experts in depression or breast cancer, experts on clinical practice guidelines and/or shared decision making, and patient representatives were interviewed (N=20). Using illustrative treatment decisions on depression or breast cancer, we asked the interviewees to indicate as specifically as they could how guidelines could be used to facilitate shared decision making. Interviewees suggested some generic strategies, namely to include a separate chapter on the importance of shared decision making, to use language that encourages patient involvement, and to develop patient versions of guidelines. Recommendation-specific strategies, related to specific decision points in the guideline, were also suggested: These include structuring the presentation of healthcare options to increase professionals' option awareness; structuring the deliberation process between professionals and patients; and providing relevant patient support tools embedded at important decision points in the guideline. This study resulted in an overview of strategies to adapt clinical practice guidelines to facilitate shared decision making. Some strategies seemed more contentious than others. Future research should assess the feasibility and impact of these strategies to make clinical practice guidelines more conducive to facilitate shared decision making.

Patients' Experiences With Vehicle Collision to Inform the Development of Clinical Practice Guidelines: A Narrative Inquiry.

PubMed

Lindsay, Gail M; Mior, Silvano A; Côté, Pierre; Carroll, Linda J; Shearer, Heather M

2016-01-01

The purpose of this narrative inquiry was to explore the experiences of persons who were injured in traffic collisions and seek their recommendations for the development of clinical practice guideline (CPG) for the management of minor traffic injuries. Patients receiving care for traffic injuries were recruited from 4 clinics in Ontario, Canada resulting in 11 adult participants (5 men, 6 women). Eight were injured while driving cars, 1 was injured on a motorcycle, 2 were pedestrians, and none caused the collision. Using narrative inquiry methodology, initial interviews were audiotaped, and follow-up interviews were held within 2 weeks to extend the story of experience created from the first interview. Narrative plotlines across the 11 stories were identified, and a composite story inclusive of all recommendations was developed by the authors. The research findings and composite narrative were used to inform the CPG Expert Panel in the development of new CPGs. Four recommended directions were identified from the narrative inquiry process and applied. First, terminology that caused stigma was a concern. This resulted in modified language ("injured persons") being adopted by the Expert Panel, and a new nomenclature categorizing layers of injury was identified. Second, participants valued being engaged as partners with health care practitioners. This resulted in inclusion of shared decision-making as a foundational recommendation connecting CPGs and care planning. Third, emotional distress was recognized as a factor in recovery. Therefore, the importance of early detection and the ongoing evaluation of risk factors for delayed recovery were included in all CPGs. Fourth, participants shared that they were unfamiliar with the health care system and insurance industry before their accident. Thus, repeatedly orienting injured persons to the system was advised. A narrative inquiry of 11 patients' experiences with traffic collision and their recommendations for clinical guidelines informed the Ontario Protocol for Traffic Injury Management Collaboration in the development of new Minor Injury Guidelines. The values and findings of the qualitative inquiry were interwoven into each clinical pathway and embedded within the final guideline report submitted to government. Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Venous Thromboembolism and Varicose Veins Share Familial Susceptibility: A Nationwide Family Study in Sweden

PubMed Central

Zöller, Bengt; Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

2014-01-01

Background Varicose veins (VVs) have been associated with venous thromboembolism (VTE), but whether these diseases share familial susceptibility has not been determined. This nationwide study aimed to determine whether VTE shares familial susceptibility with VVs. Methods and Results Swedish Multigeneration Register data for persons aged 0 to 76 years during the period 1964–2008 were linked to the Swedish Inpatient and Outpatient Registers. Familial risks (standardized incidence ratios [SIRs]) of VTE and VVs were examined in 2 ways (ie, bidirectionally): risk of VTE in subjects whose siblings had been diagnosed with VVs and risk of VVs in persons whose siblings had been diagnosed with VTE. The analyses were repeated for spouses to determine the importance of shared adult family environment. In total, 96 810 siblings had VVs and 87 564 had VTE. An increased risk of VTE was observed in persons whose siblings had VVs (SIR 1.30, 95% CI 1.26 to 1.33), whereas persons whose siblings had VTE had an increased risk of VVs (SIR 1.30, 95% CI 1.27 to 1.34). If 2 or more siblings were affected by VTE, the risk for VVs was 1.70 (95% CI 1.53 to 1.88). Conversely, if 2 or more siblings were affected by VVs, the risk for VTE was 1.52 (95% CI 1.38 to 1.67). In spouses of VTE patients, a minor increased risk of VVs was observed (SIR 1.05 for husbands, SIR 1.06 for wives). The risk of VTE in spouses of VV patients was similarly small (SIR 1.01 for husbands, SIR 1.05 for wives). Conclusions VVs and VTE share familial susceptibility. This novel finding suggests the existence of shared familial and possibly genetic factors. PMID:25158864

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

Personalized risk communication for personalized risk assessment: Real world assessment of knowledge and motivation for six mortality risk measures from an online life expectancy calculator.

PubMed

Manuel, Douglas G; Abdulaziz, Kasim E; Perez, Richard; Beach, Sarah; Bennett, Carol

2018-01-01

In the clinical setting, previous studies have shown personalized risk assessment and communication improves risk perception and motivation. We evaluated an online health calculator that estimated and presented six different measures of life expectancy/mortality based on a person's sociodemographic and health behavior profile. Immediately after receiving calculator results, participants were invited to complete an online survey that asked how informative and motivating they found each risk measure, whether they would share their results and whether the calculator provided information they need to make lifestyle changes. Over 80% of the 317 survey respondents found at least one of six healthy living measures highly informative and motivating, but there was moderate heterogeneity regarding which measures respondents found most informative and motivating. Overall, health age was most informative and life expectancy most motivating. Approximately 40% of respondents would share the results with their clinician (44%) or social networks (38%), although the information they would share was often different from what they found informative or motivational. Online personalized risk assessment allows for a more personalized communication compared to historic paper-based risk assessment to maximize knowledge and motivation, and people should be provided a range of risk communication measures that reflect different risk perspectives.

Using a shared governance structure to evaluate the implementation of a new model of care: the shared experience of a performance improvement committee.

PubMed

Myers, Mary; Parchen, Debra; Geraci, Marilla; Brenholtz, Roger; Knisely-Carrigan, Denise; Hastings, Clare

2013-10-01

Sustaining change in the behaviors and habits of experienced practicing nurses can be frustrating and daunting, even when changes are based on evidence. Partnering with an active shared governance structure to communicate change and elicit feedback is an established method to foster partnership, equity, accountability, and ownership. Few recent exemplars in the literature link shared governance, change management, and evidence-based practice to transitions in care models. This article describes an innovative staff-driven approach used by nurses in a shared governance performance improvement committee to use evidence-based practice in determining the best methods to evaluate the implementation of a new model of care.

Using a Shared Governance Structure to Evaluate the Implementation of a New Model of Care: The Shared Experience of a Performance Improvement Committee

PubMed Central

Myers, Mary; Parchen, Debra; Geraci, Marilla; Brenholtz, Roger; Knisely-Carrigan, Denise; Hastings, Clare

2013-01-01

Sustaining change in the behaviors and habits of experienced practicing nurses can be frustrating and daunting, even when changes are based on evidence. Partnering with an active shared governance structure to communicate change and elicit feedback is an established method to foster partnership, equity, accountability and ownership. Few recent exemplars in the literature link shared governance, change management and evidence-based practice to transitions in care models. This article describes an innovative staff-driven approach used by nurses in a shared governance performance improvement committee to use evidence based practice in determining the best methods to evaluate the implementation of a new model of care. PMID:24061583

Sisters in hereditary breast and ovarian cancer families: communal coping, social integration, and psychological well-being.

PubMed

Koehly, Laura M; Peters, June A; Kuhn, Natalia; Hoskins, Lindsey; Letocha, Anne; Kenen, Regina; Loud, Jennifer; Greene, Mark H

2008-08-01

We investigated the association between psychological distress and indices of social integration and communal coping among sisters from hereditary breast and ovarian cancer (HBOC) families. Sixty-five sisters from 31 HBOC families completed the Brief Symptom Inventory-18 and the Colored Eco-Genetic Relationship Map, which identified members of participants' social support networks. Hierarchical linear models were used for all analyses to account for the clustering of sisters within families. Intra-family correlation coefficients suggested that sisters shared perceptions of breast cancer risk and worry, but not ovarian cancer risk and worry. Further, sisters demonstrated shared levels of anxiety and somatization, but not depressive symptoms. Communal coping indices quantifying shared support resources were negatively related to anxiety and somatization. The number of persons with whom cancer risk information was shared exhibited a positive trend with somatization. Social integration, as measured by the size of participants' emotional support network, was negatively associated with anxiety. Lower depression scores were observed among participants with more persons playing multiple support roles and fewer persons providing tangible assistance. Understanding how support relationships impact well-being among persons adjusting to HBOC risk, and the particular role of family in that process, will facilitate developing appropriate management approaches to help cancer-prone families adjust to their cancer risk.

State of the practice on data access, sharing, and integration.

DOT National Transportation Integrated Search

2016-12-01

The purpose of this state-of-the-practice review was to lay both technical and institutional foundation for all aspects of the development of the Virtual Data Access Framework. The review focused on current data sharing and integration practices amon...

Keys to career satisfaction: insights from a survey of women pediatric surgeons.

PubMed

Caniano, Donna A; Sonnino, Roberta E; Paolo, Anthony M

2004-06-01

Declining interest in the field of surgery is attributed to lifestyle issues, more women per class, high debt, and long residency. To maintain surgery as a premier career choice, female students must find surgery to be professionally and personally rewarding. A 35-item questionnaire was mailed to 95 women pediatric surgeons (WPS), assessing multiple professional and personal factors. Responses were entered into a confidential database and analyzed by chi2 or t tests. Seventy-nine percent of surveys were returned; practice was identified as academic (60%) and private (40%). Respondents were grouped by age: A, less than 44 years (41%); B, 45 to 54 years (37%); and C, greater than 55 years (22%). For academic WPS, 81% are on timeline for promotion. Insufficient protected time was a significant obstacle for a successful academic career in groups A and B (P =.001). Clinical load, on-call responsibilities, lack of mentorship, and departmental support were major obstacles in all groups (P =.05). Seventy-three percent of WPS in private practice were satisfied with their role in practice management; poor practice conditions were cited as the most frequent reason for job relocation. Sixty-one percent of WPS are married, and 46% are raising children. WPS had statistically significant more responsibilities for child care and household tasks in comparison with their partners. Eighty-three percent report career satisfaction but desire more time with family and for personal interests. Part-time and flexible work schedules were identified as attractive ways to achieve career-family balance. Eighty-four percent believe that quality-of-life issues are the dominant reason that fewer medical students choose surgical fields. WPS express career satisfaction but share the concerns of their female colleagues in other surgical disciplines. Quality of life is viewed as central to career choice for the current generation of medical students; female role models are key to recruiting women into pediatric surgery.

Physician Willingness and Resources to Serve More Medicaid Patients: Perspectives from Primary Care Physicians

PubMed Central

Sommers, Anna S.; Paradise, Julia; Miller, Carolyn

2011-01-01

Objective Sixteen million people will gain Medicaid under health reform. This study compares primary care physicians (PCPs) on reported acceptance of new Medicaid patients and practice characteristics. Data and Methods Sample of 1,460 PCPs in outpatient settings was drawn from a 2008 nationally representative survey of physicians. PCPs were classified into four categories based on distribution of practice revenue from Medicaid and Medicare and acceptance of new Medicaid patients. Fifteen in-depth telephone interviews supplemented analysis. Findings Most high- and moderate-share Medicaid PCPs report accepting “all” or “most” new Medicaid patients. High-share Medicaid PCPs were more likely than others to work in hospital-based practices (20%) and health centers (18%). About 30% of high- and moderate-share Medicaid PCPs worked in practices with a hospital ownership interest. Health IT use was similar between these two groups and high-share Medicare PCPs, but more high- and moderate-share Medicaid PCPs provided interpreters and non-physician staff for patient education. Over 40% of high- and moderate-share Medicaid PCPs reported inadequate patient time as a major problem. Low- and no-share Medicaid PCPs practiced in higher-income areas than high-share Medicaid PCPs. In interviews, difficulty arranging specialist care, reimbursement, and administrative hassles emerged as reasons for limiting Medicaid patients. Policy Implications PCPs already serving Medicaid are positioned to expand capacity but also face constraints. Targeted efforts to increase their capacity could help. Acceptance of new Medicaid patients under health reform will hinge on multiple factors, not payment alone. Trends toward hospital ownership could increase practices' capacity and willingness to serve Medicaid. PMID:22340772

Stakeholder engagement in diabetes self-management: patient preference for peer support and other insights.

PubMed

Kwan, Bethany M; Jortberg, Bonnie; Warman, Meredith K; Kane, Ilima; Wearner, Robyn; Koren, Romona; Carrigan, Thomas; Martinez, Vincent; Nease, Donald E

2017-06-01

Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices. To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR). Twenty-seven diabetes care stakeholders, including patients and providers from a local network of federally qualified health centres participated. Stakeholders met in-person and by conference call over the course of 8 months. Subject matter experts provided education on the diabetes SMS evidence. Facilitators engaged the group in discussions about barriers to self-management and opportunities for improving delivery of SMS. BCT participants identified lack of social support, personal resources, trust, knowledge and confidence as barriers to diabetes self-management. Intervention opportunities emphasized peer support, use of multidisciplinary care teams and centralized systems for sharing information about community and practice resources. BCT informed new services and a PCOR study proposal. Patients and family engaged in diabetes care research value peer support, group visits, and multidisciplinary care teams as key features of SMS models. SMS should be tailored to an individual patient's health literacy. BCT can be used to engage multiple stakeholders in translation of evidence into practice and to inform PCOR. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nursing advocacy during a military operation.

PubMed

Foley, B J; Minick, P; Kee, C

2000-06-01

Advocacy is an essential component of the registered nurse's professional role, yet experts provide no consistent definition of advocacy. The purpose of this study was to explore the experiences of military nurses as they engage in advocating practices and to describe their shared practices and common meanings. Heideggerian hermeneutic phenomenology, provided the framework and method for this study. Twenty-four U.S. Army nurses were individually interviewed and the researcher kept interview observational notes. The constant comparative method of analysis was used. The stories of these nurses revealed one constitutive pattern--safeguarding--and four related themes. The themes were advocating as protecting, advocating as attending the whole person, advocating as being the patient's voice, and advocating as preserving personhood. One conclusion was that military nurses must be prepared for the important safe-guarding role. They must be coached in how to deal with other members of the health team on the patient's behalf.

Opening minds in Canada: background and rationale.

