"The Whole Family Suffered, so the Whole Family Needs to Recover": Thematic Analysis of Substance-Abusing Mothers' Family Therapy Sessions.

PubMed

Brakenhoff, Brittany; Slesnick, Natasha

2015-03-01

Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children's discussion during family therapy. Mothers' ages ranged from 28 to 35 years and the children's ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families' ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology.

The art of being healthy: a qualitative study to develop a thematic framework for understanding the relationship between health and the arts

PubMed Central

Davies, Christina R; Knuiman, Matthew; Wright, Peter; Rosenberg, Michael

2014-01-01

Objective In recent years the health–arts nexus has received increasing attention; however, the relationship is not well understood and the extent of possible positive, negative and unintended outcomes is unknown. Guided by the biopsychosocial model of health and theories of social epidemiology, the aim of this study was to develop a framework pertaining to the relationship between arts engagement and population health that included outcomes, confounders and effect modifiers. A health–arts framework is of value to researchers seeking to build the evidence base; health professionals interested in understanding the health–arts relationship, especially those who use social prescribing for health promotion or to complement treatments; in teaching medical, nursing and health-science students about arts outcomes, as well as artists and health professionals in the development of policy and programmes. Design A qualitative study was conducted. Semistructured interviews were analysed thematically. Setting Western Australia. Participants 33 Western Australian adults (18+ years). Participants were randomly selected from a pool of general population nominees who engaged in the arts for enjoyment, entertainment or as a hobby (response rate=100%). Results A thematic analysis was conducted using QSR-NVivo10. The resulting framework contained seven outcome themes and 63 subthemes. Three themes specifically related to health, that is, mental, social and physical health, while economic, knowledge, art and identity outcomes were classified as health determinants. Within each theme, positive, negative and unintended outcomes (subthemes) were identified and categorised as relating to the individual and/or to the community. A list of confounding and/or effect modifying factors, related to both the arts and health, was identified. Conclusions Given the increasing pressure on health resources, the arts have the potential to assist in the promotion of health and healing. This framework expands on current knowledge, further defines the health–arts relationship and is a step towards the conceptualisation of a causal health–arts model. PMID:24770587

A conceptual framework of clinical nursing care in intensive care.

PubMed

da Silva, Rafael Celestino; Ferreira, Márcia de Assunção; Apostolidis, Thémistoklis; Brandão, Marcos Antônio Gomes

2015-01-01

to propose a conceptual framework for clinical nursing care in intensive care. descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software. the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks. the conceptual framework of the clinic's intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization.

Emergency Department Staff Beliefs About Self-Harm: A Thematic Framework Analysis.

PubMed

Koning, Kate Louise; McNaught, Angela; Tuffin, Keith

2017-11-03

To explore the beliefs and attitudes of emergency department staff about self-harm behaviour. Existing studies looking at views regarding self-harm rely solely on the information provided by medical and nursing staff using a questionnaire format. No studies currently consider ancillary staff members' beliefs about self-harm, even though they also work with these patients. A thematic framework analysis of interview transcripts was carried out. Individual semi-structured interviews were conducted from December 2015 to February 2016. Fifteen medical, nursing, and ancillary staff members from a large, tertiary emergency department participated. There were 5 major themes identified-causes of self-harm are multifactorial; beliefs about self-harm can change over time; emergency departments should only focus on the physical; self-harm occurs on a spectrum; and the system has failed. The results suggest participants felt ill-prepared and lacking in appropriate training to help patients that self-harm, and furthermore they have little faith in the mental health system. Staff beliefs and attitudes may change over time with exposure to patients who self-harm, possibly becoming more positive in response to a greater understanding of why the self-harm behaviour is occurring.

African Primary Care Research: Qualitative data analysis and writing results

PubMed Central

Govender, Indiran; Ogunbanjo, Gboyega A.; Mash, Bob

2014-01-01

Abstract This article is part of a series on African primary care research and gives practical guidance on qualitative data analysis and the presentation of qualitative findings. After an overview of qualitative methods and analytical approaches, the article focuses particularly on content analysis, using the framework method as an example. The steps of familiarisation, creating a thematic index, indexing, charting, interpretation and confirmation are described. Key concepts with regard to establishing the quality and trustworthiness of data analysis are described. Finally, an approach to the presentation of qualitative findings is given. PMID:26245437

African Primary Care Research: qualitative data analysis and writing results.

PubMed

Mabuza, Langalibalele H; Govender, Indiran; Ogunbanjo, Gboyega A; Mash, Bob

2014-06-05

This article is part of a series on African primary care research and gives practical guidance on qualitative data analysis and the presentation of qualitative findings. After an overview of qualitative methods and analytical approaches, the article focuses particularly on content analysis, using the framework method as an example. The steps of familiarisation, creating a thematic index, indexing, charting, interpretation and confirmation are described. Key concepts with regard to establishing the quality and trustworthiness of data analysis are described. Finally, an approach to the presentation of qualitative findings is given.

Connecting Effective Instruction and Technology. Intel-elebration: Safari.

ERIC Educational Resources Information Center

Burton, Larry D.; Prest, Sharon

Intel-ebration is an attempt to integrate the following research-based instructional frameworks and strategies: (1) dimensions of learning; (2) multiple intelligences; (3) thematic instruction; (4) cooperative learning; (5) project-based learning; and (6) instructional technology. This paper presents a thematic unit on safari, using the…

"We're the Mob You Should Be Listening to": Aboriginal Elders at Mornington Island Speak up about Productive Relationships with Visiting Teachers

ERIC Educational Resources Information Center

Bond, Hilary

2010-01-01

This paper explores, with a qualitative framework, critical social theory and thematic analysis, the narratives of many Aboriginal elders of Mornington Island (Kunhanhaa) about their history and their potential to form productive kin-based relationships with visiting teachers in order to influence the curriculum and pedagogy delivered at the local…

“The Whole Family Suffered, so the Whole Family Needs to Recover”: Thematic Analysis of Substance-Abusing Mothers’ Family Therapy Sessions

PubMed Central

Brakenhoff, Brittany; Slesnick, Natasha

2014-01-01

Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children’s discussion during family therapy. Mothers’ ages ranged from 28 to 35 years and the children’s ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families’ ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology. PMID:25729116

Deliberate teaching tools for clinical teaching encounters: A critical scoping review and thematic analysis to establish definitional clarity.

PubMed

Sidhu, Navdeep S; Edwards, Morgan

2018-04-27

We conducted a scoping review of tools designed to add structure to clinical teaching, with a thematic analysis to establish definitional clarity. Six thousand and forty nine citations were screened, 434 reviewed for eligibility, and 230 identified as meeting study inclusion criteria. Eighty-nine names and 51 definitions were identified. Based on a post facto thematic analysis, we propose that these tools be named "deliberate teaching tools" (DTTs) and defined as "frameworks that enable clinicians to have a purposeful and considered approach to teaching encounters by incorporating elements identified with good teaching practice." We identified 46 DTTs in the literature, with 38 (82.6%) originally described for the medical setting. Forty justification articles consisted of 16 feedback surveys, 13 controlled trials, seven pre-post intervention studies with no control group, and four observation studies. Current evidence of efficacy is not entirely conclusive, and many studies contain methodology flaws. Forty-nine clarification articles comprised 12 systematic reviews and 37 narrative reviews. The most number of DTTs described by any review was four. A common design theme was identified in approximately three-quarters of DTTs. Applicability of DTTs to specific alternate settings should be considered in context, and appropriately designed justification studies are warranted to demonstrate efficacy.

A Thematic Analysis of Self-described Authentic Leadership Behaviors Among Experienced Nurse Executives.

PubMed

Alexander, Catherine; Lopez, Ruth Palan

2018-01-01

The aim of this study is to understand the behaviors experienced nurse executives use to create healthy work environments (HWEs). The constructs of authentic leadership formed the conceptual framework for the study. The American Association of Critical-Care Nurses recommends authentic leadership as the preferred style of leadership for creating and sustaining HWEs. Behaviors associated with authentic leadership in nursing are not well understood. A purposive sample of 17 experienced nurse executives were recruited from across the United States for this qualitative study. Thematic analysis was used to analyze the in-depth, semistructured interviews. Four constructs of authentic leaders were supported and suggest unique applications of each including self-awareness (a private and professional self), balanced processing (open hearted), transparency (limiting exposure), and moral leadership (nursing compass). Authentic leadership may provide a sound foundation to support nursing leadership practices; however, its application to the discipline requires additional investigation.

An empirically based conceptual framework for fostering meaningful patient engagement in research.

PubMed

Hamilton, Clayon B; Hoens, Alison M; Backman, Catherine L; McKinnon, Annette M; McQuitty, Shanon; English, Kelly; Li, Linda C

2018-02-01

Patient engagement in research (PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data. To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective. We conducted a qualitative secondary analysis of in-depth interviews with 18 patient research partners from a research centre-affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team. Participants' experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team. The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient-researcher partnerships are led by researchers with little experience of engaging patients in research. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Creating the environment for driver distraction: A thematic framework of sociotechnical factors.

PubMed

Parnell, Katie J; Stanton, Neville A; Plant, Katherine L

2018-04-01

As modern society becomes more reliant on technology, its use within the vehicle is becoming a concern for road safety due to both portable and built-in devices offering sources of distraction. While the effects of distracting technologies are well documented, little is known about the causal factors that lead to the drivers' engagement with technological devices. The relevance of the sociotechnical system within which the behaviour occurs requires further research. This paper presents two experiments, the first aims to assess the drivers self-reported decision to engage with technological tasks while driving and their reasoning for doing so with respect to the wider sociotechnical system. This utilised a semi-structured interview method, conducted with 30 drivers to initiate a discussion on their likelihood of engaging with 22 different tasks across 7 different road types. Inductive thematic analysis provided a hierarchical thematic framework that detailed the self-reported causal factors that influence the drivers' use of technology whilst driving. The second experiment assessed the relevance of the hierarchical framework to a model of distraction that was established from within the literature on the drivers use of distracting technologies while driving. The findings provide validation for some relationships studied in the literature, as well as providing insights into relationships that require further study. The role of the sociotechnical system in the engagement of distractions while driving is highlighted, with the causal factors reported by drivers suggesting the importance of considering the wider system within which the behaviour is occurring and how it may be creating the conditions for distraction to occur. This supports previous claims made within the literature based model. Recommendations are proposed that encourage a movement away from individual focused countermeasures towards systemic actors. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Thematic Approach to Regional Geography

ERIC Educational Resources Information Center

Walter, Bob J.; Bernard, Frank E.

1973-01-01

An innovative, thematic approach to the teaching of African geography is offered in an attempt to modernize African regional geography, bring it in phase with the rest of the discipline, and emphasize the essential unity of the spatial viewpoint. Five themes are used as the framework for providing an integrating overview of the continent and its…

Literature Frameworks: From Apples to Zoos. Second Edition. Professional Growth Series.

ERIC Educational Resources Information Center

McElmeel, Sharron L.

Intended for use by teachers in preschool through intermediate grade classrooms, library media specialists, and other educators, this book presents 26 literature frameworks that involve students in reading and sharing literature in connection with thematic units. Each framework suggests books and literature-related materials to coincide with…

Literature Frameworks--From Apples to Zoos. Professional Growth Series.

ERIC Educational Resources Information Center

McElmeel, Sharron L.

Intended for use by teachers in preschool through intermediate grade classrooms, library media specialists, and other educators, this book presents 26 literature frameworks that involve students in reading and sharing literature in connection with thematic units. Each framework suggests books and literature-related materials to coincide with…

Person-centred rehabilitation: what exactly does it mean? Protocol for a scoping review with thematic analysis towards framing the concept and practice of person-centred rehabilitation

PubMed Central

Bright, Felicity; Kayes, Nicola; Cott, Cheryl A

2016-01-01

Introduction Person-centredness is a philosophy for organising and delivering healthcare based on patients’ needs, preferences and experiences. Although widely endorsed, the concept suffers from a lack of detail and clarification, in turn accounting for ambiguous implementation and outcomes. While a conceptual framework based on a systematic review defines person/patient-centred care components (Scholl et al, 2014), it applies across healthcare contexts and may not be sensitive to the nuances of the rehabilitation of adults with physical impairments. Accordingly, this study aims to build a conceptual framework, based on existing literature, of what person-centredness means in the rehabilitation of adults with physical impairments in the clinical encounter and broader health service delivery. Methods and analysis We will use a scoping review methodology. Searches on relevant databases will be conducted first, combining keywords for ‘rehabilitation’, ‘person-centered’ and associated terms (including patient preferences/experiences). Next, snowball searches (citation tracking, references lists) will be performed. Papers will be included if they fall within predefined selection categories (seen as most likely informative on elements pertaining to person-centred rehabilitation) and are written in English, regardless of design (conceptual, qualitative, quantitative). Two reviewers will independently screen titles and abstracts, followed by screening of the full text to determine inclusion. Experts will then be consulted to identify relevant missing papers. This can include elements other than the peer-reviewed literature (eg, book chapters, policy/legal papers). Finally, information that helps to build the concept and practice of person-centred rehabilitation will be abstracted independently by two reviewers and analysed by inductive thematic analysis to build the conceptual framework. Dissemination The resulting framework will aid clarification regarding person-centred rehabilitation, which in turn is expected to conceptually ground and inform its operationalisation (eg, measurement, implementation, improvement). Findings will be disseminated through local, national and international stakeholders, both at the clinical and service organisation levels. PMID:27436670

Qualitative Research in Palliative Care: Applications to Clinical Trials Work.

PubMed

Lim, Christopher T; Tadmor, Avia; Fujisawa, Daisuke; MacDonald, James J; Gallagher, Emily R; Eusebio, Justin; Jackson, Vicki A; Temel, Jennifer S; Greer, Joseph A; Hagan, Teresa; Park, Elyse R

2017-08-01

While vast opportunities for using qualitative methods exist within palliative care research, few studies provide practical advice for researchers and clinicians as a roadmap to identify and utilize such opportunities. To provide palliative care clinicians and researchers descriptions of qualitative methodology applied to innovative research questions relative to palliative care research and define basic concepts in qualitative research. Body: We describe three qualitative projects as exemplars to describe major concepts in qualitative analysis of early palliative care: (1) a descriptive analysis of clinician documentation in the electronic health record, (2) a thematic content analysis of palliative care clinician focus groups, and (3) a framework analysis of audio-recorded encounters between patients and clinicians as part of a clinical trial. This study provides a foundation for undertaking qualitative research within palliative care and serves as a framework for use by other palliative care researchers interested in qualitative methodologies.

Health Seeking in Men: A Concept Analysis.

PubMed

Hooper, Gwendolyn L; Quallich, Susanne A

2016-01-01

This article describes the analysis of the concept of health seeking in men. Men have shorter life expectancies and utilize health services less often than women, leading to poor health outcomes, but a gendered basis for health seeking remains poorly defined. Walker and Avant’s framework was used to guide this concept analysis. Literature published in English from 1990-2015 was reviewed. Thematic analysis identified attributes, antecedents, and consequences of the concept. Based on the analysis, a contemporary definition for health seeking in men was constructed, rooted in the concept of health. The definition is based on the concept analysis and the defining attributes that were identified. This analysis provides a definition specifically for health seeking in American men, making it more specific and gender-based than the parent concept of “health.” This concept analysis provides conceptual clarity that can guide development of a conceptual framework that may be uniquely relevant to providers in urology. Further exploration will uncover specific cultural, social, sexual, and geographic perspectives.

Thematic versus Subject-Based Curriculum Delivery and Achievement Goals: Findings from a Single-School Study

ERIC Educational Resources Information Center

Putwain, Dave; Whiteley, Helen; Caddick, Lee

2011-01-01

Background: It has been claimed that thematic or integrated approaches to curriculum delivery offer a range of advantages over subject-based modes of delivery including improved pupil motivation. Purpose: This study put claims regarding pupil motivation to the test, using the achievement goals framework. This contemporary approach to understanding…

Questioning diagnoses in clinical practice: a thematic analysis of clinical psychologists' accounts of working beyond diagnosis in the United Kingdom.

