Quota sampling in internet research: practical issues.

PubMed

Im, Eun-Ok; Chee, Wonshik

2011-07-01

Quota sampling has been suggested as a potentially good method for Internet-based research and has been used by several researchers working with Internet samples. However, very little is known about the issues or concerns in using a quota sampling method in Internet research. The purpose of this article was to present the practical issues using quota sampling in an Internet-based study. During the Internet study, the research team recorded all recruitment issues that arose and made written notes indicating the possible reasons for the problems. In addition, biweekly team discussions were conducted for which written records were kept. Overall, quota sampling was effective in ensuring that an adequate number of midlife women were recruited from the targeted ethnic groups. However, during the study process, we encountered the following practical issues using quota sampling: (1) difficulty reaching out to women in lower socioeconomic classes, (2) difficulty ensuring authenticity of participants' identities, (3) participants giving inconsistent answers for the screening questions versus the Internet survey questions, (4) potential problems with a question on socioeconomic status, (5) resentment toward the research project and/or researchers because of rejection, and (6) a longer time and more expense than anticipated.

Socioeconomic status and oppositional defiant disorder in preschoolers: parenting practices and executive functioning as mediating variables.

PubMed

Granero, Roser; Louwaars, Leonie; Ezpeleta, Lourdes

2015-01-01

To investigate the mediating mechanisms of oppositional defiant disorder (ODD) in preschoolers through pathways analysis, considering the family socioeconomic status (SES) as the independent variable and the parenting style and the children's executive functioning (EF) as the mediating factors. The sample included 622 three-year-old children from the general population. Multi-informant reports from parents and teachers were analyzed. Structural Equation Modeling showed that the associations between SES, EF, parenting style and ODD levels differed by children's gender: (a) for girls, the association of low SES and high ODD scores was partially mediated by difficulties in EF inhibition, and parenting practices defined by corporal punishment and inconsistent discipline obtained a quasi-significant indirect effect into the association between SES and ODD; (b) for boys, SES and EF (inhibition and emotional control) had a direct effect on ODD with no mediation. SES seems a good indicator to identify children at high-risk for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition control.

Patient difficulty using tablet computers to screen in primary care.

PubMed

Hess, Rachel; Santucci, Aimee; McTigue, Kathleen; Fischer, Gary; Kapoor, Wishwa

2008-04-01

Patient-administered computerized questionnaires represent a novel tool to assist primary care physicians in the delivery of preventive health care. The aim of this study was to assess patient-reported ease of use with a self-administered tablet computer-based questionnaire in routine clinical care. All patients seen in a university-based primary care practice were asked to provide routine screening information using a touch-screen tablet computer-based questionnaire. Patients reported difficulty using the tablet computer after completion of their first questionnaire. Ten thousand nine hundred ninety-nine patients completed the questionnaire between January 2004 and January 2006. We calculated rates of reporting difficulty (no difficulty, some difficulty, or a lot of difficulty) using the tablet computers based on patient age, sex, race, educational attainment, marital status, and number of comorbid medical conditions. We constructed multivariable ordered logistic models to identify predictors of increased self-reported difficulty using the computer. The majority of patients (84%) reported no difficulty using the tablet computers to complete the questionnaire, with only 3% reporting a lot of difficulty. Significant predictors of reporting more difficulty included increasing age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.05-1.05)]; Asian race (OR 2.3, 95% CI 1.8-2.9); African American race (OR 1.4, 95% CI 1.2-1.6); less than a high school education (OR 3.0, 95% CI 2.6-3.4); and the presence of comorbid medical conditions (1-2: OR 1.3, 95% CI 1.2-1.5; > or =3: OR 1.7 95% CI 1.5-2.1). The majority of primary care patients reported no difficulty using a self-administered tablet computer-based questionnaire. While computerized questionnaires present opportunities to collect routine screening information from patients, attention must be paid to vulnerable groups.

An independent Cepheid distance scale: Current status

NASA Technical Reports Server (NTRS)

Barnes, T. G., III

1980-01-01

An independent distance scale for Cepheid variables is discussed. The apparent magnitude and the visual surface brightness, inferred from an appropriate color index, are used to determine the angular diameter variation of the Cepheid. When combined with the linear displacement curve obtained from the integrated radial velocity curve, the distance and linear radius are determined. The attractiveness of the method is its complete independence of all other stellar distance scales, even though a number of practical difficulties currently exist in implementing the technique.

Learner-controlled practice difficulty in the training of a complex task: cognitive and motivational mechanisms.

PubMed

Hughes, Michael G; Day, Eric Anthony; Wang, Xiaoqian; Schuelke, Matthew J; Arsenault, Matthew L; Harkrider, Lauren N; Cooper, Olivia D

2013-01-01

An inherent aspect of learner-controlled instructional environments is the ability of learners to affect the degree of difficulty faced during training. However, research has yet to examine how learner-controlled practice difficulty affects learning. Based on the notion of desirable difficulties (Bjork, 1994), this study examined the cognitive and motivational antecedents and outcomes of learner-controlled practice difficulty in relation to learning a complex task. Using a complex videogame involving both strong cognitive and psychomotor demands, 112 young adult males were given control over their practice difficulty, which was reflected in the complexity of the training task. Results show that general mental ability, prior experience, pre-training self-efficacy, and error encouragement were positively related to learner-controlled practice difficulty. In turn, practice difficulty was directly related to task knowledge and post-training performance, and it was related to adaptive performance through the mediating influences of task knowledge and post-training performance. In general, this study supports the notion that training difficulty operationalized in terms of task complexity is positively related to both knowledge and performance outcomes. Results are discussed with respect to the need for more research examining how task complexity and other forms of difficulty could be leveraged to advance learner-controlled instructional practices. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Determining the pregnancy status of patients before diagnostic nuclear medicine procedures: the Australian experience.

PubMed

James, Daphne J; Cardew, Paul; Warren-Forward, Helen M

2011-09-01

Ionizing radiation used in diagnostic nuclear medicine procedures has the potential to have biologic effects on a fetus. Nuclear medicine technologists (NMTs) therefore have a responsibility to ensure that they question all patients of childbearing age about their pregnancy status before starting any procedure, to avoid unnecessary fetal irradiation. In Australia, there are no clearly defined practice guidelines to assist NMTs in determining whom to question or how to question their patients. Semistructured interviews were conducted with chief NMTs and staff NMTs in 8 nuclear medicine departments in Australia. Questions were based around 5 areas: regulations and policy, fetal radiation exposure, questioning of the patient, difficulties in determining pregnancy status, and the impact of the use of hybrid imaging. Audio files of the interviews were transcribed and coded. Topics were coded into 5 themes: policy and awareness of guidelines, questioning the patient, radiation knowledge, decisions and assumptions made by NMTs, and the use of pregnancy testing. There was a wide variation in practice between and within departments. NMTs demonstrated a lack of knowledge and awareness of the possible biologic effects of radiation. This study identified a need in Australia for nuclear medicine to arrive at a consensus approach to verifying a patient's pregnancy status so that NMTs can successfully question patients about their pregnancy status. Continuing education programs are also required to keep NMTs up to date in their knowledge.

A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions

PubMed Central

2011-01-01

Background This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. Methods Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. Results Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. Conclusions Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. PMID:21787394

Self reported behavioral and emotional difficulties in relation to dentition status among school going children of Dilsukhnagar, Hyderabad, India.

PubMed

Srilatha, Adepu; Doshi, Dolar; Reddy, Madupu Padma; Kulkarni, Suhas; Reddy, Bandari Srikanth

2016-01-01

Oral health has strong biological, psychological, and social projections, which influence the quality of life. Thus, developing a common vision and a comprehensive approach to address children's social, emotional, and behavioral health needs is an integral part of the child and adolescent's overall health. To assess and compare the behavior and emotional difficulties among 15-year-olds and to correlate it with their dentition status based on gender. Study Settings and Design: A cross-sectional questionnaire study among 15-year-old schoolgoing children in six private schools in Dilsukhnagar, Hyderabad, India. The behavior and emotional difficulties were assessed using self-reported Strengths and Difficulties Questionnaire (SDQ). The dentition status was recorded by the criteria given by the World Health Organization (WHO) in the Basic Oral Health Survey Assessment Form (1997). Independent Student's t-test was used for comparison among the variables. Correlation between scales of SDQ and dentition status was done using Karl Pearson's correlation coefficient method. Girls reported more emotional problems and good prosocial behavior and males had more conduct problems, hyperactivity, peer problems, and total difficulty problems. Total decayed-missing-filled teeth (DMFT) and decayed component were significantly and positively correlated with total difficulty, emotional symptom, and conduct problems scale while missing component was correlated with the hyperactivity scale and filled component with prosocial behavior. DMFT and its components showed an association with all scales of SDQ except for peer problem scale. Thus, the oral health of children was significantly influenced by behavioral and emotional difficulties; so, changes in the mental health status will affect the oral health of children.

Remediating Number Combination and Word Problem Deficits Among Students With Mathematics Difficulties: A Randomized Control Trial

PubMed Central

Fuchs, Lynn S.; Powell, Sarah R.; Seethaler, Pamela M.; Cirino, Paul T.; Fletcher, Jack M.; Fuchs, Douglas; Hamlett, Carol L.; Zumeta, Rebecca O.

2009-01-01

The purposes of this study were to assess the efficacy of remedial tutoring for 3rd graders with mathematics difficulty, to investigate whether tutoring is differentially efficacious depending on students’ math difficulty status (mathematics difficulty alone vs. mathematics plus reading difficulty), to explore transfer from number combination (NC) remediation, and to examine the transportability of the tutoring protocols. At 2 sites, 133 students were stratified on mathematics difficulty status and site and then randomly assigned to 3 conditions: control (no tutoring), tutoring on automatic retrieval of NCs (i.e., Math Flash), or tutoring on word problems with attention to the foundational skills of NCs, procedural calculations, and algebra (i.e., Pirate Math). Tutoring occurred for 16 weeks, 3 sessions per week and 20–30 min per session. Math Flash enhanced fluency with NCs with transfer to procedural computation but without transfer to algebra or word problems. Pirate Math enhanced word problem skill as well as fluency with NCs, procedural computation, and algebra. Tutoring was not differentially efficacious as a function of students’ mathematics difficulty status. The tutoring protocols proved transportable across sites. PMID:19865600

The views and experiences of female GPs on professional practice and career support.

PubMed

Wedderburn, Clare; Scallan, Samantha; Whittle, Clare; Curtis, Anthony

2013-09-01

National GP demographic data demonstrate an increasing 'feminisation' of the workforce. With female GP specialty trainees continuing to outnumber males, this trend is set to continue. The changing composition of the workforce presents challenges in terms of how best to support the long-term career and educational development needs of this sector of the workforce in an evolving healthcare context. The aim of this work was to capture female GPs' experiences of working in general practice and their expectations concerning their career and educational development. Participants were surveyed and completed a semi-structured questionnaire, which generated qualitative and quantitative data. The sample comprised GP registrars, principals and sessionals. This study has generated an important dataset on working patterns, educational experiences and long-term career intentions of female GPs. Despite increased representation in the GP workforce, female GPs (particularly those with young children) appear less likely to be involved in education and training than their male counterparts, and even less likely to be involved in roles linked to primary care trusts, medico-political issues, hospital service delivery, special clinical interests or deanery education management. younger GPs reported significantly more difficulties in managing their childcare needs than older colleagues. Marital status, number of children and employment status did not moderate the effect of these difficulties. Female GPs reported working more hours with increasing age, but were not necessarily represented in a range of educational and/or training posts as a consequence.

Neurocognitive complaints and functional status among patients with chronic fatigue syndrome and fibromyalgia.

PubMed

Schmaling, Karen B; Betterton, Karran L

2016-05-01

The purpose of this study was to conduct a longitudinal examination of cognitive complaints and functional status in patients with chronic fatigue syndrome (CFS) alone and those who also had fibromyalgia (CFS/FM). A total of 93 patients from a tertiary care fatigue clinic were evaluated on four occasions, each 6 months apart. Each evaluation included a tender point assessment, and self-reported functional status and cognitive complaints. Patients with CFS/FM reported significantly worse physical functioning, more bodily pain, and more cognitive difficulties (visuo-perceptual ability and verbal memory) than patients with CFS alone. Over time, bodily pain decreased only for participants with CFS alone. Verbal memory problems were associated with more bodily pain for both patient groups, whereas visuo-perceptual problems were associated with worse functional status for patients with CFS alone. This study adds to the literature on functional status, longitudinal course, and cognitive difficulties among patients with CFS and those with CFS and FM. The results suggest that patients with CFS/FM are more disabled, have more cognitive complaints, and improve more slowly over time than patients with CFS alone. Specific cognitive difficulties are related to worse functional status, which supports the addition of cognitive difficulties to the FM case criteria.

Sexual function and practice in elderly men of lower socioeconomic status.

PubMed

Cogen, R; Steinman, W

1990-08-01

Normal aging plus certain prevalent diseases are believed to render many elderly men impotent. Recent studies have suggested that educated middle-class and upper-class elderly men continue sexual activity, despite erectile dysfunction, by employing alternative practices such as mutual masturbation and oral sex. Few elderly men of lower socioeconomic background have been included in these studies, however. Using physician-administered interviews, 87 men attending an urban Veterans Administration geriatric clinic were studied to determine (1) the prevalence of erectile dysfunction, and (2) the sexual practices and attitudes of this group. Of the 87 men, 28% reported complete loss of erectile function, while 31% had frequent difficulties achieving vaginal intromission. Unlike economically advantaged groups, only 29% used mutual masturbation and 16% used oral sex. Attitudes toward these practices were negative. With one exception, men unable to perform coitus ceased all heterosexual activities.

Nominal and functional task difficulty in skill acquisition: Effects on performance in two tests of transfer.

PubMed

Sanli, Elizabeth A; Lee, Timothy D

2015-06-01

The influence of nominal and functional task difficulty during the acquisition of a motor skill was examined in two tests of transfer of learning. The task involved a ballistic, target-directed, finger action. Nominal task difficulty was defined as the distance of the target from the home position. Functional task difficulty was created by manipulating the progression of target distances during practice. Based on the challenge point framework (Guadagnoli & Lee, 2004), we predicted that practice with a set of targets farther away from the performer would benefit from less functional task difficulty, while practice with a closer set of targets would benefit from more functional task difficulty. In single-task transfer tests, learners who practiced using the high nominal task difficulty targets benefitted in terms of persistence of performance over time. In dual-task transfer tests, groups with an intermediate combined (nominal and functional) task difficulty performed with greater persistence over time on tests of transfer than those who practiced with the highest or lowest combined difficulty. Together these findings suggest that the influences of nominal and functional task difficulty during acquisition are weighted differentially depending upon the transfer test context. The challenge point framework does not accurately capture this complex relationship in its current form. Copyright © 2015 Elsevier B.V. All rights reserved.

Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders.

PubMed

Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle

2016-10-01

Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were assessed for ASD at 3-years. Parent stress and proband mental health difficulties predicted concurrent toddler mental health difficulties at 2-years, but only baseline proband internalising problems continued to predict toddler internalising problems at 3-years; high-risk status did not confer additional risk. Baseline toddler mental health difficulties robustly predicted later difficulties, while high-risk status and diagnostic outcome conferred no additional risk. A family systems perspective may be useful for understanding toddler mental health difficulties.

A prospective multipractice investigation of patients with full-thickness rotator cuff tears: the importance of comorbidities, practice, and other covariables on self-assessed shoulder function and health status.

PubMed

Harryman, Douglas T; Hettrich, Carolyn M; Smith, Kevin L; Campbell, Barry; Sidles, John A; Matsen, Frederick A

2003-04-01

Rotator cuff tears are among the most common conditions of the shoulder. One of the major difficulties in studying patients with rotator cuff tears is that the clinical expression of these tears varies widely and different practices may have substantially different patient populations. The goals of the present prospective multipractice study were to use patient self-assessment questionnaires (1) to identify some of the characteristics of patients with rotator cuff tears, other than the size of the cuff tear, that are correlated with shoulder function, and (2) to determine whether there are significant differences in these characteristics among patients from the practices of different surgeons. Ten surgeons enrolled a total of 333 patients with a full-thickness tear of the supraspinatus tendon into this prospective study. Each patient completed self-assessment questionnaires that included items regarding demographic characteristics, prior treatment, medical and social comorbidities, general health status, and shoulder function. As expected, patients who had an infraspinatus tendon tear as well as a supraspinatus tendon tear had significantly worse ability to use the arm overhead compared with those who had a supraspinatus tear alone (p < 0.005). However, shoulder function and health status were correlated with patient characteristics other than the size of the rotator cuff tear. The number of shoulder functions that were performable was correlated with the subscales of the Short Form-36 and was inversely associated with medical and social comorbidities. The patients from the ten different surgeon practices showed significant differences in almost every parameter, including age, gender, method of tear documentation, tear size, prior treatment, medical and social comorbidities, general health status, and shoulder function. Clinical studies on the natural history of rotator cuff tears and the effectiveness of treatment must control for a wide range of variables, many of which do not pertain directly to the shoulder. Patients from the practices of different surgeons cannot be assumed to be similar with respect to these variables. Patient self-assessment questionnaires appear to offer a practical method of uniform assessment across different practices.

Learner-Controlled Practice Difficulty in the Training of a Complex Task: Cognitive and Motivational Mechanisms

ERIC Educational Resources Information Center

Hughes, Michael G.; Day, Eric Anthony; Wang, Xiaoqian; Schuelke, Matthew J.; Arsenault, Matthew L.; Harkrider, Lauren N.; Cooper, Olivia D.

2013-01-01

An inherent aspect of learner-controlled instructional environments is the ability of learners to affect the degree of difficulty faced during training. However, research has yet to examine how learner-controlled practice difficulty affects learning. Based on the notion of "desirable difficulties" (Bjork, 1994), this study examined the…

Spelling errors among children with ADHD symptoms: the role of working memory.

PubMed

Re, Anna Maria; Mirandola, Chiara; Esposito, Stefania Sara; Capodieci, Agnese

2014-09-01

Research has shown that children with attention deficit/hyperactivity disorder (ADHD) may present a series of academic difficulties, including spelling errors. Given that correct spelling is supported by the phonological component of working memory (PWM), the present study examined whether or not the spelling difficulties of children with ADHD are emphasized when children's PWM is overloaded. A group of 19 children with ADHD symptoms (between 8 and 11 years of age), and a group of typically developing children matched for age, schooling, gender, rated intellectual abilities, and socioeconomic status, were administered two dictation texts: one under typical conditions and one under a pre-load condition that required the participants to remember a series of digits while writing. The results confirmed that children with ADHD symptoms have spelling difficulties, produce a higher percentages of errors compared to the control group children, and that these difficulties are enhanced under a higher load of PWM. An analysis of errors showed that this holds true, especially for phonological errors. The increased errors in the PWM condition was not due to a tradeoff between working memory and writing, as children with ADHD also performed more poorly in the PWM task. The theoretical and practical implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of Functional Status on the Quality of Bowel Preparation in Elderly Patients Undergoing Screening and Surveillance Colonoscopy

PubMed Central

Kumar, Akash; Lin, Lisa; Bernheim, Oren; Bagiella, Emilia; Jandorf, Lina; Itzkowitz, Steven H.; Shah, Brijen J.

2016-01-01

Background/Aims Optimal bowel preparation is essential for successful screening or for surveillance colonoscopy (SC). Inadequate bowel preparation is associated with older age, the male gender, and the presence of certain comorbidities. However, the association between patients’ functional status and bowel preparation quality has not been studied. We prospectively examined the relationship between functional status, namely, the ability to perform activities of daily living (ADLs) and ambulate, and the quality of bowel preparation in elderly patients undergoing SC. Methods Before undergoing SC, 88 elderly patients were surveyed regarding their functional status, specifically regarding their ability to perform ADLs and ambulate a quarter of a mile. Gastroenterologists then determined the quality of the bowel preparation, which was classified as either adequate or inadequate. Then, the frequency of inadequate bowel preparation in patients who did or did not experience difficulty performing ADLs and ambulating was calculated. Results Difficulty ambulating (unadjusted odds ratio [OR], 4.83; p<0.001), difficulty performing ADLs (OR, 2.93; p=0.001), and history of diabetes (OR, 2.88; p=0.007) were significant univariate predictors of inadequate bowel preparation. After adjusting for the above variables, only difficulty ambulating (adjusted OR, 5.78; p=0.004) was an independent predictor of inadequate bowel preparation. Conclusions Difficulty with ambulation is a strong predictor of inadequate bowel preparation in elderly patients undergoing SC. PMID:27021501

Impact of Psychosocial Environment on Young Children's Emotional and Behavioral Difficulties.

PubMed

Grazuleviciene, Regina; Andrusaityte, Sandra; Petraviciene, Inga; Balseviciene, Birute

2017-10-24

Objective: The impact of maternal psychosocial stress on young children's mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4-6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children's mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4-6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51-3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children's emotional and behavioral difficulties.

Urology training in the developing world: The trainees’ perspective in Kurdistan, Iraq

PubMed Central

Friad, Goran; Sabah, Kawa; Ameen, Ismaeel Hama

2013-01-01

Objective To analyse the advanced systems of urology residency in the developed world, to compare them to a system in the developing world, and thereby identify the shortcomings and make recommendations to improve residency programmes for urology in the Kurdistan Region of Iraq. Methods A survey was conducted amongst the urology Residents (55) in the three governorates of the Kurdistan Region of Iraq, to assess the accessibility of the training programme, the types of the residency programmes, skills acquisition, the use of modern technology for teaching and assessment, the environment of the settings of practice, and the status of research in their training. Results An overwhelming majority (88%) of trainees reported difficulty in securing a training position. A high proportion (43%) felt disappointed at the beginning of their training. There is no unified curriculum of training, and more than two-thirds of the respondents reported a lack of a proper evidence-based medical education. There is no formal subspecialty training programme. Of the respondents, 65% referred to the difficulties in the environment for training, and that there was a low level of research involvement (12%). Conclusions Urology training is not easily accessible, there is no unified programme of residency, there are limited facilities, and a minimal assessment of practical skills. The environment for practice needs enormous improvements and a strong foundation for research should be created. PMID:26019913

Urology training in the developing world: The trainees' perspective in Kurdistan, Iraq.

PubMed

Friad, Goran; Sabah, Kawa; Ameen, Ismaeel Hama

2014-03-01

To analyse the advanced systems of urology residency in the developed world, to compare them to a system in the developing world, and thereby identify the shortcomings and make recommendations to improve residency programmes for urology in the Kurdistan Region of Iraq. A survey was conducted amongst the urology Residents (55) in the three governorates of the Kurdistan Region of Iraq, to assess the accessibility of the training programme, the types of the residency programmes, skills acquisition, the use of modern technology for teaching and assessment, the environment of the settings of practice, and the status of research in their training. An overwhelming majority (88%) of trainees reported difficulty in securing a training position. A high proportion (43%) felt disappointed at the beginning of their training. There is no unified curriculum of training, and more than two-thirds of the respondents reported a lack of a proper evidence-based medical education. There is no formal subspecialty training programme. Of the respondents, 65% referred to the difficulties in the environment for training, and that there was a low level of research involvement (12%). Urology training is not easily accessible, there is no unified programme of residency, there are limited facilities, and a minimal assessment of practical skills. The environment for practice needs enormous improvements and a strong foundation for research should be created.

Value of supervised learning events in predicting doctors in difficulty.

PubMed

Patel, Mumtaz; Agius, Steven; Wilkinson, Jack; Patel, Leena; Baker, Paul

2016-07-01

In the UK, supervised learning events (SLE) replaced traditional workplace-based assessments for foundation-year trainees in 2012. A key element of SLEs was to incorporate trainee reflection and assessor feedback in order to drive learning and identify training issues early. Few studies, however, have investigated the value of SLEs in predicting doctors in difficulty. This study aimed to identify principles that would inform understanding about how and why SLEs work or not in identifying doctors in difficulty (DiD). A retrospective case-control study of North West Foundation School trainees' electronic portfolios was conducted. Cases comprised all known DiD. Controls were randomly selected from the same cohort. Free-text supervisor comments from each SLE were assessed for the four domains defined in the General Medical Council's Good Medical Practice Guidelines and each scored blindly for level of concern using a three-point ordinal scale. Cumulative scores for each SLE were then analysed quantitatively for their predictive value of actual DiD. A qualitative thematic analysis was also conducted. The prevalence of DiD in this sample was 6.5%. Receiver operator characteristic curve analysis showed that Team Assessment of Behaviour (TAB) was the only SLE strongly predictive of actual DiD status. The Educational Supervisor Report (ESR) was also strongly predictive of DiD status. Fisher's test showed significant associations of TAB and ESR for both predicted and actual DiD status and also the health and performance subtypes. None of the other SLEs showed significant associations. Qualitative data analysis revealed inadequate completion and lack of constructive, particularly negative, feedback. This indicated that SLEs were not used to their full potential. TAB and the ESR are strongly predictive of DiD. However, SLEs are not being used to their full potential, and the quality of completion of reports on SLEs and feedback needs to be improved in order to better identify and manage DiD. © 2016 John Wiley & Sons Ltd.

[Assessing the Current Status of Enhanced Recovery after Surgery in the Usage of Web-based Survey Questionnaires by Thoracic Surgeons and Nurses Attending the Meeting in Mainland China].

PubMed

Du, Na; Guo, Chenglin; Yang, Mei; Ji, Yanli; Wang, Wei; Li, Jie; Li, Chuan; Liu, Lunxu; Che, Guowei

2017-03-20

Though the concept of enhanced recovery after surgery (ERAS) has been progressively known by the surgeons and applied clinically, the current status of its cognition among thoracic surgeons and application in thoracic surgery is still unknown. Based on the analysis of a survey of thoracic surgeons and nurses on chest ERAS during a national conference, we aimed to analyze the status and difficulties of the application of ERAS in thoracic surgery. A total of 773 questionnaires were collected during the first West China chest ERAS Forum and analyzed. The content of the questionnaire can be divided into two parts, including the respondents' institute and personal information, 10 questions on ERAS. (1) Current status of clinical application of ERAS is the concept rather than the practice: 69.6% of the surgeons and 58.7% of the nurses agreed with this view; in addition, 88.5% of the doctors and 85.7% of the nurses believed that the concept of ERAS may be applicable to every branches of surgery; (2) 55.6% of the doctors and 69.1% of the nurses believed that the reason of poor clinical application of ERAS included no mature procedure, lack of consensus and specifications; (3) The best team for the clinical practice of ERAS should be based on surgeon-centered multidisciplinary cooperation and integration of medical care: 62.1% of the surgeons and 70.7% of nurses agreed with this view; (4) 73.7% of the surgeons and 81.9% of the nurses agreed that mean hospital stay, patients' experience in hospital and social satisfaction should be the evaluation standard of ERAS practice. The application of ERAS in thoracic surgery is still the concept rather than the practice. The reason included the lack of clinical applicable specifications and scheme.

Men's experiences of sexuality after cancer: a material discursive intra-psychic approach.

PubMed

Gilbert, Emilee; Ussher, Jane M; Perz, Janette; Wong, W K Tim; Hobbs, Kim; Mason, Catherine

2013-01-01

Men can experience significant changes to their sexuality following the onset of cancer. However, research on men's sexuality post-cancer has focused almost exclusively on those with prostate and testicular cancer, despite evidence that the diagnosis and treatment for most cancers can impact on men's sexuality. This Australian qualitative study explores the experiences of changes to sexuality for 21 men across a range of cancer types and stages, sexual orientations and relationship contexts. Semi-structured interviews were analysed with theoretical thematic analysis guided by a material discursive intra-psychic approach, recognising the materiality of sexual changes, men's intrapsychic experience of such changes within a relational context and the influence of the discursive construction of masculine sexuality. Material changes included erectile difficulty, decreased desire, and difficulty with orgasm. The use of medical aids to minimise the impact of erectile difficulties was shaped by discursive constructions of 'normal' masculine sexuality. The majority of men reported accepting the changes to their sexuality post-cancer and normalised them as part of the natural ageing process. Men's relationship status and context played a key role managing the changes to their sexuality. We conclude by discussing the implications for clinical practice.

Eating difficulties among stroke patients in the acute state: a descriptive, cross-sectional, comparative study.

PubMed

Medin, Jörgen; Windahl, Jenny; von Arbin, Magnus; Tham, Kerstin; Wredling, Regina

2011-09-01

To examine eating difficulties among stroke patients - a comparison between women and men. Gender differences have been reported in studies of stroke, but the findings are inconclusive and few of these studies have specifically focused on gender differences in eating difficulties. This study was a descriptive, cross-sectional, comparative study. Patients with stroke were recruited at a general hospital in Sweden. To detect eating difficulties, individual observations of the patients were made during one meal using a structured observation protocol. Assessment also included measurements of nutritional and oral status, degree of independence, stroke severity, neglect and well-being. One hundred and four patients (53·8% women) were included in the study. The proportion of stroke patients with one or more eating difficulties was 81·7%. The most common eating difficulties were 'managing food on the plate' (66·3%), 'food consumption' (54·8%) and 'sitting position' (45·2%). Women had lower 'food consumption', more severe stroke (p = 0·003), worse functional status (p = 0·001) and lower quality of life (QoL) (p=0·038) than men. More women than men were malnourished and living alone. After adjustment for functional status and motor arm, the odds ratio of having difficulties with food consumption was four times higher among women than men (1·7-9·4, confidence interval 95%). More women than men with stroke suffered from inadequate food consumption. The women had more severe strokes, experienced poorer QoL and showed lower functional status than the men. In the rehabilitation process of women with stroke, these factors should be taken into consideration. Structured observation of meals, including assessment of food consumption, might be necessary in acute stroke care to detect patients, especially women, who might need closer supervision and nutritional intervention. © 2011 Blackwell Publishing Ltd.

Impact of ethnicity, violence and acculturation on displaced migrants: psychological distress and psychosomatic complaints among refugees in Sweden.

PubMed

Sundquist, J; Bayard-Burfield, L; Johansson, L M; Johansson, S E

2000-06-01

This study uses data collected in 1996 by the Swedish National Board of Health and Welfare. By means of interviews with 1980 foreign-born immigrants, an attempt was made to determine the impact of a) migration status (country of birth/ethnicity), b) exposure to violence, c) Antonovsky's sense of coherence, d) acculturation status (knowledge of Swedish), e) sense of control over one's life, f) economic difficulties, and g) education, both on psychological distress (using General Health Questionnaire 12) and psychosomatic complaints (daytime fatigue, sleeping difficulties, and headache/migraine). Iranians and Chileans (age-adjusted) were at great risk for psychological distress as compared with Poles, whereas Turks and Kurds exhibited no such risk. When the independent factors were included in the model, the migration status effect decreased to insignificance (with the exception of Iranian men). A low sense of coherence, poor acculturation (men only), poor sense of control, and economic difficulties were strongly associated with the outcomes, generally accounting for a convincing link between migration status and psychological distress. Furthermore, a low sense of coherence, poor acculturation (men only), poor sense of control, and economic difficulties in exile seemed to be stronger risk factors for psychological distress in this group than exposure to violence before migration.

Assessment of Pragmatic Difficulties and Socioemotional Adjustment in Practice

ERIC Educational Resources Information Center

Farmer, Marion; Oliver, Alice

2005-01-01

Background: In professional practice, psychologists and other professionals such as therapists and teachers receive referrals of many children who present with social, emotional and behavioural difficulties that are difficult to understand and assess. The problems of some of these children may stem from pragmatic difficulties in communication.…

Impact of obesity on body image dissatisfaction and social integration difficulty in adolescent and young adult burn injury survivors

PubMed Central

Chondronikola, Maria; Sidossis, Labros S.; Richardson, Lisa M.; Temple, Jeff R.; van den Berg, Patricia A.; Herndon, David N.; Meyer, Walter J.

2012-01-01

Objective Burn injury deformities and obesity have been associated with social integration difficulty and body image dissatisfaction. However, the combined effects of obesity and burn injury in social integration difficulty and body image dissatisfaction are unknown. Methods Adolescent and young adults burn injury survivors were categorized as normal weight (n=47) or overweight and obese (n=21). Burn-related and anthropometric information was obtained from patients' medical records, while validated questionnaires were used to assess the main outcomes and possible confounders. Analysis of covariance and multiple linear regressions were performed to evaluate the objectives of this study. Results Obese and overweight burn injury survivors did not experience increased body image dissatisfaction (12 ± 4.3 vs 13.1 ± 4.4, p = 0.57) or social integration difficulty (17.5 ± 6.9 vs 15.5 ± 5.7, p=0.16) compared to normal weight burn injury survivors. Weight status was not a significant predictor of social integration difficulty or body image dissatisfaction (p=0.19 and p=0.24, respectively). However, mobility limitations predicted greater social integration difficulty (p=0.005) and body image dissatisfaction (p<0.001), while higher weight status at burn was a borderline significant predictor of body image dissatisfaction (p=0.05). Conclusions Obese and overweight adolescents and young adults, who sustained a major burn injury as children, do not experience greater social integration difficulty and body image dissatisfaction compared to normal weight burn injury survivors. Mobility limitations and higher weight status at burn are likely more important factors affecting the long-term social integration difficulty and body image dissatisfaction of these young people. PMID:23292577

Correlates of physical function among stroke survivors: an examination of the 2015 BRFSS.

PubMed

Ilunga Tshiswaka, D; Seals, S R; Raghavan, P

2018-02-01

To identify the characteristics of stroke survivors with poor physical function. Cross-sectional. Secondary data analyses were performed with the 2015 Behavioral Risk Factor Surveillance System data set. Unadjusted and adjusted logistic regressions were employed to determine the correlates of poor physical function in stroke survivors. Self-reported difficulty with walking and stairs was used as a proxy for physical function. Characteristics such as age, race, sex, difficulty doing errands alone, difficult dressing or bathing alone, health care coverage, time since last routine checkup, and reported financial difficulty with regard to health care access were examined as contributing factors to physical function. Approximately half of all stroke survivors reported having difficulty with walking and stairs (50.3%). As expected, the odds of reporting difficulty with walking and stairs were higher among stroke survivors aged 40 years and above (p < 0.0001). Interestingly, black/African American and multiracial respondents had higher odds of reporting difficulty with walking and stairs than whites, whereas Hispanic respondents had lower odds of reporting difficulty with walking and stairs than whites (p < 0.0001). Further analyses revealed that the disparity of physical function was preserved (p < 0.0001) after adjusting for age, race, sex, education level, family income, marital status, employment status, health insurance status, affordability of healthcare, and length of time from last doctor's visit. There were racial/ethnic disparities in physical function. Specifically, blacks/ African Americans had a 5.6% increase in the odds of reporting difficulty with walking and stairs than whites. Moreover, Hispanics reported significantly fewer problems than whites. Overall, similar sociocultural patterns in non-stroke and stroke populations were observed in this study. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Does gender affect career satisfaction and advancement in gastroenterology? Results of an AGA institute-sponsored survey.

PubMed

Gerson, Lauren B; Twomey, Kay; Hecht, Gail; Lee, Linda; McQuaid, Ken; Pizarro, Theresa T; Street, Sarah; Yoshida, Cynthia; Early, Dayna

2007-04-01

Women comprise 19% of the American Gastroenterological Association (AGA) membership. We performed a prospective study to determine whether female gastroenterologists were less likely to achieve career advancement and satisfaction. We administered an online survey to AGA members from 2004-2006. The survey contained questions regarding effects of gender on career advancement, satisfaction with career, promotional policies, and integration of family and career. A total of 457 individuals (response rate 9% after 2 major invitations) completed the survey, including 262 (57%) women (20% in private practice, 53% in academic careers, and 27% trainees) and 195 men (23% in private practice, 58% in academic careers, and 19% trainees). The male gastroenterologists were significantly older (P < .005) and in their careers for significantly more years (P = .002). There were no significant differences with respect to marital status, number of children, or number of hours worked between the genders. Men were more likely to achieve the rank of full professor (P = .035), and significantly more women reported that gender affected their career advancement (47% vs 9%; P < .001). Women in academic careers reported less satisfaction with their careers (P = .01) and perceived more difficulty in achieving promotion and tenure. Women were more likely to choose private practice careers because of part-time options (P = .025). Equal numbers of men and women in practice reported difficulty balancing work and family life. Significantly more female than male gastroenterologists perceive that gender has affected their career advancement. Female academic gastroenterologists reported less overall career satisfaction and promotion than male academic gastroenterologists.

Bi-Stability of Movement Coordination as a Function of Skill Level and Task Difficulty

ERIC Educational Resources Information Center

Liu, Yeou-Teh; Mayer-Kress, Gottfried; Newell, Karl M.

2010-01-01

This study investigated whether the level of practice interacts with the initial conditions (here manipulated as preparatory movements) and task difficulty (ball angular velocity and friction) in determining the stability of movement coordination for a roller ball motor task. Practice level and task difficulty were manipulated as two control…

Current status of brachytherapy in Korea: a national survey of radiation oncologists

PubMed Central

Kim, Joo-Young; Park, Won; Kim, Young Seok

2016-01-01

Objective The aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists. Methods Between October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea. Results The response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using 192Ir (26 centers) or 60Co (two centers). Among the 26 centers using 192Ir sources, 11 treated fewer than 40 patients per year. In the two centers using 60Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement. Conclusion The present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy. PMID:27102244

Current status of brachytherapy in Korea: a national survey of radiation oncologists.

PubMed

Kim, Haeyoung; Kim, Joo Young; Kim, Juree; Park, Won; Kim, Young Seok; Kim, Hak Jae; Kim, Yong Bae

2016-07-01

The aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists. Between October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea. The response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using (192)Ir (26 centers) or (60)Co (two centers). Among the 26 centers using (192)Ir sources, 11 treated fewer than 40 patients per year. In the two centers using (60)Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement. The present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy.

Maternal Mind-Mindedness and Children's Behavioral Difficulties: Mitigating the Impact of Low Socioeconomic Status

ERIC Educational Resources Information Center

Meins, Elizabeth; Centifanti, Luna C. Munoz; Fernyhough, Charles; Fishburn, Sarah

2013-01-01

Relations between mothers' tendency to comment appropriately on their 8-month-olds' internal states (mind-mindedness) and children's behavioral difficulties (Strengths and Difficulties Questionnaire) at ages 44 and 61 months were investigated in a socially diverse sample (N = 171, 88 boys). Controlling for maternal depressive symptoms, perceived…

Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study.

PubMed

Russel, M G V M; Ryan, B M; Dagnelie, P C; de Rooij, M; Sijbrandij, J; Feleus, A; Hesselink, M; Muris, J W; Stockbrugger, R

2003-03-01

The majority of patients with inflammatory bowel disease (IBD) have a normal life expectancy and therefore should not be weighted when applying for life assurance. There is scant literature on this topic. In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls. A population based case control study of 1126 IBD patients and 1723 controls. Based on a detailed questionnaire, the frequency and type of difficulties encountered when applying for life and medical insurance in matched IBD and control populations were appraised. In comparison with controls, IBD patients had an 87-fold increased risk of encountering difficulties when applying for life assurance (odds ratio (OR) 87 (95% confidence interval (CI) 31-246)), with a heavily weighted premium being the most common problem. Patients of high educational status, with continuous disease activity, and who smoked had the highest odds of encountering such problems. Medical insurance difficulties were fivefold more common in IBD patients compared with controls (OR 5.4 (95% CI 2.3-13)) although no specific disease or patient characteristics were identified as associated with such difficulties. This is the first detailed case control study that has investigated insurance difficulties among IBD patients. Acquiring life and medical insurance constituted a major problem for IBD patients in this study. These results are likely to be more widely representative given that most insurance companies use international guidelines for risk assessment. In view of the recent advances in therapy and promising survival data on IBD patients, evidence based guidelines for risk assessment of IBD patients by insurance companies should be drawn up to prevent possible discriminatory practices.

Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study

PubMed Central

Russel, M G V M; Ryan, B M; Dagnelie, P C; de Rooij, M; Sijbrandij, J; Feleus, A; Hesselink, M; Muris, J W; Stockbrugger, R

2003-01-01

Background and aims: The majority of patients with inflammatory bowel disease (IBD) have a normal life expectancy and therefore should not be weighted when applying for life assurance. There is scant literature on this topic. In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls. Methods: A population based case control study of 1126 IBD patients and 1723 controls. Based on a detailed questionnaire, the frequency and type of difficulties encountered when applying for life and medical insurance in matched IBD and control populations were appraised. Results: In comparison with controls, IBD patients had an 87-fold increased risk of encountering difficulties when applying for life assurance (odds ratio (OR) 87 (95% confidence interval (CI) 31–246)), with a heavily weighted premium being the most common problem. Patients of high educational status, with continuous disease activity, and who smoked had the highest odds of encountering such problems. Medical insurance difficulties were fivefold more common in IBD patients compared with controls (OR 5.4 (95% CI 2.3–13)) although no specific disease or patient characteristics were identified as associated with such difficulties. Conclusions: This is the first detailed case control study that has investigated insurance difficulties among IBD patients. Acquiring life and medical insurance constituted a major problem for IBD patients in this study. These results are likely to be more widely representative given that most insurance companies use international guidelines for risk assessment. In view of the recent advances in therapy and promising survival data on IBD patients, evidence based guidelines for risk assessment of IBD patients by insurance companies should be drawn up to prevent possible discriminatory practices. PMID:12584216

'Nobody knows what's around the corner': the challenges of caring for people with long-term conditions in care homes.

PubMed

Martin, Susan; Martin, Joy

2018-06-02

People living with long-term conditions are increasingly being cared for in care homes. Prognostication in this population is particularly challenging, and outcomes are often uncertain. This case history highlights some of the difficulties encountered when clinicians give a time-bound prognosis. It also illustrates how education programmes with high facilitation and ongoing support for care home staff can sustain practice development and enable staff to become highly skilled in working with uncertainty. Practice development programmes such as those based on the Six Steps to Success Programme for care homes give care home staff a framework within which to regularly review a resident's clinical status and the confidence to have the ongoing conversations that empower residents to contribute to decision making and focus on their own goals for care.

A cross sectional survey of the barriers for implementing rapid HIV testing among French general practitioners.

PubMed

Fraisse, Thibaut; Fourcade, Camille; Brazes-Sanz, Julie; Koumar, Yatrika; Lavigne, Jean Philippe; Sotto, Albert; Laureillard, Didier

2016-10-01

In France, almost 30,000 people are unaware of their HIV-positive status. Innovative screening strategies are essential to reach this population. The aim of this study was to describe the acceptability of rapid HIV testing (RHT) among French general practitioners (GPs) working in the south of France and barriers for implementing this strategy. We analysed an anonymous questionnaire sent by mail to GPs about demographic data, routine practice, knowledge of RHT and barriers to its use. Between 1 April and 30 September 2013, out of the 165 GPs contacted, 78 returned the questionnaires. The GPs' mean age was 52 years; 49 were men. Fifty-one GPs reported that their registered patients included at least one HIV-infected person and 70 GPs reported taking care of high-risk patients. Sixty-three percent of GPs reported being interested in using RHT in their daily practice. The main reasons reported by uninterested GPs were: greater confidence in standard HIV testing, difficulties including RHT during the routine consultation, difficulties to screen for other sexually transmitted infections simultaneously, and difficulties to deliver a positive result. French National Authorities for Health propose to screen the population at least once in their lifetime and high-risk people at least once a year. In order to achieve this aim, RHT should be included in the GPs' arsenal for HIV testing. We showed a high acceptability of RHT by GPs. If specific and adapted training is developed, and if solutions to barriers reported by GPs are found, RHT could be implemented in to their routine activity. © The Author(s) 2016.

The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation.

PubMed

Yang, Min-Jeong; Zvolensky, Michael J; Leyro, Teresa M

2017-09-01

Panic disorder (PD) and cigarette smoking are highly comorbid and associated with worse panic and smoking outcomes. Smoking may become an overlearned automatized response to relieve panic-like withdrawal distress, leading to corresponding smoking cognitions, which contribute to its reinforcing properties and difficultly abstaining. Difficulties in emotion regulation (ER) may underlie this relation such that in the absence of adaptive emotion regulatory strategies, smokers with PD may more readily rely upon smoking to manage affective distress. In the current study, the indirect relation between PD status and smoking cognitions through ER difficulties was examined among daily smokers (N=74). We found evidence for an indirect relation between PD status and negative affect, addictive and habitual smoking motives, and anticipating smoking will result in negative reinforcement and personal harm, through self-reported difficulties with ER. Our findings are aligned with theoretical models on anxiety and smoking, and suggest that reports of greater smoking cognitions may be due to ER difficulties. Copyright © 2017. Published by Elsevier Ltd.

Structural equation modeling of the relationships between pesticide poisoning, depressive symptoms and safety behaviors among Colorado farm residents.

PubMed

Beseler, Cheryl Lynn; Stallones, Lorann

2006-01-01

To use structural equation modeling (SEM) to test the theory that a past pesticide poisoning may act as a mediator in the relationship between depression and safety practices. Depression has been associated with pesticide poisoning and was more strongly associated with safety behaviors than workload, social support or health status of farm residents in a previously published report. A cross-sectional survey of farmers and their spouses was conducted in eight counties in northeastern Colorado. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale. Exploratory and confirmatory factor analyses were used to identify symptoms most correlated with risk factors for depression and safety practices. SEM was used to examine theoretical causal models of the relationship between depression and poor health, financial difficulties, a history of pesticide poisoning, and safety practices. Exploratory factor analysis identified three factors in the CES-D scale. The SEM showed that poor health, financial difficulties and a history of pesticide poisoning significantly explained the depressive symptoms. Models with an excellent fit for the safety behaviors resulted when modeling the probability that the pesticide poisoning preceded depression, but no fit was possible when reversing the direction and modeling depression preceding pesticide poisoning. Specific depressive symptoms appeared to be significantly associated with primarily animal handling and farm machinery. The order of events, based on SEM results, was a pesticide poisoning preceding depressed mood in relation to safety behaviors.

Gender differences in the association of depression with career indecisiveness, career-decision status, and career-preference crystallization.

PubMed

Gadassi, Reuma; Waser, Ayelet; Gati, Itamar

2015-10-01

Depression has detrimental effects on broad areas of functioning. However, its association with career decision-making factors has been largely unexplored. In the present study, we focused on the association between career decision-making difficulties, career-decision status, and career-preference crystallization, on the one hand, and depression, on the other. The hypothesis that high levels of career decision-making difficulties, less advanced decision status, and low levels of preference crystallization are associated with higher levels of depressive symptoms was tested with a sample of 222 college seniors. In addition, since it has been found that work-related stressors are more often associated with depression among men than women, it was hypothesized that the associations between vocational factors and depression would be stronger for men than for women. The participants filled out online self-report questionnaires assessing depressive symptoms, emotional and personality-related career decision-making difficulties, career-decision status, and career preferences. The results indicated that self-concept and identity-related career decision-making difficulties were associated with depressive symptoms for both men and women. In addition, for men, but not for women, less crystallization of career preferences also predicted higher levels of depressive symptoms. These results show how important it is for counseling psychologists to understand the role of the individual's vocational situation in depression. (c) 2015 APA, all rights reserved).

HIV disclosure as practice and public policy

PubMed Central

Adam, Barry D.; Corriveau, Patrice; Elliott, Richard; Globerman, Jason; English, Ken; Rourke, Sean

2015-01-01

Responses to the largest surveys of HIV-positive people in Ontario show that most either disclose to or do not have partners who are HIV-negative or of unknown status. Non-disclosure strategies and assumptions are reported by relatively small sets of people with some variation according to employment status, sexual orientation, gender, ethnicity, and having had a casual partner. Interviews with 122 people living with HIV show that disclosure is an undertaking fraught with emotional pitfalls complicated by personal histories of having misread cues or having felt deceived leading up to their own sero-conversion, then having to negotiate a stigmatized status with new people. In gay communities, constructions of the self as individual actors in a marketplace of risk co-exist with the sexual etiquette developed throughout the AIDS era of care of the self and other through safer sex. Among heterosexual populations, notions of responsibility show some divergence by gender. The findings of this study suggest that the heightened pressure of criminal sanction on decision-making about disclosure in personal interactions does not address difficulties in HIV transmission and is unlikely to result in enhanced prevention. PMID:26339127

Liquid Biopsy in Metastasized Breast Cancer as Basis for Treatment Decisions.

PubMed

Krawczyk, Natalia; Fehm, Tanja; Banys-Paluchowski, Malgorzata; Janni, Wolfgang; Schramm, Amelie

2016-01-01

According to current guidelines, the additional biopsy of breast cancer metastases to analyze the receptor status for phenotype assessment is recommended. However, due to clinical difficulties in performing biopsies of metastatic lesions, the phenotype of the primary tumor most often determines the treatment decisions in metastatic breast cancer. Liquid biopsy allows the analysis of several circulating biomarkers like circulating tumor cells (CTCs) or circulating tumor DNA (ctDNA) in peripheral blood samples of cancer patients. Thus, it is an elegant and easily practicable technique that delivers information on the current disease status. Determination of the CTC phenotype regarding the hormone receptor and human epidermal growth factor receptor 2 (HER2) status might replace additional tissue biopsy for planning further therapy strategies. Liquid biopsy is a crucial step towards a more individualized cancer therapy. In contrast to the conventional concept of tissue biopsy, it offers an easy, less invasive acquisition of biomaterial. In addition, it allows multiple repetitions and real-time monitoring of metastasized disease in the clinical routine. However, the clinical utility of liquid biopsy still needs to be evaluated. © 2016 S. Karger GmbH, Freiburg.

Feeding difficulties in children with cerebral palsy: low-cost caregiver training in Dhaka, Bangladesh.

PubMed

Adams, M S; Khan, N Z; Begum, S A; Wirz, S L; Hesketh, T; Pring, T R

2012-11-01

The majority of children with cerebral palsy have feeding difficulties, which, if not managed, result in stressful mealtimes, chronic malnutrition, respiratory disease, reduced quality of life for caregiver and child, and early death. In well-resourced countries, high- and low-cost medical interventions, ranging from gastrostomy tube feeding to caregiver training, are available. In resource-poor countries such as Bangladesh, the former is not viable and the latter is both scarce and its effectiveness not properly evaluated. The aim of this study was to evaluate the effectiveness of a low-cost, low-technology intervention to improve the feeding practices of carers of children with moderate-severe cerebral palsy and feeding difficulties in Bangladesh. An opportunistic sample of 37 caregivers and their children aged 1-11 years were invited to a six-session training programme following an initial feeding assessment with brief advice. During home visits, pre- and post-measures of nutritional status, chest health and feeding-related stress were taken and feeding practices were observed. A control phase was evaluated for 20 of the participant pairs following initial assessment with advice, while awaiting full training. A minimum of four training sessions showed significant improvements in the children's respiratory health (P = 0.005), cooperation during mealtimes (P = 0.003) and overall mood (P < 0.001). Improvements in growth were inconsistent. Dramatic reductions were observed in caregiver stress (P < 0.001). A significant difference in the outcomes following advice only compared with advice plus training was also observed. In situations of poverty, compliance is restricted by lack of education, finances and time. Nonetheless, carers with minimal formal education, living in conditions of extreme poverty were able to change feeding practices after a short, low-cost training intervention, with highly positive consequences. The availability of affordable food supplementation for this population, however, requires urgent attention. © 2011 Blackwell Publishing Ltd.

Ability to walk 1/4 mile predicts subsequent disability, mortality, and health care costs.

PubMed

Hardy, Susan E; Kang, Yihuang; Studenski, Stephanie A; Degenholtz, Howard B

2011-02-01

Mobility, such as walking 1/4 mile, is a valuable but underutilized health indicator among older adults. For mobility to be successfully integrated into clinical practice and health policy, an easily assessed marker that predicts subsequent health outcomes is required. To determine the association between mobility, defined as self-reported ability to walk 1/4 mile, and mortality, functional decline, and health care utilization and costs during the subsequent year. Analysis of longitudinal data from the 2003-2004 Medicare Current Beneficiary Survey, a nationally representative sample of Medicare beneficiaries. Participants comprised 5895 community-dwelling adults aged 65 years or older enrolled in Medicare. Mobility (self-reported ability to walk 1/4 mile), mortality, incident difficulty with activities of daily living (ADLs), total annual health care costs, and hospitalization rates. Among older adults, 28% reported difficulty and 17% inability to walk 1/4 mile at baseline. Compared to those without difficulty and adjusting for demographics, socioeconomic status, chronic conditions, and health behaviors, mortality was greater in those with difficulty [AOR (95% CI): 1.57 (1.10-2.24)] and inability [AOR (CI): 2.73 (1.79-4.15)]. New functional disability also occurred more frequently as self-reported ability to walk 1/4 mile declined (subsequent incident disability among those with no difficulty, difficulty, or inability to walk 1/4 mile at baseline was 11%, 29%, and 47% for instrumental ADLs, and 4%, 14%, and 23% for basic ADLs). Total annual health care costs were $2773 higher (95% CI $1443-4102) in persons with difficulty and $3919 higher (CI $1948-5890) in those who were unable. For each 100 persons, older adults reporting difficulty walking 1/4 mile at baseline experienced an additional 14 hospitalizations (95% CI 8-20), and those who were unable experienced an additional 22 hospitalizations (CI 14-30) during the follow-up period, compared to persons without walking difficulty. Mobility disability, a simple self-report measure, is a powerful predictor of future health, function, and utilization independent of usual health and demographic indicators. Mobility disability may be used to target high-risk patients for care management and preventive interventions.

Patient acceptability and practical implications of pharmacokinetic studies in patients with advanced cancer.

PubMed

Dobbs, N A; Twelves, C J; Ramirez, A J; Towlson, K E; Gregory, W M; Richards, M A

1993-01-01

We have studied the practical implications and acceptability to patients of pharmacokinetic studies in 34 women receiving anthracyclines for advanced breast cancer. The following parameters were recorded: age, ECOG performance status, psychological state (Rotterdam Symptom Checklist), cytotoxic drug and dose, number of venepunctures for treatment and sampling, and time when the sampling cannula was removed. Immediately after finishing pharmacokinetic sampling, patients completed a questionnaire which revealed that (i) all patients understood sampling was for research, (ii) 35% of patients experienced problems with sampling, (iii) benefits from participation were perceived by 56% of patients. Of 20 patients later questioned after completion of their treatment course, 40% recalled difficulties with blood sampling. Factors identifying in advance those patients who tolerate pharmacokinetic studies poorly were not identified but the number of venepunctures should be minimised. Patients may also perceive benefits from 'non-therapeutic' research.

A comparison of patients with major depressive disorder recruited through newspaper advertising versus consultation referrals for clinical drug trials.

PubMed

Miller, C A; Hooper, C L; Bakish, D

1997-01-01

Difficulties in recruiting patients for clinical trials have plagued investigators for many years. One concern is the generalizability of clinical trial results to community practice, that is, whether volunteers recruited through advertising are homogeneous with those seeking treatment in a clinical setting. This article retrospectively compares the baseline characteristics of patients recruited through newspaper advertisements with those recruited through consultation referrals by reviewing the charts of 54 patients enrolled in two clinical trials for major depressive disorder (MDD). We examined demographic data, background information, clinical histories, and baseline status. Results indicated homogeneity for most variables. The consultation group was significantly more likely to have had previous treatment for the current episode of depression. These results suggest that, although the advertisement and consultation groups were very similar, the drug naivety of the advertisement group may make them a preferred source in terms of generalizability to community practice.

Divided attention: an undesirable difficulty in memory retention.

PubMed

Gaspelin, Nicholas; Ruthruff, Eric; Pashler, Harold

2013-10-01

How can we improve memory retention? A large body of research has suggested that difficulty encountered during learning, such as when practice sessions are distributed rather than massed, can enhance later memory performance (see R. A. Bjork & E. L. Bjork, 1992). Here, we investigated whether divided attention during retrieval practice can also constitute a desirable difficulty. Following two initial study phases and one test phase with Swahili-English word pairs (e.g., vuvi-snake), we manipulated whether items were tested again under full or divided attention. Two days later, participants were brought back for a final cued-recall test (e.g., vuvi-?). Across three experiments (combined N = 122), we found no evidence that dividing attention while practicing retrieval enhances memory retention. This finding raises the question of why many types of difficulty during practice do improve long-term retention, but dividing attention does not.

Nurse care coordination and technology effects on health status of frail older adults via enhanced self-management of medication: randomized clinical trial to test efficacy.