PubMed

Stuart, Heather; Chen, Shu-Ping; Christie, Romie; Dobson, Keith; Kirsh, Bonnie; Knaak, Stephanie; Koller, Michelle; Krupa, Terry; Lauria-Horner, Bianca; Luong, Dorothy; Modgill, Geeta; Patten, Scott B; Pietrus, Mike; Szeto, Andrew; Whitley, Rob

2014-10-01

To summarize the background and rationale of the approach taken by the Mental Health Commission of Canada's Opening Minds (OM) Anti-Stigma Initiative. The approach taken by OM incorporates a grassroots, community development philosophy, has clearly defined target groups, uses contact-based education as the central organizing element across interventions, and has a strong evaluative component, so that best practices can be identified, replicated, and disseminated. Contact-based education occurs when people who have experienced a mental illness share their personal story of recovery and hope. OM has acted as a catalyst to develop partnerships between community groups who are undertaking anti-stigma work and an interdisciplinary team of academic researchers in 5 universities who are evaluating the results of these programs. Building partnerships with existing community programs and promoting systematic evaluation using standardized approaches and instruments have contributed to our understanding of best practices in the field of anti-stigma programming.

Helping fellow beings: anthropomorphized social causes and the role of anticipatory guilt.

PubMed

Ahn, Hee-Kyung; Kim, Hae Joo; Aggarwal, Pankaj

2014-01-01

People are often reluctant to comply with social causes because doing so may involve personal sacrifices of time, money, and effort for benefits that are shared by other members of society. In an effort to increase compliance, government agencies and public institutions sometimes employ financial tools to promote social causes. However, employing financial tools to induce prosocial behavior is expensive and often ineffective. We propose that anthropomorphizing a social cause is a practical and inexpensive tool for increasing compliance with it. Across three prosocial contexts, we found that individuals exposed to a message from an anthropomorphized social cause, compared with individuals exposed to a message relating to a nonanthropomorphized social cause, were more willing to comply with the message. This effect was mediated by feelings of anticipatory guilt experienced when they considered the likely consequences of not complying with the cause. The theoretical and practical implications of these findings are discussed.

"It's Just a Lot of Work": Adolescents' Self-Presentation Norms and Practices on Facebook and Instagram.

PubMed

Yau, Joanna C; Reich, Stephanie M

2018-02-12

We explored adolescents' (12- to 18-year-olds; n = 51) awareness of their audience and subsequent self-presentation practices on Facebook and Instagram through focus group discussions. Findings suggest that teens, who are developmentally able to perceive a situation from the third-person perspective and who value peer approval, purposefully share content to appear interesting, well liked, and attractive. Some teens invested great effort into posting by these norms, even asking their friends to help; however, this was more common among girls. Older teens especially discussed taking the perspective of their audience when deciding what to post, which is consistent with the finding that perspective taking continues to develop throughout adolescence. These findings suggest that perspective taking skills and need for peer approval influence self-presentation online. © 2018 Society for Research on Adolescence.

Private health insurance and access to healthcare.

PubMed

Duggal, Ravi

2011-01-01

The health insurance business in India has seen a growth of over 25% per annum in the last few years with the expansion of the private health insurance sector. The premium incomes of health insurance have crossed the Rs 8,000 crore mark with the share of private companies increasing to over 41%. This is despite the fact that from the perspective of patients, health insurance is not a good deal, especially when they need it most. This raises a number of ethical issues regarding how the health insurance business runs and how medical practice adjusts to it for profiteering. This article uses the personal experience of the author to argue that health insurance in an unregulated environment can only lead to unethical practices, further victimising the patient. Further, publicly financed healthcare which operates in an environment regulating both public and private healthcare provisioning is the only way to assure access to ethical and equitable healthcare to people.

Cookies as agents for community membership

NASA Astrophysics Data System (ADS)

Rodriguez, Idaykis; Goertzen, Renee Michelle; Brewe, Eric; Kramer, Laird

2013-01-01

When becoming a member of a community of practice, a novice must adopt certain community norms to participate, and these include the social norms of the group. Using the analytical perspective of Legitimate Peripheral Participation in a Community of Practice, this paper explores the social role of cookies as agents for community participation and membership in a physics research group. We analyze data from an ethnographic case study of a physics research group weekly research meeting. The mentors bring cookies to each meeting and view the cookies as a token of appreciation for the graduate students' work. These cookies take on a subtler role of initiating guests and students into scientific conversations and participation. Via the cookies, members also share personal histories and stories that help members strengthen their membership. The study of social norms in this research group is part of a larger study of physics expert identity development.

Toward clinical genomics in everyday medicine: perspectives and recommendations.

PubMed

Delaney, Susan K; Hultner, Michael L; Jacob, Howard J; Ledbetter, David H; McCarthy, Jeanette J; Ball, Michael; Beckman, Kenneth B; Belmont, John W; Bloss, Cinnamon S; Christman, Michael F; Cosgrove, Andy; Damiani, Stephen A; Danis, Timothy; Delledonne, Massimo; Dougherty, Michael J; Dudley, Joel T; Faucett, W Andrew; Friedman, Jennifer R; Haase, David H; Hays, Tom S; Heilsberg, Stu; Huber, Jeff; Kaminsky, Leah; Ledbetter, Nikki; Lee, Warren H; Levin, Elissa; Libiger, Ondrej; Linderman, Michael; Love, Richard L; Magnus, David C; Martland, AnneMarie; McClure, Susan L; Megill, Scott E; Messier, Helen; Nussbaum, Robert L; Palaniappan, Latha; Patay, Bradley A; Popovich, Bradley W; Quackenbush, John; Savant, Mark J; Su, Michael M; Terry, Sharon F; Tucker, Steven; Wong, William T; Green, Robert C

2016-01-01

Precision or personalized medicine through clinical genome and exome sequencing has been described by some as a revolution that could transform healthcare delivery, yet it is currently used in only a small fraction of patients, principally for the diagnosis of suspected Mendelian conditions and for targeting cancer treatments. Given the burden of illness in our society, it is of interest to ask how clinical genome and exome sequencing can be constructively integrated more broadly into the routine practice of medicine for the betterment of public health. In November 2014, 46 experts from academia, industry, policy and patient advocacy gathered in a conference sponsored by Illumina, Inc. to discuss this question, share viewpoints and propose recommendations. This perspective summarizes that work and identifies some of the obstacles and opportunities that must be considered in translating advances in genomics more widely into the practice of medicine.

Toward clinical genomics in everyday medicine: perspectives and recommendations

PubMed Central

Delaney, Susan K.; Hultner, Michael L.; Jacob, Howard J.; Ledbetter, David H.; McCarthy, Jeanette J.; Ball, Michael; Beckman, Kenneth B.; Belmont, John W.; Bloss, Cinnamon S.; Christman, Michael F.; Cosgrove, Andy; Damiani, Stephen A.; Danis, Timothy; Delledonne, Massimo; Dougherty, Michael J.; Dudley, Joel T.; Faucett, W. Andrew; Friedman, Jennifer R.; Haase, David H.; Hays, Tom S.; Heilsberg, Stu; Huber, Jeff; Kaminsky, Leah; Ledbetter, Nikki; Lee, Warren H.; Levin, Elissa; Libiger, Ondrej; Linderman, Michael; Love, Richard L.; Magnus, David C.; Martland, AnneMarie; McClure, Susan L.; Megill, Scott E.; Messier, Helen; Nussbaum, Robert L.; Palaniappan, Latha; Patay, Bradley A.; Popovich, Bradley W.; Quackenbush, John; Savant, Mark J.; Su, Michael M.; Terry, Sharon F.; Tucker, Steven; Wong, William T.; Green, Robert C.

2016-01-01

ABSTRACT Precision or personalized medicine through clinical genome and exome sequencing has been described by some as a revolution that could transform healthcare delivery, yet it is currently used in only a small fraction of patients, principally for the diagnosis of suspected Mendelian conditions and for targeting cancer treatments. Given the burden of illness in our society, it is of interest to ask how clinical genome and exome sequencing can be constructively integrated more broadly into the routine practice of medicine for the betterment of public health. In November 2014, 46 experts from academia, industry, policy and patient advocacy gathered in a conference sponsored by Illumina, Inc. to discuss this question, share viewpoints and propose recommendations. This perspective summarizes that work and identifies some of the obstacles and opportunities that must be considered in translating advances in genomics more widely into the practice of medicine. PMID:26810587

Heritability estimates of the Big Five personality traits based on common genetic variants.

PubMed

Power, R A; Pluess, M

2015-07-14

According to twin studies, the Big Five personality traits have substantial heritable components explaining 40-60% of the variance, but identification of associated genetic variants has remained elusive. Consequently, knowledge regarding the molecular genetic architecture of personality and to what extent it is shared across the different personality traits is limited. Using genomic-relatedness-matrix residual maximum likelihood analysis (GREML), we here estimated the heritability of the Big Five personality factors (extraversion, agreeableness, conscientiousness, neuroticism and openness for experience) in a sample of 5011 European adults from 527,469 single-nucleotide polymorphisms across the genome. We tested for the heritability of each personality trait, as well as for the genetic overlap between the personality factors. We found significant and substantial heritability estimates for neuroticism (15%, s.e. = 0.08, P = 0.04) and openness (21%, s.e. = 0.08, P < 0.01), but not for extraversion, agreeableness and conscientiousness. The bivariate analyses showed that the variance explained by common variants entirely overlapped between neuroticism and openness (rG = 1.00, P < 0.001), despite low phenotypic correlation (r = - 0.09, P < 0.001), suggesting that the remaining unique heritability may be determined by rare or structural variants. As far as we are aware of, this is the first study estimating the shared and unique heritability of all Big Five personality traits using the GREML approach. Findings should be considered exploratory and suggest that detectable heritability estimates based on common variants is shared between neuroticism and openness to experiences.

To Share or Not to Share: When Do Toddlers Respond to Another's Needs?

ERIC Educational Resources Information Center

Brownell, Celia A.; Svetlova, Margarita; Nichols, Sara

2009-01-01

The developmental origins of sharing remain little understood. Using procedures adapted from research on prosocial behavior in chimpanzees, we presented 18- and 25-month-old children with a sharing task in which they could choose to deliver food to themselves only, or to both themselves and another person, thereby making it possible for them to…

Job Sharing in the Schools: A Study of Nine Bay Area Districts. A Preliminary Report.

ERIC Educational Resources Information Center

New Ways to Work, Palo Alto, CA.

Under job sharing, two people share responsibility for one full-time position. Each person has a permanent, part-time job with salary and fringe benefits prorated according to hours worked. Job sharing has been available in some Bay Area school districts for the last four years. For this preliminary report, nine districts--Alum rock, Fremont,…

Health Data Sharing Preferences of Consumers: Public Policy and Legal Implications of Consumer-Mediated Data Management

ERIC Educational Resources Information Center

Moon, Lisa A.

2017-01-01

An individual's choice to share or have control of the sharing or withholding of their personal health information is one of the most significant public policy challenges associated with electronic information exchange. There were four aims of this study. First, to describe predictors of health data sharing preferences of consumers. Second, to…

Do reading and spelling share a lexicon?

PubMed

Jones, Angela C; Rawson, Katherine A

2016-05-01

In the reading and spelling literature, an ongoing debate concerns whether reading and spelling share a single orthographic lexicon or rely upon independent lexica. Available evidence tends to support a single lexicon account over an independent lexica account, but evidence is mixed and open to alternative explanation. In the current work, we propose another, largely ignored account--separate-but-shared lexica--according to which reading and spelling have separate orthographic lexica, but information can be shared between them. We report three experiments designed to competitively evaluate these three theoretical accounts. In each experiment, participants learned new words via reading training and/or spelling training. The key manipulation concerned the amount of reading versus spelling practice a given item received. Following training, we assessed both response time and accuracy on final outcome measures of reading and spelling. According to the independent lexica account, final performance in one modality will not be influenced by the level of practice in the other modality. According to the single lexicon account, final performance will depend on the overall amount of practice regardless of modality. According to the separate-but-shared account, final performance will be influenced by the level of practice in both modalities but will benefit more from same-modality practice. Results support the separate-but-shared account, indicating that reading and spelling rely upon separate lexica, but information can be shared between them. Copyright © 2016 Elsevier Inc. All rights reserved.

Beyond the big five: the Dark Triad and the supernumerary personality inventory.

PubMed

Veselka, Livia; Schermer, Julie Aitken; Vernon, Philip A

2011-04-01

The Dark Triad of personality, comprising Machiavellianism, narcissism, and psychopathy, was investigated in relation to the Supernumerary Personality Inventory (SPI) traits, because both sets of variables are predominantly distinct from the Big Five model of personality. Correlational and principal factor analyses were conducted to assess the relations between the Dark Triad and SPI traits. Multivariate behavioral genetic model-fitting analyses were also conducted to determine the correlated genetic and/or environmental underpinnings of the observed phenotypic correlations. Participants were 358 monozygotic and 98 same-sex dizygotic adult twin pairs from North America. As predicted, results revealed significant correlations between the Dark Triad and most SPI traits, and these correlations were primarily attributable to common genetic and non-shared environmental factors, except in the case of Machiavellianism, where shared environmental effects emerged. Three correlated factors were extracted during joint factor analysis of the Dark Triad and SPI traits, as well as a heritable general factor of personality - results that clarified the structure of the Dark Triad construct. It is concluded that the Dark Triad represents an exploitative and antisocial construct that extends beyond the Big Five model and shares a theoretical space with the SPI traits.

Strategies for innovative energy-based nursing practice: the Healing Touch program.

PubMed

Kelley, Mari

2002-01-01

The purpose of this article is to share professional knowledge, practice, and educational opportunities related to energy-based nursing in order to broaden and improve the delivery of health care services. The holistic, theory-based approach places a patient's perceived needs first, and cares for the human body as well as the spirit. Energy medicine is an intricate part of the patient's expectation for health care. Watson's transpersonal-caring-healing model is explored (Watson, 1999). This model expands the view of the person to one that embodies energy that is comprised of spirit, a universal mind, and consciousness. The North American Nurses Diagnosis Association (NANDA) recognizes energy therapy as an intervention representing a specific theory: human energy field theory (HEFT). This therapy is related to the approved nursing diagnosis of energy field disturbance 1.8 (NANDA, 1995/1996). Healing touch (HT) is an energy-based therapeutic approach to healing that emphasizes caring for the whole person based on the HEFT. It is used in the nursing profession to influence changes in the human energy system; HT affects physical, emotional, mental, and spiritual health. The nursing process is evident throughout the curriculum. Nurse researchers report positive patients outcomes. The holistic nursing concept of energetic healing returns nurse professionals to the essence of nursing. Spinal cord injury (SCI) nurses will benefit by increasing their knowledge and awareness of energy therapy to increase patient satisfaction and improve outcomes for persons with SCI.

Are you happy for me? How sharing positive events with others provides personal and interpersonal benefits.