PubMed

Randall-James, James; Coles, Steven

2018-02-08

The British Psychological Society proposes that clinical psychologists are well placed to move beyond psychiatric diagnoses and develop alternative practices. This study sought to explore what the application of these guiding principles looks like in clinical practice, the challenges faced and possible routes forward. A purpose-designed survey was completed by 305 respondents and a thematic analysis completed. Thematic analysis was used to identify five superordinate themes relating to individuals, relational, others, structures and society, comprising of a total of 21 group themes. The presented group themes highlight an array of approaches to practicing beyond diagnosis and factors that help and hinder such action; from scaffolding change, becoming leaders, relating to the multi-disciplinary team, restructuring services and the processes of change. A key concept was "playing the diagnostic game". "Playing the diagnostic game" enables psychologists to manage an array of tensions and anxieties: conflicts between belief and practice, relationships with colleagues, and dilemmas of position and power. It also potentially limits a concerted questioning of diagnosis and consideration of alternatives. An alternative conceptual framework for non-diagnostic practice is needed to aid the collective efforts of clinical psychologists developing their practice beyond diagnosis, some of which have been highlighted in this study. Until then, ways of mitigating the perceived threats to questioning diagnosis need further exploration, theorising and backing.

A method for studying decision-making by guideline development groups.

PubMed

Gardner, Benjamin; Davidson, Rosemary; McAteer, John; Michie, Susan

2009-08-05

Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG. This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.

[Challenges for the construction of 'Health and Environment "in view of its Thematic Group in the Brazilian Association of Collective Health].

PubMed

Augusto, Lia Giraldo da Silva; Tambellini, Anamaria Testa; de Miranda, Ary Carvalho; Carneiro, Fernando Ferreira; Castro, Hermano; Porto, Marcelo Firpo de Souza; Rigotto, Raquel Maria; Schütz, Gabriel Eduardo

2014-10-01

'Health and Environment' is the nucleus of knowledge and practices surrounding the relations between society and nature, mediated by the mode of production and human labor, which help to understand the determination of the health-disease process of different social classes and groups. This paper discusses the challenges to build this field from the perspective of its Thematic Group of the Association of Collective Health. The three core themes of the 2nd Brazilian Symposium on Environmental Health are taken as the theoretical framework for analysis. A timeline of the group's trajectory, in its historical context, helps to identify the contemporary challenges. Among the main challenges identified, the challenge of building an interdisciplinary, intersectoral and participatory scientific practice, which could build knowledge and dialogue with social movements, is highlighted.

Iterative categorization (IC): a systematic technique for analysing qualitative data

PubMed Central

2016-01-01

Abstract The processes of analysing qualitative data, particularly the stage between coding and publication, are often vague and/or poorly explained within addiction science and research more broadly. A simple but rigorous and transparent technique for analysing qualitative textual data, developed within the field of addiction, is described. The technique, iterative categorization (IC), is suitable for use with inductive and deductive codes and can support a range of common analytical approaches, e.g. thematic analysis, Framework, constant comparison, analytical induction, content analysis, conversational analysis, discourse analysis, interpretative phenomenological analysis and narrative analysis. Once the data have been coded, the only software required is a standard word processing package. Worked examples are provided. PMID:26806155

Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling.

PubMed

Cragun, Deborah; Zierhut, Heather

2018-02-01

Conceptual frameworks bring together existing theories and models in order to identify, consolidate, and fill in gaps between theory, practice, and evidence. Given the vast number of possible outcomes that could be studied in genetic counseling, a framework for organizing outcomes and postulating relationships between communication services and genetic counseling outcomes was sought. Through an iterative approach involving literature review, thematic analysis, and consolidation, outcomes and processes were categorized to create and define components of a conceptual framework. The final product, "Framework for Outcomes of Clinical commUnication Services" (FOCUS) contains the following domains: communication strategy; communication process measures; patient care experience, patient changes, patient health; and family changes. A website was created to allow easier access and ongoing modifications to the framework. In addition, a step-by-step guide and two examples were created to show flexibility in how the framework can be used. FOCUS may help in conceptualizing, organizing and summarizing outcomes research related to risk communication and counseling in genetic service delivery as well as other healthcare settings.

An overview of infusing service-learning in medical education.

PubMed

Stewart, Trae; Wubbena, Zane

2014-08-04

To identify and review existing empirical research about service-learning and medical education and then to develop a framework for infusing service-learning in Doctor of Medicine or Doctor of Osteopathic Medicine curricula. We selected literature on service-learning and medical education. Articles were screened with a protocol for inclusion or exclusion at two separate stages. At stage one, articles were screened according to their titles, abstracts, and keywords. The second stage involved a full-text review. Finally, a thematic analysis using focused and selective coding was conducted. Eighteen studies were analyzed spanning the years 1998 to 2012. The results from our analysis informed the development of a four-stage service-learning framework: 1) planning and preparation, 2) action, 3) reflection and demonstration, and 4) assessment and celebration. The presented service-learning framework can be used to develop curricula for the infusion of service-learning in medical school. Service-learning curricula in medical education have the potential to provide myriad benefits to faculty, students, community members, and university-community partnerships.

Understanding Online Teacher Best Practices: A Thematic Analysis to Improve Learning

ERIC Educational Resources Information Center

Corry, Michael; Ianacone, Robert; Stella, Julie

2014-01-01

The purpose of this study was to examine brick-and-mortar and online teacher best practice themes using thematic analysis and a newly developed theory-based analytic process entitled Synthesized Thematic Analysis Criteria (STAC). The STAC was developed to facilitate the meaningful thematic analysis of research based best practices of K-12…

Global Inventory of Regional and National Qualifications Frameworks. Volume I: Thematic Chapters

ERIC Educational Resources Information Center

Deij, Arjen; Graham, Michael; Bjornavold, Jens; Grm, Slava Pevec; Villalba, Ernesto; Christensen, Hanne; Chakroun, Borhene; Daelman, Katrien; Carlsen, Arne; Singh, Madhu

2015-01-01

The "Global Inventory of Regional and National Qualifications Frameworks," the result of collaborative work between the European Training Foundation (ETF), the European Centre for the Development of Vocational Training (Cedefop), UNESCO [United Nations Educational, Scientific and Cultural Organization] and UIL [UNESCO Institute for…

[History of care to women in the Maternity Carmela Dutra, Florianópolis-SC, Brazil (1956-2001)].

PubMed

Gregório, Vitoria Regina Petters; Padilha, Maria Itayra Coelho de Souza

2012-01-01

This study examines the practices of care developed by nurses to women at Maternity Carmela Dutra, Florianópolis, Santa Catarina state, Brazil, in the period 1956 to 2001. It is a qualitative research with socio-historical approach. Nine nurses were interviewed using the technique of thematic oral history. The data were categorized using thematic content analysis and based on the foulcaultian theoretical framework. Four categories emerged: Context of Motherhood; care practices to women on admission; care practices to women on childbirth and care practices to women on puerperium. It was concluded that the care provided to women at the Maternity has been exercised by religious and midwives, nurses and lay nurse midwives, a path that goes from laic to professional care, intercalated with knowledge-power relationships marked by struggles and resistances to doctor's hegemony of that time.

Mapping Science in Discourse-based Inquiry Classrooms

NASA Astrophysics Data System (ADS)

Yeneayhu, Demeke Gesesse

Abstract The purpose of this study was to investigate how discourse-based inquiry science lessons provided opportunities for students to develop a network of semantic relations among core ideas and concepts in science. It was a naturalistic inquiry classroom lessons observation study on three science teachers--- a middle school science teacher and two high school physics teachers in an urban school district located in the Western New York region. Discourse and thematic analysis drawn from the theory of Systemic Functional Linguistics were utilized as guiding framework and analysis tools. Analysis of the pre-observation and post-observation interviews of the participant teachers revealed that all of the three teachers participated in at least one inquiry-based science teaching teacher professional development program and they all thought their classroom teaching practice was inquiry-based. Analysis of their classroom lesson videos that each participant teacher taught on a specific science topic revealed that the middle school teacher was found to be a traditional teacher-dominated classroom whereas the two high school physics teachers' classroom teaching approach was found to be discourse-based inquiry. One of the physics teachers who taught on a topic of Magnetic Interaction used relatively structured and guided-inquiry classroom investigations. The other physics teacher who taught on a topic of Color Mixing utilized open-ended classroom investigations where the students planned and executed the series of classroom science investigations with minimal guidance from the teacher. The traditional teacher-based classroom communicative pattern was found to be dominated by Triadic Dialogue and most of the science thematics were jointly developed by the teacher and the students, but the students' role was limited to providing responses to the teacher's series questions. In the guided-inquiry classroom, the common communicative pattern was found to be True Dialogue and most of the science thematic patterns in the lessons were not only developed by the students but also resemble the standard thematics. Similarly, in the open-ended inquiry classroom, True Dialogue and Cross-discussion were the two most common communicative patterns and students did most of the science thematic patterns in the lessons but most of the student thematics were commonsense than resembling the standard thematics on the topic. This research showed that if teachers are to help students participate in classroom discourse that would enable them meaningfully connects core ideas and concepts in science, teachers could use various discourse tools and pedagogic resources that could fit into their particular classroom realities and contexts. This study demonstrated that when given the opportunity, students in challenging contexts such in typical inner city schools are able to engage in scientific processes and develop nuanced understandings of scientific phenomena.

Fit for purpose? Validation of a conceptual framework for personal recovery with current mental health consumers.

PubMed

Bird, Victoria; Leamy, Mary; Tew, Jerry; Le Boutillier, Clair; Williams, Julie; Slade, Mike

2014-07-01

Mental health services in the UK, Australia and other Anglophone countries have moved towards supporting personal recovery as a primary orientation. To provide an empirically grounded foundation to identify and evaluate recovery-oriented interventions, we previously published a conceptual framework of personal recovery based on a systematic review and narrative synthesis of existing models. Our objective was to test the validity and relevance of this framework for people currently using mental health services. Seven focus groups were conducted with 48 current mental health consumers in three NHS trusts across England, as part of the REFOCUS Trial. Consumers were asked about the meaning and their experience of personal recovery. Deductive and inductive thematic analysis applying a constant comparison approach was used to analyse the data. The analysis aimed to explore the validity of the categories within the conceptual framework, and to highlight any areas of difference between the conceptual framework and the themes generated from new data collected from the focus groups. Both the inductive and deductive analysis broadly validated the conceptual framework, with the super-ordinate categories Connectedness, Hope and optimism, Identity, Meaning and purpose, and Empowerment (CHIME) evident in the analysis. Three areas of difference were, however, apparent in the inductive analysis. These included practical support; a greater emphasis on issues around diagnosis and medication; and scepticism surrounding recovery. This study suggests that the conceptual framework of personal recovery provides a defensible theoretical base for clinical and research purposes which is valid for use with current consumers. However, the three areas of difference further stress the individual nature of recovery and the need for an understanding of the population and context under investigation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Thematic Processes in the Comprehension of Technical Prose.

DTIC Science & Technology

1982-02-20

theoretical framework for this process is that the important content of a passage is constructed by the reader based on the semantic content of the...against actual reader behavior. These models represent the general theoretical framework in a highly specific way, and thus summarize the major results of the project. (Author)

Important questions asked by family members of intensive care unit patients.

PubMed

Peigne, Vincent; Chaize, Marine; Falissard, Bruno; Kentish-Barnes, Nancy; Rusinova, Katerina; Megarbane, Bruno; Bele, Nicolas; Cariou, Alain; Fieux, Fabienne; Garrouste-Orgeas, Maite; Georges, Hugues; Jourdain, Merce; Kouatchet, Achille; Lautrette, Alexandre; Legriel, Stephane; Regnier, Bernard; Renault, Anne; Thirion, Marina; Timsit, Jean-Francois; Toledano, Dany; Chevret, Sylvie; Pochard, Frédéric; Schlemmer, Benoît; Azoulay, Elie

2011-06-01

Relatives often lack important information about intensive care unit patients. High-quality information is crucial to help relatives overcome the often considerable situational stress and to acquire the ability to participate in the decision-making process, most notably regarding the appropriate level of care. We aimed to develop a list of questions important for relatives of patients in the intensive care unit. This was a multicenter study. Questions asked by relatives of intensive care unit patients were collected from five different sources (literature, panel of 28 intensive care unit nurses and physicians, 1-wk survey of nurses and 1-wk survey of physicians in 14 intensive care units, and in-depth interviews with 14 families). After a qualitative analysis (framework approach and thematic analysis), questions were rated by 22 relatives and 14 intensive care unit physicians, and the ratings were analyzed using principal component analysis and hierarchical clustering. The five sources produced 2,135 questions. Removal of duplicates and redundancies left 443 questions, which were distributed among nine predefined domains using a framework approach ("diagnosis," "treatment," "prognosis," "comfort," "interaction," "communication," "family," "end of life," and "postintensive care unit management"). Thematic analysis in each domain led to the identification of 46 themes, which were reworded as 46 different questions. Ratings by relatives and physicians showed that 21 of these questions were particularly important for relatives of intensive care unit patients. This study increases knowledge about the informational needs of relatives of intensive care unit patients. This list of questions may prove valuable for both relatives and intensive care unit physicians as a tool for improving communication in the intensive care unit.

Shared decision-making - Rhetoric and reality: Women's experiences and perceptions of adjuvant treatment decision-making for breast cancer.

PubMed

Mahmoodi, Neda; Sargeant, Sally

2017-01-01

This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients' subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor-patient power dynamics within shared decision-making for breast cancer.

[The individual and the State as agents responsible for the production of healthy societies: a thematic analysis from the perspective of health professionals in Catalonia (Spain)].

PubMed

Lamelas, Valeria Santoro

2017-01-01

This article aims to analyze the meanings upon which health promotion intervention practices are based, and the consequences of these meanings in the identification of responsibilities in health. The passage of Catalonia's Public Health Law 18/2009 facilitated the development of the Demonstrative Project of the Public Health Agency, in the framework of which fieldwork for the Plan for Health Education and Promotion in Children and Adolescents in La Garrotxa (region of Catalonia) was carried out. In this way, 20 interviews with key informants were conducted. Through a thematic analysis, it was found that the State and the individual are identified as the primary agents responsible for the production of healthy societies. It was also evidenced that, in the articulation between the discourses referring to free and rational decision-making and those referring to the social, political and economic environment, different approaches towards responsibility are construed, with effects related to the potentiation (or lack thereof) of the State as a guarantor of the population's health in opposition to blaming of the individual.

Improving Quality and Reducing Waste in Allied Health Workplace Education Programs: A Pragmatic Operational Education Framework Approach.

PubMed

Golder, Janet; Farlie, Melanie K; Sevenhuysen, Samantha

2016-01-01

Efficient utilisation of education resources is required for the delivery of effective learning opportunities for allied health professionals. This study aimed to develop an education framework to support delivery of high-quality education within existing education resources. This study was conducted in a large metropolitan health service. Homogenous and purposive sampling methods were utilised in Phase 1 (n=43) and 2 (n=14) consultation stages. Participants included 25 allied health professionals, 22 managers, 1 educator, and 3 executives. Field notes taken during 43 semi-structured interviews and 4 focus groups were member-checked, and semantic thematic analysis methods were utilised. Framework design was informed by existing published framework development guides. The framework model contains governance, planning, delivery, and evaluation and research elements and identifies performance indicators, practice examples, and support tools for a range of stakeholders. Themes integrated into framework content include improving quality of education and training provided and delivery efficiency, greater understanding of education role requirements, and workforce support for education-specific knowledge and skill development. This framework supports efficient delivery of allied health workforce education and training to the highest standard, whilst pragmatically considering current allied health education workforce demands.