PubMed

Marek, Karen Dorman; Stetzer, Frank; Ryan, Polly A; Bub, Linda Denison; Adams, Scott J; Schlidt, Andrea; Lancaster, Rachelle; O'Brien, Anne-Marie

2013-01-01

Self-management of complex medication regimens for chronic illness is challenging for many older adults. The purpose of this study was to evaluate health status outcomes of frail older adults receiving a home-based support program that emphasized self-management of medications using both care coordination and technology. This study used a randomized controlled trial with three arms and longitudinal outcome measurement. Older adults having difficulty in self-managing medications (n = 414) were recruited at discharge from three Medicare-certified home healthcare agencies in a Midwestern urban area. All participants received baseline pharmacy screens. The control group received no further intervention. A team of advanced practice nurses and registered nurses coordinated care for 12 months to two intervention groups who also received either an MD.2 medication-dispensing machine or a medplanner. Health status outcomes (the Geriatric Depression Scale, Mini Mental Status Examination, Physical Performance Test, and SF-36 Physical Component Summary and Mental Component Summary) were measured at baseline and at 3, 6, 9, and 12 months. After covariate and baseline health status adjustment, time × group interactions for the MD.2 and medplanner groups on health status outcomes were not significant. Time × group interactions were significant for the medplanner and control group comparisons. Participants with care coordination had significantly better health status outcomes over time than those in the control group, but addition of the MD.2 machine to nurse care coordination did not result in better health status outcomes.

Mathematics of the Bulgarian Electoral System

NASA Astrophysics Data System (ADS)

Konstantinov, Mihail M.; Pelova, Galina B.; Boneva, Juliana K.

2009-11-01

In this paper we consider the mathematical aspects of the Bulgarian proportional electoral systems used since 1990. They are variants of a proportional system at a nationwide level with 4-percent barrier such that the party seats are personified from a number of regional party lists. This system is unique in the world electoral practice and may lead to severe inter-party distortions. These distortions although formally correct are hardly accepted by the public and by local party activists in particular. Methods to overcome these difficulties as well as the status-quo of the problem are considered. Finally new paradoxes are studied which are generalizations of the well known paradoxes for the plain proportional systems.

Links between maternal feeding practices and children's eating difficulties. Validation of French tools.

PubMed

Rigal, Natalie; Chabanet, Claire; Issanchou, Sylvie; Monnery-Patris, Sandrine

2012-04-01

The main objectives of the present study were to validate measures of young children's eating difficulties and maternal feeding practices in a French sample, as well as to assess the links between these practices and children's eating difficulties. Mothers (n=502) of French children aged 20-36 months completed four questionnaires that were validated using a Structural Equation Modelling approach. Links between children and maternal components were investigated using a PLS regression. The Children's Eating Difficulties Questionnaire yielded a 4-dimension solution: Neophobia, Pickiness, Low Appetite and Low Enjoyment in food. The Feeding Style Questionnaire assessed three dimensions: Authoritarian, Authoritative and Permissive Styles. The Feeding Strategy Questionnaire, designed to evaluate strategies used by mothers to make their child taste rejected foods, resulted in four factors: Coercion, Explanation, Contingency and Preference. The Questionnaire relating to Parental Motivations when buying food for children presented a 6-dimension solution: Convenience, Weight-control, Natural, Health-concern, Preference and Price. The factors associated positively with the four dimensions of the Children's Eating Difficulties Questionnaire were on the one hand Permissive Style and Practices to fulfil child's desires, and on the other hand Authoritarian Style, Contingent and Coercive Practices aimed at forcing children to taste rejected foods. Copyright © 2012 Elsevier Ltd. All rights reserved.

Influence of fatigue on construction workers’ physical and cognitive function

PubMed Central

Zhang, M.; Murphy, L. A.; Fang, D.

2015-01-01

Background Despite scientific evidence linking workers’ fatigue to occupational safety (due to impaired physical or cognitive function), little is known about this relationship in construction workers. Aims To assess the association between construction workers’ reported fatigue and their perceived difficulties with physical and cognitive functions. Methods Using data from a convenience sample of US construction workers participating in the 2010–11 National Health Interview Survey two multivariate weighted logistic regression models were built to predict difficulty with physical and with cognitive functions associated with workers’ reported fatigue, while controlling for age, smoking status, alcohol consumption status, sleep hygiene, psychological distress and arthritis status. Results Of 606 construction workers surveyed, 49% reported being ‘tired some days’ in the past 3 months and 10% reported ‘tired most days or every day’. Compared with those feeling ‘never tired’, workers who felt ‘tired some days’ were significantly more likely to report difficulty with physical function (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] 1.17–3.51) and cognitive function (AOR = 2.27; 95% CI 1.06–4.88) after controlling for potential confounders. Conclusions Our results suggest an association between reported fatigue and experiencing difficulties with physical and cognitive functions in construction workers. PMID:25701835

Repeated retrieval practice and item difficulty: does criterion learning eliminate item difficulty effects?

PubMed

Vaughn, Kalif E; Rawson, Katherine A; Pyc, Mary A

2013-12-01

A wealth of previous research has established that retrieval practice promotes memory, particularly when retrieval is successful. Although successful retrieval promotes memory, it remains unclear whether successful retrieval promotes memory equally well for items of varying difficulty. Will easy items still outperform difficult items on a final test if all items have been correctly recalled equal numbers of times during practice? In two experiments, normatively difficult and easy Lithuanian-English word pairs were learned via test-restudy practice until each item had been correctly recalled a preassigned number of times (from 1 to 11 correct recalls). Despite equating the numbers of successful recalls during practice, performance on a delayed final cued-recall test was lower for difficult than for easy items. Experiment 2 was designed to diagnose whether the disadvantage for difficult items was due to deficits in cue memory, target memory, and/or associative memory. The results revealed a disadvantage for the difficult versus the easy items only on the associative recognition test, with no differences on cue recognition, and even an advantage on target recognition. Although successful retrieval enhanced memory for both difficult and easy items, equating retrieval success during practice did not eliminate normative item difficulty differences.

Reentry challenges facing women with mental health problems.

PubMed

Visher, Christy A; Bakken, Nicholas W

2014-01-01

Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this article, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston, Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The article concludes with a discussion of recommendations for improved policy and practice.

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children.

PubMed

Penagini, Francesca; Mameli, Chiara; Fabiano, Valentina; Brunetti, Domenica; Dilillo, Dario; Zuccotti, Gian Vincenzo

2015-11-13

Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children.

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children

PubMed Central

Penagini, Francesca; Mameli, Chiara; Fabiano, Valentina; Brunetti, Domenica; Dilillo, Dario; Zuccotti, Gian Vincenzo

2015-01-01

Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children. PMID:26580646

Medical students’ perceptions and understanding of their specific learning difficulties

PubMed Central

Abbott, Stephen; Bevere, Grazia; Roberts, Christopher M.

2013-01-01

Objectives The purpose of this study is to explore how medical students with Specific Learning Difficulties perceive and understand their Specific Learning Difficulty and how it has impacted on their experience of medical training. Method A purposive sample of fifteen students from one medical school was interviewed. Framework Analysis was used to identify and organise themes emerging from the data. An interpretation of the data was made capturing the essence of what had been learned. The concept of ‘reframing’ was then used to re-analyse and organise the data. Results Students reported having found ways to cope with their Specific Leaning Difficulty in the past, some of which proved inadequate to deal with the pressures of medical school. Diagnosis was a mixed experience: many felt relieved to understand their difficulties better, but some feared discrimination. Practical support was available in university but not in placement. Students focused on the impact of their Specific Learning Difficulty on their ability to pass undergraduate exams. Most did not contemplate difficulties post-qualification. Conclusions The rigours of the undergraduate medical course may reveal undisclosed Specific Learning Difficulties. Students need help to cope with such challenges, psychologically and practically in both classroom and clinical practice. University services for students with Specific Learning Difficulties should become familiar with the challenges of clinical placements, and ensure that academic staff has access to information about the needs of these students and how these can be met.

Locum doctors in general practice: motivation and experiences.

PubMed Central

McKevitt, C; Morgan, M; Hudson, M

1999-01-01

BACKGROUND: There is evidence of dissatisfaction with locum doctors' performance, but little is known about doctors who work as locums in general practice or about their experiences of this work. AIM: To describe the motivations and experiences of doctors providing locum cover in general practices. METHOD: A postal questionnaire survey distributed to locums through organizations such as locum groups, commercial agencies, and general practices. RESULTS: Questionnaires were returned by 111 doctors currently working as locums in general practice. Four main reasons for working as a locum GP were: as a short-term option while between posts, to gain experience of different practices before commitment to one practice, to balance work and family or other commitments, to continue part-time work after retirement. One-quarter of responders intended to continue working as a locum indefinitely. The drawbacks of locum work included frustration with low status, lack of security, and difficulty accessing structured training and education. CONCLUSION: Locum doctors in general practice are a heterogeneous group that includes those who have chosen this type of work. The doctors who intend to continue as locums indefinitely represent a useful resource in primary care whose ability to provide short-term cover could be maximized. The need to control the quality of 'freelance' doctors should not overshadow the need to control the quality of their working environments. PMID:10621983

Evaluating the User Experience of Exercising Reaching Motions With a Robot That Predicts Desired Movement Difficulty.

PubMed

Shirzad, Navid; Van der Loos, H F Machiel

2016-01-01

The notion of an optimal difficulty during practice has been articulated in many areas of cognitive psychology: flow theory, the challenge point framework, and desirable difficulties. Delivering exercises at a participant's desired difficulty has the potential to improve both motor learning and users' engagement in therapy. Motivation and engagement are among the contributing factors to the success of exercise programs. The authors previously demonstrated that error amplification can be used to introduce levels of challenge into a robotic reaching task, and that machine-learning algorithms can dynamically adjust difficulty to the desired level with 85% accuracy. Building on these findings, we present the results of a proof-of-concept study investigating the impacts of practicing under desirable difficulty conditions. A control condition with a predefined random order for difficulty levels was deemed more suitable for this study (compared to constant or continuously increasing difficulty). By practicing the task at their desirable difficulties, participants in the experimental group perceived their performance at a significantly higher level and reported lower required effort to complete the task, in comparison to a control group. Moreover, based on self-reports, participants in the experimental group were willing, on average, to continue the training session for 4.6 more training blocks (∼45 min) compared to the control group's average. This study demonstrates the efficiency of delivering the exercises at the user's desired difficulty level to improve the user's engagement in exercise tasks. Future work will focus on clinical feasibility of this approach in increasing stroke survivors' engagement in their therapy programs.

Learning to attain an advanced level of professional responsibility.

PubMed

Ter Maten-Speksnijder, Ada; Grypdonck, Mieke; Pool, Aart; Meurs, Pauline; Van Staa, AnneLoes

2015-08-01

After graduation, nurse practitioner students are expected to be capable of providing complex, evidence-based nursing care independently, combined with standardized medical care. The students who follow work-study programs have to develop their competencies in a healthcare environment dominated by efficiency policies. This study aims to explore nurse practitioner students' perceptions of their professional responsibility for patient care. This qualitative interpretative study entails a content analysis of 46 reflective case studies written by nurse practitioner students. The students felt responsible for the monitoring of patients' health status, attending to psychosocial problems, emphasizing compliance, and optimizing the family's role as informal caregivers. At the same time, students struggled to understand the complexities of their patients' needs, and they had difficulty applying their knowledge and skills to complex medical, psychological, and social problems. The students' perceptions of their new responsibility were characterized by a strong focus on curative care, while psychosocial components of health and illness concerns were often overlooked. The students experienced difficulties in meeting the criteria of advanced practice nursing described in the Dutch competency framework. Copyright © 2015 Elsevier Ltd. All rights reserved.

Podcasts on Mobile Devices as a Read-Aloud Testing Accommodation in Middle School Science Assessment

NASA Astrophysics Data System (ADS)

McMahon, Don; Wright, Rachel; Cihak, David F.; Moore, Tara C.; Lamb, Richard

2016-04-01

The purpose of this study was to examine the effect of a digitized podcast to deliver read-aloud testing accommodations on mobile devices to students with disabilities and reading difficulties. The total sample for this study included 47 middle school students with reading difficulties. Of the 47 students, 16 were identified as students with disabilities who received special education services. Participants were randomly assigned to three experimental testing conditions, standard administration, teacher-controlled read-aloud in traditional group delivery format, and student-controlled read-aloud delivered as a podcast and accessed on a mobile device, and given sample end-of-year science assessments. Based on a factorial analysis of variances, with test conditions and student status as the fixed factors, both student groups demonstrated statistically significant gains based on their testing conditions. Results support the use of podcast delivery as a viable alternative to the traditional teacher-delivered read-aloud test accommodation. Conclusions are discussed in the context of universal design for learning testing accommodations for future research and practice.

Errors in Multi-Digit Arithmetic and Behavioral Inattention in Children With Math Difficulties

PubMed Central

Raghubar, Kimberly; Cirino, Paul; Barnes, Marcia; Ewing-Cobbs, Linda; Fletcher, Jack; Fuchs, Lynn

2009-01-01

Errors in written multi-digit computation were investigated in children with math difficulties. Third-and fourth-grade children (n = 291) with coexisting math and reading difficulties, math difficulties, reading difficulties, or no learning difficulties were compared. A second analysis compared those with severe math learning difficulties, low average achievement in math, and no learning difficulties. Math fact errors were related to the severity of the math difficulties, not to reading status. Contrary to predictions, children with poorer reading, regardless of math achievement, committed more visually based errors. Operation switch errors were not systematically related to group membership. Teacher ratings of behavioral inattention were related to accuracy, math fact errors, and procedural bugs. The findings are discussed with respect to hypotheses about the cognitive origins of arithmetic errors and in relation to current discussions about how to conceptualize math disabilities. PMID:19380494

The Effect of Self-Regulated and Experimenter-Imposed Practice Schedules on Motor Learning for Tasks of Varying Difficulty

ERIC Educational Resources Information Center

Keetch, Katherine M.; Lee, Timothy D.

2007-01-01

Research suggests that allowing individuals to control their own practice schedule has a positive effect on motor learning. In this experiment we examined the effect of task difficulty and self-regulated practice strategies on motor learning. The task was to move a mouse-operated cursor through pattern arrays that differed in two levels of…

Experiencing 'pathologized presence and normalized absence'; understanding health related experiences and access to health care among Iraqi and Somali asylum seekers, refugees and persons without legal status.

PubMed

Fang, Mei Lan; Sixsmith, Judith; Lawthom, Rebecca; Mountian, Ilana; Shahrin, Afifa

2015-09-19

Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities. For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status. The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. Macro- and micro-level intersections of accustomed societal beliefs, practices and norms, broad-level legislation and policy decisions, and health care and social services delivery methods have affected the health and health care experiences of forced migrants that reside in the UK. Research highlights how 'minoritization processes,' influencing the intersections between social identities, can hinder access to and delivery of health and social services to vulnerable groups. Similar findings were reported here; and the most influential mechanism directly impacting health and access to health and social services was legal status. Equitable health care provision requires systemic change that incorporate understandings of marginalization, 'othering' processes and the intersections between the past histories and everyday realities of asylum seekers, refugees and persons without legal status.

Socio-economic inequalities in health services utilization: a cross-sectional study.

PubMed

Ranjbar Ezzatabadi, Mohammad; Khosravi, Ameneh; Bahrami, Mohammad Amin; Rafiei, Sima

2018-02-12

Purpose Developing country workers mainly face important challenges when examining equality in health services utilization among the population and identifying influential factors. The purpose of this paper us to: understand health service use among households with different socio-economic status in Isfahan province; and to investigate probable inequality determinants in service utilization. Design/methodology/approach Almost 1,040 households living in Isfahan province participated in this cross-sectional study in 2013. Data were collected by a questionnaire with three sections: demographic characteristics; socio-economic status; and health services utilization. The concentration index was applied to measure inequality. Analysts used STATA 11. Findings Economic status, educational level, insurance coverage and household gender were the most influential factors on health services utilization. Those with a high socio-economic level were more likely to demand and use such services; although self-medication patterns showed an opposite trend. Practical implications Female-headed families face with more difficulties in access to basic human needs including health. Supportive policies are needed to meet their demands. Originality/value The authors used principle component analysis to assess households' economic situation, which reduced the variables into a single index.

Distribution of autistic traits and their association with sociodemographic characteristics in Japanese workers.

PubMed

Suzuki, Tomoko; Miyaki, Koichi; Eguchi, Hisashi; Tsutsumi, Akizumi

2017-09-01

This study aimed to confirm whether autistic traits are normally distributed across a population and to describe their association with the sociodemographic characteristics of Japanese workers. The participants were 2075 workers aged 23-65 years from various parts of Japan. Autistic traits were measured using an abridged Japanese version of the Autism-Spectrum Quotient (AQ-Short). The AQ-Short comprises five subcomponents assessing a fascination for numbers and patterns (numbers/patterns), difficulties with imagination, a preference for routine, difficulties with social skills, and difficulties with switching attention. The five subcomponents of the autistic phenotype as well as the overall autistic phenotype itself were continuously distributed across the sample population of Japanese workers. Men had significantly higher AQ-Short scores than women. AQ-Short scores were not associated with age. Except for the numbers/patterns scores, workers of a lower socioeconomic status had significantly higher AQ-Short scores than their respective counterparts. For the numbers/patterns trait, workers of a higher socioeconomic status scored higher. Workers with low general physical activity had or tended to have higher scores for total and all subcomponent traits, except for the numbers/patterns trait. Generally, the autistic phenotype was more prevalent in workers of a low socioeconomic status, while a particular trait was prevalent among workers of a high socioeconomic status.

PTSD and Trauma-Related Difficulties in Sexual Minority Women: The Impact of Perceived Social Support.

PubMed

Weiss, Brandon J; Garvert, Donn W; Cloitre, Marylène

2015-12-01

This study examined posttraumatic stress disorder (PTSD) and related symptoms among sexual minority (SM) and heterosexual women and the influence of social support on the relationship between SM status and symptoms. We hypothesized that SM women would endorse higher symptoms of PTSD and related difficulties and that social support would moderate the relationship between SM status and symptoms. The sample, women seeking treatment for PTSD related to interpersonal violence (n = 477; mean age = 36.07 years; 22.9% SM) completed clinician-administered measures of PTSD and self-report measures of trauma-related difficulties and social support. The rate of PTSD diagnosis was higher for SM women. Social support and SM status were significantly associated with suicidality, self-perceptions, depression, somatic complaints, and functional impairment. The interaction between social support and SM status was significant for both functional impairment (β = -.26) and somatic complaints (β = -.39). High social support had an equal, positive effect among SM and nonminority women, whereas low social support had a greater negative impact among SM women. Results suggested the particular salience of social support on functioning and symptom severity among SM women and the potential importance of including interventions addressing social support into PTSD treatments for SM women. Copyright © 2015 International Society for Traumatic Stress Studies.

Perceived Income Adequacy Among Older Adults in 12 Countries: Findings From the Survey of Health, Ageing, and Retirement in Europe

PubMed Central

Litwin, Howard; Sapir, Eliyahu V.

2009-01-01

Purpose: To validate a survey research measure of subjective income, as measured by perceived income adequacy, in an international context. Design and Methods: The study population comprised persons aged 50 years and older in 12 countries from the Survey of Health, Ageing and Retirement in Europe (n = 28,939). Perceived difficulty in making ends meet was regressed on sociodemographic variables, economic indicators, health status measures, and expectations regarding one's financial future. Country differences were also controlled. Results: The findings confirm a multidimensional explanation of perceived income adequacy but also point to the primacy of objective economic indicators in predicting household financial distress. Respondents aged 80 years and older report less financial difficulty. Poor health status and pessimistic financial expectations also predict greater household financial distress but to a lesser degree. Implications: Self-rated economic status is a robust indicator of financial capacity in older age and can be used by practitioners to gain meaningful information. However, practitioners should keep in mind that the oldest-old may underestimate financial difficulties. PMID:19386829

Technology-enhanced practice for patients with chronic cardiac disease: home implementation and evaluation.

PubMed

Brennan, Patricia Flatley; Casper, Gail R; Burke, Laura J; Johnson, Kathy A; Brown, Roger; Valdez, Rupa S; Sebern, Marge; Perez, Oscar A; Sturgeon, Billie

2010-01-01

This 3-year field experiment engaged 60 nurses and 282 patients in the design and evaluation of an innovative home-care nursing model, referred to as technology-enhanced practice (TEP). Nurses using TEP augmented the usual care with a web-based resource (HeartCareII) that provided patients with self-management information, self-monitoring tools, and messaging services. Patients exposed to TEP demonstrated better quality of life and self-management of chronic heart disease during the first 4 weeks, and were no more likely than patients in usual care to make unplanned visits to a clinician or hospital. Both groups demonstrated the same long-term symptom management and achievements in health status. This project provides new evidence that the purposeful creation of patient-tailored web resources within a hospital portal is possible; that nurses have difficulty with modifying their practice routines, even with a highly-tailored web resource; and that the benefits of this intervention are more discernable in the early postdischarge stages of care. Copyright © 2010 Elsevier Inc. All rights reserved.

Advantages and limitations of teleneurology.

PubMed

Wechsler, Lawrence R

2015-03-01

The growing disparity between the demand for neurological services and the need for neurologists requires new and innovative strategies for delivering care. Teleneurology allows neurological expertise to be delivered to remote locations to supplement or replace in-person neurological care. To summarize the current status of teleneurology. Applications of teleneurology include acute care, outpatient teleneurology, and teleconsultations. Existing barriers to further expansion of teleneurology are also discussed. Published studies pertaining to teleneurology were reviewed. Practical experience with telemedicine in neurological practice contributed to the conclusions. Outcomes after intravenous tissue plasminogen activator treatment via telemedicine (telestroke) are similar to those achieved with in-person evaluations. Other aspects of teleneurology are less established but have demonstrated feasibility, high patient satisfaction, and, in some cases, cost savings. Teleneurology provides neurological expertise to rural areas with limited availability of neurologists and improves care for patients with difficulty traveling owing to neurological disease. It is likely that use of teleneurology will continue to grow and become incorporated into many aspects of neurological practice. Understanding the advantages and limitations of teleneurology is vital to delivering optimal clinical care for patients with neurological disease regardless of the setting.

Employment status and work-related difficulties in stomach cancer survivors compared with the general population

PubMed Central

Lee, M K; Lee, K M; Bae, J-M; Kim, S; Kim, Y-W; Ryu, K W; Lee, J H; Noh, J-H; Sohn, T-S; Hong, S-K; Yun, Y H

2008-01-01

Little was known about work situation and work-related difficulties, including housework after stomach cancer diagnosis. We aimed to compare employment status and work-related difficulties between stomach cancer survivors and the general population. We enrolled 408 stomach cancer survivors from two hospitals 28 months after diagnosis and 994 representative volunteers from the general population from 15 geographic districts. Working was defined as being employed (including self-employed) and nonworking as being retired or a homemaker. Nonworking was significantly higher among stomach cancer survivors (46.6%) than in the general population (36.5%). Compared with the general population, the survivors had more fatigue in performing both housework (adjusted odds ratio (aOR)=2.08; 95% confidence interval (95% CI)=1.01–4.29) and gainful work (aOR=4.02; 2.55–6.33). More cancer survivors had reduced working hours (aOR=1.42; 95% CI=4.60–28.35) and reduced work-related ability (aOR=6.11; 95% CI=3.64–10.27) than did the general population. The association of nonworking with older age and being female was significantly more positive for survivors than for the general population. Among survivors, poorer Eastern Cooperation Oncology Group Performance Status and receiving total gastrectomy were positively associated with nonworking. Stomach cancer survivors experienced more difficulties in both housework and gainful employment than did the general population. Our findings on stomach cancer survivors' work-related difficulties and the predictors of nonworking will help physicians guide patients towards more realistic postsurgical employment plans. PMID:18283298

Employment status and work-related difficulties in stomach cancer survivors compared with the general population.

PubMed

Lee, M K; Lee, K M; Bae, J-M; Kim, S; Kim, Y-W; Ryu, K W; Lee, J H; Noh, J-H; Sohn, T-S; Hong, S-K; Yun, Y H

2008-02-26

Little was known about work situation and work-related difficulties, including housework after stomach cancer diagnosis. We aimed to compare employment status and work-related difficulties between stomach cancer survivors and the general population. We enrolled 408 stomach cancer survivors from two hospitals 28 months after diagnosis and 994 representative volunteers from the general population from 15 geographic districts. Working was defined as being employed (including self-employed) and nonworking as being retired or a homemaker. Nonworking was significantly higher among stomach cancer survivors (46.6%) than in the general population (36.5%). Compared with the general population, the survivors had more fatigue in performing both housework (adjusted odds ratio (aOR)=2.08; 95% confidence interval (95% CI)=1.01-4.29) and gainful work (aOR=4.02; 2.55-6.33). More cancer survivors had reduced working hours (aOR=1.42; 95% CI=4.60-28.35) and reduced work-related ability (aOR=6.11; 95% CI=3.64-10.27) than did the general population. The association of nonworking with older age and being female was significantly more positive for survivors than for the general population. Among survivors, poorer Eastern Cooperation Oncology Group Performance Status and receiving total gastrectomy were positively associated with nonworking. Stomach cancer survivors experienced more difficulties in both housework and gainful employment than did the general population. Our findings on stomach cancer survivors' work-related difficulties and the predictors of nonworking will help physicians guide patients towards more realistic postsurgical employment plans.

Demographic and Parenting Correlates of Adolescent Sleep Functioning.

PubMed

Zapata Roblyer, Martha I; Grzywacz, Joseph G

2015-11-01

Despite the importance of parenting practices for adolescent adjustment, parenting correlates of adolescent sleep functioning remain understudied. This study delineated patterns of sleep functioning in a sample of ethnically diverse, low-income, adolescents and examined associations among three types of parenting practices (parental involvement, parent-child conflict, and parental control) and adolescent sleep functioning (difficulties initiating sleep and maintaining sleep, and sleep duration). Adolescents ( N = 91, 11-19 years old) self-reported on sleep functioning and parenting practices. Results showed that in the preceding month, 60.5% of adolescents had difficulties initiating sleep and 73.6% had difficulties maintaining sleep. Most adolescents slept 8 or more hours per night, but 30.7% slept less than 8 hours. Latino adolescents slept longer and had fewer difficulties maintaining sleep than non-Latino. High school students had fewer difficulties maintaining sleep than their middle school counterparts; conversely, older adolescents experienced shorter sleep duration than younger ones. Adolescents whose parents had post-secondary education had shorter sleep duration than those whose parents had not graduated from high school. Parental control was correlated with fewer difficulties initiating sleep, whereas parent-child conflict was correlated with more difficulties maintaining sleep. There were no parenting correlates of sleep duration. Latino adolescents had better sleep profiles than non-Latino ones. Regression analyses showed that parental control and parent-child conflict were associated with adolescent sleep functioning across ethnicities. Results suggest that parenting practices, as well as demographic characteristics, are associated with adolescent sleep functioning and should be taken into account in interventions aimed at improving sleep functioning among adolescents.

Change in economic difficulties and physical and mental functioning: Evidence from British and Finnish employee cohorts.

PubMed

Lallukka, Tea; Ferrie, Jane E; Rahkonen, Ossi; Shipley, Martin J; Pietiläinen, Olli; Kivimäki, Mika; Marmot, Michael G; Lahelma, Eero

2013-09-01

The main aims of this longitudinal study were to (i) examine associations between changes in economic difficulties and health functioning among middle-aged employees and (ii) assess whether the associations remained after considering conventional domains of socioeconomic position. The associations were tested in two European welfare state occupational cohorts to strengthen the evidence base and improve generalizability. Data came from two cohorts: the Finnish Helsinki Health Study (baseline 2000-2002, follow-up 2007, N = 6328) and the British Whitehall II Study (baseline 1997-1999, follow-up 2003-2004, N = 4350). Responses to the survey item "finding it hard to afford adequate food and clothes and pay bills" repeated at baseline and follow-up were used to examine persistent, increasing, and decreasing economic difficulties. Poor physical and mental health functioning were denoted as being in the lowest quartile of the Short Form 36 physical and mental component summary. Logistic regression analyses were adjusted for sex, age, childhood economic difficulties, household income at baseline and follow-up, employment status at follow-up, and baseline health functioning. We observed strong sex- and age-adjusted associations between increasing [odds ratio (OR) range 1.69-2.96] and persistent (OR range 2.54-3.21) economic difficulties and poorer physical and mental health functioning in both British and Finnish occupational cohorts. These associations remained after full adjustments. Those reporting decreasing difficulties over follow-up also had poorer functioning (OR range 1.30-1.61) compared to those who did not have difficulties at baseline, possibly reflecting residual effects of economic difficulties at baseline. Changes in economic difficulties are associated with poorer physical and mental health functioning independent of income, employment status, and baseline health functioning.

Difficulties in Recognising Vocational Skills and Qualifications across Europe

ERIC Educational Resources Information Center

Brockmann, Michaela; Clarke, Linda; Winch, Christopher

2009-01-01

The development of the European Qualification Framework (EQF) as a means of assessing the relative status of qualifications across the EU is described, together with its fundamental design characteristics, particularly the adoption of a "learning outcomes" approach. Ways in which it may be implemented, and possible difficulties in this,…

Social ties may play a critical role in mitigating sleep difficulties in disaster-affected communities: a cross-sectional study in the Ishinomaki area, Japan.

PubMed

Matsumoto, Shoko; Yamaoka, Kazue; Inoue, Machiko; Muto, Shinsuke

2014-01-01

We examined the association between social factors and sleep difficulties among the victims remaining at home in the Ishinomaki area after the Great East Japan Earthquake and Tsunami and identified potentially modifiable factors that may mitigate vulnerability to sleep difficulties during future traumatic events or disasters. A cross-sectional household survey was conducted from October 2011 to March 2012 (6-12 mo after the disaster) in the Ishinomaki area, Japan. Univariate and multivariate logistic regression models were used to examine associations between social factors and sleep difficulties. We obtained data on 4,176 household members who remained in their homes after the earthquake and tsunami. N/A. Sleep difficulties were prevalent in 15.0% of the respondents (9.2% male, 20.2% female). Two potentially modifiable factors (lack of pleasure in life and lack of interaction with/visiting neighbors) and three nonmodifiable or hardly modifiable factors (sex, source of income, and number of household members) were associated with sleep difficulties. Nonmodifiable or hardly modifiable consequences caused directly by the disaster (severity of house damage, change in family structure, and change in working status) were not significantly associated with sleep difficulties. Our data suggest that the lack of pleasure in life and relatively strong networks in the neighborhood, which are potentially modifiable, might have stronger associations with sleep difficulties than do nonmodifiable or hardly modifiable consequences of the disaster (e.g., house damage, change in family structure, and change in work status).

Reviewing Evidence-Based Practice for Pupils with Dyslexia and Literacy Difficulties

ERIC Educational Resources Information Center

Griffiths, Yvonne; Stuart, Morag

2013-01-01

There is now a strong evidence base from theory and research providing a "template" to inform practice at Wave 2, guiding the design and implementation of time-limited effective early intervention programmes for pupils identified as "at risk" of reading difficulties following initial literacy instruction (Rose, 2009). In…

Changing the individual to promote health-enhancing physical activity: the difficulties of producing evidence and translating it into practice.

PubMed

Blamey, Avril; Mutrie, Nanette

2004-08-01

This paper presents conclusions from recent systematic reviews and highlights individually targeted interventions that are effective at increasing physical activity. It discusses the limitations of currently available evidence, considers what factors lead to these limitations and what barriers exist in terms of implementing the evidence as part of local and national policy and practice. Barriers present themselves in terms of getting evidence into practice and in terms of ensuring that practice informs the evidence base. These barriers include difficulties in conducting systematic reviews, disaggregating knowledge from complex interventions, making local adaptations to existing evidence, the lack of an evaluation culture, ethical and pragmatic difficulties in designing interventions, selecting appropriate outcome measures, poor designs and implementation of evidence and, finally, a recognition that policy making is not only based on the available evidence. New and more integrated approaches to evaluation and to practice are needed.

Ability to Walk 1/4 Mile Predicts Subsequent Disability, Mortality, and Health Care Costs

PubMed Central

Kang, Yihuang; Studenski, Stephanie A.; Degenholtz, Howard B.

2010-01-01

ABSTRACT Background Mobility, such as walking 1/4 mile, is a valuable but underutilized health indicator among older adults. For mobility to be successfully integrated into clinical practice and health policy, an easily assessed marker that predicts subsequent health outcomes is required. Objective To determine the association between mobility, defined as self-reported ability to walk 1/4 mile, and mortality, functional decline, and health care utilization and costs during the subsequent year. Design Analysis of longitudinal data from the 2003–2004 Medicare Current Beneficiary Survey, a nationally representative sample of Medicare beneficiaries. Participants Participants comprised 5895 community-dwelling adults aged 65 years or older enrolled in Medicare. Main Measures Mobility (self-reported ability to walk 1/4 mile), mortality, incident difficulty with activities of daily living (ADLs), total annual health care costs, and hospitalization rates. Key Results Among older adults, 28% reported difficulty and 17% inability to walk 1/4 mile at baseline. Compared to those without difficulty and adjusting for demographics, socioeconomic status, chronic conditions, and health behaviors, mortality was greater in those with difficulty [AOR (95% CI): 1.57 (1.10-2.24)] and inability [AOR (CI): 2.73 (1.79-4.15)]. New functional disability also occurred more frequently as self-reported ability to walk 1/4 mile declined (subsequent incident disability among those with no difficulty, difficulty, or inability to walk 1/4 mile at baseline was 11%, 29%, and 47% for instrumental ADLs, and 4%, 14%, and 23% for basic ADLs). Total annual health care costs were $2773 higher (95% CI $1443-4102) in persons with difficulty and $3919 higher (CI $1948-5890) in those who were unable. For each 100 persons, older adults reporting difficulty walking 1/4 mile at baseline experienced an additional 14 hospitalizations (95% CI 8-20), and those who were unable experienced an additional 22 hospitalizations (CI 14-30) during the follow-up period, compared to persons without walking difficulty. Conclusions Mobility disability, a simple self-report measure, is a powerful predictor of future health, function, and utilization independent of usual health and demographic indicators. Mobility disability may be used to target high-risk patients for care management and preventive interventions. PMID:20972641

Influence of fatigue on construction workers' physical and cognitive function.

PubMed

Zhang, M; Murphy, L A; Fang, D; Caban-Martinez, A J

2015-04-01

Despite scientific evidence linking workers' fatigue to occupational safety (due to impaired physical or cognitive function), little is known about this relationship in construction workers. To assess the association between construction workers' reported fatigue and their perceived difficulties with physical and cognitive functions. Using data from a convenience sample of US construction workers participating in the 2010-11 National Health Interview Survey two multivariate weighted logistic regression models were built to predict difficulty with physical and with cognitive functions associated with workers' reported fatigue, while controlling for age, smoking status, alcohol consumption status, sleep hygiene, psychological distress and arthritis status. Of 606 construction workers surveyed, 49% reported being 'tired some days' in the past 3 months and 10% reported 'tired most days or every day'. Compared with those feeling 'never tired', workers who felt 'tired some days' were significantly more likely to report difficulty with physical function (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] 1.17-3.51) and cognitive function (AOR = 2.27; 95% CI 1.06-4.88) after controlling for potential confounders. Our results suggest an association between reported fatigue and experiencing difficulties with physical and cognitive functions in construction workers. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Burnout among Volunteers in the Social Services: The Impact of Gender and Employment Status

ERIC Educational Resources Information Center

Kulik, Liat

2006-01-01

This study examines whether gender and employment status affect burnout, motives for volunteering, and difficulties associated with volunteer activity in social and community services in Israel. The sample included 375 men and women aged 16 through 80. Participants were divided into four groups by employment status: high school students, employed…

School Performance, Status Relations, and the Structure of Sentiment: Bringing the Teacher Back In.

ERIC Educational Resources Information Center

Alexander, Karl L; And Others

1987-01-01

Teachers' social origins influence their reactions to students. Low-status and minority students experience difficulties in the classrooms of high-status teachers. Outcomes of these relationships are that the students are seen as less mature and less is expected of them. A model of teacher-pupil background congruence is proposed. (Author/VM)

Experiencing sexuality in youth living in Greece: contraceptive practices, risk taking, and psychosocial status.

PubMed

Tsitsika, Artemis; Andrie, Elisabeth; Deligeoroglou, Efthymios; Tzavara, Chara; Sakou, Irene; Greydanus, Donald; Papaevangelou, Vassiliki; Tsolia, Mariza; Creatsas, George; Bakoula, Chryssa

2014-08-01

To assess initiation of sexual activity and contraception methods used among Greek adolescents. To determine the association of adolescents' emotional and behavioral status with their sexual activity. A descriptive cross-sectional survey was conducted. The population (N = 1074, age 14-16) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece. Anonymous self-reported questionnaires were used to assess sexual activity choices and contraception methods. The Youth Self-Report questionnaire was used to evaluate the psychosocial competencies and difficulties of Greek adolescents. Analyses included frequencies with chi-square tests and multivariate logistic regression analysis. Factors that may influence sexual engagement of Greek adolescents were assessed. Of the adolescents who completed the questionnaire 21.8% reported having experienced sexual intercourse. The male/female ratio was 3/1 (P < .001) and the mean age of sexual debut was 14.5 ± 0.9 years. Condoms were the most preferred contraceptive method (79.9%), followed by withdrawal (38.9%). Emergency contraception was used by 9.6% of participants. Adolescents with separated, divorced or with a deceased parent, and non-Greek nationality have higher possibility of being sexually active. Adolescents who reported sexual intercourse had significantly higher score of thought problems (β = 1.07, SE = 0.35, P = .002), attention difficulties (β = 0.67, SE = 0.29, P = .022), delinquent behavior problems (β = 2.37, SE = 0.34, P < .001), aggressive behavior (β = 1.97, SE = 0.48, P < .001), and externalizing problems (β = 4.18, SE = 0.78, P < .001). Engagement in sexual activities was significantly associated with psychosocial difficulties among adolescents living in Greece. Copyright © 2014. Published by Elsevier Inc.

Good cell culture practices &in vitro toxicology.

PubMed

Eskes, Chantra; Boström, Ann-Charlotte; Bowe, Gerhard; Coecke, Sandra; Hartung, Thomas; Hendriks, Giel; Pamies, David; Piton, Alain; Rovida, Costanza

2017-12-01

Good Cell Culture Practices (GCCP) is of high relevance to in vitro toxicology. The European Society of Toxicology In Vitro (ESTIV), the Center for Alternatives for Animal Testing (CAAT) and the In Vitro Toxicology Industrial Platform (IVTIP) joined forces to address by means of an ESTIV 2016 pre-congress session the different aspects and applications of GCCP. The covered aspects comprised the current status of the OECD guidance document on Good In Vitro Method Practices, the importance of quality assurance for new technological advances in in vitro toxicology including stem cells, and the optimized implementation of Good Manufacturing Practices and Good Laboratory Practices for regulatory testing purposes. General discussions raised the duality related to the difficulties in implementing GCCP in an academic innovative research framework on one hand, and on the other hand, the need for such GCCP principles in order to ensure reproducibility and robustness of in vitro test methods for toxicity testing. Indeed, if good cell culture principles are critical to take into consideration for all uses of in vitro test methods for toxicity testing, the level of application of such principles may depend on the stage of development of the test method as well as on the applications of the test methods, i.e., academic innovative research vs. regulatory standardized test method. Copyright © 2017 Elsevier Ltd. All rights reserved.

Do word-problem features differentially affect problem difficulty as a function of students' mathematics difficulty with and without reading difficulty?

PubMed

Powell, Sarah R; Fuchs, Lynn S; Fuchs, Douglas; Cirino, Paul T; Fletcher, Jack M

2009-01-01

This study examined whether and, if so, how word-problem features differentially affect problem difficulty as a function of mathematics difficulty (MD) status: no MD (n = 109), MD only (n = 109), or MD in combination with reading difficulties (MDRD; n = 109). The problem features were problem type (total, difference, or change) and position of missing information in the number sentence representing the word problem (first, second, or third position). Students were assessed on 14 word problems near the beginning of third grade. Consistent with the hypothesis that mathematical cognition differs as a function of MD subtype, problem type affected problem difficulty differentially for MDRD versus MD-only students; however, the position of missing information in word problems did not. Implications for MD subtyping and for instruction are discussed.

The effects of autonomous difficulty selection on engagement, motivation, and learning in a motion-controlled video game task.

PubMed

Leiker, Amber M; Bruzi, Alessandro T; Miller, Matthew W; Nelson, Monica; Wegman, Rebecca; Lohse, Keith R

2016-10-01

This experiment investigated the relationship between motivation, engagement, and learning in a video game task. Previous studies have shown increased autonomy during practice leads to superior retention of motor skills, but it is not clear why this benefit occurs. Some studies suggest this benefit arises from increased motivation during practice; others suggest the benefit arises from better information processing. Sixty novice participants were randomly assigned to a self-controlled group, who chose the progression of difficulty during practice, or to a yoked group, who experienced the same difficulty progression but did not have choice. At the end of practice, participants completed surveys measuring intrinsic motivation and engagement. One week later, participants returned for a series of retention tests at three different difficulty levels. RM-ANCOVA (controlling for pre-test) showed that the self-controlled group had improved retention compared to the yoked group, on average, β=46.78, 95% CI=[2.68, 90.87], p=0.04, but this difference was only statistically significant on the moderate difficulty post-test (p=0.004). The self-controlled group also showed greater intrinsic motivation during practice, t(58)=2.61, p=0.01. However, there was no evidence that individual differences in engagement (p=0.20) or motivation (p=0.87) were associated with learning, which was the relationship this experiment was powered to detect. These data are inconsistent with strictly motivational accounts of how autonomy benefits learning, instead suggesting the benefits of autonomy may be mediated through other mechanisms. For instance, within the information processing framework, the learning benefits may emerge from learners appropriately adjusting difficulty to maintain an appropriate level of challenge (i.e., maintaining the relationship between task demands and cognitive resources). Copyright © 2016 Elsevier B.V. All rights reserved.

Teacher Strategies for Effective Intervention with Students Presenting Social, Emotional and Behavioural Difficulties: Implications for Policy and Practice

ERIC Educational Resources Information Center

Cooper, Paul

2011-01-01

In this paper some key practice and policy implications emerging from a review of literature on effective teacher strategies for social, emotional and behavioural difficulties are set out. Particular attention is given to implications in relation to the development of teachers' skills.

Religious Observance by Muslim Employees: A Framework for Discussion.

ERIC Educational Resources Information Center

Commission for Racial Equality, London (England).

This paper discusses the relationship between the religious practices of Muslim employees and the requirements of the workplace. It is designed to provide information on the norms of Islam and the difficulties involved in its workplace practice, and to propose suggestions for resolving these difficulties that can form the basis for discussion and…

Assessment and Management of the Communication Difficulties of Children with Cerebral Palsy: A UK Survey of SLT Practice

ERIC Educational Resources Information Center

Watson, Rose Mary; Pennington, Lindsay

2015-01-01

Background: Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims:…

Using Two Models in Optics: Students' Difficulties and Suggestions for Teaching.

ERIC Educational Resources Information Center

Colin, P.; Viennot, L.

2001-01-01

Focuses on difficulties linked to situations in physics involving two models--geometrical optics and wave optics. Presents content analysis underlining two important features required for addressing such situations: (1) awareness of the status of the drawings; and (2) the 'backward selection' of paths of light. (Contains 24 references.)…

The Relationship between Social-Emotional Difficulties and Underachievement of Gifted Students

ERIC Educational Resources Information Center

Blaas, Sabrina

2014-01-01

Gifted students are a diverse minority group with high intelligence and talent whose needs are often unrecognised and unmet. It is believed that this group of students, from a range of backgrounds, socio-economic statuses and abilities, may experience a range of social-emotional difficulties, including peer exclusion, isolation, stress, anxiety,…

How University Students with Reading Difficulties Are Supported in Achieving Their Goals

ERIC Educational Resources Information Center

Stack-Cutler, Holly L.; Parrila, Rauno K.; Jokisaari, Markku; Nurmi, Jari-Erik

2015-01-01

We examine (a) what social ties university students with a history of reading difficulty (RD) report assisting them to achieve their goals, (b) outlets available for developing social ties, (c) resources mobilized within these relationships, and (d) the impact of social ties' status on academic achievement. Participants were 107 university…

Breastfeeding difficulties and exclusivity among late preterm and term infants: results from the all our babies study.

PubMed

Nagulesapillai, Tharsiya; McDonald, Sheila W; Fenton, Tanis R; Mercader, Hannah Faye G; Tough, Suzanne C

2013-07-25

To compare breastfeeding difficulties attributable to the baby and mother/milk and exclusive breastfeeding between a group of late preterm (LP) infants and term infants. We utilized data from a prospective community-based cohort (n=2977) in Calgary, Alberta, and performed bivariate and multivariable analyses to identify demographic, obstetric, maternal and infant health indicators that were independently associated with term status and breastfeeding outcomes. Multivariable analyses found that LP status was an independent risk factor for breastfeeding difficulties attributable to the baby (OR 1.72, 95% CI 1.24-2.38), but not for difficulties due to mother/milk (defined as not producing enough milk or having flat or inverted nipples). Among women who were breastfeeding at hospital discharge, mothers of LP infants were less likely to report exclusive breastfeeding at 4 months (OR 0.67, 95% CI 0.46-0.97), after controlling for household income level, mode of delivery and postpartum maternal physical health. Mothers of LP infants need increased support to establish successful breastfeeding outcomes and to ensure that these infants receive the full benefits of breast milk.

Do changes in spousal employment status lead to domestic violence? Insights from a prospective study in Bangalore, India.

PubMed

Krishnan, Suneeta; Rocca, Corinne H; Hubbard, Alan E; Subbiah, Kalyani; Edmeades, Jeffrey; Padian, Nancy S

2010-01-01

The prevalence of physical domestic violence--violence against women perpetrated by husbands--is staggeringly high across the Indian subcontinent. Although gender-based power dynamics are thought to underlie women's vulnerability, relatively little is known about risk and protective factors. This prospective study in southern India examined the association between key economic aspects of gender-based power, namely spousal employment status, and physical domestic violence. In 2005-2006, 744 married women, aged 16-25, residing in low-income communities in Bangalore, India were enrolled in the study. Data were collected at enrollment, 12 and 24 months. Multivariable logistic regression models were used to examine the prospective association between women's employment status, their perceptions of their husband's employment stability, and domestic violence. Women who were unemployed at one visit and began employment by the next visit had an 80% higher odds of violence, as compared to women who maintained their unemployed status. Similarly, women whose husbands had stable employment at one visit and newly had difficulty with employment had 1.7 times the odds of violence, as compared to women whose husbands maintained their stable employment. To our knowledge, this study is the first from a developing country to confirm that changes in spousal employment status are associated with subsequent changes in violence risk. It points to the complex challenges of violence prevention, including the need for interventions among men and gender-transformative approaches to promote gender-equitable attitudes, practices and norms among men and women.

African-American and Hispanic Children’s Beverage Intake: Differences in Associations with Desire to Drink, Fathers’ Feeding Practices, and Weight Concerns

PubMed Central

Lora, Karina R.; Hubbs-Tait, Laura; Ferris, Ann M.; Wakefield, Dorothy

2016-01-01

Relationships of African-American and Hispanic fathers’ feeding practices and weight concerns and preschoolers’ desire to drink with children’s beverage intake were examined, and associations between fathers’ feeding practices and children’s weight status were evaluated. Fathers’ (Hispanic n = 61, African-American n = 49) difficulty in child feeding, use of food to calm, use of food as reward, and concern about the child being under and overweight as well as their child’s desire to drink were assessed. Preschoolers’ (ages 2 to 5) total sugar-sweetened beverage (SSB), fruit juice, and water intake were measured by a modified beverage intake questionnaire. Body Mass Index (BMI) and BMI percentile were calculated for fathers and children, respectively. Multiple regressions revealed that, in Hispanics, difficulty in feeding, concern about underweight, use of food to calm, and use of food as a reward were significantly associated with child intake of total SSB, whereas, in African-Americans, child desire to drink was associated with total SSB and fruit juice. Concern about the child being underweight was inversely associated with child BMI percentile in Hispanics. Significant differences in regression coefficients of child SSB intake to fathers’ behaviors versus child desire to drink between the two racial-ethnic groups indicated that use of food to calm the child predicted increased intake of SSB by Hispanic but not by African-American children, while child desire to drink predicted increased intake of SSB by African-American but not by Hispanic children. Because of these significant differences, future research might profitably explore socio-cultural influences on associations of additional child feeding behaviors with fathers’ attempts to control them. Furthermore, practitioners should consider developing and evaluating different child obesity interventions for these two racial-ethnic groups. PMID:27620644

[Maternity for others: from desiring a child to desiring a child at any price].

PubMed

de Montgolfier, Sandrine; Mirkovic, Aude

2009-04-01

Surrogacy is prohibited by French law. On December 17th 2008 the French Court of Cassation has refused the transcription on the French register of civil status of U.S. birth certificates of children born to a surrogate mother in California. Some have been requesting that legislators amend current laws so as to legalize the practice. Such a claim is far from unanimous. Two successive reports of the French Parliament have underlined their opposition to such modifications: the first report has been delivered by a working group of the Senate and the second by the Parliamentary Office for Scientific and Technological Choices. We propose to analyze the elements that are opposed to the legalization of the practice. We do not underestimate the suffering of couples without children or the love they want to give but if surrogacy is forbidden it is because of the numerous difficulties it entails and that can not be bypassed by sentimental considerations.

Analytical Methods for Quantification of Vitamin D and Implications for Research and Clinical Practice.

PubMed

Stokes, Caroline S; Lammert, Frank; Volmer, Dietrich A

2018-02-01

A plethora of contradictory research surrounds vitamin D and its influence on health and disease. This may, in part, result from analytical difficulties with regard to measuring vitamin D metabolites in serum. Indeed, variation exists between analytical techniques and assays used for the determination of serum 25-hydroxyvitamin D. Research studies into the effects of vitamin D on clinical endpoints rely heavily on the accurate assessment of vitamin D status. This has important implications, as findings from vitamin D-related studies to date may potentially have been hampered by the quantification techniques used. Likewise, healthcare professionals are increasingly incorporating vitamin D testing and supplementation regimens into their practice, and measurement errors may be also confounding the clinical decisions. Importantly, the Vitamin D Standardisation Programme is an initiative that aims to standardise the measurement of vitamin D metabolites. Such a programme is anticipated to eliminate the inaccuracies surrounding vitamin D quantification. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Sociometric-Status-Group Classification of Mainstreamed Children Who Have Moderate Learning Difficulties: An Investigation of Personal and Environmental Factors.

ERIC Educational Resources Information Center

Frederickson, Norah L.; Furnham, Adrian F.

1998-01-01

Study examines the classes of variables identified in D. L. MacMillan and G. M. Morrison's (1984) multicomponent model for research on sociometric status in special education. Results are discussed with reference to social-exchange theory, as an integrative basis for research on children's sociometric status. Implications for mainstreaming…

The Challenges of Science Inquiry Teaching for Pre-Service Teachers in Elementary Classrooms: Difficulties on and under the Scene

NASA Astrophysics Data System (ADS)

Yoon, Hye-Gyoung; Joung, Yong Jae; Kim, Mijung

2012-06-01

In the context of the emphasis on inquiry teaching in science education, this study looks into how pre-service elementary teachers understand and practise science inquiry teaching during field experience. By examining inquiry lesson preparation, practice, and reflections of pre-service elementary teachers, we attempt to understand the difficulties they encounter and what could result from those difficulties in their practice. A total of 16 seniors (fourth-year students) in an elementary teacher education program participated in this study. In our findings, we highlight three difficulties `on the lesson' that are related to teaching practices that were missing in the classrooms: (1) developing children's own ideas and curiosity, (2) guiding children in designing valid experiments for their hypotheses, (3) scaffolding children's data interpretation and discussion and another three difficulties `under the lesson' that are related to problems with the pre-service teachers' conceptualization of the task: (4) tension between guided and open inquiry, (5) incomplete understanding of hypothesis, and (6) lack of confidence in science content knowledge. Based on these findings, we discuss how these difficulties are complexly related in the pre-service teachers' understandings and action. Several suggestions for science teacher education for inquiry teaching, especially hypothesis-based inquiry teaching, are then explored.

Employment status, difficulties at work and quality of life in inflammatory bowel disease patients.

PubMed

De Boer, Angela G E M; Bennebroek Evertsz', Floor; Stokkers, Pieter C; Bockting, Claudia L; Sanderman, Robert; Hommes, Daniel W; Sprangers, Mirjam A G; Frings-Dresen, Monique H W

2016-10-01

To assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression. IBD patients attending an IBD outpatients' clinic received self-report questionnaires on employment status, IBD-related difficulties at work and sick leave (Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness), sociodemographic factors, QoL (Inflammatory Bowel Disease Questionnaire and 12-item Short-form Health Survey) and anxiety and depression (Hospital Anxiety and Depression Scale). Disease activity was assessed by their gastroenterologist. Associations between paid employment and sick leave with sociodemographic and clinical factors, QoL and anxiety and depression were assessed by regression analyses. In total, 202 IBD patients of working age, with a mean age of 41 years, participated; 63% had Crohn's disease and 37% had ulcerative colitis, and 57% were women and 19% had active disease. In all, 123 (61%) patients were in paid employment, of whom 31 (25%) were on sick leave, whereas 46 (23%) received a disability pension. Concentration problems (72%), low working pace (78%) and delayed work production (50%) were the most prevalent IBD-related work difficulties. IBD patients without paid employment were older and more often women, with active disease, lower QoL and higher anxiety and depression rates. Sick leave was associated with lower QoL and higher anxiety and depression rates. More than half of IBD patients were in paid employment, whereas almost a quarter was receiving a disability pension. A large majority experienced work difficulties. Having no paid employment was associated with poorer QoL and more anxiety and depression symptomatology.

Does Visual Impairment Affect Mobility Over Time? The Salisbury Eye Evaluation Study

PubMed Central

Swenor, Bonnielin K.; Muñoz, Beatriz; West, Sheila K.

2013-01-01

Purpose. To determine if the odds of mobility disability increases at a different rate among visually impaired (VI) as compared with nonvisually impaired (NVI) over an 8-year period. Methods. A total of 2520 Salisbury Eye Evaluation Study participants were followed 2, 6, and 8 years after baseline. VI was defined as best-corrected visual acuity worse than 20/40, or visual field of approximately less than 20°. Self-reported difficulty with three tasks was assessed at each visit: walking up 10 steps, walking down 10 steps, and walking 150 feet. Generalized estimating equation models included a 6-year spline, and explored differences in mobility difficulty trajectories by including an interaction between VI status and the spline terms. Odds ratios (OR) and 95% confidence intervals (CI) compared mobility difficulty for each task by VI status. Results. At baseline, the VI were significantly more likely to report difficulty mobility tasks than the NVI (ORdifficultywalkingup10steps = 1.37, CI: 1.02–1.80; ORdifficultywalkingdown10steps = 1.55, CI: 1.16–2.08; ORdifficultywalking150feet = 1.50, CI: 1.10–2.04). The trajectory of mobility disability did not differ by VI status from baseline to the 6-year visit. However, the difference between the VI and NVI declined at the 8-year visit, which may be due to loss of VI participants at risk of developing mobility difficulty. Conclusions. The VI were more likely to report mobility disability than the NVI, but the trajectory of mobility disability was not steeper among the VI as compared to the NVI over the study period. PMID:24176902

Practices of Other-Initiated Repair in the Classrooms of Children with Specific Speech and Language Difficulties

ERIC Educational Resources Information Center

Radford, Julie

2010-01-01

Repair practices used by teachers who work with children with specific speech and language difficulties (SSLDs) have hitherto remained largely unexplored. Such classrooms therefore offer a new context for researching repairs and considering how they compare with non-SSLD interactions. Repair trajectories are of interest because they are dialogic…

Sharing Good Practice: Prevention and Support Concerning Pupils Presenting Social, Emotional and Behavioural Difficulties.

ERIC Educational Resources Information Center

Lloyd, Gwynedd, Ed.; Munn, Pamela, Ed.

This book is the result of a project to identify and disseminate examples of good practice in providing for children experiencing social, emotional, and behavioral difficulties in schools. The focus is on whole-school or classroom approaches to mainstreaming with experience from teachers of preschool to secondary grades. A major theme is providing…

Identifying Students' Difficulties When Learning Technical Skills via a Wireless Sensor Network

ERIC Educational Resources Information Center

Wang, Jingying; Wen, Ming-Lee; Jou, Min

2016-01-01

Practical training and actual application of acquired knowledge and techniques are crucial for the learning of technical skills. We established a wireless sensor network system (WSNS) based on the 5E learning cycle in a practical learning environment to improve students' reflective abilities and to reduce difficulties for the learning of technical…

Reading and Spelling Difficulties in the ELT Classroom

ERIC Educational Resources Information Center

Gerlach, David

2017-01-01

Learners with reading and/or spelling difficulties (RSD) generally also show severe problems in learning EFL. Taking into consideration several observational and interventional studies, this article illustrates some practical and pragmatic means of identifying RSD, and provides possible solutions when addressing these difficulties in ELT…

Gradual training reduces practice difficulty while preserving motor learning of a novel locomotor task.