PubMed

Reis, Harry T; Smith, Shannon M; Carmichael, Cheryl L; Caprariello, Peter A; Tsai, Fen-Fang; Rodrigues, Amy; Maniaci, Michael R

2010-08-01

Sharing good news with others is one way that people can savor those experiences while building personal and interpersonal resources. Although prior research has established the benefits of this process, called capitalization, there has been little research and no experiments to examine the underlying mechanisms. In this article, we report results from 4 experiments and 1 daily diary study conducted to examine 2 mechanisms relevant to capitalization: that sharing good news with others increases the perceived value of those events, especially when others respond enthusiastically, and that enthusiastic responses to shared good news promote the development of trust and a prosocial orientation toward the other. These studies found consistent support for these effects across both interactions with strangers and in everyday close relationships.

Lost in the present but confident of the past: experiences of being in a psycho-geriatric unit as narrated by persons with dementia.

PubMed

Edvardsson, David; Nordvall, Karin

2008-02-01

To illuminate meanings of being in a psycho-geriatric unit. Background. There are known risks associated with moving persons with dementia from home to an institution, but little is known about how they experience being in psycho-geriatric units. Using open-ended research interviews, six persons with mild to severe dementia were asked to narrate about their experiences in the hospital. The interviews were interpreted using a phenomenological hermeneutical method of analysis. The comprehensive understanding of being in a psycho-geriatric unit points towards an understanding of being lost in the present but confident of the past. The analysis showed that the participants appeared lost as they could not narrate where they were and why, but that they became confident when narrating about their previous life. The analysis also showed that being in the hospital meant sharing living space with strangers, invasions of private space and establishing new acquaintances. Being in the unit could also mean boredom and devaluation for participants. The interviews were interpreted in the light of narrative theory of identity: persons with dementia narrating about previous life experiences as to make claims of how to be interpreted by others; as persons instead of merely as 'demented' patients. Experiences of care narrated by persons with dementia present meaningful and useful information that can provide feedback to inform care practice. Experiences of care from persons with dementia provide meaningful information about care and the doing and being of staff. Creating time for conversations with these persons may facilitate well-being.

Barriers to Shared Use of Indoor and Outdoor Facilities at US Elementary Schools

ERIC Educational Resources Information Center

Turner, Lindsey; Calvert, Hannah G.; Chaloupka, Frank J.

2018-01-01

Background: School policies and practices, such as the sharing of school facilities with the surrounding community, support physical activity among students and community members, but are often underutilized. This study examined variations in shared use practices, and associations with perceived barriers. Methods: Surveys were completed by a…

Shared Values and Socio-Cultural Norms: E-Learning Technologies from a Social Practice Perspective

ERIC Educational Resources Information Center

Shih, Patti; Velan, Gary M.; Shulruf, Boaz

2017-01-01

From a perspective of social practice, learning is a socially constituted practice that is imbued with socio-culturally significant meanings and shaped by the values and norms shared within a community of learners. This focus group study examines the role of e-learning technologies in mediating the social practice of learning among coursework…

Development Engineers' Work and Learning as Shared Practice

ERIC Educational Resources Information Center

Collin, Kaija

2008-01-01

The field of workplace learning lacks empirical studies that view workplace practices as places for learning and see these practices in a critical light. Accordingly, the aim of this study is, first, to describe examples of everyday shared practice and consider what kinds of various conflicting aims and demands exist in it. Second, the purpose is…

Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital.

PubMed

Sepucha, Karen R; Simmons, Leigh H; Barry, Michael J; Edgman-Levitan, Susan; Licurse, Adam M; Chaguturu, Sreekanth K

2016-04-01

Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital's integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005-15, more than 900 clinicians and other staff members were trained in shared decision making, and more than 28,000 orders for one of about forty patient decision aids were placed to support informed patient-centered decisions. We profile two different implementation initiatives that increased the use of patient decision aids at the hospital's eighteen adult primary care practices, and we summarize key elements of the shared decision making program. Project HOPE—The People-to-People Health Foundation, Inc.

7 CFR 12.8 - Affiliated persons.

Code of Federal Regulations, 2010 CFR

2010-01-01

...; (2) Any partnership, joint venture, or other enterprise in which the person or any person listed in... who has requested benefits from USDA is a corporation, partnership, or other joint venture, the... corporation, partnership, or other joint venture or persons with a 20 percent or less share in a corporation...

The Personal Assistance Dilemma for People with Disabilities Living in Rural Areas.

ERIC Educational Resources Information Center

Nosek, Margaret A.

1992-01-01

Disabled persons may receive needed personal assistance from spouse, parents, other family, or a hired assistant (possibly shared) who is compensated by cash or barter. Disabled persons in rural areas rely heavily on family members and face overwhelming locational, financial, and attitudinal barriers to independent living. (SV)

The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals.

PubMed

Wexler, Anna

2016-04-01

Scientists and neuroethicists have recently drawn attention to the ethical and regulatory issues surrounding the do-it-yourself (DIY) brain stimulation community, which comprises individuals stimulating their own brains with transcranial direct current stimulation (tDCS) for self-improvement. However, to date, existing regulatory proposals and ethical discussions have been put forth without engaging those involved in the DIY tDCS community or attempting to understand the nature of their practices. I argue that to better contend with the growing ethical and safety concerns surrounding DIY tDCS, we need to understand the practices of the community. This study presents the results of a preliminary inquiry into the DIY tDCS community, with a focus on knowledge that is formed, shared and appropriated within it. I show that when making or acquiring a device, DIYers (as some members call themselves) produce a body of knowledge that is completely separate from that of the scientific community, and share it via online forums, blogs, videos and personal communications. However, when applying tDCS, DIYers draw heavily on existing scientific knowledge, posting links to academic journal articles and scientific resources and adopting the standardised electrode placement system used by scientists. Some DIYers co-opt scientific knowledge and modify it by creating their own manuals and guides based on published papers. Finally, I explore how DIYers cope with the methodological limitations inherent in self-experimentation. I conclude by discussing how a deeper understanding of the practices of DIY tDCS has important regulatory and ethical implications. 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/

Facilitating Secure Sharing of Personal Health Data in the Cloud.

PubMed

Thilakanathan, Danan; Calvo, Rafael A; Chen, Shiping; Nepal, Surya; Glozier, Nick

2016-05-27

Internet-based applications are providing new ways of promoting health and reducing the cost of care. Although data can be kept encrypted in servers, the user does not have the ability to decide whom the data are shared with. Technically this is linked to the problem of who owns the data encryption keys required to decrypt the data. Currently, cloud service providers, rather than users, have full rights to the key. In practical terms this makes the users lose full control over their data. Trust and uptake of these applications can be increased by allowing patients to feel in control of their data, generally stored in cloud-based services. This paper addresses this security challenge by providing the user a way of controlling encryption keys independently of the cloud service provider. We provide a secure and usable system that enables a patient to share health information with doctors and specialists. We contribute a secure protocol for patients to share their data with doctors and others on the cloud while keeping complete ownership. We developed a simple, stereotypical health application and carried out security tests, performance tests, and usability tests with both students and doctors (N=15). We developed the health application as an app for Android mobile phones. We carried out the usability tests on potential participants and medical professionals. Of 20 participants, 14 (70%) either agreed or strongly agreed that they felt safer using our system. Using mixed methods, we show that participants agreed that privacy and security of health data are important and that our system addresses these issues. We presented a security protocol that enables patients to securely share their eHealth data with doctors and nurses and developed a secure and usable system that enables patients to share mental health information with doctors.

Personality and well-being: reexamining methods and meanings.

PubMed

Schmutte, P S; Ryff, C D

1997-09-01

Because measures of personality and well-being share common affective underpinnings and items, previously reported links between these domains may be tautological. To explicate the connections between personality and well-being, 2 samples of midlife adults (N = 215 and N = 139) completed measures of personality (NEO Five Factor Inventory; P.T. Costa & R.R. McCrae, 1992) and psychological well-being (C. D. Ryff's, 1989b, Psychological Well-Being [PWB] inventory) that were maximally distinct, both conceptually and methodologically. Analyses included additional controls for source overlap, common affective underpinnings, and shared item content. Distinctive personality correlates were observed for the 6 PWB outcomes: self-acceptance, environmental mastery, and purpose in life were linked with Neuroticism (N) Extraversion (E) and Conscientiousness (C); personal growth was linked with Openness to Experience (O) and E; positive relations with others was linked with Agreeableness (A) and E; autonomy was linked with N. Psychological wellness and its personality correlates may be more complex than prior studies suggest.

From Our Practices to Yours: Key Messages for the Journey to Integrated Behavioral Health.

PubMed

Gold, Stephanie B; Green, Larry A; Peek, C J

The historic, cultural separation of primary care and behavioral health has caused the spread of integrated care to lag behind other practice transformation efforts. The Advancing Care Together study was a 3-year evaluation of how practices implemented integrated care in their local contexts; at its culmination, practice leaders ("innovators") identified lessons learned to pass on to others. Individual feedback from innovators, key messages created by workgroups of innovators and the study team, and a synthesis of key messages from a facilitated discussion were analyzed for themes via immersion/crystallization. Five key themes were captured: (1) frame integrated care as a necessary paradigm shift to patient-centered, whole-person health care; (2) initialize: define relationships and protocols up-front, understanding they will evolve; (3) build inclusive, empowered teams to provide the foundation for integration; (4) develop a change management strategy of continuous evaluation and course-correction; and (5) use targeted data collection pertinent to integrated care to drive improvement and impart accountability. Innovators integrating primary care and behavioral health discerned key messages from their practical experience that they felt were worth sharing with others. Their messages present insight into the challenges unique to integrating care beyond other practice transformation efforts. © Copyright 2017 by the American Board of Family Medicine.

Attitudes towards personal and shared space during the flight.

PubMed

Ahmadpour, N; Kühne, M; Robert, J-M; Vink, P

2016-07-25

Aircraft passenger comfort experience was previously defined based on its underlying thematic components representing passengers' perception of the environmental elements and their link to their concerns. This paper aims to 1) identify aircraft passengers' attitudes towards their personal and shared space in the cabin environment during the flight which are linked to their comfort experience and 2) highlight passenger concerns associated with those attitudes. A sample involving 16 participants was conducted, collecting full accounts of their real-time flight experiences onboard commercial aircrafts, using questionnaires. Four types of attitudes were identified in reaction to participants' personal and shared space during the flight. Those were described as adjust, avoid, approach, and shield. Passengers' concerns associated with those attitudes were respectively: control, privacy, connectedness and tolerance. It is concluded that passenger comfort can be improved once the identified concerns and attitudes are addressed in the design of the aircraft seat and interior. Design recommendations are provided accordingly.

Communicating shared knowledge in infancy.

PubMed

Egyed, Katalin; Király, Ildikó; Gergely, György

2013-07-01

Object-directed emotion expressions provide two types of information: They can convey the expressers' person-specific subjective disposition toward objects, or they can be used communicatively as referential symbolic devices to convey culturally shared valence-related knowledge about referents that can be generalized to other individuals. By presenting object-directed emotion expressions in communicative versus noncommunicative contexts, we demonstrated that 18-month-olds can flexibly assign either a person-centered interpretation or an object-centered interpretation to referential emotion displays. When addressed by ostensive signals of communication, infants generalized their object-centered interpretation of the emotion display to other individuals as well, whereas in the noncommunicative emotion-expression context, they attributed to the emoting agent a person-specific subjective dispositional attitude without generalizing this attribution as relevant to other individuals. The findings indicate that, as proposed by natural pedagogy theory, infants are prepared to learn shared cultural knowledge from nonverbal communicative demonstrations addressed to them at a remarkably early age.

Evidence summaries (decision boxes) to prepare clinicians for shared decision-making with patients: a mixed methods implementation study.

PubMed

Giguere, Anik M C; Labrecque, Michel; Haynes, R Brian; Grad, Roland; Pluye, Pierre; Légaré, France; Cauchon, Michel; Greenway, Matthew; Carmichael, Pierre-Hugues

2014-10-05

Decision boxes (Dboxes) provide clinicians with research evidence about management options for medical questions that have no single best answer. Dboxes fulfil a need for rapid clinical training tools to prepare clinicians for clinician-patient communication and shared decision-making. We studied the barriers and facilitators to using the Dbox information in clinical practice. We used a mixed methods study with sequential explanatory design. We recruited family physicians, residents, and nurses from six primary health-care clinics. Participants received eight Dboxes covering various questions by email (one per week). For each Dbox, they completed a web questionnaire to rate clinical relevance and cognitive impact and to assess the determinants of their intention to use what they learned from the Dbox to explain to their patients the advantages and disadvantages of the options, based on the theory of planned behaviour (TPB). Following the 8-week delivery period, we conducted focus groups with clinicians and interviews with clinic administrators to explore contextual factors influencing the use of the Dbox information. One hundred clinicians completed the web surveys. In 54% of the 496 questionnaires completed, they reported that their practice would be improved after having read the Dboxes, and in 40%, they stated that they would use this information for their patients. Of those who would use the information for their patients, 89% expected it would benefit their patients, especially in that it would allow the patient to make a decision more in keeping with his/her personal circumstances, values, and preferences. They intended to use the Dboxes in practice (mean 5.6±1.2, scale 1-7, with 7 being "high"), and their intention was significantly related to social norm, perceived behavioural control, and attitude according to the TPB (P<0.0001). In focus groups, clinicians mentioned that co-interventions such as patient decision aids and training in shared decision-making would facilitate the use of the Dbox information. Some participants would have liked a clear "bottom line" statement for each Dbox and access to printed Dboxes in consultation rooms. Dboxes are valued by clinicians. Tailoring of Dboxes to their needs would facilitate their implementation in practice.

Toward an interdisciplinary approach to understanding sensory function in autism spectrum disorder.

PubMed

Cascio, Carissa J; Woynaroski, Tiffany; Baranek, Grace T; Wallace, Mark T

2016-09-01

Heightened interest in sensory function in persons with autism spectrum disorder (ASD) presents an unprecedented opportunity for impactful, interdisciplinary work between neuroscientists and clinical practitioners for whom sensory processing is a focus. In spite of this promise, and a number of overlapping perspectives on sensory function in persons with ASD, neuroscientists and clinical practitioners are faced with significant practical barriers to transcending disciplinary silos. These barriers include divergent goals, values, and approaches that shape each discipline, as well as different lexical conventions. This commentary is itself an interdisciplinary effort to describe the shared perspectives, and to conceptualize a framework that may guide future investigation in this area. We summarize progress to date and issue a call for clinical practitioners and neuroscientists to expand cross-disciplinary dialogue and to capitalize on the complementary strengths of each field to unveil the links between neural and behavioral manifestations of sensory differences in persons with ASD. Joining forces to face these challenges in a truly interdisciplinary way will lead to more clinically informed neuroscientific investigation of sensory function, and better translation of those findings to clinical practice. Likewise, a more coordinated effort may shed light not only on how current approaches to treating sensory processing differences affect brain and behavioral responses to sensory stimuli in individuals with ASD, but also on whether such approaches translate to gains in broader characteristics associated with ASD. It is our hope that such interdisciplinary undertakings will ultimately converge to improve assessment and interventions for persons with ASD. Autism Res 2016, 9: 920-925. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Developing Mentors: An Analysis of Shared Mentoring Practices

ERIC Educational Resources Information Center

Bower-Phipps, Laura; Klecka, Cari Van Senus; Sature, Amanda L.