Qualitative research in healthcare: an introduction to grounded theory using thematic analysis.

PubMed

Chapman, A L; Hadfield, M; Chapman, C J

2015-01-01

In today's NHS, qualitative research is increasingly important as a method of assessing and improving quality of care. Grounded theory has developed as an analytical approach to qualitative data over the last 40 years. It is primarily an inductive process whereby theoretical insights are generated from data, in contrast to deductive research where theoretical hypotheses are tested via data collection. Grounded theory has been one of the main contributors to the acceptance of qualitative methods in a wide range of applied social sciences. The influence of grounded theory as an approach is, in part, based on its provision of an explicit framework for analysis and theory generation. Furthermore the stress upon grounding research in the reality of participants has also given it credence in healthcare research. As with all analytical approaches, grounded theory has drawbacks and limitations. It is important to have an understanding of these in order to assess the applicability of this approach to healthcare research. In this review we outline the principles of grounded theory, and focus on thematic analysis as the analytical approach used most frequently in grounded theory studies, with the aim of providing clinicians with the skills to critically review studies using this methodology.

A thematic content analysis of #cheatmeal images on social media: Characterizing an emerging dietary trend.

PubMed

Pila, Eva; Mond, Jonathan M; Griffiths, Scott; Mitchison, Deborah; Murray, Stuart B

2017-06-01

Despite the pervasive social endorsement of "cheat meals" within pro-muscularity online communities, there is an absence of empirical work examining this dietary phenomenon. The present study aimed to characterize cheat meals, and explore the meaning ascribed to engagement in this practice. Thematic content analysis was employed to code the photographic and textual elements of a sample (n = 600) that was extracted from over 1.6 million images marked with the #cheatmeal tag on the social networking site, Instagram. Analysis of the volume and type of food revealed the presence of very large quantities (54.5%) of calorie-dense foods (71.3%) that was rated to qualify as an objective binge episode. Photographic content of people commonly portrayed highly-muscular bodies (60.7%) in the act of intentional body exposure (40.0%). Meanwhile, textual content exemplified the idealization of overconsumption, a strict commitment to fitness, and a reward-based framework around diet and fitness. Collectively, these findings position cheat meals as goal-oriented dietary practices in the pursuit of physique-ideals, thus underscoring the potential clinical repercussions of this socially-endorsed dietary phenomenon. © 2017 Wiley Periodicals, Inc.

Building and expanding interprofessional teaching teams.

PubMed

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

2017-03-01

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

Evidence based practice in traditional & complementary medicine: An agenda for policy, practice, education and research.

PubMed

Leach, Matthew J; Canaway, Rachel; Hunter, Jennifer

2018-05-01

To develop a policy, practice, education and research agenda for evidence-based practice (EBP) in traditional and complementary medicine (T&CM). The study was a secondary analysis of qualitative data, using the method of roundtable discussion. The sample comprised seventeen experts in EBP and T&CM. The discussion was audio-recorded, and the transcript analysed using thematic analysis. Four central themes emerged from the data; understanding evidence and EBP, drivers of change, interpersonal interaction, and moving forward. Captured within these themes were fifteen sub-themes. These themes/sub-themes translated into three broad calls to action: (1) defining terminology, (2) defining the EBP approach, and (3) fostering social movement. These calls to action formed the framework of the agenda. This analysis presents a potential framework for an agenda to improve EBP implementation in T&CM. The fundamental elements of this action plan seek clarification, leadership and unification on the issue of EBP in T&CM. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development and application of a framework to assess community nutritionists' use of environmental strategies to prevent obesity.

PubMed

Lu, Angela H; Dickin, Katherine; Dollahite, Jamie

2014-01-01

To develop and apply a framework exploring the extent of involvement in promoting environmental changes to prevent obesity by a group of nutrition educators (NE). Cross-sectional, mixed methods: qualitative interviews informed framework development; survey applied framework to describe NE's involvement in environmental changes. Cooperative Extension in New York State. Interviewees (n = 7) selected to vary in environmental change activities and rural/urban location. Survey response rate was 100% (n = 58). Dimensions and degree of NE's involvement in promoting environmental change. Thematic analysis of qualitative data, triangulated with descriptive analyses of NE's performance of tasks in various settings. NE's promotion of environmental changes was characterized using framework based on settings and tasks, dimensions that emerged from qualitative analysis. NE's actions varied across these dimensions and ranged from low to high intensity of collaboration and leadership for environmental change. Most NE surveyed reported actions limited to providing information and recommendations on healthy eating and physical activity. Few reported intensive engagement in developing, implementing, and evaluating plans to change environments for obesity prevention. Framework identifies the levels of engagement in promoting environmental changes and supports future research and practice of community nutrition professionals by providing a roadmap for assessing their involvement on multiple levels to prevent obesity. Copyright © 2014 Society for Nutrition Education and Behavior. All rights reserved.

Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis

PubMed Central

Niccum, Blake A; Sarker, Arnab; Wolf, Stephen J; Trowbridge, Matthew J

2017-01-01

ABSTRACT Background: Training in innovation and entrepreneurship (I&E) in medical education has become increasingly prevalent among medical schools to train students in complex problem solving and solution design. Objective: We aim to characterize I&E education in US allopathic medical schools to provide insight into the features and objectives of this growing field. Design: I&E programs were identified in 2016 via structured searches of 158 US allopathic medical school websites. Program characteristics were identified from public program resources and structured phone interviews with program directors. Curricular themes were identified via thematic analysis of program resources, and themes referenced by >50% of programs were analyzed. Results: Thirteen programs were identified. Programs had a median age of four years, and contained a median of 13 students. Programs were led by faculty from diverse professional backgrounds, and all awarded formal recognition to graduates. Nine programs spanned all four years of medical school and ten programs required a capstone project. Thematic analysis revealed seven educational themes (innovation, entrepreneurship, technology, leadership, healthcare systems, business of medicine, and enhanced adaptability) and two teaching method themes (active learning, interdisciplinary teaching) referenced by >50% of programs. Conclusions: The landscape of medical school I&E programs is rapidly expanding to address newfound skills needed by physicians due to ongoing changes in healthcare, but programs remain relatively few and small compared to class size. This landscape analysis is the first review of I&E in medical education and may contribute to development of a formal educational framework or competency model for current or future programs. Abbreviations: AAMC: American Association of Medical Colleges; AMA: American Medical Association; I&E: Innovation and entrepreneurship PMID:28789602

Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis.

PubMed

Niccum, Blake A; Sarker, Arnab; Wolf, Stephen J; Trowbridge, Matthew J

2017-01-01

Training in innovation and entrepreneurship (I&E) in medical education has become increasingly prevalent among medical schools to train students in complex problem solving and solution design. We aim to characterize I&E education in US allopathic medical schools to provide insight into the features and objectives of this growing field. I&E programs were identified in 2016 via structured searches of 158 US allopathic medical school websites. Program characteristics were identified from public program resources and structured phone interviews with program directors. Curricular themes were identified via thematic analysis of program resources, and themes referenced by >50% of programs were analyzed. Thirteen programs were identified. Programs had a median age of four years, and contained a median of 13 students. Programs were led by faculty from diverse professional backgrounds, and all awarded formal recognition to graduates. Nine programs spanned all four years of medical school and ten programs required a capstone project. Thematic analysis revealed seven educational themes (innovation, entrepreneurship, technology, leadership, healthcare systems, business of medicine, and enhanced adaptability) and two teaching method themes (active learning, interdisciplinary teaching) referenced by >50% of programs. The landscape of medical school I&E programs is rapidly expanding to address newfound skills needed by physicians due to ongoing changes in healthcare, but programs remain relatively few and small compared to class size. This landscape analysis is the first review of I&E in medical education and may contribute to development of a formal educational framework or competency model for current or future programs. AAMC: American Association of Medical Colleges; AMA: American Medical Association; I&E: Innovation and entrepreneurship.

Biotechnology worldwide and the 'European Biotechnology Thematic Network' Association (EBTNA).

PubMed

Bruschi, F; Dundar, M; Gahan, P B; Gartland, K; Szente, M; Viola-Magni, M P; Akbarova, Y

2011-09-01

The European Biotechnology Congress 2011 held under the auspices of the European Biotechnology Thematic Network Association (EBTNA) in conjunction with the Turkish Medical Genetics Association brings together a broad spectrum of biotechnologists from around the world. The subsequent abstracts indicate the manner in which biotechnology has permeated all aspects of research from the basic sciences through to small and medium enterprises and major industries. The brief statements before the presentation of the abstracts aim to introduce not only Biotechnology in general and its importance around the world, but also the European Biotechnology Thematic Network Association and its aims especially within the framework of education and ethics in biotechnology. Copyright © 2011 Elsevier Ltd. All rights reserved.

An overview of infusing service-learning in medical education

PubMed Central

Wubbena, Zane

2014-01-01

Objectives To identify and review existing empirical research about service-learning and medical education and then to develop a framework for infusing service-learning in Doctor of Medicine or Doctor of Osteopathic Medicine curricula. Methods We selected literature on service-learning and medical education. Articles were screened with a protocol for inclusion or exclusion at two separate stages. At stage one, articles were screened according to their titles, abstracts, and keywords. The second stage involved a full-text review. Finally, a thematic analysis using focused and selective coding was conducted. Results Eighteen studies were analyzed spanning the years 1998 to 2012. The results from our analysis informed the development of a four-stage service-learning framework: 1) planning and preparation, 2) action, 3) reflection and demonstration, and 4) assessment and celebration. Conclusions The presented service-learning framework can be used to develop curricula for the infusion of service-learning in medical school. Service-learning curricula in medical education have the potential to provide myriad benefits to faculty, students, community members, and university-community partnerships. PMID:25341224

Iterative categorization (IC): a systematic technique for analysing qualitative data.

PubMed

Neale, Joanne

2016-06-01

The processes of analysing qualitative data, particularly the stage between coding and publication, are often vague and/or poorly explained within addiction science and research more broadly. A simple but rigorous and transparent technique for analysing qualitative textual data, developed within the field of addiction, is described. The technique, iterative categorization (IC), is suitable for use with inductive and deductive codes and can support a range of common analytical approaches, e.g. thematic analysis, Framework, constant comparison, analytical induction, content analysis, conversational analysis, discourse analysis, interpretative phenomenological analysis and narrative analysis. Once the data have been coded, the only software required is a standard word processing package. Worked examples are provided. © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

An overview of animal science research 1945-2011 through science mapping analysis.

PubMed

Rodriguez-Ledesma, A; Cobo, M J; Lopez-Pujalte, C; Herrera-Viedma, E

2015-12-01

The conceptual structure of the field of Animal Science (AS) research is examined by means of a longitudinal science mapping analysis. The whole of the AS research field is analysed, revealing its conceptual evolution. To this end, an automatic approach to detecting and visualizing hidden themes or topics and their evolution across a consecutive span of years was applied to AS publications of the JCR category 'Agriculture, Dairy & Animal Science' during the period 1945-2011. This automatic approach was based on a coword analysis and combines performance analysis and science mapping. To observe the conceptual evolution of AS, six consecutive periods were defined: 1945-1969, 1970-1979, 1980-1989, 1990-1999, 2000-2005 and 2006-2011. Research in AS was identified as having focused on ten main thematic areas: ANIMAL-FEEDING, SMALL-RUMINANTS, ANIMAL-REPRODUCTION, DAIRY-PRODUCTION, MEAT-QUALITY, SWINE-PRODUCTION, GENETICS-AND-ANIMAL-BREEDING, POULTRY, ANIMAL-WELFARE and GROWTH-FACTORS-AND-FATTY-ACIDS. The results show how genomic studies gain in weight and integrate with other thematic areas. The whole of AS research has become oriented towards an overall framework in which animal welfare, sustainable management and human health play a major role. All this would affect the future structure and management of livestock farming. © 2014 Blackwell Verlag GmbH.

Analyzing existing conventional soil information sources to be incorporated in thematic Spatial Data Infrastructures

NASA Astrophysics Data System (ADS)

Pascual-Aguilar, J. A.; Rubio, J. L.; Domínguez, J.; Andreu, V.

2012-04-01

New information technologies give the possibility of widespread dissemination of spatial information to different geographical scales from continental to local by means of Spatial Data Infrastructures. Also administrative awareness on the need for open access information services has allowed the citizens access to this spatial information through development of legal documents, such as the INSPIRE Directive of the European Union, adapted by national laws as in the case of Spain. The translation of the general criteria of generic Spatial Data Infrastructures (SDI) to thematic ones is a crucial point for the progress of these instruments as large tool for the dissemination of information. In such case, it must be added to the intrinsic criteria of digital information, such as the harmonization information and the disclosure of metadata, the own environmental information characteristics and the techniques employed in obtaining it. In the case of inventories and mapping of soils, existing information obtained by traditional means, prior to the digital technologies, is considered to be a source of valid information, as well as unique, for the development of thematic SDI. In this work, an evaluation of existing and accessible information that constitutes the basis for building a thematic SDI of soils in Spain is undertaken. This information framework has common features to other European Union states. From a set of more than 1,500 publications corresponding to the national territory of Spain, the study was carried out in those documents (94) found for five autonomous regions of northern Iberian Peninsula (Asturias, Cantabria, Basque Country, Navarra and La Rioja). The analysis was performed taking into account the criteria of soil mapping and inventories. The results obtained show a wide variation in almost all the criteria: geographic representation (projections, scales) and geo-referencing the location of the profiles, map location of profiles integrated with edaphic units, description and taxonomic classification systems of soils (FAO, Soil taxonomy, etc.), amount and type of soil analysis parameters and dates of the inventories. In conclusion, the construction of thematic SDI on soil should take into account, prior to the integration of all maps and inventories, a series of processes of harmonization that allows spatial continuity between existing information and also temporal identification of the inventories and maps. This should require the development of at least two types of integration tools: (1) enabling spatial continuity without contradictions between maps made at different times and with different criteria and (2) the development of information systems data (metadata) to highlight the characteristics of information and connection possibilities with other sources that comprise the Spatial Data Infrastructure. Acknowledgements This research has financed by the European Union within the framework of the GS Soil project (eContentplus Programme ECP-2008-GEO-318004).

Sustainability and productivity of southern pine ecosystems: A thematic framework for integrating research and building partnerships

Treesearch

Charles K. McMahon; James P. Barnett

2000-01-01

In 1997, the USDA Forest Service Southern Research Station (SRS) published a Strategic Plan that formed a framework for addressing the Sustainability of Southern Forest Ecosystems. Six crosscutting themes were identified to facilitate research integration and partnership building among the widely dispersed SRS research work units. The Sustainability and Productivity of...

Conducting qualitative research in mental health: Thematic and content analyses.

PubMed

Crowe, Marie; Inder, Maree; Porter, Richard

2015-07-01

The objective of this paper is to describe two methods of qualitative analysis - thematic analysis and content analysis - and to examine their use in a mental health context. A description of the processes of thematic analysis and content analysis is provided. These processes are then illustrated by conducting two analyses of the same qualitative data. Transcripts of qualitative interviews are analysed using each method to illustrate these processes. The illustration of the processes highlights the different outcomes from the same set of data. Thematic and content analyses are qualitative methods that serve different research purposes. Thematic analysis provides an interpretation of participants' meanings, while content analysis is a direct representation of participants' responses. These methods provide two ways of understanding meanings and experiences and provide important knowledge in a mental health context. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Policy advocacy and leadership training for formerly incarcerated women: an empowerment evaluation of ReConnect, a program of the Women in Prison Project, Correctional Association of New York.