PubMed

Sawers, Andrew; Hahn, Michael E

2013-08-01

Motor learning strategies that increase practice difficulty and the size of movement errors are thought to facilitate motor learning. In contrast to this, gradual training minimizes movement errors and reduces practice difficulty by incrementally introducing task requirements, yet remains as effective as sudden training and its large movement errors for learning novel reaching tasks. While attractive as a locomotor rehabilitation strategy, it remains unknown whether the efficacy of gradual training extends to learning locomotor tasks and their unique requirements. The influence of gradual vs. sudden training on learning a locomotor task, asymmetric split belt treadmill walking, was examined by assessing whole body sagittal plane kinematics during 24 hour retention and transfer performance following either gradual or sudden training. Despite less difficult and less specific practice for the gradual cohort on day 1, gradual training resulted in equivalent motor learning of the novel locomotor task as sudden training when assessed by retention and transfer a day later. This suggests that large movement errors and increased practice difficulty may not be necessary for learning novel locomotor tasks. Further, gradual training may present a viable locomotor rehabilitation strategy avoiding large movement errors that could limit or impair improvements in locomotor performance. Copyright © 2013 Elsevier B.V. All rights reserved.

Average and Bright Adults with Parents with Mild Cognitive Difficulties: The Huck Finn Syndrome 20 Years Later

ERIC Educational Resources Information Center

O'Neill, Audrey Myerson

2011-01-01

Background: This longitudinal study of 20 average and bright adults with parents with cognitive difficulties follows a study 20 years earlier of their childhood adaptation to their parents. Method: Semistructured interviews about life situation and changes and perception of family-of-origin. Results: The participants' socioeconomic status changed…

Impact of flooding on feeding practices of infants and young children in Dhaka, Bangladesh Slums: what are the coping strategies?

PubMed

Goudet, Sophie M; Griffiths, Paula L; Bogin, Barry A; Selim, Nasima

2011-04-01

Previous research has shown that urban slums are hostile environments for the growth of infants and young children (IYC). Flooding is a hazard commonly found in Dhaka slums (Bangladesh) which negatively impacts IYC's nutritional and health status. This paper aims 1) to identify the impact of flooding on IYC's feeding practices, and 2) to explore the coping strategies developed by caregivers. Qualitative data (participant observation and semi-structured interviews) and quantitative data (household questionnaire and anthropometric measurements) collected in slums in Dhaka (n=18 mothers, n=5 community health workers, and n=55 children) were analysed. The subjects of the interviews were mothers and Bangladesh Rural Advancement Committee (BRAC) community health workers living and working in the slums. Research findings showed that breastfeeding and complementary feeding practices for IYC were poor and inappropriate due to lack of knowledge, time, and resources in normal times and worse during flooding. One coping strategy developed by mothers purposely to protect their IYC's nutritional status was to decrease their personal food intake. Our research findings suggest that mothers perceived the negative impact of flooding on their IYC's nutritional health but did not have the means to prevent it. They could only maintain their health through coping strategies which had other negative consequences. The results suggests a holistic approach combining 1) provision of relief for nutritionally vulnerable groups during flooding, 2) support to mothers in their working role, 3) breastfeeding counseling and support to lactating mothers with difficulties, and 4) preventing malnutrition in under 2 year old children. © 2010 Blackwell Publishing Ltd.

Does Early Algebraic Reasoning Differ as a Function of Students’ Difficulty with Calculations versus Word Problems?

PubMed Central

Powell, Sarah R.; Fuchs, Lynn S.

2014-01-01

According to national mathematics standards, algebra instruction should begin at kindergarten and continue through elementary school. Most often, teachers address algebra in the elementary grades with problems related to solving equations or understanding functions. With 789 2nd- grade students, we administered (a) measures of calculations and word problems in the fall and (b) an assessment of pre-algebraic reasoning, with items that assessed solving equations and functions, in the spring. Based on the calculation and word-problem measures, we placed 148 students into 1 of 4 difficulty status categories: typically performing, calculation difficulty, word-problem difficulty, or difficulty with calculations and word problems. Analyses of variance were conducted on the 148 students; path analytic mediation analyses were conducted on the larger sample of 789 students. Across analyses, results corroborated the finding that word-problem difficulty is more strongly associated with difficulty with pre-algebraic reasoning. As an indicator of later algebra difficulty, word-problem difficulty may be a more useful predictor than calculation difficulty, and students with word-problem difficulty may require a different level of algebraic reasoning intervention than students with calculation difficulty. PMID:25309044

Mental health outcomes of developmental coordination disorder in late adolescence.

PubMed

Harrowell, Ian; Hollén, Linda; Lingam, Raghu; Emond, Alan

2017-09-01

To assess the relationship between developmental coordination disorder (DCD) and mental health outcomes in late adolescence. Data were analyzed from the Avon Longitudinal Study of Parents and Children. Moderate-to-severe DCD was defined at 7 to 8 years according to the DSM-IV-TR criteria. Mental health was assessed at 16 to 18 years using self-reported questionnaires: Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire, and the Warwick-Edinburgh Mental Well-being Scale. Logistic and linear regressions assessed the associations between DCD and mental health, using multiple imputation to account for missing data. Adjustments were made for socio-economic status, IQ, and social communication difficulties. Adolescents with DCD (n=168) had an increased risk of mental health difficulties (total Strengths and Difficulties Questionnaire score) than their peers (n=3750) (odds ratio 1.78, 95% confidence interval 1.12-2.83, adjusted for socio-economic status and IQ). This was, in part, mediated through poor social communication skills. Adolescent females with DCD (n=59) were more prone to mental health difficulties than males. Greater mental well-being was associated with better self-esteem (β 0.82, p<0.001). Individuals with DCD, particularly females, had increased risk of mental health difficulties in late adolescence. Interventions that aim to promote resilience in DCD should involve improving social communication skills and self-esteem. © 2017 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Visual difficulty and employment status in the world.

PubMed

Harrabi, Hanen; Aubin, Marie-Josee; Zunzunegui, Maria Victoria; Haddad, Slim; Freeman, Ellen E

2014-01-01

Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters). Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other). The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05). As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.

Abortion and neonaticide: ethics, practice, and policy in four nations.

PubMed

Gross, Michael L

2002-06-01

Abortion, particularly later-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late-term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain or suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible, legislative reform.

Predictors of Depressive Symptoms in Caregivers of Patients with Heart Failure

PubMed Central

Chung, Misook L.; Pressler, Susan J.; Dunbar, Sandra B.; Lennie, Terry A.; Moser, Debra K.; Endowed, Gill

2010-01-01

Background Millions of family members deliver informal care and support to patients with heart failure (HF). Caregivers of patients with HF suffer from depressive symptoms, but factors associated with depressive symptoms are unknown. The purposes of this study were (1) to examine differences between caregivers with and without depressive symptoms in patients’ characteristics and caregivers’ functional status, caregiving burden (time devoted to caregiving, difficulty of caregiving tasks, and overall perceived caregiving distress), and perceived control; and (2) to determine predictors of depressive symptoms of caregivers. Method A total of 109 caregivers (mean age of 57 years; spousal caregiver 79%) and patients with HF participated in this study. Depressive symptoms, perceived control, and functional status of both patients and caregivers were assessed using the Beck Depression Inventory-II (BDI-II), the Control Attitudes Scale-Revised, and the Duke Activity Status Index, respectively. Caregivers’ burden (time and difficulty of caregiving tasks and burden) were assessed using the Oberst Caregiving Burden Scale, and the Zarit Burden Interview. Results The 27.5% of HF caregivers with depressive symptoms (BDI-II ≥ 14) had poorer functional status, lower perceived control, higher perceived caregiving distress, experienced more caregiving difficulty and spent more time in caregiving tasks than caregivers without depressive symptoms. Controlling for age and gender in a multiple regression, caregivers’ own functional disability (sβ = -.307, P < .001), perceived control (sβ = -.304, P < .001), and caregiver burden (sβ =.316, P = .002) explained 45% of the variance in caregivers’ depressive symptoms. Patients’ NYHA class and functional status did not predict caregivers’ depressive symptoms. Conclusion Caregivers’ poor functional status, overall perception of caregiving distress, and perceived control were associated with depressive symptoms. Depressed caregivers of patients with HF may benefit from interventions that improve caregivers’ perceived control, address the caregiving burden and improve or assist with caregivers’ functional status. PMID:20714239

Social Ties May Play a Critical Role in Mitigating Sleep Difficulties in Disaster-Affected Communities: A Cross-Sectional Study in the Ishinomaki Area, Japan

PubMed Central

Matsumoto, Shoko; Yamaoka, Kazue; Inoue, Machiko; Muto, Shinsuke

2014-01-01

Study Objectives: We examined the association between social factors and sleep difficulties among the victims remaining at home in the Ishinomaki area after the Great East Japan Earthquake and Tsunami and identified potentially modifiable factors that may mitigate vulnerability to sleep difficulties during future traumatic events or disasters. Design: A cross-sectional household survey was conducted from October 2011 to March 2012 (6-12 mo after the disaster) in the Ishinomaki area, Japan. Univariate and multivariate logistic regression models were used to examine associations between social factors and sleep difficulties. Participants: We obtained data on 4,176 household members who remained in their homes after the earthquake and tsunami. Interventions: N/A. Results: Sleep difficulties were prevalent in 15.0% of the respondents (9.2% male, 20.2% female). Two potentially modifiable factors (lack of pleasure in life and lack of interaction with/visiting neighbors) and three nonmodifiable or hardly modifiable factors (sex, source of income, and number of household members) were associated with sleep difficulties. Nonmodifiable or hardly modifiable consequences caused directly by the disaster (severity of house damage, change in family structure, and change in working status) were not significantly associated with sleep difficulties. Conclusions: Our data suggest that the lack of pleasure in life and relatively strong networks in the neighborhood, which are potentially modifiable, might have stronger associations with sleep difficulties than do nonmodifiable or hardly modifiable consequences of the disaster (e.g., house damage, change in family structure, and change in work status). Citation: Matsumoto S; Yamaoka K; Inoue M; Muto S. Social ties may play a critical role in mitigating sleep difficulties in disaster-affected communities: a cross-sectional study in the Ishinomaki area, Japan. SLEEP 2014;37(1):137-145. PMID:24470703

Obesity Prevention in Early Child Care Settings: A Bistate (Minnesota and Wisconsin) Assessment of Best Practices, Implementation Difficulty, and Barriers

ERIC Educational Resources Information Center

Nanney, Marilyn S.; LaRowe, Tara L.; Davey, Cynthia; Frost, Natasha; Arcan, Chrisa; O'Meara, Joyce

2017-01-01

Background: Long-term evaluation studies reveal that high-quality early care and education (ECE) programs that include a lifestyle component predict later adult health outcomes. The purpose of this article is to characterize the nutrition and physical activity (PA) practices, including implementation difficulty and barriers, of licensed center-…

Primary School Teachers' Practices and Troubles with the Students Who They Think Have Undiagnosed Difficulties in Verbal Communication, Reading and Writing

ERIC Educational Resources Information Center

Ergen, Yusuf; Elma, Cevat

2018-01-01

The primary school Turkish program was basically built on three learning domains. These are the learning domains of verbal communication, reading and writing. The purpose of the present study is to determine primary school teachers' practices and difficulties related to students considered to have undiognosed verbal communication, reading and…

Teachers' Teaching Practices and Beliefs Regarding Context-Based Tasks and Their Relation with Students' Difficulties in Solving These Tasks

ERIC Educational Resources Information Center

Wijaya, Ariyadi; van den Heuvel-Panhuizen, Marja; Doorman, Michiel

2015-01-01

In this study, we investigated teachers' teaching practices and their underlying beliefs regarding context-based tasks to find a possible explanation for students' difficulties with these tasks. The research started by surveying 27 Junior High School teachers from seven schools in Indonesia through a written questionnaire. Then, to further examine…

Developing Pedagogical Expertise in Modern Language Learning and Specific Learning Difficulties through Collaborative and Open Educational Practices

ERIC Educational Resources Information Center

Gallardo, Matilde; Heiser, Sarah; Arias McLaughlin, Ximena

2017-01-01

This paper analyses teachers' engagement with collaborative and open educational practices to develop their pedagogical expertise in the field of modern language (ML) learning and specific learning difficulties (SpLD). The study analyses the findings of a staff development initiative at the Department of Languages, Open University, UK, in 2013,…

Teaching Children with Down Syndrome in Inclusive Primary Mathematics Classrooms

ERIC Educational Resources Information Center

Faragher, Rhonda; Stratford, Melanie; Clarke, Barbara

2017-01-01

At the turn of this century, expectations for learning mathematics by students with Down syndrome were low. Research and practice continued to indicate considerable difficulty with number and calculation (Bird & Buckley, 2001). Unfortunately, most authors extrapolated difficulty with number to difficulty with mathematics in general, even…

Cultural influences on implementing environmental impact assessment: Insights from Thailand, Indonesia, and Malaysia

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

Boyle, J.

In Thailand, Indonesia, and Malaysia, political and business support for environmental impact assessment (EIA) is low, and environmental agencies are virtually powerless compared with economic development agencies. Whereas technical factors contribute to the consequent ineffectiveness of EIA, cultural factors provide complementary explanations. A reliance on paternalistic authority, hierarchy, and status as principles of social organization; a dependence on patron-client relationships for ensuring loyalty and advancement among political, bureaucratic, and private-sector actors; and a strong desire to avoid conflict and maintain face; all of these factors reinforce the power of political and business elites and circumscribe that of individuals and communities.more » They also result in government bureaucracies where low-status environmental agencies have little power or authority and the interagency cooperation needed for effective EIA is lacking. The article demonstrates that it is vital to consider cultural as well as technical factors when examining the difficulties of implementing policies or programs like EIA, which are invented in the West and transferred to another culture with very different social and political heritages and practices.« less

Helping Students Understand Challenging Topics in Science through Ontology Training

ERIC Educational Resources Information Center

Slotta, James D.; Chi, Michelene T. H.

2006-01-01

Chi (2005) proposed that students experience difficulty in learning about physics concepts such as light, heat, or electric current because they attribute to these concepts an inappropriate ontological status of material substances rather than the more veridical status of emergent processes. Conceptual change could thus be facilitated by training…

Circumcision in Australia: further evidence on its effects on sexual health and wellbeing.

PubMed

Ferris, Jason A; Richters, Juliet; Pitts, Marian K; Shelley, Julia M; Simpson, Judy M; Ryall, Richard; Smith, Anthony M A

2010-04-01

To report on the prevalence and demographic variation in circumcision in Australia and examine sexual health outcomes in comparison with earlier research. A representative household sample of 4,290 Australian men aged 16-64 years completed a computer-assisted telephone interview including questions on circumcision status, demographic variables, reported lifetime experience of selected sexually transmissible infections (STIs), experience of sexual difficulties in the previous 12 months, masturbation, and sexual practices at last heterosexual encounter. More than half the men (58%) were circumcised. Circumcision was less common (33%) among men under 30 and more common (66%) among those born in Australia. After adjustment for age and number of partners, circumcision was unrelated to STI history except for non-specific urethritis (higher among circumcised men, OR=2.11, p<0.001) and penile candidiasis (lower among circumcised men, OR=0.49, p<0.001). Circumcision was unrelated to any of the sexual difficulties we asked about (after adjusting for age) except that circumcised men were somewhat less likely to have worried during sex about whether their bodies looked unattractive (OR=0.77, p=0.04). No association between lack of circumcision and erection difficulties was detected. After correction for age, circumcised men were somewhat more likely to have masturbated alone in the previous 12 months (OR=1.20, p=0.02). Circumcision appears to have minimal protective effects on sexual health in Australia. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

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

Lakshminarayan, Raghuram, E-mail: raghuram.lakshminarayan@hey.nhs.u; Simpson, James O.; Ettles, Duncan F., E-mail: Duncan.Ettles@hey.nhs.u

Magnetic resonance angiography (MRA) has become an established imaging modality in the management of lower-limb arterial disease, with emerging roles in treatment planning and follow-up. Contrast-enhanced MRA is now the most widely used technique with clinically acceptable results in the majority of patients. Difficulties in imaging and image interpretation are recognised in certain subgroups, including patients with critical limb ischaemia as well as patients with stents. Although newer contrast agents and refined imaging protocols may offer some solutions to these problems, this optimism is balanced by concerns about the toxicity of certain gadolinium chelates. Further development of interventional MRA remainsmore » one of the most significant challenges in the development of magnetic resonance imaging-guided peripheral vascular intervention. The status of MRA in managing patients with lower-limb arterial disease in current clinical practice is reviewed.« less

Problem drinking among at-risk college students: The examination of Greek involvement, freshman status, and history of mental health problems.

PubMed

Martinez, Haley S; Klanecky, Alicia K; McChargue, Dennis E

2018-02-06

Scarce research has examined the combined effect of mental health difficulties and demographic risk factors such as freshman status and Greek affiliation in understanding college problem drinking. The current study is interested in looking at the interaction among freshman status, Greek affiliation, and mental health difficulties. Undergraduate students (N = 413) from a private and public Midwestern university completed a large online survey battery between January 2009 and April 2013. Data from both schools were aggregated for the analyses. After accounting for gender, age, and school type, the three-way interaction indicated that the highest drinking levels were reported in freshman students who reported a history of mental health problems although were not involved in Greek life. Findings are discussed in the context of perceived social norms, as well as alcohol-related screenings and intervention opportunities on college campuses.

Dentist's distress in the management of chronic pain control: The example of TMD pain in a dental practice-based research network.

PubMed

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V; Gilbert, Gregg H

2018-01-01

We aimed to obtain greater understanding of dentists' distress when they diagnose and treat patients with temporomandibular disorders (TMD), and to explore ways in which TMD can be better treated.We conducted a cross-sectional study based on a questionnaire survey of dentists (n = 148). Dentists were queried using an open-ended questionnaire about distress they experienced when treating patients with TMD. Survey responses were analyzed using mixed methods. Associations between specific dentist and patient characteristics and types of distress were analyzed by one way analysis of variance and residual analysis.One hundred thirteen clinicians responded to the questionnaire, giving a 76% response rate. Thematic analysis identified 6 major themes: difficulty in predicting therapeutic effect and prognosis; difficulty in diagnosis; difficulty in the decision about whether to do occlusal adjustment; difficulty in specifying a cause; difficulty in communicating with patients and mental factors; and health insurance system barriers. Clinicians who reported difficulty in deciding whether to do occlusal adjustment saw significantly more patients who experienced shoulder stiffness and headache (P = .008 and P = .022, respectively). Dentists' knowledge of TMD guidelines was associated with a lower percentage of difficulty in predicting therapeutic effect and prognosis (residual analysis; P = .010).These findings provide important insights into clinician's perception of difficulties with patients experiencing TMD-related pain. Knowledge of the existence of TMD clinical practice guidelines may lower dentist distress, particularly with regard to prognosis. Further studies are needed to decrease dentist's distress and to overcome the evidence-practice gap in TMD treatment. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.

PubMed

Shakespeare, Judy; Blake, Fiona; Garcia, Jo

2004-09-01

to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals. qualitative in-depth interview study. postnatal women of 22 general practices within Oxford City Primary Care Group area. 39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received 'listening visits' from health visitors. a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt. in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the 'Baby Friendly Initiative', may be a contributing factor. This needs to be explored in a further study.

A Study of the Interrelationship between the Behaviour and Social Status of a Class of Year 2 Pupils

ERIC Educational Resources Information Center

Slade, Melanie

2008-01-01

The influence of social status on child development has been the subject of research for several decades, with children who are not accepted by their peers being shown to be at risk of a range of difficulties both at the time and in later life. Strong links have also been established between behaviour and social status. A small-scale action…

The Bears Family Projective Test: evaluating stories of children with emotional difficulties.

PubMed

Iandolo, Giuseppe; Esposito, Gianluca; Venuti, Paola

2012-06-01

The aim of this study was to describe and analyze the storytelling of children with emotional difficulties. Forty children with emotional and relational difficulties (inhibited and impulsive), ages between 5.5 and 9.4 years old, were assessed by a multiaxial procedure and the bears family projective test. The bears family test is a constructive-thematic-projective method based on an anthropomorphic family of bears that children can manipulate to tell a story. The stories of 40 children without emotional difficulties (matched by IQ, socio-economic status, and gender) and 322 typically developing children, aged between four and 10 years old, were used as a reference for comparisons. Results indicated that the stories of children with emotional difficulties showed many unsolved problematic events, unclear characters, negative relationships, and negative behaviors. Unlike the stories of children without emotional difficulties, positive contents didn't prevail over negative, and there wasn't a positive compensation for negative elements.

Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey.

PubMed

Yokoya, Shoji; Kizawa, Yoshiyuki; Maeno, Takami

2018-03-01

The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education-providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. A large discrepancy was found between GHSF nurses' practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident's preferences concerning EOL care.

Decreasing barriers for nurse practitioner social entrepreneurship.

PubMed

Sharp, Dayle B; Monsivais, Diane

2014-10-01

To describe difficulties associated with the business-related aspects of practice in role transition of rural nurse practitioners (NPs), and to give practice implications. This focused ethnographic study derived data from semi-structured interviews. Participants provided information about rural NP practice ownership and barriers. The sample consisted of 24 rural NPs living throughout the United States. The majority were 51-60 years of age (45%) and females (93%) who had been in rural practice for 1 to over 20 years. NP social entrepreneurs experience difficulties related to scope of practice, business skills, and role conflict. To decrease barriers for NP clinic ownership and management, NPs need to receive education related to financing a rural practice, legal/regulatory practices, strategic planning, leadership, and clinic management. ©2014 American Association of Nurse Practitioners.

Social isolation and loneliness: Prospective associations with functional status in older adults.

PubMed

Shankar, Aparna; McMunn, Anne; Demakakos, Panayotes; Hamer, Mark; Steptoe, Andrew

2017-02-01

The present analysis aimed to examine the associations of isolation and loneliness, individually as well as simultaneously, with 2 measures of functional status (gait speed and difficulties in activities of daily living) in older adults over a 6-year period using data from the English Longitudinal Study of Ageing, and to assess if these associations differ by SES. Loneliness was measured using the short form of the Revised UCLA scale, and an index of social isolation was computed incorporating marital status; frequency of contact with friends, family, and children; and participation in social activities. Measures of functional status were assessed identically at baseline and 6 years later for 3070 participants (mean age 69 years). Wealth was used as an indicator of SES. In fully and mutually adjusted models, social isolation and loneliness were found to be associated with a decrease in gait speed at follow-up, with stronger effects among more disadvantaged individuals. Loneliness was associated with an increase in difficulties with activities of daily living. Isolation and loneliness were adversely associated with different aspects of functional status. Interventions to reduce isolation and loneliness may be particularly beneficial for individuals in disadvantaged groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Challenges of Making a Diagnosis in the Outpatient Setting: A Multi-Site Survey of Primary Care Physicians

PubMed Central

Sarkar, Urmimala; Bonacum, Doug; Strull, William; Spitzmueller, Christiane; Jin, Nancy; Lopez, Andrea; Giardina, Traber Davis; Meyer, Ashley N.D.; Singh, Hardeep

2013-01-01

Background Although misdiagnosis in the outpatient setting leads to significant patient harm and wasted resources, it is not well studied. We surveyed primary care physicians (PCPs) about barriers to timely diagnosis in the outpatient setting and assessed their perceptions of diagnostic difficulty. Methods We conducted a survey of general internists and family physicians practicing in an integrated health system across 10 geographically dispersed states in 2005. The survey elicited information on key cognitive failures (such as in clinical knowledge or judgment) for a specific case, and solicited strategies for reducing diagnostic delays. Content analysis was used to categorize cognitive failures and strategies for improvement. We examined the extent and predictors of diagnostic difficulty, defined as reporting >5% patients difficult to diagnose. Results Of 1817 physicians surveyed, 1054 (58%) responded; 848 (80%) respondents primarily practiced in outpatient settings and had an assigned patient panel (inclusion sample). Inadequate knowledge (19.9%) was the most commonly reported cognitive factor. Half reported >5% of their patients were difficult to diagnose; more experienced physicians reported less diagnostic difficulty. In adjusted analyses, problems with information processing (information availability and time to review it) and the referral process, were associated with greater diagnostic difficulty. Strategies for improvement most commonly involved workload issues (panel size, non-visit tasks). Conclusions PCPs report a variety of reasons for diagnostic difficulties in primary care practice. In our study, knowledge gaps appear to be a prominent concern. Interventions that address these gaps as well as practice level issues such as time to process diagnostic information and better subspecialty input may reduce diagnostic difficulties in primary care. PMID:22626738

Policy-to-Practice Context to the Delays and Difficulties in the Acquisition of Speech, Language and Communication in the Early Years

ERIC Educational Resources Information Center

Blackburn, Carolyn; Aubrey, Carol

2016-01-01

The aim was to investigate the policy-to-practice context of delays and difficulties in the acquisition of speech, language and communication (SLC) in children from birth to five in one local authority within the context of Bronfenbrenner's bio-ecological model. Methods included a survey of early years practitioners (64 responses), interviews with…

“Do Changes in Spousal Employment Status Lead to Domestic Violence? Insights from a Prospective Study in Bangalore, India”

PubMed Central

Rocca, Corinne H; Hubbard, Alan E; Subbiah, Kalyani; Edmeades, Jeffrey; Padian, Nancy S

2009-01-01

The prevalence of physical domestic violence – violence against women perpetrated by husbands – is staggeringly high across the Indian subcontinent. Although gender-based power dynamics are thought to underlie women's vulnerability, relatively little is known about risk and protective factors. This prospective study in southern India examined the association between key economic aspects of gender-based power, namely spousal employment status, and physical domestic violence. In 2005-2006, 744 married women, aged 16-25, residing in low-income communities in Bangalore, India were enrolled in the study. Data were collected at enrolment, 12 and 24 months. Multivariable logistic regression models were used to examine the prospective association between women's employment status, their perceptions of their husband's employment stability, and domestic violence. Women who were unemployed at one visit and began employment by the next visit had an 80% higher odds of violence, as compared to women who maintained their unemployed status. Similarly, women whose husbands had stable employment at one visit and newly had difficulty with employment had 1.7 times the odds of violence, as compared to women whose husbands maintained their stable employment. To our knowledge, this study is the first from a developing country to confirm that changes in spousal employment status are associated with subsequent changes in violence risk. It points to the complex challenges of violence prevention, including the need for interventions among men and gender transformative approaches to promote gender-equitable attitudes, practices and norms among men and women. PMID:19828220

Gender and procreation among patients with schizophrenia.

PubMed

Bhatia, T; Franzos, M A; Wood, J A; Nimgaonkar, V L; Deshpande, S N

2004-06-01

Reduced procreation among men with schizophrenia has been reported consistently when compared with female patients, but the cause is unknown. Reports on Caucasian individuals predominate in the published literature. Therefore, analyses were conducted concurrently among independent Indian and US samples in the present study. Individuals with schizophrenia or schizoaffective disorder (DSM-IV criteria) were ascertained and interviewed at New Delhi and in the northeastern United States using identical procedures (n=224 and 144, respectively). Selected indices of fertility and fecundity were compared among men and women at each site. In the smaller US sample, male cases were significantly more likely to be single and childless compared with female cases. They also had fewer children. In contrast, there were no significant gender differences in the larger Indian sample with regard to the reproductive indices. Multivariate analyses revealed that the indices of reproduction were associated with different variables in the US and Indian samples. Fertility (the presence or absence of offspring) was associated with gender and age in the US sample while in the Indian sample conjugal status and age were significant predictors. Fecundity (the number of offspring) was associated with gender, conjugal status and educational status in the US sample while in the Indian sample conjugal status and educational status were both significant. The reproductive deficit observed among US males was not observed among the Indian men. Conjugal status was a significant covariate for reproduction in both samples. The reproductive deficit may be due to difficulties in establishing long-term conjugal relationships among the US men. The differences may also reflect underlying cultural variations related to marital practices in these two countries. Our analyses suggest that the male reproductive deficit in schizophrenia is variable and may be overcome.

Influence of Khat Chewing on Periodontal Tissues and Oral Hygiene Status among Yemenis

PubMed Central

Al-Kholani, Abdulwahab I.

2010-01-01

Background: Khat chewing is popular among Yemenis. This study was performed to investigate the effects of khat chewing on periodontal tissue and oral hygiene status. Methods: A total of 730 subjects (336 chewers and 394 non-chewers with a mean age of 31.5 ± 0.8 and 29.4 ± 0.9 years, respectively) were involved. Clinical data on periodontal tissues, oral hygiene sta-tus, gingival bleeding, burning sensation in the soft tissues, halitosis, ulcers in the oral cavity, difficulty in opening the mouth and swallowing solid food were collected to evaluate periodontal condition. Lo-gistic regression analysis, student t test and chi-squared test were employed according to which hypo-theses were being tested. Results: The oral hygiene status of non-chewers was significantly better than that of chewers. The mean oral hygiene index of chewers was 2.12 ± 0.86 while that of non-chewers was 1.54 ± 1.12, the difference being statistically significant (P < 0.001). The incidence of gingival bleeding was signifi-cantly higher in khat-chewers. About 23% of chewers complained of difficulty in mouth-opening, as compared with only about 1% of non-chewers. Furthermore, 10% of chewers had difficulty in swal-lowing solid food. A burning sensation in the soft tissues was also found in a higher proportion of khat-chewers. Similarly, ulcers on the oral mucosa were present in about 7% of chewers, as com-pared to 0.5% of non-chewers. Gingival recession was present in about 51% and 26% of chewers and non-chewers, respectively. Conclusion: There does appear to be a relationship between the effect of chewing khat on peri-odontal tissue and oral hygiene status. PMID:21448439

Associations between intensity of child welfare involvement and child development among young children in child welfare.

PubMed

Stahmer, Aubyn C; Hurlburt, Michael; Horwitz, Sarah McCue; Landsverk, John; Zhang, Jinjin; Leslie, Laurel K

2009-09-01

To examine developmental and behavioral status of children in child welfare (CW) over time, by intensity of CW involvement using a national probability sample. As part of the National Survey of Child and Adolescent Well-being (NSCAW), data were collected on 1,049 children 12-47 months old investigated by CW agencies for possible abuse or neglect. Analyses used descriptive statistics to characterize developmental and behavioral status across four domains (developmental/cognitive, language, adaptive functioning, and behavior) by intensity of CW involvement (in-home with CW services, in-home with no CW services or out-of-home care) over time. Multivariate analyses were used to examine the relationship between independent variables (age, gender, home environment, race/ethnicity, maltreatment history, intensity of CW involvement) and follow-up domain scores. On average, children improved in developmental/cognitive, communication/language status over time, but these improvements did not differ by intensity of CW involvement. Analyses revealed a positive relationship between the home environment and change in language and adaptive behavior standard scores over time, and few predictors of change in behavioral status. An interaction between intensity of CW involvement and initial developmental/cognitive status was present. Across domains, intensity of CW involvement does not appear to have a significant effect on change in developmental and behavioral status, although out-of-home care does have differential relationships with children's developmental/cognitive status for those with very low initial cognitive/developmental status. Facilitating development in children in CW may require supportive, enriched care environments both for children remaining at home and those in foster care. Toddler and preschool age children known to child welfare are likely to have difficulties with development whether they are removed from their homes or not. It would be helpful if child welfare workers were trained to screen for developmental, language, adaptive behavior and behavioral difficulties in children in foster care, and those remaining at home. Additional support for biological, foster, and kinship caregivers in encouraging development is important for the attainment of critical developmental skills, especially for children with developmental difficulties.

[Immunization status of risk newborns and difficulties experienced by mothers].

PubMed

Lopes, Edilene Gianelli; Martins, Christine Baccarat de Godoy; Lima, Fernanda Cristina Aguiar; Gaíva, Maria Aparecida Munhoz

2013-01-01

Among newborns at risk, immunization becomes relevant due to its preventive characteristic. The research aimed to analyze the vaccination status of newborns at risk of Cuiabá-MT, as well as satisfaction and difficulties of mothers regarding immunization. This is descriptive study, quantitative, with 113 newborns at risk, selected by the Statement of Live Birth: 25.7% had delayed immunization, being the lack of vaccine at the Health Unit (50.0%) the reason most often reported. Of the children with delayed immunization, 65.5% had more than one vaccine late, 100% had weight less than expected, 75.9% were accompanied in their growth and development by the Health Unit, 69.0% had an episode of illness in the six first months of life, 41.4% of mothers were under 18 years. The mothers reported more difficulties to the immunization service. We emphasize the importance of strategies to improve the quality of care, structure of health services, reception and professional preparation.

Fatigue in the first year after traumatic brain injury: course, relationship with injury severity, and correlates.

PubMed

Beaulieu-Bonneau, Simon; Ouellet, Marie-Christine

2017-10-01

The objectives of this study were to document the evolution of fatigue in the first year after traumatic brain injury (TBI), and to explore correlates of fatigue. Participants were 210 adults who were hospitalised following a TBI. They completed questionnaires 4, 8, and 12 months post-injury, including the Multidimensional Fatigue Inventory (MFI). Participants with severe TBI presented greater mental and physical fatigue, and reduced activity compared to participants with moderate TBI. For all MFI subscales except reduced motivation, the general pattern was a reduction of fatigue levels over time after mild TBI, an increase of fatigue after severe TBI, and stable fatigue after moderate TBI. Fatigue was significantly associated with depression, insomnia, cognitive difficulties, and pain at 4 months; the same variables and work status at 8 months; and depression, insomnia, cognitive difficulties, and work status at 12 months. These findings suggest that injury severity could have an impact on the course of fatigue in the first year post-TBI. Depression, insomnia, and cognitive difficulties remain strong correlates of fatigue, while for pain and work status the association with fatigue evolves over time. This could influence the development of intervention strategies for fatigue, implemented at specific times for each severity subgroup.

Self-reported hearing difficulties, main income sources, and socio-economic status; a cross-sectional population-based study in Sweden.

PubMed

Pierre, Pernilla Videhult; Fridberger, Anders; Wikman, Anders; Alexanderson, Kristina

2012-10-15

Hearing difficulties constitute the most common cause of disability globally. Yet, studies on people with hearing difficulties regarding socio-economic status (SES), work, long-term unemployment, sickness absence, and disability pension are scarce. The aim of the present study was to investigate the main income sources of men and women of working ages with and without self-reported hearing difficulties and associations with gender, age, SES, type of living area, and country of birth. A cross-sectional population-based study, using information on self-reported hearing difficulties and SES of 19 045 subjects aged 20-64 years participating in Statistics Sweden's annual Living Conditions Surveys in any of the years 2004 through 2008. The information was linked to a nationwide database containing data on demographics and income sources. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated, using binary logistic regression analysis. Hearing difficulties increased with age and were more common in men (age-adjusted OR: 1.42 (95% CI: 1.30-1.56)) with an overall prevalence of 13.1% in men and 9.8% in women. Using working men as reference, the OR of having hearing difficulties was 1.23 (0.94-1.60) in men with unemployment benefits and 1.36 (1.13-1.65) in men with sickness benefits or disability pension, when adjusting for age and SES. The corresponding figures in women were 1.59 (1.17-2.16) and 1.73 (1.46-2.06). The OR of having sickness benefits or disability pension in subjects with hearing difficulties was 1.36 (1.12-1.64) in men and 1.70 (1.43-2.01) in women, when adjusting for age and SES and using men and women with no hearing difficulties as reference. Hearing difficulties were more prevalent in men. After adjustment with age and SES as well as with type of living area and country of birth, a significant association with unemployment benefits was found only in women, and the associations with long-term sickness absence and disability pension tended to be stronger in women.

Self-reported hearing difficulties, main income sources, and socio-economic status; a cross-sectional population-based study in Sweden

PubMed Central

2012-01-01

Background Hearing difficulties constitute the most common cause of disability globally. Yet, studies on people with hearing difficulties regarding socio-economic status (SES), work, long-term unemployment, sickness absence, and disability pension are scarce. The aim of the present study was to investigate the main income sources of men and women of working ages with and without self-reported hearing difficulties and associations with gender, age, SES, type of living area, and country of birth. Methods A cross-sectional population-based study, using information on self-reported hearing difficulties and SES of 19 045 subjects aged 20–64 years participating in Statistics Sweden’s annual Living Conditions Surveys in any of the years 2004 through 2008. The information was linked to a nationwide database containing data on demographics and income sources. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated, using binary logistic regression analysis. Results Hearing difficulties increased with age and were more common in men (age-adjusted OR: 1.42 (95% CI: 1.30-1.56)) with an overall prevalence of 13.1% in men and 9.8% in women. Using working men as reference, the OR of having hearing difficulties was 1.23 (0.94-1.60) in men with unemployment benefits and 1.36 (1.13-1.65) in men with sickness benefits or disability pension, when adjusting for age and SES. The corresponding figures in women were 1.59 (1.17-2.16) and 1.73 (1.46-2.06). The OR of having sickness benefits or disability pension in subjects with hearing difficulties was 1.36 (1.12-1.64) in men and 1.70 (1.43-2.01) in women, when adjusting for age and SES and using men and women with no hearing difficulties as reference. Conclusions Hearing difficulties were more prevalent in men. After adjustment with age and SES as well as with type of living area and country of birth, a significant association with unemployment benefits was found only in women, and the associations with long-term sickness absence and disability pension tended to be stronger in women. PMID:23067045

Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly.

PubMed

Iizaka, Shinji; Tadaka, Etsuko; Sanada, Hiromi

2008-03-01

Malnutrition among the elderly has become a serious problem as their population increases in Japan. To approach the risk of malnutrition in the healthy, community-dwelling elderly is important for early prevention of malnutrition. The nutritional status and mutable associated factors with poor nutritional status specific to the healthy elderly were examined comprehensively. One hundred and thirty healthy elderly people from a senior college in Tokyo, Japan were eligible for this study. Nutritional status was evaluated by Mini-Nutritional Assessment (MNA). The demographic status and potential correlates with poor nutritional status, including the physical factors (mobility, cognitive impairment and oral status) and the psychosocial factors (depression, self-efficacy, attitudes toward health, instrumental activities of daily living, public health service knowledge, and difficulty and dissatisfaction with meal preparation) were investigated. The multiple linear regression analysis using a stepwise procedure adjusted for demographic status was performed to detect independent associated factors. There were 16 participants (12.6%) at risk of malnutrition. The independent associated factors with lower MNA scores were depression (beta = -0.27, P = 0.005), lower self-efficacy (beta = 0.25, P = 0.009), lower attitudes toward health scores (beta = 0.21, P = 0.02) and difficulty with meal preparation (beta = -0.18, P = 0.03). The prevalence of the healthy elderly at the initial risk of malnutrition was relatively high and should not be overlooked. The comprehensive geriatric screening and intervention including mental health, health management and life-situation will be important for the healthy, community-dwelling elderly.

The MCAT and Success in Medical School.

ERIC Educational Resources Information Center

Feitz, Robert H.

This study looked at Medical College Admissions Test (MCAT) scores by race in relation to medical college status. It was found that promoted students differed significantly on all four MCAT subtests from those dismissed for academic difficulties and those repeating a year. For both black and white racial groups, the latter two status categories…

Predicting Handwriting Difficulties through Spelling Processes

ERIC Educational Resources Information Center

Rodríguez, Cristina; Villarroel, Rebeca

2017-01-01

This study examined whether spelling tasks contribute to the prediction of the handwriting status of children with poor and good handwriting skills in a cross-sectional study with 276 Spanish children from Grades 1 and 3. The main hypothesis was that the spelling tasks would predict the handwriting status of the children, although this influence…

Hispanics in 1979--A Statistical Appraisal.

ERIC Educational Resources Information Center

Martinez, Douglas R.

1979-01-01

Public Law 94-311, passed by Congress in 1976, called for the expansion of statistics reflecting the socioeconomic status of Hispanics. The article discusses the state of the Hispanic community in early 1979, one agency's difficulties in implementing the mandates of P.L. 94-311, and the status of other agencies' work on the law's requirements. (NQ)

Self-reported Hearing Difficulty and Risk of Accidental Injury in US Adults, 2007 to 2015.

PubMed

Lin, Harrison W; Mahboubi, Hossein; Bhattacharyya, Neil

2018-03-22

Accidental injuries are a leading cause of morbidity and mortality in the United States. Hearing problems may be associated with an increased risk for such injuries. To investigate associations between hearing difficulty and risk of accidental injuries among US adults. Cross-sectional analysis of responses of a nationally representative sample of 232.2 million individuals 18 years or older who participated in the National Health Interview Survey from 2007 to 2015 and responded to the questions related to the hearing and injury modules. The main outcome variable was accidental injury in the preceding 3 months. Hearing status was self-reported as "excellent," "good," "a little trouble," "moderate trouble," "a lot of trouble," and "deaf." Prevalence of accidental injuries was analyzed based on demographic characteristics and hearing status. Odds ratios (ORs) and 95% CIs for injuries adjusted for demographics were calculated for degrees of hearing difficulty. A secondary outcome was association of hearing status with type of injury and was classified as driving related, work related, or leisure/sport related. Of 232.2 million US adults, 120.2 million (51.7%) were female, and 116.3 million (50.1%) considered their hearing to be less than excellent. Accidental injuries occurred in 2.8% of survey respondents. In comparison with normal-hearing adults (those with self-rated excellent or good hearing), the odds of accidental injury were higher in those with a little trouble hearing (4.1%; OR, 1.6; 95% CI, 1.5-1.8), moderate trouble hearing (4.2%; OR, 1.7; 95% CI, 1.4-1.9), and a lot of trouble hearing (4.8%; OR, 1.9; 95% CI, 1.6-2.3). Work- and leisure-related injuries were more prevalent among those with self-perceived hearing difficulty. Multivariate analysis, adjusted for age and sex, revealed leisure-related injuries was most consistently associated with various degrees of hearing difficulty. Odds ratios were 1.2 (95% CI, 1.0-1.4) in those with a little trouble hearing, 1.4 (95% CI, 1.1-1.9) in those with moderate trouble hearing, and 1.5 (95% CI, 1.1-2.2) in those with a lot of trouble hearing. Hearing difficulty is significantly associated with accidental injury, especially injury related to work or leisure. Increased awareness about hearing difficulty and its proper screening and management may assist in decreasing accidental injury.

Early language impairments and developmental pathways of emotional problems across childhood.

PubMed

Yew, Shaun Goh Kok; O'Kearney, Richard

2015-01-01

Language impairments are associated with an increased likelihood of emotional difficulties later in childhood or adolescence, but little is known about the impact of LI on the growth of emotional problems. To examine the link between early language status (language impaired (LI), typical language (TL)) and the pattern and predictors of growth in emotional difficulties from school entry to the start of high school in a large cohort of Australian children. Unconditional latent growth curves of emotional difficulties were modelled across four waves (ages 4-5, 6-7, 8-9 and 10-11) using data from 1627 boys (280 LI, 1347 TL) and 1609 girls (159 LI, 1450 TL). Conditional latent growth curves estimated the main effects of LI on the severity and slope of growth in emotional problems. Simultaneous multiple regression tested the interaction between language status and the other predictors of the development of emotional symptoms. LI predicted a significant persistent elevation in severity of emotional difficulties across childhood among boys (d = 0.33-0.57) and girls (d = 0.25-0.39) but was not associated with their growth. LI moderated the association between hostile parenting and the severity of emotional symptoms for boys and the effect of socioeconomic status (SES) and temperamental sociability on the linear and quadratic growth of emotional problems for girls but had no impact on the influence of other predictors. There is no effect of LI on the characteristic rate and shape of growth in emotional symptoms across childhood although LI children maintain elevated severities of emotional difficulties. The associations between child reactivity, peer problems, prosocial behaviours, maternal distress and parental warmth and the development of emotional difficulties were the same for LI and TL children. LI enhanced the influence of hostile parenting on a higher severity of emotional symptoms for boys and of lower SES on a faster rate of development of emotional symptoms for girls. LI offset the usual protective effect of higher sociability and the usual vulnerability of higher social avoidance to a faster increase in emotional symptoms with age. © 2014 Royal College of Speech and Language Therapists.

Difficulties with Emotion Regulation and Psychopathology Interact to Predict Early Smoking Cessation Lapse.

PubMed

Farris, Samantha G; Zvolensky, Michael J; Schmidt, Norman B

2016-06-01

There is little knowledge about how emotion regulation difficulties interplay with psychopathology in terms of smoking cessation. Participants ( n = 250; 53.2 % female, M age = 39.5, SD = 13.85) were community-recruited daily smokers (≥8 cigarettes per day) who self-reported motivation to quit smoking; 38.8 % of the sample met criteria for a current (past 12-month) psychological disorder. Emotion regulation deficits were assessed pre-quit using the Difficulties with Emotion Regulation Scale (DERS; Gratz and Roemer in J Psychopathol Behav Assess 26(1):41-54, 2004) and smoking behavior in the 28 days post-quit was assessed using the Timeline Follow-Back (TLFB; Sobell and Sobell in Measuring alcohol consumption: psychosocial and biochemical methods. Humana Press, Totowa, 1992). A Cox proportional-hazard regression analysis was used to model the effects of past-year psychopathology, DERS (total score), and their interaction, in terms of time to lapse post-quit day. After adjusting for the effects of gender, age, pre-quit level of nicotine dependence, and treatment condition, the model revealed a non-significant effect of past-year psychopathology ( OR = 1.14, CI 95 % = 0.82-1.61) and difficulties with emotion regulation ( OR = 1.01, CI 95 % = 1.00-1.01) on likelihood of lapse rate. However, the interactive effect of psychopathology status and difficulties with emotion regulation was significant ( OR = 0.98, CI 95 % = 0.97-0.99). Specifically, there was a significant conditional effect of psychopathology status on lapse rate likelihood at low, but not high, levels of emotion regulation difficulties. Plots of the cumulative survival functions indicated that for smokers without a past-year psychological disorder, those with lower DERS scores relative to elevated DERS scores had significantly lower likelihood of early smoking lapse, whereas for smokers with past-year psychopathology, DERS scores did not differentially impact lapse rate likelihood. Smokers with emotion regulation difficulties may have challenges quitting, and not having such difficulties, especially without psychopathology, decreases the potential likelihood of early lapse.

The Effective Teacher's Guide to Autism and Communication Difficulties: Practical Strategies, Second Edition. The Effective Teacher's Guides

ERIC Educational Resources Information Center

Farrell, Michael

2011-01-01

In this welcome second edition of "The Effective Teacher's Guide to Autism and Communication Difficulties", best-selling author Michael Farrell addresses how teachers and others can develop provision for students with autism and students that have difficulties with speech, grammar, meaning, use of language and comprehension. Updated and expanded,…

Visual-Perceptual Difficulties and the Impact on Children's Learning: Are Teachers Missing the Page?

ERIC Educational Resources Information Center

Boyle, Christopher; Jindal-Snape, Divya

2012-01-01

This article attempts to bring to the fore of educational practice the importance of considering the visual-perceptual condition of Meares-Irlen syndrome (MIS) when identifying students who have prolonged reading difficulties. Dyslexia is a frequently used term which can be used to label children who have specific difficulties with reading and/or…

Self-Regulation and Infant-Directed Singing in Infants with Down Syndrome.

PubMed

de l'Etoile, Shannon K

2015-01-01

Infants learn how to regulate internal states and subsequent behavior through dyadic interactions with caregivers. During infant-directed (ID) singing, mothers help infants practice attentional control and arousal modulation, thus providing critical experience in self-regulation. Infants with Down syndrome are known to have attention deficits and delayed information processing as well as difficulty managing arousability, factors that may disrupt their efforts at self-regulation. The researcher explored responses to ID singing in infants with Down syndrome (DS) and compared them with those of typically developing (TD) infants. Behaviors measured included infant gaze and affect as indicators of self-regulation. Participants included 3- to 9-month-old infants with and without DS who were videotaped throughout a 2-minute face-to-face interaction during which their mothers sang to them any song(s) of their choosing. Infant behavior was then coded for percentage of time spent demonstrating a specific gaze or affect type. All infants displayed sustained gaze more than any other gaze type. TD infants demonstrated intermittent gaze significantly more often than infants with DS. Infant status had no effect on affect type, and all infants showed predominantly neutral affect. Findings suggest that ID singing effectively maintains infant attention for both TD infants and infants with DS. However, infants with DS may have difficulty shifting attention during ID singing as needed to adjust arousal levels and self-regulate. High levels of neutral affect for all infants imply that ID singing is likely to promote a calm, curious state, regardless of infant status. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Applications of and Barriers to Holistic Self-Care in a Low-Income, High-Risk Obstetric Population.

PubMed

Rhoades, Katherine; Telliard, Sarah; Thomas, Tiffany Stanfill; Barkin, Jennifer L

We examined 1) women's perceptions regarding self-care, 2) applications of self-care, and 3) barriers to practicing effective self-care. Four focus groups were conducted in a low-income, pregnant population. Focus group recruitment and discussions took place at a large medical center in a medically underserved area of central Georgia. Thirty-two adult pregnant women attending a high-risk obstetric clinic were included. Data related to holistic self-care were identified and grouped into one of three categories: women's valuations of self-care, applications of self-care, and barriers to self-care. The results were synthesized and compared to results from a study of postpartum women in which the same analytic framework for examining self-care practice was applied. Although women tended to understand the importance of self-care, they had difficulty practicing all forms of self-care on a regular basis owing to financial constraints, limited family support, health complications due to their high-risk obstetric status, external commitments, and childcare and household responsibilities. Applications of self-care were typically inexpensive and mainly required time rather than money. Socioeconomic status seems to influence the specific applications of and barriers to self-care. Health care providers should be aware of existing low-cost resources in the community that may assist prospective and new mothers in tending to their own emotional and physical needs. Providers should also discuss the importance of self-care with women during the perinatal period. Efforts should be made to educate school administrators regarding the impact of spontaneous requests for money for school activities, supplies, and field trips on the family budget. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Retrieval Practice and Spacing Effects in Young and Older Adults: An Examination of the Benefits of Desirable Difficulty

PubMed Central

Maddox, Geoffrey B.; Balota, David A.

2015-01-01

The present study examined how the function relating continued retrieval practice (e.g., 1, 3, or 5 tests) and long-term memory retention is modulated by desirable difficulty (Bjork, 1994). Of particular interest was how retrieval difficulty differed across young and older adults and across manipulations of lag (Experiment 1) and spacing (Experiment 2). To extend on previous studies, acquisition phase response latency was used as a proxy for retrieval difficulty, and analysis of final test performance was conditionalized on acquisition phase retrieval success to more directly examine the influence of desirable difficulty on retention. Results from Experiment 1 revealed that continued testing in the short lag condition led to consistent increases in retention, whereas continued testing in the long lag condition led to increasingly smaller benefits in retention for both age groups. Results from Experiment 2 revealed that repeated spaced testing enhanced retention relative to taking one spaced test for both age groups; however, repeated massed testing only enhanced retention over taking one test for young adults. Across both experiments, the response latency results were overall consistent with an influence of desirable difficulty on retention. Discussion focuses on the role of desirable difficulty during encoding in producing the benefits of lag, spacing, and testing. PMID:25616776

Psychogenic Non-epileptic Seizures: An Updated Primer.

PubMed

Baslet, Gaston; Seshadri, Ashok; Bermeo-Ovalle, Adriana; Willment, Kim; Myers, Lorna

2016-01-01

Psychogenic non-epileptic seizures are the most common paroxysmal event misdiagnosed as epilepsy. They significantly affect quality of life, functional status, and use of medical resources. The goal of this review is to provide guidance to psychiatrists and other mental health professionals in the understanding and practical management of this condition. An abundance of new reports on the pathogenesis and effective treatments have become available over the last decade, yet specific barriers impede the fluid transition to treatment and remain an important challenge in the management of patients with psychogenic non-epileptic seizures. In the context of these difficulties, we initially present background information on psychogenic non-epileptic seizures covering their historic context, epidemiology, etiologic factors (including psychiatric, neuromedical, and neuropsychological factors), and current neurobiological models. Updated evidence-based treatments are discussed along with data on long-term outcomes. We also provide practical tools to help clinicians navigate differential diagnoses, establish their interdisciplinary roles, communicate the diagnosis, deliver treatment, and sort out commonly encountered challenges in the management of this condition. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Effects of Service Barriers on Health Status of Older Chinese Immigrants in Canada

ERIC Educational Resources Information Center

Lai, Daniel W. L.; Chau, Shirley B.

2007-01-01

The authors examine the effects of service barriers on the health status of older Chinese immigrants in Canada. A survey was completed in seven Canadian cities by a random sample of 2,214 older Chinese immigrants age 55 years or older. Service barriers related to administrative problems, personal attitudes, and circumstantial difficulties were…

Lower Maternal Folate Status in Early Pregnancy Is Associated with Childhood Hyperactivity and Peer Problems in Offspring

ERIC Educational Resources Information Center

Schlotz, Wolff; Jones, Alexander; Phillips, David I. W.; Gale, Catharine R.; Robinson, Sian M.; Godfrey, Keith M.

2010-01-01

Background: Maternal nutrition during pregnancy has been linked with fetal brain development and psychopathology in the offspring. We examined for associations of maternal folate status and dietary intake during pregnancy with brain growth and childhood behavioural difficulties in the offspring. Methods: In a prospective cohort study, maternal red…

Work Limitations 4 Years After Mild Traumatic Brain Injury: A Cohort Study.

PubMed

Theadom, Alice; Barker-Collo, Suzanne; Jones, Kelly; Kahan, Michael; Te Ao, Braden; McPherson, Kathryn; Starkey, Nicola; Feigin, Valery

2017-08-01

To explore employment status, work limitations, and productivity loss after mild traumatic brain injury (TBI). Inception cohort study over 4 years. General community. Adults (N=245; >16y at the time of injury) who experienced a mild TBI and who were employed prior to their injury. Not applicable. Details of the injury, demographic information, and preinjury employment status were collected from medical records and self-report. Symptoms and mood were assessed 1 month postinjury using the Rivermead Post-Concussion Symptom Questionnaire and the Hospital Anxiety and Depression Scale. Postinjury employment status and work productivity were assessed 4 years postinjury using the Work Limitations Questionnaire. Four years after mild TBI, 17.3% of participants had exited the workforce (other than for reasons of retirement or to study) or had reduced their working hours compared with preinjury. A further 15.5% reported experiencing limitations at work because of their injury. Average work productivity loss was 3.6%. The symptom of taking longer to think 1 month postinjury significantly predicted work productivity loss 4 years later (β=.47, t=3.79, P≤.001). Although changes in employment status and difficulties at work are likely over time, the results indicate increased unemployment rates, work limitations, and productivity loss in the longer term after a mild TBI. Identification of cognitive difficulties 1 month after TBI in working aged adults and subsequent interventions to address these difficulties are required to facilitate work productivity. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Do patients with schizophrenia use prosody to encode contrastive discourse status?

PubMed Central

Michelas, Amandine; Faget, Catherine; Portes, Cristel; Lienhart, Anne-Sophie; Boyer, Laurent; Lançon, Christophe; Champagne-Lavau, Maud

2014-01-01

Patients with schizophrenia (SZ) often display social cognition disorders, including Theory of Mind (ToM) impairments and communication disruptions. Thought language disorders appear to be primarily a disruption of pragmatics, SZ can also experience difficulties at other linguistic levels including the prosodic one. Here, using an interactive paradigm, we showed that SZ individuals did not use prosodic phrasing to encode the contrastive status of discourse referents in French. We used a semi-spontaneous task to elicit noun-adjective pairs in which the noun in the second noun-adjective fragment was identical to the noun in the first fragment (e.g., BONBONS marron “brown candies” vs. BONBONS violets “purple candies”) or could contrast with it (e.g., BOUGIES violettes “purple candles” vs. BONBONS violets “purple candies”). We found that healthy controls parsed the target noun in the second noun-adjective fragment separately from the color adjective, to warn their interlocutor that this noun constituted a contrastive entity (e.g., BOUGIES violettes followed by [BONBONS] [violets]) compared to when it referred to the same object as in the first fragment (e.g., BONBONS marron followed by [BONBONS violets]). On the contrary, SZ individuals did not use prosodic phrasing to encode contrastive status of target nouns. In addition, SZ's difficulties to use prosody of contrast were correlated to their score in a classical ToM task (i.e., the hinting task). Taken together, our data provide evidence that SZ patients exhibit difficulties to prosodically encode discourse statuses and sketch a potential relationship between ToM and the use of linguistic prosody. PMID:25101025

Characteristics of Students at Risk for Mathematics Difficulties Predicting Arithmetic Word Problem Solving Performance: The Role of Attention, Behavior, and Reading

ERIC Educational Resources Information Center

Jitendra, Asha K.; Corroy, Kelly Cozine; Dupuis, Danielle N.