2016-01-01

Understanding how experienced teachers share and articulate effective mentoring practices can guide efforts to prepare quality mentors. This qualitative study focused on mentoring practices within a teacher-designed student-teaching program conceptualized while the mentor teachers within the program were students in a graduate-level mentoring…

Personality disorder traits, family environment, and alcohol misuse: a multivariate behavioural genetic analysis.

PubMed

Jang, K L; Vernon, P A; Livesley, W J

2000-06-01

This study seeks to estimate the extent to which a common genetic and environmental basis is shared between (i) traits delineating specific aspects of antisocial personality and alcohol misuse, and (ii) childhood family environments, traits delineating broad domains of personality pathology and alcohol misuse. Postal survey data were collected from monozygotic and dizygotic twin pairs. Twin pairs were recruited from Vancouver, British Columbia and London, Ontario, Canada using newspaper advertisements, media stories and twin clubs. Data obtained from 324 monozygotic and 335 dizygotic twin pairs were used to estimate the extent to which traits delineating specific antisocial personality traits and alcohol misuse shared a common genetic and environmental aetiology. Data from 81 monozygotic and 74 dizygotic twin pairs were used to estimate the degree to which traits delineating personality pathology, childhood family environment and alcohol misuse shared a common aetiology. Current alcohol misuse and personality pathology were measured using scales contained in the self-report Dimensional Assessment of Personality Pathology. Perceptions of childhood family environment were measured using the self-report Family Environment Scale. Multivariate genetic analyses showed that a subset of traits delineating components of antisocial personality (i.e. grandiosity, attention-seeking, failure to adopt social norms, interpersonal violence and juvenile antisocial behaviours) are influenced by genetic factors in common to alcohol misuse. Genetically based perceptions of childhood family environment had little relationship with alcohol misuse. Heritable personality factors that influence the perception of childhood family environment play only a small role in the liability to alcohol misuse. Instead, liability to alcohol misuse is related to genetic factors common a specific subset of antisocial personality traits describing conduct problems, narcissistic and stimulus-seeking behaviour.

How personal resources predict work engagement and self-rated performance among construction workers: a social cognitive perspective.

PubMed

Lorente, Laura; Salanova, Marisa; Martínez, Isabel M; Vera, María

2014-06-01

Traditionally, research focussing on psychosocial factors in the construction industry has focused mainly on the negative aspects of health and on results such as occupational accidents. This study, however, focuses on the specific relationships among the different positive psychosocial factors shared by construction workers that could be responsible for occupational well-being and outcomes such as performance. The main objective of this study was to test whether personal resources predict self-rated job performance through job resources and work engagement. Following the predictions of Bandura's Social Cognitive Theory and the motivational process of the Job Demands-Resources Model, we expect that the relationship between personal resources and performance will be fully mediated by job resources and work engagement. The sample consists of 228 construction workers. Structural equation modelling supports the research model. Personal resources (i.e. self-efficacy, mental and emotional competences) play a predicting role in the perception of job resources (i.e. job control and supervisor social support), which in turn leads to work engagement and self-rated performance. This study emphasises the crucial role that personal resources play in determining how people perceive job resources by determining the levels of work engagement and, hence, their self-rated job performance. Theoretical and practical implications are discussed. © 2014 International Union of Psychological Science.

Personality traits and body weight: Evidence using sibling comparisons.

PubMed

Kim, Jinho

2016-08-01

Past research has shown that personality traits relate to body weight, but this relationship may be confounded by unobserved family-level characteristics such as genetic endowments. The purpose of this study was to investigate whether the association between personality traits, as measured by the Big Five taxonomy, and body weight among young adults is spurious owing to shared family background. Participants were drawn from the full (n = 14,366) and family (n = 2813) samples of the National Longitudinal Study of Adolescent to Adult Health (Add Health). The study employed family-fixed effects to eliminate shared family background factors that might affect personality traits and body weight simultaneously. Among the Big Five personality traits, only conscientiousness showed a robust association with body weight, including body mass index (BMI) and obesity risk. These results were robust to adjustments for family-fixed effects, which indicates that the association between conscientiousness and body weight is generally not confounded by unobserved family-level characteristics shared by siblings. A one-standard-deviation increase in conscientiousness was associated with a decrease in BMI by 0.89 (equivalent to a 2.5 kg decrease in weight for an individual with an average height of the sample) and a 12% reduction in the probability of being obese. This study also found some suggestive evidence of gender and racial/ethnic differences. The association between conscientiousness and obesity was larger and statistically significant only for women, and conscientiousness was most strongly associated with obesity among Hispanic people. Conscientiousness is associated with decreased body weight net of unobserved background characteristics that are shared by siblings. The results suggest that interventions that develop personality traits may have "spillover effects"; in other words, they may also help reduce obesity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Personality Traits and Body Weight: Evidence Using Sibling Comparisons

PubMed Central

Kim, Jinho

2016-01-01

Rationale Past research has shown that personality traits relate to body weight, but this relationship may be confounded by unobserved family-level characteristics such as genetic endowments. Objective The purpose of this study was to investigate whether the association between personality traits, as measured by the Big Five taxonomy, and body weight among young adults is spurious owing to shared family background. Methods Participants were drawn from the full (n = 14,366) and family (n = 2,813) samples of the National Longitudinal Study of Adolescent to Adult Health (Add Health). The study employed family-fixed effects to eliminate shared family background factors that might affect personality traits and body weight simultaneously. Results Among the Big Five personality traits, only conscientiousness showed a robust association with body weight, including body mass index (BMI) and obesity risk. These results were robust to adjustments for family-fixed effects, which indicates that the association between conscientiousness and body weight is generally not confounded by unobserved family-level characteristics shared by siblings. A one-standard-deviation increase in conscientiousness was associated with a decrease in BMI by 0.89 (equivalent to a 2.5 kg decrease in weight for an individual with an average height of the sample) and a 12% reduction in the probability of being obese. This study also found some suggestive evidence of gender and racial/ethnic differences. The association between conscientiousness and obesity was larger and statistically significant only for women, and conscientiousness was most strongly associated with obesity among Hispanic people. Conclusion Conscientiousness is associated with decreased body weight net of unobserved background characteristics that are shared by siblings. The results suggest that interventions that develop personality traits may have “spillover effects”; in other words, they may also help reduce obesity. PMID:27394194

Force-stabilizing synergies in motor tasks involving two actors

PubMed Central

Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M.; Latash, Mark L.

2015-01-01

We investigated the ability of two persons to produce force-stabilizing synergies in accurate multi-finger force production tasks under visual feedback on the total force only. The subjects produced a time profile of total force (the sum of two hand forces in one-person tasks and the sum of two subject forces in two-person tasks) consisting of a ramp-up, steady-state, and ramp-down segments; the steady-state segment was interrupted in the middle by a quick force pulse. Analyses of the structure of inter-trial finger force variance, motor equivalence, anticipatory synergy adjustments (ASAs), and the unintentional drift of the sharing pattern were performed. The two-person performance was characterized by a dramatically higher amount of inter-trial variance that did not affect total force, higher finger force deviations that did not affect total force (motor equivalent deviations), shorter ASAs, and larger drift of the sharing pattern. The rate of sharing pattern drift correlated with the initial disparity between the forces produced by the two persons (or two hands). The drift accelerated following the quick force pulse. Our observations show that sensory information on the task-specific performance variable is sufficient for the organization of performance-stabilizing synergies. They suggest, however, that two actors are less likely to follow a single optimization criterion as compared to a single performer. The presence of ASAs in the two-person condition might reflect fidgeting by one or both of the subjects. We discuss the characteristics of the drift in the sharing pattern as reflections of different characteristic times of motion within the sub-spaces that affect and do not affect salient performance variables. PMID:26105756

Force-stabilizing synergies in motor tasks involving two actors.

PubMed

Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M; Latash, Mark L

2015-10-01

We investigated the ability of two persons to produce force-stabilizing synergies in accurate multi-finger force production tasks under visual feedback on the total force only. The subjects produced a time profile of total force (the sum of two hand forces in one-person tasks and the sum of two subject forces in two-person tasks) consisting of a ramp-up, steady-state, and ramp-down segments; the steady-state segment was interrupted in the middle by a quick force pulse. Analyses of the structure of inter-trial finger force variance, motor equivalence, anticipatory synergy adjustments (ASAs), and the unintentional drift of the sharing pattern were performed. The two-person performance was characterized by a dramatically higher amount of inter-trial variance that did not affect total force, higher finger force deviations that did not affect total force (motor equivalent deviations), shorter ASAs, and larger drift of the sharing pattern. The rate of sharing pattern drift correlated with the initial disparity between the forces produced by the two persons (or two hands). The drift accelerated following the quick force pulse. Our observations show that sensory information on the task-specific performance variable is sufficient for the organization of performance-stabilizing synergies. They suggest, however, that two actors are less likely to follow a single optimization criterion as compared to a single performer. The presence of ASAs in the two-person condition might reflect fidgeting by one or both of the subjects. We discuss the characteristics of the drift in the sharing pattern as reflections of different characteristic times of motion within the subspaces that affect and do not affect salient performance variables.

Views of Ethical Best Practices in Sharing Individual-Level Data From Medical and Public Health Research

PubMed Central

Roberts, Nia; Parker, Michael

2015-01-01

There is increasing support for sharing individual-level data generated by medical and public health research. This scoping review of empirical research and conceptual literature examined stakeholders’ perspectives of ethical best practices in data sharing, particularly in low- and middle-income settings. Sixty-nine empirical and conceptual articles were reviewed, of which, only five were empirical studies and eight were conceptual articles focusing on low- and middle-income settings. We conclude that support for sharing individual-level data is contingent on the development and implementation of international and local policies and processes to support ethical best practices. Further conceptual and empirical research is needed to ensure data sharing policies and processes in low- and middle-income settings are appropriately informed by stakeholders’ perspectives. PMID:26297745

The influence of flexible management practices on the sharing of experiential knowledge in the workplace: a case study of food service helpers.

PubMed

Ledoux, Elise; Cloutier, Esther; Fournier, Pierre-Sébastien

2012-01-01

Previous studies have shown that the job knowledge and prudent knowledge of experienced workers constitute a wealth that needs to be shared in workplaces to promote worker integration, job retention and occupational health and safety. It appears, however, that certain management practices undermine this knowledge sharing process. This case study of food service helpers in institutional food service departments is part of a research project aimed at comparing the impact of different work organization methods on knowledge sharing in the workplace on the basis of case studies carried out in several organizations. The results of this case study reveal that by destabilizing and weakening the work teams, flexible management practices create an environment that is not conducive to experiential knowledge sharing.

The OCHIN community information network: bringing together community health centers, information technology, and data to support a patient-centered medical village.

PubMed

Devoe, Jennifer E; Sears, Abigail

2013-01-01

Creating integrated, comprehensive care practices requires access to data and informatics expertise. Information technology (IT) resources are not readily available to individual practices. One model of shared IT resources and learning is a "patient-centered medical village." We describe the OCHIN Community Health Information Network as an example of this model; community practices have come together collectively to form an organization that leverages shared IT expertise, resources, and data, providing members with the means to fully capitalize on new technologies that support improved care. This collaborative facilitates the identification of "problem sheds" through surveillance of network-wide data, enables shared learning regarding best practices, and provides a "community laboratory" for practice-based research. As an example of a community of solution, OCHIN uses health IT and data-sharing innovations to enhance partnerships between public health leaders, clinicians in community health centers, informatics experts, and policy makers. OCHIN community partners benefit from the shared IT resource (eg, a linked electronic health record, centralized data warehouse, informatics, and improvement expertise). This patient-centered medical village provides (1) the collective mechanism to build community-tailored IT solutions, (2) "neighbors" to share data and improvement strategies, and (3) infrastructure to support innovations based on electronic health records across communities, using experimental approaches.

Non-Monosex Research Publication in U.S.-Based Social Work Journals Between 2008-2016.

PubMed

Ferguson, Aidan; Gilmour, Matt

2018-01-01

An estimated 4% of men and 9% of women identify as non-monosex, a term for sexual identities outside of the heterosexual/homosexual binary, such as bisexual, pansexual, polysexual, and asexual. In addition to experiences of oppression shared with all sexual minorities, non-monosex-identifying persons face additional issues of monosex bias in their personal lives, in mass media, and in research. Despite social work's commitment to issues of social justice and inclusion, prior reviews of the literature have indicated a gap in research on non-monosex-identifying persons, which can lead to inappropriate clinical practices and continued stigmatization. The authors of this article examined the state of social work literature on non-monosex-identifying persons through a systematic review and content analysis of primary-study data-based publications from 2008 to 2016 in 24 social work journals based in the United States. Only four articles were found that met the inclusion criteria, and while 31% of the 357 total study participants identified as non-monosex, a content analysis showed subtle forms of monosex bias in the reporting of study results, such as collapsing of gay/lesbian participants with non-monosex participants and the use of marginalizing language. Implications and suggestions for future social work researchers are discussed.

A Preliminary Investigation of the Relationship between Parenting, Parent-Child Shared Reading Practices, and Child Development in Low-Income Families

ERIC Educational Resources Information Center

Dexter, Casey A.; Stacks, Ann M.

2014-01-01

This study examined relations between parenting, shared reading practices, and child development. Participants included 28 children (M = 24.66 months, SD = 8.41 months) and their parents. Measures included naturalistic observations of parenting and shared reading quality, assessments of child cognitive and language development, and home reading…

Sharing Knowledge in Universities: Communities of Practice the Answer?

ERIC Educational Resources Information Center

Buckley, Sheryl; du Toit, Adeline

2009-01-01

The change from an industrial economy to a knowledge economy forced many organizations to change their modus operandi if they were going to survive in a sustainable way. The introduction of communities of practice (CoPs) by Jean Lave and Etienne Wenger shed new light on knowledge sharing and dissemination of information. Sharing, interacting,…

Genomics and privacy: implications of the new reality of closed data for the field.