PubMed

Pinto, R M; Rahman, R; Williams, A

2014-12-01

There is limited knowledge on re-entry initiatives for formerly incarcerated women specifically on building women's advocacy and leadership skills. Our research highlights an empowerment evaluation on ReConnect, a 12-session; innovative advocacy and leadership development program rooted in an integrated framework of empowerment, and transformational leadership theories. Using thematic analysis, we coded three focus groups with 24 graduates, for themes that matched our framework's concepts. ReConnect graduates reported being empowered by the information they received on parental rights, housing, and employment. Participants agreed that ReConnect improved their communication skills, preparing them to advocate for themselves and community members. Copyright © 2014 Elsevier Ltd. All rights reserved.

What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance.

PubMed

Le Boutillier, Clair; Leamy, Mary; Bird, Victoria J; Davidson, Larry; Williams, Julie; Slade, Mike

2011-12-01

Recovery is a multifaceted concept, and the need for operationalization in practice has been identified. Although guidance on recovery-oriented practice exists, it is from disparate sources and is difficult to apply. The aims of the study were to identify the key characteristics of recovery-oriented practice guidance on the basis of current international perspectives and to develop an overarching conceptual framework to aid the translation of recovery guidance into practice. A qualitative analysis of 30 international documents offering recovery-oriented practice guidance was conducted. Inductive, semantic-level, thematic analysis was used to identify dominant themes. Interpretive analysis was then undertaken to group the themes into practice domains. The guidance documents were diverse; from six countries-the United States, England, Scotland, Republic of Ireland, Denmark, and New Zealand-and varied in document type, categories of guidance, and level of service user involvement in guidance development. The emerging conceptual framework consists of 16 dominant themes, grouped into four practice domains: promoting citizenship, organizational commitment, supporting personally defined recovery, and working relationship. A key challenge for mental health services is the lack of clarity about what constitutes recovery-oriented practice. The conceptual framework contributes to this knowledge gap and provides a synthesis of recovery-oriented practice guidance.

Research to practice in The Journal of Continuing Education in the Health Professions: a thematic analysis of volumes 1 through 24.

PubMed

MacIntosh-Murray, Anu; Perrier, Laure; Davis, David

2006-01-01

Authors have stressed the importance of the broader contextual influences on practice improvement and learning and have expressed concern about gaps between research and practice. This implies a potential expansion of the knowledge base for continuing education in the health professions (CEHP) and an increased emphasis on research evidence for that knowledge. How has the content of The Journal of Continuing Education in the Health Professions (JCEHP) reflected those changes? What are the implications for CEHP practitioners? Based on all abstracts, tables of contents, and editorials, a thematic analysis was completed for volumes 1 through 24 of JCEHP. All texts were downloaded into qualitative analysis software and coded. Main code categories included demographics of articles, concepts relating to CEHP as a discipline, knowledge translation and outcomes-oriented continuing education, and theories and frameworks. Key themes were identified. Key themes include categories of topics included in JCEHP over the years, the increased prominence of research in JCEHP, a dual research evidence-to-practice gap, the professionalization of continuing education providers, and interdisciplinarity and the links with broader frameworks that have been proposed for CEHP. Two sets of research-to-practice gaps are portrayed in the journal: the gap between clinical research and practice and the gap between research and practice in CEHP. To close the first gap, authors have asserted that the second gap must be addressed, ensuring that CEHP practices themselves are evidence based, driven by theory-based research. This is a variation on prior debates regarding the need to define CEHP as a discipline, which uses the language of professionalization. The increased focus of continuing education on the contexts of health care providers' practices has multiplied the topics that are potentially relevant to CEHP practice.

Identifying Barriers to Delivering the Awakening and Breathing Coordination, Delirium, and Early Exercise/Mobility Bundle to Minimize Adverse Outcomes for Mechanically Ventilated Patients: A Systematic Review.

PubMed

Costa, Deena Kelly; White, Matthew R; Ginier, Emily; Manojlovich, Milisa; Govindan, Sushant; Iwashyna, Theodore J; Sales, Anne E

2017-08-01

Improved outcomes are associated with the Awakening and Breathing Coordination, Delirium, and Early exercise/mobility bundle (ABCDE); however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and to provide a resource to guide clinicians in overcoming barriers to implementation. We searched MEDLINE via PubMed, CINAHL, and Scopus for original research articles from January 1, 2007, to August 31, 2016, that identified barriers to ABCDE implementation for adult patients in the ICU. Two reviewers independently reviewed studies, extracted barriers, and conducted thematic content analysis of the barriers, guided by the Consolidated Framework for Implementation Research. Discrepancies were discussed, and consensus was achieved. Our electronic search yielded 1,908 articles. After applying our inclusion/exclusion criteria, we included 49 studies. We conducted thematic content analysis of the 107 barriers and identified four classes of ABCDE barriers: (1) patient-related (ie, patient instability and safety concerns); (2) clinician-related (ie, lack of knowledge, staff safety concerns); (3) protocol-related (ie, unclear protocol criteria, cumbersome protocols to use); and, not previously identified in past reviews, (4) ICU contextual barriers (ie, interprofessional team care coordination). We provide the first, to our knowledge, systematic differential diagnosis of barriers to ABCDE delivery, moving beyond the conventional focus on patient-level factors. Our analysis offers a differential diagnosis checklist for clinicians planning ABCDE implementation to improve patient care and outcomes. Copyright © 2017 American College of Chest Physicians. All rights reserved.

Systems thinking applied to safety during manual handling tasks in the transport and storage industry.

PubMed

Goode, Natassia; Salmon, Paul M; Lenné, Michael G; Hillard, Peter

2014-07-01

Injuries resulting from manual handling tasks represent an on-going problem for the transport and storage industry. This article describes an application of a systems theory-based approach, Rasmussen's (1997. Safety Science 27, 183), risk management framework, to the analysis of the factors influencing safety during manual handling activities in a freight handling organisation. Observations of manual handling activities, cognitive decision method interviews with workers (n=27) and interviews with managers (n=35) were used to gather information about three manual handling activities. Hierarchical task analysis and thematic analysis were used to identify potential risk factors and performance shaping factors across the levels of Rasmussen's framework. These different data sources were then integrated using Rasmussen's Accimap technique to provide an overall analysis of the factors influencing safety during manual handling activities in this context. The findings demonstrate how a systems theory-based approach can be applied to this domain, and suggest that policy-orientated, rather than worker-orientated, changes are required to prevent future manual handling injuries. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using land-cover data to understand effects of agricultural and urban development on regional water quality

USGS Publications Warehouse

Karstensen, Krista A.; Warner, Kelly L.

2010-01-01

The Land-Cover Trends project is a collaborative effort between the Geographic Analysis and Monitoring Program of the U.S. Geological Survey (USGS), the U.S. Environmental Protection Agency (EPA) and the National Aeronautics and Space Administration (NASA) to understand the rates, trends, causes, and consequences of contemporary land-use and land-cover change in the United States. The data produced from this research can lead to an enriched understanding of the drivers of future landuse change, effects on environmental systems, and any associated feedbacks. USGS scientists are using the EPA Level III ecoregions as the geographic framework to process geospatial data collected between 1973 and 2000 to characterize ecosystem responses to land-use changes. General land-cover classes for these periods were interpreted from Landsat Multispectral Scanner, Thematic Mapper, and Enhanced Thematic Mapper Plus imagery to categorize and evaluate land-cover change using a modified Anderson Land-Use/Land-Cover Classification System for image interpretation.

Fundamental procedures of geographic information analysis

NASA Technical Reports Server (NTRS)

Berry, J. K.; Tomlin, C. D.

1981-01-01

Analytical procedures common to most computer-oriented geographic information systems are composed of fundamental map processing operations. A conceptual framework for such procedures is developed and basic operations common to a broad range of applications are described. Among the major classes of primitive operations identified are those associated with: reclassifying map categories as a function of the initial classification, the shape, the position, or the size of the spatial configuration associated with each category; overlaying maps on a point-by-point, a category-wide, or a map-wide basis; measuring distance; establishing visual or optimal path connectivity; and characterizing cartographic neighborhoods based on the thematic or spatial attributes of the data values within each neighborhood. By organizing such operations in a coherent manner, the basis for a generalized cartographic modeling structure can be developed which accommodates a variety of needs in a common, flexible and intuitive manner. The use of each is limited only by the general thematic and spatial nature of the data to which it is applied.

The pervasive triad of food security, gender inequity and women's health: exploratory research from sub-Saharan Africa.

PubMed

Hyder, Adnan A; Maman, Suzanne; Nyoni, Joyce E; Khasiani, Shaniysa A; Teoh, Noreen; Premji, Zul; Sohani, Salim

2005-12-01

This study was designed to explore the interactions between food securing activities, health and gender equity from the perspective of rural east African women. The specific objectives were to document the critical interaction among these three issues-food security, gender inequity, women's health within the context of sub-Saharan Africa; to describe the nature of this triad from the perspective of women farmers in Africa; and to propose a framework for linking available interventions to the vicious nature of this triad. In-depth interviews and focus group discussions were conducted with rural women farmers in Kwale District, Kenya and Bagamoyo District, Tanzania. A total of 12 in-depth interviews and 4 focus group discussions have been included in this analysis. Transcribed text from interviews and focus group discussions were coded and thematic conceptual matrices were developed to compare dimensions of common themes across interviews and settings. A thematic analysis was then performed and a framework developed to understand the nature of the triad and explore the potential for interventions within the interactions. The vicious cycle of increasing work, lack of time, and lack of independent decision making for women who are responsible for food production and health of their families, has health and social consequences. Food securing activities have negative health consequences for women, which are further augmented by issues of gender inequity. The African development community must respond by thinking of creative solutions and appropriate interventions for the empowerment of women farmers in the region to ensure their health.

Using Evidence-Based Conceptual Frameworks to Identify Leadership Practices of Principals of Successful Schools Serving English Learners

ERIC Educational Resources Information Center

Bishop, Robert C.

2013-01-01

This study is one of five thematic dissertations investigating the leadership practices of principals leading successful schools serving ELA learners. Schools selected for participation in this study had (a) an open enrollment policy, (b) at least 40% of total enrollment consists of ELL students, (c) has earned a School Performance Framework (SPF)…

Person-centred rehabilitation: what exactly does it mean? Protocol for a scoping review with thematic analysis towards framing the concept and practice of person-centred rehabilitation.

PubMed

Jesus, Tiago S; Bright, Felicity; Kayes, Nicola; Cott, Cheryl A

2016-07-19

Person-centredness is a philosophy for organising and delivering healthcare based on patients' needs, preferences and experiences. Although widely endorsed, the concept suffers from a lack of detail and clarification, in turn accounting for ambiguous implementation and outcomes. While a conceptual framework based on a systematic review defines person/patient-centred care components (Scholl et al, 2014), it applies across healthcare contexts and may not be sensitive to the nuances of the rehabilitation of adults with physical impairments. Accordingly, this study aims to build a conceptual framework, based on existing literature, of what person-centredness means in the rehabilitation of adults with physical impairments in the clinical encounter and broader health service delivery. We will use a scoping review methodology. Searches on relevant databases will be conducted first, combining keywords for 'rehabilitation', 'person-centered' and associated terms (including patient preferences/experiences). Next, snowball searches (citation tracking, references lists) will be performed. Papers will be included if they fall within predefined selection categories (seen as most likely informative on elements pertaining to person-centred rehabilitation) and are written in English, regardless of design (conceptual, qualitative, quantitative). Two reviewers will independently screen titles and abstracts, followed by screening of the full text to determine inclusion. Experts will then be consulted to identify relevant missing papers. This can include elements other than the peer-reviewed literature (eg, book chapters, policy/legal papers). Finally, information that helps to build the concept and practice of person-centred rehabilitation will be abstracted independently by two reviewers and analysed by inductive thematic analysis to build the conceptual framework. The resulting framework will aid clarification regarding person-centred rehabilitation, which in turn is expected to conceptually ground and inform its operationalisation (eg, measurement, implementation, improvement). Findings will be disseminated through local, national and international stakeholders, both at the clinical and service organisation levels. 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/

The Long-Term Conditions Questionnaire: conceptual framework and item development.

PubMed

Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A'Court, Christine; Fitzpatrick, Ray

2016-01-01

To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey.

Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review

PubMed Central

Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

2017-01-01

Objective The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Design Thematic analysis review of CM studies. Methods We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004–December 2015 period, then updated to July 2017, with the keywords ‘CM’ and ‘frequent use’. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir’s implementation of health innovations framework was used to organise results into four broad levels of factors: (1) environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Results Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. Conclusions CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. PMID:29061623

WhatsApp messenger as a tool to supplement medical education for medical students on clinical attachment.

PubMed

Raiman, Lewis; Antbring, Richard; Mahmood, Asad

2017-01-06

Instant messaging applications have the potential to improve and facilitate communication between hospital doctors and students, hence generating and improving learning opportunities. This study aims to demonstrate the feasibility and acceptability of instant messaging communication to supplement medical education for medical students whilst on clinical attachment. A total of 6 WhatsApp Messenger (WhatsApp Inc.) groups were created for medical students on clinical attachment. These were used to provide communication within Problem Based Learning (PBL) groups for a duration of 8 weeks. The frequency and type of communication were recorded. Students' opinions were evaluated through a structured interview process at the end of the study period. A thematic analysis was performed on the content of the instant messaging groups and on the results of the structured interviews. All of the participants were active in their respective messaging groups (19 students and 6 tutors). A total of 582 messages, 22 images and 19 webpage links were sent. Thematic analysis on content of the instant messaging groups identified the following themes: organisational, educational and social. Thematic analysis on the content of interviews identified themes such as the ease of use of instant messaging, benefit of instant messaging to foster understanding and learning, and the ability to access recorded discussions. The findings of this study illustrate a method by which communication within PBL groups can be facilitated by the use of instant messaging. The results indicate the feasibility and acceptability of WhatsApp Messenger in supplementing PBL teaching for medical students, and provides a framework for studies to investigate use amongst larger cohorts of students.

Combining Users’ Needs With Health Behavior Models in Designing an Internet- and Mobile-Based Intervention for Physical Activity in Cardiac Rehabilitation

PubMed Central

2014-01-01

Background Internet-based physical activity interventions have great potential in supporting patients in cardiac rehabilitation. Health behavior change theories and user input are identified as important contributors in the effectiveness of the interventions, but they are rarely combined in a systematic way in the design of the interventions. Objective The aim of this study is to identify the appropriate theoretical framework, along with the needs of the users of a physical activity intervention for cardiac rehabilitation, and to combine them into an effective Internet- and mobile-based intervention. Methods We explain the theoretical framework of the intervention in a narrative overview of the existing health behavior change literature as it applies to physical activity. We also conducted a focus group with 11 participants of a cardiac rehabilitation program and used thematic analysis to identify and analyze patterns of meaning in the transcribed data. Results We chose stage-based approaches, specifically the transtheoretical model and the health action process approach as our main framework for tailoring, supplemented with other theoretical concepts such as regulatory focus within the appropriate stages. From the thematic analysis of the focus group data, we identified seven themes: (1) social, (2) motivation, (3) integration into everyday life, (4) information, (5) planning, (6) monitoring and feedback, and (7) concerns and potential problems. The final design of the intervention was based on both the theoretical review and the user input, and it is explained in detail. Conclusions We applied a combination of health behavioral theory and user input in designing our intervention. We think this is a promising design approach with the potential to combine the high efficacy of theory-based interventions with the higher perceived usefulness of interventions designed according to user input. Trial Registration Clinicaltrials.gov NCT01223170; http://clinicaltrials.gov/show/NCT01223170 (Archived by WebCite at http://www.webcitation.org/6M5FqT9Q2). PMID:24413185

Applying thematic analysis theory to practice: a researcher's experience.