2013-01-01

The purposes of this study were (a) to evaluate differences in arithmetic word problem solving between high and low at-risk students for mathematics difficulties (MD) and (b) to assess the influence of attention, behavior, reading, and socio-economic status (SES) in predicting the word problem solving performance of third-grade students with MD.…

Sleep Differences by Race in Preschool Children: The Roles of Parenting Behaviors and Socioeconomic Status.

PubMed

Patrick, Kristina E; Millet, Genevieve; Mindell, Jodi A

2016-01-01

This study aimed to examine whether socioeconomic variables (SES) and parenting behaviors mediate differences in sleep problems between Black and White preschool-aged children. Parents of 191 preschool-aged children (53% male; 77% White) completed questionnaires regarding SES and sleep behaviors. Parenting behaviors and SES were analyzed as mediators of differences in sleep problems between Black and White children. Parent behaviors related to bedtime routine and independence mediated the relationship between race and parent-reported bedtime difficulty, parent confidence managing sleep, and sleep onset latency. SES mediated the relationship between race and sleep onset latency. Sleep differences between Black and White preschool children were primarily mediated by parent behaviors rather than socioeconomic variables. Results may reflect differences in cultural practices and provide important information for treatment and parent-directed intervention regarding improving sleep in young children.

Early Years Centres for Pre-School Children with Primary Language Difficulties: What Do They Cost, and are They Cost-Effective?

ERIC Educational Resources Information Center

Law, J.; Dockrell, J. E.; Castelnuovo, E.; Williams, K.; Seeff, B.; Normand, C.

2006-01-01

Background: High levels of early language difficulties raise practical issues about the efficient and effective means of meeting children's needs. Persistent language difficulties place significant financial pressures on health and education services. This has led to large investment in intervention in the early years; yet, little is known about…

What Is Literacy for Students with Severe Learning Difficulties? Exploring Conventional and Inclusive Literacy

ERIC Educational Resources Information Center

Lacey, Penny; Layton, Lyn; Miller, Carol; Goldbart, Juliet; Lawson, Hazel

2007-01-01

This paper arises from research into inclusive literacy for pupils with severe learning difficulties who do not learn to read and write conventionally. The ultimate aim of the study was to seek out examples of good practice in teaching and learning literacy that includes students with severe learning difficulties and disseminate them as widely as…

[Clarifying the implementation of nursing care systematization].

PubMed

Hermida, Patricia Madalena Vieira

2004-01-01

This study has reviewed the national literature regarding nursing assistance systematization (NAS), with the aim of identifying the difficulties implementing this practice and the factors that interfere with and harm its implementation. The MEDLINE, LILACS, and BDENF databases have been utilized and six studies published in nursing periodicals in the last five years have been surveyed. The results indicate several difficulties implementing the NAS and several factors that interfere negatively with its implementation. Considering the importance of this assistance methodology for valuing professional nursing, it is necessary to reflect on/discuss its practical difficulties so that we can overcome them, making it a pleasurable activity capable of providing nurses with autonomy and providing patients with quality assistance.

Health disparities among immigrant and non-immigrant elders: the association of acculturation and education.

PubMed

Lum, Terry Y; Vanderaa, Julianne P

2010-10-01

Guided by the theories of human capital and acculturation, this study investigated the association of immigrant status among older people with their physical and mental health outcomes, health services utilization, and health insurance coverage. Specifically, it examined the interactive effects of immigrant status, education, acculturation, race, and ethnicity on these dependent variables. The study used a national representation sample of 7,345 older Americans from the first wave of the Asset and Health Dynamic of the Oldest Old study (AHEAD) survey. We used both logistic regression and ordered logit regression for our multivariate analyses. The findings are as follows: (1) immigrant status was negatively associated with level of depression, number of IADL difficulties, and on types of health insurance coverage. Immigrant status had a significant relationship only with the utilization of outpatient surgery, but not on other health services utilization. (2) There were significant interactive effects of race and ethnicity and immigrant status on these dependent variables. The findings support the existence of double jeopardy among those who are simultaneously an immigrant and a member of a racial and ethnic minority group in the United States. (3) Acculturation has strong associations with health insurance coverage and with number of difficulties with IADL.

Social status correlates of reporting gender discrimination and racial discrimination among racially diverse women.

PubMed

Ro, Annie E; Choi, Kyung-Hee

2009-01-01

The growing body of research on discrimination and health indicates a deleterious effect of discrimination on various health outcomes. However, less is known about the sociodemographic correlates of reporting racial discrimination and gender discrimination among racially diverse women. We examined the associations of social status characteristics with lifetime experiences of racial discrimination and gender discrimination using a racially-diverse sample of 754 women attending family planning clinics in North California (11.4% African American, 16.8% Latina, 10.1% Asian and 61.7% Caucasian). A multivariate analysis revealed that race, financial difficulty and marital status were significantly correlated with higher reports of racial discrimination, while race, education, financial difficulty and nativity were significantly correlated with gender discrimination scores. Our findings suggest that the social patterning of perceiving racial discrimination is somewhat different from that of gender discrimination. This has implications in the realm of discrimination research and applied interventions, as different forms of discrimination may have unique covariates that should be accounted for in research analysis or program design.

Risk factors associated with academic difficulty in an Australian regionally located medical school.

PubMed

Malau-Aduli, Bunmi S; O'Connor, Teresa; Ray, Robin A; van der Kruk, Yolanda; Bellingan, Michelle; Teague, Peta-Ann

2017-12-28

Despite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal. This study used survival analysis to identify the non-academic and academic risk factors (and their relative risks) associated with academic difficulty at a regionally located medical school. Retrospective non-academic and academic entry data for all medical students who were enrolled at the time of the study (2009-2014) were collated and analysed. Non-academic variables included age at commencement of studies, gender, Indigenous status, origin, first in family to go to University (FIF), non-English speaking background (NESB), socio-economic status (SES) and rurality expressed as Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). Academic variables included tertiary entrance exam score expressed as overall position (OP) and interview score. In addition, post-entry mid- and end-of-year summative assessment data in the first and second years of study were collated. The results of the survival analysis indicated that FIF, Indigenous and very remote backgrounds, as well as low post-entry Year 1 (final) and Year 2 (mid-year and final) examination scores were strong risk factors associated with academic difficulty. A high proportion of the FIF students who experienced academic difficulty eventually failed and exited the medical program. Further exploratory research will be required to identify the specific needs of this group of students in order to develop appropriate and targeted academic support programs for them. This study has highlighted the need for medical schools to be proactive in establishing support interventions/strategies earlier rather than later, for students experiencing academic difficulty because, the earlier such students can be flagged, the more likely they are able to obtain positive academic outcomes.

Religiousness and Longitudinal Trajectories in Elders' Functional Status

PubMed Central

Park, Nan Sook; Klemmack, David L.; Roff, Lucinda L.; Parker, Michael W.; Koenig, Harold G.; Sawyer, Patricia; Allman, Richard M.

2010-01-01

The purpose of this study was to examine the effects of religiousness on the trajectories of difficulties with activities of daily living (ADLs) and instrumental ADLs (IADLs) in community-dwelling older adults over a three-year period. Seven waves of data from the University of Alabama at Birmingham Study of Aging were analyzed using a hierarchical linear modeling method. The study was based on the 784 participants who completed interviews every six months between December 1999 and February 2004. Frequent religious service attendance was associated with fewer ADL difficulties and IADL difficulties at baseline. Furthermore, religious service attendance predicted slower increases for frequent churchgoers and steeper increases for less frequent churchgoers in IADL difficulties, controlling for variables related to demographics and resources. Religious service attendance was independently associated with ADL and IADL difficulties cross-sectionally. However, significant protective effects of religious service attendance were identified longitudinally only for the IADL trajectory. PMID:20485460

The publication strategies of Jöns Jacob Berzelius (1779-1848): negotiating national and linguistic boundaries in chemistry.

PubMed

Beckman, Jenny

2016-04-01

This article follows the publication strategies of the Swedish chemist Jöns Jacob Berzelius (1779-1848). It focuses on the role of language and translation in Berzelius' efforts to strengthen his own reputation, and that of Swedish science. As an author and editor, Berzelius encouraged the translation of his own works into several languages, while endeavouring to preserve the status of Swedish as a language of scientific publication in the face of French, and increasingly German and English, dominance. Reforming the Transactions of the Royal Swedish Academy of Sciences and launching several new scientific periodicals, Berzelius also attempted to influence the publication practices in other countries. Recent scholarship on the history of scientific publication has drawn attention to the practical difficulties of determining and getting hold of the relevant publications in one's field, the 'malleability' of the journal medium, and the common practice of reprinting and summarising papers published elsewhere. Berzelius' publication strategies highlight translation - time-consuming, unreliable and problematic in terms of authorisation and ownership - as one aspect of the wider problem of communicating across national and linguistic boundaries. Berzelius' struggles with the practicalities of communicating across borders in times of war, the choice of language and its consequences, and national standards of publication, demonstrate the importance of a transnational perspective on the history of scientific publication.

New approaches for moving upstream: how state and local health departments can transform practice to reduce health inequalities.

PubMed

Freudenberg, Nicholas; Franzosa, Emily; Chisholm, Janice; Libman, Kimberly

2015-04-01

Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream" behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators' role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities. © 2015 Society for Public Health Education.

Psychosocial risk factors associated with cyberbullying among adolescents: a population-based study.

PubMed

Sourander, Andre; Brunstein Klomek, Anat; Ikonen, Maria; Lindroos, Jarna; Luntamo, Terhi; Koskelainen, Merja; Ristkari, Terja; Helenius, Hans

2010-07-01

To our knowledge, no population study examining psychosocial and psychiatric risk factors associated with cyberbullying among adolescents exists. To study cross-sectional associations between cyberbullying and psychiatric and psychosomatic problems among adolescents. Population-based cross-sectional study. Finland. The sample consists of 2215 Finnish adolescents aged 13 to 16 years with complete information about cyberbullying and cybervictimization. Self-reports of cyberbullying and cybervictimization during the past 6 months. In the total sample, 4.8% were cybervictims only, 7.4% were cyberbullies only, and 5.4% were cyberbully-victims. Cybervictim-only status was associated with living in a family with other than 2 biological parents, perceived difficulties, emotional and peer problems, headache, recurrent abdominal pain, sleeping difficulties, and not feeling safe at school. Cyberbully-only status was associated with perceived difficulties, hyperactivity, conduct problems, low prosocial behavior, frequent smoking and drunkenness, headache, and not feeling safe at school. Cyberbully-victim status was associated with all of these risk factors. Among cybervictims, being cyberbullied by a same-sex or opposite-sex adult, by an unknown person, and by a group of people were associated with fear for safety, indicating possible trauma. Both cyberbullying and cybervictimization are associated with psychiatric and psychosomatic problems. The most troubled are those who are both cyberbullies and cybervictims. This indicates the need for new strategies for cyberbullying prevention and intervention.

Working beyond 65: a qualitative study of perceived hazards and discomforts at work.

PubMed

Reynolds, Frances; Farrow, Alexandra; Blank, Alison

2013-01-01

This qualitative study explored self-reports of hazards and discomforts in the workplace and coping strategies among those choosing to work beyond the age of 65 years. 30 people aged 66-91 years took part. Most worked part-time in professional or administrative roles. Each participant engaged in one semi-structured interview. Participants described some hazards and discomforts in their current work, but no recent accidents. The main age-related discomfort was tiredness. Other hazards that recurred in participants' accounts were physical demands of the job, driving, and interpersonal difficulties such as client or customer complaints, and in very rare cases, bullying. Most work-related hazards (e.g. prolonged sitting at computers, lifting heavy items and driving) were thought likely to affect any worker regardless of age. Coping strategies included making adaptations to age-related changes (such as decreased stamina) by keeping fit and being open about difficulties to colleagues, reducing hours of work, altering roles at work, limiting driving, applying expertise derived from previous work experiences, being assertive, using authority and status, and (among the minority employed in larger organisations) making use of supportive company/organisational policies and practices. Participants described taking individual responsibility for managing hazards at work and perceived little or no elevation of risk linked to age.

Nursing students assess nursing education.

PubMed

Norman, Linda; Buerhaus, Peter I; Donelan, Karen; McCloskey, Barbara; Dittus, Robert

2005-01-01

This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.

21 CFR 210.1 - Status of current good manufacturing practice regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice regulations...

Facilitators and barriers in expanding scope of practice: findings from a national survey of Irish nurses and midwives.

PubMed

Fealy, Gerard M; Rohde, Daniela; Casey, Mary; Brady, Anne-Marie; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine

2015-12-01

The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. A postal survey design was used to examine registered nurses' and midwives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal consequences, time restrictions and lack of remuneration. Professional satisfaction, patients' needs, organisational support and having access to continuing professional education were perceived as facilitators of practice expansion. Older nurses and midwives as well as nurses and midwives holding more senior promotional grades, such as clinical nurse manager grades, perceived fewer barriers than their younger and more junior counterparts. Nurses and midwives continue to experience difficulties in relation to expanding their practice. Practitioners can operate to optimal scope of practice when practitioner-centred and workplace-based circumstances are optimal. The optimal circumstances for practice expansion exist when the facilitators of practice expansion outweigh the barriers. Given the critical role that nurses and midwives play in modern health services, it is important that they are empowered and enabled to expand their practice and to work to full scope of practice when patient needs and service requirements warrant it. © 2015 John Wiley & Sons Ltd.

Immigration, citizenship, and the mental health of adolescents

PubMed Central

Fenelon, Andrew; Boudreaux, Michel

2018-01-01

Purpose To examine the reported mental health outcomes of adolescent foreign-born non-citizens and adolescent foreign-born U.S. citizens compared to adolescent U.S.-born citizens. Methods Using the Strengths and Difficulties Questionnaire in the National Health Interview Survey, we compared mental health status of U.S.-born adolescent citizens to foreign-born citizens and non-citizens in the years 2010–2015, and examined how differences in emotional difficulty changed based on time spent in the U.S. Results Results suggest that non-citizen adolescents experience better mental health outcomes than U.S.-born citizens. However, the mental health status of foreign-born citizens is indistinguishable from that of the U.S.-born, after accounting for basic socio-demographic characteristics. The prevalence of emotional difficulty experienced by immigrant adolescents increased with a family’s duration in the U.S. Conclusion Our findings are consistent with a broader health advantage for the foreign-born, but we present new evidence that the mental health advantage of foreign-born adolescents exists only for non-citizens. PMID:29723297

School Performance, Status Relations, and the Structure of Sentiment: Bringing the Teacher Back In. Report No. 9.

ERIC Educational Resources Information Center

Alexander, Karl L.; And Others

Previous research has failed to support the widely held assumption that the academic difficulties experienced by many minority and low socioeconomic status youth are due to their "outsider" standing vis-a-vis the middle class culture thought to govern the social relations of schooling. This analysis suggests that this proposition errs in…

Advancing in the Career Decision-Making Process: The Role of Coping Strategies and Career Decision-Making Profiles

ERIC Educational Resources Information Center

Perez, Maya; Gati, Itamar

2017-01-01

We tested the associations among the career decision-making difficulties, the career decision status, and either (a) the career decision-making profiles of 575 young adults, or (b) the coping strategies of 379 young adults. As hypothesized, a more advanced decision status was negatively associated with both career decision-making difficulties…

[Inactivity, obesity and mental health in the Spanish population from 4 to 15 years of age].

PubMed

Rodríguez-Hernández, Arturo; Cruz-Sánchez, Ernesto de la; Feu, Sebastián; Martínez-Santos, Raúl

2011-08-01

An active lifestyle and a good weight status are two major health determinants from a public health perspective. To evaluate the degree of association between physical activity, weight status and the emotional and mental health of Spanish schoolchildren. Mental health status was assessed through the Strengths and Difficulties Questionnaire (SDQ), also leisure time physical activity and body mass index (BMI) in a total of 6 803 children from 4 to 15 years participating in the Spanish National Health Survey 2006. The degree of association between. these variables was estimated by a multinomial logistic regression analysis. Among sedentary schoolchildren are more common mental health problems (OR 2.10), emotional problems (OR 1.84), conduct problems (OR 1.53), problems with peers (OR 2.35) and social relationship difficulties (OR 1.36). Obesity is associated with poor general mental health (OR 1.58), and obese schoolchildren show more often emotional problems (OR 1.52) and problems with peers (OR 2.43). In the Spanish schoolchildren, a healthy BMI is associated with increased mental well-being, although an active lifestyle is the best indicator of a good mental health status.

[Analysis of the characteristics of the older adults with depression using data mining decision tree analysis].

PubMed

Park, Myonghwa; Choi, Sora; Shin, A Mi; Koo, Chul Hoi

2013-02-01

The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method. A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs. The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease. The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

Status report on the establishment of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) International Monitoring System (IMS) infrasound network

NASA Astrophysics Data System (ADS)

Vivas Veloso, J. A.; Christie, D. R.; Campus, P.; Bell, M.; Hoffmann, T. L.; Langlois, A.; Martysevich, P.; Demirovik, E.; Carvalho, J.; Kramer, A.

2002-11-01

The infrasound component of the International Monitoring System (IMS) for Comprehensive Nuclear-Test-Ban Treaty verification aims for global detection and localization of low-frequency sound waves originating from atmospheric nuclear explosions. The infrasound network will consist of 60 array stations, distributed as evenly as possible over the globe to assure at least two-station detection capability for 1-kton explosions at any point on earth. This network will be larger and more sensitive than any other previously operated infrasound network. As of today, 85% of the site surveys for IMS infrasound stations have been completed, 25% of the stations have been installed, and 8% of the installations have been certified and are transmitting high-quality continuous data to the International Data Center in Vienna. By the end of 2002, 20% of the infrasound network is expected to be certified and operating in post-certification mode. This presentation will discuss the current status and progress made in the site survey, installation, and certification programs for IMS infrasound stations. A review will be presented of the challenges and difficulties encountered in these programs, together with practical solutions to these problems.

Translating new knowledge into practices: reconceptualising stroke as an emergency condition

PubMed Central

Snow, Stephanie J

2013-01-01

Objectives To examine how the new concept of stroke as an emergency condition led to the development of new clinical pathways for stroke patients in Newcastle Upon Tyne, implemented through protocols which were then rapidly adopted across the UK and further afield. Methods Historical analysis using health policy documents, published papers and correspondence on stroke alongside 17 interviews with stroke clinicians and managers in the UK and the US. Results The challenges of implementation stemmed from organisational and professional barriers rather than scientific or technological difficulties. Stroke’s historical status as a non-treatable illness was a barrier to the adoption of acute treatments. Building new pathways for stroke patients by developing protocols for paramedics and emergency room staff originated as a local solution to a local problem but were taken up widely. Discussion Understanding the clinical response to the reconceptualisation of stroke as a treatable disease contributes to our understandings of the relations between clinical research and practice. These findings have implications for how we understand the translation of new knowledge into practice and its transfer across different clinical communities and settings. Protocols are shown to be a particularly valuable tool, bridging knowledge between communities and manifesting a new identity for stroke. PMID:23129788

Current status of electroconvulsive therapy for mood disorders: a clinical review.

PubMed

Kolar, Dusan

2017-02-01

Electroconvulsive therapy (ECT) is an effective treatment for mood disorders and a viable treatment option especially when urgency of clinical situation requires a prompt treatment response. After acute series of ECT, the ECT long-term treatment may be considered, although this practice may vary significantly between countries or even within the same country, because there is no universal consensus about its indications, duration and frequency of administration. Continuation or maintenance ECT is common in routine clinical practice and clinicians should be aware of the risks of using ECT long term. Neuropsychological assessment should be an essential part of a good clinical practice in ECT services. Cognitive side effects of ECT are sometimes underestimated and may last much longer after completed treatment than it is usually expected. These cognitive impairments associated with ECT may cause significant functional difficulties and prevent patients to return to work. Cognitive assessment during ECT treatment is usually not comprehensive enough and is limited to bedside assessment. A more proactive approach to careful neuropsychological assessment and consideration of combined maintenance medication treatment after ECT are essential. 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/.

Difficulties, Problems and Countermeasures in Chinese Educational Technology Researches

ERIC Educational Resources Information Center

Chen, Yun-hong; Li, Bing; Xie, Bai-zhi

2007-01-01

The paper discussed the difficulties and problems in experimental researches in educational technology, such as misunderstanding in teachers' concept, disjointedness between theory and practice, inadequate understanding of dialectics in experimental educational technology researches, research project selection and theoretical hypothesis formation…

Nonconvulsive status epilepticus disguising as hepatic encephalopathy.

PubMed

Jo, Yong Min; Lee, Sung Wook; Han, Sang Young; Baek, Yang Hyun; Ahn, Ji Hye; Choi, Won Jong; Lee, Ji Young; Kim, Sang Ho; Yoon, Byeol A

2015-04-28

Nonconvulsive status epilepticus has become an important issue in modern neurology and epileptology. This is based on difficulty in definitively elucidating the condition and its various clinical phenomena and on our inadequate insight into the intrinsic pathophysiological processes. Despite nonconvulsive status epilepticus being a situation that requires immediate treatment, this disorder may not be appreciated as the cause of mental status impairment. Although the pathophysiology of nonconvulsive status epilepticus remains unknown, this disorder is thought to lead to neuronal damage, so its identification and treatment are important. Nonconvulsive status epilepticus should be considered in the differential diagnosis of patients with liver cirrhosis presenting an altered mental status. We report a case of a 52-year-old male with liver cirrhosis presenting an altered mental status. He was initially diagnosed with hepatic encephalopathy but ultimately diagnosed with nonconvulsive status epilepticus by electroencephalogram.

Recruitment strategies for a clinical trial of community-based water therapy for osteoarthritis.

PubMed

Davey, Rachel; Edwards, Sarah Matthes; Cochrane, Tom

2003-04-01

This study compares the efficiency of two methods of recruitment into a randomised controlled trial examining the cost-effectiveness of water therapy for elderly people with lower limb osteoarthritis. The direct cost of recruiting patients via general practice was 27.66 Pounds per patient (1.1 personnel hours/patient). The cost per recruited patient from a local newspaper article was 2.72 Pounds (0.2 personnel hours/patient). The cost differential between the two recruitment methods was largely owing to poor administration practices, difficulties in accessing patient information, and difficulties in contacting patients from the general practice computer database.

Dental screening and referral of young children by pediatric primary care providers.

PubMed

dela Cruz, Georgia G; Rozier, R Gary; Slade, Gary

2004-11-01

Several health care organizations recommend that physicians provide preventive dentistry services, including dental screening and referral. This study is the first to investigate characteristics of medical providers that influence their referral to a dentist of children who are at risk for dental disease. A cross-sectional survey was undertaken of primary care clinicians in 69 pediatric practices and 49 family medicine practices who were enrolled in a study to evaluate a pediatric preventive dentistry program targeted toward Medicaid-eligible children in North Carolina. A 100-item, self-administered questionnaire with 23 items on some aspect of dental referral elicited providers' knowledge and opinions toward oral health, their provision of dental services, and their confidence in providing these services. We hypothesized that providers' dental knowledge, opinions about the importance of oral health, and confidence in providing oral health services would be associated with their propensity to refer children who are younger than 3 years and are suspected of having risk factors for future dental disease or a few teeth in the beginning stages of decay. We also hypothesized that providers' perceived referral difficulty would affect their referral activities. Patient characteristics (tooth decay status, insurance status, immigrant status, English speaking), practice characteristics (setting, number of providers, patient volume, busyness), practice environment (perceived and actual availability of dentists), and other provider characteristics (gender, type, practice experience, board certification, training in oral health during or after professional education, hours worked, teaching of residents, preventive behaviors) were assessed and used as control variables. Preliminary bivariate analysis (analysis of variance, chi2) identified characteristics associated with referral activity. Multivariable logistic regression analysis using backward stepwise logistic regression tested the posed hypotheses, with provider, practice, and patient characteristics included as potential control variables. Nearly 78% of 169 primary care clinicians who participated in the survey reported that they were likely to refer children who had signs of early decay or high risk for future disease. Approximately half (54%) call a dental office sometimes or more frequently to make an appointment for a child whom they refer, but the most common method is to give the caregiver the name of a dentist without additional assistance (96%). Bivariate analysis revealed that providers who had high confidence in their ability to perform screenings and reported low overall referral difficulty were more likely to refer children. Bivariate analyses also found that providers who were not in group practices, were board certified, graduated 20 years ago or more, saw 80 or more patients per week, had >60% of their total patients who were infants and toddlers, and saw >3.5 patients per hour were significantly less likely to refer at-risk children for dental care. No patient characteristics were associated with referral. The regression model revealed that an increase in odds of referral was significantly associated with confidence in screening abilities (odds ratio [OR]: 5.0; 95% confidence interval [CI]: 1.7-15.1), low referral difficulty (OR: 6.0; 95% CI: 1.0-34.5), and group practice (OR: 4.2; 95% CI: 1.4-12.1). Having a patient population of >60% infants or toddlers was significantly associated with a decrease in odds of referral (OR: 0.2; 95% CI: 0.1-0.7). Oral health knowledge and opinions did not help to explain referral practices. Tooth decay remains a substantial problem in young children and is made worse by existing barriers that prevent them from obtaining dental care. Because most children are exposed to medical care but not dental care at an early age, primary care medical providers have the opportunity to play an important role in helping children and their families gain access to dental care. This study has identified several factors that need consideration in the further exploration and development of primary care physicians' role in providing for the oral health of their young patients. First, instructional efforts to increase providers' dental knowledge or opinions of the importance of oral diseases are unlikely to be effective in increasing dental referral unless they include methods to increase confidence in providers' ability to identify and appropriately refer children with disease. Medical education in oral health may need to be designed to include components that address self-efficacy in providing risk assessment, early detection, and referral services. Traditional, didactic instruction does not fulfill these requirements, but because the effectiveness of instructional methods for teaching medical providers oral health care, particularly confidence-building aspects, is untested, controlled evaluations are necessary. A second conclusion from this study is that the referral environment is more important than provider knowledge, experience, opinions, or patient characteristics in determining whether medical practitioners refer at-risk children for dental care. Most providers in this study held positive opinions about providing dental services in their practices, had relatively high levels of knowledge, screened for dental disease, accessed risk factors in their patients, and referred; they can be instrumental in helping young children get dental care, yet most providers face difficulties in making dental referrals, and changes in the availability of dental care will be necessary to decrease these barriers before referral can be most effective. The longer-term approach of increasing the number of dental graduates can be complemented in the shorter term by other approaches to increase dentists' participation in Medicaid, such as increases in reimbursement rates; training general dentists to treat young children; and community organization activities to link families, physicians, dentists, and public programs such as Early Head Start. Finally, pediatric primary health care providers can provide oral health promotion and disease prevention activities, thereby eliminating or delaying dental disease and the need for treatment at a very young age. However, effective and appropriate involvement of pediatric primary care clinicians can be expected only after they receive the appropriate training and encouragement and problems with the dental referral environment are addressed.

The difference a word makes: responding to questions on 'disability' and 'difficulty' in South Africa.

PubMed

Schneider, Marguerite

2009-01-01

This article discusses the current efforts to measure disability in a comparable manner internationally, the effects of using different types of wording in questions, and the implications of the approach of asking about 'difficulties' rather than 'disability' on the use of disability statistics. The study design was qualitative. Twenty-one focus groups were run with adults responding for themselves. Nine groups were classified a priori by the author as 'disabled', six as 'unsure', and the last six as 'non-disabled'. The participants completed a questionnaire using the Washington Group on Disability Statistics (WG) Short Set, the South African Census 2001 question, and the question 'Are you disabled?'. This was followed by group discussion on these questions and on how the concept of disability is understood by group participants. Participants understand disability as being a permanent, unchangeable state, mostly physical, and where a person is unable to do anything. The participants in the three groups of allocated disability status (disabled, unsure and non-disabled) provided quite different responses on the three questions. All participants in the 'disabled' and 'unsure' groups reported having 'difficulty' on the WG questions, but the 'unsure' groups did not identify as being 'disabled' on either of the two other questions. Using questions that ask about 'difficulty' rather than 'disability' provides a more comprehensive and inclusive measure of disability with a clearer understanding of what is being measured. Asking about 'difficulty' provides an improved measure of disability status for effective data collection and analysis to promote development, implementation and monitoring of disability-inclusive policies.

Difficulties with Emotion Regulation and Psychopathology Interact to Predict Early Smoking Cessation Lapse

PubMed Central

Zvolensky, Michael J.; Schmidt, Norman B.

2015-01-01

There is little knowledge about how emotion regulation difficulties interplay with psychopathology in terms of smoking cessation. Participants (n = 250; 53.2 % female, Mage = 39.5, SD = 13.85) were community-recruited daily smokers (≥8 cigarettes per day) who self-reported motivation to quit smoking; 38.8 % of the sample met criteria for a current (past 12-month) psychological disorder. Emotion regulation deficits were assessed pre-quit using the Difficulties with Emotion Regulation Scale (DERS; Gratz and Roemer in J Psychopathol Behav Assess 26(1):41–54, 2004) and smoking behavior in the 28 days post-quit was assessed using the Timeline Follow-Back (TLFB; Sobell and Sobell in Measuring alcohol consumption: psychosocial and biochemical methods. Humana Press, Totowa, 1992). A Cox proportional-hazard regression analysis was used to model the effects of past-year psychopathology, DERS (total score), and their interaction, in terms of time to lapse post-quit day. After adjusting for the effects of gender, age, pre-quit level of nicotine dependence, and treatment condition, the model revealed a non-significant effect of past-year psychopathology (OR = 1.14, CI95 % = 0.82–1.61) and difficulties with emotion regulation (OR = 1.01, CI95 % = 1.00–1.01) on likelihood of lapse rate. However, the interactive effect of psychopathology status and difficulties with emotion regulation was significant (OR = 0.98, CI95 % = 0.97–0.99). Specifically, there was a significant conditional effect of psychopathology status on lapse rate likelihood at low, but not high, levels of emotion regulation difficulties. Plots of the cumulative survival functions indicated that for smokers without a past-year psychological disorder, those with lower DERS scores relative to elevated DERS scores had significantly lower likelihood of early smoking lapse, whereas for smokers with past-year psychopathology, DERS scores did not differentially impact lapse rate likelihood. Smokers with emotion regulation difficulties may have challenges quitting, and not having such difficulties, especially without psychopathology, decreases the potential likelihood of early lapse. PMID:27239081

Fostering Cognitive Growth Through Writing.

ERIC Educational Resources Information Center

Sternglass, Marilyn S.

Recent research studies and texts in composition demonstrate the growing belief that students' difficulties with the writing tasks assigned to them are inextricably linked with their difficulties in handling complex cognitive processes. Through appropriate writing activities, students can be provided with practice in the intellectual functions…

Researchers' perspectives on pediatric obesity research participant recruitment.

PubMed

Parikh, Yasha; Mason, Maryann; Williams, Karen

2016-12-01

Childhood obesity prevalence has tripled over the last three decades. Pediatric obesity has important implications for both adult health as well as the United States economy. In order to combat pediatric obesity, exploratory studies are necessary to create effective interventions. Recruitment is an essential part of any study, and it has been challenging for all studies, especially pediatric obesity studies. The objective of this study was to understand barriers to pediatric obesity study recruitment and review facilitators to overcome recruitment difficulties. Twenty four childhood obesity researchers were contacted. Complete data for 11 researchers were obtained. Interviews were transcribed and analyzed using content analysis. Grounded Theory methodological approach was used, as this was an exploratory study. Investigators YP and MM coded the interviews using 28 codes. Barriers to recruitment included: family and study logistics, family economics, lack of provider interest, invasive protocols, stigma, time restraints of clinicians, lack of patient motivation/interest, groupthink of students in a classroom, and participants who do not accept his or her own weight status. Facilitators to enhance recruitment practices included accommodating participants outside of regular clinic hours, incentivizing participants, cultivating relationships with communities, schools and clinics prior to study recruitment, emphasizing benefits of a study for the patient, and shifting language to focus on health rather than obesity. Pediatric obesity researchers face many standard and some unique challenges to recruitment, reflecting challenges common to clinical research as well as some specific to pediatrics and some specific to obesity research. Both pediatric studies as well as obesity studies are an added challenge to the already-difficult task of general study recruitment. Our findings can be used to make researchers more aware of potential difficulties, approaches and on-going needs for enhancing recruitment and enrollment practices, and in turn if applied, may result in increased study efficiency.

Prevalence of aggressive challenging behaviours in intellectual disability and its relationship to personality status: Jamaican study.

PubMed

Tyrer, P; Oliver, P; Tarabi, S A

2014-11-01

Both the classification of personality disorder in intellectual disability (ID) and its identification in practice are deemed to be difficult. A simpler approach to classification and its relationship to challenging behaviours were tested in an adult Jamaican population with ID. The study was carried out in Kingston, Jamaica, as part of a programme of field trials to determine the utility of the proposed revision of personality disorders in the 11th Revision of the International Classification of Diseases (ICD-11), in a population of adults with ID living with their families or in supported care homes. Thirty-eight people with borderline (n = 5), mild (n = 16), moderate (n = 14) and severe (n = 3) ID were assessed at face-to-face interview and with relatives or staff using the provisional criteria for severity of personality disorder and its associated domain traits, and challenging behaviour was assessed using the Problem Behaviour Check List (PBCL) (a 5-point, 7-item scale). Using the severity scale 18 patients (47%) had no personality disorder, 7 (18%) had personality difficulty, 9 (24%) had mild personality disorder, and 4 (11%) had moderate personality disorder. None of the sample had severe personality disorder in which there is high risk of harm to self or others. Of the four major trait domains, provisionally named anankastic, detached, emotional and dissocial, three were evenly distributed in those with personality disturbance with the antagonistic (antisocial) trait less commonly shown (6 only). Scores on the PBCL were higher in those with increasing severity of personality disorder (P = 0.03) and those in the antagonistic personality trait domain had the highest PCL scores. Despite previous difficulties in assessing personality disorder in intellectual difficulties the ICD-11 classification was easy to administer in practice in this population, and the higher problem behaviour scores in those with greater severity of personality disturbance support its construct validity. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Reciprocal Associations between Electronic Media Use and Behavioral Difficulties in Preschoolers.

PubMed

Poulain, Tanja; Vogel, Mandy; Neef, Madlen; Abicht, Franziska; Hilbert, Anja; Genuneit, Jon; Körner, Antje; Kiess, Wieland

2018-04-21

The use of electronic media has increased substantially and is already observable in young children. The present study explored associations of preschoolers’ use of electronic media with age, gender, and socio-economic status, investigated time trends, and examined reciprocal longitudinal relations between children’s use of electronic media and their behavioral difficulties. The study participants included 527 German two- to six-year-old children whose parents had provided information on their use of electronic media and their behavioral difficulties at two time points, with approximately 12 months between baseline and follow-up. The analyses revealed that older vs. younger children, as well as children from families with a lower vs. higher socio-economic status, were more often reported to use electronic media. Furthermore, the usage of mobile phones increased significantly between 2011 and 2016. Most interestingly, baseline usage of computer/Internet predicted more emotional and conduct problems at follow-up, and baseline usage of mobile phones was associated with more conduct problems and hyperactivity or inattention at follow-up. Peer relationship problems at baseline, on the other hand, increased the likelihood of using computer/Internet and mobile phones at follow-up. The findings indicate that preschoolers’ use of electronic media, especially newer media such as computer/Internet and mobile phones, and their behavioral difficulties are mutually related over time.

Reciprocal Associations between Electronic Media Use and Behavioral Difficulties in Preschoolers

PubMed Central

Vogel, Mandy; Neef, Madlen; Abicht, Franziska; Hilbert, Anja; Körner, Antje; Kiess, Wieland

2018-01-01

The use of electronic media has increased substantially and is already observable in young children. The present study explored associations of preschoolers’ use of electronic media with age, gender, and socio-economic status, investigated time trends, and examined reciprocal longitudinal relations between children’s use of electronic media and their behavioral difficulties. The study participants included 527 German two- to six-year-old children whose parents had provided information on their use of electronic media and their behavioral difficulties at two time points, with approximately 12 months between baseline and follow-up. The analyses revealed that older vs. younger children, as well as children from families with a lower vs. higher socio-economic status, were more often reported to use electronic media. Furthermore, the usage of mobile phones increased significantly between 2011 and 2016. Most interestingly, baseline usage of computer/Internet predicted more emotional and conduct problems at follow-up, and baseline usage of mobile phones was associated with more conduct problems and hyperactivity or inattention at follow-up. Peer relationship problems at baseline, on the other hand, increased the likelihood of using computer/Internet and mobile phones at follow-up. The findings indicate that preschoolers’ use of electronic media, especially newer media such as computer/Internet and mobile phones, and their behavioral difficulties are mutually related over time. PMID:29690498

Symptom management in HIV-infected patients.

PubMed

Hughes, Anne

2004-01-01

Symptom management has always been a focus of nursing care. Assessing and managing symptoms is an important component of HIV nursing practice. When effective, interventions to relieve symptoms may improve quality of life (QoL), potentially increase adherence to highly active antiretroviral therapy, and improve other outcomes such as functional status. Common underrecognized and/or undertreated symptoms that may influence the QoL of persons living with HIV include fatigue, pain, anxiety/depression, and sleep disturbances. These symptoms may also contribute to the difficulty of adhering to HAART When evaluating a patient's symptoms, the nurse attempts to understand the symptom experience from the patient's perspective because symptoms are subjective experiences. Together, the nurse and patient work to determine feasible interventions. Symptom management plans are evaluated frequently. Fundamentally, symptom management aims to decrease the frequency, intensity, and distress of symptoms, with the ultimate goal of improving QoL.

Departments: Problems and Alternatives.

ERIC Educational Resources Information Center

Faricy, William H.

This paper deals with the existing inter- and intra-departmental phenomena. Current practices of forming departments and aggregating departments into colleges are investigated and are shown to have inherent difficulties which inhibit the performance of a university. These difficulties are illustrated with empirical data from a representative set…

Dentist's distress in the management of chronic pain control

PubMed Central

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V.; Gilbert, Gregg H.

2018-01-01

Abstract We aimed to obtain greater understanding of dentists’ distress when they diagnose and treat patients with temporomandibular disorders (TMD), and to explore ways in which TMD can be better treated. We conducted a cross-sectional study based on a questionnaire survey of dentists (n = 148). Dentists were queried using an open-ended questionnaire about distress they experienced when treating patients with TMD. Survey responses were analyzed using mixed methods. Associations between specific dentist and patient characteristics and types of distress were analyzed by one way analysis of variance and residual analysis. One hundred thirteen clinicians responded to the questionnaire, giving a 76% response rate. Thematic analysis identified 6 major themes: difficulty in predicting therapeutic effect and prognosis; difficulty in diagnosis; difficulty in the decision about whether to do occlusal adjustment; difficulty in specifying a cause; difficulty in communicating with patients and mental factors; and health insurance system barriers. Clinicians who reported difficulty in deciding whether to do occlusal adjustment saw significantly more patients who experienced shoulder stiffness and headache (P = .008 and P = .022, respectively). Dentists’ knowledge of TMD guidelines was associated with a lower percentage of difficulty in predicting therapeutic effect and prognosis (residual analysis; P = .010). These findings provide important insights into clinician's perception of difficulties with patients experiencing TMD-related pain. Knowledge of the existence of TMD clinical practice guidelines may lower dentist distress, particularly with regard to prognosis. Further studies are needed to decrease dentist's distress and to overcome the evidence-practice gap in TMD treatment. PMID:29505535

Very low birth weight children: behavior problems and school difficulty in a national sample.

PubMed

McCormick, M C; Gortmaker, S L; Sobol, A M

1990-11-01

We addressed three questions concerning the behavioral and academic status of low and very low birth weight infants through a secondary analysis of the 1981 National Health Interview Survey--Child Health Supplement: (1) in children born with very low birth weight, what is the risk of behavior problems and school difficulty compared with that in heavier low birth weight and normal birth weight children? (2) What are the correlates of school difficulty? (3) Are behavior problems associated with school difficulty when variables are controlled for these correlates? The analysis revealed that 34% of very low birth weight children could be characterized as having school difficulty, compared with 20% and 14% of the other groups, respectively, and that they were more likely to have higher scores on the hyperactive subscale of the Behavior Problems Index. Although a broad array of sociodemographic factors correlated with school difficulty, very low birth weight and hyperactivity scores contributed independently to the risk of academic problems. We conclude that very low birth weight infants are at risk of having school problems that are in part associated with hyperactive behavior.

Who is At Risk for Persistent Mathematics Difficulties in the U.S?

PubMed Central

Morgan, Paul L.; Farkas, George; Hillemeier, Marianne M.; Maczuga, Steve

2015-01-01

We analyzed two nationally representative, longitudinal datasets of U.S. children to identify risk factors for persistent mathematics difficulties (PMD). Results indicated that children from low socioeconomic households were at elevated risk of PMD at 48 and 60 months of age, as were children with cognitive delays, identified developmental delays or disabilities, or those with vocabulary difficulties. In contrast, children attending preschool either in Head Start or non-Head Start classrooms are at initially lower risk of PMD. Kindergarten-aged children experiencing either low socioeconomic status or mathematics difficulties are at greatest risk for PMD across 3rd, 5th, and 8th grade. Also at risk for PMD between 3rd–8th grade are children displaying reading difficulties or inattention and other learning-related behaviors problems, children with identified disabilities, and those who are retained. Educationally relevant and potentially malleable factors for decreasing young children’s risk for PMD may include increasing children’s access to preschool, decreasing their risk of experiencing vocabulary or reading difficulties, and avoiding use of grade retention. PMID:25331758

Internationalizing Practical ChE Education: The M.I.T. Practice School in Japan.

ERIC Educational Resources Information Center

O'Connor, Andrea J.; Kandas, Angelo W.; Natori, Yukikazu; Hatton, T. Alan

1999-01-01

Describes the establishment, benefits, and difficulties of an overseas branch of the Massachusetts Institute of Technology's (MIT) chemical engineering Practice School for student internship study at the Mitsubishi Chemical Corporation's Mizushima Plant in Kurashiki, Japan. (WRM)

Considering the health care entity C corporation conversion to tax pass-through entity status.

PubMed

Reilly, Robert F

2012-01-01

The double taxation of C corporation income from operations and from the ultimate sale of its assets makes the C corporation an inefficient tax status for many health care entities. At the time of this writing, the changes in the federal tax law that are scheduled to take effect in 2013 will increase this level of double-taxation inefficiency. The owners of a C corporation practice can avoid the C corporation status tax inefficiency by converting the practice to either (1) S corporation status or (2) LLC status. The conversion of the health care C corporation to an S corporation may be accomplished without a current tax cost. However, the conversion of a health care C corporation to an LLC status can result in a current tax at both the corporation level and the shareholder level. Nonetheless, the current conversion tax cost may be less than the future tax cost (1) of operating the practice as a C corporation and incurring double taxation at what may be higher tax rates or (2) of incurring the higher tax cost (or reduced price) on the ultimate disposition of the practice assets and the attendant double taxation of the appreciation in the value of the practice assets. Since individual income tax rates on qualifying dividends from C corporations and on capital gains are currently at very low rates, this may be a good time for C corporation practice owners to consider the costs and benefits of a conversion to either S corporation status or LLC status. The practice owners should consult with their accounting, legal, and valuation advisors in order to consider all of the costs and benefits of a possible corporate tax status conversion. An estimation of both the costs and benefits of the corporate tax status conversion depends on the concluded fair market values of the medical practice, dental practice, or other health care entity assets. And, that practice asset appraisal should encompass all of the practice assets, both tangible assets and intangible assets.

Tele-yoga for Chronic Pain: Current Status and Future Directions.

PubMed

Mathersul, Danielle C; Mahoney, Louise A; Bayley, Peter J

2018-01-01

Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed.

Tele-yoga for Chronic Pain: Current Status and Future Directions

PubMed Central

Mahoney, Louise A; Bayley, Peter J

2018-01-01

Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed. PMID:29637012

Employment status and work-related difficulties among family members of terminally ill patients compared with the general population.

PubMed

Kim, Seon Young; Chang, Yoon-Jung; Do, Young Rok; Kim, Sam Yong; Park, Sang Yoon; Jeong, Hyun Sik; Kang, Jung Hun; Kim, Si-Yung; Ro, Jung Sil; Lee, Jung Lim; Lee, Woo Jin; Park, Sook Ryun; Yun, Young Ho

2013-01-01

Although caregiving to patients with terminal illness is known to be a stressful burden to family members, little attention has been focused on work-related problems. We aimed to investigate employment status and work-related difficulties of family caregivers of terminal cancer patients, comparing with the general population. Using structured questionnaires, we assessed family caregivers of 481 cancer patients determined by physicians to be terminally ill, from 11 university hospitals and the National Cancer Center in Korea. Among 381 family caregivers of terminal cancer patients (response rate, 87.6%), 169 (43.9%) were not working before cancer diagnosis, but currently 233 (63.7%) were not working. Compared with the general population (36.5%), the percentage of not working among the family caregivers was higher (OR = 2.39; 95% CI= 1.73-3.29). A major reason for not working was to provide assistance to the patients (71.6%). 40.6% of those who continued working and 32.3% of those who not working family members reported extreme fatigue. Caregivers of old age, those who were female, those with a lower household income, and those caring for patients with a low performance status were not working at a more significant rate. Family caregivers of terminal cancer patients suffer job loss and severe work-related difficulties, probably due to caregiving itself and to fatigue. We need to develop supportive programs to overcome the burden of caregivers of the terminally ill.

Impact of gender-based career obstacles on the working status of women physicians in Japan.

PubMed

Nomura, Kyoko; Gohchi, Kengo

2012-11-01

Research has shown that women physicians work fewer hours and are more likely to become inactive professionally and to switch to part-time labor, compared with their male counterparts. The published literature suggests that a gender disparity still exists in medicine which may decrease work motivation among women physicians. The authors investigated whether the experience and the perception of gender-based career obstacles among women physicians in Japan are associated with their working status (i.e., full-time vs. part-time). The present cross-sectional study is based on surveys of alumnae from 13 private medical schools in Japan conducted between June 2009 and May 2011. Of those who agreed to participate in this study, 1684 completed a self-administered questionnaire (overall response rate 83%). Experience of gender-based obstacles was considered affirmative if a woman physician had been overlooked for opportunities of professional advancement based on gender. Perception of gender-based obstacles referred to the self-reported degree of difficulty of promotion and opportunities for a position in higher education. Approximately 20% of the study participants responded that they experienced gender-based obstacles while 24% answered that they were not sure. The scores for perception of gender-based career obstacles were statistically higher among part-time workers compared with full-time workers (mean difference = 1.20, 95% CI: 0.39-2.00). Adjusting for age, marital status, the presence of children, workplace, board certification, holding a PhD degree, overall satisfaction of being a physician, and household income, stepwise logistic regression models revealed that physicians with the strongest perception of gender-based career obstacles were more likely to work part-time rather than full-time (OR, 0.59; 95% CI: 0.40-0.88). Although the experience of gender-based obstacles was not associated with working status among women physicians, the results demonstrated that a strong perception of gender-based obstacles was associated with part-time practice rather than full-time practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Pilot interaction with cockpit automation - Operational experiences with the Flight Management System

NASA Technical Reports Server (NTRS)

Sarter, Nadine B.; Woods, David D.

1992-01-01

Results are presented of two studies on the potential effect of cockpit automation on the pilot's performance, which provide data on pilots' difficulties with understanding and operating one of the core systems of cockpit automation, the Flight Management System (FMS). The results of both studies indicate that, although pilots do become proficient in standard FMS operations through ground training and subsequent flight experience, they still have difficulties tracking the FMS status and behavior in certain flight contexts and show gaps in the understanding of the functional structure of the system. The results suggest that design-related factors such as opaque interfaces contribute to these difficulties, which can affect the pilot's situation awareness.

Working after a metastatic cancer diagnosis: Factors affecting employment in the metastatic setting from ECOG-ACRIN's Symptom Outcomes and Practice Patterns study.

PubMed

Tevaarwerk, Amye J; Lee, Ju-Whei; Terhaar, Abigail; Sesto, Mary E; Smith, Mary Lou; Cleeland, Charles S; Fisch, Michael J

2016-02-01

Improved survival for individuals with metastatic cancer accentuates the importance of employment for cancer survivors. A better understanding of how metastatic cancer affects employment is a necessary step toward the development of tools for assisting survivors in this important realm. The ECOG-ACRIN Symptom Outcomes and Practice Patterns study was analyzed to investigate what factors were associated with the employment of 680 metastatic cancer patients. Univariate and multivariate logistic regression analyses were conducted to compare patients stably working with patients no longer working. There were 668 metastatic working-age participants in the analysis: 236 (35%) worked full- or part-time, whereas 302 (45%) had stopped working because of illness. Overall, 58% reported some change in employment due to illness. A better performance status and non-Hispanic white ethnicity/race were significantly associated with continuing to work despite a metastatic cancer diagnosis in the multivariate analysis. The disease type, time since metastatic diagnosis, number of metastatic sites, location of metastatic disease, and treatment status had no significant impact. Among the potentially modifiable factors, receiving hormonal treatment (if a viable option) and decreasing symptom interference were associated with continuing to work. A significant percentage of the metastatic patients remained employed; increased symptom burden was associated with a change to no longer working. Modifiable factors resulting in work interference should be minimized so that patients with metastatic disease may continue working if this is desired. Improvements in symptom control and strategies developed to help address workplace difficulties have promise for improving this aspect of survivorship. © 2015 American Cancer Society.

Fathers' feeding practices and children's weight status in Mexican American families.

PubMed

Penilla, Carlos; Tschann, Jeanne M; Deardorff, Julianna; Flores, Elena; Pasch, Lauri A; Butte, Nancy F; Gregorich, Steven E; Greenspan, Louise C; Martinez, Suzanna M; Ozer, Emily

2017-10-01

Mothers' feeding practices are associated with their children's weight status, but little is known about the associations between fathers' feeding practices and children's weight status. Moreover, there is a dearth of research on Latino fathers' feeding practices and children's weight status, even though Latino children suffer some of the highest obesity rates in the U.S. We examined the associations between fathers' feeding practices and child weight status, conditional on mothers' feeding practices, within 174 Mexican American families with children aged 8-10 years. Parents completed the Parental Feeding Practices Questionnaire, which consists of four subscales: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. To assess child weight status, body mass index (BMI) was calculated and converted to age- and gender-specific percentile scores (BMI z-score). We fit four sets of regression models, one set for each of the four parental feeding practices subscales, with child BMI z-score as the outcome variable. Fathers' pressure to eat (b = -0.20, p = 0.04; 95% CI: -0.39, -0.01) and use of food to control behavior (b = -0.36, p = 0.02; 95% CI: -0.65, -0.07) were associated with lower child BMI z-score, and restriction of amount of food (b = 0.56, p < 0.001; 95% CI: 0.27, 0.84) was associated with higher child BMI z-score, after accounting for mothers' feeding practices. Fathers' positive involvement in child eating was not associated with child BMI z-score. These findings provide empirical evidence that fathers' feeding practices are independently associated with children's weight status, even when mothers' feeding practices are taken into account, and suggest that fathers' feeding practices also matter in regard to children's weight status. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state

PubMed Central

Silva, Tatiane M.; Costa, Lucíola C. M.; Costa, Leonardo O. P.

2015-01-01

BACKGROUND: Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. OBJECTIVE: To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. METHOD: A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. RESULTS: The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). CONCLUSION: Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully. PMID:26443977

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state.

PubMed

Silva, Tatiane M; Costa, Lucíola C M; Costa, Leonardo O P

2015-01-01

Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully.

Mental health status and healthcare utilization among community dwelling older adults.

PubMed

Adepoju, Omolola; Lin, Szu-Hsuan; Mileski, Michael; Kruse, Clemens Scott; Mask, Andrew

2018-04-27

Shifts in mental health utilization patterns are necessary to allow for meaningful access to care for vulnerable populations. There have been long standing issues in how mental health is provided, which has caused problems in that care being efficacious for those seeking it. To assess the relationship between mental health status and healthcare utilization among adults ≥65 years. A negative binomial regression model was used to assess the relationship between mental health status and healthcare utilization related to office-based physician visits, while a two-part model, consisting of logistic regression and negative binomial regression, was used to separately model emergency visits and inpatient services. The receipt of care in office-based settings were marginally higher for subjects with mental health difficulties. Both probabilities and counts of inpatient hospitalizations were similar across mental health categories. The count of ER visits was similar across mental health categories; however, the probability of having an emergency department visit was marginally higher for older adults who reported mental health difficulties in 2012. These findings are encouraging and lend promise to the recent initiatives on addressing gaps in mental healthcare services.

Caretaker mental health and family environment factors are associated with adolescent psychiatric problems in a Vietnamese sample.

PubMed

Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth

2014-12-15

Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam. Published by Elsevier Ireland Ltd.

Social Status Correlates of Reporting Racial Discrimination and Gender Discrimination among Racially Diverse Women

PubMed Central

Ro, Annie E.; Choi, Kyung-Hee

2009-01-01

The growing body of research on discrimination and health indicates a deleterious effect of discrimination on various health outcomes. However, less is known about the sociodemographic correlates of reporting racial discrimination and gender discrimination among racially diverse women. We examined the associations of social status characteristics with lifetime experiences of racial discrimination and gender discrimination using a racially-diverse sample of 754 women attending family planning clinics in Northern California (11.4% African American, 16.8% Latina, 10.1% Asian and 61.7% Caucasian). A multivariate analysis revealed that race, financial difficulty and marital status were significantly correlated with higher reports of racial discrimination, while race, education, financial difficulty and nativity were significantly correlated with gender discrimination scores. Our findings suggest that the social patterning of perceiving racial discrimination is somewhat different from that of gender discrimination. This has implications in the realm of discrimination research and applied interventions, as different forms of discrimination may have unique covariates that should be accounted for in research analysis or program design. PMID:19485231

Improving School Nurse Pain Assessment Practices for Students With Intellectual Disability.

PubMed

Quinn, Brenna L; Smolinski, Megan

2017-01-01

School nurses are afforded minimal resources related to assessing pain in students with intellectual disability (ID) and have called for continuing education. The purpose of this study was to measure the effectiveness of an education program regarding best practices for assessing pain in students with ID. Educational sessions were presented to 248 school nurses. Pre-, post-, and follow-up surveys measured (1) difficulty school nurses face when assessing pain, (2) knowledge and use of pain assessment methods, and (3) intent to change and actual changes to professional practices. Participants experienced less difficulty assessing pain following the educational program. Almost all participants intended to change pain assessment practices, but large caseloads limited new practice adoption. Policy makers must consider population size and acuity when determining school nurse staffing. Trainings and other resources should be made available to school nurses in order to make pain assessments for students with ID more thorough and efficient.

Microcomputers and Continuing Motivation.

ERIC Educational Resources Information Center

Seymour, Sherrie L.; And Others

1987-01-01

Describes study that investigated the effects of medium of instructional practice, task difficulty, and gender on continuing motivation. Microcomputers and paper and pencil format were compared on tasks at a hard or easy difficulty level with fifth and sixth grade students, and questionnaires were used to determine student attitudes. (Author/LRW)

Impact of financial incentives on alcohol intervention delivery in primary care: a mixed-methods study.

PubMed

O'Donnell, Amy; Haighton, Catherine; Chappel, David; Shevills, Colin; Kaner, Eileen

2016-11-25

Local and national financial incentives were introduced in England between 2008 and 2015 to encourage screening and brief alcohol intervention delivery in primary care. We used routine Read Code data and interviews with General Practitioners (GPs) to assess their impact. A sequential explanatory mixed-methods study was conducted in 16 general practices representing 106,700 patients and 99 GPs across two areas in Northern England. Data were extracted on screening and brief alcohol intervention delivery for 2010-11 and rates were calculated by practice incentive status. Semi-structured interviews with 14 GPs explored which factors influence intervention delivery and recording in routine consultations. Screening and brief alcohol intervention rates were higher in financially incentivised compared to non-incentivised practices. However absolute rates were low across all practices. Rates of short screening test administration ranged from 0.05% (95% CI: 0.03-0.08) in non-incentivised practices to 3.92% (95% CI: 3.70-4.14) in nationally incentivised practices. For the full AUDIT, rates were also highest in nationally incentivised practices (3.68%, 95% CI: 3.47-3.90) and lowest in non-incentivised practices (0.17%, 95% CI: 0.13-0.22). Delivery of alcohol interventions was highest in practices signed up to the national incentive scheme (9.23%, 95% CI: 8.91-9.57) and lowest in non-incentivised practices (4.73%, 95% CI: 4.50-4.96). GP Interviews highlighted a range of influences on alcohol intervention delivery and subsequent recording including: the hierarchy of different financial incentive schemes; mixed belief in the efficacy of alcohol interventions; the difficulty of codifying complex conditions; and GPs' beliefs about patient-centred practice. Financial incentives have had some success in encouraging screening and brief alcohol interventions in England, but levels of recorded activity remain low. To improve performance, future policies must prioritise alcohol prevention work within the quality and outcomes framework, and address the values, attitudes and beliefs that shape how GPs' provide care.