PubMed

Greenbaum, Dov; Sboner, Andrea; Mu, Xinmeng Jasmine; Gerstein, Mark

2011-12-01

Open source and open data have been driving forces in bioinformatics in the past. However, privacy concerns may soon change the landscape, limiting future access to important data sets, including personal genomics data. Here we survey this situation in some detail, describing, in particular, how the large scale of the data from personal genomic sequencing makes it especially hard to share data, exacerbating the privacy problem. We also go over various aspects of genomic privacy: first, there is basic identifiability of subjects having their genome sequenced. However, even for individuals who have consented to be identified, there is the prospect of very detailed future characterization of their genotype, which, unanticipated at the time of their consent, may be more personal and invasive than the release of their medical records. We go over various computational strategies for dealing with the issue of genomic privacy. One can "slice" and reformat datasets to allow them to be partially shared while securing the most private variants. This is particularly applicable to functional genomics information, which can be largely processed without variant information. For handling the most private data there are a number of legal and technological approaches-for example, modifying the informed consent procedure to acknowledge that privacy cannot be guaranteed, and/or employing a secure cloud computing environment. Cloud computing in particular may allow access to the data in a more controlled fashion than the current practice of downloading and computing on large datasets. Furthermore, it may be particularly advantageous for small labs, given that the burden of many privacy issues falls disproportionately on them in comparison to large corporations and genome centers. Finally, we discuss how education of future genetics researchers will be important, with curriculums emphasizing privacy and data security. However, teaching personal genomics with identifiable subjects in the university setting will, in turn, create additional privacy issues and social conundrums. © 2011 Greenbaum et al.

Transitions from biomedical to recovery-oriented practices in mental health: a scoping review to explore the role of Internet-based interventions.

PubMed

Strand, Monica; Gammon, Deede; Ruland, Cornelia M

2017-04-07

The Internet is transforming mental health care services by increasing access to, and potentially improving the quality of, care. Internet-based interventions in mental health can potentially play a role in transitions from biomedical to recovery-oriented research and practices, but an overview of what this may entail, current work, and issues that need addressing, is lacking. The objective of this study is to describe Internet-based recovery-oriented interventions (referred to as e-recovery) and current research, and to identify gaps and issues relevant to advancing recovery research and practices through opportunities provided by the Internet. Five iterative stages of a scoping review framework were followed in searching and analyzing the literature. A recovery framework with four domains and 16 themes was used to deductively code intervention characteristics according to their support for recovery-oriented practices. Only Internet-based interventions used in conjunction with ongoing care were included. Twenty studies describing six e-recovery interventions were identified and originated in Australia, Finland, the Netherlands, Norway and USA. The domain supporting personal recovery was most clearly reflected in interventions, whereas the last three domains, i.e., promoting citizenship, organizational commitment and working relationship were less evident. Support for the formulation and follow-up of personal goals and preferences, and in accessing peer-support, were the characteristics shared by most interventions. Three of the six studies that employed a comparison group used randomization, and none presented definitive findings. None used recovery-oriented frameworks or specific recovery outcome measures. Four of the interventions were specific to a diagnosis. Research about how technologies might aid in illuminating and shaping recovery processes is in its formative stages. We recommend that future e-recovery research and innovation attend to four dimensions: evidence-supported interventions, new knowledge about personal recovery, values-based approaches and Internet as a facilitator for organizational transformation. The incremental changes facilitated by e-recovery may help propel a shift in mental health care toward recovery-oriented practices.

Linking molar organizational climate and strategic implementation climate to clinicians' use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study.

PubMed

Williams, Nathaniel J; Ehrhart, Mark G; Aarons, Gregory A; Marcus, Steven C; Beidas, Rinad S

2018-06-25

Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians' shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes clinicians' shared perceptions of the extent to which evidence-based practice implementation is expected, supported, and rewarded by the organization. Theory suggests these climates have joint, cross-level effects on clinicians' implementation of evidence-based practice and that these effects may be long term (i.e., up to 2 years); however, no empirical studies have tested these relationships. We hypothesize that molar climate moderates implementation climate's concurrent and long-term relationships with clinicians' use of evidence-based practice such that strategic implementation climate will have its most positive effects when it is accompanied by a positive molar climate. Hypotheses were tested using data collected from 235 clinicians in 20 behavioral health organizations. At baseline, clinicians reported on molar climate and implementation climate. At baseline and at a 2-year follow-up, all clinicians who were present in the organizations reported on their use of cognitive-behavioral psychotherapy techniques, an evidence-based practice for youth psychiatric disorders. Two-level mixed-effects regression models tested whether baseline molar climate and implementation climate interacted in predicting clinicians' evidence-based practice use at baseline and at 2-year follow-up. In organizations with more positive molar climates at baseline, higher levels of implementation climate predicted increased evidence-based practice use among clinicians who were present at baseline and among clinicians who were present in the organizations at 2-year follow-up; however, in organizations with less positive molar climates, implementation climate was not related to clinicians' use of evidence-based practice at either time point. Optimizing clinicians' implementation of evidence-based practice in behavioral health requires attention to both molar climate and strategic implementation climate. Strategies that focus exclusively on implementation climate may not be effective levers for behavior change if the organization does not also engender a positive molar climate. These findings have implications for the development of implementation theory and effective implementation strategies.

Exploring the perception of nursing students about consequences of reflection in clinical settings

PubMed Central

Karimi, Shahnaz; Haghani, Fariba; Yamani, Nikoo; Kalyani, Majid Najafi

2017-01-01

Background Reflection on practical experiences is a key element that enables students to recognize their own strengths and weaknesses and develop nursing skills. Whilst reflection may enhance students’ learning in practice, there is little evidence about nursing students’ perception of the consequences of reflection in clinical settings. Objective This study aimed to explore Iranian nursing students’ perception regarding the consequences of reflection during clinical practices. Methods This qualitative study was conducted by a conventional content analysis approach in two nursing schools at Shiraz and Fasa Universities of Medical Sciences in Iran. Data were collected through in-depth semi-structured interviews during 2015–2016, from 20 students selected by purposive sampling. All the interviews were tape-recorded, transcribed verbatim, and analyzed by content analysis method. Rigor of this study was approved by member check and external audit. Results Two categories emerged from the data analysis, including movement toward professionalism and self-actualization of emotions. The former consisted of three subcategories of function modification, sharing experiences and generalizing experiences. The latter consisted of two subcategories of inner satisfaction and peace of mind. Conclusion The results indicated that nursing students’ reflection in clinical settings is effective in personal and professional levels. Reflection in a personal level led to positive emotions that increased the quality of care in patients. Accordingly, nursing educators need to create a nurturing climate as well as supporting reflective behaviors of nursing students. PMID:29038696

The meaning of co- production for clinicians: an exploratory case study of Practitioner Trainers in one Recovery College.

PubMed

Dalgarno, Mark; Oates, Jennifer

2018-05-15

Co-production between service users and clinicians is a desirable element of recovery-oriented practice in mental health but the effect of co-production on clinicians has not been explored thoroughly. to explore the meaning of co-production for clinicians based on their experience of co-production in a Recovery College Method: Thematic analysis of eight semi-structured interviews with clinicians who have co-produced and co-delivered workshops with a Recovery College Peer Trainer. The 'meaning of co-production' had four themes: definitions, power dynamics, negotiating roles and influence on practice. Clinicians' experience of co-production meant a reassessment of their expert role and power. They said that this altered their clinical practice, particularly the language they used and the personal information they shared. Role negotiation between Practitioner and Peer Trainers is an iterative process, whereby clinicians may revise their perspectives on personal disclosure, professional identity and collegiate support. The Peer and Practitioner Trainer relationship is characterised by reciprocity and mutuality, and there is some evidence that Practitioner involvement in a co-produced activity has the potential to transform service user and provider relationships beyond the Recovery College setting. Engaging in co-produced educational workshops can alter clinicians' perspectives on roles, power and clinical expertise. Findings from this case study must be tested against research on other Recovery Colleges. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Perspectives on the Role and Synergies of Architecture and Social and Built Environment in Enabling Active Healthy Aging

PubMed Central

Rabnett, Richard; Tziraki, Chariklia

2016-01-01

Research has demonstrated that enabling societal and physical infrastructure and personal accommodations enhance healthy and active aging throughout the lifespan. Yet, there is a paucity of research on how to bring together the various disciplines involved in a multidomain synergistic collaboration to create new living environments for aging. This paper aims to explore the key domains of skills and knowledge that need to be considered for a conceptual prototype of an enabling educational process and environments where healthcare professionals, architects, planners, and entrepreneurs may establish a shared theoretical and experiential knowledge base, vocabulary, and implementation strategies, for the creation of the next generation of living communities of active healthy adults, for persons with disabilities and chronic disease conditions. We focus on synergistic, paradigmatic, simple, and practical issues that can be easily upscaled through market mechanisms. This practical and physically concrete approach may also become linked with more elaborate neuroscientific and technologically sophisticated interventions. We examine the domains of knowledge to be included in establishing a learning model that focuses on the still-understudied impact of the benefits toward active and healthy aging, where architects, urban planners, clinicians, and healthcare facility managers are educated toward a synergistic approach at the operational level. PMID:27656295

Can administrative claim file review be used to gather physical therapy, occupational therapy, and psychology payment data and functional independence measure scores? Implications for rehabilitation providers in the private health sector.

PubMed

Riis, Viivi; Jaglal, Susan; Boschen, Kathryn; Walker, Jan; Verrier, Molly

2011-01-01

Rehabilitation costs for spinal-cord injury (SCI) are increasingly borne by Canada's private health system. Because of poor outcomes, payers are questioning the value of their expenditures, but there is a paucity of data informing analysis of rehabilitation costs and outcomes. This study evaluated the feasibility of using administrative claim file review to extract rehabilitation payment data and functional status for a sample of persons with work-related SCI. Researchers reviewed 28 administrative e-claim files for persons who sustained a work-related SCI between 1996 and 2000. Payment data were extracted for physical therapy (PT), occupational therapy (OT), and psychology services. Functional Independence Measure (FIM) scores were targeted as a surrogate measure for functional outcome. Feasibility was tested using an existing approach for evaluating health services data. The process of administrative e-claim file review was not practical for extraction of the targeted data. While administrative claim files contain some rehabilitation payment and outcome data, in their present form the data are not suitable to inform rehabilitation services research. A new strategy to standardize collection, recording, and sharing of data in the rehabilitation industry should be explored as a means of promoting best practices.

Analysis of the Uniform Accident And Sickness Policy Provision Law: lessons for social work practice, policy, and research.

PubMed

Cochran, Gerald

2010-01-01

The Uniform Accident and Sickness Policy Provision Law (UPPL) is a state statute that allows insurance companies in 26 states to deny claims for accidents and injuries incurred by persons under the influence of drugs or alcohol. Serious repercussions can result for patients and health care professionals as states enforce this law. To examine differences within the laws that might facilitate amendments or reduce insurance companies' ability to deny claims, a content analysis was carried out of each state's UPPL law. Results showed no meaningful differences between each state's laws. These results indicate patients and health professionals share similar risk related to the UPPL regardless of state.

Tinea corporis, tinea cruris, tinea nigra, and piedra.

PubMed

Gupta, Aditya K; Chaudhry, Maria; Elewski, Boni

2003-07-01

Tinea infections are among the most common dermatologic conditions throughout the world. To avoid a misdiagnosis, identification of dermatophyte infections requires both a fungal culture on Sabouraud's agar media, and a light microscopic mycologic examination from skin scrapings. Topical antifungals may be sufficient for treatment of tinea corporis and cruris and tinea nigra, and the shaving of hair infected by piedra may also be beneficial. Systemic therapy, however, may be required when the infected areas are large, macerated with a secondary infection, or in immunocompromised individuals. Preventative measures of tinea infections include practicing good personal hygiene; keeping the skin dry and cool at all times; and avoiding sharing towels, clothing, or hair accessories with infected individuals.

Conference scene: Latin American Pharmacogenomics and Personalized Medicine Conference.

PubMed

Suarez-Kurtz, Guilherme

2012-10-01

There are nearly 600 million people living in 24 Latin American countries, speaking two major languages (Portuguese and Spanish) and sharing ancestral roots in America, Europe and Africa. Ethnic and cultural diversity, socioeconomical, scientific and technological disparities across Latin America must be taken into account in the design, interpretation and implications of pharmacogenomic studies in this region. The conference covered some of these aspects, but also took on a more global approach on the growing contribution of genomic information and biotechnological tools to the way medicines are developed, regulated and prescribed to patients. Translation of pharmacogenomics into clinical practice was the topic of a keynote lecture and two debate sessions. A preconference Introductory Course of Pharmacogenomics was offered.

Sharing stories: life history narratives in stuttering research.

PubMed

Kathard, H

2001-01-01

The life experiences of people who stutter (PWS) have not featured prominently in research. Historically, the profession of speech and language therapy has amassed data and developed its theory of stuttering within a positivistic frame. As a consequence, the existing over-arching theory of research and practice does not engage holistically with the dynamic personal, socio-cultural and political contexts of the individual who stutters. Therefore a conceptual shift is required in ontology, epistemology and methodology underpinning the knowledge construction process. The use of the life history narratives as a research tool is promoted. An exploratory study of a single participant is presented to illuminate the methodological approach and emerging theoretical constructs.

Shared reality in interpersonal relationships.

PubMed

Andersen, Susan M; Przybylinski, Elizabeth

2017-11-24

Close relationships afford us opportunities to create and maintain meaning systems as shared perceptions of ourselves and the world. Establishing a sense of mutual understanding allows for creating and maintaining lasting social bonds, and as such, is important in human relations. In a related vein, it has long been known that knowledge of significant others in one's life is stored in memory and evoked with new persons-in the social-cognitive process of 'transference'-imbuing new encounters with significance and leading to predictable cognitive, evaluative, motivational, and behavioral consequences, as well as shifts in the self and self-regulation, depending on the particular significant other evoked. In these pages, we briefly review the literature on meaning as interpersonally defined and then selectively review research on transference in interpersonal perception. Based on this, we then highlight a recent series of studies focused on shared meaning systems in transference. The highlighted studies show that values and beliefs that develop in close relationships (as shared reality) are linked in memory to significant-other knowledge, and thus, are indirectly activated (made accessible) when cues in a new person implicitly activate that significant-other knowledge (in transference), with these shared beliefs then actively pursued with the new person and even protected against threat. This also confers a sense of mutual understanding, and all told, serves both relational and epistemic functions. In concluding, we consider as well the relevance of co-construction of shared reality n such processes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Attachment styles and personality disorders: their connections to each other and to parental divorce, parental death, and perceptions of parental caregiving.

PubMed

Brennan, K A; Shaver, P R

1998-10-01

Attachment theory was explored as a means of understanding the origins of personality disorders. We investigated whether adult attachment styles and personality disorders share a common underlying structure, and how both kinds of variables relate to family background factors, including parental death, parental divorce, and current representations of childhood relationships with parents. A nonclinical group of 1407 individuals, mostly adolescents and young adults, were surveyed about their attachment styles, parental marital status, parental mortality status, perceptions of treatment by parents in childhood, and 13 personality disorders. Results indicated substantial overlap between attachment and personality-disorder measures. Two of the personality-disorder dimensions are related to the two dimensions of the attachment space; that is, there is a two-dimensional space in which both the attachment patterns and most of the personality disorders can be arrayed. The one personality-disorder factor that is unrelated to attachment appears akin to psychopathy. Both personality disorders and attachment styles were associated with family-of-origin variables. Results are discussed in terms of encouraging further research to test the idea that insecure attachment and most of the personality disorders share similar developmental antecedents.