PubMed

Tuckett, Anthony G

2005-01-01

This article describes an experience of thematic analysis. In order to answer the question 'What does analysis look like in practice?' it describes in brief how the methodology of grounded theory, the epistemology of social constructionism, and the theoretical stance of symbolic interactionism inform analysis. Additionally, analysis is examined by evidencing the systematic processes--here termed organising, coding, writing, theorising, and reading--that led the researcher to develop a final thematic schema.

Developing an evidence-based methodological framework to systematically compare HTA coverage decisions: A mixed methods study.

PubMed

Nicod, Elena; Kanavos, Panos

2016-01-01

Health Technology Assessment (HTA) often results in different coverage recommendations across countries for a same medicine despite similar methodological approaches. This paper develops and pilots a methodological framework that systematically identifies the reasons for these differences using an exploratory sequential mixed methods research design. The study countries were England, Scotland, Sweden and France. The methodological framework was built around three stages of the HTA process: (a) evidence, (b) its interpretation, and (c) its influence on the final recommendation; and was applied to two orphan medicinal products. The criteria accounted for at each stage were qualitatively analyzed through thematic analysis. Piloting the framework for two medicines, eight trials, 43 clinical endpoints and seven economic models were coded 155 times. Eighteen different uncertainties about this evidence were coded 28 times, 56% of which pertained to evidence commonly appraised and 44% to evidence considered by only some agencies. The poor agreement in interpreting this evidence (κ=0.183) was partly explained by stakeholder input (ns=48 times), or by agency-specific risk (nu=28 uncertainties) and value preferences (noc=62 "other considerations"), derived through correspondence analysis. Accounting for variability at each stage of the process can be achieved by codifying its existence and quantifying its impact through the application of this framework. The transferability of this framework to other disease areas, medicines and countries is ensured by its iterative and flexible nature, and detailed description. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Progressive Learning of Topic Modeling Parameters: A Visual Analytics Framework.

PubMed

El-Assady, Mennatallah; Sevastjanova, Rita; Sperrle, Fabian; Keim, Daniel; Collins, Christopher

2018-01-01

Topic modeling algorithms are widely used to analyze the thematic composition of text corpora but remain difficult to interpret and adjust. Addressing these limitations, we present a modular visual analytics framework, tackling the understandability and adaptability of topic models through a user-driven reinforcement learning process which does not require a deep understanding of the underlying topic modeling algorithms. Given a document corpus, our approach initializes two algorithm configurations based on a parameter space analysis that enhances document separability. We abstract the model complexity in an interactive visual workspace for exploring the automatic matching results of two models, investigating topic summaries, analyzing parameter distributions, and reviewing documents. The main contribution of our work is an iterative decision-making technique in which users provide a document-based relevance feedback that allows the framework to converge to a user-endorsed topic distribution. We also report feedback from a two-stage study which shows that our technique results in topic model quality improvements on two independent measures.

Taxonomic and Thematic Semantic Systems

PubMed Central

Mirman, Daniel; Landrigan, Jon-Frederick; Britt, Allison E.

2017-01-01

Object concepts are critical for nearly all aspects of human cognition, from perception tasks like object recognition, to understanding and producing language, to making meaningful actions. Concepts can have two very different kinds of relations: similarity relations based on shared features (e.g., dog – bear), which are called “taxonomic” relations, and contiguity relations based on co-occurrence in events or scenarios (e.g., dog – leash), which are called “thematic” relations. Here we report a systematic review of experimental psychology and cognitive neuroscience evidence of this distinction in the structure of semantic memory. We propose two principles that may drive the development of distinct taxonomic and thematic semantic systems: (1) differences between which features determine taxonomic vs. thematic relations and (2) differences in the processing required to extract taxonomic vs. thematic relations. This review brings together distinct threads of behavioral, computational, and neuroscience research on semantic memory in support of a functional and neural dissociation, and defines a framework for future studies of semantic memory. PMID:28333494

Selection and Evaluation of Media for Behavioral Health Interventions Employing Critical Media Analysis.

PubMed

Wilson, Patrick A; Cherenack, Emily M; Jadwin-Cakmak, Laura; Harper, Gary W

2018-01-01

Although a growing number of psychosocial health promotion interventions use the critical analysis of media to facilitate behavior change, no specific guidelines exist to assist researchers and practitioners in the selection and evaluation of culturally relevant media stimuli for intervention development. Mobilizing Our Voices for Empowerment is a critical consciousness-based health enhancement intervention for HIV-positive Black young gay/bisexual men that employs the critical analysis of popular media. In the process of developing and testing this intervention, feedback on media stimuli was collected from youth advisory board members (n = 8), focus group participants (n = 19), intervention participants (n = 40), and intervention facilitators (n = 6). A thematic analysis of qualitative data resulted in the identification of four key attributes of media stimuli and participants' responses to media stimuli that are important to consider when selecting and evaluating media stimuli for use in behavioral health interventions employing the critical analysis of media: comprehension, relevance, emotionality, and action. These four attributes are defined and presented as a framework for evaluating media, and adaptable tools are provided based on this framework to guide researchers and practitioners in the selection and evaluation of media for similar interventions.

An evaluation of simulated Thematic Mapper data and Landsat MSS data for discriminating suburban and regional land use and land cover

NASA Technical Reports Server (NTRS)

Toll, D. L.

1984-01-01

An airborne multispectral scanner, operating in the same spectral channels as the Landsat Thematic Mapper (TM), was used in a region east of Denver, CO, for a simulation test performed in the framework of using TM to discriminate the level I and level II classes. It is noted that at the 30-m spatial resolution of the Thematic Mapper Simulator (TMS) the overall discrimination for such classes as commercial/industrial land, rangeland, irrigated sod, irrigated alfalfa, and irrigated pasture was superior to that of the Landsat Multispectral Scanner, primarily due to four added spectral bands. For residential and other spectrally heterogeneous classes, however, the higher resolution of TMS resulted in increased variability within the class and a larger spectral overlap.

Understanding the implementation of maternity waiting homes in low- and middle-income countries: a qualitative thematic synthesis.

PubMed

Penn-Kekana, Loveday; Pereira, Shreya; Hussein, Julia; Bontogon, Hannah; Chersich, Matthew; Munjanja, Stephen; Portela, Anayda

2017-08-31

Maternity waiting homes (MWHs) are accommodations located near a health facility where women can stay towards the end of pregnancy and/or after birth to enable timely access to essential childbirth care or care for complications. Although MWHs have been implemented for over four decades, different operational models exist. This secondary thematic +analysis explores factors related to their implementation. A qualitative thematic analysis was conducted using 29 studies across 17 countries. The papers were identified through an existing Cochrane review and a mapping of the maternal health literature. The Supporting the Use of Research Evidence framework (SURE) guided the thematic analysis to explore the perceptions of various stakeholders and barriers and facilitators for implementation. The influence of contextual factors, the design of the MWHs, and the conditions under which they operated were examined. Key problems of MWH implementation included challenges in MWH maintenance and utilization by pregnant women. Poor utilization was due to lack of knowledge and acceptance of the MWH among women and communities, long distances to reach the MWH, and culturally inappropriate care. Poor MWH structures were identified by almost all studies as a major barrier, and included poor toilets and kitchens, and a lack of space for family and companions. Facilitators included reduced or removal of costs associated with using a MWH, community involvement in the design and upkeep of the MWHs, activities to raise awareness and acceptance among family and community members, and integrating culturally-appropriate practices into the provision of maternal and newborn care at the MWHs and the health facilities to which they are linked. MWHs should not be designed as an isolated intervention but using a health systems perspective, taking account of women and community perspectives, the quality of the MWH structure and the care provided at the health facility. Careful tailoring of the MWH to women's accommodation, social and dietary needs; low direct and indirect costs; and a functioning health system are key considerations when implementing MWH. Improved and harmonized documentation of implementation experiences would provide a better understanding of the factors that impact on successful implementation.

The design and testing of a caring teaching model based on the theoretical framework of caring in the Chinese Context: a mixed-method study.

PubMed

Guo, Yujie; Shen, Jie; Ye, Xuchun; Chen, Huali; Jiang, Anli

2013-08-01

This paper aims to report the design and test the effectiveness of an innovative caring teaching model based on the theoretical framework of caring in the Chinese context. Since the 1970's, caring has been a core value in nursing education. In a previous study, a theoretical framework of caring in the Chinese context is explored employing a grounded theory study, considered beneficial for caring education. A caring teaching model was designed theoretically and a one group pre- and post-test quasi-experimental study was administered to test its effectiveness. From Oct, 2009 to Jul, 2010, a cohort of grade-2 undergraduate nursing students (n=64) in a Chinese medical school was recruited to participate in the study. Data were gathered through quantitative and qualitative methods to evaluate the effectiveness of the caring teaching model. The caring teaching model created an esthetic situation and experiential learning style for teaching caring that was integrated within the curricula. Quantitative data from the quasi-experimental study showed that the post-test scores of each item were higher than those on the pre-test (p<0.01). Thematic analysis of 1220 narratives from students' caring journals and reports of participant class observation revealed two main thematic categories, which reflected, from the students' points of view, the development of student caring character and the impact that the caring teaching model had on this regard. The model could be used as an integrated approach to teach caring in nursing curricula. It would also be beneficial for nursing administrators in cultivating caring nurse practitioners. Copyright © 2012 Elsevier Ltd. All rights reserved.

Teaching the History of Black Women: A Bibliographic Essay.

ERIC Educational Resources Information Center

Terborg-Penn, Rosalyn

1980-01-01

Reviews selected literature about Black women within the framework of Black history in the United States. Includes recent books and articles as well as older classic titles. Uses two approaches: thematic and chronological. (Author/CK)

From transitions to transformation - A study of pharmacists developing patient-centered communication skills.

PubMed

Luetsch, Karen; Burrows, Judith

2017-08-12

Pharmacists' communication with patients often focuses on technical aspects of advice giving, while limiting socio-emotional content. To develop pharmacists' patient-centered communication a learning and practice module integrating motivational interviewing (MI) was designed for an online postgraduate program, and its impact on their self-described practice evaluated. To investigate whether training in patient-centered communication changes pharmacists' perceptions of communicating with patients, and how any changes in their communication style influenced interactions and relationships with patients. A descriptive, qualitative study analyzing reflective journal entries detailing pharmacists' experiences of implementing patient-centered communication in practice was designed, evaluating reflections on initial patient interactions after training and 9-12 weeks later. Using the framework method of content and thematic analysis, an evaluation framework was devised that integrated communication, change and learning theories. Reflections were categorized within the framework as transitional (e.g. using good communication skills), transactional (e.g. using MI techniques, achieving reciprocity) or transformational (e.g. describing transformative learning, changing frames of reference in understanding of patient-centeredness). Differences between the first and last journal entries were evaluated and analyzed using descriptive statistics. Eighty-nine pharmacists provided two reflective journal entries for evaluation. Over 9-12 weeks, pharmacists described a change in their perspective of patient-centeredness, how they expanded the socio-emotional aspects of communication and succeeded in difficult conversations. When applying the thematic evaluation framework to initial journal entries, 38 (42%) of reflections fell within the transitional category, 51 (58%) were deemed transactional and none transformational. This changed to 10 (11%) transitional, 45 (51%) transactional and 34 (38%) transformational. Differences were observed between journal entries from pharmacists who studied completely online and those who also attended a workshop. Learning and practicing techniques of MI and person-focused communication changed many pharmacists' frames of reference in regards to patient-centeredness and their self-reported communication style with patients. Copyright © 2017 Elsevier Inc. All rights reserved.

A method comparison of photovoice and content analysis: research examining challenges and supports of family caregivers.

PubMed

Faucher, Mary Ann; Garner, Shelby L

2015-11-01

The purpose of this manuscript is to compare methods and thematic representations of the challenges and supports of family caregivers identified with photovoice methodology contrasted with content analysis, a more traditional qualitative approach. Results from a photovoice study utilizing a participatory action research framework was compared to an analysis of the audio-transcripts from that study utilizing content analysis methodology. Major similarities between the results are identified with some notable differences. Content analysis provides a more in-depth and abstract elucidation of the nature of the challenges and supports of the family caregiver. The comparison provides evidence to support the trustworthiness of photovoice methodology with limitations identified. The enhanced elaboration of theme and categories with content analysis may have some advantages relevant to the utilization of this knowledge by health care professionals. Copyright © 2015 Elsevier Inc. All rights reserved.

Beliefs about hypertension among Nigerian immigrants to the United Kingdom: A qualitative study

PubMed Central

Akinlua, James Tosin; Meakin, Richard; Freemantle, Nick

2017-01-01

Objective The aim of the study was to elicit beliefs about hypertension among Nigerian immigrants in the United Kingdom. Background The distributions of cardiovascular risk factors and diseases are not shared equally across ethnic and economic groups in the United Kingdom. Its burden is more clustered among minority ethnic populations and migrant groups including black African Nigerian migrants. Similar patterns have been reported across Europe, Australia, Canada, Nordic countries and the United States of America. There are about 300 distinct ethnic groups in Nigeria and reliable information about their beliefs about hypertension is not available. Given that the United Kingdom has a large community of Nigerian immigrants from these different ethno-cultural backgrounds, understanding their unique beliefs about hypertension may help promote appropriate care for this population in the United Kingdom and Nigeria. Setting A single Pentecostal church community in West London Participants Twenty-seven Nigerian migrant members of the church entered and completed the study Methods and outcome measure A qualitative interview study was conducted. The interviews were analysed using thematic framework analysis. The outcome measures were emerging themes from the thematic framework analysis. Results Participants expressed beliefs in four major areas related to hypertension: (1) The Meaning of the term hypertension, (2) Perceptions of causation, (3) Effects of hypertension, and (4) Perceptions of treatment. The study revealed a diversity of beliefs about hypertension which incorporated both orthodox and culturally framed ideas. Conclusions This study identified important beliefs among Nigerian migrants about hypertension that can contribute to our understanding of the management of hypertension in this group and suggests the need for further research to determine whether these beliefs may be representative of this group. PMID:28750080

Human factors paradigm and customer care perceptions.

PubMed

Clarke, Colin; Eales-Reynolds, Lesley-Jane

2015-01-01

The purpose of this paper is to examine if customer care (CC) can be directly linked to patient safety through a human factors (HF) framework. Data from an online questionnaire, completed by a convenience healthcare worker sample (n=373), was interrogated using thematic analysis within Vincent et al.'s (1998) HF theoretical framework. This proposes seven areas affecting patient safety: institutional context, organisation and management, work environment, team factors, individual, task and patient. Analysis identified responses addressing all framework areas. Responses (597) principally focused on work environment 40.7 per cent (n=243), organisation and management 28.8 per cent (n=172). Nevertheless, reference to other framework areas were clearly visible within the data: teams 10.2 per cent (n=61), individual 6.7 per cent (n=40), patients 6.0 per cent (n=36), tasks 4.2 per cent (n=24) and institution 3.5 per cent (n=21). Findings demonstrate congruence between CC perceptions and patient safety within a HF framework. The questionnaire requested participants to identify barriers to rather than CC enablers. Although this was at a single site complex organisation, it was similar to those throughout the NHS and other international health systems. CC can be viewed as consonant with patient safety rather than the potentially dangerous consumerisation stance, which could ultimately compromise patient safety. This work provides an original perspective on the link between CC and patient safety and has the potential to re-focus healthcare perceptions.

The Long-Term Conditions Questionnaire: conceptual framework and item development

PubMed Central

Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A’Court, Christine; Fitzpatrick, Ray

2016-01-01

Purpose To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Materials and methods Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Results Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. Conclusion The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey. PMID:27621678

Treatment implications arising from a qualitative analysis of letters written by the nonoffending partners of men who have perpetrated child sexual abuse.