Autonoesis and dissociative identity disorder.

PubMed

Morton, John

2018-01-01

Dissociative identity disorder is characterised by the presence in one individual of two or more alternative personality states (alters). For such individuals, the memory representation of a particular event can have full episodic, autonoetic status for one alter, while having the status of knowledge or even being inaccessible to a second alter. This phenomenon appears to create difficulties for a purely representational theory and is presented to Mahr & Csibra (M&C) for their consideration.

Assessment of mental health status among school going adolescents in North East India: A cross sectional school based survey.

PubMed

U, Harikrishnan; Arif, Ali; H, Sobhana

2017-12-01

Adolescent emotional responses and behaviors are often passed off as growth pangs and academic stress, thereby missing those that need deeper understanding and mental health interventions. The aim of the study is to understand mental health status among the school adolescents in Tezpur, Assam. The present study was a cross sectional study that used convenience sampling in selection of the schools. A total of 10 schools were selected for the purpose of the study. 1403 Adolescents were selected for data analysis. Socio-Demographic Performa and Strengths and Difficulties Questionnaire [SDQ] were administered to the participants. The results indicated that five predictors (gender, education, family type, academic performance, socio economic status in the family) explained 9.79% of the variance (F=5.040, P<0.000) in total difficulty levels: (Academic performance; β=0.08; t=3.15; P=0.002) and (Socio economic status; β=0.07, t=3.02, P=0.003). In the study less than one tenth of the participants have some mental health issues and this calls for concern. Schools should have standing operation procedures in place to periodically screen adolescents for mental health related issues. Copyright © 2017 Elsevier B.V. All rights reserved.

Rethinking Difficulties of Teaching Inquiry-Based Practical Work: Stories from Elementary Pre-Service Teachers

ERIC Educational Resources Information Center

Kim, Mijung; Tan, Aik-Ling

2011-01-01

To alleviate teachers' reluctance toward practical work, there has been much discussion on teachers' pedagogical content knowledge, teaching materials, and failsafe strategies for practical work. Despite these efforts, practical work is still regarded as a challenging task for many elementary science teachers. To understand the complexity of…

State of family medicine practice in Lebanon

PubMed Central

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843

State of family medicine practice in Lebanon.

PubMed

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.

[HIV/AIDS masks in a therapist's practice].

PubMed

Roshchina, A A; Ponomareva, E Yu; Rebrov, A P

2015-01-01

To investigate clinical manifestations and diagnostic difficulties in patients with HIV/AIDS in the practice of therapeutic units of a multidisciplinary hospital. The investigation included 65 HIV/AIDS patients admitted to the therapy units of a Saratov Regional clinical hospital in 2007 to 2011. The clinical features of HIV/AIDS, immunological status, and viral load were studied. The structure of the clinical manifestation of HIV/AIDS showed a preponderance of lung injury in 45 (69%) patients. There were hematological disorders in 38 (58%) patients and nephropathy in 33 (51 %); 11 (17%) patients were diagnosed with infective endocarditis. Rheumatic symptoms and syndromes mimicking HIV/AIDS were found in 10 (15.4%) patients. The degree of immune disorders was most severe in patients with pulmonary dissemination and rheumatic masks and mutually related to the rate of cutaneous manifestations. The specific features of lung injury, infective endocarditis, pulmonary hypertension, rheumatic symptoms, and kidney injury were discussed in HIV/AIDS patients having different causes for admission to specialized therapy units. In connection with the clinical polymorphism of HIV/AIDS, physicians of all specialties should be alert for the possible clinical manifestations of this disease to timely examine patients.

Leading from the middle: Constrained realities of clinical leadership in healthcare organizations.

PubMed

Martin, Graham P; Waring, Justin

2013-07-01

In many developed-world countries, there have been efforts to increase the 'leadership capacity' of healthcare professionals, particularly lower-status staff without formal managerial power. Creating frontline 'leaders' is seen as a means of improving the quality of healthcare, but such efforts face considerable challenges in practice. This article reports on a qualitative, interview-based study of 23 staff in two UK operating theatre departments, mostly nurses by professional background, who were given formal leadership responsibilities by their hospitals and redesignated as 'team leaders' and 'theatre co-ordinators'. While participants were familiar with leadership theory and could offer clear accounts of good leadership in practice, they were often limited in their ability to enact their leadership roles. Professional and managerial hierarchies constrained participants' leadership capacity, and consequently the exercise of leadership rested on alignment with managerial relationships and mandates. The findings highlight difficulties with accounts of leadership as something to be distributed across organizations; in healthcare organizations, established institutional structures and norms render this approach problematic. Rather, if fostering leadership capacity is to have the transformational effect that policymakers desire, it may need to be accompanied by other, wider changes that attend to institutional, organizational and professional context.

Greek Immigrants in Australia: Implications for Culturally Sensitive Practice.

PubMed

Georgiades, Savvas Daniel

2015-10-01

This exploratory research examined adjustment challenges, resiliencies, attitudes, emotional health, economic stability, criminal involvement, victimization and service experiences, and some cultural propensities of Greek Immigrants (GIs) in Australia using a convenient multi-generational sample (n = 123; response rate = .5). Data were collected via surveys, telephone, and personal-interviews in four major Australian cities. Among other things, the study revealed that Greek identity and cultural customs are often significant to first generation GIs. Adjustment challenges upon entry include primarily language, housing, and transportation difficulties, nostalgia for relatives and the motherland, unfamiliarity with socio-cultural systems, unemployment, money challenges, and lack of friendships. Christian faith, the extended family, family values and traditions, cultural pride for ancient Greek achievements, and a hard 'work ethic' are notable resiliencies that support GIs in their struggles and solidify their pursuit for happiness and success. Financial concerns, aging, and nostalgia for relatives and the motherland were the primary causes of socio-emotional instability. Attitudinal differences in the respondents based on age, gender, and socio-economic status, cross-cultural comparisons, and recommendations for culturally-sensitive practice with GIs are analyzed and methodological limitations illuminated. Future research needs in the field are also highlighted.

A Practical Concussion Physical Examination Toolbox.

PubMed

Matuszak, Jason M; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Clinical review. Level 3. The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking.

Dyspraxia 5-11: A Practical Guide.

ERIC Educational Resources Information Center

Macintyre, Christine

This book attempts to explain dyspraxia, a coordination disorder, and how the condition affects children of primary school age. The first chapter defines dyspraxia and answers common questions concerning what the condition is, difficulties these children experience, reasons for these difficulties, the prevalence of dyspraxia, and ways to help.…

Assessing, Understanding, and Supporting Students with ADHD at School: Contemporary Science, Practice, and Policy

ERIC Educational Resources Information Center

DuPaul, George J.; Jimerson, Shane R.

2014-01-01

Students with attention-deficit/hyperactivity disorder (ADHD) exhibit chronic behavior difficulties that deleteriously impact their academic and social functioning in school settings. These difficulties not only impair student performance, but also present significant challenges to teachers, school psychologists, and other school professionals…

Take the Pencil out of the Process

ERIC Educational Resources Information Center

Broun, Leslie

2009-01-01

In classrooms, it is not unusual to see students who struggle to produce legible print. In actuality, many students have difficulty with the physical printing and writing processes ("handwriting")--difficulty that is significant enough to interfere with their academic performance. Some students grow out of this, and some, with extra practice,…

Using Literature Response Activities To Build Strategic Reading for Students with Reading Difficulties.

ERIC Educational Resources Information Center

Martin, Sarah H.; Martin, Michael A.

2001-01-01

Describes two classroom activities that can be implemented in accordance with the best practices revealed by current research on reading instruction with learning disabled students. Describes what research suggests for promoting comprehension for students with reading difficulties. Describes instructional sequences for two literacy activities,…

Translations among Mathematical Representations: Teacher Beliefs and Practices

ERIC Educational Resources Information Center

Bosse, Michael J.; Adu-Gyamfi, Kwaku; Cheetham, Meredith

2011-01-01

Student ability, teacher expectations, respective degrees of difficulty, and curriculum and instructional practices all work together to provide students experiences leading to differing levels of success in respect to mathematical translations. Herein, we discuss teacher beliefs and instructional practices, investigate why some translations seem…

Socioeconomic Associations with ADHD: Findings from a Mediation Analysis.

PubMed

Russell, Abigail Emma; Ford, Tamsin; Russell, Ginny

2015-01-01

Children from disadvantaged socioeconomic backgrounds are at greater risk of a range of negative outcomes throughout their life course than their peers; however the specific mechanisms by which socioeconomic status relates to different health outcomes in childhood are as yet unclear. The current study investigates the relationship between socioeconomic disadvantage in childhood and attention deficit/hyperactivity disorder (ADHD), and investigates putative mediators of this association in a longitudinal population-based birth cohort in the UK. Data from the Avon Longitudinal Study of Parents and Children was used (n = 8,132) to explore the relationship between different measures of socioeconomic status at birth-3 years and their association with a diagnosis of ADHD at age 7. A multiple mediation model was utilised to examine factors occurring between these ages that may mediate the association. Financial difficulties, housing tenure, maternal age at birth of child and marital status were significantly associated with an outcome of ADHD, such that families either living in financial difficulty, living in council housing, with younger or single mothers' were more likely to have a child with a research diagnosis of ADHD at age 7. Financial difficulties was the strongest predictor of ADHD (OR 2.23 95% CI 1.57-3.16). In the multiple mediation model, involvement in parenting at age 6 and presence of adversity at age 2-4 mediated 27.8% of the association. Socioeconomic disadvantage, conceptualised as reported difficulty in affording basic necessities (e.g. heating, food) has both direct and indirect impacts on a child's risk of ADHD. Lower levels of parent involvement mediates this association, as does presence of adversity; with children exposed to adversity and those with less involved parents being at an increased risk of having ADHD. This study highlights the importance of home and environmental factors as small but important contributors toward the aetiology of ADHD.

Implementing Practical Based Courses under Open and Distance Learning System: A Study of the Perception of Learners and Counsellors

ERIC Educational Resources Information Center

Basantia, Tapan Kumar

2018-01-01

Implementing practical based courses under Open and Distance Learning (ODL) system is a very difficult and challenging task as the teaching of practical based courses involves intensive practical work. For removing the difficulties and challenges in implementing the practical based courses under ODL system, there is a need to study the existing…

Practice Environments and Job Satisfaction in Patient-Centered Medical Homes

PubMed Central

Alidina, Shehnaz; Rosenthal, Meredith B.; Schneider, Eric C.; Singer, Sara J.; Friedberg, Mark W.

2014-01-01

PURPOSE We undertook a study to evaluate the effects of medical home transformation on job satisfaction in the primary care setting. METHODS We collected primary data from 20 primary care practices participating in medical home pilot projects in Rhode Island and Colorado from 2009 to 2011. We surveyed clinicians and staff about the quality of their practice environments (eg, office chaos, communication, difficulties in providing safe, high-quality care) and job satisfaction at baseline and 30 months, and about stress, burnout, and intention to leave at 30 months. We interviewed practice leaders about the impact of pilot project participation. We assessed longitudinal changes in the practice environment and job satisfaction and, in the final pilot year, examined cross-sectional associations between the practice environment and job satisfaction, stress, burnout, and intention to leave. RESULTS Between baseline and 30 months, job satisfaction improved in Rhode Island (P =.03) but not in Colorado. For both pilot projects, reported difficulties in providing safe, high-quality care decreased (P <.001), but emphasis on quality and the level of office chaos did not change significantly. In cross-sectional analyses, fewer difficulties in providing safe, high-quality care and more open communication were associated with greater job satisfaction. Greater office chaos and an emphasis on electronic information were associated with greater stress and burnout. CONCLUSIONS Medical home transformations that emphasize quality and open communication while minimizing office chaos may offer the best chances of improving job satisfaction. PMID:25024241

Single-dose intra-alveolar chlorhexidine gel application, easier surgeries, and younger ages are associated with reduced dry socket risk.

PubMed

Haraji, Afshin; Rakhshan, Vahid

2014-02-01

Although dry socket (DS) is commonly investigated, many of its risk factors remain highly controversial. In addition, few studies are available to show the preventive effect of chlorhexidine gel on DS. Moreover, multivariable analyses of DS risk factors are scarce, and their interactions have not been assessed previously. Therefore, the simultaneous effect of chlorhexidine gel and 4 DS risk factors and their interactions were analyzed within a multivariable framework. Using a split-mouth randomized clinical trial design, the investigators enrolled a cohort of patients requiring extraction of 2 mandibular third molars. The primary predictor variable was extraction socket treatment status, classified as experimental or standard. Experimental treatment was the insertion of chlorhexidine gel (0.2%) into the extraction socket. Each patient had 1 third molar randomly selected as the treatment site. The contralateral third molar served as the control socket and was treated in the usual manner. The primary outcome variable was DS status, present or absent, assessed on postoperative day 3. Other study variables were categorized as demographic, smoking, and surgical difficulty according to the Pederson scale. Appropriate bivariate and multiple logistic regression statistics were used to measure the association between risk for DS and chlorhexidine gel use, age, gender, smoking, and surgical difficulty and their interactions (α = 0.05). The sample consisted of 90 bilateral extraction sockets in 45 patients (24 men; 21 smokers; mean age, 21.1 ± 2.7 yr). Regression analysis showed that when other factors and their interactions were controlled for, chlorhexidine gel application lowered the risk of DS (odds ratio [OR] = 0.05; P = .004). Increasing age (OR = 2.9; P = .030) was associated with an increased risk for DS. A similar association existed between increased difficulty level of extraction and DS risk (OR = 3.8; P = .051). The effect of gender was marginally significant (P = .091), whereas smoking did not have a significant influence (P = .4). Intra-alveolar application of chlorhexidine gel and practicing less traumatic surgeries are advocated, particularly in older patients. Smoking seems unlikely to affect DS frequency. The role of gender is inconclusive. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Difficulties and practices regarding information provision among Korean and Italian nurses.

PubMed

Ingravallo, F; Kim, K H; Han, Y H; Volta, A; Chiari, P; Taddia, P; Kim, J S

2017-12-01

To investigate nurses' opinions and practices of providing information in a global context through cultural comparison. Providing sufficient information to patients about nursing interventions and plans is essential for patient-centred care. While many countries have specific legislation making information delivery to patients a legal duty of nurses, no such legislation exists in both the Republic of Korea and Italy; nurses' only guidance is the deontological code. This was a cross-sectional survey study involving a convenience sample of 174 Korean nurses and 121 Italian nurses working in internal medicine and surgery at university hospitals. Data were collected using a self-administered questionnaire between February and November 2014. The questionnaire assessed demographic and professional characteristics, and difficulties and practices regarding information provision. Korean and Italian nurses significantly differed in all demographic and professional characteristics. More Korean than Italian participants reported that their role in providing information was well explained within their teams, but both groups reported the same level and type of difficulties in delivering information. Nurses in both countries regularly informed patients about medications and nursing procedures, but provided information about nursing care plans less frequently. Few nurses frequently provided information to relatives instead of patients. Despite cultural, demographic and professional differences between Korean and Italian nurses, their difficulties and practices in information delivery to patient were similar. Hospital managers and policymakers should be aware that nurse-patient communication can be impaired by organizational factors, patient characteristics or the interaction among providers. Educational interventions and strategies are needed to increase information provision to patients about nursing care plans. © 2017 International Council of Nurses.

Parental practices and political violence: the protective role of parental warmth and authority-control in Jewish and Arab Israeli children.

PubMed

Lavi, Iris; Slone, Michelle

2012-10-01

Parental warmth and parental authority-control patterns have been documented as practices with highest significance for children's well-being and development in a variety of life areas. Various forms of these practices have been shown to have a direct positive effect on children and also to protect children from adverse effects of numerous stressors. However, surprisingly, few studies have examined the role of these practices as possible protective factors for children exposed to intractable conflict and political violence. Participants in this study were Jewish (n = 88) and Arab (n = 105) Israeli families, with children aged 7-12.5 (M = 10.73, SD = 0.99). Children completed questionnaires assessing political violence exposure, behavioral, psychological, and social difficulties, and perceived paternal and maternal warmth. Mothers and fathers completed questionnaires assessing parental warmth, parental authority-control, and the child's difficulties. Results showed parental warmth to be a significant moderator of political violence, related to low levels of behavioral and social difficulties of children. Parental authority-control patterns were not protectors from adverse effects of political violence exposure. Maternal authoritarian authority-control showed an effect resembling a risk factor. Differential roles of parental warmth and authority-control, fathers' versus mothers' roles, and ethnic differences are discussed, and practical clinical implications are proposed. © 2012 American Orthopsychiatric Association.

Assessment and management of the communication difficulties of children with cerebral palsy: a UK survey of SLT practice

PubMed Central

Mary Watson, Rose; Pennington, Lindsay

2015-01-01

Background Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims To describe the assessment and intervention practices of speech–language therapist (SLTs) in the UK in their management of communication difficulties associated with CP in childhood. Methods & Procedures An online survey of the assessments and interventions employed by UK SLTs working with children and young people with CP was conducted. The survey was publicized via NHS trusts, the Royal College of Speech and Language Therapists (RCSLT) and private practice associations using a variety of social media. The survey was open from 5 December 2011 to 30 January 2012. Outcomes & Results Two hundred and sixty-five UK SLTs who worked with children and young people with CP in England (n = 199), Wales (n = 13), Scotland (n = 36) and Northern Ireland (n = 17) completed the survey. SLTs reported using a wide variety of published, standardized tests, but most commonly reported assessing oromotor function, speech, receptive and expressive language, and communication skills by observation or using assessment schedules they had developed themselves. The most highly prioritized areas for intervention were: dysphagia, alternative and augmentative (AAC)/interaction and receptive language. SLTs reported using a wide variety of techniques to address difficulties in speech, language and communication. Some interventions used have no supporting evidence. Many SLTs felt unable to estimate the hours of therapy per year children and young people with CP and communication disorders received from their service. Conclusions & Implications The assessment and management of communication difficulties associated with CP in childhood varies widely in the UK. Lack of standard assessment practices prevents comparisons across time or services. The adoption of a standard set of agreed clinical measures would enable benchmarking of service provision, permit the development of large-scale research studies using routine clinical data and facilitate the identification of potential participants for research studies in the UK. Some interventions provided lack evidence. Recent systematic reviews could guide intervention, but robust evidence is needed in most areas addressed in clinical practice. PMID:25652139

Assessment and management of the communication difficulties of children with cerebral palsy: a UK survey of SLT practice.

PubMed

Watson, Rose Mary; Pennington, Lindsay

2015-01-01

Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. To describe the assessment and intervention practices of speech-language therapist (SLTs) in the UK in their management of communication difficulties associated with CP in childhood. An online survey of the assessments and interventions employed by UK SLTs working with children and young people with CP was conducted. The survey was publicized via NHS trusts, the Royal College of Speech and Language Therapists (RCSLT) and private practice associations using a variety of social media. The survey was open from 5 December 2011 to 30 January 2012. Two hundred and sixty-five UK SLTs who worked with children and young people with CP in England (n = 199), Wales (n = 13), Scotland (n = 36) and Northern Ireland (n = 17) completed the survey. SLTs reported using a wide variety of published, standardized tests, but most commonly reported assessing oromotor function, speech, receptive and expressive language, and communication skills by observation or using assessment schedules they had developed themselves. The most highly prioritized areas for intervention were: dysphagia, alternative and augmentative (AAC)/interaction and receptive language. SLTs reported using a wide variety of techniques to address difficulties in speech, language and communication. Some interventions used have no supporting evidence. Many SLTs felt unable to estimate the hours of therapy per year children and young people with CP and communication disorders received from their service. The assessment and management of communication difficulties associated with CP in childhood varies widely in the UK. Lack of standard assessment practices prevents comparisons across time or services. The adoption of a standard set of agreed clinical measures would enable benchmarking of service provision, permit the development of large-scale research studies using routine clinical data and facilitate the identification of potential participants for research studies in the UK. Some interventions provided lack evidence. Recent systematic reviews could guide intervention, but robust evidence is needed in most areas addressed in clinical practice. © 2015 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Boredom in psychiatric practice.

PubMed

Morrant, J C

1984-08-01

This paper discusses some of the causes of boredom in psychiatric practice. It also describes how many psychiatric conditions can have boring facets to them, which can lead to difficulties in treatment and "burn-out" in the therapist. Finally, some practical suggestions are given to help avoid and deal with boredom.

Client Attachment Status and Changes in Therapeutic Alliance Early in Treatment.

PubMed

Siefert, Caleb J; Hilsenroth, Mark J

2015-01-01

Several studies have examined associations between client attachment status and therapeutic alliance. Most, however, measure alliance at a single time point only. This study is among the first to examine how client attachment relates to changes in the therapeutic alliance early in treatment. Forty-six outpatients from a university-based community clinic participated. Attachment status was assessed with the Relationship Questionnaire (Bartholomew & Horowitz, 1991) prior to beginning treatment. Participants rated therapeutic alliance after an evaluation feedback session and again early in psychotherapy. Fearful insecurity was associated with declines in therapeutic alliance, while attachment security was associated with increasing client-therapist bonds. Although unrelated to global alliance, preoccupied insecurity was associated with greater confident collaboration at both time points and declines in idealized relationship from the evaluation to the early therapy time point. Results are discussed in light of prior theoretical formulations and previous research. Limitations of the study are reviewed, implications for clinical practice are noted, and suggestions for future research are made. Assessing client attachment status can provide clinicians with information that helps them identify clients at risk for difficulties establishing a therapeutic alliance. Clients high in attachment security are more likely to develop strong bonds with therapists during the early portion of treatment. Clients high in fearful insecurity are at risk for developing weaker alliances early in treatment. Such clients appear more likely to experience declines in client-therapist bond, goal-task agreement and overall alliance early in the treatment process. Clients high in preoccupied insecurity may enter therapy with great confidence in the therapist and willing to engage in therapy but report more conflicts with therapists in the early phase of treatment. Copyright © 2014 John Wiley & Sons, Ltd.

Developmental “Roots” in Mature Biological Knowledge

PubMed Central

Goldberg, Robert F.; Thompson-Schill, Sharon L.

2009-01-01

Young children tend to claim that moving artifacts and nonliving natural kinds are alive, but neglect to ascribe life to plants. This research tested whether adults exhibit similar confusions when verifying life status in a speeded classification task. Experiment 1 showed that undergraduates encounter greater difficulty (reduced accuracy and increased response times) in determining life status for plants, relative to animals, and for natural and moving nonliving things, relative to artifacts and non-moving things. Experiment 2 replicated these effects in university biology professors. The professors showed a significantly reduced effect size for living things, as compared with the students, but still showed greater difficulty for plants than animals, even as no differences from the students were apparent in their responses to nonliving things. These results suggest that mature biological knowledge relies on a developmental foundation that is not radically overwritten or erased with the profound conceptual changes that accompany mastery of the domain. PMID:19399979

Developmental "roots" in mature biological knowledge.

PubMed

Goldberg, Robert F; Thompson-Schill, Sharon L

2009-04-01

Young children tend to claim that moving artifacts and nonliving natural kinds are alive, but neglect to ascribe life to plants. This research tested whether adults exhibit similar confusions when verifying life status in a speeded classification task. Experiment 1 showed that undergraduates encounter greater difficulty (reduced accuracy and increased response times) in determining life status for plants, relative to animals, and for natural and moving nonliving things, relative to artifacts and non-moving things. Experiment 2 replicated these effects in university biology professors. The professors showed a significantly reduced effect size for living things, as compared with the students, but still showed greater difficulty for plants than animals, even as no differences from the students were apparent in their responses to nonliving things. These results suggest that mature biological knowledge relies on a developmental foundation that is not radically overwritten or erased with the profound conceptual changes that accompany mastery of the domain.

The Development and Status of Earth Science Education: A Comparison of Three Case Studies: Israel, England and Wales and the United States of America. Part I.

ERIC Educational Resources Information Center

Orion, Nir; King, Chris; Krockover, Gerald H.; Adams, Paul E.

1999-01-01

Explores the development and status of Earth Science Education in Israel and England and Wales. Finds that, despite separate traditions for education in the Earth Sciences, there are a surprisingly large number of commonalities between current trends in each of the countries in the study, and each has had difficulty determining what constitutes an…

Economic difficulties and subsequent sleep problems: Evidence from British and Finnish occupational cohorts

PubMed Central

Lallukka, Tea; Ferrie, Jane E.; Kivimäki, Mika; Shipley, Martin J.; Rahkonen, Ossi; Lahelma, Eero

2012-01-01

Background Social determinants of sleep may prove to be as important as health status. In this study we examined the extent to which persistent and changing economic difficulties are associated with sleep problems in two prospective occupational cohorts. Methods We used data from Finnish (baseline 2000–2002; follow-up 2007; n = 6328) and British (baseline 1997–1999; follow-up 2003–2004; n = 5002) public sector employees. Economic difficulties, sleep problems, and a variety of covariates were assessed at baseline and follow-up. Results Prevalence of frequent sleep problems at follow-up was 27% and 20% among women and men in the Finnish cohort, and 34% and 27% in the British cohort, respectively. Odds for sleep problems were higher among those with persistent economic difficulties (frequent economic difficulties at baseline and follow-up) compared to those with no difficulties. This association remained after multiple adjustments, including parental and current socioeconomic position, in the Finnish (OR 1.72, 95% CI 1.35–2.18) cohort. Increases in economic difficulties were similarly associated with sleep problems in the Finnish and the British cohort. Conclusion Evidence from two occupational cohorts suggests strong associations between economic difficulty and poor sleep. Awareness of this association will help health care professionals identify and prevent sleep problems. PMID:22445231

Dentists interacting and working with female dental nurses: a qualitative investigation of gender differences in primary dental care.

PubMed

Freeman, R; Gorter, R; Braam, A

2004-02-14

To investigate if women compared with men dentists experience deferential treatment from their female nurses, what workplace strategies women use to manage chair-side assistance and to examine if these were country related. A convenience sample of 22 male and female dentists of different ages working in general dental practice in The Netherlands and Northern Ireland participated. The sample framework was determined by saturation of the concepts. All informants were interviewed in a clinical setting. The data was subjected to rigorous line by line coding in order to identify clusters of codes, themes and concepts. Three themes were identified. These were: experiencing deferential nursing assistance; adopting 'friendly-like' working strategies and adopting business-like, hierarchical working strategies. Gender differences were shown for each of the themes. Women rather than men made friends with their nurses and attempted to reduce status inequalities. This led to workplace strategy inconsistencies. This suggested that it was not the type of strategy adopted but the inconsistency with which it was implemented that caused difficulties between younger women dentists and their nurses. Training dental students and young graduates how to interact appropriately in the clinical situation and to appreciate the nurses' work status will assist in improving working relationships.

How to ask: Older adults’ preferred tools in health outcome prioritization

PubMed Central

Case, Siobhan M.; Fried, Terri R.; O’Leary, John

2012-01-01

OBJECTIVE To assess older adults’ attitudes toward eliciting health outcome priorities. METHODS This observational cohort study of 356 community-living adults age ≥ 65 included three tools: 1) Health Outcomes: ranking four outcomes (survival, function, freedom from pain, and freedom from other symptoms); 2) Now vs. Later: rating importance of current versus future quality of life; 3) Attitude Scale: agreement with statements about health outcomes and current versus future health. RESULTS Whereas 41% preferred Health Outcomes, 40% preferred the Attitude Scale. Only 7–12% rated any tool as very hard or hard. In bivariate analysis, participants of non-white race and with lower education, health literacy, and functional status were significantly more likely to rate at least one of the tools as easy (p<0.05). Across all tools, 17% of participants believed tools would change care. The main reason for thinking there would be no change was satisfaction with existing care (62%). CONCLUSIONS There is variability in how older persons wish to be asked about health outcome priorities. Few find this task difficult, and difficulty was not greater among participants with lower health literacy, education, or health status. PRACTICE IMPLICATIONS By offering different tools, healthcare providers can help patients clarify their health outcome priorities. PMID:23218242

School-Based Assessment of ADHD: Purpose, Alignment with Best Practice Guidelines, and Training

ERIC Educational Resources Information Center

Ogg, Julia; Fefer, Sarah; Sundman-Wheat, Ashley; McMahan, Melanie; Stewart, Tiffany; Chappel, Ashley; Bateman, Lisa

2013-01-01

Youth exhibiting symptoms of attention deficit hyperactivity disorder are frequently referred to school psychologists because of academic, social, and behavioral difficulties that they face. To address these difficulties, evidence-based assessment methods have been outlined for multiple purposes of assessment. The goals of this study were to…

Supporting Children with Communication Difficulties in Inclusive Settings: School-Based Language Intervention.

ERIC Educational Resources Information Center

McCormick, Linda; And Others

Preparing language interventionists and special education teachers to work with colleagues and families on collaborative teams in public school settings, this book provides basic procedures for intervention for all children with language and communication difficulties, with hands-on activities to give students practice in applying the procedures.…

Psycho-Pedagogical Interventions in the Prevention and the Therapy of Learning Difficulties in the Field of Mathematics

ERIC Educational Resources Information Center

Anca, Maria; Hategan, Carolina

2009-01-01

In the given study dyscalculia is approached in the context of learning difficulties, but also in relation with damaged psychic processes and functions. The practical part of the study describes intervention models from the perspective of dyscalculia prevention and therapymaterialized in personalized intervention programs.

Evidence-Based Practice, Response to Intervention, and the Prevention of Reading Difficulties

ERIC Educational Resources Information Center

Justice, Laura M.

2006-01-01

Purpose: This article provides an evidence-based perspective on what school communities can do to lower the prevalence of reading difficulties among their pupils through preventive interventions. It also delineates the roles that speech-language pathologists (SLPs) might play in these interventions. Method: This article is organized to first…

Asperger Syndrome and the Elementary School Experience: Practical Solutions for Academic & Social Difficulties.

ERIC Educational Resources Information Center

Moore, Susan Thompson.

This book provides educators with an understanding of Asperger syndrome (AS) and how it affects a student academically and socially, and provides specific strategies for helping elementary school students with AS function successfully. Following an introductory chapter, chapter 2 presents the major areas of difficulty for individuals with AS with…

Difficulties in Field-Based Observation among Pre-Service Teachers: Implications to Practice Teaching

ERIC Educational Resources Information Center

Abas, Maripaz C.

2016-01-01

Field-based observation has long been a central part of pre-service teacher education in many countries and is crucial for implementing effective practicum of pre-service teachers. This paper focused on the perspectives of graduating pre-service teachers regarding their difficulties related to administrative support, cooperating teachers, student…

[Abortion in unsafe conditions. Concealment, illegality, corruption and negligence].

PubMed

Ortiz Ortega, A

1993-01-01

"Abortion practiced under conditions of risk" is a phrase used to refer to illegal abortion. The phrase does not highlight the disappearance of risk when legislation changes. Rather, it calls attention to the fact that legal restrictions significantly increase dangers while failing to discourage women determined to terminate pregnancies. The International Planned Parenthood Federation defines abortion under conditions of risk as the use of nonoptimal technology, lack of counseling and services to orient the woman's decision and provide postabortion counseling, and the limitation of freedom to make the decision. The phrase encompasses concealment, illegality, corruption, and negligence. It is designed to impose a reproductive health perspective in response to an unresolved social conflict. Steps have been developed to improve the situation of women undergoing abortion even without a change in its legal status. Such steps include training and purchase of equipment for treatment of incomplete abortions and development of counseling and family planning services. The central difficulty of abortion induced in conditions of risk derives from the laws imposing the need for secrecy. In Mexico, the abortion decision belongs to the government and the society, while individual absorb the consequences of the practice of abortion. Public decision making about abortion is dominated by the concept that the female has an obligation to carry any pregnancy to term. Women who interfere with male descendency and practice a sexuality distinct from reproduction are made to pay a price in health and emotional balance. Resolution of the problem of abortion will require new concepts in terms of legal status, public health issues, and the rights of women. The problem becomes more pressing as abortion becomes more common in a country anxious to advance in the demographic transition. Only a commitment to the reproductive health of women and the full development of their rights as citizens will permit a favorable outcome to the problem.

Women's sexuality: from aging to social representations.

PubMed

Ringa, Virginie; Diter, Kevin; Laborde, Caroline; Bajos, Nathalie

2013-10-01

Studies designed in northern countries show that most women are still sexually active after the age of 50. Many factors other than hormones influence sexual life in and after middle age; they include social status, personal characteristics, physical and psychological conditions, relationship factors, and social representations of sexuality. This study aims to analyze various components of sexuality, including its social representations, among women aged 45-55 years, as they reach menopause. Comparison of three groups: all postmenopausal women (277), postmenopausal women not currently using hormonal treatment (HT) (209), postmenopausal women currently using HT (68), with a reference group of premenopausal women (408). All were recruited in a national general population-based survey of sexual behaviors and interviewed by telephone. Practices, sexual function, satisfaction, and representations and expectations concerning sexuality. The women did not differ according to menopausal status for sexual activity, practices (wide range of practices beyond sexual intercourse), dysfunction, or satisfaction. They also attributed equal importance to sexuality. Nevertheless, although postmenopausal women not using HT did not report less sexual activity than premenopausal women, they were less likely to consider that a 3-month period without sex is a sign of difficulty in a relationship (30.3% vs. 47.7%; odds ratio: 0.35 [0.21-0.57], P=0.000). This difference was not observed between postmenopausal women using HT and premenopausal women. Our results suggest that for middle-aged women who are at the onset of menopause, the biological/hormonal changes characterizing menopause do not negatively affect sexual life. Any negative reported effects on sexuality are more likely due to anticipation or negative representations of sexuality around menopause than to biological or hormonal effects. The effect of menopause at this point in women's lives may thus be more symbolic than biological, expressed as a form of anticipation of old age. © 2013 International Society for Sexual Medicine.

Adolescents' strengths and difficulties: approach to attachment styles.

PubMed

Keskin, G; Cam, O

2010-06-01

This research is a descriptive field study conducted in order to investigate the relationship between adolescent difficulties and the attachment style. The study aims to investigate the relationship between adolescent attachment style and strength and difficulties in Turkey. Children attachment style and difficulties pattern in the group of adolescents aged 11-16 years old were compared with each other. Several different questionnaires, including The Strength and Difficulties Questionnaire, The Relationship Scale Questionnaire were applied to 384 (mean age 12.10 +/- 1.4 years) adolescents. The data were analysed using descriptive statistics, Pearson correlation coefficients, anova, t-test, Kruskall Wallis and effect sizes. The adolescent secure attachment style was associated with increased levels of prosocial behaviour, decreased levels of emotional symptoms, hyperactivity/inattention, peer relationship problems, conduct problems, total difficulties scores. The adolescent fearful attachment style was associated with increased levels of emotional symptoms, and total difficulties scores. The adolescent dismissing attachment style was significantly associated with higher levels of emotional symptoms, hyperactivity/inattention, total difficulties scores and lower levels of prosocial behaviour. Adolescent strengths and difficulties are associated with their attachment style. Insecure attachment styles of dismissing and fearful were associated with increased mental symptom reporting. It is suggested that further studies may illuminate the clinical value of the attachment disorder and quantify parental contribution to psychopathology. Giving the therapeutic, structured mental support programme to adolescents that have attachment problems could be beneficial in improving mental status of these individuals.

[Development and Effects of a Coping Skill Training Program for Caregivers in Feeding Difficulty of Older Adults with Dementia in Long-Term Care Facilities].

PubMed

Hong, Hyun Hwa; Gu, Mee Ock

2018-04-01

We developed and tested the effects of a coping skill training program for caregivers in feeding difficulty among older adults with dementia in long-term care facilities. A non-equivalent control group pretest-posttest design was used. The subjects comprised 34 caregivers (experimental group: 17, control group: 17) and 40 older adults with dementia (experimental group: 20, control group: 20). The developed program was delivered in 4-hour sessions over 6 weeks (including 2 weeks of lectures and lab practice on feeding difficulty coping skills, and 4 weeks of field practice). Data were collected before, immediately after, and 4 weeks after the program (January 3 to April 6, 2016). The data were analyzed using t-test and repeated measures ANOVA using SPSS/WIN 20.0. Compared to their counterparts in the control group, caregivers in the experimental group showed a significantly greater improvement in feeding knowledge and feeding behavior, while older adults with dementia showed greater improvements in feeding difficulty and Body Mass Index. The study findings indicate that this coping skill training program for caregivers in feeding difficulty is an effective intervention for older adults with dementia in long-term care facilities. © 2018 Korean Society of Nursing Science.

Gifted Learners: The Boomerang Kids of Middle School?

ERIC Educational Resources Information Center

Tomlinson, Carol Ann

1994-01-01

A variety of beliefs and practices central to middle schools may cause special difficulties for gifted learners. Such practices often focus on potentially competing goals of student competencies versus student excellence and include such practices as heterogeneous grouping, cooperative learning, and an absence of clearly defined middle school…

Prevalence, predictors and covariates of functional status impairment among Finnish Second World War veterans during 1992-2004.

PubMed

Leskinen, Riitta; Laatikainen, Tiina; Peltonen, Markku; Levälahti, Esko; Antikainen, Riitta

2013-07-01

the functional status is one of the most important health measurements in the elderly. This study aimed to investigate the prevalence of self-reported physical and mental conditions among Finnish Second World War veterans during 1992-2004. We also aimed to study the ability of these conditions in 1992 to predict the functional status impairment in 2004 and to determine whether the worsening of symptoms or the onset of new diseases during 1992-2004 was associated with impaired basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in 2004. the study population was 4,999 veterans living in Finland participating in both the Veteran Project 1992 and 2004. Logistic regression models were employed to identify predictors for impaired BADL and IADL. Analyses were conducted separately for men with and without disability and for women. the highest risk estimate for impaired BADL in 2004 was in men without disability who had a neurological disease in 1992 [odds ratios (OR): 5.78, 95% CI: 2.49-13.43], in men with disability with walking difficulties in 1992 (OR: 2.41, 95% CI: 1.79-3.25) and in women with a musculoskeletal disease in 1992 (OR: 2.39, 95% CI: 1.58-3.62). For impaired IADL, walking difficulties had the highest risk estimate in all veteran groups. mental and physical conditions, especially walking difficulties, can predict veterans' future functional impairment even 12 years in advance, and worsening of these conditions is associated with impaired ADL.

Impulse control disorders in Parkinson's disease: the role of personality and cognitive status.

PubMed

Poletti, Michele; Bonuccelli, Ubaldo

2012-11-01

This study reviews empirical findings on two debated issues related to the phenomenon of impulse control disorders (ICD) in patients with Parkinson's disease (PD) treated with dopamine agonists: the role of "premorbid" or "baseline" personality traits and the role of cognitive status. A review of both these issues may help clinicians to understand why only some PD patients, when treated with dopamine agonists, develop an ICD: besides the treatment, which other neuropsychiatric characteristics represent a risk factor to develop an ICD? A literature review was performed on studies of ICD in PD patients, in electronic databases ISI Web of Knowledge, Medline and PsychInfo, conducted in January 2011. In the general population, impulsivity, depression and difficulties with executive functions, especially of inhibitory control, are factors associated with ICD development. As regards cognitive functions, PD patients present executive difficulties, and patients with ICD present more difficulties in comparison to patients without ICD. As regards personality characteristics, PD patients present a trait of negative affect, which could predispose them to affective disorders and could represent an affective risk factor for the development of ICD; as regards impulsivity, preliminary findings support the hypothesis that premorbid "baseline" levels may moderate the decrease of impulsivity because of the progressive dopaminergic deficit in PD patients and therefore also moderate the development of ICD. Longitudinal psychometric and cognitive studies, following PD patients since the clinical diagnosis and during dopaminergic treatment, are needed to confirm the role of personality traits and cognitive status on ICD development in this clinical population.

Screening Primary-Care Patients Forgoing Health Care for Economic Reasons

PubMed Central

Bodenmann, Patrick; Favrat, Bernard; Wolff, Hans; Guessous, Idris; Panese, Francesco; Herzig, Lilli; Bischoff, Thomas; Casillas, Alejandra; Golano, Thomas; Vaucher, Paul

2014-01-01

Background Growing social inequities have made it important for general practitioners to verify if patients can afford treatment and procedures. Incorporating social conditions into clinical decision-making allows general practitioners to address mismatches between patients' health-care needs and financial resources. Objectives Identify a screening question to, indirectly, rule out patients' social risk of forgoing health care for economic reasons, and estimate prevalence of forgoing health care and the influence of physicians' attitudes toward deprivation. Design Multicenter cross-sectional survey. Participants Forty-seven general practitioners working in the French–speaking part of Switzerland enrolled a random sample of patients attending their private practices. Main Measures Patients who had forgone health care were defined as those reporting a household member (including themselves) having forgone treatment for economic reasons during the previous 12 months, through a self-administered questionnaire. Patients were also asked about education and income levels, self-perceived social position, and deprivation levels. Key Results Overall, 2,026 patients were included in the analysis; 10.7% (CI95% 9.4–12.1) reported a member of their household to have forgone health care during the 12 previous months. The question “Did you have difficulties paying your household bills during the last 12 months” performed better in identifying patients at risk of forgoing health care than a combination of four objective measures of socio-economic status (gender, age, education level, and income) (R2 = 0.184 vs. 0.083). This question effectively ruled out that patients had forgone health care, with a negative predictive value of 96%. Furthermore, for physicians who felt powerless in the face of deprivation, we observed an increase in the odds of patients forgoing health care of 1.5 times. Conclusion General practitioners should systematically evaluate the socio-economic status of their patients. Asking patients whether they experience any difficulties in paying their bills is an effective means of identifying patients who might forgo health care. PMID:24699726

A systematic literature review of evidence-based clinical practice for rare diseases: what are the perceived and real barriers for improving the evidence and how can they be overcome?

PubMed

Rath, Ana; Salamon, Valérie; Peixoto, Sandra; Hivert, Virginie; Laville, Martine; Segrestin, Berenice; Neugebauer, Edmund A M; Eikermann, Michaela; Bertele, Vittorio; Garattini, Silvio; Wetterslev, Jørn; Banzi, Rita; Jakobsen, Janus C; Djurisic, Snezana; Kubiak, Christine; Demotes-Mainard, Jacques; Gluud, Christian

2017-11-22

Evidence-based clinical practice is challenging in all fields, but poses special barriers in the field of rare diseases. The present paper summarises the main barriers faced by clinical research in rare diseases, and highlights opportunities for improvement. Systematic literature searches without meta-analyses and internal European Clinical Research Infrastructure Network (ECRIN) communications during face-to-face meetings and telephone conferences from 2013 to 2017 within the context of the ECRIN Integrating Activity (ECRIN-IA) project. Barriers specific to rare diseases comprise the difficulty to recruit participants because of rarity, scattering of patients, limited knowledge on natural history of diseases, difficulties to achieve accurate diagnosis and identify patients in health information systems, and difficulties choosing clinically relevant outcomes. Evidence-based clinical practice for rare diseases should start by collecting clinical data in databases and registries; defining measurable patient-centred outcomes; and selecting appropriate study designs adapted to small study populations. Rare diseases constitute one of the most paradigmatic fields in which multi-stakeholder engagement, especially from patients, is needed for success. Clinical research infrastructures and expertise networks offer opportunities for establishing evidence-based clinical practice within rare diseases.

Enhancing the Student Experiment Experience: Visible Scientific Inquiry Through a Virtual Chemistry Laboratory

NASA Astrophysics Data System (ADS)

Donnelly, Dermot; O'Reilly, John; McGarr, Oliver

2013-08-01

Practical work is often noted as a core reason many students take on science in secondary schools (high schools). However, there are inherent difficulties associated with classroom practical work that militate against scientific inquiry, an approach espoused by many science educators. The use of interactive simulations to facilitate student inquiry has emerged as a complement to practical work. This study presents case studies of four science teachers using a virtual chemistry laboratory (VCL) with their students in an explicitly guided inquiry manner. Research tools included the use of the Inquiry Science Implementation Scale in a `talk-aloud' manner, Reformed Teaching Observation Protocol for video observations, and teacher interviews. The findings suggest key aspects of practical work that hinder teachers in adequately supporting inquiry and highlight where a VCL can overcome many of these difficulties. The findings also indicate considerations in using the VCL in its own right.

The role of parenting in the relationship between childhood eating problems and broader behaviour problems.

PubMed

Blissett, J; Meyer, C; Haycraft, E

2011-09-01

Previous research has established that childhood feeding and eating problems are often related to other behavioural difficulties. Parenting practices have been implicated in both eating behaviour and broader behaviour problems. The aim of this study was to examine whether the relationship between eating and behaviour problems could be explained in part by parenting style and practices. Seventy-seven mothers of 3- to 8-year-old children completed measures of children's eating behaviours, behaviour problems, parenting style and feeding practices. Eating behaviours (food responsiveness, emotional under-eating, fussiness) and behaviour problems (conduct problems, hyperactivity, total difficulties) were significantly correlated, but when parenting style and feeding practices were controlled for, significant associations disappeared. Although the findings are limited because of a relatively low response rate, in non-clinical groups, the perceived commonality between eating and behaviour problems may be explained by parenting. © 2011 Blackwell Publishing Ltd.

Forced sex: a critical factor in the sleep difficulties of young Australian women.

PubMed

Astbury, Jill; Bruck, Dorothy; Loxton, Deborah

2011-01-01

The prevalence of forced sex and its contribution to sleep difficulties among young Australian women aged 24-30 years (n=9,061) was examined using data from the 2003 Australian Longitudinal Study of Women's Health. The lifetime prevalence of reported forced sex was 8.7%. Significantly higher levels of recurrent sleep difficulties, prescription sleep medication, clinical depression, anxiety disorder, self-harm, and substance use, as well as lower socioeconomic status (SES) indicators, were reported by the forced sex group compared to the no forced sex group. Hierarchical logistic regression revealed the high odds (OR=1.95, CI=1.66-2.26) of recurrent sleep difficulty in such women becomes partially attenuated, but remains statistically significant, after adjusting for key psychological, SES, and behavioral variables. Clinical implications for primary care providers and sleep specialists are discussed. Sleep difficulties are highly prevalent and affect more than 30% of those seeking primary health care (Kushida et al., 2005). They negatively impact on the way a person feels and functions (Dinges et al., 1997) and make a significant contribution to accidents, health care costs, and problems at work (Roth, 2005).

Educational provision for children with specific speech and language difficulties: perspectives of speech and language therapy service managers.

PubMed

Dockrell, Julie E; Lindsay, Geoff; Letchford, Becky; Mackie, Clare

2006-01-01

Children with specific speech and language difficulties (SSLD) pose a challenge to the education system, and to speech and language therapists who support them, as a result of their language needs and associated educational and social-behavioural difficulties. The development of inclusion raises questions regarding appropriate provision, whether the tradition of language units or full inclusion into mainstream schools. To gather the views of speech and language therapy service managers in England and Wales regarding approaches to service delivery, terminology and decision-making for educational provision, and the use of direct and indirect (consultancy) models of intervention. The study reports on a national survey of speech and language therapy (SLT) services in England and Wales (129 respondents, 72.1% response rate) and interviews with 39 SLT service managers. Provision varied by age group with support to children in the mainstream common from pre-school to the end of Key Stage 2 (up to 11 years), and to those in designated specialist provision, common at Key Stages 1/2 (ages 5-11 years), but less prevalent at Key Stages 3/4 (11-16 years). Decision-making regarding provision was influenced by the lack of common terminology, with SSLD and specific language impairment (SLI) the most common, and criteria, including the use of the discrepancy model for defining SSLD. Practice was influenced by the difficulties in distinguishing children with SSLD from those with autistic spectrum disorder, and difficulties translating policies into practice. The implications of the study are discussed with reference to SLT practice, including consultancy models, and the increasingly prevalent policy in local education authorities of inclusion of children with special educational needs.

Pediatric parenting stress among parents of children with type 1 diabetes: the role of self-efficacy, responsibility, and fear.

PubMed

Streisand, Randi; Swift, Erika; Wickmark, Tara; Chen, Rusan; Holmes, Clarissa S

2005-09-01

Parents of children with type 1 diabetes are crucial to promoting positive disease adaptation and health outcomes among these youngsters, yet this success may come at some consequence to parents' own well-being. Little research has examined the stress faced by parents, or explored the psychological and behavioral correlates of their stress. One hundred and thirty-four parents of children with type 1 diabetes completed measures of diabetes self-efficacy, responsibility for diabetes management, fear of hypoglycemia, and a recently developed measure of pediatric parenting stress (the Pediatric Inventory for Parents [PIP]; R. Streisand, S. Braniecki, K. P. Tercyak, & A. E. Kazak, 2001). Bivariate analyses suggest that pediatric parenting stress is multifaceted; the frequency of parenting stress is negatively related to child age and family socioeconomic status and positively related to single parent status and regimen status (injections vs. insulin pump). Difficulty of parenting stress is negatively related to child age and positively related to regimen status. In multivariate analyses, a significant portion of the variance in stress frequency (32%) and difficulty (19%) are associated with parent psychological and behavioral functioning, including lower self-efficacy, greater responsibility for diabetes management, and greater fear of hypoglycemia. Each area of parent functioning associated with pediatric parenting stress is amenable to behavioral intervention aimed at stress reduction or control and improvement of parent psychological and child-health outcomes.

Early Lactation and Infant Feeding Practices Differ by Maternal Gestational Diabetes History.

PubMed

Oza-Frank, Reena; Moreland, Jennifer J; McNamara, Kelly; Geraghty, Sheela R; Keim, Sarah A

2016-11-01

Detailed data on lactation practices by gestational diabetes mellitus (GDM) history are lacking, precluding potential explanations and targets for interventions to improve lactation intensity and duration and, ultimately, long-term maternal and child health. This study aimed to examine breastfeeding practices through 12 months postpartum by GDM history. Women who delivered a singleton, liveborn infant at The Ohio State University Wexner Medical Center (Columbus, OH), in 2011 completed a postal questionnaire to assess lactation and infant feeding practices and difficulties. Bivariate and multivariate associations between GDM history and lactation and infant feeding practices were examined. The sample included 432 women (62% response rate), including 7.9% who had GDM during the index pregnancy. Women with GDM initiated breastfeeding (at-the-breast or pumping) as often as women without any diabetes but were more likely to report introduction of formula within the first 2 days of life (79.4% vs 53.8%, P < .01; adjusted odds ratio: 3.48; 95% confidence interval, 1.47-8.26). Women with GDM initiated pumping 4 days earlier than women without diabetes ( P < .05), which was confirmed in adjusted analyses. There was no difference in the proportion of women reporting breastfeeding difficulty (odds ratio: 2.08; 95% confidence interval, 0.78-5.52). However, there was a trend toward women with GDM reporting more formula feeding and less at-the-breast feeding as strategies to address difficulty compared with women without diabetes. Additional research is needed to understand why women with GDM engage in different early lactation and infant feeding practices, and how best to promote and sustain breastfeeding among these women.

A Historical Study to Understand Students' Current Difficulties about RMS Values

ERIC Educational Resources Information Center

Khantine-Langlois, Françoise; Munier, Valérie

2016-01-01

Several studies show that students experience more and more difficulties managing the measurements of electrical values in alternating current and that they have trouble making links between theory and practice. They find it difficult to give meaning to root mean square (RMS; or effective) values, which are not understood as average values and are…

Parental Mediation of the Internet Use of Primary Students: Beliefs, Strategies and Difficulties

ERIC Educational Resources Information Center

Bartau-Rojas, Isabel; Aierbe-Barandiaran, Ana; Oregui-González, Eider

2018-01-01

The use of the Internet by children at an increasingly early age today constitutes a major challenge for families and schools, as well as affecting educational and social policy. This is a qualitative piece of research that analyzes parents' beliefs, everyday practices and the difficulties they face in teaching their children the benefits and…

Educating Children and Young People with Fetal Alcohol Spectrum Disorders: Constructing Personalised Pathways to Learning

ERIC Educational Resources Information Center

Blackburn, Carolyn; Carpenter, Barry; Egerton, Jo

2012-01-01

The range of learning difficulties associated with children and young people who have Fetal Alcohol Spectrum Disorders (FASD) has been highlighted as an emerging but little understood area of Special Educational Needs. This engaging, timely and highly practical book will raise awareness about FASD and its associated difficulties across the entire…

Children Placed at Risk for Learning and Behavioral Difficulties: Implementing a School-Wide System of Early Identification and Intervention.

ERIC Educational Resources Information Center

O'Shaughnessy, Tam E.; Lane, Kathleen L.; Gresham, Frank M.; Beebe-Frankenberger, Margaret E.

2003-01-01

This article describes a school-wide system of early identification and intervention for children recognized as being at risk for learning and behavior difficulties. Suggested guidelines for implementing such a program include: evaluating existing theory, knowledge, and practice; providing ongoing professional development; creating a school-wide…

Tightening the Grip over an Elusive System: Innovative Practices

ERIC Educational Resources Information Center

Vennakkadan, Abdul Latheef; Irudayasamy, Julius

2014-01-01

The present study examines the need for a specific approach to spelling instruction in ELT curriculum for ESL/EFL learners as it is an area where the L2 learners encounter a lot of learning difficulties or experience both inter/intra linguistic transfer. The study further explores the rationale for combating the spelling difficulties of ESL/EFL…

Cognitive Behaviour Therapies and Their Implications for Applied Educational Psychology Practice

ERIC Educational Resources Information Center

Rait, Shami; Monsen, Jeremy J.; Squires, Garry

2010-01-01

This paper critically considers the growing interest in the use of Cognitive Behaviour Therapies to support children and young people presenting with a wide range of social-emotional difficulties. This focus has emerged since the prevalence of such difficulties in children and young people has increased over the past four decades, and the…

The Use of Response to Intervention Practices for Behavior: An Examination of the Validity of a Screening Instrument

ERIC Educational Resources Information Center

Muyskens, Paul; Marston, Doug; Reschly, Amy L.

2007-01-01

Behavioral difficulties of school-aged students are typically dealt with in a reactive, rather than preventative manner. This article examines a proactive approach, consistent with the Response-to-Intervention model, using a screening measure designed to identify students at risk for behavior difficulties and targeting these students for early…

Rasch Measurement and Item Banking: Theory and Practice.

ERIC Educational Resources Information Center

Nakamura, Yuji

The Rasch Model is an item response theory, one parameter model developed that states that the probability of a correct response on a test is a function of the difficulty of the item and the ability of the candidate. Item banking is useful for language testing. The Rasch Model provides estimates of item difficulties that are meaningful,…

Exploring the Acceptability of Innovative Technology: A Pilot Study Using LENA with Parents of Young Deaf Children in the UK

ERIC Educational Resources Information Center

Allen, Sarah; Crawford, Paul; Mulla, Imran

2017-01-01

Early intervention is widely recommended for children at risk of difficulties with speech, language and communication. Evidence for effective practice remains limited due in part to inherent difficulties in defining complex interventions and measuring change. The innovative Language Environment Analysis (LENA) system has exciting potential for…

Dyscalculia ? Maths Difficulties. An Analysis of Conflicting Positions at a Time That Calls for Inclusive Practices

ERIC Educational Resources Information Center

Schmidt, Maria Christina Secher

2016-01-01

Using Bourdieu's notion of field, the Scandinavian field of maths pedagogy occurs at a time characterised by increasing inclusion efforts in primary school. Various stakeholders in maths pedagogy are arguing about what should be done about pupils who perform poorly in mathematics and what causes their difficulties. Four analytical positions are…

West Indians and Afro-Americans: A Partnership

ERIC Educational Resources Information Center

Best, Tony

1975-01-01

In addition to the difficulties connected with their status as immigrants, West Indians must contend with the problems arising because of their blackness. The ties that bind Afro-Americans and West Indians together are said to consist in survival processes. (Author/AM)

Redress of Grievances.

ERIC Educational Resources Information Center

Davies, Helen C.; Davies, Robert E.