Putting the Focus Back on the Patient: How Privacy Concerns Affect Personal Health Information Sharing Intentions

PubMed Central

Sanders, G Lawrence

2017-01-01

Background Health care providers are driven by greater participation and systemic cost savings irrespective of benefits to individual patients derived from sharing Personal Health Information (PHI). Protecting PHI is a critical issue in the sharing of health care information systems; yet, there is very little literature examining the topic of sharing PHI electronically. A good overview of the regulatory, privacy, and societal barriers to sharing PHI can be found in the 2009 Health Information Technology for Economic and Clinical Health Act. Objective This study investigated the factors that influence individuals’ intentions to share their PHI electronically with health care providers, creating an understanding of how we can represent a patient’s interests more accurately in sharing settings, instead of treating patients like predetermined subjects. Unlike privacy concern and trust, patient activation is a stable trait that is not subject to change in the short term and, thus, is a useful factor in predicting sharing behavior. We apply the extended privacy model in the health information sharing context and adapt this model to include patient activation and issue involvement to predict individuals’ intentions. Methods This was a survey-based study with 1600+ participants using the Health Information National Trends Survey (HINTS) data to validate a model through various statistical techniques. The research method included an assessment of both the measurement and structural models with post hoc analysis. Results We find that privacy concern has the most influence on individuals’ intentions to share. Patient activation, issue involvement, and patient-physician relationship are significant predictors of sharing intention. We contribute to theory by introducing patient activation and issue involvement as proxies for personal interest factors in the health care context. Conclusions Overall, this study found that although patients are open to sharing their PHI, they still have concerns over the privacy of their PHI during the sharing process. It is paramount to address this factor to increase information flow and identify how patients can assure that their privacy is protected. The outcome of this study is a set of recommendations for motivating the sharing of PHI. The goal of this research is to increase the health profile of the patients by integrating the testing and diagnoses of various doctors across health care providers and, thus, bring patients closer to the physicians. PMID:28903895

Sisters in hereditary breast and ovarian cancer families: communal coping, social integration, and psychological well-being†

PubMed Central

Koehly, Laura M.; Peters, June A.; Kuhn, Natalia; Hoskins, Lindsey; Letocha, Anne; Kenen, Regina; Loud, Jennifer; Greene, Mark H.

2011-01-01

Objective We investigated the association between psychological distress and indices of social integration and communal coping among sisters from hereditary breast and ovarian cancer (HBOC) families. Sample and methods Sixty-five sisters from 31 HBOC families completed the Brief Symptom Inventory-18 and the Colored Eco-Genetic Relationship Map, which identified members of participants’ social support networks. Hierarchical linear models were used for all analyses to account for the clustering of sisters within families. Results Intra-family correlation coefficients suggested that sisters shared perceptions of breast cancer risk and worry, but not ovarian cancer risk and worry. Further, sisters demonstrated shared levels of anxiety and somatization, but not depressive symptoms. Communal coping indices quantifying shared support resources were negatively related to anxiety and somatization. The number of persons with whom cancer risk information was shared exhibited a positive trend with somatization. Social integration, as measured by the size of participants’ emotional support network, was negatively associated with anxiety. Lower depression scores were observed among participants with more persons playing multiple support roles and fewer persons providing tangible assistance. Conclusion Understanding how support relationships impact well-being among persons adjusting to HBOC risk, and the particular role of family in that process, will facilitate developing appropriate management approaches to help cancer-prone families adjust to their cancer risk. Published in 2008 by John Wiley & Sons Ltd. PMID:18688790

Stepsiblings

MedlinePlus

... rivalries that may already exist. Privacy and Personal Space Sometimes a child is asked to share a ... sometimes creating anger and jealousy. Privacy and personal space become important issues in blended families. Whenever possible, ...

The five-factor model of personality and borderline personality disorder: a genetic analysis of comorbidity.

PubMed

Distel, Marijn A; Trull, Timothy J; Willemsen, Gonneke; Vink, Jacqueline M; Derom, Catherine A; Lynskey, Michael; Martin, Nicholas G; Boomsma, Dorret I

2009-12-15

Recently, the nature of personality disorders and their relationship with normal personality traits has received extensive attention. The five-factor model (FFM) of personality, consisting of the personality traits neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness, is one of the proposed models to conceptualize personality disorders as maladaptive variants of continuously distributed personality traits. The present study examined the phenotypic and genetic association between borderline personality and FFM personality traits. Data were available for 4403 monozygotic twins, 4425 dizygotic twins, and 1661 siblings from 6140 Dutch, Belgian, and Australian families. Broad-sense heritability estimates for neuroticism, agreeableness, conscientiousness, extraversion, openness to experience, and borderline personality were 43%, 36%, 43%, 47%, 54%, and 45%, respectively. Phenotypic correlations between borderline personality and the FFM personality traits ranged from .06 for openness to experience to .68 for neuroticism. Multiple regression analyses showed that a combination of high neuroticism and low agreeableness best predicted borderline personality. Multivariate genetic analyses showed the genetic factors that influence individual differences in neuroticism, agreeableness, conscientiousness, and extraversion account for all genetic liability to borderline personality. Unique environmental effects on borderline personality, however, were not completely shared with those for the FFM traits (33% is unique to borderline personality). Borderline personality shares all genetic variation with neuroticism, agreeableness, conscientiousness, and extraversion. The unique environmental influences specific to borderline personality may cause individuals with a specific pattern of personality traits to cross a threshold and develop borderline personality.

Successful Architectural Knowledge Sharing: Beware of Emotions

NASA Astrophysics Data System (ADS)

Poort, Eltjo R.; Pramono, Agung; Perdeck, Michiel; Clerc, Viktor; van Vliet, Hans

This chapter presents the analysis and key findings of a survey on architectural knowledge sharing. The responses of 97 architects working in the Dutch IT Industry were analyzed by correlating practices and challenges with project size and success. Impact mechanisms between project size, project success, and architectural knowledge sharing practices and challenges were deduced based on reasoning, experience and literature. We find that architects run into numerous and diverse challenges sharing architectural knowledge, but that the only challenges that have a significant impact are the emotional challenges related to interpersonal relationships. Thus, architects should be careful when dealing with emotions in knowledge sharing.

Biomedical Data Sharing and Reuse: Attitudes and Practices of Clinical and Scientific Research Staff.

PubMed

Federer, Lisa M; Lu, Ya-Ling; Joubert, Douglas J; Welsh, Judith; Brandys, Barbara

2015-01-01

Significant efforts are underway within the biomedical research community to encourage sharing and reuse of research data in order to enhance research reproducibility and enable scientific discovery. While some technological challenges do exist, many of the barriers to sharing and reuse are social in nature, arising from researchers' concerns about and attitudes toward sharing their data. In addition, clinical and basic science researchers face their own unique sets of challenges to sharing data within their communities. This study investigates these differences in experiences with and perceptions about sharing data, as well as barriers to sharing among clinical and basic science researchers. Clinical and basic science researchers in the Intramural Research Program at the National Institutes of Health were surveyed about their attitudes toward and experiences with sharing and reusing research data. Of 190 respondents to the survey, the 135 respondents who identified themselves as clinical or basic science researchers were included in this analysis. Odds ratio and Fisher's exact tests were the primary methods to examine potential relationships between variables. Worst-case scenario sensitivity tests were conducted when necessary. While most respondents considered data sharing and reuse important to their work, they generally rated their expertise as low. Sharing data directly with other researchers was common, but most respondents did not have experience with uploading data to a repository. A number of significant differences exist between the attitudes and practices of clinical and basic science researchers, including their motivations for sharing, their reasons for not sharing, and the amount of work required to prepare their data. Even within the scope of biomedical research, addressing the unique concerns of diverse research communities is important to encouraging researchers to share and reuse data. Efforts at promoting data sharing and reuse should be aimed at solving not only technological problems, but also addressing researchers' concerns about sharing their data. Given the varied practices of individual researchers and research communities, standardizing data practices like data citation and repository upload could make sharing and reuse easier.

Informal milk sharing: what nurses need to know.

PubMed

Martino, Kimberly; Spatz, Diane

2014-01-01

Human milk is the ideal food for human infants. However, some infants will be in situations wherein there is insufficient human milk to meet their needs. This article addresses formal breast milk donation (donor milk) and informal sharing of breast milk. Healthcare providers are likely to encounter families who access milk by informal breast milk sharing or cross-nursing. Both practices rely heavily on receiving human milk from women who are potentially unscreened for disease, medication, and illicit substances. Therefore, it is important for perinatal nurses to have adequate information to be able to inform these families of the risks and benefits of breast milk sharing. Two case exemplars are provided to illustrate the nuances of informal milk sharing. Implications for practice include providing families with information on health history and laboratory screening as well as safe milk-handling practices.

Neuropsychology and emotion processing in violent individuals with antisocial personality disorder or schizophrenia: The same or different? A systematic review and meta-analysis.

PubMed

Sedgwick, Ottilie; Young, Susan; Baumeister, David; Greer, Ben; Das, Mrigendra; Kumari, Veena

2017-12-01

To assess whether there are shared or divergent (a) cognitive and (b) emotion processing characteristics among violent individuals with antisocial personality disorder and/or schizophrenia, diagnoses which are commonly encountered at the interface of mental disorder and violence. Cognition and emotion processing are incorporated into models of violence, and thus an understanding of these characteristics within and between disorder groups may help inform future models and therapeutic targets. Relevant databases (OVID, Embase, PsycINFO) were searched to identify suitable literature. Meta-analyses comparing cognitive function in violent schizophrenia and antisocial personality disorder to healthy controls were conducted. Neuropsychological studies not comparing these groups to healthy controls, and emotion processing studies, were evaluated qualitatively. Meta-analyses indicated lower IQ, memory and executive function in both violent schizophrenia and antisocial personality disorder groups compared to healthy controls. The degree of deficit was consistently larger in violent schizophrenia. Both antisocial personality disorder and violent schizophrenia groups had difficulties in aspects of facial affect recognition, although theory of mind results were less conclusive. Psychopathic traits related positively to experiential emotion deficits across the two disorders. Very few studies explored comorbid violent schizophrenia and antisocial personality disorder despite this being common in clinical practice. There are qualitatively similar, but quantitatively different, neuropsychological and emotion processing deficits in violent individuals with schizophrenia and antisocial personality disorder which could be developed into transdiagnostic treatment targets for violent behaviour. Future research should aim to characterise specific subgroups of violent offenders, including those with comorbid diagnoses.

Talk, trust and time: a longitudinal study evaluating knowledge translation and exchange processes for research on violence against women

PubMed Central

2011-01-01

Background Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies including two randomized trials, the McMaster University VAW Research Program studied one key research gap: evidence about the effectiveness of screening women for exposure to intimate partner violence. This project developed and evaluated KTE strategies to share research findings with policymakers, health and community service providers, and women's advocates. Methods A longitudinal cross-sectional design, applying concurrent mixed data collection methods (surveys, interviews, and focus groups), was used to evaluate the utility of specific KTE strategies, including a series of workshops and a day-long Family Violence Knowledge Exchange Forum, on research sharing, uptake, and use. Results Participants valued the opportunity to meet with researchers, provide feedback on key messages, and make personal connections with other stakeholders. A number of factors specific to the knowledge itself, stakeholders' contexts, and the nature of the knowledge gap being addressed influenced the uptake, sharing, and use of the research. The types of knowledge use changed across time, and were specifically related to both the types of decisions being made, and to stage of decision making; most reported use was conceptual or symbolic, with few examples of instrumental use. Participants did report actively sharing the research findings with their own networks. Further examination of these second-order knowledge-sharing processes is required, including development of appropriate methods and measures for its assessment. Some participants reported that they would not use the research evidence in their decision making when it contradicted professional experiences, while others used it to support apparently contradictory positions. The online wiki-based 'community of interest' requested by participants was not used. Conclusions Mobilizing knowledge in the area of VAW practice and policy is complex and resource-intensive, and must acknowledge and respect the values of identified knowledge users, while balancing the objectivity of the research and researchers. This paper provides important lessons learned about these processes, including attending to the potential unintended consequences of knowledge sharing. PMID:21896170

Talk, trust and time: a longitudinal study evaluating knowledge translation and exchange processes for research on violence against women.

PubMed

Wathen, C Nadine; Sibbald, Shannon L; Jack, Susan M; Macmillan, Harriet L

2011-09-06

Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies including two randomized trials, the McMaster University VAW Research Program studied one key research gap: evidence about the effectiveness of screening women for exposure to intimate partner violence. This project developed and evaluated KTE strategies to share research findings with policymakers, health and community service providers, and women's advocates. A longitudinal cross-sectional design, applying concurrent mixed data collection methods (surveys, interviews, and focus groups), was used to evaluate the utility of specific KTE strategies, including a series of workshops and a day-long Family Violence Knowledge Exchange Forum, on research sharing, uptake, and use. Participants valued the opportunity to meet with researchers, provide feedback on key messages, and make personal connections with other stakeholders. A number of factors specific to the knowledge itself, stakeholders' contexts, and the nature of the knowledge gap being addressed influenced the uptake, sharing, and use of the research. The types of knowledge use changed across time, and were specifically related to both the types of decisions being made, and to stage of decision making; most reported use was conceptual or symbolic, with few examples of instrumental use. Participants did report actively sharing the research findings with their own networks. Further examination of these second-order knowledge-sharing processes is required, including development of appropriate methods and measures for its assessment. Some participants reported that they would not use the research evidence in their decision making when it contradicted professional experiences, while others used it to support apparently contradictory positions. The online wiki-based 'community of interest' requested by participants was not used. Mobilizing knowledge in the area of VAW practice and policy is complex and resource-intensive, and must acknowledge and respect the values of identified knowledge users, while balancing the objectivity of the research and researchers. This paper provides important lessons learned about these processes, including attending to the potential unintended consequences of knowledge sharing.

Facet personality and surface-level diversity as team mental model antecedents: implications for implicit coordination.

PubMed

Fisher, David M; Bell, Suzanne T; Dierdorff, Erich C; Belohlav, James A

2012-07-01

Team mental models (TMMs) have received much attention as important drivers of effective team processes and performance. Less is known about the factors that give rise to these shared cognitive structures. We examined potential antecedents of TMMs, with a specific focus on team composition variables, including various facets of personality and surface-level diversity. Further, we examined implicit coordination as an important outcome of TMMs. Results suggest that team composition in terms of the cooperation facet of agreeableness and racial diversity were significantly related to team-focused TMM similarity. TMM similarity was also positively predictive of implicit coordination, which mediated the relationship between TMM similarity and team performance. Post hoc analyses revealed a significant interaction between the trust facet of agreeableness and racial diversity in predicting TMM similarity. Results are discussed in terms of facilitating the emergence of TMMs and corresponding implications for team-related human resource practices. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Assessing the Exposome with External Measures: Commentary on the State of the Science and Research Recommendations.