PubMed

Cahalane, Hilary; Parker, Gemma; Duff, Simon

2013-01-01

There is a dearth of current empirical research exploring the experiences of nonoffending partners, or women whose partners have perpetrated child sexual abuse. Existing literature is dated and focuses disproportionately on intrafamilial abuse. This research explores how nonoffending partners construct and understand their experiences using thematic analysis within a social constructionist framework. Findings indicate that discovery of a partner's sexual offending is a profoundly distressing experience. It can inhibit a woman's ability to process the broader implications of her partner's behavior, including issues of risk, the impact on the victim, and the additional protective responsibilities she must adopt in the future. Implications for future research and clinical practice are discussed.

A systemic integrative framework to describe comprehensively a swine health system, Flanders as an example.

PubMed

Rojo-Gimeno, Cristina; Dewulf, Jeroen; Maes, Dominiek; Wauters, Erwin

2018-06-01

A well-functioning swine health system is crucial to ensure a sustainable pig production. Yet, little attention has been paid to understand it. The objective of this study was to unravel the complexity of a swine health system by using a systems-thinking approach for the case of Flanders (Northern part of Belgium). To that end, qualitative interviews were held with 33 relevant stakeholders. A hybrid thematic analysis was conducted which consisted of two phases. First, an inductive thematic analysis was conducted and second, the resulting themes were classified into the building blocks of a systemic framework. This framework combined a structural and a functional analysis that allowed to identify the key actors and their functions. Additionally, a transformational analysis was performed to evaluate how structures and the entire swine health system enable or disable functions. Findings revealed that the Flemish swine health system presents several merits such as the synchronization of policies and sector's agreements to reduce the antimicrobial use in the pig sector and the presence of a rich network of universities and research institutes that contribute to the education of health professionals. Nevertheless, several systemic failures were observed at different levels such as the lack of a good professional body representing the swine veterinarians, the tradition that veterinary advice is provided for 'free' by feed mill companies, and the shortage of reliable farm productivity data. Both latter failures may hinder swine practitioners to provide integrative advice. While few veterinarians are remunerated per hour or per visit by farmers, the most common business model used by veterinarians is largely based on the sale of medicines. Thus, veterinarians encounter often a conflict of interest when advising on preventive vaccinations and, in turn, farmers distrust their advice. On a positive note, alternatives to the traditional business model were suggested by both veterinarians and farmers which may indicate that there is intention to change; however, the broader institutional and socio-cultural environment does not enable this evolution. The results of this study can aid policy makers to anticipate the effects of proposed interventions and regulations so that they can be fine-tuned before they are enforced. Copyright © 2018 Elsevier B.V. All rights reserved.

An analysis of Australian graduate critical care nurse education.

PubMed

Gill, Fenella J; Leslie, Gavin D; Grech, Carol; Latour, Jos M

2015-01-01

Preparation of specialist critical care nurses in Australia is at graduate level, although there remains considerable variation in courses offered in relation to qualification, content, assessment and outcomes. As higher education providers must now comply with the Australian Qualifications Framework (AQF) a study was conducted to examine existing critical care courses and graduate practice outcomes. Twenty-two critical care courses were reviewed. Data sources included course provider, websites, course curricula and telephone interviews with course coordinators. A framework approach, was used consisting of five key stages: preliminary immersion of raw data, conceptualising a thematic framework, indexing, charting, mapping and interpretation of data. Analysis revealed considerable variations in course delivery and graduate practice outcomes. Most courses used professional competency standards as a framework for course curricula and clinical assessment, with inconsistency in their translation to graduate practice outcomes. Twenty-one courses included clinical assessment at graduate certificate level with no clinical assessment conducted at master level. The expected practice outcome for fifteen courses was safe practice with graduates not expected to practice at a specialist or team leadership level. Minimum graduate practice standards were not included in three courses as an expected outcome. The AQF requires graduate nurse education to be compliant with academic outcome standards. The findings of our study indicate variations between courses and subsequent graduate practice outcomes. It is therefore timely to establish national critical care education graduate practice standards.

A Framework for Integrating Qualitative and Quantitative Data in Knowledge, Attitude, and Practice Studies: A Case Study of Pesticide Usage in Eastern Uganda

PubMed Central

Muleme, James; Kankya, Clovice; Ssempebwa, John C.; Mazeri, Stella; Muwonge, Adrian

2017-01-01

Knowledge, attitude, and practice (KAP) studies guide the implementation of public health interventions (PHIs), and they are important tools for political persuasion. The design and implementation of PHIs assumes a linear KAP relationship, i.e., an awareness campaign results in the desirable societal behavioral change. However, there is no robust framework for testing this relationship before and after PHIs. Here, we use qualitative and quantitative data on pesticide usage to test this linear relationship, identify associated context specific factors as well as assemble a framework that could be used to guide and evaluate PHIs. We used data from a cross-sectional mixed methods study on pesticide usage. Quantitative data were collected using a structured questionnaire from 167 households representing 1,002 individuals. Qualitative data were collected from key informants and focus group discussions. Quantitative and qualitative data analysis was done in R 3.2.0 as well as qualitative thematic analysis, respectively. Our framework shows that a KAP linear relationship only existed for households with a low knowledge score, suggesting that an awareness campaign would only be effective for ~37% of the households. Context specific socioeconomic factors explain why this relationship does not hold for households with high knowledge scores. These findings are essential for developing targeted cost-effective and sustainable interventions on pesticide usage and other PHIs with context specific modifications. PMID:29276703

A Framework for Integrating Qualitative and Quantitative Data in Knowledge, Attitude, and Practice Studies: A Case Study of Pesticide Usage in Eastern Uganda.

PubMed

Muleme, James; Kankya, Clovice; Ssempebwa, John C; Mazeri, Stella; Muwonge, Adrian

2017-01-01

Knowledge, attitude, and practice (KAP) studies guide the implementation of public health interventions (PHIs), and they are important tools for political persuasion. The design and implementation of PHIs assumes a linear KAP relationship, i.e., an awareness campaign results in the desirable societal behavioral change. However, there is no robust framework for testing this relationship before and after PHIs. Here, we use qualitative and quantitative data on pesticide usage to test this linear relationship, identify associated context specific factors as well as assemble a framework that could be used to guide and evaluate PHIs. We used data from a cross-sectional mixed methods study on pesticide usage. Quantitative data were collected using a structured questionnaire from 167 households representing 1,002 individuals. Qualitative data were collected from key informants and focus group discussions. Quantitative and qualitative data analysis was done in R 3.2.0 as well as qualitative thematic analysis, respectively. Our framework shows that a KAP linear relationship only existed for households with a low knowledge score, suggesting that an awareness campaign would only be effective for ~37% of the households. Context specific socioeconomic factors explain why this relationship does not hold for households with high knowledge scores. These findings are essential for developing targeted cost-effective and sustainable interventions on pesticide usage and other PHIs with context specific modifications.

Why Map Issues? On Controversy Analysis as a Digital Method

PubMed Central

2015-01-01

This article takes stock of recent efforts to implement controversy analysis as a digital method in the study of science, technology, and society (STS) and beyond and outlines a distinctive approach to address the problem of digital bias. Digital media technologies exert significant influence on the enactment of controversy in online settings, and this risks undermining the substantive focus of controversy analysis conducted by digital means. To address this problem, I propose a shift in thematic focus from controversy analysis to issue mapping. The article begins by distinguishing between three broad frameworks that currently guide the development of controversy analysis as a digital method, namely, demarcationist, discursive, and empiricist. Each has been adopted in STS, but only the last one offers a digital “move beyond impartiality.” I demonstrate this approach by analyzing issues of Internet governance with the aid of the social media platform Twitter. PMID:26336325

"Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder.

PubMed

Perich, Tania; Ussher, Jane; Parton, Chloe

2017-11-16

Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Themes identified included 'Constructions of mood change: menopause or bipolar disorder?',' Life events, bipolar disorder and menopause coming together'; 'Treatment choices for mood change during menopause'. The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices.

Hermeneutic phenomenological analysis: the 'possibility' beyond 'actuality' in thematic analysis.

PubMed

Ho, Ken H M; Chiang, Vico C L; Leung, Doris

2017-07-01

This article discusses the ways researchers may become open to manifold interpretations of lived experience through thematic analysis that follows the tradition of hermeneutic phenomenology. Martin Heidegger's thinking about historical contexts of understandings and the notions of 'alētheia' and 'techne' disclose what he called meaning of lived experience, as the 'unchanging Being of changing beings'. While these notions remain central to hermeneutic phenomenological research, novice phenomenologists usually face the problem of how to incorporate these philosophical tenets into thematic analysis. Discussion paper. This discussion paper is based on our experiences of hermeneutic analysis supported by the writings of Heidegger. Literature reviewed for this paper ranges from 1927 - 2014. We draw on data from a study of foreign domestic helpers in Hong Kong to demonstrate how 'dwelling' in the language of participants' 'ek-sistence' supported us in a process of thematic analysis. Data were collected from December 2013 - February 2016. Nurses doing hermeneutic phenomenology have to develop self-awareness of one's own 'taken-for-granted' thinking to disclose the unspoken meanings hidden in the language of participants. Understanding the philosophical tenets of hermeneutic phenomenology allows nurses to preserve possibilities of interpretations in thinking. In so doing, methods of thematic analysis can uncover and present the structure of the meaning of lived experience. We provide our readers with vicarious experience of how to begin cultivating thinking that is aligned with hermeneutic phenomenological philosophical tenets to conduct thematic analysis. © 2017 John Wiley & Sons Ltd.

Narratives of community engagement: a systematic review-derived conceptual framework for public health interventions.

PubMed

Brunton, Ginny; Thomas, James; O'Mara-Eves, Alison; Jamal, Farah; Oliver, Sandy; Kavanagh, Josephine

2017-12-11

Government policy increasingly supports engaging communities to promote health. It is critical to consider whether such strategies are effective, for whom, and under what circumstances. However, 'community engagement' is defined in diverse ways and employed for different reasons. Considering the theory and context we developed a conceptual framework which informs understanding about what makes an effective (or ineffective) community engagement intervention. We conducted a systematic review of community engagement in public health interventions using: stakeholder involvement; searching, screening, appraisal and coding of research literature; and iterative thematic syntheses and meta-analysis. A conceptual framework of community engagement was refined, following interactions between the framework and each review stage. From 335 included reports, three products emerged: (1) two strong theoretical 'meta-narratives': one, concerning the theory and practice of empowerment/engagement as an independent objective; and a more utilitarian perspective optimally configuring health services to achieve defined outcomes. These informed (2) models that were operationalized in subsequent meta-analysis. Both refined (3) the final conceptual framework. This identified multiple dimensions by which community engagement interventions may differ. Diverse combinations of intervention purpose, theory and implementation were noted, including: ways of defining communities and health needs; initial motivations for community engagement; types of participation; conditions and actions necessary for engagement; and potential issues influencing impact. Some dimensions consistently co-occurred, leading to three overarching models of effective engagement which either: utilised peer-led delivery; employed varying degrees of collaboration between communities and health services; or built on empowerment philosophies. Our conceptual framework and models are useful tools for considering appropriate and effective approaches to community engagement. These should be tested and adapted to facilitate intervention design and evaluation. Using this framework may disentangle the relative effectiveness of different models of community engagement, promoting effective, sustainable and appropriate initiatives.

[The 20th century legal framework regarding risk at work and occupational health in Colombia].

PubMed

Arango-Soler, Juan M; Luna-García, Jairo E; Correa-Moreno, Yerson A; Campos, Adriana C

2013-01-01

Analyzing the 20th century Colombian legal framework from the point of view of labor law, social security and public health for identifying concepts regarding occupational health and professional risk and trying to establish convergence and differences between such foci and whether they fulfilled a complementary view. This work involved documentary research by means of thematic categorical analysis of the laws and statutes promulgated in 20th century Colombia, considering the main element or entity which should have regulated that related to professional risk or occupational health. The development of the 20th century Colombian legal framework regarding health at work was periodized, revealing the predominance of a view of social law focused on protecting dependent workers' work-related risks, as part of a tendency extending to the Colombian Sistema General de Riesgos Laborales. The proposed stages used for organizing the legal framework concerning social security regarding professional risk and occupational health facilitated some important elements being recognized concerning the social, legal and institutional context from which workers' health laws emerged. Tension was noted concerning statutes orientated towards redress and compensation regarding accidents at work and legislation emphasizing prevention.

DESperately Seeking Service: A narrative review informing a disability employment services reform framework for Australians with mental illness.

PubMed

Mellifont, Damian

2017-01-01

Notwithstanding efforts by vocational services to assist Australians with mental illness into employment many of these consumers remain unemployed. To inform policymakers and practitioners of a disability employment services reform framework that endeavours to help more consumers who are experiencing mental illness to attain and retain employment. Thematic analysis was directed to summarize results obtained from a narrative literature review of disability employment service reforms utilising Scopus, Medline and Pubmed databases and including articles published between 2000 and 2016. Research results reveal a preparative framework covering three levels of disability employment services reform for consumers with mental illness. This research makes important theoretical contributions across three areas. First this study reveals individualised, integrated and outcome-oriented services as dimensions of disability employment services reform that warrant greater government investment, practitioner focus and consumer involvement. Second recognising that none of these service reforms are immune from challenges which may hinder their effectiveness, future research is needed to identify evidence-based mitigation measures. Finally with individualised services positioned at the nucleus of the reform framework, integrated services and outcome-oriented reforms should be operationalised in ways that remain sensitive to the principle of strength-based support.

Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study.

PubMed

Phillips, Cameron J; Marshall, Andrea P; Chaves, Nadia J; Jankelowitz, Stacey K; Lin, Ivan B; Loy, Clement T; Rees, Gwyneth; Sakzewski, Leanne; Thomas, Susie; To, The-Phung; Wilkinson, Shelley A; Michie, Susan

2015-01-01

The Theoretical Domains Framework (TDF) is an integrative framework developed from a synthesis of psychological theories as a vehicle to help apply theoretical approaches to interventions aimed at behavior change. This study explores experiences of TDF use by professionals from multiple disciplines across diverse clinical settings. Mixed methods were used to examine experiences, attitudes, and perspectives of health professionals in using the TDF in health care implementation projects. Individual interviews were conducted with ten health care professionals from six disciplines who used the TDF in implementation projects. Deductive content and thematic analysis were used. Three main themes and associated subthemes were identified including: 1) reasons for use of the TDF (increased confidence, broader perspective, and theoretical underpinnings); 2) challenges using the TDF (time and resources, operationalization of the TDF) and; 3) future use of the TDF. The TDF provided a useful, flexible framework for a diverse group of health professionals working across different clinical settings for the assessment of barriers and targeting resources to influence behavior change for implementation projects. The development of practical tools and training or support is likely to aid the utility of TDF.

Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study

PubMed Central

Phillips, Cameron J; Marshall, Andrea P; Chaves, Nadia J; Jankelowitz, Stacey K; Lin, Ivan B; Loy, Clement T; Rees, Gwyneth; Sakzewski, Leanne; Thomas, Susie; To, The-Phung; Wilkinson, Shelley A; Michie, Susan

2015-01-01

Background The Theoretical Domains Framework (TDF) is an integrative framework developed from a synthesis of psychological theories as a vehicle to help apply theoretical approaches to interventions aimed at behavior change. Purpose This study explores experiences of TDF use by professionals from multiple disciplines across diverse clinical settings. Methods Mixed methods were used to examine experiences, attitudes, and perspectives of health professionals in using the TDF in health care implementation projects. Individual interviews were conducted with ten health care professionals from six disciplines who used the TDF in implementation projects. Deductive content and thematic analysis were used. Results Three main themes and associated subthemes were identified including: 1) reasons for use of the TDF (increased confidence, broader perspective, and theoretical underpinnings); 2) challenges using the TDF (time and resources, operationalization of the TDF) and; 3) future use of the TDF. Conclusion The TDF provided a useful, flexible framework for a diverse group of health professionals working across different clinical settings for the assessment of barriers and targeting resources to influence behavior change for implementation projects. The development of practical tools and training or support is likely to aid the utility of TDF. PMID:25834455

Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

PubMed

Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

2016-11-01

Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

Teaching for Cultural Literacy: A Curriculum Study.