The status of women in higher education, sex discrimination, laws providing protection against sex descrimination, grievance procedures, and difficulties involved in filing complaints are addressed. Empirical evidence is cited that illustrates discrimination against women at the hiring level in the scientific academic community. To substantiate…

Working after a metastatic cancer diagnosis: factors affecting employment in the metastatic setting from ECOG’s Symptom Outcomes and Practice Patterns (SOAPP) study

PubMed Central

Tevaarwerk, Amye; Lee, Ju-Whei; Terhaar, Abigail; Sesto, Mary; Smith, Mary Lou; Cleeland, Charles; Fisch, Michael

2015-01-01

Background Improved survival for individuals with metastatic cancer accentuates the importance of employment for cancer survivors. Better understanding of how metastatic cancer affects employment is a necessary step towards the development of tools to assist survivors in this important realm. Methods We analyzed the Eastern Cooperative Oncology Group’s “Symptom Outcomes and Practice Patterns (SOAPP)” study to investigate what factors were associated with employment of 680 metastatic cancer patients. Univariable and multivariable logistic regression analyses were conducted to compare patients stably working (Group A) to patients no longer working (Group B). Results There were 668 metastatic working-age participants in our analysis; 236 (35%) worked full or part-time while 302 (45%) stopped working due to illness. Overall, 58% reported some change in employment due to illness. Better performance status and non-Hispanic White ethnicity/race were significantly associated with continuing to work despite a metastatic cancer diagnosis on multivariable analysis. Disease type, time since metastatic diagnosis, number of metastatic sites, location of metastatic disease, and treatment status had no significant impact. Among the potentially modifiable factors, receiving hormonal treatment (if a viable option) and decreasing symptom interference were associated with continuing to work. Conclusions A significant percentage of metastatic patients remain employed; symptom burden was associated with change to no longer working. Modifiable factors resulting in work interference should be minimized so that patients with metastatic disease may continue working, if desired. Improvements in symptom control and strategies developed to help address work place difficulties have promise to improve this aspect of survivorship. PMID:26687819

Outcome evaluation of the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education: nationwide physician education project for primary palliative care in Japan.

PubMed

Yamamoto, Ryo; Kizawa, Yoshiyuki; Nakazawa, Yoko; Ohde, Sachiko; Tetsumi, Sato; Miyashita, Mitsunori

2015-01-01

Palliative care is an essential part of medicine, but most physicians have had no formal opportunity to acquire basic skills in palliative care. In Japan, the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education (PEACE) was launched to provide formal primary palliative care education for all physicians engaged in cancer care. This study sought to determine whether PEACE could improve physicians' knowledge of, practices in, and difficulties with palliative care. In 2011, we conducted questionnaire-based surveys before, just after, and 2 months after completion of the PEACE program in physicians participating in the program at each of 15 designated cancer hospitals in Japan. Knowledge was measured using the palliative care knowledge questionnaire for PEACE (PEACE-Q). Practices and difficulties were evaluated using the Palliative Care self-reported Practice Scale (PCPS) and the Palliative Care Difficulties Scale (PCDS), respectively. Among 223 physicians participating in the program, 85 (38%) answered the follow-up survey. Significant improvements were noted on the PEACE-Q compared with baseline immediately after completion of the program, and this progress was maintained at 2 months (21.7 ± 5.56 versus 29.5 ± 2.10 versus 28.7 ± 3.28, respectively; p < 0.0001). Similarly, significant improvements were noted for total scores on both the PCPS and the PCDS at 2 months after completion of the program (62.1 ± 13.9 versus 69.6 ± 9.94 [p < 0.0001] for the PCPS; 44.4 ± 9.96 versus 39.4 ± 10.7 [p < 0.0001] for the PCDS). The PEACE education program improved physicians' knowledge of, practices in, and difficulties with palliative care.

The prevalence of self-reported vision difficulty in economically disadvantaged regions of South Africa

PubMed Central

Naidoo, Kovin S.; Ramson, Prasidh; Chinanayi, Farai; Zhuwau, Tom; Øverland, Lene

2015-01-01

Background Vision impairment, resulting in vision difficulties, is a leading cause of disability, and hence one of the key barriers for people to access education and employment, which may force them into poverty. Objectives The objective of this study was to determine the prevalence of self-reported vision difficulties as an indicator of vision impairment in economically disadvantaged regions in South Africa, and to examine the relationship between self-reported vision difficulties and socio-economic markers of poverty, namely, income, education and health service needs. Methods A cross-sectional study was conducted in economically disadvantaged districts to collect data from households on poverty and health, including vision difficulty. As visual acuity measurements were not conducted, the researchers used the term vision difficulty as an indicator of vision impairment. Data were collected from 27 districts (74 901 respondents). Logistic regression analysis and chi-square tests were used to determine bivariate relationships between variables and self-reported vision difficulty. Kernel density estimators were used for age, categorised by self-reported and not reported vision difficulty. Results Prevalence of self-reported vision difficulty was 11.2% (95% CI, 8.7% – 13.7%). More women (12.7%) compared to men (9.5%) self-reported vision difficulty (p < 0.01). Self-reported vision difficulty was higher (14.2%) for respondents that do not spend any money. A statistically significant relationship was found between the highest level of education and self-reporting of vision difficulty; as completed highest level of education increased, self-reporting of vision difficulty became lower (p < 0.01). A significantly higher prevalence of self-reported vision difficulty was found in respondents who are employed (p < 0.01), 17% (95% CI: 12.8% – 21.1%). Conclusion The evidence from this study suggests associations between socio-economic factors and vision difficulties that have a two-fold relationship (some factors such as education, and access to eye health services are associated with vision difficulty whilst vision difficulty may trap people in their current poverty or deepen their poverty status). The results are thus indicative of the need for further research in South Africa. PMID:28730022

Prevalence of poor sleep quality and its relationship with body mass index among teenagers: evidence from Taiwan.

PubMed

Chen, Duan-Rung; Truong, Khoa D; Tsai, Meng-Ju

2013-08-01

The linkage between sleep quality and weight status among teenagers has gained more attention in the recent literature and health policy but no consensus has been reached. Using both a propensity score method and multivariate linear regression for a cross-sectional sample of 2,113 teenagers, we analyzed their body mass index (BMI) in relation to sleep quality while controlling for family characteristics (household income, parent/guardian level of education, disability status, work night shift, and smoking) and individual factors (age, sex, regular exercise, smoking, employment, and feeling secure in the neighborhood). Sleep quality was assessed using 3 scales: difficulty in initiating sleep, difficulty in maintaining sleep, and non-restorative sleep, based on Diagnostic and Statistical Manual of Mental Disorders-IV-defined insomnia. Considering all 3 types of poor sleep quality, 20.9% of teenagers in Taiwan experienced some form of sleep problems. After adjusting for the other variables, 2 factors independently and statistically predicted sleep problems: current smoking and working night shifts by the head of the household. Teens experiencing difficulty in initiating sleep had higher BMIs ranging from 0.86 to 1.41 units. Efforts to address childhood obesity need to take into consideration sleep problems that are highly prevalent among teenagers. © 2013, American School Health Association.

Guided Retrieval Practice of Educational Materials Using Automated Scoring

ERIC Educational Resources Information Center

Grimaldi, Phillip J.; Karpicke, Jeffrey D.

2014-01-01

Retrieval practice is a powerful way to promote long-term retention and meaningful learning. However, students do not frequently practice retrieval on their own, and when they do, they have difficulty evaluating the correctness of their responses and making effective study choices. To address these problems, we have developed a guided retrieval…

The Occupation and Participation Approach to Reading Intervention (OPARI): A Community of Practice Study

ERIC Educational Resources Information Center

Grajo, Lenin C.; Candler, Catherine

2017-01-01

We employed a community of practice to expand the application of the Occupation and Participation Approach to Reading Intervention (OPARI) and build the capacity of practitioners to support children with reading difficulties. Twelve pediatric practitioners participated in a community of practice for 7 months. We used a one…

Relating Theory and Practice in Laboratory Work: A Variation Theoretical Study

ERIC Educational Resources Information Center

Eckerdal, Anna

2015-01-01

Computer programming education has practice-oriented as well as theory-oriented learning goals. Here, lab work plays an important role in students' learning. It is however widely reported that many students face great difficulties in learning theory as well as practice. This paper investigates the important but problematic relation between the…

Understanding Preservice Teachers' Development of Pedagogical Knowledge Practices When Co-Teaching Primary Science to Peers

ERIC Educational Resources Information Center

Hudson, Peter

2014-01-01

Preservice teachers articulate the need for more teaching experiences for developing their practices, however, extending beyond existing school arrangements may present difficulties. Thus, it is important to understand preservice teachers' development of pedagogical knowledge practices when in the university setting. This mixed-method study…

Mathematics Practice without Feedback: A Desirable Difficulty in a Classroom Setting

ERIC Educational Resources Information Center

Fyfe, Emily R.; Rittle-Johnson, Bethany

2017-01-01

Recent research highlights the potential benefits of practice without feedback on learner's strategy knowledge. However, most prior work has been conducted in one-on-one settings with short retention intervals. We compared the effects of mathematics practice with and without correct-answer feedback on immediate and 1-week delayed performance in a…

Ethical difficulties in clinical practice: experiences of European doctors

PubMed Central

Hurst, S A; Perrier, A; Pegoraro, R; Reiter‐Theil, S; Forde, R; Slowther, A‐M; Garrett‐Mayer, E; Danis, M

2007-01-01

Background Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services. Methods A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK. Results Survey respondents (n = 656, response rate 43%) ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority (17.6%) reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision‐making capacity (94.8%), disagreement among caregivers (81.2%) and limitation of treatment at the end of life (79.3%). The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct (47.5%), someone capable of providing specific advice (41.1%), help in weighing outcomes (36%) and clarification of the issues (35.9%). Few of the types of help expected to be useful varied among countries. Conclusion Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. PMID:17209113

The use of depth interviewing with vulnerable subjects: lessons from a research study of parents with learning difficulties.

PubMed

Booth, T; Booth, W

1994-08-01

This paper explores the practicalities of using the technique of depth interviewing with people who have learning difficulties. The authors set out to provide other researchers with guidance in the use of the life story approach and to demonstrate its utility with this vulnerable and devalued group of informants. They conclude that depth interviewing can provide new knowledge not accessible through other methods of data collection, and offers a way of giving people with learning difficulties a voice in the making of their own history.

Advanced Clinical Decision Support for Transport of the Critically Ill Patient

DTIC Science & Technology

2013-12-01

algorithms, status asthmaticus and status epilepticus , are to "go live" for use on pediatric critical care transport by the end of October. (Appendices 5...additional algorithms ( status asthmaticus and status epilepticus , Appendices 5 and 6). 8) Plans for validation testing to other transport teams...Practice Guideline Status Epilepticus Clinical Practice Guideline 17 d .s:. ... > 0 Cf :~f t t) ’ U t I .!! ~ .. z ~ i ~ t 0 - : i l

Traumatic Brain Injury Severity, Comorbidity, Social Support, Family Functioning, and Community Reintegration Among Veterans of the Afghanistan and Iraq Wars.

PubMed

Pugh, Mary Jo; Swan, Alicia A; Carlson, Kathleen F; Jaramillo, Carlos A; Eapen, Blessen C; Dillahunt-Aspillaga, Christina; Amuan, Megan E; Delgado, Roxana E; McConnell, Kimberly; Finley, Erin P; Grafman, Jordan H

2018-02-01

To examine the association between traumatic brain injury (TBI) severity; social, family, and community reintegration outcomes; and return to work status among post-9/11 veterans in Department of Veterans Affairs (VA) care. Retrospective observational cohort study. Mail/online survey fielded to a national sample of veterans. Sample of post-9/11 veterans with at least 3 years of VA care stratified according to TBI severity and comorbidities who completed and returned surveys (N=2023). Not applicable. Deployment Risk and Resilience Inventory-2 family functioning and social support subscales; Military to Civilian Questionnaire; and employment status. Bivariate analyses revealed that veterans with every classification of TBI severity reported significantly more difficulty on social, family, and community reintegration outcomes than those with no TBI. In the fully adjusted model, veterans with unclassified and moderate/severe TBI reported significantly more difficulty with community reintegration and were less likely to be employed relative to those with no TBI; those with unclassified TBI also reported significantly more difficulty with family functioning. Veterans with mild TBI also reported significantly more difficulty with community reintegration. This study provides insight into long-term outcomes associated with TBI in post-9/11 veterans and suggests that exposure to TBI has a negative effect on social and family functioning, community reintegration, and return to work even after controlling for comorbidity, deployment experiences, and sociodemographic characteristics. Additional research is required to explicate what appears to be complex interactions among TBI severity, psychosocial well-being, combat exposures, and socioeconomic resources in this population. Published by Elsevier Inc.

Effect of hierarchy legitimacy on low status group members' attributions for ingroup and outgroup failures.

PubMed

Beatson, Ruth M; Halloran, Michael J

2015-04-01

Previous research has shown that people have a tendency to explain successes and failures in ways that favor their ingroups relative to outgroups. However, there has been a dearth of research examining whether social-contextual factors such as group status and hierarchy legitimacy moderate such intergroup attributions. Participants in this study were assigned to a low status group, and perceived hierarchy legitimacy was then experimentally manipulated; the extent to which ingroup versus outgroup failures were attributed to several causes was measured. When low status was considered illegitimate, ingroup failure was attributed to external causes (task difficulty, bad luck) more so than outgroup failure. Implications and directions for future research examining consequences and mediating processes are discussed.

Use of standardized outcome measures in physical therapist practice: perceptions and applications.

PubMed

Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak

2009-02-01

Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

16 CFR Appendix D to Part 436 - Sample Item 20(3) Table-Status of Franchise Outlets

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Sample Item 20(3) Table-Status of Franchise Outlets D Appendix D to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES... Item 20(3) Table—Status of Franchise Outlets Status of Franchise Outlets For years 2004 to 2006 Column...

16 CFR Appendix D to Part 436 - Sample Item 20(3) Table-Status of Franchise Outlets

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Sample Item 20(3) Table-Status of Franchise Outlets D Appendix D to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES... Item 20(3) Table—Status of Franchise Outlets Status of Franchise Outlets For years 2004 to 2006 Column...

16 CFR Appendix D to Part 436 - Sample Item 20(3) Table-Status of Franchise Outlets

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Sample Item 20(3) Table-Status of Franchise Outlets D Appendix D to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES... Item 20(3) Table—Status of Franchise Outlets Status of Franchise Outlets For years 2004 to 2006 Column...

16 CFR Appendix D to Part 436 - Sample Item 20(3) Table-Status of Franchise Outlets

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Sample Item 20(3) Table-Status of Franchise Outlets D Appendix D to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES... Item 20(3) Table—Status of Franchise Outlets Status of Franchise Outlets For years 2004 to 2006 Column...

16 CFR Appendix D to Part 436 - Sample Item 20(3) Table-Status of Franchise Outlets

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Sample Item 20(3) Table-Status of Franchise Outlets D Appendix D to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES... Item 20(3) Table—Status of Franchise Outlets Status of Franchise Outlets For years 2004 to 2006 Column...

Self-reported learning difficulties and dietary intake in Norwegian adolescents.

PubMed

Øverby, Nina Cecilie; Lüdemann, Eva; Høigaard, Rune

2013-11-01

The academic performance of children impacts future educational attainment which may increase socioeconomic status which again influences their health. One of several factors that might affect academic performance is the diet. The aim of this study was to investigate the cross sectional relation between diet and self-reported reading-, writing-, and mathematical difficulties in Norwegian adolescents. In total, 475 ninth- and tenth-grade students out of 625 eligible ones from four different secondary schools in three different municipalities in Vest-Agder County, Norway, participated, giving a participation rate of 77%. The students filled in a questionnaire with food frequency questions of selected healthy and unhealthy food items, questions of meal frequency and different learning difficulties. Regular breakfast was significantly associated with decreased odds of both writing and reading difficulties (OR: 0.44 (0.2-0.8), p = 0.01) and mathematical difficulties (OR: 0.33 (0.2-0.6), p ≤ 0.001). In addition, having lunch, dinner and supper regularly were associated with decreased odds of mathematical difficulties. Further, a high intake of foods representing a poor diet (sugar-sweetened soft drinks, sweets, chocolate, savory snacks, pizza and hot dogs) was significantly associated with increased odds of mathematical difficulties. Having a less-frequent intake of unhealthy foods and not skipping meals are associated with decreased odds of self-reported learning difficulties in Norwegian adolescents in this study. The results of this study support the need for a larger study with a more representative sample.

Associations between sports participation and psychological difficulties during childhood: a two-year follow up.

PubMed

Vella, Stewart A; Cliff, Dylan P; Magee, Christopher A; Okely, Anthony D

2015-05-01

This paper assessed the associations between sports participation and the development of psychological strengths and difficulties during childhood. Two-year follow up study of a sample of 4042 Australian children who were followed from age 8 years to 10 years. Parents reported children's participation in organised sports, and completed the Strengths and Difficulties Questionnaire. Univariate general linear models were used to examine the association between changes in sports participation and psychological strengths and difficulties at 10 years, adjusting for psychological strengths and difficulties at age 8. Children who maintained participation in sport had lower rates of parent-reported psychological difficulties at 10 years compared with children who dropped out of sport. Less internalising problems were also reported for children who participated in organised sports compared to children who dropped out of sports and children who did not participate in sports. These relationships did not differ by BMI, socioeconomic status, or parental education. Greater psychological difficulties are experienced by children who drop out of sports, and greater social and emotional problems are experienced by children who drop out of sports and who do not participate in organised sports. Due consideration should be given to the quality and implementation of sporting programs to ensure that they provide benefits to mental health. Due consideration should also be given to the potential psychological difficulties being experienced by children who drop out of organised sports as a higher level of psychological difficulties may be experienced prior to or subsequent to dropout. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

[Self-perception of cancer patients on the relationship existing between their nutritional status, their feeding status, and their illness].

PubMed

Gómez Candela, C; Marín Caro, M M; Benítez Cruz, S; Loria Kohen, V; García Huerta, M; Lourenço Nogueira, T; Villarino Sanz, M; Castillo Rabaneda, R; Zamora Auñón, P

2008-01-01

Knowing the opinion of oncologic patients about the importance they give to their feeding, the difficulties they have with feeding, their body image, weight, and ponderal changes, the relationship between their feeding and their illness, the relationship between their physical activity and their mood and health is essential to look for nutritional therapeutic interventions leading to improvement of quality of life and, in general, the feeling of well being. Thus, it is paramount to know the patients' opinion of these issues. We passed a questionnaire to 131 patients. The patients were recruited from the Day-Hospital of the Medical Oncology and Radiotherapeutic Oncology Departments, and from the Hospitalization Department of Medical Oncology. In the questionnaire, we asked in a simple manner about the importance the patients give to all these issues. This is a 20-item questionnaire, divided into six parts: 1. Vital statistics; 2) perception about the disease and its relationship with feeding; 3) Perception of the relationship between physical activity and mood with feeding; 4) Nutritional therapies prescribed to the patients and their perception on its effect on the disease progression; 5) Current difficulties with feeding; 6) Demand of nutritional care. The patients mean age was 57 +/- 13 years. 45% were males, and the remaining females. 81% life in an urban area, and only 14% in a rural area. The educational level was categorized in 5 groups: without education, basic education, elementary school, high school, or college studies. 28% had basic education, and 19% college studies, and only 8% had no education at all. Their occupation was also categorized in five groups: home-keeping, student, unemployed, employed, and retired. 33% were employed, 29% retired, and 34% were home-keepers. Most of the patients (74%) are aware of their illness and perceive it as severe or very much severe. Most of these patients worry about their body image, weight, and ponderal changes, and they relate them with their feeding status. 74% find a relationship between their nutritional status and their physical activity, and 73% relate it with their mood. At least half of the patients perceive their mood as being low. Although 47% manifested having some difficulty for feeding, only 34% had received some information about their diet, 26% had consumed nutritional supplements, and 81% still consumed their diet without any change. The most common difficulties for feeding were decreased appetite (38%), early satiety (32%), and nausea (20%). The nutritional intervention most commonly required by the patients was general and specific nutritional education to alleviate the symptoms associated to oncologic therapies. Most of the patients are aware of the severity of their illness and care about their body image, weight, and ponderal changes, which they associate with their nutrition. Most of the patients find a close relationship between their nutritional status, their physical activity and their mood. More than half of the patients manifest having some difficulty feeding, but only one third of the population has received information about their diet some time. It is clearly shown that oncologic patients need different effective nutritional intervention measures contributing to improve their feeling of well being.

Handbook of Reading Interventions

ERIC Educational Resources Information Center

O'Connor, Rollanda E., Ed.; Vadasy, Patricia F., Ed.

2011-01-01

Comprehensive, authoritative, and designed for practical utility, this handbook presents evidence-based approaches for helping struggling readers and those at risk for literacy difficulties or delays. Leading experts explain how current research on all aspects of literacy translates into innovative classroom practices. Chapters include clear…

Are the barriers for physical activity practice equal for all peripheral artery disease patients?

PubMed

Cavalcante, Bruno R; Farah, Breno Q; dos A Barbosa, João Paulo; Cucato, Gabriel Grizzo; da Rocha Chehuen, Marcel; da Silva Santana, Fábio; Wolosker, Nelson; de Moraes Forjaz, Cláudia Lúcia; Ritti-Dias, Raphael M

2015-02-01

To investigate barriers to physical activity related to the sociodemographic comorbidities and clinical variables of patients with intermittent claudication. Cross-sectional study. Ambulatory care. The medical histories of patients (N=145) aged ≥50 years with intermittent claudication were examined. Not applicable. Sociodemographic data (sex, race, level of education, socioeconomic status, marital status), comorbidities (overweight, hypertension, dyslipidemia, diabetes, currently smoking, heart disease), and clinical variables (initial claudication distance, total walking distance, ankle-brachial index). Information on personal and environmental barriers was obtained by questionnaire. Low economic status was most associated with "being afraid of falling" (odd ratios [OR]=2.22; 95% confidence interval [CI], 1.08-4.54). Low education level was most associated with "lack of street pedestrian crossing" (OR=3.34; 95% CI, 1.48-7.52). Diabetes was associated with lack of energy (OR=3.38; 95% CI, 1.68-6.79) and other medical conditions (eg, arthritis, angina) (OR=3.44; 95% CI, 1.65-7.16). Ankle brachial index was associated with "some difficulty in getting to a place where physical activity can be performed" (OR=2.75; 95% CI, 1.22-6.21). Walking capacity was strongly associated with barriers relating to leg pain (OR=7.39; 95% CI, 1.66-32.88). Older patients, those with a low education level, patients with diabetes, low ankle brachial index, and those with a lower walking capacity are more likely to experience barriers to physical activity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Differences in health care seeking behaviour between rural and urban communities in South Africa

PubMed Central

2012-01-01

Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour. PMID:22691443

A Practical Concussion Physical Examination Toolbox

PubMed Central

Matuszak, Jason M.; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

2016-01-01

Context: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Evidence Acquisition: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Study Design: Clinical review. Level of Evidence: Level 3. Results: The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Conclusion: Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking. PMID:27022058

Qualitative Analysis: The Current Status.

ERIC Educational Resources Information Center

Cole, G. Mattney, Jr.; Waggoner, William H.

1983-01-01

To assist in designing/implementing qualitative analysis courses, examines reliability/accuracy of several published separation schemes, notes methods where particular difficulties arise (focusing on Groups II/III), and presents alternative schemes for the separation of these groups. Only cation analyses are reviewed. Figures are presented in…

Perceived Difficulty with Physical Tasks, Lifestyle, and Physical Performance in Obese Children

PubMed Central

D'Amico, Osvaldo; Sticco, Maura; Nugnes, Rosa; Mozzillo, Enza; Franzese, Adriana

2014-01-01

We estimated perceived difficulty with physical tasks, lifestyle, and physical performance in 382 children and adolescents (163 obese, 54 overweight, and 165 normal-weight subjects) and the relationship between perceived physical difficulties and sports participation, sedentary behaviors, or physical performance. Perceived difficulty with physical tasks and lifestyle habits was assessed by interview using a structured questionnaire, while physical performance was assessed through the six-minute walking test (6MWT). Obese children had higher perceived difficulty with several activities of daily living, were less engaged in sports, and had lower physical performance than normal-weight or overweight children; on the contrary, they did not differ with regard to time spent in sedentary behaviors. Perceived difficulty in running and hopping negatively predicted sports participation (P < 0.05 and <0.01, resp.), while perceived difficulty in almost all physical activities negatively predicted the 6MWT, independently of BMI (P < 0.01). Our results indicate that perception of task's difficulty level may reflect an actual difficulty in obese children. These findings may have practical implications for approaching physical activity in obese children. Exploring both the perception of a task's difficulty level and physical performance may be useful to design exercise programs that allow safe and successful participation. PMID:25105139

Schooling with Care? Developing Provision for Children and Young People Presenting Social, Emotional and Behavioural Difficulties.

ERIC Educational Resources Information Center

Munn, Pamela, Ed.

This book is the product of collaboration between Education and Social Work, at both the national and local level, on a project to identify and disseminate examples of good practice in the provision for children and young people presenting social, emotional, and behavioral difficulties. There are many issues which surround the setting up and…

"That Sounds So Cooool": Entanglements of Children, Digital Tools, and Literacy Practices

ERIC Educational Resources Information Center

Toohey, Kelleen; Dagenais, Diane; Fodor, Andreea; Hof, Linda; Nuñez, Omar; Singh, Angelpreet; Schulze, Liz

2015-01-01

Many observers have argued that minority language speakers often have difficulty with school-based literacy and that the poorer school achievement of such learners occurs at least partly as a result of these difficulties. At the same time, many have argued for a recognition of the multiple literacies required for citizens in a 21st century world.…

The Trouble with Maths: A Practical Guide to Helping Learners with Numeracy Difficulties, 2nd Edition

ERIC Educational Resources Information Center

Chinn, Steve

2011-01-01

Now in a second edition, the award-winning "The Trouble with Maths" offers important insights into the often confusing world of numeracy. By looking at learning difficulties in maths from several perspectives, including the language of mathematics, thinking styles and the demands of individual topics, this book offers a complete overview of the…

A Comparison of Father and Mother Report of Child Behaviour on the Strengths and Difficulties Questionnaire

ERIC Educational Resources Information Center

Dave, Shreya; Nazareth, Irwin; Senior, Rob; Sherr, Lorraine

2008-01-01

To date there has been no comparison of father and mother report on the Strengths and Difficulties Questionnaire (SDQ), a standardised measure of child behaviour used widely in the UK in clinical practice and research. The objectives of the study were to investigate differences and agreement between parents on the various SDQ domains of child…

Treating the Whole Person: A Counseling, Psychology and Support Model for Learners with Learning Difficulty and Disabilities

ERIC Educational Resources Information Center

Lee, Larry

2014-01-01

Concerned about traditional practice that attempted to manage the challenging behavior of learners with learning difficulty and disabilities (LLDD) in learning and social environments, I questioned the extent to which they could manage themselves. From 265 students, 15 males, median age of 19, were invited to participate in 12 weekly one-hour…

Trials and Tribulations: Student Approaches and Difficulties with Proposing Mechanisms Using the Electron-Pushing Formalism

ERIC Educational Resources Information Center

Bhattacharyya, Gautam

2014-01-01

The skill of proposing mechanisms of reactions using the electron-pushing formalism (EPF) is not only of value to practicing organic chemists but it is also emphasized to students enrolled in organic chemistry courses at all levels. Several research studies in the past decade have documented the difficulties that undergraduate, and even graduate…

Stem Cell Banking for Regenerative and Personalized Medicine

PubMed Central

Harris, David T.

2014-01-01

Regenerative medicine, tissue engineering and gene therapy offer the opportunity to treat and cure many of today’s intractable afflictions. These approaches to personalized medicine often utilize stem cells to accomplish these goals. However, stem cells can be negatively affected by donor variables such as age and health status at the time of collection, compromising their efficacy. Stem cell banking offers the opportunity to cryogenically preserve stem cells at their most potent state for later use in these applications. Practical stem cell sources include bone marrow, umbilical cord blood and tissue, and adipose tissue. Each of these sources contains stem cells that can be obtained from most individuals, without too much difficulty and in an economical fashion. This review will discuss the advantages and disadvantages of each stem cell source, factors to be considered when contemplating banking each stem cell source, the methodology required to bank each stem cell source, and finally, current and future clinical uses of each stem cell source. PMID:28548060

Recent Advances in Understanding and Managing Autism Spectrum Disorders

PubMed Central

Germain, Blair; Eppinger, Melissa A.; Mostofsky, Stewart H.; DiCicco-Bloom, Emanuel; Maria, Bernard L.

2017-01-01

Autism spectrum disorder in children is a group of neurodevelopmental disorders characterized by difficulties with social communication and behavior. Growing scientific evidence in addition to clinical practice has led the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to categorize several disorders into the broader category of autism spectrum disorder. As more is learned about how autism spectrum disorder manifests, progress has been made toward better clinical management including earlier diagnosis, care, and when specific interventions are required. The 2014 Neurobiology of Disease in Children symposium, held in conjunction with the 43rd annual meeting of the Child Neurology Society, aimed to (1) describe the clinical concerns involving diagnosis and treatment, (2) review the current status of understanding in the pathogenesis of autism spectrum disorder, (3) discuss clinical management and therapies for autism spectrum disorder, and (4) define future directions of research. The article summarizes the presentations and includes an edited transcript of question-and-answer sessions. PMID:26336201

An academic nursing clinic's financial survival.

PubMed

Holman, E J; Branstetter, E

1997-01-01

The authors suggest that academic institutions build business-oriented policies and practices into the development of any nurse-run clinic to set the stage for financial independence when special or development funding ends. One university-affiliated program that provides 4,000 to 5,000 annual visits drastically changed its strategies when threatened with closure after free rent and other subsidies were withdrawn. The growing emphasis on ambulatory care roles for nurses at all levels makes such clinics critical to the success of the broad-based curricula of nursing education programs, as well as the clinic's value to communities they serve. Funding difficulties frequently threaten the existence of such nurse-run clinics once the initial grant funding is no longer available. This has caused a new emphasis on running such clinics in a business-wise manner. Among the strategies initiated were: direct full-pay at the time of service; a realistic business management plan; aggressive planned marketing; contracts and agreements with other agencies; obtaining provider status with selected HMOs.

Structure and function of the oncologic boards in Greece. Description of the institutional and scientific frame; objective problems and difficulties.

PubMed

Zygogianni, A; Syrigos, K; Mistakidou, K; Fotineas, A; Kyrgias, G; Ferendouros, V; Kouvaris, J; Papadimitriou, C; Kantzou, I; Pantelakos, P; Kouloulias, V

2013-01-01

Oncology boards should constitute a routine in all hospitals that are dealing with the care of cancer patients. Unfortunately the procedure which should be followed to deal with this health problem has some deficiencies. A literature review has recently been attempted, searching Internet databases by using key words such as oncologic board, medical legislation and medical ethics. Current mentality suggests that hiding the truth from the patient is wrong and unethical. However, in the Greek society, this is not the case as it seems not right to adopt foreign practices, i.e. to disclose directly to the patient all information relevant to his health status, the intended therapy and possible outcome. Instead, ambiguous information pass onto relatives who in turn bear the burden of informing the patient. The best solution would be the integration of the positive elements of the patient's awareness and the beneficial effects of the involvement of the Greek family in the general care of the cancer patient.

Treatment of severe non-infectious uveitis in high-risk conditions (Part I): pregnancy and malignancies, management and safety issues.

PubMed

Cordero-Coma, Miguel; Salazar-Méndez, Raquel; Yilmaz, Taygan

2015-07-01

Management of patients with severe immune-mediated uveitis requires the use of immunosuppressive drugs in selected cases. This may be especially challenging in certain patients with concomitant conditions, which could increase the risk of side effects or modify guidelines for the use of such drugs. Therapeutic decision-making and management may be of particular difficulty in pregnancy as well as in patients with associated malignancies unrelated to a specific ophthalmic inflammatory condition. The main aim of this review is to provide an updated comprehensive practical guide for practitioners regarding the therapeutic decision-making and management of patients with severe immune-mediated uveitis in the context of pregnancy and malignancies. Management of patients with immune-mediated uveitis requiring immunosuppressive/immunomodulatory drugs might be particularly complicated by other conditions affecting their health and immune status. Clinicians should take into account such conditions, which might influence treatment response and the clinical outcome of these patients.

Psychological distress and visual functioning in relation to vision-related disability in older individuals with cataracts.

PubMed

Walker, J G; Anstey, K J; Lord, S R

2006-05-01

To determine whether demographic, health status and psychological functioning measures, in addition to impaired visual acuity, are related to vision-related disability. Participants were 105 individuals (mean age=73.7 years) with cataracts requiring surgery and corrected visual acuity in the better eye of 6/24 to 6/36 were recruited from waiting lists at three public out-patient ophthalmology clinics. Visual disability was measured with the Visual Functioning-14 survey. Visual acuity was assessed using better and worse eye logMAR scores and the Melbourne Edge Test (MET) for edge contrast sensitivity. Data relating to demographic information, depression, anxiety and stress, health care and medication use and numbers of co-morbid conditions were obtained. Principal component analysis revealed four meaningful factors that accounted for 75% of the variance in visual disability: recreational activities, reading and fine work, activities of daily living and driving behaviour. Multiple regression analyses determined that visual acuity variables were the only significant predictors of overall vision-related functioning and difficulties with reading and fine work. For the remaining visual disability domains, non-visual factors were also significant predictors. Difficulties with recreational activities were predicted by stress, as well as worse eye visual acuity, and difficulties with activities of daily living were associated with self-reported health status, age and depression as well as MET contrast scores. Driving behaviour was associated with sex (with fewer women driving), depression, anxiety and stress scores, and MET contrast scores. Vision-related disability is common in older individuals with cataracts. In addition to visual acuity, demographic, psychological and health status factors influence the severity of vision-related disability, affecting recreational activities, activities of daily living and driving.

Chinese American Parents’ Acculturation and Enculturation, Bicultural Management Difficulty, Depressive Symptoms, and Parenting

PubMed Central

Kim, Su Yeong; Shen, Yishan; Huang, Xuan; Wang, Yijie; Orozco-Lapray, Diana

2014-01-01

This study examined whether Chinese American parents’ acculturation and enculturation were related to parenting practices (punitive parenting, democratic child participation, and inductive reasoning) indirectly through the mediation of parents’ bicultural management difficulty and parental depressed mood. Data came from a two-wave study of Chinese American families in Northern California. Mothers and fathers were assessed when their children were in early adolescence and then again in middle adolescence (407 mothers and 381 fathers at Wave 1; 308 mothers and 281 fathers at Wave 2). For both waves, we examined cross-sectional models encompassing both direct and indirect links from parental cultural orientations to parenting practices. We also used individual fixed-effects techniques to account for selection bias in testing model relationships at Wave 2. At Wave 1, via bicultural management difficulty and depressive symptoms, American orientation was related to less punitive parenting and more inductive reasoning for both parents, and Chinese orientation was related to more punitive parenting and less inductive reasoning for fathers. The findings indicate that bicultural management difficulty and parental depressed mood are important mechanisms to be considered when studying the relation between Chinese American parents’ acculturation/enculturation and parenting. PMID:25678944

To evaluate the comparative status of oral health practices, oral hygiene and periodontal status amongst visually impaired and sighted students.

PubMed

Jain, Ashish; Gupta, Jyoti; Aggarwal, Vyom; Goyal, Chinu

2013-01-01

The aim of this study was to evaluate the comparative status of oral health practices, oral hygiene, and periodontal status amongst visually impaired and sighted students. In this study, 142 visually impaired children from a blind school in the age group of 6-18 years were enrolled with a similar number of age and sex matched sighted students studying in different schools of Chandigarh. The outcome variables were oral hygiene practices, oral hygiene status, and periodontal status. The visually impaired had been found to have better oral hygiene practices, a nonsignificant difference of oral hygiene scores but a significantly high value for bleeding scores as compared to sighted students. Age wise comparisons showed that bleeding scores were highly significant in 9-11 years and 12-14 years age group as compared to 6-8 years and 15-18 years age group. It could be related that the increased prevalence of bleeding sites despite of better oral hygiene practices in visually impaired group might be the result of their handicap to visualize plaque. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Examining Malaysian Teachers' Online Blogs for Reflective Practices: Towards Teacher Professional Development

ERIC Educational Resources Information Center

Nambiar, R. M. K.; Thang, S. M.

2016-01-01

Blogs are commonly used for online interaction because of their ease of use and access, which allow people to gather in a virtual space to share knowledge, experiences and practices. Teachers can also use blogs as an avenue to think, reflect and respond to views and comments regarding pedagogical practices and difficulties, thereby developing…

Comparison of the Effects of Computer-Based Practice and Conceptual Understanding Interventions on Mathematics Fact Retention and Generalization

ERIC Educational Resources Information Center

Kanive, Rebecca; Nelson, Peter M.; Burns, Matthew K.; Ysseldyke, James

2014-01-01

The authors' purpose was to determine the effects of computer-based practice and conceptual interventions on computational fluency and word-problem solving of fourth- and fifth-grade students with mathematics difficulties. A randomized pretest-posttest control group design found that students assigned to the computer-based practice intervention…

A Case Study of Unfounded Concepts Underpinning Controversial Practices: Lost in "Space Dyslexia"

ERIC Educational Resources Information Center

Stephenson, Jennifer

2009-01-01

Although many are critical of the uptake of unproven practices by teachers and families in their search for treatment for children with reading difficulties, there has been little examination of the specific conditions that persuade teachers and families to adopt such practices. This article traces the emergence and evolution of a particular meme,…

Burnout in Counseling Practice: Some Potential Professional and Personal Hazards of Becoming a Counselor.

ERIC Educational Resources Information Center

Watkins, C. Edward, Jr.

1983-01-01

Defines the syndrome of burnout and discusses some of the professional and personal hazards that confront the practicing counselor. Examines intrapersonal and interpersonal difficulties which result from burnout. Provides suggestions for dealing with burnout. (Author/RC)

Experimenting with embryos: can philosophy help?

PubMed

Heyd, David

1996-10-01

Beyond the well-known ethical issues involved in medical experimentation on human subjects, experimenting with embryos raises unique and particularly hard problems. Besides the psychological obstacles connected with the fear of "playing God" and the awe with which we hold the process of the creation of human beings, there are three philosophical problems which are the main subject of the article: 1. The logical problem of circularity: the morality of experimenting on embryos is dependent on the status of the embryo, which in turn is partly decided by experimentation; 2. The metaphysical problem: experiments are justified by the benefits they bring to human subjects; but it is doubtful whether an early embryo is a "subject" and whether coming into being is a "benefit"; 3. The moral problem: the standard constraint on medical experiments is that they benefit either the individual subject or at least members of a relevantly defined group of patients suffering from the same syndrome. But embryo experimentation is often associated with potential cure to people of a completely different category (like geriatric patients). Finally, the article discusses the limits of the force of philosophical arguments in the formation of actual policies for regulating such practices as experimenting with embryos. The widely-shared fourteen-day limit is shown to be a sound practical compromise despite the difficulties in justifying it philosophically.

Primary Care Physicians' Struggle with Current Adult Pneumococcal Vaccine Recommendations.

PubMed

Hurley, Laura P; Allison, Mandy A; Pilishvili, Tamara; O'Leary, Sean T; Crane, Lori A; Brtnikova, Michaela; Beaty, Brenda L; Lindley, Megan C; Bridges, Carolyn B; Kempe, Allison

2018-01-01

In 2012, the Advisory Committee on Immunization Practices recommended 13-valent pneumococcal conjugate vaccine (PCV13) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) for at-risk adults ≥19; in 2014, it expanded this recommendation to adults ≥65. Primary care physicians' practice, knowledge, attitudes, and beliefs regarding these recommendations are unknown. Primary care physicians throughout the U.S. were surveyed by E-mail and post from December 2015 to January 2016. Response rate was 66% (617 of 935). Over 95% of respondents reported routinely assessing adults' vaccination status and recommending both vaccines. A majority found the current recommendations to be clear (50% "very clear," 38% "somewhat clear"). Twenty percent found the upfront cost of purchasing PCV13, lack of insurance coverage, inadequate reimbursement, and difficulty determining vaccination history to be "major barriers" to giving these vaccines. Knowledge of recommendations varied, with 83% identifying the PCV13 recommendation for adults ≥65 and only 21% identifying the recommended interval between PCV13 and PPSV23 in an individual <65 at increased risk. Almost all surveyed physicians reported recommending both pneumococcal vaccines, but a disconnect seems to exist between perceived clarity and knowledge of the recommendations. Optimal implementation of these recommendations will require addressing knowledge gaps and reported barriers. © Copyright 2018 by the American Board of Family Medicine.

Physical Activity and Cognitive Function in the Elderly.

ERIC Educational Resources Information Center

Spirduso, Waneen W.; Asplund, Lesli A.

1995-01-01

A relationship between physical fitness and cognition has been difficult to document. The paper describes cognition and examines the effects of aging on cognition, the fitness-cognition relationship hypothesis, difficulties in determining the fitness-cognition relationship, and the current status of the relationship. (SM)

Response to Intervention and Math Instruction

ERIC Educational Resources Information Center

Hinton, Vanessa; Flores, Margaret M.; Shippen, Margaret

2013-01-01

Response to intervention (RTI) is a framework in which interventions are implemented mostly in general education classes to resolve academic difficulties and help to mitigate contextual variables (i.e., lack of instruction, socio economic status, cultural differences, etc.) as an explanation for academic failure. The implementation of…

The Army National Guard; Operational Reserve or Homeland Security Force?

DTIC Science & Technology

2008-12-12

is presented chronologically and establishes the constitutional roles and missions of the NG and as they have metamorphosed over time. I will...Unfortunately, these mobilizations were plagued with difficulties ranging from inaccurate status reporting to the lack of dental readiness of NG

When good news is bad news: psychological impact of false positive diagnosis of HIV.

PubMed

Bhattacharya, Rahul; Barton, Simon; Catalan, Jose

2008-05-01

HIV testing is known to be stressful, however the impact of false positive HIV results on individuals is not well documented. This is a series of four case who developed psychological difficulties and psychiatric morbidities after being informed they had been misdiagnosed with HIV-positive status. We look into documented cases of misdiagnosis and potential risks of misdiagnosis. The case series highlights the implications a false diagnosis HIV-positive status can have, even when the diagnosis is rectified. Impact of misdiagnosis of HIV can lead to psychosocial difficulties and psychiatric morbidity, have public health and epidemiological implications and can lead to medico-legal conflict. This further reiterates the importance of HIV testing carried out ethically and sensitively, and in line with guidelines, respecting confidentiality and consent, and offering counselling pre-test and post-test, being mindful of the reality of erroneous and false positive HIV test results. The implications of misdiagnosis are for the individual, their partners and social contacts, as well as for the community.

Promoting recovery via an integrated model of care to deliver a bed-based, mental health prevention and recovery centre.

PubMed

Lee, Stuart J; Collister, Laura; Stafrace, Simon; Crowther, Elizabeth; Kroschel, Jon; Kulkarni, Jayashri

2014-10-01

This research was conducted in order to explore the experience of care and outcomes for people entering a bed-based step-up/step-down Prevention and Recovery Centre (PARC). An audit of files for PARC participants in 2010 collected demographic (age, gender, and marital, housing, employment and education/training status) and clinical measures (length of stay, entry and exit outcome measures, psychiatric hospital use). Participants were also invited to a feedback group to discuss their PARC experience. In 2010, 118 people entered PARC. Most were single and unemployed and 35% were in temporary housing or homeless. In the six months following PARC exit, participants spent significantly less time in psychiatric hospital than in the six months prior to entry (p<0.001). Significant reductions in clinician-rated difficulties were documented at exit (p<0.001). For 40 episodes of care with self-report measures at entry and exit, significant reductions in difficulties with relating to self/others (p=0.004), daily living/role functioning (p=0.006), and depression/anxiety (p=0.019) were seen. Twelve participants attended a feedback group. Positive aspects of PARC included: supportive and caring staff; help with practical issues or community access; therapeutic activities and learning about health; and socialization opportunities. A step-up/step-down PARC can facilitate recovery for people with mental illness through promoting independence and illness self-management. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Professional’s Perspectives on Care Management of Young People with Perinatally Acquired HIV during Transition: A Qualitative Study in Adult Care Setting

PubMed Central

Le Roux, Enora; Gottot, Serge; Aupiais, Camille; Girard, Thomas; Teixeira, Maria; Alberti, Corinne

2017-01-01

Background Increasing numbers of young people with perinatally acquired HIV are surviving to adulthood. When they come of age, they leave pediatric services in which they were followed and have to be transferred to the adult health care system. Difficulties in adaptation to adult care and the numbers of young people lost to follow up after transfer to adult care have been reported. This transition phase and their retention in adult care are crucial in maintaining the clinical status of these young with HIV in adulthood. Our study aimed to explore how HIV professionals working in adult care perceive and adapt their practices to young people in transition. Methods Qualitative interviews were conducted with 18 health and social services professionals in hospitals or patient associations in France. A thematic analysis was conducted. Results Adult care professionals were found to be making a distinction between these young people and their patients who were infected during adulthood. On the basis of the healthcare teams’ experience, a simplified categorization of these young people into four levels can be used: those “who have everything good”; those who have some deficiencies that must be addressed; those “who have everything bad”; and those lost to follow up. Professionals interviewed highlighted the difficulties they encountered with young people in transition. Three types of problematic situations were identified: problems of acceptance of the disease; communication problems; and problems of disorientation in the new care environment. Conclusions Despite the lack of specific training or national policy recommendations for the integration of young people with perinatally acquired HIV into adult services, all the adult healthcare teams interviewed tried to adapt their practice to this population. The results suggested that professional involvement during transition should depend on the characteristics of the patient, not be limited to a single transition model and that a dedicated structure for transition care is not appropriate for all young people. PMID:28114376

Professional's Perspectives on Care Management of Young People with Perinatally Acquired HIV during Transition: A Qualitative Study in Adult Care Setting.

PubMed

Le Roux, Enora; Gottot, Serge; Aupiais, Camille; Girard, Thomas; Teixeira, Maria; Alberti, Corinne

2017-01-01

Increasing numbers of young people with perinatally acquired HIV are surviving to adulthood. When they come of age, they leave pediatric services in which they were followed and have to be transferred to the adult health care system. Difficulties in adaptation to adult care and the numbers of young people lost to follow up after transfer to adult care have been reported. This transition phase and their retention in adult care are crucial in maintaining the clinical status of these young with HIV in adulthood. Our study aimed to explore how HIV professionals working in adult care perceive and adapt their practices to young people in transition. Qualitative interviews were conducted with 18 health and social services professionals in hospitals or patient associations in France. A thematic analysis was conducted. Adult care professionals were found to be making a distinction between these young people and their patients who were infected during adulthood. On the basis of the healthcare teams' experience, a simplified categorization of these young people into four levels can be used: those "who have everything good"; those who have some deficiencies that must be addressed; those "who have everything bad"; and those lost to follow up. Professionals interviewed highlighted the difficulties they encountered with young people in transition. Three types of problematic situations were identified: problems of acceptance of the disease; communication problems; and problems of disorientation in the new care environment. Despite the lack of specific training or national policy recommendations for the integration of young people with perinatally acquired HIV into adult services, all the adult healthcare teams interviewed tried to adapt their practice to this population. The results suggested that professional involvement during transition should depend on the characteristics of the patient, not be limited to a single transition model and that a dedicated structure for transition care is not appropriate for all young people.

The transfer of theoretical knowledge to clinical practice by nursing students and the difficulties they experience: A qualitative study.

PubMed

Günay, Ulviye; Kılınç, Gülsen

2018-06-01

Nursing education contains both theoretical and practical training processes. Clinical training is the basis of nursing education. The quality of clinical training is closely related to the quality of the clinical learning environment. This study aimed to determine the transfer of theoretical knowledge into clinical practice by nursing students and the difficulties they experience during this process. A qualitative research design was used in the study. The study was conducted in 2015 with 30 nursing students in a university located in the east of Turkey, constituting three focus groups. The questions directed to the students during the focus group interviews were as follows: What do you think about your clinical training? How do you evaluate yourself in the process of putting your theoretical knowledge into clinical practice? What kind of difficulties are you experiencing in clinical practices? The data were interpreted using the method of content analysis. Most of the students reported that theoretical information they received was excessive, their ability to put most of this information into practice was weak, and they lacked courage to touch patients for fear of implementing procedures incorrectly. As a result of the analysis of the data, five main themes were determined: clinical training, guidance and communication, hospital environment and expectations. The results of this study showed that nursing students found their clinical knowledge and skills insufficient and usually failed to transfer their theoretical knowledge into clinical practices. The study observed that nursing students experienced various issues in clinical practices. In order to fix these issues and achieve an effective clinical training environment, collaboration should be achieved among nursing instructors, nurses, nursing school and hospital managements. Additionally, the number of nursing educators should be increased and training programs should be provided regarding effective clinical training methods. Copyright © 2018 Elsevier Ltd. All rights reserved.

Spirituality in nursing practice.

PubMed

Rogers, Melanie; Wattis, John

2015-05-27

Spirituality is an important aspect of holistic care that is frequently overlooked. This is because of difficulties in conceptualising spirituality and confusion about how it should be integrated into nursing care. This article explores what is meant by spirituality and spiritually competent practice. It examines attitudes to spirituality, describes factors that might affect the integration of spirituality into nursing care and offers practical guidance to equip nurses to incorporate spirituality into their practice.

Female genital mutilation.

PubMed

Ladjali, M; Rattray, T W; Walder, R J

1993-08-21

Female genital mutilation, also misleadingly known as female circumcision, is usually performed on girls ranging in from 1 week to puberty. Immediate physical complications include severe pain, shock, infection, bleeding, acute urinary infection, tetanus, and death. Longterm problems include chronic pain, difficulties with micturition and menstruation, pelvic infection leading to infertility, and prolonged and obstructed labor during childbirth. An estimated 80 million girls and women have undergone female genital mutilation. In Britain alone an estimated 10,000 girls are currently at risk. Religious, cultural, medical, and moral grounds rationalize the custom which is practiced primarily in sub-Saharan Africa, the Arab world, Malaysia, Indonesia, and among migrant populations in Western countries. According to WHO it is correlated with poverty, illiteracy, and the low status of women. Women who escape mutilation are not sought in marriage. WHO, the UN Population Fund, the UN Children's Fund, the International Planned Parenthood Federation, and the UN Convention on the Rights of the Child have issued declarations on the eradication of female genital mutilation. In Britain, local authorities have intervened to prevent parents from mutilating their daughters. In 1984, the Inter-African Committee Against Harmful Traditional Practices Affecting Women and Children was established to work toward eliminating female genital mutilation and other damaging customs. National committees in 26 African countries coordinate projects run by local people using theater, dance, music, and storytelling for communication. In Australia, Canada, Europe, and the US women have organized to prevent the practice among vulnerable migrants and refugees.

"Being flexible and creative": a qualitative study on maternity care assistants' experiences with non-Western immigrant women.

PubMed

Boerleider, Agatha W; Francke, Anneke L; van de Reep, Merle; Manniën, Judith; Wiegers, Therese A; Devillé, Walter L J M

2014-01-01

Several studies conducted in developed countries have explored postnatal care professionals' experiences with non-western women. These studies reported different cultural practices, lack of knowledge of the maternity care system, communication difficulties, and the important role of the baby's grandmother as care-giver in the postnatal period. However, not much attention has been paid in existing literature to postnatal care professionals' approaches to these issues. Our main objective was to gain insight into how Dutch postnatal care providers--'maternity care assistants' (MCA)--address issues encountered when providing care for non-western women. A generic qualitative research approach was used. Two researchers interviewed fifteen MCAs individually, analysing the interview material separately and then comparing and discussing their results. Analytical codes were organised into main themes and subthemes. MCAs perceive caring for non-western women as interesting and challenging, but sometimes difficult too. To guarantee the health and safety of mother and baby, they have adopted flexible and creative approaches to address issues concerning traditional practices, socioeconomic status and communication. Furthermore, they employ several other strategies to establish relationships with non-western clients and their families, improve women's knowledge of the maternity care system and give health education. Provision of postnatal care to non-western clients may require special skills and measures. The quality of care for non-western clients might be improved by including these skills in education and retraining programmes for postnatal care providers on top of factual knowledge about traditional practices.

Maternal Psychological Distress and Perceived Impact on Child Feeding Practices in South Kivu, DR Congo.

PubMed

Emerson, Jillian A; Tol, Wietse; Caulfield, Laura E; Doocy, Shannon

2017-09-01

Maternal mental health problems are associated with poor child growth and suboptimal child feeding practices, yet little qualitative research has been conducted to understand mothers' perceptions about how maternal mental ill health and child nutrition are related. The objective of the study was to understand maternal perceptions on sources of psychological distress, and how distress impacts functioning, especially related to childcare and feeding practices among mothers of young children in South Kivu, DR Congo. Mothers of young children who were participating in a larger study were eligible. Using purposive sampling, participants were selected if they had high or low levels of psychological distress, based on their mean item score on measures of symptoms of depression, anxiety, and post-traumatic stress. Twenty in-depth interviews and 2 focus group discussions were conducted, with a total of 35 mothers. Key informant interviews were conducted with 5 local health workers. Audio recordings were transcribed and coded, and the analysis was guided by Grounded Theory methodology. Major themes to emerge were that women's husbands were a significant source of distress, with husbands' infidelity, abandonment, and lack of financial support mentioned by participants. Psychological distress resulted in appetite and weight loss, and poor nutritional status made it difficult to breastfeed. Participants perceived psychological distress caused milk insufficiency and difficulty breastfeeding. Mothers experiencing psychological distress may need greater support for maternal nutrition and breastfeeding, and engaging fathers through responsible parenting interventions may reduce psychological distress and have a positive impact on child health.

The Effects of Schema-Based Instruction on the Proportional Thinking of Students With Mathematics Difficulties With and Without Reading Difficulties.

PubMed

Jitendra, Asha K; Dupuis, Danielle N; Star, Jon R; Rodriguez, Michael C

2016-07-01

This study examined the effect of schema-based instruction (SBI) on the proportional problem-solving performance of students with mathematics difficulties only (MD) and students with mathematics and reading difficulties (MDRD). Specifically, we examined the responsiveness of 260 seventh grade students identified as MD or MDRD to a 6-week treatment (SBI) on measures of proportional problem solving. Results indicated that students in the SBI condition significantly outperformed students in the control condition on a measure of proportional problem solving administered at posttest (g = 0.40) and again 6 weeks later (g = 0.42). The interaction between treatment group and students' difficulty status was not significant, which indicates that SBI was equally effective for both students with MD and those with MDRD. Further analyses revealed that SBI was particularly effective at improving students' performance on items related to percents. Finally, students with MD significantly outperformed students with MDRD on all measures of proportional problem solving. These findings suggest that interventions designed to include effective instructional features (e.g., SBI) promote student understanding of mathematical ideas. © Hammill Institute on Disabilities 2014.

Dyslexia in general practice education: considerations for recognition and support.

PubMed

Shrewsbury, Duncan

2016-07-01

Dyslexia is a common developmental learning difficulty, which persists throughout life. It is highly likely that those working in primary care will know, or even work with someone who has dyslexia. Dyslexia can impact on performance in postgraduate training and exams. The stereotypical characteristics of dyslexia, such as literacy difficulties, are often not obvious in adult learners. Instead, recognition requires a holistic approach to evaluating personal strengths and difficulties, in the context of a supportive relationship. Strategies to support dyslexic learners should consider recommendations made in formal diagnostic reports, and aim to address self-awareness and coping skills.

Kolmogorov-Smirnov statistical test for analysis of ZAP-70 expression in B-CLL, compared with quantitative PCR and IgV(H) mutation status.

PubMed

Van Bockstaele, Femke; Janssens, Ann; Piette, Anne; Callewaert, Filip; Pede, Valerie; Offner, Fritz; Verhasselt, Bruno; Philippé, Jan

2006-07-15

ZAP-70 has been proposed as a surrogate marker for immunoglobulin heavy-chain variable region (IgV(H)) mutation status, which is known as a prognostic marker in B-cell chronic lymphocytic leukemia (CLL). The flow cytometric analysis of ZAP-70 suffers from difficulties in standardization and interpretation. We applied the Kolmogorov-Smirnov (KS) statistical test to make analysis more straightforward. We examined ZAP-70 expression by flow cytometry in 53 patients with CLL. Analysis was performed as initially described by Crespo et al. (New England J Med 2003; 348:1764-1775) and alternatively by application of the KS statistical test comparing T cells with B cells. Receiver-operating-characteristics (ROC)-curve analyses were performed to determine the optimal cut-off values for ZAP-70 measured by the two approaches. ZAP-70 protein expression was compared with ZAP-70 mRNA expression measured by a quantitative PCR (qPCR) and with the IgV(H) mutation status. Both flow cytometric analyses correlated well with the molecular technique and proved to be of equal value in predicting the IgV(H) mutation status. Applying the KS test is reproducible, simple, straightforward, and overcomes a number of difficulties encountered in the Crespo-method. The KS statistical test is an essential part of the software delivered with modern routine analytical flow cytometers and is well suited for analysis of ZAP-70 expression in CLL. (c) 2006 International Society for Analytical Cytology.

Mental workload and motor performance dynamics during practice of reaching movements under various levels of task difficulty.