PubMed

Turner, Michelle C; Nieuwenhuijsen, Mark; Anderson, Kim; Balshaw, David; Cui, Yuxia; Dunton, Genevieve; Hoppin, Jane A; Koutrakis, Petros; Jerrett, Michael

2017-03-20

The exposome comprises all environmental exposures that a person experiences from conception throughout the life course. Here we review the state of the science for assessing external exposures within the exposome. This article reviews (a) categories of exposures that can be assessed externally, (b) the current state of the science in external exposure assessment, (c) current tools available for external exposure assessment, and (d) priority research needs. We describe major scientific and technological advances that inform external assessment of the exposome, including geographic information systems; remote sensing; global positioning system and geolocation technologies; portable and personal sensing, including smartphone-based sensors and assessments; and self-reported questionnaire assessments, which increasingly rely on Internet-based platforms. We also discuss priority research needs related to methodological and technological improvement, data analysis and interpretation, data sharing, and other practical considerations, including improved assessment of exposure variability as well as exposure in multiple, critical life stages.

Protocol evaluation for effective music therapy for persons with nonfluent aphasia.

PubMed

Kim, Mijin; Tomaino, Concetta M

2008-01-01

Although the notion of the language specificity of neural correlates has been widely accepted in the past (e.g., lefthemispheric dominance including Broca's and Wernike's area, N400 ERP component of semantic processing, and the P600 ERP component of syntactic processing, etc.), recent studies have shown that music and language share some important neurological aspects in their processing, both involving bilateral hemispheric activities. In line with this are the frequent behavioral clinical observations that persons with aphasia show improved articulation and prosody of speech in musically assisted phrases. Connecting recent neurological findings with clinical observations would not only inform clinical practice but would enhance understanding of the neurological mechanisms involved in the processing of speech/language and music. This article presents a music therapy treatment protocol study of 7 nonfluent patients with aphasia. The data and findings are discussed with regard to some of the recent focuses and issues addressed in the experimental studies using cognitive-behavioral, electrophysiological, and brain-imaging techniques.

A room with a view of integrity and professionalism: personal reflections on teaching responsible conduct of research in the neurosciences.

PubMed

Bell, Emily

2015-04-01

Neuroscientists are increasingly put into situations which demand critical reflection about the ethical and appropriate use of research tools and scientific knowledge. Students or trainees also have to know how to navigate the ethical domains of this context. At a time when neuroscience is expected to advance policy and practice outcomes, in the face of academic pressures and complex environments, the importance of scientific integrity comes into focus and with it the need for training at the graduate level in the responsible conduct of research (RCR). I describe my experience teaching RCR in a graduate neuroscience program and identify three personal reflections where further dialogue could be warranted: (1) mobilizing a common set of competencies and virtues standing for professionalism in the neurosciences; (2) tailoring RCR for the neurosciences and empowering students through the active engagement of mentors; (3) soliciting shared responsibility for RCR training between disciplines, institutions and governmental or funding agencies.

Micro-marketing healthier choices: effects of personalized ordering suggestions on restaurant purchases.

PubMed

Bedard, Kelly; Kuhn, Peter

2015-01-01

We study the effects of the Nutricate receipt, which makes personalized recommendations to switch from unhealthy to healthier items at a restaurant chain. We find that the receipts shifted the mix of items purchased toward the healthier alternatives. For example, the share of adult main dishes requesting "no sauce" increased by 6.8 percent, the share of kids' meals with apples (instead of fries) rose by 7.0 percent and the share of breakfast sandwiches without sausage increased by 3.8 percent. The results illustrate the potential of emerging information technologies, which allow retailers to tailor product marketing to individual consumers, to generate healthier choices. Copyright © 2014 Elsevier B.V. All rights reserved.

Micro-Marketing Healthier Choices: Effects of Personalized Ordering Suggestions on Restaurant Purchases

PubMed Central

Bedard, Kelly; Kuhn, Peter

2014-01-01

We study the effects of the Nutricate receipt, which makes personalized recommendations to switch from unhealthy to healthier items at a restaurant chain. We find that the receipts shifted the mix of items purchased towards the healthier alternatives. For example, the share of adult main dishes requesting “no sauce” increased by 6.8 percent, the share of kids’ meals with apples (instead of fries) rose by 7.0 percent and the share of breakfast sandwiches without sausage increased by 3.8 percent. The results illustrate the potential of emerging information technologies, which allow retailers to tailor product marketing to individual consumers, to generate healthier choices. PMID:25544398

Tragedy in moral case deliberation.

PubMed

Spronk, Benita; Stolper, Margreet; Widdershoven, Guy

2017-09-01

In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants. A case study design is used by conducting semi-structured interviews (N = 10) with health care professionals who both played a role in the treatment of the patient and attended the MCD. The results show that MCD helps people to deal with tragic situations. An important element of MCD in this respect is making explicit the dilemma and the damage, demonstrating that there is no simple solution. MCD prompts participants to formulate and share personal experiences with one another and thus helps to create a shared perception of the situation as tragic. The article concludes that MCD contributes to the sharing of tragic experiences, and fosters mutual interaction during a tragedy. Its value could be increased through explicit reflection on the aspect of contingency that characterises tragedy.

DEPRESSION AND INTERNALLY DIRECTED AGGRESSION: GENETIC AND ENVIRONMENTAL CONTRIBUTIONS

PubMed Central

Haddad, Suzanne K.; Neiderhiser, Jenae M.; Spotts, Erica L.; Ganiban, Jody; Lichtenstein, Paul; Reiss, David

2013-01-01

This study uses behavior genetic (BG) methodology to investigate Freud’s theory of depression as aggression directed toward the self (1930) and the extent to which genetically and environmentally influenced aggressive tendencies contribute to depressive symptoms. Data from the Twin and Offspring Study in Sweden (TOSS) is used to demonstrate how, in estimating shared and unique environmental influences, BG methods can inform psychoanalytic theory and practice, particularly because of their shared emphasis on the importance of individual experience in development. The TOSS sample consists of 909 pairs of adult twins, their partners, and one adolescent child per couple. The Center for Epidemiologic Studies Depression Scale (Radloff 1977) was used to measure depressive symptoms and the Karolinska Scales of Personality (Schalling and Edman 1993) to measure internally directed aggression. Genetic analyses indicated that for both men and women, their unique experiences as well as genetic factors contributed equally to the association between internally directed aggression and depressive symptoms. These findings support Freud’s theory that constitutionally based differences in aggression, along with individual experiences, contribute to a person’s depressive symptoms. Establishing that an individual’s unique, not shared, experiences and perceptions contribute to depressive symptoms and internally directed aggression reinforces the use of patient-specific treatment approaches implemented in psychoanalytic psychotherapy or psychoanalysis. PMID:18515705

Development and field testing of a consumer shared decision-making training program for adults with low literacy.

PubMed

Muscat, Danielle M; Morony, Suzanne; Shepherd, Heather L; Smith, Sian K; Dhillon, Haryana M; Trevena, Lyndal; Hayen, Andrew; Luxford, Karen; Nutbeam, Don; McCaffery, Kirsten

2015-10-01

Given the scarcity of shared decision-making (SDM) interventions for adults with low literacy, we created a SDM training program tailored to this population to be delivered in adult education settings. Formative evaluation during program development included a review of the problem and previous efforts to address it, qualitative interviews with the target population, program planning and field testing. A comprehensive SDM training program was developed incorporating core SDM elements. The program aimed to improve students' understanding of SDM and to provide them with the necessary skills (understanding probabilistic risks and benefits, personal values and preferences) and self-efficacy to use an existing set of questions (the AskShareKnow questions) as a means to engage in SDM during healthcare interactions. There is an ethical imperative to develop SDM interventions for adults with lower literacy. Generic training programs delivered direct-to-consumers in adult education settings offer promise in a national and international environment where too few initiatives exist. Formative evaluation of the program offers practical insights into developing consumer-focused SDM training. The content of the program can be used as a guide for future efforts to engage consumers in SDM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Measuring Shared Decision Making in Psychiatric Care

PubMed Central

Salyers, Michelle P.; Matthias, Marianne S.; Fukui, Sadaaki; Holter, Mark C.; Collins, Linda; Rose, Nichole; Thompson, John; Coffman, Melinda; Torrey, William C.

2014-01-01

Objective Shared decision making is widely recognized to facilitate effective health care; tools are needed to measure the level of shared decision making in psychiatric practice. Methods A coding scheme assessing shared decision making in medical settings (1) was adapted, including creation of a manual. Trained raters analyzed 170 audio recordings of psychiatric medication check-up visits. Results Inter-rater reliability among three raters for a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of nine elements of shared decision making and 100% for the overall agreement between provider and consumer. Just over half of the decisions met minimum criteria for shared decision making. Shared decision making was not related to length of visit after controlling for complexity of decision. Conclusions The shared decision making rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts. PMID:22854725

The Costs of Sharing: Attending to Contact in Composition Practices

ERIC Educational Resources Information Center

Heard, Matthew

2014-01-01

"Sharing" is a ubiquitous yet largely unexamined term in composition scholarship and practice. Scholars and teachers use the term widely to talk about practices such as peer review, collaboration, and student-teacher conferences, all of which have been used to support the relevance of composition as a social and communal act. Yet, as…

Fluency Idol: Using Pop Culture to Engage Students and Boost Fluency Skills

ERIC Educational Resources Information Center

Calo, Kristine M.; Woolard-Ferguson, Taylor; Koitz, Ellen

2013-01-01

This article shares an oral reading practice that develops children's fluency skills, with a particular emphasis on performance reading and prosody. The authors share their experiences with Fluency Idol! as a way to engage young children by tapping into pop culture. The practice emphasizes repeated readings, feedback, practice, and…

Mobile phones carry the personal microbiome of their owners

PubMed Central

Altrichter, Adam E.; Green, Jessica L.

2014-01-01

Most people on the planet own mobile phones, and these devices are increasingly being utilized to gather data relevant to our personal health, behavior, and environment. During an educational workshop, we investigated the utility of mobile phones to gather data about the personal microbiome — the collection of microorganisms associated with the personal effects of an individual. We characterized microbial communities on smartphone touchscreens to determine whether there was significant overlap with the skin microbiome sampled directly from their owners. We found that about 22% of the bacterial taxa on participants’ fingers were also present on their own phones, as compared to 17% they shared on average with other people’s phones. When considered as a group, bacterial communities on men’s phones were significantly different from those on their fingers, while women’s were not. Yet when considered on an individual level, men and women both shared significantly more of their bacterial communities with their own phones than with anyone else’s. In fact, 82% of the OTUs were shared between a person’s index and phone when considering the dominant taxa (OTUs with more than 0.1% of the sequences in an individual’s dataset). Our results suggest that mobile phones hold untapped potential as personal microbiome sensors. PMID:25024916

Enhancing Father Engagement and Interparental Teamwork in an Evidence-Based Parenting Intervention: A Randomized-Controlled Trial of Outcomes and Processes.

PubMed

Frank, Tenille J; Keown, Louise J; Sanders, Matthew R

2015-11-01

This study examined the outcomes and process in a positive parenting program adapted to enhance father engagement and teamwork. A randomized control trial of the Group Triple P Program with additional father-relevant content was conducted with 42 families of children with conduct problems aged between 3 to 8years. Families were allocated to either the intervention or waitlist condition. Assessments of child behavior, self- and partner-reported parenting, and the interparental relationship were conducted at T1 (pre), T2 (post), and T3 (6-month follow-up). Observations were used to examine fathers' and mothers' unique and shared contributions to group process during participation in parenting group sessions. Following program completion (T2) intervention group fathers and mothers reported significantly fewer child behavior problems, dysfunctional parenting practices, and interparental conflict about child-rearing than waitlist parents. Intervention group mothers also reported increased parenting confidence and rated their partners as showing significantly fewer dysfunctional parenting practices. Intervention effects were maintained at 6-month follow-up. Observational data showed that fathers and mothers made similar contributions during the group sessions. The most frequent types of contributions were asking questions and sharing information with other parents about implementing parenting strategies. The key differences between parents were fathers' more frequent use of humor and mothers' more frequent sharing of personal stories and reporting co-parenting cooperation. The levels of session attendance and program satisfaction were high for both fathers and mothers. Findings highlight the potential benefits of efforts to engage both fathers and mothers for program adherence, satisfaction, and effectiveness. Copyright © 2015. Published by Elsevier Ltd.

Identifying emotional intelligence in professional nursing practice.

PubMed

Kooker, Barbara Molina; Shoultz, Jan; Codier, Estelle E

2007-01-01

The National Center for Health Workforce Analysis projects that the shortage of registered nurses in the United States will double by 2010 and will nearly quadruple to 20% by 2015 (Bureau of Health Professionals Health Resources and Services Administration. [2002]. Projected supply, demand, and shortages of registered nurses, 2000-2020 [On-line]. Available: http:bhpr.hrsa.gov/healthworkforce/reports/rnprojects/report.htm). The purpose of this study was to use the conceptual framework of emotional intelligence to analyze nurses' stories about their practice to identify factors that could be related to improved nurse retention and patient/client outcomes. The stories reflected evidence of the competencies and domains of emotional intelligence and were related to nurse retention and improved outcomes. Nurses recognized their own strengths and limitations, displayed empathy and recognized client needs, nurtured relationships, used personal influence, and acted as change agents. Nurses were frustrated when organizational barriers conflicted with their knowledge/intuition about nursing practice, their communications were disregarded, or their attempts to create a shared vision and teamwork were ignored. Elements of professional nursing practice, such as autonomy, nurse satisfaction, respect, and the professional practice environment, were identified in the excerpts of the stories. The shortage of practicing nurses continues to be a national issue. The use of emotional intelligence concepts may provide fresh insights into ways to keep nurses engaged in practice and to improve nurse retention and patient/client outcomes.

Perspectives of the optical coherence tomography community on code and data sharing

NASA Astrophysics Data System (ADS)

Lurie, Kristen L.; Mistree, Behram F. T.; Ellerbee, Audrey K.

2015-03-01

As optical coherence tomography (OCT) grows to be a mature and successful field, it is important for the research community to develop a stronger practice of sharing code and data. A prolific culture of sharing can enable new and emerging laboratories to enter the field, allow research groups to gain new exposure and notoriety, and enable benchmarking of new algorithms and methods. Our long-term vision is to build tools to facilitate a stronger practice of sharing within this community. In line with this goal, our first aim was to understand the perceptions and practices of the community with respect to sharing research contributions (i.e., as code and data). We surveyed 52 members of the OCT community using an online polling system. Our main findings indicate that while researchers infrequently share their code and data, they are willing to contribute their research resources to a shared repository, and they believe that such a repository would benefit both their research and the OCT community at large. We plan to use the results of this survey to design a platform targeted to the OCT research community - an effort that ultimately aims to facilitate a more prolific culture of sharing.