ERIC Educational Resources Information Center

Flinders, David J.

1996-01-01

Explores the concept of curriculum enactment, which calls attention to classroom uses of content and contextual constructions of meaning. The study's methodological framework draws on descriptive, interpretive, evaluative, and thematic dimensions of educational criticism. Two high school English and social studies classes exemplifying curriculum…

Tectonic evaluation of the Nubian shield of Northeastern Sudan using thematic mapper imagery

NASA Technical Reports Server (NTRS)

1986-01-01

Bechtel is nearing completion of a one-year program that uses digitally enhanced LANDSAT Thematic Mapper (TM) data to compile the first comprehensive regional tectonic map of the Proterozoic Nubian Shield exposed in the northern Red Sea Hills of northeastern Sudan. The status of significant objectives of this study are given. Pertinent published and unpublished geologic literature and maps of the northern Red Sea Hills to establish the geologic framework of the region were reviewed. Thematic mapper imagery for optimal base-map enhancements was processed. Photo mosaics of enhanced images to serve as base maps for compilation of geologic information were completed. Interpretation of TM imagery to define and delineate structural and lithogologic provinces was completed. Geologic information (petrologic, and radiometric data) was compiled from the literature review onto base-map overlays. Evaluation of the tectonic evolution of the Nubian Shield based on the image interpretation and the compiled tectonic maps is continuing.

Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study.

PubMed

Vaismoradi, Mojtaba; Turunen, Hannele; Bondas, Terese

2013-09-01

Qualitative content analysis and thematic analysis are two commonly used approaches in data analysis of nursing research, but boundaries between the two have not been clearly specified. In other words, they are being used interchangeably and it seems difficult for the researcher to choose between them. In this respect, this paper describes and discusses the boundaries between qualitative content analysis and thematic analysis and presents implications to improve the consistency between the purpose of related studies and the method of data analyses. This is a discussion paper, comprising an analytical overview and discussion of the definitions, aims, philosophical background, data gathering, and analysis of content analysis and thematic analysis, and addressing their methodological subtleties. It is concluded that in spite of many similarities between the approaches, including cutting across data and searching for patterns and themes, their main difference lies in the opportunity for quantification of data. It means that measuring the frequency of different categories and themes is possible in content analysis with caution as a proxy for significance. © 2013 Wiley Publishing Asia Pty Ltd.

The Utility of Template Analysis in Qualitative Psychology Research.

PubMed

Brooks, Joanna; McCluskey, Serena; Turley, Emma; King, Nigel

2015-04-03

Thematic analysis is widely used in qualitative psychology research, and in this article, we present a particular style of thematic analysis known as Template Analysis. We outline the technique and consider its epistemological position, then describe three case studies of research projects which employed Template Analysis to illustrate the diverse ways it can be used. Our first case study illustrates how the technique was employed in data analysis undertaken by a team of researchers in a large-scale qualitative research project. Our second example demonstrates how a qualitative study that set out to build on mainstream theory made use of the a priori themes (themes determined in advance of coding) permitted in Template Analysis. Our final case study shows how Template Analysis can be used from an interpretative phenomenological stance. We highlight the distinctive features of this style of thematic analysis, discuss the kind of research where it may be particularly appropriate, and consider possible limitations of the technique. We conclude that Template Analysis is a flexible form of thematic analysis with real utility in qualitative psychology research.

Evidence appraisal: a scoping review, conceptual framework, and research agenda.

PubMed

Goldstein, Andrew; Venker, Eric; Weng, Chunhua

2017-11-01

Critical appraisal of clinical evidence promises to help prevent, detect, and address flaws related to study importance, ethics, validity, applicability, and reporting. These research issues are of growing concern. The purpose of this scoping review is to survey the current literature on evidence appraisal to develop a conceptual framework and an informatics research agenda. We conducted an iterative literature search of Medline for discussion or research on the critical appraisal of clinical evidence. After title and abstract review, 121 articles were included in the analysis. We performed qualitative thematic analysis to describe the evidence appraisal architecture and its issues and opportunities. From this analysis, we derived a conceptual framework and an informatics research agenda. We identified 68 themes in 10 categories. This analysis revealed that the practice of evidence appraisal is quite common but is rarely subjected to documentation, organization, validation, integration, or uptake. This is related to underdeveloped tools, scant incentives, and insufficient acquisition of appraisal data and transformation of the data into usable knowledge. The gaps in acquiring appraisal data, transforming the data into actionable information and knowledge, and ensuring its dissemination and adoption can be addressed with proven informatics approaches. Evidence appraisal faces several challenges, but implementing an informatics research agenda would likely help realize the potential of evidence appraisal for improving the rigor and value of clinical evidence. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Pharmaceutical strategic purchasing requirements in Iran: Price interventions and the related effective factors.

PubMed

Bastani, Peivand; Dinarvand, Rasoul; SamadBeik, Mahnaz; Pourmohammadi, Kimia

2016-01-01

Pharmaceutical access for the poor is an essential factor in developing countries that can be improved through strategic purchasing. This study was conducted to identify the elements affecting price in order to enable insurance organizations to put strategic purchasing into practice. This was a qualitative study conducted through content analysis with an inductive approach applying a five-stage framework analysis (familiarization, identifying a thematic framework, indexing, mapping, and interpretation). Data analysis was started right after transcribing each interview applying ATLAS.ti. Data were saturated after 32 semi-structured interviews by experts. These key informants were selected purposefully and through snowball sampling. Findings showed that there are four main themes as Pharmaceutical Strategic Purchasing Requirements in Iran as follows essential and structural factors, international factors, economical factors, and legal factors. Moreover, totally 14 related sub-themes were extracted in this area as the main effective variables. It seems that paying adequate attention to the four present themes and 14 sub-themes affecting price can enable health system policy-makers of developing countries like Iran to make the best decisions through strategic purchasing of drugs by the main insurers in order to improve access and health in the country.

How do people with body dysmorphic disorder view themselves? A thematic analysis.

PubMed

Silver, Joanna; Reavey, Paula; Anne Fineberg, Naomi

2010-09-01

Abstract Objectives. To examine the accounts of people with body dysmorphic disorder (BDD) and qualitatively explore self perceptions. Methods. Eleven people with BDD were interviewed using a semi-structured schedule. Participants brought photographs of themselves and drew a self-portrait. Transcribed interviews were analysed using a thematic analysis. Results. The most common theme was increased threat perception resulting in disordered interpersonal relationships. Other themes included the wish for regularity and symmetry in appearance, an idealised childhood self, the duty to look good, and a focus on specific "defective" features rather than general ugliness. Conclusions. Using thematic analysis and visual methods, we identified core themes that appear to characterise the way individuals with BDD perceive themselves and their interpersonal relationships. Thematic analysis offers promise as a tool to explore the overlap between BDD and other putatively related mental health problems.

Mapping Mathematics in Classroom Discourse

ERIC Educational Resources Information Center

Herbel-Eisenmann, Beth A.; Otten, Samuel

2011-01-01

This article offers a particular analytic method from systemic functional linguistics, "thematic analysis," which reveals the mathematical meaning potentials construed in discourse. Addressing concerns that discourse analysis is too often content-free, thematic analysis provides a way to represent semantic structures of mathematical content,…

Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review.

PubMed

Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

2017-10-22

The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Thematic analysis review of CM studies. We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004-December 2015 period, then updated to July 2017, with the keywords 'CM' and 'frequent use'. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir's implementation of health innovations framework was used to organise results into four broad levels of factors: (1) ,environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

["...cause in such a big hospital ... visually impaired persons like me, alone, can't get anywhere"--the experience of visually impaired people of the in-patient care--an empirical, explorative study].

PubMed

Golde, Christian

2007-02-01

The aim of this study is to explore the experiences of people with visual impairment within in-patient care. Actually, in nursing literature, no similar research is known in the German speaking area. Therefore, an qualitative research framework was used. By using a convenience sampling eight participants have been chosen. Mainly, the thematic content analysis of Burnard has been applied to the analysis of the empirical data. Mental spatial concepts for orientation, primarily acoustically made communicative resonance fields, and Action techniques constitute three major topics, which have been categorised in this study. These concepts are discussed in the cause of the research with respect to their implications on nursing care.

Perceived Instrumentality and Normativeness of Corporal Punishment Use among Black Mothers

PubMed Central

Taylor, Catherine A.; Hamvas, Lauren; Paris, Ruth

2011-01-01

Corporal punishment (CP) remains highly prevalent in the U.S. despite its association with increased risk for child aggression and physical abuse. Five focus groups were conducted with parents (n=18) from a community at particularly high risk for using CP (Black, low socioeconomic status, Southern) in order to investigate their perceptions about why CP use is so common. A systematic qualitative analysis was conducted using grounded theory techniques within an overall thematic analysis. Codes were collapsed and two broad themes emerged. CP was perceived to be: 1) instrumental in achieving parenting goals and 2) normative within participants' key social identity groups, including race/ethnicity, religion, and family of origin. Implications for the reduction of CP are discussed using a social ecological framework. PMID:22707816

Organizational culture and climate for promoting innovativeness.

PubMed

Joseph, M Lindell

2015-03-01

The aim of this study is to explore the experiences of nurse leaders and nurses in a hospital whose patient care mission was stated as innovation. Nurses are critically positioned to provide creative and innovative solutions that make a difference in the lives of patients, organizations, communities, and the profession. This 2-phase qualitative study used a content analysis and thematic analysis approach to describe experiences and to generate a beginning conceptual framework of the experience. Results from phase 1 and phase 2 of this study demonstrate that innovativeness in nursing is a multifaceted phenomenon consisting of workplace antecedents followed by a social process. Nursing innovation requires organizational commitment to allow employees to inquire and question organizational practices and issues on behalf of the mission, patient care, and nursing practice.

A conceptual framework to facilitate the mental health of student nurses working with persons with intellectual disabilities.

PubMed

van Rensburg, Elsie S Janse; Poggenpoel, Marie; Myburgh, Chris

2015-11-25

Student nurses (SNs) experience emotional discomfort during placement in the clinical psychiatric learning environment. This may negatively influence their mental health. Limited support is available to assist both SNs working with persons with intellectual disabilities and nurse educators during clinical accompaniment. This article aims to discuss the generation of this framework to enhance student support. A theory-generative, qualitative, exploratory, descriptive, contextual design was utilised to develop the framework by applying four steps. In step 1 concept analysis identified the central concept through field work. Data were collected from 13 SNs purposively selected from a specific higher educational institution in Gauteng through two focus group interviews, reflective journals, a reflective letter, naïve sketches, drawings and field notes and analysed with thematic coding. The central concept was identified from the results, supported by a literature review and defined by essential attributes. The central concept was classified through a survey list and demonstrated in a model case. In step 2 the central concepts were placed into relationships with each other. The conceptual framework was described and evaluated in step 3 and guidelines for implementation were described in step 4. The focus of this article will be on generating the conceptual framework. The central concept was 'the facilitation of engagement on a deeper emotional level of SNs'. The conceptual framework was described and evaluated. The conceptual framework can enhance the educational practices of nurse educators and can SN's practices of care for persons with intellectual disabilities.

Simulation of Thematic Mapper performance as a function of sensor scanning parameters

NASA Technical Reports Server (NTRS)

Johnson, R. H.; Shah, N. J.; Schmidt, N. F.

1975-01-01

The investigation and results of the Thematic Mapper Instrument Performance Study are described. The Thematic Mapper is the advanced multispectral scanner initially planned for the Earth Observation Satellite and now planned for LANDSAT D. The use of existing digital airborne scanner data obtained with the Modular Multispectral Scanner (M2S) at Bendix provided an opportunity to simulate the effects of variation of design parameters of the Thematic Mapper. Analysis and processing of this data on the Bendix Multispectral Data Analysis System were used to empirically determine categorization performance on data generated with variations of the sampling period and scan overlap parameters of the Thematic Mapper. The Bendix M2S data, with a 2.5 milliradian instantaneous field of view and a spatial resolution (pixel size) of 10-m from 13,000 ft altitude, allowed a direct simulation of Thematic Mapper data with a 30-m resolution. The flight data chosen were obtained on 30 June 1973 over agricultural test sites in Indiana.

Career Paths in Educational Leadership: Examining Principals' Narratives

ERIC Educational Resources Information Center

Parylo, Oksana; Zepeda, Sally J.; Bengtson, Ed

2012-01-01

This qualitative study analyzes the career path narratives of active principals. Structural narrative analysis was supplemented with sociolinguistic theory and thematic narrative analysis to discern the similarities and differences, as well as the patterns in the language used by participating principals. Thematic analysis found four major themes…

Pixels, Blocks of Pixels, and Polygons: Choosing a Spatial Unit for Thematic Accuracy Assessment

EPA Science Inventory

Pixels, polygons, and blocks of pixels are all potentially viable spatial assessment units for conducting an accuracy assessment. We develop a statistical population-based framework to examine how the spatial unit chosen affects the outcome of an accuracy assessment. The populati...

Developing an integrated framework of problem-based learning and coaching psychology for medical education: a participatory research.

PubMed

Wang, Qing; Li, Huiping; Pang, Weiguo; Liang, Shuo; Su, Yiliang

2016-01-05

Medical schools have been making efforts to develop their own problem-based learning (PBL) approaches based on their educational conditions, human resources and existing curriculum structures. This study aimed to explore a new framework by integrating the essential features of PBL and coaching psychology applicable to the undergraduate medical education context. A participatory research design was employed. Four educational psychology researchers, eight undergraduate medical school students and two accredited PBL tutors participated in a four-month research programme. Data were collected through participatory observation, focus groups, semi-structured interviews, workshop documents and feedback surveys and then subjected to thematic content analysis. The triangulation of sources and member checking were used to ensure the credibility and trustworthiness of the research process. Five themes emerged from the analysis: current experience of PBL curriculum; the roles of and relationships between tutors and students; student group dynamics; development of self-directed learning; and coaching in PBL facilitation. On the basis of this empirical data, a systematic model of PBL and coaching psychology was developed. The findings highlighted that coaching psychology could be incorporated into the facilitation system in PBL. The integrated framework of PBL and coaching psychology in undergraduate medical education has the potential to promote the development of the learning goals of cultivating clinical reasoning ability, lifelong learning capacities and medical humanity. Challenges, benefits and future directions for implementing the framework are discussed in this paper.

Evidence-based Frameworks for Teaching and Learning in Classical Singing Training: A Systematic Review.

PubMed

Crocco, Laura; Madill, Catherine J; McCabe, Patricia

2017-01-01

The study systematically reviews evidence-based frameworks for teaching and learning of classical singing training. This is a systematic review. A systematic literature search of 15 electronic databases following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines was conducted. Eligibility criteria included type of publication, participant characteristics, intervention, and report of outcomes. Quality rating scales were applied to support assessment of the included literature. Data analysis was conducted using meta-aggregation. Nine papers met the inclusion criteria. No complete evidence-based teaching and learning framework was found. Thematic content analysis showed that studies either (1) identified teaching practices in one-to-one lessons, (2) identified student learning strategies in one-to-one lessons or personal practice sessions, and (3) implemented a tool to enhance one specific area of teaching and learning in lessons. The included studies showed that research in music education is not always specific to musical genre or instrumental group, with four of the nine studies including participant teachers and students of classical voice training only. The overall methodological quality ratings were low. Research in classical singing training has not yet developed an evidence-based framework for classical singing training. This review has found that introductory information on teaching and learning practices has been provided, and tools have been suggested for use in the evaluation of the teaching-learning process. High-quality methodological research designs are needed. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Protocol for a qualitative synthesis of barriers and facilitators in implementing guidelines for diagnosis of tuberculosis.