PubMed

Shuggi, Isabelle M; Oh, Hyuk; Shewokis, Patricia A; Gentili, Rodolphe J

2017-09-30

The assessment of mental workload can inform attentional resource allocation during task performance that is essential for understanding the underlying principles of human cognitive-motor behavior. While many studies have focused on mental workload in relation to human performance, a modest body of work has examined it in a motor practice/learning context without considering individual variability. Thus, this work aimed to examine mental workload by employing the NASA TLX as well as the changes in motor performance resulting from the practice of a novel reaching task. Two groups of participants practiced a reaching task at a high and low nominal difficulty during which a group-level analysis assessed the mental workload, motor performance and motor improvement dynamics. A secondary cluster analysis was also conducted to identify specific individual patterns of cognitive-motor responses. Overall, both group- and cluster-level analyses revealed that: (i) all participants improved their performance throughout motor practice, and (ii) an increase in mental workload was associated with a reduction of the quality of motor performance along with a slower rate of motor improvement. The results are discussed in the context of the optimal challenge point framework and in particular it is proposed that under the experimental conditions employed here, functional task difficulty: (i) would possibly depend on an individuals' information processing capabilities, and (ii) could be indexed by the level of mental workload which, when excessively heightened can decrease the quality of performance and more generally result in delayed motor improvements. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Pediatricians' knowledge, attitudes, and practice patterns regarding special education and individualized education programs.

PubMed

Shah, Reshma P; Kunnavakkam, Rangesh; Msall, Michael E

2013-01-01

The medical community has called upon pediatricians to be knowledgeable about an individualized education program (IEP). We sought to: 1) evaluate pediatricians' knowledge and attitudes regarding special education; 2) examine the relationship between perceived responsibilities and practice patterns; and 3) identify barriers that impact pediatricians' ability to provide comprehensive care to children with educational difficulties. Surveys were mailed to a national sample of 1000 randomly selected general pediatricians and pediatric residents from October 2010 to February 2011. The response rate was 47%. Of the knowledge items, respondents answered an average of 59% correctly. The majority of respondents thought pediatricians should be responsible for identifying children who may benefit from special education services and assist families in obtaining services, but less than 50% thought they should assist in the development of an IEP. The majority of pediatricians inquired whether a child is having difficulty at school, but far fewer conducted screening tests or asked parents if they needed assistance obtaining services. Overall, the prevalence of considering a practice a pediatrician's responsibility is significantly higher than examples of such a practice pattern being reported. Financial reimbursement and insufficient training were among the most significant barriers affecting a pediatrician's ability to provide care to children with educational difficulties. In order to provide a comprehensive medical home, pediatricians must be informed about the special education process. This study demonstrates that there are gaps in pediatricians' knowledge and practice patterns regarding special education that must be addressed. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Analysis of difficulties in mathematics learning on students with guardian personality type in problem-solving HOTS geometry test

NASA Astrophysics Data System (ADS)

Karimah, R. K. N.; Kusmayadi, T. A.; Pramudya, I.

2018-04-01

Learning in the current 2013 curriculum is based on contextual issues based on questions that can encourage students to think broadly. HOTS is a real-life based assessment of everyday life, but in practice, the students are having trouble completing the HOTS issue. Learning difficulty is also influenced by personality type Based on the fact that the real difference one can see from a person is behavior. Kersey classifies the personality into 4 types, namely Idealist, Rational, Artisan, and Guardian. The researcher focuses on the type of guardian personality that is the type of personality that does not like the picture. This study aims to describe the difficulty of learning mathematics in students with a type of guardian personality in the completion of Geometry materials especially in solving HOTS. This research type is descriptive qualitative research. Instruments used in this study were the researchers themselves, personality class test sheets, learning difficulty test sheets in the form of HOTS Geometry test, and interview guides. The results showed that students with guardian personality it was found that a total of 3.37 % difficulties of number fact skill, 4.49 % difficulties of arithmetics skill, 37.08 % difficulties of information skill, 31.46% difficulties of language skill, 23.60 % difficulties of visual-spatial skill.

Unconscious and Unnoticed Professional Practice within an Outstanding School for Children and Young People with Complex Learning Difficulties and Disabilities

ERIC Educational Resources Information Center

Crombie, Richard; Sullivan, Lesley; Walker, Kate; Warnock, Rebecca

2014-01-01

This article describes a three-year project undertaken at Pear Tree School for children and young people with severe and multiple and profound learning difficulties. Lesley Sullivan, the school's head teacher, believed that much of the value within the work of this outstanding school went unidentified by existing approaches to planning, monitoring…

Perspectives of SENCos and Support Staff in England on Their Roles, Relationships and Capacity to Support Inclusive Practice for Students with Behavioural Emotional and Social Difficulties

ERIC Educational Resources Information Center

Burton, Diana; Goodman, Ruth

2011-01-01

With teachers under pressure to meet curriculum targets, responsibility for including students with behavioural emotional and social difficulties (BESD) in mainstream schools falls heavily on non-teaching staff. In this article, semi-structured interviews were conducted with special educational needs coordinators (SENCos) and support staff in a…

A Community of Practice as an Inclusive Model to Support Children with Social, Emotional and Behavioural Difficulties in School Contexts

ERIC Educational Resources Information Center

Botha, Johan; Kourkoutas, Elias

2016-01-01

Many school children throughout the world who exhibit antisocial or destructive behaviour or have social, emotional and behavioural difficulties (SEBD) do not receive the support they need. As a result, they are caught up in a cycle of vulnerability. Systemic collaborative support is needed to counter this. Although in some cases teachers and…

Reflections on being therapeutic and reflection.

PubMed

Elcock, K

1997-01-01

This article offers a reflective account of an incident that occurred between a nurse tutor and a patient on a cardiology ward. It highlights the importance of interpersonal skills in creating a therapeutic relationship, in particular those of self-awareness, empathy and intuition. The author's difficulties in running reflective practice sessions for pre-registration students are discussed and insights are offered into why these difficulties arose.

School Leavers with Learning Disabilities Moving from Child to Adult Speech and Language Therapy (SLT) Teams: SLTs' Views of Successful and Less Successful Transition Co-Working Practices

ERIC Educational Resources Information Center

McCartney, Elspeth; Muir, Margaret

2017-01-01

School-leaving for pupils with long-term speech, language, swallowing or communication difficulties requires careful management. Speech and language therapists (SLTs) support communication, secure assistive technology and manage swallowing difficulties post-school. UK SLTs are employed by health services, with child SLT teams based in schools.…

A Review of the Empirical Evidence Identifying Effective Interventions and Teaching Practices for Students with Learning Difficulties in Years 4, 5 and 6. Literature Review

ERIC Educational Resources Information Center

Purdie, Nola; Ellis, Louise

2005-01-01

This review has been prepared by the Australian Council for Educational research (ACER) under an Agreement with the Australian Government Department of Education, Science and Training (DEST). It is one component of a project to investigate effective third wave intervention strategies for students and learning difficulties that persist beyond the…

Dietary Practices, Attitudes, and Physiological Status of Collegiate Freshman Football Players.

ERIC Educational Resources Information Center

Jonnalagadda, Satya S.; Rosenbloom, Christine A.; Skinner, Robert

2001-01-01

Determined the eating habits, attitudes, and physiological status of freshman collegiate football players who completed a nutrition screening survey and provided fasting blood samples and data on height and weight. Results indicated that as a group, there were no major problems in dietary practices and physiological status, though there was room…

Evaluation of nutritional status in children with refractory epilepsy.

PubMed

Bertoli, S; Cardinali, S; Veggiotti, P; Trentani, C; Testolin, G; Tagliabue, A

2006-04-26

children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 +/- 3,2 years; Body Mass Index 15,7 +/- 3,6) underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting) and weight-for-height (wasting) were estimated compared to those of a reference population of the same age. 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate). Adequacy index [nutrient daily intake/recommended allowance (RDA) x 100] was < 60% for calcium iron and zinc. many children with refractory epilepsy would benefit from individual nutritional assessment and management as part of their overall care.

Gender and rural-urban differences in reported health status by older people in Bangladesh.

PubMed

Kabir, Zarina Nahar; Tishelman, Carol; Agüero-Torres, Hedda; Chowdhury, A M R; Winblad, Bengt; Höjer, Bengt

2003-01-01

The study aims to (i) describe regional variation and gender differences in health status of older people (60 years and older) in Bangladesh, indicated by self-reported health problems and functional ability; (ii) explore influence of socio-economic factors on health status of older people. In a cross-sectional study in rural and urban Bangladesh, 696 older persons were asked about their health problems and ability to manage activities of daily living (ADL). More than 95% of older people reported health problems. Approximately 80% of elderly women in both the regions reported having four or more health problems compared with 42% and 63% elderly men in the urban and rural regions, respectively. More women (urban: 55%; rural: 36%) than men (urban: 32%; rural: 22%) also reported difficulties with ADL. Irrespective of age, sex and area of residence, those reporting greater number of health problems were more likely to report difficulty with at least one ADL task. Reporting pattern of specific health problems varied between urban and rural regions. Socio-economic indicators were found to have little influence on reporting of health problems, particularly in the rural region. Observed regional difference may be related to the influence of social and environmental factors, and level of awareness concerning certain health conditions.

Childhood acute lymphoblastic leukemia: refusal and abandonmentof treatment in the southeast of Iran.

PubMed

Naderi, Majid; Esmaeili Reykande, Samira; Tabibian, Shadi; Alizadeh, Shaban; Dorgalaleh, Akbar; Shamsizadeh, Morteza

2016-04-19

Acute lymphoblastic leukemia (ALL) accounts for 25% of all malignancies in children. ALL treatment has standard protocols, and treatment abandonment is a main cause of treatment failure. Therefore, this study aimed to assess the relationship between socioeconomic status and rate as well as cause of abandoned treatment in children with ALL in the southeast of Iran. This retrospective, descriptive cohort study was conducted with ALL patients at the Ali Asghar Hospital in the city of Zahedan. The study population included 22 children with different subtypes of ALL who had abandoned their treatment. A structural questionnaire was filled out by patients or their parents. Results were assessed using descriptive and analytical tests. The rate of treatment abandonment was 24.4% (22 patients).We had 18 ALL-L1 (78.3%) and four ALL-L2 (17.4%) patients. Reasons for treatment abandonment were low family income, transportation difficulties, the father's education status, conviction about ALL's incurability, and reference to spiritual means, respectively. Low family income, transportation difficulties, the father's education status, belief about ALL's incurability, and reference to spiritual means were the most common associations with ALL treatment abandonment in that order. Financial problems in this part of the country can impose high costs to the healthcare system.

Effect of water potential and void ratio on erodibility for agricultural soils

USDA-ARS?s Scientific Manuscript database

Soil erodibility has confounded researchers for decades. Difficulties arise with initiation of motion, pore-water status, physical, and perhaps biological, material properties and type of applied energy (i.e. rainfall, runoff, freeze/thaw, wind). Though specific tests have been developed to determin...

Resilience in Language Learners and the Relationship to Storytelling

ERIC Educational Resources Information Center

Nguyen, Kate; Stanley, Nile; Stanley, Laurel; Wang, Yonghui

2015-01-01

International students, who study a foreign language abroad, experience more adversities than their domestic peers. The social challenges they face include problems with immigration status, isolation, difficulty speaking a new language, and learning unfamiliar customs. There is limited research focused on the coping strategies of these…

Hugging, Drinking Tea, and Listening: Mental Health Needs of Turkish Immigrants

ERIC Educational Resources Information Center

Sohtorik, Yasemin; McWilliams, Nancy

2011-01-01

Twelve Turkish immigrants were interviewed in a hypothesis-generating, qualitative investigation of their immigration experiences and mental health needs. Findings suggest high levels of psychological distress associated with homesickness, lack of English proficiency, problematic immigration status, difficulty adjusting to a new culture, and…

The status of mineral trioxide aggregate in endodontics education in dental schools in Turkey.

PubMed

Tanalp, Jale; Karapinar-Kazandag, Meriç; Ersev, Handan; Bayirli, Gündüz

2012-06-01

The aim of this study was to assess the current status of mineral trioxide aggregate (MTA) as an educational material in dental schools in Turkey. A survey was sent to senior members of the endodontic departments of seventeen dental schools; fourteen responded. All respondents reported that they used MTA in their clinical practice, with apexification, perforations, retrograde fillings, and root resorptions being the most frequently occurring treatment procedures. All reported that information was given to students regarding MTA mainly as part of the curriculum. The third and fourth years were the periods when MTA was introduced to students in most of the schools. Twelve schools reported that students had the opportunity to observe procedures in which MTA was used, but students had the chance to use the material in a very minor proportion of the schools, mainly under the supervision of clinical instructors. Ten schools agreed that MTA should be included in the regular endodontic curriculum. Financial constraints seemed to be the predominant reason for those who answered this question negatively, followed by difficult handling properties and low radiopacity of the material. Within the limitations of this study, it can be concluded that ways should be sought to prevent financial difficulties from depriving dental students of the opportunity to receive information about contemporary methodologies such as MTA utilization.

Multisyllabic Word Reading as a Moderator of Morphological Awareness and Reading Comprehension

PubMed Central

Gilbert, Jennifer K.; Goodwin, Amanda P.; Compton, Donald L.; Kearns, Devin M.

2013-01-01

The purpose of this study was to investigate whether the relation between morphological awareness on reading comprehension is moderated by multisyllabic word reading ability in fifth grade students (N = 169, 53.7% female, 65.2% minority status, 69.2% free/reduced lunch status), oversampled for poor reading skill, when controlling for general knowledge and vocabulary. Based on the lexical quality hypothesis (Perfetti, 2007), it was expected that morphological awareness would have a stronger effect on comprehension for children with poor word reading skills, suggesting possible use of morphological awareness for word identification support. Results indicated that neither morphological awareness nor word reading was uniquely associated with reading comprehension when both were included in the model along with vocabulary and general knowledge. Instead, the interaction between word reading and morphological awareness explained significant additional variance in reading comprehension. By probing this interaction, it was determined that the effect of morphological awareness on reading comprehension was significant for the 39% of the sample that had more difficulty reading multisyllabic words), but not for students at the higher end of the multisyllabic word reading continuum. We conclude from these results that the relation between morphological awareness and reading comprehension is moderated by multisyllabic word reading ability, providing support for the lexical quality hypothesis (Perfetti, 2007). Although we have only correlational data, we suggest tentative instructional practices for improving the reading skill of upper elementary struggling readers. PMID:24219914

Undesirable financial effects of head and neck cancer radiotherapy during the initial treatment period.

PubMed

Egestad, Helen; Nieder, Carsten

2015-01-01

Healthcare cost and reforms are at the forefront of international debates. One of the current discussion themes in oncology is whether and how patients' life changes due to costs of cancer care. In Norway, the main part of the treatment costs is supported by general taxpayer revenues. The objective of this study was to clarify whether head and neck cancer patients (n=67) in northern Norway experienced financial health-related quality of life (HRQOL) deterioration due to costs associated with treatment. HRQOL was examined by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 in the beginning and in the end of radiation treatment in patients treated at the University Hospital in Northern Norway. Changes in financial HRQOL were calculated and compared by paired sample T-tests. Multiple regression analyses were used to examine correlations among gender, marital status, age and treatment with or without additional chemotherapy and changes in the HRQOL domain of financial difficulties. The majority of score results at both time points were in the lower range (mean 15-25), indicating limited financial difficulties. We observed no statistically significant differences by gender, marital status and age. Increasing financial difficulties during treatment were reported by male patients and those younger than 65, that is, patients who were younger than retirement age. The largest effect was seen in singles. However, differences were not statistically significant. During the initial phase of the disease trajectory, no significant increase in financial difficulties was found. This is in line with the aims of the Norwegian public healthcare model. However, long-term longitudinal studies should be performed, especially with regard to the trends we observed in single, male and younger patients.

Severity of eczema and mental health problems in Japanese schoolchildren: The ToMMo Child Health Study.

PubMed

Kuniyoshi, Yasutaka; Kikuya, Masahiro; Miyashita, Masako; Yamanaka, Chizuru; Ishikuro, Mami; Obara, Taku; Metoki, Hirohito; Nakaya, Naoki; Nagami, Fuji; Tomita, Hiroaki; Hozawa, Atsushi; Tsuji, Ichiro; Kure, Shigeo; Yaegashi, Nobuo; Yamamoto, Masayuki; Kuriyama, Shinichi

2018-04-13

The association between eczema and mental health problems in schoolchildren has been underexplored. We aimed to investigate this association with the validated questionnaires. Of 46,648 invited children, we analyzed 9954 (21.3%) in the 2nd to the 8th grades from the ToMMo Child Health Study conducted in 2014 and 2015, a cross-sectional survey in Miyagi Prefecture, Japan. We defined eczema status as "normal," "mild/moderate," or "severe," based on the presence of persistent flexural eczema and sleep disturbance, according to the International Study of Asthma and Allergies in Childhood (ISAAC) Eczema Symptom Questionnaire. Clinical ranges of Strengths and Difficulties Questionnaire (SDQ) total difficulties scores and four SDQ subcategories of emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems were defined as scores ≥16, ≥5, ≥5, ≥7, and ≥5, respectively. The mean SDQ total difficulties score significantly increased as eczema status worsened (all P ≤ 0.004 for trend). The OR of scores in the clinical range for SDQ total difficulties were 1.51 (95% CI, 1.31-1.74) for mild/moderate eczema and 2.63 (95% CI, 1.91-3.63) for severe eczema (P < 0.001 for trend), adjusted for sex, school grade, current wheeze, and disaster-related factors, using normal eczema as a reference. The association between severity of eczema and four SDQ subcategories showed a similar trend (all P ≤ 0.017 for trend). We found a significant association between severity of eczema and mental health problems. The presence of eczema was associated with four SDQ subcategories. Copyright © 2018 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

The association between imported factors and prisoners' mental health: Implications for adaptation and intervention.

PubMed

Bowler, Nicholas; Phillips, Ceri; Rees, Paul

In the United Kingdom (UK) the prison population has increased by around one third since the turn of the millennium amid growing concern over the correctional mission of prisons, the number of prisoners exhibiting mental health difficulties and high levels of recidivism. This study aims to explore the relationship between 'imported' (pre-prison) factors and prisoner mental health status. Prisoners (N = 756) from two UK prisons completed an established measure of mental health (General Health Questionnaire: GHQ-12) and a bespoke survey on pre-prison characteristics and experiences (for example, dispositions, childhood abuse, substance misuse, learning difficulties and employment). Prevalence of mental health difficulties was high, with 40.3% reaching the 'caseness' threshold. Binary logistic regression and odds ratio analyses were used to explore the ability of imported factors to predict mental health 'caseness' and the direction of influence. Collectively, the imported factors correctly predicted the caseness category of 76.5% of participants (p < .001). Pre-prison dispositions proved to be strong predictors of caseness as did childhood sexual abuse and learning difficulties at school. We found the direction of influence of three imported factors differed from all others: unemployment, prior experience of prison and a history of substance misuse. These three factors are associated with a lower rate of mental health caseness. It is of concern that, on release, these same factors are likely to militate against re-integration into society. Imported factors can serve as powerful predictors of 'within-prison' mental health status, but practitioners need to be cognisant of the relative importance and direction of influence of factors, as evidenced by these findings. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Migrant tuberculosis patient needs and health system response along the Thailand-Myanmar border.

PubMed

Tschirhart, Naomi; Nosten, Francois; Foster, Angel M

2017-10-01

This article aims to identify how the health system in Tak province, Thailand has responded to migrants' barriers to tuberculosis (TB) treatment. Our qualitatively driven multi-methods project utilized focus group discussions, key informant interviews, and a survey of community health volunteers to collect data in 2014 from multiple perspectives. Migrants identified legal status and transportation difficulties as the primary barriers to seeking TB treatment. Lack of financial resources and difficulties locating appropriate and affordable health services in other Thai provinces or across the border in Myanmar further contributed to migrants' challenges. TB care providers responded to barriers to treatment by bringing care out into the community, enhancing patient mobility, providing supportive services, and reaching out to potential patients. Interventions to improve migrant access and adherence to TB treatment necessarily extend outside of the health system and require significant resources to expand equitable access to treatment. Although this research is specific to the Thailand-Myanmar border, we anticipate that the findings will contribute to broader conversations around the inputs that are necessary to address disparities and inequities. Our study suggests that migrants need to be provided with resources that help stabilize their financial situation and overcome difficulties associated with their legal status in order to access and continue TB treatment. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Work and family life of childrearing women workers in Japan: comparison of non-regular employees with short working hours, non-regular employees with long working hours, and regular employees.

PubMed

Seto, Masako; Morimoto, Kanehisa; Maruyama, Soichiro

2006-05-01

This study assessed the working and family life characteristics, and the degree of domestic and work strain of female workers with different employment statuses and weekly working hours who are rearing children. Participants were the mothers of preschoolers in a large Japanese city. We classified the women into three groups according to the hours they worked and their employment conditions. The three groups were: non-regular employees working less than 30 h a week (n=136); non-regular employees working 30 h or more per week (n=141); and regular employees working 30 h or more a week (n=184). We compared among the groups the subjective values of work, financial difficulties, childcare and housework burdens, psychological effects, and strains such as work and family strain, work-family conflict, and work dissatisfaction. Regular employees were more likely to report job pressures and inflexible work schedules and to experience more strain related to work and family than non-regular employees. Non-regular employees were more likely to be facing financial difficulties. In particular, non-regular employees working longer hours tended to encounter socioeconomic difficulties and often lacked support from family and friends. Female workers with children may have different social backgrounds and different stressors according to their working hours and work status.

Association Between Chewing Difficulty and Symptoms of Depression in Adults: Results from the Korea National Health and Nutrition Examination Survey.

PubMed

Shin, Hye-Sun; Ahn, Yong-Soon; Lim, Do-Seon

2016-12-01

To assess the association between chewing difficulty and symptoms of depression in a representative sample of the Korean population. Cross-sectional. Korea National Health and Nutrition Examination Survey (KNHANES). KNHANES participants (N = 5,158). Chewing difficulty was assessed according to the self-reported presence of chewing problems using a structured questionnaire. Symptoms of depression were defined as having feelings of sadness or depression consecutively over 2 weeks during the last 12 months. Multivariable logistic regression analysis was used to determine the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of the associations between chewing difficulty and symptoms of depression, adjusted for age; sex; monthly household income; education; number of teeth; number of decayed, missing, or filled permanent teeth; periodontitis; state of dentition; tooth brushing frequency; regular dental visits; smoking status; alcohol consumption; hypertension; diabetes mellitus; and obesity. The interaction effects between chewing difficulty and confounders were evaluated, and age- and sex-stratified analyses were performed. There was a significant positive association between chewing difficulty and symptoms of depression in the fully adjusted model (AOR = 1.86, 95% CI = 1.48-2.33). The strength of the association was highest in men aged 60 and older (AOR = 3.28, 95% CI = 1.54-7.00). Chewing difficulty was independently associated with symptoms of depression in a representative sample of Korean adults. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

The relationship between doctors' and nurses' own weight status and their weight management practices: a systematic review.

PubMed

Zhu, D Q; Norman, I J; While, A E

2011-06-01

It has been established that health professionals' smoking and physical activity influence their related health-promoting behaviours, but it is unclear whether health professionals' weight status also influences their related professional practices. A systematic review was conducted to understand the relationship between personal weight status and weight management practices. Nine eligible studies were identified from a search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and Chinese databases. All included studies were cross-sectional surveys employing self-reported questionnaires. Weight management practice variables studied were classified under six practice indicators, developed from weight management guidelines. Syntheses of the findings from the selected studies suggest that: normal weight doctors and nurses were more likely than those who were overweight to use strategies to prevent obesity in-patients, and, also, provide overweight or obese patients with general advice to achieve weight loss. Doctors' and nurses' own weight status was not found to be significantly related to their referral and assessment of overweight or obese patients, and associations with their relevant knowledge/skills and specific treatment behaviours were inconsistent. Additionally, in female, primary care providers, relevant knowledge and training, self-efficacy and a clear professional identity emerged as positive predictors of weight management practices. This review's findings will need to be confirmed by prospective theoretically driven studies, which employ objective measures of weight status and weight management practices and involve multivariate analyses to identify the relative contribution of weight status to weight management. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Parenting style and child-feeding behaviour in predicting children's weight status change in Taiwan.

PubMed

Tung, Ho-Jui; Yeh, Ming-Chin

2014-05-01

The prevalence of overweight and obesity among children is on the rise worldwide. Prior studies find that parents' child-feeding practices are associated with child weight status and the efficacy of specific parental child-feeding practices can be moderated by parenting styles. In the current longitudinal study, we examined the associations between child-feeding practices and weight status changes over 1 year among a sample of school-aged children in Taiwan. In autumn 2008, a child-feeding questionnaire and parenting-style questionnaire were administered to parents of the second and fourth graders in an elementary school in Taiwan. The weight and height of the students were measured by a trained school nurse in 2008 and again in 2009. An elementary school in central Taiwan. A total of 465 parent-child pairs were included in the analysis. Using a gender- and age-adjusted BMI classification scheme issued by the Taiwan Department of Health, 29·2 % of the students were considered overweight at the 2009 measurement. Controlling for 2008 weight status revealed moderating effects of parenting style on the relationship between child-feeding practices and child weight status. Both authoritative and authoritarian mothers might monitor their children's dietary intake; however, the effectiveness of this practice was better, in terms of weight status control, among the authoritative mothers. Findings suggest that parenting styles have a moderating effect on specific parental child-feeding practices. Parenting styles and parent's feeding practices could be an important focus for future public health interventions addressing the rising childhood obesity epidemic.

Personal Transferable Skills in Higher Education: The Problems of Implementing Good Practice.

ERIC Educational Resources Information Center

Drummond, Ian; Nixon, Iain; Wiltshire, John

1998-01-01

Promotion of effective development of personal transferable skills has had limited success in British higher education. Difficulties inherent in implementing established good practice include institutional inertia, issues of academic freedom, resources, high levels of commitment to a particular discipline, and modularization. (SK)

Authentic Cultural and Linguistic Learning through Practicum in a Nursing Home

ERIC Educational Resources Information Center

Andrew, Martin

2012-01-01

This study investigates the value of community experience for mediating linguistic practice and cultural learning. Learners of English as an Additional Language (EAL), both immigrants and international students, frequently report difficulties in practicing English outside the classroom (Wright, 2006). Grounded in poststructuralist social identity…

Leadership: Who Needs It?

ERIC Educational Resources Information Center

Gronn, Peter

2003-01-01

Critique focuses on the discourse of leadership as a vehicle for representing organizational practice. Identifies a series of conceptual inadequacies, such as difficulties in distinguishing leadership from management. Embedded in each criticism is a claim that, if leadership is to retain its conceptual and practical utility, then it has to be…

Explaining social class differences in depression and well-being.

PubMed

Stansfeld, S A; Head, J; Marmot, M G

1998-01-01

Work characteristics, including skill discretion and decision authority, explain most of the socioeconomic status gradient in well-being and depression in middle-aged British civil servants from the Whitehall II Study, London. Social support explained about one-third of the gradient, life events and material difficulties less than one-third. Socioeconomic status was measured by employment grade. Work characteristics were based on the Karasek model, social support was measured by the Close Persons Questionnaire, depression by the General Health Questionnaire and well-being by the Affect Balance Scale. Despite a small contribution from social selective factors measured by upward mobility, the psychosocial work environment explained most of the cross-sectional socioeconomic status gradient in well-being and depression.

Evidence for global processing of complex visual displays

NASA Technical Reports Server (NTRS)

Munson, Robert C.; Horst, Richard L.

1986-01-01

'Polar graphic' displays, in which changes in system status are represented by distortions in the form of a geometric figure, were presented to subjects, and reaction time (RT) to discriminate system status was recorded. Of interest was the extent to which reaction time showed evidence of global processing of these displays as the number of nodes and difficulty of discrimination were varied. When discrimination of system status was easy, RT showed no increase with increasing number of nodes, providing evidence of global processing. When discrimination was difficult, systematic differences in RT as a function of the number of nodes suggested the invocation of other (local) processes, although the data were not consistent with a node-by-node search process.

Can GPs working in secure environments in England re-license using the Royal College of General Practitioners revalidation proposals?

PubMed Central

2012-01-01

Background Revalidation for UK doctors is expected to be introduced from late 2012. For general practitioners (GPs), this entails collecting supporting information to be submitted and assessed in a revalidation portfolio every five years. The aim of this study was to explore the feasibility of GPs working in secure environments to collect supporting information for the Royal College of General Practitioners’ (RCGP) proposed revalidation portfolio. Methods We invited GPs working in secure environments in England to submit items of supporting information collected during the previous 12 months using criteria and standards required for the proposed RCGP revalidation portfolio and complete a GP issues log. Initial focus groups and initial and follow-up semi-structured face-to-face and telephone interviews were held to explore GPs’ views of this process. Quantitative and qualitative data were analysed using descriptive statistics and identifying themes respectively. Results Of the 50 GPs who consented to participate in the study, 20 submitted a portfolio. Thirty-eight GPs participated in an initial interview, nine took part in a follow-up interview and 17 completed a GP issues log. GPs reported difficulty in collecting supporting information for valid patient feedback, full-cycle clinical audits and evidence for their extended practice role(s) as sessional practitioners in the high population turnover custodial environment. Peripatetic practitioners experienced more difficulty than their institution based counterparts collating this evidence. Conclusions GPs working in secure environments may experience difficulties in collecting the newer types of supporting information for the proposed RCGP revalidation portfolio primarily due to their employment status within a non-medical environment and characteristics of the detainee population. Increased support from secure environment service commissioners and employers will be a prerequisite for these practitioners to enable them to re-license using the RCGP revalidation proposals. PMID:23253694

Who helps the leaders? Difficulties experienced by cancer support group leaders.

PubMed

Kirsten, Laura; Butow, Phyllis; Price, Melanie; Hobbs, Kim; Sunquist, Kendra

2006-07-01

Cancer support groups are an important source of support for cancer patients, yet little is known about the challenges and training needs of both professionally trained and untrained leaders. The aim of this study was to discover the difficulties experienced and training desired by cancer support group leaders. Twenty-seven leaders of 34 cancer support groups participated in focus groups or individual interviews. Groups were purposively selected as representative of 173 support groups identified in New South Wales which were for adults with cancer and/or their adult carers and were not therapeutic or education-only groups. Difficulties identified included dealing with people's different communication styles and needs; dealing with recurrence, metastases and death; practical issues, including resources, setting the programme and funding security; maintaining personal balance and preventing burn out; establishing group credibility; dealing with group cycles; and leading groups in rural areas. Leaders also identified benefits and rewards from group leadership such as contributing to others' well-being, self-development and insight into others' lives. Non-professionally trained leaders experienced more difficulties, particularly in dealing with group process and practical issues. Difficulties identified were related both to working with a cancer population specifically and to working with groups in general. While some issues were common to both health professionals and non-health professionals, non-health professionals reported greater supportive needs. Clear guidelines, targeted training and development of better methods of support to reduce the stress and burn out experienced by group leaders are needed.

The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12

PubMed Central

Hoffman, D L; Dukes, E M

2008-01-01

Objective The current review describes how the health status profile of people with fibromyalgia (FM) compares to that of people in the general population and patients with other health conditions. Methods A review of 37 studies of FM that measured health status with the 36-item Medical Outcomes Study Short-Form Health Survey (SF-36) or the 12-item Short-Form Health Survey (SF-12). Results Studies performed worldwide showed that FM groups were significantly more impaired than people in the general population on all eight health status domains assessed. These domains include physical functioning, role functioning difficulties caused by physical problems, bodily pain, general health, vitality (energy vs. fatigue), social functioning, role functioning difficulties caused by emotional problems and mental health. FM groups had mental health summary scores that fell 1 standard deviation (SD) below the general population mean, and physical health summary scores that fell 2 SD below the general population mean. FM groups also had a poorer overall health status compared to those with other specific pain conditions. FM groups had similar or significantly lower (poorer) physical and mental health status scores compared to those with rheumatoid arthritis, osteoarthritis, osteoporosis, systemic lupus erythematosus, myofacial pain syndrome, primary Sjögren's syndrome and others. FM groups scored significantly lower than the pain condition groups mentioned above on domains of bodily pain and vitality. Health status impairments in pain and vitality are consistent with core features of FM. Conclusions People with FM had an overall health status burden that was greater in magnitude compared to people with other specific pain conditions that are widely accepted as impairing. Review Criteria Studies in this review were identified through a search of electronic databases (MEDLINE: 1990–2006; EMBASE: 1990–2006). Search terms included: ‘fibromyalgia’, ‘health status’, ‘quality of life’, ‘SF-36’ and ‘SF-12’. Reference lists from published articles were also searched. Studies were selected if they were published in the English language between 1990 and (March) 2006 and assessed health status with a validated version of the SF-36 or the SF-12. Message for the Clinic Although FM is a controversial construct, studies performed worldwide showed that the health status profile of people with FM was remarkably consistent. People with FM had significant impairments in both mental and physical health status domains. People with FM had a poorer overall health status than people with specific pain conditions that are widely accepted as impairing. PMID:18039330

Impact of sleep difficulty on single and repeated injuries in adolescents.

PubMed

Chau, Kénora

2015-08-01

Injuries are frequent and may be caused by sleep difficulty in youth. This study assessed the impact of sleep difficulty on single and repeated school and out-of-school injuries and the confounding role of socioeconomic factors and school, behaviour and health-related difficulties among adolescents. The study population included 1559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3) who completed at the end of school year a self-administered questionnaire to gather school and out-of-school injuries during the school year, and to assess sleep difficulty and previous injury risk factors which were socioeconomic factors (family structure, parents' education, father's occupation, and family income), school performance, obesity, alcohol/tobacco/cannabis/hard drugs use, health status, psychological health, and involvement-in-violence. For sleep difficulty and behaviour and health-related difficulties their first occurring over adolescent's life course was gathered. Multinomial logistic regression models were used retaining only sleep difficulty and other risk factors which had started before the school year (thus before the injuries studied). School and out-of-school injuries and sleep difficulty were frequent. The adolescents with sleep difficulty without medical treatment had a higher risk of single school and out-of-school injuries (gender-age-adjusted odds ratio gaOR 1.86 and 1.76, respectively) and a much higher risk of repeated school and out-of-school injuries (≥2 injuries; gaOR 2.43 and 3.73, respectively). The adolescents with persistent sleep difficulty despite a medical treatment also had a higher risk of single school and out-of-school injury (gaOR 2.31 and 1.78, respectively), and a much higher risk of repeated school and out-of-school injuries (gaOR 4.92 and 4.36, respectively). Socioeconomic factors had a moderate contribution (<27%) while school, behaviour and health-related difficulties had a high contribution (reaching 71%) to the association between sleep difficulty and single/repeated injuries. The role of these factors differed between single/repeated school/out-of-school injuries. Injury prevention should focus on screening and monitoring sleep difficulty and previous difficulties, especially among adolescents with socioeconomic difficulties, via physician-parent-school-adolescent collaborations. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Students' practice in the construction of knowledge about the phenomenon of drug abuse].

PubMed

dos Santos, Vanessa Oliveira Guimarães; Vargens, Octavio Muniz da Costa

2010-03-01

This is a qualitative descriptive research, carried out with nursing undergraduates from Rio de Janeiro State University, Brazil. The purpose is to discuss students' experiences and their social practice in assisting drugs uses. Data were collected from December 2008 to January, 2009, with the use of focal groups composed by 19 undergraduates from the last three semesters of the course. The project was approved by the Ethics Research Commission. All participants signed the Informed Consent. The results evidenced students' difficulty in facing reality, due to the contrast between theory and practice. Such difficulty came out as a consequence of an inapropriate educational approach. We concluded that the academic institutions should optimize the use of teaching process. Professional formation related to the phenomenon of drug abuse is considered essential as it becomes more and more frequent in nurses' daily routines.

Women, microcredit and family planning practices: a case study from rural Ghana.

PubMed

Norwood, Carolette

2011-01-01

This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women’s demographic background characteristics, membership status and length, and women’s empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.

Daydreaming in 40- to 60-Year-Old Women: Menopause, Health, Values, and Sexuality.

ERIC Educational Resources Information Center

Giambra, Leonard M.

1983-01-01

Investigated midlife influences on daydreaming for 477 women from 40 to 60 years of age. Examined 42 variables including health status, symptom presence, menstruation difficulties, sexual activities, and effects of menopause. Results indicated daydreaming was more prevalent among women with various psychological symptoms. (PAS)

Policy Issues in the Education of Minorities: A World View.

ERIC Educational Resources Information Center

Male, George A.

1986-01-01

Presents an overview of several countries and which factors produce difficulties in the education of minorities. Focuses on Australia, Canada, England, West Germany, India, Israel, Japan, and Malaysia. Suggests factors such as race, color, caste, religion, nationality, immigrant status, and worldview for consideration by policymakers. (SA)

Medicine Use among Warsaw Ninth-Grade Students

ERIC Educational Resources Information Center

Pisarska, Agnieszka; Ostaszewski, Krzysztof

2011-01-01

Aim: This study examined the prevalence of medicine use for headache, stomachache, difficulties in getting to sleep, nervousness, depression and lack of energy among 15- to 16-year-old students; the relationship between medicine use and students' health status; and the relationship between medicine and nicotine, illegal drug, and alcohol use.…

A Current Look at Phenylketonuria (PKU).

ERIC Educational Resources Information Center

Fischer, Margaret

Research was reviewed on the current status of phenylketonuria, an hereditary amino acid metabolic disorder that can cause severe mental retardation, physical complications, and emotional difficulties if not detected and treated early in childhood. A majority of the research cited was published in the 1960's. Topics covered were: discovery of…

Status Struggles: Network Centrality and Gender Segregation in Same- and Cross-Gender Aggression

ERIC Educational Resources Information Center

Faris, Robert; Felmlee, Diane

2011-01-01

Literature on aggression often suggests that individual deficiencies, such as social incompetence, psychological difficulties, or troublesome home environments, are responsible for aggressive behavior. In this article, by contrast, we examine aggression from a social network perspective, arguing that social network centrality, our primary measure…

Migration and Ethnic Group Disproportionality in Special Education: An Exploratory Study

ERIC Educational Resources Information Center

Gabel, Susan L.; Curcic, Svjetlana; Powell, Justin J. W.; Khader, Khaled; Albee, Lynn

2009-01-01

Issues of educational equity and opportunity cannot be understood without regard to special education, as a key response to disabilities, disadvantages, and difficulties. Likewise, globalization cannot be understood without regard to cross-border migration and minority group status in society. Illuminating the nexus of these, research into…

The Gifted Disadvantaged of Israel.

ERIC Educational Resources Information Center

Shmueli, Eliezer

The immigrant population of Israel falls into two large groups: those of European descent and those from North African and Middle Eastern countries. Families from traditionally agrarian Arab countries generally have a lower socioeconomic status, and their children have difficulty competing in school with children from a more urban, industrialized,…

The Extension of the Voting Rights Act: The Case of Arizona.

ERIC Educational Resources Information Center

Garcia, John A.

Although Arizona's Chicano population has increased since 1960, their generally lower socioeconomic status has had a direct impact on their voting participation. Such problems as language, altered polling places and precinct boundaries, absence of bilingual staff, and literacy tests have also contributed to the voting difficulties encountered by…

[Patriarchate as a cause of violence; the difficulty to identify abusive relationships in one's own home].

PubMed

Garriga, Rosa María

2007-01-01

Why in the 21st century do women continue to accept and endure the use of physical, verbal and psychological force as an inherent condition to their status as a woman and yet refuse to denounce this violation of their human rights?

Understanding Piaget's New Theory Requires Assimilation and Accommodation.

ERIC Educational Resources Information Center

Acredolo, Curt

1997-01-01

Suggests some difficulties and challenges in understanding and teaching Piaget's new theory. Outlines some differences between Piaget's new and standard theories, such as the diminished status of the emergent skills that mark the onset of concrete operational thinking and the perception of achievements in concrete operations as empirical…

Child Exploitation: Some Pieces of the Puzzle.

ERIC Educational Resources Information Center

Rohlader, Dorothy

The report addresses the status in North Carolina and in the nation of child exploitation. Legislative and judicial backgrounds of child pornography and child prostitution are reviewed, and difficulties in obtaining statistical data are noted. Law enforcement issues in pornography are cited, and suggestions for further legislation regarding child…

Effects of Social Capital on General Health Status

PubMed Central

Yamaguchi, Ayano

2014-01-01

This paper discusses the concept of social capital as a potential factor in understanding the controversial relationship between income inequality and individual health status, arguing a positive, important role for social capital. Most of the health research literature focuses on individual health status and reveals that social capital increases individual health. However, the difficulty in measuring social capital, together with what may be the nearly impossible task of attributing causality, should relegate the concept to a more theoretical role in health research. Nonetheless, social capital receives academic attention as a potentially important factor in health research. This paper finds that the mixed results of empirical research on income inequality and health status remain a problem in the context of defining a stable relationship between socioeconomic status and health status. Clearly, further research is needed to elaborate on the income inequality and health relationship. In addition, focused, rigorous examination of social capital in a health context is needed before health researchers can comfortably introduce it as a concept of influence or significance. PMID:24762345

Burdens and difficulties experienced by caregivers of children and adolescents with schizophrenia-spectrum disorders: a qualitative study.

PubMed

Knock, Jane; Kline, Emily; Schiffman, Jason; Maynard, Ashley; Reeves, Gloria

2011-11-01

The purpose of this qualitative study was to investigate the burdens and difficulties associated with the experience of caring for youth with schizophrenia-spectrum disorders. Ten caregivers participated in a modified version of the Knowledge about Schizophrenia Illness interview. The most common areas of general difficulties reported by caregivers were emotional burdens and the everyday practical demands and sacrifices required in caring for their dependents. RESULTS also suggested high levels of burden for caregivers concerning difficulties with mental health services. Additional work is needed to learn more about the challenges that caregivers of youth with schizophrenia-spectrum disorders are facing, as well as to develop empirically based strategies for helping these caregivers and their dependents. © 2011 Blackwell Publishing Asia Pty Ltd.

Learning from patients: Identifying design features of medicines that cause medication use problems.

PubMed

Notenboom, Kim; Leufkens, Hubert Gm; Vromans, Herman; Bouvy, Marcel L

2017-01-30

Usability is a key factor in ensuring safe and efficacious use of medicines. However, several studies showed that people experience a variety of problems using their medicines. The purpose of this study was to identify design features of oral medicines that cause use problems among older patients in daily practice. A qualitative study with semi-structured interviews on the experiences of older people with the use of their medicines was performed (n=59). Information on practical problems, strategies to overcome these problems and the medicines' design features that caused these problems were collected. The practical problems and management strategies were categorised into 'use difficulties' and 'use errors'. A total of 158 use problems were identified, of which 45 were categorized as use difficulties and 113 as use error. Design features that contributed the most to the occurrence of use difficulties were the dimensions and surface texture of the dosage form (29.6% and 18.5%, respectively). Design features that contributed the most to the occurrence of use errors were the push-through force of blisters (22.1%) and tamper evident packaging (12.1%). These findings will help developers of medicinal products to proactively address potential usability issues with their medicines. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty.

PubMed

Simonsick, E M; Guralnik, J M; Fried, L P

1999-06-01

To determine how severity of walking difficulty and sociodemographic, psychosocial, and health-related factors influence walking behavior in disabled older women. Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS). An urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, Maryland. A total of 920 moderately to severely disabled community-resident women, aged 65 years and older, identified from an age-stratified random sample of Medicare beneficiaries. Walking behavior was defined as minutes walked for exercise and total blocks walked per week. Independent variables included self-reported walking difficulty, sociodemographic factors, psychological status (depression, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking, and cane use). Walking at least 8 blocks per week was strongly negatively related to severity of walking difficulty. Independent of difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associated with walking; living alone and high mastery had a positive association with walking. Even among functionally limited women, sociocultural, psychological, and health-related factors were independently associated with walking behavior. Thus, programs aimed at improving walking ability need to address these factors in addition to walking difficulties to maximize participation and compliance.

The future of energy and climate

ScienceCinema

Steinberger, Jack

2018-04-26

The talk will review some of the basic facts about the history and present status of the use of energy and its climatic consequences. It is clear that the world will have to change its way of energy production, the sooner the better. Because of the difficulty of storing electric energy, by far the best energy source for the future is thermal solar from the deserts, with overnight thermal storage. I will give some description of the present status of the technologies involved and end up with a pilot project for Europe and North Africa.

Automotive Stirling engine development program - Overview and status report

NASA Technical Reports Server (NTRS)

Nightingale, N. P.

1983-01-01

The current status of the automotive-Stirling-engine development program being undertaken by DOE and NASA Lewis is reviewed. The program goals and the reference-engine design are explained, and the modifications introduced to improve performance and lower manufacturing costs are discussed and illustrated, including part-power optimization; increased operating temperature (from 720 to 820 C); 45.4-kg weight reduction; elimination of Co and reduction of Cr used; and improved seals, ceramic components, and high-temperature alloys. The test program, some difficulties encountered, and results after 2042 h are summarized.

Mathematical model for production of an industry focusing on worker status

NASA Astrophysics Data System (ADS)

Visalakshi, V.; kiran kumari, Sheshma

2018-04-01

Productivity improvement is posing a great challenge for industry everyday because of the difficulties in keeping track and priorising the variables that have significant impact on the productivity. The variation in production depends on the linguistic variables such as worker commitment, worker motivation and worker skills. Since the variables are linguistic we try to propose a model which gives an appropriate production of an industry. Fuzzy models aids the relationship between the factors and status. The model will support the industry to focus on the mentality of worker to increase the production.

The Development Status and Key Technologies of Solar Powered Unmanned Air Vehicle

NASA Astrophysics Data System (ADS)

Sai, Li; Wei, Zhou; Xueren, Wang

2017-03-01

By analyzing the development status of several typical solar powered unmanned aerial vehicles (UAV) at home and abroad, the key technologies involved in the design and manufacture of solar powered UAV and the technical difficulties need to be solved at present are obtained. It is pointed out that with the improvement of energy system efficiency, advanced aerodynamic configuration design, realization of high applicability flight stability and control system, breakthrough of efficient propulsion system, the application prospect of solar powered UAV will be more extensive.

Evidence-based interventions for reading and language difficulties: creating a virtuous circle.

PubMed

Snowling, Margaret J; Hulme, Charles

2011-03-01

BACKGROUND. Children may experience two very different forms of reading problem: decoding difficulties (dyslexia) and reading comprehension difficulties. Decoding difficulties appear to be caused by problems with phonological (speech sound) processing. Reading comprehension difficulties in contrast appear to be caused by problems with 'higher level' language difficulties including problems with semantics (including deficient knowledge of word meanings) and grammar (knowledge of morphology and syntax). AIMS. We review evidence concerning the nature, causes of, and treatments for children's reading difficulties. We argue that any well-founded educational intervention must be based on a sound theory of the causes of a particular form of learning difficulty, which in turn must be based on an understanding of how a given skill is learned by typically developing children. Such theoretically motivated interventions should in turn be evaluated in randomized controlled trials (RCTs) to establish whether they are effective, and for whom. RESULTS. There is now considerable evidence showing that phonologically based interventions are effective in ameliorating children's word level decoding difficulties, and a smaller evidence base showing that reading and oral language (OL) comprehension difficulties can be ameliorated by suitable interventions to boost vocabulary and broader OL skills. CONCLUSIONS. The process of developing theories about the origins of children's educational difficulties and evaluating theoretically motivated treatments in RCTs, produces a 'virtuous circle' whereby theory informs practice, and the evaluation of effective interventions in turn feeds back to inform and refine theories about the nature and causes of children's reading and language difficulties. ©2010 The British Psychological Society.

Adult Attitudes about School Counselor Role.

ERIC Educational Resources Information Center

Yockey, Karen S.

In a time of financial difficulties for schools, few counselors use accountability practices--practices which are necessary in order to justify the expense of school counseling and guidance programs. This descriptive study examines opinions of adults about school counselors. Following a review of literature concerning the role of the counselor, a…

Instruction and Assessment for Struggling Writers Evidence-Based Practices

ERIC Educational Resources Information Center

Troia, Gary A., Ed.

2009-01-01

This book focuses on how to provide effective instruction to K-12 students who find writing challenging, including English language learners and those with learning disabilities or language impairments. Prominent experts illuminate the nature of writing difficulties and offer practical suggestions for building students' skills at the word,…

How to Retain Postgraduate Students in Engineering Programmes: A Practical Perspective

ERIC Educational Resources Information Center

Le, Khoa N.; Tam, Vivian W. Y.

2008-01-01

Six factors for pursuing an engineering postgraduate programme at Griffith University including (i) programme quality; (ii) employment prospects; (iii) practicality; (iv) personal interest; (v) popularity; and (vi) reputation; and 11 factors for not pursuing this engineering programme including (i) employment prospects; (ii) degree of difficulty;…

Thickened Liquids: Practice Patterns of Speech-Language Pathologists

ERIC Educational Resources Information Center

Garcia, Jane Mertz; Chambers, Edgar, IV; Molander, Michelle

2005-01-01

This study surveyed the practice patterns of speech-language pathologists in their use of thickened liquids for patients with swallowing difficulties. A 25-item Internet survey about thickened liquids was posted via an e-mail list to members of the American Speech-Language-Hearing Association Division 13, Swallowing and Swallowing Disorders…

Parents' Talk: Multiple Schemas and Parenting Practice

ERIC Educational Resources Information Center

Sarda, Zoltan G.

2012-01-01

The impetus for this study is derived from the researcher's experience as a teacher and parent educator. In such contexts, parents frequently lament about the difficulties they experience in developing and sustaining "best practices" in raising their children, and the intransigent nature of existing habits. Much schematic cognition…

The Cultivation of Cross-Cultural Communication Competence in Oral English Teaching Practice

ERIC Educational Resources Information Center

Sun, Chunyan

2015-01-01

This paper analyzes the main problems and difficulties in current college English oral English teaching practice, illustrates the relationship between oral English teaching and cross-cultural communication competence. On the one hand, cross-cultural communication plays an essential role in oral English teaching; besides, oral English teaching…

Using Playful Practice to Communicate with Special Children. David Fulton/Nasen

ERIC Educational Resources Information Center

Corke, Margaret

2011-01-01

Playfulness is important; it creates an alternative space where emotional, cognitive and social dimensions can be explored and tested. This highly practical book explores the endless possibilities of using playful, creative and interactive activities to meaningfully engage with children with multiple learning difficulties or autistic spectrum…

Communicating with Families across Cultures: An Investigation of Teacher Perceptions and Practices

ERIC Educational Resources Information Center

Eberly, Jody L.; Joshi, Arti; Konzal, Jean

2007-01-01

Increasing diversity in the student population intensifies the need for and the difficulties of establishing culturally sensitive and meaningful communication between teachers and parents. This study examined the practices of early childhood and elementary teachers concerning culturally sensitive home-school communication. As a second phase of a…

Developmental Perspectives on Reflective Practices of Elementary Science Education Students

ERIC Educational Resources Information Center

Olson, Joanne K.; Finson, Kevin D.

2009-01-01

Instructors of elementary science methods classes have long lamented the significant difficulties their students exhibit when trying to understand the many complexities of teaching science. As noted by some researchers and practicing teachers, preservice teachers often fail to developmentally function at desired levels with respect to…

SOAP Methodology in General Practice/Family Medicine Teaching in Practical Context.

PubMed

Santiago, Luiz Miguel; Neto, Isabel

2016-12-30

Medical records in General Practice/Family Medicine are an essential information support on the health status of the patient and a communication document between health professionals. The development of competencies in General Practice/Family Medicine during pre-graduation must include the ability to make adequate medical records in practical context. As of 2012, medicine students at the University of Beira Interior have been performing visits using the Subjective, Objective, Assessment and Plan - SOAP methodology, with a performance evaluation of the visit, with the aim to check on which Subjective, Objective, Assessment and Plan - SOAP aspects students reveal the most difficulties in order to define improvement techniques and to correlate patient grade with tutor evaluation. Analysing the evaluation data for the 2015 - 2016 school year at the General Practice/Family Medicine visit carried out by fourth year students in medicine, comparing the averages of each item in the Subjective, Objective, Assessment and Plan - SOAP checklist and the patient evaluation. In the Subjective, Objective, Assessment and Plan - SOAP, 29.7% of students are on the best grade quartile, 37.1% are on the best competencies quartile and 27.2% on the best patient grade quartile. 'Evolution was verified/noted' received the worst grades in Subjective, 'Record of physical examination focused on the problem of the visit' received the worst grades in Objective, 'Notes of Diagnostic reasoning / differential diagnostic' received de worst grades in Assessment and 'Negotiation of aims to achieve' received the worst grades in Plan. The best tutor evaluation is found in 'communication'. Only one single study evaluated student´s performance under examination during a visit, with similar results to the present one and none addressed the patient's evaluation. Students revealed a good performance in using the Subjective, Objective, Assessment and Plan - SOAP. The findings represent the beginning of the introduction of the Subjective, Objective, Assessment and Plan - SOAP to the students. This evaluation breaks ground towards better ways to teach the most difficult aspects.

Mental Health in School-Aged Children Prenatally Exposed to Alcohol and Other Substances

PubMed Central

Sandtorv, Lisbeth Beate; Hysing, Mari; Rognlid, Malin; Nilsen, Sondre Aasen; Elgen, Irene Bircow

2017-01-01

Prenatal exposure to substances can possibly influence a child’s neurodevelopment and may impact on subsequent mental health. We investigated the mental health status of school-aged children referred to a pediatric hospital with a history of prenatal exposure to alcohol or other substances. Mental health was assessed using the Strengths and Difficulties Questionnaire and compared with a reference group. A total of 105 of 128 (82%) eligible children prenatally exposed to substances participated in the study, with 48 children exposed to alcohol and 57 to other substances. Strengths and Difficulties Questionnaire subscale mean scores, total difficulties scores, and total impact scores were statistically significantly higher in the group of exposed children, compared with the reference group. In this hospital-based population of school-aged children prenatally exposed to alcohol or other substances, the exposed group had an increased risk of mental health problems, compared with the reference group. PMID:29581703

Ecological, psychological, and cognitive components of reading difficulties: testing the component model of reading in fourth graders across 38 countries.

PubMed

Chiu, Ming Ming; McBride-Chang, Catherine; Lin, Dan

2012-01-01

The authors tested the component model of reading (CMR) among 186,725 fourth grade students from 38 countries (45 regions) on five continents by analyzing the 2006 Progress in International Reading Literacy Study data using measures of ecological (country, family, school, teacher), psychological, and cognitive components. More than 91% of the differences in student difficulty occurred at the country (61%) and classroom (30%) levels (ecological), with less than 9% at the student level (cognitive and psychological). All three components were negatively associated with reading difficulties: cognitive (student's early literacy skills), ecological (family characteristics [socioeconomic status, number of books at home, and attitudes about reading], school characteristics [school climate and resources]), and psychological (students' attitudes about reading, reading self-concept, and being a girl). These results extend the CMR by demonstrating the importance of multiple levels of factors for reading deficits across diverse cultures.

Socioeconomic variation, number competence, and mathematics learning difficulties in young children.

PubMed

Jordan, Nancy C; Levine, Susan C

2009-01-01

As a group, children from disadvantaged, low-income families perform substantially worse in mathematics than their counterparts from higher-income families. Minority children are disproportionately represented in low-income populations, resulting in significant racial and social-class disparities in mathematics learning linked to diminished learning opportunities. The consequences of poor mathematics achievement are serious for daily functioning and for career advancement. This article provides an overview of children's mathematics difficulties in relation to socioeconomic status (SES). We review foundations for early mathematics learning and key characteristics of mathematics learning difficulties. A particular focus is the delays or deficiencies in number competencies exhibited by low-income children entering school. Weaknesses in number competence can be reliably identified in early childhood, and there is good evidence that most children have the capacity to develop number competence that lays the foundation for later learning.

The use of negative inflections by Finnish-speaking children with and without specific language impairment

PubMed Central

Kunnari, Sari; Savinainen-Makkonen, Tuula; Leonard, Laurence B.; Mäkinen, Leena; Tolonen, Anna-Kaisa

2015-01-01

Children with specific language impairment (SLI) have difficulty expressing subject-verb agreement. However, in many languages, tense is fused with agreement, making it difficult to attribute the problem to agreement in particular. In Finnish, negative markers are function words that agree with the subject in person and number but do not express tense, providing an opportunity to assess the status of agreement in a more straightforward way. Fifteen Finnish-speaking preschoolers with SLI, 15 age controls, and 15 younger controls responded to items requiring negative markers in first person singular and plural, and third person singular and plural. The children with SLI were less accurate than both typically developing groups. However, their problems were limited to particular person-number combinations. Furthermore, the children with SLI appeared to have difficulty selecting the form of the lexical verb that should accompany the negative marker, suggesting that agreement was not the sole difficulty. PMID:24588468

Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

PubMed Central

Vreeman, Rachel C.; Scanlon, Michael L.; Marete, Irene; Mwangi, Ann; Inui, Thomas S.; McAteer, Carole I.; Nyandiko, Winstone M.