Development of the REFOCUS intervention to increase mental health team support for personal recovery.

PubMed

Slade, Mike; Bird, Victoria; Le Boutillier, Clair; Farkas, Marianne; Grey, Barbara; Larsen, John; Leamy, Mary; Oades, Lindsay; Williams, Julie

2015-12-01

There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking. To develop a theoretically based and empirically defensible new pro-recovery manualised intervention--called the REFOCUS intervention. Seven systematic and two narrative reviews were undertaken. Identified evidence gaps were addressed in three qualitative studies. The findings were synthesised to produce the REFOCUS intervention, manual and model. The REFOCUS intervention comprises two components: recovery-promoting relationships and working practices. Approaches to supporting relationships comprise coaching skills training for staff, developing a shared team understanding of recovery, exploring staff values, a Partnership Project with people who use the service and raising patient expectations. Working practices comprise the following: understanding values and treatment preferences; assessing strengths; and supporting goal-striving. The REFOCUS model describes the causal pathway from the REFOCUS intervention to improved recovery. The REFOCUS intervention is an empirically supported pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940). © The Royal College of Psychiatrists 2015.

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study

PubMed Central

Jackson, Lovie J.; White, Catherine Roller; O'Brien, Kirk; DiLorenzo, Paul; Cathcart, Ernie; Wolf, Mary; Bruskas, Delilah; Pecora, Peter J.; Nix-Early, Vivian; Cabrera, Jorge

2014-01-01

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14–17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is ‘creator’ and God is ‘love’, and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to ‘bad or tragic things happening’ by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care. PMID:25057258

Survey of Australian practitioners' provision of healthy lifestyle advice to clients who are obese.

PubMed

Ashby, Samantha; James, Carole; Plotnikoff, Ronald; Collins, Clare; Guest, Maya; Kable, Ashley; Snodgrass, Suzanne

2012-06-01

Obesity is a global issue, with healthcare practitioners increasingly involved in clinical interactions with people who are overweight or obese. These interactions are opportunities to provide evidence-based healthy lifestyle advice, and impact on public health. This study used a cross-sectional survey of Australian healthcare practitioners to investigate what influenced the provision of healthy lifestyle advice to obese and overweight clients. A modified theory of planned behavior was used to explore knowledge translation processes. Knowledge translation was linked to three factors: (i) a healthcare practitioner's education and confidence in the currency of their knowledge; (ii) personal characteristics - whether they accepted that providing this advice was within their domain of practice; and (iii) the existence of organizational support structures, such as access to education, and best practice guidelines. To fulfill the potential role healthcare practitioners can play in the provision of evidence-based health promotion advice requires organizations to provide access to practice guidelines and to instill a belief in their workforce that this is a shared professional domain. © 2012 Blackwell Publishing Asia Pty Ltd.

Animal husbandry practices in rural Bangladesh: potential risk factors for antimicrobial drug resistance and emerging diseases.

PubMed

Roess, Amira A; Winch, Peter J; Ali, Nabeel A; Akhter, Afsana; Afroz, Dilara; El Arifeen, Shams; Darmstadt, Gary L; Baqui, Abdullah H

2013-11-01

Antimicrobial drug administration to household livestock may put humans and animals at risk for acquisition of antimicrobial drug-resistant pathogens. To describe animal husbandry practices, including animal healthcare-seeking and antimicrobial drug use in rural Bangladesh, we conducted semi-structured in-depth interviews with key informants, including female household members (n = 79), village doctors (n = 10), and pharmaceutical representatives, veterinarians, and government officials (n = 27), and performed observations at animal health clinics (n = 3). Prevalent animal husbandry practices that may put persons at risk for acquisition of pathogens included shared housing and water for animals and humans, antimicrobial drug use for humans and animals, and crowding. Household members reported seeking human and animal healthcare from unlicensed village doctors rather than formal-sector healthcare providers and cited cost and convenience as reasons. Five times more per household was spent on animal than on human healthcare. Strengthening animal and human disease surveillance systems should be continued. Interventions are recommended to provide vulnerable populations with a means of protecting their livelihood and health.

Practical multimodal care for cancer cachexia.

PubMed

Maddocks, Matthew; Hopkinson, Jane; Conibear, John; Reeves, Annie; Shaw, Clare; Fearon, Ken C H

2016-12-01

Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented. We propose multimodal care approaches that incorporate nutritional support, exercise, and anti-inflammatory agents, on a background of personalized oncology care and family-centred education. Collectively, the cases reveal that multimodal care is part of everyone's remit, often focuses on supported self-management, and demands buy-in from the patient and their family. Once operationalized, multimodal care approaches can be tested pragmatically, including alongside emerging pharmacological cachexia treatments. We demonstrate that multimodal care for cancer cachexia can be achieved using simple treatments and without a dedicated team of specialists. The sharing of advice between health professionals can help build collective confidence and expertise, moving towards a position in which every team member feels they can contribute towards multimodal care.

Public health practice course using Google Plus.

PubMed

Wu, Ting-Ting; Sung, Tien-Wen

2014-03-01

In recent years, mobile device-assisted clinical education has become popular among nursing school students. The introduction of mobile devices saves manpower and reduces errors while enhancing nursing students' professional knowledge and skills. To respond to the demands of various learning strategies and to maintain existing systems of education, the concept of Cloud Learning is gradually being introduced to instructional environments. Cloud computing facilitates learning that is personalized, diverse, and virtual. This study involved assessing the advantages of mobile devices and Cloud Learning in a public health practice course, in which Google+ was used as the learning platform, integrating various application tools. Users could save and access data by using any wireless Internet device. The platform was student centered and based on resource sharing and collaborative learning. With the assistance of highly flexible and convenient technology, certain obstacles in traditional practice training can be resolved. Our findings showed that the students who adopted Google+ were learned more effectively compared with those who were limited to traditional learning systems. Most students and the nurse educator expressed a positive attitude toward and were satisfied with the innovative learning method.

Communities of Practice: Professional Development Through Fostering Connections

NASA Astrophysics Data System (ADS)

Ali, N. A.; Raftery, C.; Shackleford, R.; Nelson, A.; Turney, D.

2015-11-01

A community of practice is a group of people informally bound together by shared expertise and passion for a joint enterprise. Through facilitated discussion, we will share best practices and research about communities of practice, and explore how they evolve as they grow. The target audience for this Special Interest Group session is Education and Public Outreach professionals who are interested in using communities of practice as a way to support the professional development of their audiences. This session will be of interest to people who want to learn more about communities of practice as well as those who are currently coordinating similar efforts. Participants will have the opportunity to share their challenges and success, as well as gain new ideas for the planning, implementation, and expansion of efforts. This session will be facilitated by the coordinators of NASA's SMD Heliophysics EPO Forum online community of practice for middle and high school science teachers.

Sharing news of a lung cancer diagnosis with adult family members and friends: a qualitative study to inform a supportive intervention.

PubMed

Ewing, Gail; Ngwenya, Nothando; Benson, John; Gilligan, David; Bailey, Susan; Seymour, Jane; Farquhar, Morag

2016-03-01

Extensive research exists on breaking bad news by clinicians. This study examines perspectives of patients and those accompanying them at diagnosis-giving of subsequently sharing news of lung cancer with adult family/friends, and views of healthcare professionals, to inform development of a supportive intervention. Qualitative interviews with 20 patients, 17 accompanying persons; focus groups and interviews with 27 healthcare professionals from four Thoracic Oncology Units. Intervention development workshops with 24 healthcare professionals and six service users with experience of sharing a cancer diagnosis. Framework thematic analysis. Patients and accompanying persons shared news of lung cancer whilst coming to terms with the diagnosis. They recalled general support from healthcare professionals but not support with sharing bad news. Six elements were identified providing a framework for a potential intervention: 1-people to be told, 2-information to be shared, 3-timing of sharing, 4-responsibility for sharing, 5-methods of telling others and 6-reactions of those told. This study identifies the challenge of sharing bad news and a potential framework to guide delivery of a supportive intervention tailored to individual needs of patients. The identified framework could extend the portfolio of guidance on communication in cancer and potentially in other life-limiting conditions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Bringing Together Community Health Centers, Information Technology and Data to Support a Patient-Centered Medical Village from the OCHIN community of solutions

PubMed Central

DeVoe, Jennifer E.; Sears, Abigail

2013-01-01

Creating integrated, comprehensive care practices requires access to data and informatics expertise. Information technology (IT) resources are not readily available to individual practices. One model of shared IT resources and learning is a “patient-centered medical village.” We describe the OCHIN Community Health Information Network as an example of this model where community practices have come together collectively to form an organization which leverages shared IT expertise, resources, and data, providing members with the means to fully capitalize on new technologies that support improved care. This collaborative facilitates the identification of “problem-sheds” through surveillance of network-wide data, enables shared learning regarding best practices, and provides a “community laboratory” for practice-based research. As an example of a Community of Solution, OCHIN utilizes health IT and data-sharing innovations to enhance partnerships between public health leaders, community health center clinicians, informatics experts, and policy makers. OCHIN community partners benefit from the shared IT resource (e.g. a linked electronic health record (EHR), centralized data warehouse, informatics and improvement expertise). This patient-centered medical village provides (1) the collective mechanism to build community tailored IT solutions, (2) “neighbors” to share data and improvement strategies, and (3) infrastructure to support EHR-based innovations across communities, using experimental approaches. PMID:23657695

Adjuvant chemotherapy for soft tissue sarcoma.

PubMed

Casali, Paolo G

2015-01-01

Adjuvant chemotherapy is not standard treatment in soft tissue sarcoma (STS). However, when the risk of relapse is high, it is an option for shared decision making with the patient in conditions of uncertainty. This is because available evidence is conflicting, even if several randomized clinical trials have been performed for 4 decades and also have been pooled into meta-analyses. Indeed, available meta-analyses point to a benefit in the 5% to 10% range in terms of survival and distant relapse rate. Some local benefit also was suggested by some trials. Placing chemotherapy in the preoperative setting may help gain a local advantage in terms of the quality of surgical margins or decreased sequelae. This may be done within a personalized approach according to the clinical presentation. Attempts to personalize treatment on the basis of the variegated pathology and molecular biology of STS subgroups are ongoing as well, according to what is done in the medical treatment of advanced STS. Thus, decision making for adjuvant and neoadjuvant indications deserves personalization in clinical research and in clinical practice, taking profit from all multidisciplinary clinical skills available at a sarcoma reference center, though with a degree of subjectivity because of the limitations of available evidence.

RUDO: A Home Ambient Intelligence System for Blind People

PubMed Central

Hudec, Milan

2017-01-01

The article introduces an ambient intelligence system for blind people which besides providing assistance in home environment also helps with various situations and roles in which blind people may find themselves involved. RUDO, the designed system, comprises several modules that mainly support or ensure recognition of approaching people, alerting to other household members’ movement in the flat, work on a computer, supervision of (sighted) children, cooperation of a sighted and a blind person (e.g., when studying), control of heating and zonal regulation by a blind person. It has a unified user interface that gives the blind person access to individual functions. The interface for blind people offers assistance with work on a computer, including writing in Braille on a regular keyboard and specialized work in informatics and electronics (e.g., programming). RUDO can complement the standard aids used by blind people at home, it increases their independence and creates conditions that allow them to become fully involved. RUDO also supports blind people sharing a home with sighted people, which contributes to their feeling of security and greater inclusion in society. RUDO has been implemented in a household for two years, which allows an evaluation of its use in practice. PMID:28829372

RUDO: A Home Ambient Intelligence System for Blind People.

PubMed

Hudec, Milan; Smutny, Zdenek

2017-08-22

The article introduces an ambient intelligence system for blind people which besides providing assistance in home environment also helps with various situations and roles in which blind people may find themselves involved. RUDO, the designed system, comprises several modules that mainly support or ensure recognition of approaching people, alerting to other household members' movement in the flat, work on a computer, supervision of (sighted) children, cooperation of a sighted and a blind person (e.g., when studying), control of heating and zonal regulation by a blind person. It has a unified user interface that gives the blind person access to individual functions. The interface for blind people offers assistance with work on a computer, including writing in Braille on a regular keyboard and specialized work in informatics and electronics (e.g., programming). RUDO can complement the standard aids used by blind people at home, it increases their independence and creates conditions that allow them to become fully involved. RUDO also supports blind people sharing a home with sighted people, which contributes to their feeling of security and greater inclusion in society. RUDO has been implemented in a household for two years, which allows an evaluation of its use in practice.

Recovery in Scotland: Beyond service development

PubMed Central

2012-01-01

Over the last ten years there has been significant activity related to the promotion and support of recovery in Scotland, much of it linked to the work of the Scottish Recovery Network. A range of government policies have consistently identified recovery as a guiding principle of both service design and mental health improvement efforts. New learning has been developed and shared, workforce competencies reviewed and training developed, and a range of national initiatives put in place. In Scotland, as elsewhere, these efforts have tended to focus primarily on ensuring that mental health services offer environments and practices that support personal recovery. While service improvement is crucial, a wider challenge is ensuring that opportunities and support for self-directed recovery are enhanced outside statutory services. Providing examples, this paper will look at the development of recovery in Scotland – including the work of the Scottish Recovery Network – and consider the potential for building on progress made by rebalancing efforts to support personal recovery, highlighting the importance of public attitudes and community-based learning approaches. We will also touch on the role of identity in personal recovery and consider cultural issues related to the promotion of recovery in Scotland. PMID:22385428

Politics, policy and payment--facilitators or barriers to person-centred rehabilitation?

PubMed

Turner-Stokes, Lynne

This paper explores the tensions between politics and payment in providing affordable services that satisfy the public demand for patient-centred care. The two main approaches taken by the UK Government to curtail the spiralling costs of healthcare have been to focus development in priority areas and to cap spending through the introduction of a fixed-tariff episode-based funding system. The National Service Framework for Long Term Neurological Conditions embraces many laudable principles of person-centred management, but the 'one-size-fits all' approach to reimbursement potentially cuts right across these. A series of tools have been developed to determine complexity of rehabilitation needs that will support the development of banded tariffs. A practical approach is also offered to demonstrate the cost-efficiency of rehabilitation services for people with complex needs, and help to ensure that they are not excluded from treatment because of their higher treatment costs. Whilst responding to public demand for person-centred care, we must recognize the current financial pressure on healthcare systems. Clinicians will have greater credibility if they routinely collect and share outcomes that demonstrate the economic benefits of intervention, as well the impact on health, function and quality of life.