2015-01-01

Knowledge of one’s own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver–child dyads enrolled in the study, children’s mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child’s knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5–2.1), better WHO disease stage (OR 2.5, 95% CI 1.4–4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1–3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes. PMID:26616121

The need to know: HIV status disclosure expectations and practices among non-HIV-positive gay and bisexual men in Australia.

PubMed

Murphy, Dean A; de Wit, John B F; Donohoe, Simon; Adam, Philippe C G

2015-01-01

Although there is evidence of increasing overall rates of HIV status disclosure among gay and bisexual men, little is known about men's disclosure expectations and practices. In this study, we investigate the importance non-HIV-positive men in Australia vest in knowing the HIV status of their sexual partners, and the extent to which they restrict sex to partners of the same HIV status, and their HIV disclosure expectations. Data were collected through a national, online self-report survey. Of the 1044 men included in the study, 914 were HIV negative and 130 were untested. Participants completed the assessment of socio-demographic characteristics, HIV status preferences, and disclosure expectations and practices. Participants also completed reliable multi-item measures of perceived risk of HIV transmission, expressed HIV-related stigma, and engagement with the gay community and the community of people living with HIV. A quarter (25.9%) of participants wanted to know the HIV status of all sexual partners, and one-third (37.2%) restricted sex to partners of similar HIV status. Three quarters (76.3%) expected HIV-positive partners to disclosure their HIV status before sex, compared to 41.6% who expected HIV-negative men to disclose their HIV status. Less than half (41.7%) of participants reported that they consistently disclosed their HIV status to sexual partners. Multivariate linear regression analysis identified various covariates of disclosure expectations and practices, in particular of disclosure expectations regarding HIV-positive men. Men who expected HIV-positive partners to disclose their HIV status before sex more often lived outside capital cities, were less educated, were less likely to identify as gay, perceived more risk of HIV transmission from a range of sexual practices, were less engaged with the community of people living with HIV, and expressed more stigma towards HIV-positive people. These findings suggest that an HIV-status divide is emerging or already exists among gay men in Australia. HIV-negative and untested men who are most likely to sexually exclude HIV-positive men are less connected to the HIV epidemic and less educated about HIV risk and prevention.

Psychosocial Adaptation and Depressive Manifestations in High-Risk Pregnant Women: Implications for Clinical Practice.

PubMed

Fiskin, Gamze; Kaydirak, Meltem Mecdi; Oskay, Umran Yesiltepe

2017-02-01

High-risk pregnancy research has focused primarily on psychological well-being. The aim is to determine psychosocial adaptation and depression levels of pregnant women who were admitted to hospital with diagnosis of high-risk pregnancy. This study was descriptive. Sampling was composed of 122 high-risk pregnant women who were hospitalized in the perinatology service of Istanbul University Medical School, Department of Obstetrics and Gynecology between January 1, 2014, and May 31, 2014, and met the study criteria. The Pregnant Introduction Form, Psychosocial Adjustment of Illness Scale-Self Report, and CES Depression Scale were used. Of high-risk pregnant women, 47% were found to have a poor level of psychosocial adaptation and 57% presented with depressive symptoms. There were statistically significant difference found between the levels of psychosocial adaptation and status of depressive manifestations. The difference between the average scores increased as the adaptation levels weaken and the pregnant women with a poor level of psychosocial adaptation showed more depressive manifestations. The results of this study indicate that, depending on the high-risk pregnancy status, pregnant women experience difficulty in adaptation to their current status and pregnant women with a poor level of psychosocial adaptation showed more depressive manifestations. Nurses should deliver care in high-risk pregnancies with the awareness of physiological needs as well the psychosocial needs of pregnant women, and information meetings should be held in order to increase the psychosocial support of their families and decrease their tendency toward depression. Nursing initiatives should be developed with further studies for the psychosocial adaptation of high-risk pregnancy and reduction of the depressive manifestations. © 2016 Sigma Theta Tau International.

Educational interventions to improve screening mammography interpretation: a randomized controlled trial.

PubMed

Geller, Berta M; Bogart, Andy; Carney, Patricia A; Sickles, Edward A; Smith, Robert; Monsees, Barbara; Bassett, Lawrence W; Buist, Diana M; Kerlikowske, Karla; Onega, Tracy; Yankaskas, Bonnie C; Haneuse, Sebastien; Hill, Deirdre; Wallis, Matthew G; Miglioretti, Diana

2014-06-01

The objective of our study was to conduct a randomized controlled trial of educational interventions that were created to improve performance of screening mammography interpretation. We randomly assigned physicians who interpret mammography to one of three groups: self-paced DVD, live expert-led educational seminar, or control. The DVD and seminar interventions used mammography cases of varying difficulty and provided associated teaching points. Interpretive performance was compared using a pretest-posttest design. Sensitivity, specificity, and positive predictive value (PPV) were calculated relative to two outcomes: cancer status and consensus of three experts about recall. The performance measures for each group were compared using logistic regression adjusting for pretest performance. One hundred two radiologists completed all aspects of the trial. After adjustment for preintervention performance, the odds of improved sensitivity for correctly identifying a lesion relative to expert recall were 1.34 times higher for DVD participants than for control subjects (95% CI, 1.00-1.81; p = 0.050). The odds of an improved PPV for correctly identifying a lesion relative to both expert recall (odds ratio [OR] = 1.94; 95% CI, 1.24-3.05; p = 0.004) and cancer status (OR = 1.81; 95% CI, 1.01-3.23; p = 0.045) were significantly improved for DVD participants compared with control subjects, with no significant change in specificity. For the seminar group, specificity was significantly lower than the control group (OR relative to expert recall = 0.80; 95% CI, 0.64-1.00; p = 0.048; OR relative to cancer status = 0.79; 95% CI, 0.65-0.95; p = 0.015). In this randomized controlled trial, the DVD educational intervention resulted in a significant improvement in screening mammography interpretive performance on a test set, which could translate into improved interpretative performance in clinical practice.

The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations.

PubMed

Nieminen, Markku S; Dickstein, Kenneth; Fonseca, Cândida; Serrano, Jose Magaña; Parissis, John; Fedele, Francesco; Wikström, Gerhard; Agostoni, Piergiuseppe; Atar, Shaul; Baholli, Loant; Brito, Dulce; Colet, Josep Comín; Édes, István; Gómez Mesa, Juan E; Gorjup, Vojka; Garza, Eduardo Herrera; González Juanatey, José R; Karanovic, Nenad; Karavidas, Apostolos; Katsytadze, Igor; Kivikko, Matti; Matskeplishvili, Simon; Merkely, Béla; Morandi, Fabrizio; Novoa, Angel; Oliva, Fabrizio; Ostadal, Petr; Pereira-Barretto, Antonio; Pollesello, Piero; Rudiger, Alain; Schwinger, Robert H G; Wieser, Manfred; Yavelov, Igor; Zymliński, Robert

2015-07-15

End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed. Copyright © 2015. Published by Elsevier Ireland Ltd.

A Patient Record-Filing System for Family Practice

PubMed Central

Levitt, Cheryl

1988-01-01

The efficient storage and easy retrieval of quality records are a central concern of good family practice. Many physicians starting out in practice have difficulty choosing a practical and lasting system for storing their records. Some who have established practices are installing computers in their offices and finding that their filing systems are worn, outdated, and incompatible with computerized systems. This article describes a new filing system installed simultaneously with a new computer system in a family-practice teaching centre. The approach adopted solved all identifiable problems and is applicable in family practices of all sizes.

A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers

PubMed Central

Muller-Juge, Virginie; Pereira Miozzari, Anne Catherine; Rieder, Arabelle; Hasselgård-Rowe, Jennifer; Sommer, Johanna; Audétat, Marie-Claude

2018-01-01

Purpose The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians’ private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Methods Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach. Results The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities. Conclusion These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students’ academic training and the skills needed for outpatient care. Professionalizing the role of clinical teachers should contribute to reaching these goals. PMID:29344003

A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers.

PubMed

Muller-Juge, Virginie; Pereira Miozzari, Anne Catherine; Rieder, Arabelle; Hasselgård-Rowe, Jennifer; Sommer, Johanna; Audétat, Marie-Claude

2018-01-01

The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach. The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities. These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students' academic training and the skills needed for outpatient care. Professionalizing the role of clinical teachers should contribute to reaching these goals.

Mind-Body Practice and Body Weight Status in a Large Population-Based Sample of Adults.

PubMed

Camilleri, Géraldine M; Méjean, Caroline; Bellisle, France; Hercberg, Serge; Péneau, Sandrine

2016-04-01

In industrialized countries characterized by a high prevalence of obesity and chronic stress, mind-body practices such as yoga or meditation may facilitate body weight control. However, virtually no data are available to ascertain whether practicing mind-body techniques is associated with weight status. The purpose of this study is to examine the relationship between the practice of mind-body techniques and weight status in a large population-based sample of adults. A total of 61,704 individuals aged ≥18 years participating in the NutriNet-Santé study (2009-2014) were included in this cross-sectional analysis conducted in 2014. Data on mind-body practices were collected, as well as self-reported weight and height. The association between the practice of mind-body techniques and weight status was assessed using multiple linear and multinomial logistic regression models adjusted for sociodemographic, lifestyle, and dietary factors. After adjusting for sociodemographic and lifestyle factors, regular users of mind-body techniques were less likely to be overweight (OR=0.68, 95% CI=0.63, 0.74) or obese (OR=0.55, 95% CI=0.50, 0.61) than never users. In addition, regular users had a lower BMI than never users (-3.19%, 95% CI=-3.71, -2.68). These data provide novel information about an inverse relationship between mind-body practice and weight status. If causal links were demonstrated in further prospective studies, such practice could be fostered in obesity prevention and treatment. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Drinking Patterns, Gender and Health I: Attitudes and Health Practices

PubMed Central

Polen, Michael R.; Green, Carla A.; Perrin, Nancy A.; Anderson, Bradley M.; Weisner, Constance M.

2012-01-01

Background Despite considerable research, relationships among gender, alcohol consumption, and health remain controversial, due to potential confounding by health-related attitudes and practices associated with drinking, measurement challenges, and marked gender differences in drinking. We examined gender/alcohol consumption differences in health-related attitudes and practices, and evaluated how these factors affected relationships among gender, alcohol consumption, and health status. Methods A stratified random sample of adult health-plan members completed a mail survey, yielding 7884 respondents (2995 male/4889 female). Using MANCOVAs and adjusting for health-related attitudes, values, and practices, we examined gender differences in relationships between alcohol consumption and health. Results More frequent heavy drinking was associated with worse health-related attitudes and values, worse feelings about visiting the doctor, and worse health-related practices. Relationships between health-related practices and alcohol use differed by gender, and daily or almost daily heavy drinking was associated with significantly lower physical and mental health for women compared to men. Drinking status (lifelong abstainers, former drinkers, and level of regular alcohol consumption) was related to health status and vitality, even after adjusting for health-related attitudes, values, and practices. Relationships did not differ by gender. Former drinkers reported lower physical and mental health status than either lifelong abstainers or current drinkers. Conclusions Drinking status is independently related to physical health, mental health, and vitality, even after controlling for the health-related attitudes, values, and practices expected to confound these relationships. Among current drinkers, women who engage in very frequent heavy drinking have worse physical and mental health than their male counterparts. PMID:23946720

Increasing body mass index predicts increasing difficulty, failure rate, and time to discovery of failure of epidural anesthesia in laboring patients.

PubMed

Kula, Ayse O; Riess, Matthias L; Ellinas, Elizabeth H

2017-02-01

Obese parturients both greatly benefit from neuraxial techniques, and may represent a technical challenge to obstetric anesthesiologists. Several studies address the topic of obesity and neuraxial analgesia in general, but few offer well described definitions or rates of "difficulty" and "failure" of labor epidural analgesia. Providing those definitions, we hypothesized that increasing body mass index (BMI) is associated with negative outcomes in both categories and increased time needed for epidural placement. Single center retrospective chart review. Labor and Delivery Unit of an inner city academic teaching hospital. 2485 parturients, ASA status 2 to 4, receiving labor epidural analgesia for anticipated vaginal delivery. None. We reviewed quality assurance and anesthesia records over a 12-month period. "Failure" was defined as either inadequate analgesia or a positive test dose, requiring replacement, and/or when the anesthesia record stated they failed. "Difficulty" was defined as six or more needle redirections or a note indicating difficulty in the anesthesia record. Overall epidural failure and difficulty rates were 4.3% and 3.0%, respectively. Patients with a BMI of 30kg/m 2 or higher had a higher chance of both failure and difficulty with two and almost three fold increases, respectively. Regression analysis indicated that failure was best predicted by BMI and less provider training while difficulty was best predicted by BMI. Additionally, increased BMI was associated with increased time of discovery of epidural catheter failure. Obesity is associated with increasing technical difficulty and failure of neuraxial analgesia for labor. Practitioners should consider allotting extra time for obese parturients in order to manage potential problems. Copyright © 2016 Elsevier Inc. All rights reserved.

Difficulty buying food, BMI, and eating habits in young children.

PubMed

Fuller, Anne; Maguire, Jonathon L; Carsley, Sarah; Chen, Yang; Lebovic, Gerald; Omand, Jessica; Parkin, Patricia; Birken, Catherine S

2018-01-22

To determine whether parent report of difficulty buying food was associated with child body mass index (BMI) z-score or with eating habits in young children. This was a cross-sectional study in primary care offices in Toronto, Ontario. Subjects were children aged 1-5 years and their caregivers, recruited through the TARGet Kids! Research Network from July 2008 to August 2011. Regression models were developed to test the association between parent report of difficulty buying food because of cost and the following outcomes: child BMI z-score, parent's report of child's intake of fruit and vegetables, fruit juice and sweetened beverages, and fast food. Confounders included child's age, sex, birth weight, maternal BMI, education, ethnicity, immigration status, and neighbourhood income. The study sample consisted of 3333 children. Data on difficulty buying food were available for 3099 children, and 431 of these (13.9%) were from households reporting difficulty buying food. There was no association with child BMI z-score (p = 0.86). Children from households reporting difficulty buying food (compared with never having difficulty buying food) had increased odds of consuming three or fewer servings of fruits and vegetables per day (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.03-1.69), more than one serving of fruit juice/sweetened beverage per day (OR: 1.60, 95% CI: 1.28-2.00), and, among children 1-2 years old, one or more servings of fast food per week (OR: 2.91, 95% CI: 1.67-5.08). Parental report of difficulty buying food is associated with less optimal eating habits in children but not with BMI z-score.

Bruised Witness: Bernard Spilsbury and the Performance of Early Twentieth-Century English Forensic Pathology

PubMed Central

BURNEY, IAN; PEMBERTON, NEIL

2011-01-01

This article explores the status, apparatus and character of forensic pathology in the inter-war period, with a special emphasis on the ‘people’s pathologist’, Bernard Spilsbury. The broad expert and public profile of forensic pathology, of which Spilsbury was the most prominent contemporary representative, will be outlined and discussed. In so doing, close attention will be paid to the courtroom strategies by which he and other experts translated their isolated post-mortem encounters with the dead body into effective testimony. Pathologists built a high-profile practice that transfixed the popular, legal and scientific imagination, and this article also explores, through the celebrated 1925 murder trial of Norman Thorne, how Spilsbury’s courtroom performance focused critical attention on the practices of pathology itself, which threatened to destabilise the status of forensic pathology. In particular, the Thorne case raised questions about the interrelation between bruising and putrefaction as sources of interpretative anxiety. Here, the question of practice is vital, especially in understanding how Spilsbury’s findings clashed with those of rival pathologists whose autopsies centred on a corpse that had undergone further putrefactive changes and that had thereby mutated as an evidentiary object. Examining how pathologists dealt with interpretative problems raised by the instability of their core investigative object enables an analysis of the ways in which pathological investigation of homicide was inflected with a series of conceptual, professional and cultural difficulties stemming in significant ways from the materiality of the corpse itself. This article presents early findings of a larger study of twentieth-century English homicide investigation which focuses on the interaction between two dominant forensic regimes: the first, outlined in part here, is a body-centred forensics, associated with the lone, ‘celebrity’ pathologist, his scalpel and the mortuary slab; the second is a ‘forensics of things’ centred on the laboratory and its associated technologies of trace analysis (hair, blood, fibres), deployed in closed technician-dominated spaces and in the regimentally managed crime scene. Future work will seek to illuminate the shifting landscape of English forensics by following the historical interplay between these two powerful investigative models. PMID:23752864

Bruised witness: Bernard Spilsbury and the performance of early twentieth-century English forensic pathology.

PubMed

Burney, Ian; Pemberton, Neil

2011-01-01

This article explores the status, apparatus and character of forensic pathology in the inter-war period, with a special emphasis on the 'people's pathologist', Bernard Spilsbury. The broad expert and public profile of forensic pathology, of which Spilsbury was the most prominent contemporary representative, will be outlined and discussed. In so doing, close attention will be paid to the courtroom strategies by which he and other experts translated their isolated post-mortem encounters with the dead body into effective testimony. Pathologists built a high-profile practice that transfixed the popular, legal and scientific imagination, and this article also explores, through the celebrated 1925 murder trial of Norman Thorne, how Spilsbury's courtroom performance focused critical attention on the practices of pathology itself, which threatened to destabilise the status of forensic pathology. In particular, the Thorne case raised questions about the interrelation between bruising and putrefaction as sources of interpretative anxiety. Here, the question of practice is vital, especially in understanding how Spilsbury's findings clashed with those of rival pathologists whose autopsies centred on a corpse that had undergone further putrefactive changes and that had thereby mutated as an evidentiary object. Examining how pathologists dealt with interpretative problems raised by the instability of their core investigative object enables an analysis of the ways in which pathological investigation of homicide was inflected with a series of conceptual, professional and cultural difficulties stemming in significant ways from the materiality of the corpse itself. This article presents early findings of a larger study of twentieth-century English homicide investigation which focuses on the interaction between two dominant forensic regimes: the first, outlined in part here, is a body-centred forensics, associated with the lone, 'celebrity' pathologist, his scalpel and the mortuary slab; the second is a 'forensics of things' centred on the laboratory and its associated technologies of trace analysis (hair, blood, fibres), deployed in closed technician-dominated spaces and in the regimentally managed crime scene. Future work will seek to illuminate the shifting landscape of English forensics by following the historical interplay between these two powerful investigative models.

Challenges to implementation of advance directives of will in hospital practice.

PubMed

Cogo, Silvana Bastos; Lunardi, Valéria Lerch; Quintana, Alberto Manuel; Girardon-Perlini, Nara Marilene Oliveira; Silveira, Rosemary Silva da

2016-01-01

to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication. limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.

Barriers faced by expanded practice dental hygienists in Oregon.

PubMed

Coplen, Amy E; Bell, Kathryn P

2015-04-01

Oregon allows dental hygienists to provide services without the supervision of a dentist if they hold an expanded practice permit (EPP). This study surveyed practicing and non-practicing EPP holders with the purpose of assessing perceived barriers to practicing independently and better educating students to begin independent practice upon graduation. A survey was developed, approved by the institutional review board and pilot tested with current Expanded Practice Dental Hygienists (EPDHs). A list of EPDHs was obtained from the Oregon State Dental Board, and 181 surveys were mailed in November 2011. The response rate was 39% (n=71). Data from this study indicate a large number of new EPP holders, with 62% (n=41) holding their permit for 3 years or less, but only 41% (n=29) of respondents are actually providing care in a setting requiring an EPP. Responding practicing EPDHs reported barriers including: challenges with insurance reimbursement, lack of knowledge/acceptance, equipment cost/maintenance, difficulty obtaining a collaborative agreement/cooperating facility, advertising and inability to make a living wage. Responding non-practicing EPDHs reported barriers including: currently working in another setting, lack of business knowledge, time, start-up cost, inability to make a living wage, lack of opportunity, reimbursement difficulties and lack of experience. Perceived barriers to practicing independently differ between those practicing utilizing their EPP and those not practicing. Ways to eliminate barriers for both practicing and non-practicing EPDHs should be explored. There is potential to reduce the barriers to independent practice through curricular changes, public health partnerships among EPDHs, and new health care systems that specifically address barriers found through this study. Copyright © 2015 The American Dental Hygienists’ Association.

The classification of normal screening mammograms

NASA Astrophysics Data System (ADS)

Ang, Zoey Z. Y.; Rawashdeh, Mohammad A.; Heard, Robert; Brennan, Patrick C.; Lee, Warwick; Lewis, Sarah J.

2016-03-01

Rationale and objectives: To understand how breast screen readers classify the difficulty of normal screening mammograms using common lexicon describing normal appearances. Cases were also assessed on their suitability for a single reader strategy. Materials and Methods: 15 breast readers were asked to interpret a test set of 29 normal screening mammogram cases and classify them by rating the difficulty of the case on a five-point Likert scale, identifying the salient features and assessing their suitability for single reading. Using the False Positive Fractions from a previous study, the 29 cases were classified into 10 "low", 10 "medium" and nine "high" difficulties. Data was analyzed with descriptive statistics. Spearman's correlation was used to test the strength of association between the difficulty of the cases and the readers' recommendation for single reading strategy. Results: The ratings from readers in this study corresponded to the known difficulty level of cases for the 'low' and 'high' difficulty cases. Uniform ductal pattern and density, symmetrical mammographic features and the absence of micro-calcifications were the main reasons associated with 'low' difficulty cases. The 'high' difficulty cases were described as having `dense breasts'. There was a statistically significant negative correlation between the difficulty of the cases and readers' recommendation for single reading (r = -0.475, P = 0.009). Conclusion: The findings demonstrated potential relationships between certain mammographic features and the difficulty for readers to classify mammograms as 'normal'. The standard Australian practice of double reading was deemed more suitable for most cases. There was an inverse moderate association between the difficulty of the cases and the recommendations for single reading.

Difficulties in conducting a randomized controlled trial of health service interventions in intellectual disability: implications for evidence-based practice.

PubMed

Oliver, P C; Piachaud, J; Done, J; Regan, A; Cooray, S; Tyrer, P

2002-05-01

In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for effective intervention is limited for much that happens in ordinary practice. As Fraser (2000, p. 10) has commented, the word that best explains "the transformation of learning disability practice in the past 30 years is 'enlightenment'." This is not enough to satisfy the demands of evidence, and Fraser exhorted us to embrace more research-based practice in a subject that has previously escaped randomized controlled trials (RCTs) of treatment because of ethical concerns over capacity and consent, which constitute a denial of opportunity which "is now at last regarded as disenfranchising". The present paper describes the difficulties encountered in setting up a RCT of a common intervention, i.e. assertive community treatment, and concludes that a fundamental change in attitudes to health service research in ID is needed if proper evaluation is to prosper.

“I Am a Nice Person When I Do Yoga!!!”

PubMed Central

Ross, Alyson; Bevans, Margaret; Friedmann, Erika; Williams, Laurie; Thomas, Sue

2014-01-01

Purpose To develop a better understanding of how yoga practice affects one’s interpersonal relationships. Design Qualitative. Method Content analysis was used to qualitatively analyze written comments (n = 171) made regarding yoga improving interpersonal relationships in a large cross-sectional survey of yoga practitioners (N = 1,067). Findings Four themes were identified: Yoga practice leads to personal transformation, increases social interaction, provides coping mechanisms to weather relationship losses and difficulties, and leads to spiritual transcendence. Practitioners believed that their interpersonal relationships improved because their attitude and perspective had changed, making them more patient, kind, mindful, and self-aware. They expressed an aspect of community that was both practical (they met new friends) and spiritual (they felt they belonged). They thought they could better weather difficulties such as divorce and death. A number discussed feeling a sense of purpose and that their practice contributed to a greater good. Conclusions There appears to be an aspect of community associated with yoga practice that may be beneficial to one’s social and spiritual health. Yoga could be beneficial for populations at risk for social isolation, such as those who are elderly, bereaved, and depressed, as well as individuals undergoing interpersonal crises. PMID:24166108

Long-term outcome after resection of brainstem hemangioblastomas in von Hippel-Lindau disease

PubMed Central

Wind, Joshua J.; Bakhtian, Kamran D.; Sweet, Jennifer A.; Mehta, Gautam U.; Thawani, Jayesh P.; Asthagiri, Ashok R.; Oldfield, Edward H.; Lonser, Russell R.

2016-01-01

Object Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome and management of these tumors, the authors analyzed the long-term results in patients who underwent resection of brainstem hemangioblastomas. Methods Consecutive patients with VHL disease who underwent resection of brainstem hemangioblastomas with a follow-up of 12 months or more were included in this study. Serial functional assessments, radiographic examinations, and operative records were analyzed. Results Forty-four patients (17 male and 27 female) underwent 51 operations for resection of 71 brainstem hemangioblastomas. The most common presenting symptoms were headache, swallowing difficulties, singultus, gait difficulties, and sensory abnormalities. The mean follow-up was 5.9 ± 5.0 years (range 1.0–20.8 years). Immediately after 34 operations (66.7%), the patients remained at their preoperative functional status; they improved after 8 operations (15.7%) and worsened after 9 operations (17.6%) as measured by the McCormick scale. Eight (88.9%) of the 9 patients who were worse immediately after resection returned to their preoperative status within 6 months. Two patients experienced functional decline during long-term follow-up (beginning at 2.5 and 5 years postoperatively) caused by extensive VHL disease–associated CNS disease. Conclusions Generally, resection of symptomatic brainstem hemangioblastomas is a safe and effective management strategy in patients with VHL disease. Most patients maintain their preoperative functional status, although long-term decline in functional status may occur due to VHL disease–associated progression. PMID:20932100

The Association of Waist Circumference with Walking Difficulty Among Adults with or at Risk of Knee Osteoarthritis: The Osteoarthritis Initiative

PubMed Central

Gill, Simone V.; Hicks, Gregory E.; Zhang, Yuqing; Niu, Jingbo; Apovian, Caroline M.; White, Daniel K.

2016-01-01

Objective Excess weight is a known risk factor for functional limitation and common in adults with knee osteoarthritis (OA). We asked to what extent high waist circumference was linked with developing difficulty with walking speed and distance over 4 years in adults with or at risk of knee OA. Method Using data from the Osteoarthritis Initiative, we employed WHO categories for Body Mass Index (BMI) and waist circumference (small/medium and large). Difficulty with speed was defined by slow gait: < 1.2 m/s during a 20-meter walk, and difficulty with distance was defined by an inability to walk 400 meters. We calculated risk ratios (RR) to examine the likelihood of developing difficulty with distance and speed using obesity and waist circumference as predictors with RRs adjusted for potential confounders (i.e., age, sex, race, education, physical activity, and OA status). Results Participants with obesity and large waists were 2.2 times more likely to have difficulty with speed at 4 years compared to healthy weight and small/medium waisted participants (Adjusted RR 2.2 [95% Confidence interval (CI) 1.6, 3.1], P < .0001). Participants with obesity and a large waist circumference had 2.4 times the risk of developing the inability to walk 400 meters compared with those with a healthy BMI and small/medium waist circumference (Adjusted RR 0.9 [95% CI 1.6, 3.7], P < .0001). Conclusions Waist circumference may be a main risk factor for developing difficulty with speed in adults with or at risk of knee OA. PMID:27492464

Complaints of insomnia among midlife employed people: the contribution of childhood and present socioeconomic circumstances.

PubMed

Lallukka, Tea; Arber, Sara; Rahkonen, Ossi; Lahelma, Eero

2010-10-01

Studies using conventional socioeconomic indicators have reported inconsistent evidence on socioeconomic differences in complaints of insomnia. We lack studies using a comprehensive socioeconomic framework over the life course ranging from childhood to adulthood. This study therefore aimed to examine the associations of both past and present socioeconomic circumstances with complaints of insomnia. Data were derived from cross-sectional postal surveys (2000-2002) representative of the staff of the City of Helsinki, Finland (n=8960, aged 40-60 years). Socioeconomic circumstances were measured by parental education, childhood economic difficulties, own education, occupational class, household income, housing tenure, and current economic difficulties. Complaints of insomnia during the previous month were measured by difficulties initiating and maintaining sleep and non-restorative sleep. Logistic regression analysis was used, adjusting for age and marital status. Complaints of insomnia at least once a week were reported by 25% of women and 21% of men. Childhood economic difficulties showed associations with complaints of insomnia among both women (OR 1.52; 95% CI 1.31-1.76) and men (OR 2.25; 95% CI 1.67-3.02) even after full adjustments. Also current economic difficulties remained associated with complaints of insomnia, but only among women (OR 1.65; 95% CI 1.41-1.93). However, education, occupational class, and income showed only limited age-adjusted associations with complaints of insomnia and these associations disappeared after full adjustments. Past and present economic difficulties were strongly associated with current complaints of insomnia. Supporting both families with children and adults to cope with their economic difficulties might reduce complaints of insomnia in adulthood.

Difficulties Reported by Hiv-Infected Patients Using Antiretroviral Therapy in Brazil

PubMed Central

Guimarães, Mark Drew Crosland; Rocha, Gustavo Machado; Campos, Lorenza Nogueira; de Freitas, Felipe Melo Teixeira; Gualberto, Felipe Augusto Souza; Teixeira, Ramiro d’Ávila Rivelli; de Castilho, Fábio Morato

2008-01-01

OBJECTIVE To describe the degree of difficulty that HIV-infected patients have with therapy treatment. INTRODUCTION Patients’ perceptions about their treatment are a determinant factor for improved adherence and a better quality of life. METHODS Two cross-sectional analyses were conducted in public AIDS referral centers in Brazil among patients initiating treatment. Patients interviewed at baseline, after one month, and after seven months following the beginning of treatment were asked to classify and justify the degree of difficulty with treatment. Logistic regression was used for analysis. RESULTS Among 406 patients initiating treatment, 350 (86.2%) and 209 (51.5%) returned for their first and third visits, respectively. Treatment perceptions ranged from medium to very difficult for 51.4% and 37.3% on the first and third visits, respectively. The main difficulties reported were adverse reactions to the medication and scheduling. A separate logistic regression indicated that the HIV-seropositive status disclosure, symptoms of anxiety, absence of psychotherapy, higher CD4+ cell count (> 200/mm3) and high (> 4) adverse reaction count reported were independently associated with the degree of difficulty in the first visit, while CDC clinical category A, pill burden (> 7 pills), use of other medications, high (> 4) adverse reaction count reported and low understanding of medical orientation showed independent association for the third visit. CONCLUSIONS A significant level of difficulty was observed with treatment. Our analyses suggest the need for early assessment of difficulties with treatment, highlighting the importance of modifiable factors that may contribute to better adherence to the treatment protocol. PMID:18438569

An Analysis of Technology Transition Within the Department of Defense

DTIC Science & Technology

2010-06-01

relentless adversaries, it is essential that the DoD performs technology transition in a practical yet expedient manner. Time is a critical factor in...themselves, rather than rely on DOD labs to do so—a practice that brings cost and schedule risk since programs may well find themselves addressing problems...that utilized non-traditional, industry practices to abate the difficulties bringing technologies to a suitable maturation state. Albeit these

Family Practice: A Proposed Solution to the Problem of Meeting the Medical Needs of the Community

PubMed Central

McAuley, R. G.

1967-01-01

Difficulties in meeting today's community medical needs are outlined, followed by a proposed solution in which the first-contact physician is the trained family physician. The McMaster Family Practice Course is described. The potential research contribution of a Department of Family Medicine is stressed. PMID:6020551

A Promising Practice: Using Facebook as a Communication and Social Networking Tool

ERIC Educational Resources Information Center

Schultz, Susan M.; Jacobs, Gloria; Schultz, Jacob

2013-01-01

Individuals with autism often face barriers to social interaction. Residing in a rural environment can compound these difficulties for individuals diagnosed with autism. Some of the reasons include transportation problems and small social networks, in addition to the characteristics of autism. This article discusses a promising practice for…

Enhancing the Student Experiment Experience: Visible Scientific Inquiry through a Virtual Chemistry Laboratory

ERIC Educational Resources Information Center

Donnelly, Dermot; O'Reilly, John; McGarr, Oliver

2013-01-01

Practical work is often noted as a core reason many students take on science in secondary schools (high schools). However, there are inherent difficulties associated with classroom practical work that militate against scientific inquiry, an approach espoused by many science educators. The use of interactive simulations to facilitate student…

Digital Literacies in Higher Education: Exploring Textual and Technological Practice

ERIC Educational Resources Information Center

Lea, Mary R.; Jones, Sylvia

2011-01-01

Concerns are frequently raised about undergraduates being so immersed in web-based technologies in their broader lives that they have difficulties engaging in more conventional study practices, such as academic reading and writing essays. The research reported on here examines this issue through a literacies lens. The project findings illustrate…

Fluency Training. NetNews . Volume 4, Number 5

ERIC Educational Resources Information Center

LDA of Minnesota, 2004

2004-01-01

In the past, researchers believed that reading fluency developed as a result of good word recognition skills; however, it is now believed that fluency must be explicitly taught and practiced orally in order to develop. Readers who are not fluent in reading will be less motivated to practice, have more difficulty learning academic content, and…

Current Practice of Extensive Reading in Asia: Teachers' Perceptions

ERIC Educational Resources Information Center

Chang, Anna C.-S.; Renandya, Willy A.

2017-01-01

This study investigated teachers' perceptions of the practice of extensive reading (ER) in the Asian context. One hundred and nineteen L2 teachers in Asia responded to an online questionnaire that probed into their reasons for implementing ER, the difficulties they encountered, and their perception about the effectiveness of different ways of…

Using Microcomputers To Help Learning Disabled Student with Arithmetic Difficulties.

ERIC Educational Resources Information Center

Brevil, Margarette

The use of microcomputers to help the learning disabled increase their arithmetic skills is examined. The microcomputer should be used to aid the learning disabled student to practice the concepts taught by the teacher. Computer-aided instruction such as drill and practice may help the learning disabled student because it gives immediate feedback…

Word of the Day Improves and Redirects Student Attention while Supporting Vocabulary Development

ERIC Educational Resources Information Center

Vesely, Pamela J.; Gryder, Nancy L.

2009-01-01

To learn and master new concepts, including the acquisition of new vocabulary, students must be able to sustain attention during direct instruction, stay focused throughout the guided practice activity, and successfully complete the independent practice assignments. Yet, difficulty with maintaining attention is a common characteristic for students…

Special Education Teachers' Perceptions and Intentions toward Data Collection

ERIC Educational Resources Information Center

Ruble, Lisa A.; McGrew, John H.; Wong, Wing Hang; Missall, Kristen N.

2018-01-01

Although data-based decision making is an evidence-based practice, many special educators have difficulty applying the practice within daily routines. We applied the theory of planned behavior (TPB) to understand the influences that promote or hinder early childhood special educators' intentions to collect data. We assessed three influences on…

A SAS Interface for Bayesian Analysis with WinBUGS

ERIC Educational Resources Information Center

Zhang, Zhiyong; McArdle, John J.; Wang, Lijuan; Hamagami, Fumiaki

2008-01-01

Bayesian methods are becoming very popular despite some practical difficulties in implementation. To assist in the practical application of Bayesian methods, we show how to implement Bayesian analysis with WinBUGS as part of a standard set of SAS routines. This implementation procedure is first illustrated by fitting a multiple regression model…

Language Choice for Science Education: Policy and Practice

ERIC Educational Resources Information Center

Mifsud, Jordan; Farrugia, Josette

2017-01-01

The Maltese National Minimum Curriculum published in 1999 sought to strengthen bilingualism by reinforcing the practice of teaching and assessing some subjects in English and others in Maltese. It also pointed out that code-switching should only be used in cases of severe pedagogical difficulties. As a new National Curriculum Framework was being…

Putting Teachers First: Leading Change through Design--Initiating and Sustaining Effective Teaching of Mathematics

ERIC Educational Resources Information Center

Proffitt-White, Rob

2017-01-01

The Teachers First initiative is a grass-roots cluster-model approach for bringing together primary and secondary teachers and school principals: to analyse student performance data; design and practice activities and assessment tools; and promote teaching practices that address students' learning difficulties in mathematics. The balance of both…

A Model for Determining Student Plagiarism: Electronic Detection and Academic Judgement

ERIC Educational Resources Information Center

Bretag, Tracey; Mahmud, Saadia

2009-01-01

This paper provides insights based on the authors' own practice as university instructors, researchers and arbitrators of student plagiarism. Recognising the difficulty in defining plagiarism while still acknowledging the practical importance of doing so, the authors find the common element between the various types of plagiarism to be the lack of…

Social and Occupational Integration of Disadvantaged People. Leonardo da Vinci Good Practices Series.

ERIC Educational Resources Information Center

Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

This document profiles nine European programs that exemplify good practice in social and occupational integration of disadvantaged people. The programs profiled are as follows: (1) Restaurant Venezia (a CD-ROM program to improve the reading and writing skills of young people in Luxembourg who have learning difficulties); (2) an integrated…

Maternal Dysphoric Mood, Stress, and Parenting Practices in Mothers of Head Start Preschoolers: The Role of Experiential Avoidance

ERIC Educational Resources Information Center

Shea, Sarah E.; Coyne, Lisa W.

2011-01-01

Maternal dysphoria predicts behavioral difficulties in preschool-aged children, and may contribute to negative child outcomes by exacerbating parenting stress. Parenting stress increases the likelihood of maladaptive parenting practices, especially when mothers face multiple contextual stressors. We explored maternal experiential avoidance (EA) as…

Keeping the Best: A Practical Guide to Retaining Key Employees.

ERIC Educational Resources Information Center

Bevan, Stephen; Barber, Linda; Robinson, Dilys

This book, which is intended to assist human resource professionals and line managers in the United Kingdom, is a practical guide to retaining key employees. Discussed in the introduction are the relationship between downsizing and retention, problems that retention difficulties pose for human resource management, and the effects of retention…

Refugee experiences of general practice in countries of resettlement: a literature review.

PubMed

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-03-01

Refugees and asylum seekers often struggle to use general practice services in resettlement countries. To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker's personal experiences of general practice services were identified, coded, and analysed. From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor-patient relationships, and problems with the cultural acceptability of medical care. The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. © British Journal of General Practice 2015.

A Framework for Crosslinguistic Nonword Repetition Tests: Effects of Bilingualism and Socioeconomic Status on Children's Performance

ERIC Educational Resources Information Center

Chiat, Shula; Polišenská, Kamila

2016-01-01

Purpose: As a recognized indicator of language impairment, nonword repetition has unique potential for distinguishing language impairment from difficulties due to limited experience and knowledge of a language. This study focused on a new Crosslinguistic Nonword Repetition framework, comprising 3 tests that vary the phonological characteristics of…

The Relationship between Proficiency in French and Academic Achievement for Students in Saint Martin

ERIC Educational Resources Information Center

Wilson, Martin Ezikiel

2013-01-01

School administrators and educational policy makers have made a substantial effort to address the learning needs of students in Saint Martin, yet the achievement gap between students in Saint Martin and students in metropolitan France still persists. Risk factors such as family structure, socioeconomic status, immigration, and difficulty of…

Early Language Impairments and Developmental Pathways of Emotional Problems across Childhood

ERIC Educational Resources Information Center

Goh Kok Yew, Shaun; O'Kearney, Richard

2015-01-01

Background: Language impairments are associated with an increased likelihood of emotional difficulties later in childhood or adolescence, but little is known about the impact of LI on the growth of emotional problems. Aims: To examine the link between early language status (language impaired (LI), typical language (TL)) and the pattern and…

The Current Status of the Philosophy of Biology

ERIC Educational Resources Information Center

Takacs, Peter; Ruse, Michael

2013-01-01

The philosophy of biology today is one of the most exciting areas of philosophy. It looks critically across the life sciences, teasing out conceptual issues and difficulties bringing to bear the tools of philosophical analysis to achieve clarification and understanding. This essay surveys work in all of the major directions of research:…

Diagnostic Assessment and Treatment of Reading Difficulties: A Case Study of Dyslexia

ERIC Educational Resources Information Center

Oviedo, Paula Outon; Gonzalez, Rebeca Abal

2013-01-01

Dyslexia is a specific learning disability in reading and writing, which requires adequate early intervention to prevent future school failure. We describe the diagnostic assessment of a 7-year-old boy labelled "dyslexic", the evaluation of his family, social, medical, developmental, and academic status as a preliminary for the design…

Behavioral Problems and Reading Difficulties among Language Minority and Monolingual Urban Elementary School Students

ERIC Educational Resources Information Center

Pierce, Margaret E.; Wechsler-Zimring, Adrianna; Noam, Gil; Wolf, Maryanne; Katzir, Tami

2013-01-01

This study examined the potentially compounding effect of language minority (LM) status on problem behaviors among urban second and third grade-level poor readers. Univariate analyses showed that a disproportionate percentage of both LM and English monolingual (L1) poor readers already displayed clinically significant levels of anxiety, social…

Gender and Conduct Problems Predict Peer Functioning among Children with Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Mikami, Amori Yee; Lorenzi, Jill

2011-01-01

Children with attention-deficit/hyperactivity disorder (ADHD) often have poor relationships with peers. However, research on this topic has predominantly focused on boys. This study considered child gender, ADHD status, and dimensionally assessed conduct problems as predictors of peer relationship difficulties. Participants were 125 children (ages…

Ethiopian Youth in Israel: Gender-Related Alcohol Use and Related Problem Behaviour

ERIC Educational Resources Information Center

Isralowitz, Richard; Shpiegel, Svetlana; Reznik, Alex; Laytin, Adam

2009-01-01

Jewish people from Ethiopia have been immigrating to Israel since 1973. Difficulties with language, unemployment; low socioeconomic status and prejudice have been common place and linked to problem behaviour including school drop out, delinquency and drug abuse among Ethiopian youth. This research examines the patterns of alcohol use and related…

Hyperactive and Normal Girls and Boys: Mother-Child Interaction, Parent Psychiatric Status and Child Psychopathology.

ERIC Educational Resources Information Center

Befera, Marilyn Schulte; Barkley, Russell A.

1985-01-01

Hyperactive children were less compliant and more negative than were nonhyperactive controls, and their mothers responded more negatively to their compliance than mothers of nonhyperactive children. Mothers of hyperactive children reported more psychological difficulties in relatives and rated their children as more deviant than nonhyperactive…

Comodulation Masking Release (CMR) in Children and the Influence of Reading Status

ERIC Educational Resources Information Center

Zettler, Cynthia M.; Sevcik, Rose A.; Morris, Robin D.; Clarkson, Marsha G.

2008-01-01

Purpose: Research suggests that children with reading disabilities (RD) have difficulty processing temporal and spectral components of sounds. Comodulation masking release (CMR) measures a listener's ability to use temporal and spectral information in noise to identify a signal. The purpose of this study was to determine whether children with RD…

Barriers Experienced by Mexican Immigrants: Implications for Educational Achievement and Mental Health

ERIC Educational Resources Information Center

Consoli, Melissa L. Morgan; Consoli, Andres J.; Orozco, Graciela Leon; Gonzales, Rufus R.; Vera, Elizabeth M.

2012-01-01

The adversities faced by Latina/o individuals and their families in the U.S. negatively impact educational outcomes as well as their mental and physical health. These adversities are often related to immigration status and acculturation and include difficulties with immigration, language barriers, and discrimination. Given that recent immigrants…

Perceived Barriers for First-Generation Students: Reforms to Level the Terrain

ERIC Educational Resources Information Center

Unverferth, Anthony Richard; Talbert-Johnson, Carolyn; Bogard, Treavor

2012-01-01

This article examines the pervasive difficulties experienced by first-generation students in their quest to attend postsecondary settings. A change in the profile of the undergraduate student body has changed dramatically with respect to first-generation students' age, enrollment status, and family conditions. These students are likely to enter…

Screening for Social, Emotional, and Behavioral Problems at Kindergarten Entry: Utility and Incremental Validity of Parent Report

ERIC Educational Resources Information Center

Owens, Julie Sarno; Storer, Jennifer; Holdaway, Alex S.; Serrano, Verenea J.; Watabe, Yuko; Himawan, Lina K.; Krelko, Rebecca E.; Vause, Katherine J.; Girio-Herrera, Erin; Andrews, Nina

2015-01-01

The current study examined the utility and incremental validity of parent ratings on the Strengths and Difficulties Questionnaire and Disruptive Behavior Disorders rating scale completed at kindergarten registration in identifying risk status as defined by important criterion variables (teacher ratings, daily behavioral performance, and quarterly…

Vocational Education and Training in India: Challenges, Status and Labour Market Outcomes

ERIC Educational Resources Information Center

Agrawal, Tushar

2012-01-01

This paper provides an overview of vocational education and training (VET) system in India, and discusses various challenges and difficulties in the Indian VET system. The paper also examines labour market outcomes of vocational graduates and compares these with those of general secondary graduates using a large-scale nationally representative…

Promotion of Migrant Children's Epistemic Status and Authority in Early School Life

ERIC Educational Resources Information Center

Baraldi, Claudio

2015-01-01

Migrant children may display problems of participation in school interactions with adults and peers, depending on their difficulties in speaking the host country's language and understanding its culture. This condition amplifies the general view of children as incompetent in producing and acting knowledge. This paper analyses video-recorded…

The nuclear arsenals and nuclear disarmament.

PubMed

Barnaby, F

1998-01-01

Current world stockpiles of nuclear weapons and the status of treaties for nuclear disarmament and the ultimate elimination of nuclear weapons are summarised. The need for including stockpiles of civil plutonium in a programme for ending production and disposing of fissile materials is emphasized, and the ultimate difficulty of disposing of the last few nuclear weapons discussed.

How university students with reading difficulties are supported in achieving their goals.

PubMed

Stack-Cutler, Holly L; Parrila, Rauno K; Jokisaari, Markku; Nurmi, Jari-Erik

2015-01-01

We examine (a) what social ties university students with a history of reading difficulty (RD) report assisting them to achieve their goals, (b) outlets available for developing social ties, (c) resources mobilized within these relationships, and (d) the impact of social ties' status on academic achievement. Participants were 107 university students with RD who were currently completing or had recently completed a university degree. Results showed that university students with RD named friends, parents, and significant others (e.g., boy/girlfriend, spouse) as social ties most often. Personal social ties were developed through social media networking sites and within close relationships, and institutional social ties through academic centers and university general services, among others. Resources mobilized among personal and institutional social ties included emotional and social support, advice and planning, writing and studying help, and goal setting. Institutional social ties also afforded job search assistance, accommodations, skill development, financial support, and mental health services. Finally, the status of employed, but not student, social ties explained academic achievement. © Hammill Institute on Disabilities 2013.

ERP evidence for implicit L2 word stress knowledge in listeners of a fixed-stress language.

PubMed

Kóbor, Andrea; Honbolygó, Ferenc; Becker, Angelika B C; Schild, Ulrike; Csépe, Valéria; Friedrich, Claudia K

2018-06-01

Languages with contrastive stress, such as English or German, distinguish some words only via the stress status of their syllables, such as "CONtent" and "conTENT" (capitals indicate a stressed syllable). Listeners with a fixed-stress native language, such as Hungarian, have difficulties in explicitly discriminating variation of the stress position in a second language (L2). However, Event-Related Potentials (ERPs) indicate that Hungarian listeners implicitly notice variation from their native fixed-stress pattern. Here we used ERPs to investigate Hungarian listeners' implicit L2 processing. In a cross-modal word fragment priming experiment, we presented spoken stressed and unstressed German word onsets (primes) followed by printed versions of initially stressed and initially unstressed German words (targets). ERPs reflected stress priming exerted by both prime types. This indicates that Hungarian listeners implicitly linked German words with the stress status of the primes. Thus, the formerly described explicit stress discrimination difficulty associated with a fixed-stress native language does not generalize to implicit aspects of L2 word stress processing. Copyright © 2018 Elsevier B.V. All rights reserved.

[Psychosocial and socioeconomic factors related to insomnia and menopause: Pró-Saúde Study].

PubMed

Robaina, Jaqueline Rodrigues; Lopes, Claudia S; Rotenberg, Lúcia; Faerstein, Eduardo

2015-03-01

This study evaluated the association between insomnia and menopausal status and the influence of socioeconomic and psychosocial variables on this association in a cross-sectional analysis of 2,190 university employees (the Pró-Saúde Study). A self-administered questionnaire was used, covering menopausal status, complaints of insomnia, common mental disorders, stressful life events, social support, and socioeconomic variables. Odds ratios were calculated using logistic regression with a polytomous outcome. After adjusting for potential socio-demographic confounders, women who had entered menopause more than 60 months previously were more likely to report complaints with sleep (OR 1.53-1.86) as compared to women in menopause for less than 60 months. After adjusting for psychosocial variables, in the first group the ORs decreased to 1.53 (95%CI: 0.92-2.52) for difficulty initiating sleep, 1.81 (95%CI: 1.09-2.98) for difficulty maintaining sleep, and 1.71 (95%CI: 1.08-2.73) for general complaints of insomnia. Psychosocial factors can mediate the manifestation of insomnia among menopausal women.

Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research

PubMed Central

Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E.

2013-01-01

Background Body image is a critical psychosocial issue for cancer patients as they often undergo significant changes to appearance and functioning. In this review article, our primary purpose was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. Methods We provided an overview of theoretical models of body image relevant to cancer patients, and presented findings from published literature on body image and cancer from 2003–2013. We integrated these data with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Results Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. We identified potential indicators of body image difficulties to alert healthcare professionals when to refer patients for psychosocial care, and proposed a framework for approaching conversations about body image that can be used by the oncologic treatment team. Conclusions Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the healthcare communication literature to develop practical strategies for treating body image concerns of cancer patients. PMID:24895287

Managing body image difficulties of adult cancer patients: lessons from available research.

PubMed

Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E

2014-03-01

Body image is a critical psychosocial issue for patients with cancer because they often undergo significant changes to appearance and functioning. The primary purpose of this review article was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. An overview was provided of theoretical models of body image relevant to cancer patients, and findings were presented from published literature on body image and cancer from 2003 to 2013. These data were integrated with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. Potential indicators of body image difficulties were identified to alert health care professionals when to refer patients for psychosocial care, and a framework was proposed for approaching conversations about body image that can be used by the oncologic treatment team. Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the health care communication literature to develop practical strategies for treating body image concerns of patients with cancer. © 2013 American Cancer Society.

Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry.

PubMed

Khariton, Yevgeniy; Hernandez, Adrian F; Fonarow, Gregg C; Sharma, Puza P; Duffy, Carol I; Thomas, Laine; Mi, Xiaojuan; Albert, Nancy M; Butler, Javed; McCague, Kevin; Nassif, Michael E; Williams, Fredonia B; DeVore, Adam; Patterson, J Herbert; Spertus, John A

2018-04-01

Although a key treatment goal for patients with heart failure with reduced ejection fraction is to optimize their health status (their symptoms, function, and quality of life), the variability across outpatient practices in achieving this goal is unknown. In the CHAMP-HF (Change the Management of Patients With Heart Failure) registry, associations between baseline practice characteristics and Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary (OS) and Symptom Frequency (SF) scores were assessed in 3494 patients across 140 US practices using hierarchical regression after accounting for 23 patient and 11 treatment characteristics. We then calculated an adjusted median odds ratio to quantify the average difference in likelihood that a patient would have excellent (KCCQ-OS, ≥75) health status or minimal (monthly or fewer) symptoms (KCCQ-SF, ≥75) when treated at one practice versus another, at random. The mean (±SD) KCCQ-OS and KCCQ-SF were 64.2±24 and 68.9±25.6, with 40% (n=1380) and 50% (n=1760) having KCCQ scores ≥75, respectively. The adjusted median odds ratio across practices, for KCCQ-OS ≥75, was 1.70 (95% confidence interval, 1.54-1.99; P <0.001) indicating a median 70% higher odds of a patient having good-to-excellent health status when treated at one random practice versus another. In regard to KCCQ-SF, the adjusted median odds ratio for KCCQ-SF ≥75 was 1.54 (95% confidence interval, 1.41-1.76; P =0.001). In a large, contemporary registry of outpatients with chronic heart failure with reduced ejection fraction, we observed significant practice-level variability in patients' health status. Quantifying patients' health status as a measure of quality should be explored as a foundation for improving care. URL: https://www.centerwatch.com. Unique identifier: TX144901. © 2018 American Heart Association, Inc.

The influence of maternal psychosocial circumstances and physical environment on the risk of severe wasting in rural Gambian infants: a mixed methods approach.

PubMed

Nabwera, Helen M; Moore, Sophie E; Mwangome, Martha K; Molyneux, Sassy C; Darboe, Momodou K; Camara-Trawally, Nyima; Sonko, Bakary; Darboe, Alhagie; Singhateh, Seedy; Fulford, Anthony J; Prentice, Andrew M

2018-01-06

Severe wasting affects 16 million under 5's and carries an immediate risk of death. Prevalence remains unacceptably high in sub-Saharan Africa and early infancy is a high-risk period. We aimed to explore risk factors for severe wasting in rural Gambian infants. We undertook a case-control study from November 2014 to June 2015, in rural Gambia. Cases had WHO standard weight-for-length z-scores (WLZ) < -3 on at least 1 occasion in infancy. Controls with a WLZ > -3 in the same interval, matched on age, gender, village size and distance from the clinic were selected. Standard questionnaires were used to assess maternal socioeconomic status, water sanitation and hygiene and maternal mental health. Conditional logistic regression using a multivariable model was used to determine the risk factors for severe wasting. Qualitative in depth interviews were conducted with mothers and fathers who were purposively sampled. A thematic framework was used to analyse the in-depth interviews. Two hundred and eighty (77 cases and 203 controls) children were recruited. In-depth interviews were conducted with 16 mothers, 3 fathers and 4 research staff members. The mean age of introduction of complementary feeds was similar between cases and controls (5.2 [SD 1.2] vs 5.1 [SD 1.3] months). Increased odds of severe wasting were associated with increased frequency of complementary feeds (range 1-8) [adjusted OR 2.06 (95%: 1.17-3.62), p = 0.01]. Maternal adherence to the recommended infant care practices was influenced by her social support networks, most importantly her husband, by infant feeding difficulties and maternal psychosocial stressors that include death of a child or spouse, recurrent ill health of child and lack of autonomy in child spacing. In rural Gambia, inappropriate infant feeding practices were associated with severe wasting in infants. Additionally, adverse psychosocial circumstances and infant feeding difficulties constrain mothers from practising the recommended child care practices. Interventions that promote maternal resilience through gender empowerment, prioritising maternal psychosocial support and encouraging the involvement of fathers in infant and child care promotion strategies, would help prevent severe wasting in these infants.

Upper Elementary Reading Instruction in the Age of Accountability: Balancing Best Practices with Pressures to Achieve on High-Stakes Tests

ERIC Educational Resources Information Center

Saunders, Christina Henry

2017-01-01

The present study identifies reading instructional practices used in upper elementary classrooms during the age of high-stakes test accountability and compares reading practices among schools of varying accreditation status and socio-economic status (SES). The current study partially replicates and extends a study conducted by Baumann, Hoffman,…

Status of Biology Laboratory and Practical Activities in Some Selected Secondary and Preparatory Schools of Borena Zone, South Ethiopia

ERIC Educational Resources Information Center

Daba, Tolessa Muleta; Anbassa, Baressa; Oda, Bula Kere; Degefa, Itefa

2016-01-01

Science laboratory is a very important resource input for teaching science. Learning science is enhanced and the understanding level is improved when students are engaged in science laboratory for practical experiments. The current study aimed to assess the status of Biology laboratory and practical activities in some selected secondary and…

Australian employer usage of the practice of offering reduced working hours to workers close to retirement: Extent and determinants.

PubMed

Taylor, Philip; Earl, Catherine; McLoughlin, Christopher

2016-06-01

This study aimed to determine factors associated with the implementation by employers of the practice of offering reduced working hours for workers nearing retirement. Data came from a survey of 2000 employers of more than 50 employees each (30% response rate). A minority (33%) of employers offered reduced working hours to older workers nearing retirement. Factors associated with offering reduced working hours were: expecting workforce ageing to cause a loss of staff to retirement; being a large employer; being a public/not-for-profit sector employer; not experiencing difficulties recruiting labourers; having a larger proportion of workers aged over 50; experiencing national competition for labour; not experiencing difficulties recruiting machinery operators/drivers; not expecting workforce ageing to increase workplace injuries; and experiencing difficulties with the quality of candidates. A minority of employers were found to offer reduced working hours to those nearing retirement. Factors associated with their propensity to do so included industry sector, size of employer, concerns about labour supply and the effects of workforce ageing. © 2016 AJA Inc.