PubMed

Ochodo, Eleanor; Kredo, Tamara; Young, Taryn; Wiysonge, Charles Shey

2017-06-09

Despite the introduction of new tests and guidelines for diagnosis of tuberculosis (TB), worldwide case detection rate of TB is still suboptimal. This could be in part explained by the poor implementation of TB diagnostic guidelines. We aim to identify, appraise and synthesise qualitative evidence exploring the barriers and facilitators to implementing TB diagnostic guidelines. A systematic review of qualitative studies will be conducted. Relevant electronic databases will be searched and studies included based on predefined inclusion criteria. We will also search reference lists, grey literature, conduct forward citation searches and contact relevant content experts. An adaptation of the Critical Appraisal Skills Programme tool will be used to assess the methodological quality of included studies. Two authors will review the search output, extract data and assess methodological quality independently, resolving any disagreements by consensus. We will use the thematic framework analysis approach based on the Supporting the Use of Research Evidence thematic framework to analyse and synthesise our data. We will apply the Confidence in the Evidence from Reviews of Qualitative research approach to transparently assess our confidence in the findings of the systematic review. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016039790 TRIAL REGISTRATION NUMBER: PROSPERO 2016: CRD42016039790. Available from http://www.crd.york.ac.uk/PROSPERO/. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Qualitative research methods in renal medicine: an introduction.

PubMed

Bristowe, Katherine; Selman, Lucy; Murtagh, Fliss E M

2015-09-01

Qualitative methodologies are becoming increasingly widely used in health research. However, within some specialties, including renal medicine, qualitative approaches remain under-represented in the high-impact factor journals. Qualitative research can be undertaken: (i) as a stand-alone research method, addressing specific research questions; (ii) as part of a mixed methods approach alongside quantitative approaches or (iii) embedded in clinical trials, or during the development of complex interventions. The aim of this paper is to introduce qualitative research, including the rationale for choosing qualitative approaches, and guidance for ensuring quality when undertaking and reporting qualitative research. In addition, we introduce types of qualitative data (observation, interviews and focus groups) as well as some of the most commonly encountered methodological approaches (case studies, ethnography, phenomenology, grounded theory, thematic analysis, framework analysis and content analysis). © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

JGME-ALiEM Hot Topics in Medical Education: Analysis of a Multimodal Online Discussion About Team-Based Learning.

PubMed

Riddell, Jeff; Patocka, Catherine; Lin, Michelle; Sherbino, Jonathan

2017-02-01

Team-based learning (TBL) is an instructional method that is being increasingly incorporated in health professions education, although use in graduate medical education (GME) has been more limited. To curate and describe themes that emerged from a virtual journal club discussion about TBL in GME, held across multiple digital platforms, while also evaluating the use of social media in online academic discussions. The Journal of Graduate Medical Education ( JGME ) and the Academic Life in Emergency Medicine blog facilitated a weeklong, open-access, virtual journal club on the 2015 JGME article "Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching." Using 4 stimulus questions (hosted on a blog as a starting framework), we facilitated discussions via the blog, Twitter, and Google Hangouts on Air platforms. We evaluated 2-week web analytics and performed a thematic analysis of the discussion. The virtual journal club reached a large international audience as exemplified by the blog page garnering 685 page views from 241 cities in 42 countries. Our thematic analysis identified 4 domains relevant to TBL in GME: (1) the benefits and barriers to TBL; (2) the design of teams; (3) the role of assessment and peer evaluation; and (4) crowdsourced TBL resources. The virtual journal club provided a novel forum across multiple social media platforms, engaging authors, content experts, and the health professions education community in a discussion about the importance, impediments to implementation, available resources, and logistics of adopting TBL in GME.

Blogs Written by Families During Their Child's Hospitalization: A Thematic Narrative Analysis.

PubMed

Jones, Carolyn W; Lynn, Mary R

2018-04-04

To identify stressors experienced by parents whose child is hospitalized in an intensive care unit, and identify coping mechanisms utilized to ameliorate those stressors. Using Lazarus and Folkman's Transactional Model of Stress and Coping as a framework, 20 publicly available blogs written by parents while their child was a patient in intensive care were analyzed using thematic analysis techniques. Stressors and coping techniques were identified, and grouped by theme for further analysis. The most frequently noted types of stressors were related to information; both knowing and not knowing information related to their child's condition was reported as stressful, as well as waiting for information and when the information was not what was expected. Reframing was the emotion-focused technique most often identified by the parents, and seeking support was the most frequently noted problem-focused coping mechanism. Illness blogs represent a rich source of information regarding the experiences of families with a child in the hospital. Parents transitioned from more emotion-focused coping strategies to problem-focused strategies during their child's hospital stay. When nurses give information to parents, they should be aware that knowing information can be stressful as well as not knowing, and care should be taken to provide support for parents after information is given. Nurses can also help parents identify sources of support. Writing about their experiences, either online or in a journal, may help parents cope in stressful situations. Copyright © 2017 Elsevier Inc. All rights reserved.

Resources to cope with stigma related to HIV status, gender identity, and sexual orientation in gay men and transgender women.

PubMed

Arístegui, Inés; Radusky, Pablo D; Zalazar, Virginia; Lucas, Mar; Sued, Omar

2018-02-01

The stigma related to HIV status, gender identity, and sexual orientation has negative implications for the quality of life of individuals. A qualitative study was conducted to explore the resources that these stigmatized groups recognize as tools to cope with stigma and maintain their psychological well-being. Four focus groups were conducted with gay men and transgender women divided by HIV status. A thematic analysis revealed that individual, interpersonal, and institutional resources are commonly recognized as coping resources. This article discusses the importance of enhancing self-acceptance, social support, and a legal framework that legitimizes these groups as right holders.

Land-Cover Trends of the Southern California Mountains Ecoregion

USGS Publications Warehouse

Soulard, Christopher E.; Raumann, Christian G.; Wilson, Tamara S.

2007-01-01

This report presents an assessment of land-use and land-cover (LU/LC) change in the Southern California Mountains ecoregion for the period 1973-2001. The Southern California Mountains is one of 84 Level-III ecoregions as defined by the U.S. Environmental Protection Agency (EPA). Ecoregions have served as a spatial framework for environmental resource management, denoting areas that contain a geographically distinct assemblage of biotic and abiotic phenomena including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The established Land Cover Trends methodology generates estimates of change for ecoregions using a probability sampling approach and change-detection analysis of thematic land-cover images derived from Landsat satellite imagery.

Mentoring Doctoral Students through Scholastic Engagement: Adult Learning Principles in Action

ERIC Educational Resources Information Center

Mullen, Carol A.; Fish, Valorie L.; Hutinger, Janice L.

2010-01-01

The purpose of this discussion is to explore a graduate intervention that was aimed at promoting the understanding, empowerment, and skills building of doctoral students in education. Addressed are mentoring and learning frameworks, background issues, the pedagogical context, study details, thematic results, and implications. The authors offer a…

Science through ARts (STAR)

ERIC Educational Resources Information Center

Densmore, Marycay; Kolecki, Joseph C.; Miller, Allan; Petersen, Ruth; Terrell, Mike

2005-01-01

Science Through ARts (STAR) is a free, international, cross-curricular program thematically aligned with "The Vision for Space Exploration," a framework of goals and objectives published by NASA in February 2004. Through the STAR program, students in grades 5 through 12 are encouraged to apply their knowledge in creative ways as they approach a…

Family-focused practice within a recovery framework: practitioners' qualitative perspectives.

PubMed

Ward, B; Reupert, A; McCormick, F; Waller, S; Kidd, S

2017-03-24

Family-focused practice (FFP) is an effective approach to supporting individuals with mental illness. 'Recovery' is also central to contemporary mental health care. However, there is a dearth of evidence about how the two concepts are related and subsequently implemented in practice. The aim of this study was to explore practitioners' understandings and practices of FFP within a recovery framework. Purposive/snowball sampling was used to recruit and conduct qualitative interviews with 11 mental health practitioners in rural Australia. Concurrent sampling and data collection were informed by thematic analysis and continued until data saturation was reached. Participants found it difficult to articulate their understandings of FFP within a recovery framework. Nonetheless they were able to describe practices that embodied family-focused recovery. Barriers to such practices included medical models of care, where there are often a shortage of skilled staff and high demands for care. Stigma (self and from others) and confidentiality were also identified as barriers to involving family members in recovery focused care. Family-focused recovery care is a priority in many high-income countries. A family-focused recovery framework is needed to assist service planners, practitioners, family members and those with mental health needs and ensure such care is embedded within practice guidelines.

Patients' perceptions and experiences of cardiovascular disease and diabetes prevention programmes: A systematic review and framework synthesis using the Theoretical Domains Framework.

PubMed

Shaw, Rachel L; Holland, Carol; Pattison, Helen M; Cooke, Richard

2016-05-01

This review provides a worked example of 'best fit' framework synthesis using the Theoretical Domains Framework (TDF) of health psychology theories as an a priori framework in the synthesis of qualitative evidence. Framework synthesis works best with 'policy urgent' questions. The review question selected was: what are patients' experiences of prevention programmes for cardiovascular disease (CVD) and diabetes? The significance of these conditions is clear: CVD claims more deaths worldwide than any other; diabetes is a risk factor for CVD and leading cause of death. A systematic review and framework synthesis were conducted. This novel method for synthesizing qualitative evidence aims to make health psychology theory accessible to implementation science and advance the application of qualitative research findings in evidence-based healthcare. Findings from 14 original studies were coded deductively into the TDF and subsequently an inductive thematic analysis was conducted. Synthesized findings produced six themes relating to: knowledge, beliefs, cues to (in)action, social influences, role and identity, and context. A conceptual model was generated illustrating combinations of factors that produce cues to (in)action. This model demonstrated interrelationships between individual (beliefs and knowledge) and societal (social influences, role and identity, context) factors. Several intervention points were highlighted where factors could be manipulated to produce favourable cues to action. However, a lack of transparency of behavioural components of published interventions needs to be corrected and further evaluations of acceptability in relation to patient experience are required. Further work is needed to test the comprehensiveness of the TDF as an a priori framework for 'policy urgent' questions using 'best fit' framework synthesis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Graduate Attributes for Master's Programs in Health Services and Policy Research: Results of a National Consultation

PubMed Central

Morgan, Steve; Orr, Karen; Mah, Catherine

2010-01-01

Objective: Our objective was to identify desirable attributes to be developed through graduate training in health services and policy research (HSPR) by identifying the knowledge, skills and abilities thought to be keys to success in HSPR-related careers. We aimed for a framework clear enough to serve as a touchstone for HSPR training programs across Canada yet flexible enough to permit diversity of specialization across and within those programs. Methods: Our approach involved several stages of data collection and analysis: a review of literature; telephone interviews with opinion leaders; online surveys of HSPR students, recent graduates and employers; an invitational workshop; and an interactive panel at a national conference. Our final framework was arrived at through an iterative process of thematic analysis, reflection on invited feedback from consultation participants and triangulation with existing competency frameworks. Results: Our final result was a framework that identifies traits, knowledge and abilities of master's-level graduates who are capable of fostering health system improvement through planning, management, analysis or monitoring that is informed by credible evidence and relevant theory. These attributes are organized into three levels: generic graduate attributes, knowledge related to health and health systems and, finally, attributes related to the application of knowledge for health system improvement. The HSPR-specific attributes include not only an understanding of HSPR theories and methods but also the skills related to the practical application of knowledge in the complex environments of health system decision-making and healthcare policy. Conclusion: Master's-level HSPR training programs should prepare students to pose and seek answers to important questions and provide them with the skills necessary to apply their knowledge within complex decision-making environments. PMID:21804839

Power-sharing Partnerships: Teachers' Experiences of Participatory Methodology.

PubMed

Ferreira, Ronél; Ebersöhn, Liesel; Mbongwe, Bathsheba B

2015-01-01

This article reports on the experiences of teachers as coresearchers in a long-term partnership with university researchers, who participated in an asset-based intervention project known as Supportive Teachers, Assets and Resilience (STAR). In an attempt to inform participatory research methodology, the study investigated how coresearchers (teachers) experienced power relations. We utilized Gaventa's power cube as a theoretical framework and participatory research as our methodologic paradigm. Ten teachers of a primary school in the Eastern Cape and five teachers of a secondary school in a remote area in the Mpumalanga Province in South Africa participated (n=15). We employed multiple data generation techniques, namely Participatory Reflection and Action (PRA) activities, observation, focus group discussions, and semistructured interviews, using thematic analysis and categorical aggregation for data analysis. We identified three themes, related to the (1) nature of power in participatory partnerships, (2) coreasearchers' meaning making of power and partnerships, and their (3) role in taking agency. Based on these findings, we developed a framework of power sharing partnerships to extend Gaventa's power cube theory. This framework, and its five interrelated elements (leadership as power, identifying vision and mission, synergy, interdependent role of partners, and determination), provide insight into the way coresearchers shared their experiences of participatory research methodology. We theorise power-sharing partnerships as a complimentary platform hosting partners' shared strengths, skills, and experience, creating synergy in collaborative projects.

A framework for mentoring of medical students: thematic analysis of mentoring programmes between 2000 and 2015.

PubMed

Tan, Yin Shuen; Teo, Shao Wen Amanda; Pei, Yiying; Sng, Julia Huina; Yap, Hong Wei; Toh, Ying Pin; Krishna, Lalit K R

2018-03-17

A consistent mentoring approach is key to unlocking the full benefits of mentoring, ensuring effective oversight of mentoring relationships and preventing abuse of mentoring. Yet consistency in mentoring between senior clinicians and medical students (novice mentoring) which dominate mentoring processes in medical schools is difficult to achieve particularly when mentors practice in both undergraduate and postgraduate medical schools. To facilitate a consistent approach to mentoring this review scrutinizes common aspects of mentoring in undergraduate and postgraduate medical schools to forward a framework for novice mentoring in medical schools. Four authors preformed independent literature searches of novice mentoring guidelines and programmes in undergraduate and postgraduate medical schools using ERIC, PubMed, CINAHL, OVID and Science Direct databases. 25,605 abstracts were retrieved, 162 full-text articles were reviewed and 34 articles were included. The 4 themes were identified-preparation, initiating and supporting the mentoring process and the obstacles to effective mentoring. These themes highlight 2 key elements of an effective mentoring framework-flexibility and structure. Flexibility refers to meeting the individual and changing needs of mentees. Structure concerns ensuring consistency to the mentoring process and compliance with prevailing codes of conduct and standards of practice.

Developing a framework for understanding doctors' health access: a qualitative study of Australian GPs.

PubMed

Kay, Margaret; Mitchell, Geoffrey; Clavarino, Alexandra; Frank, Erica

2012-01-01

Health access behaviours of doctors need to be understood if the profession is to adequately respond to concerns raised about doctors' health. There has been limited investigation of these issues and most qualitative studies have focussed on doctors who have been seriously unwell. This research project was designed to explore doctors' attitudes to health access and the barriers they experience using six independently facilitated focus groups (37 general practitioners) in Brisbane, Australia. Themes that emerged using inductive thematic analysis were grouped into three key categories. The findings challenge current representations of doctors' health within the medical literature. Doctors in this study reported positive attitudes towards their own health care. Health access, however, was difficult because of the barriers they encountered. These barriers are described in detail revealing the rationale used by doctors seeking care. A framework of patient, provider and profession barrier domains is developed to enable a comparison between the health access barriers of the doctor and those experienced by the general community. The complexity is highlighted as the socio-cultural factors woven through these barrier domains are recognised. The potential for this framework to provide a structure for future interventions to enhance doctors' health access is discussed.

Conceptualising paediatric health disparities: a metanarrative systematic review and unified conceptual framework.

PubMed

Ridgeway, Jennifer L; Wang, Zhen; Finney Rutten, Lila J; van Ryn, Michelle; Griffin, Joan M; Murad, M Hassan; Asiedu, Gladys B; Egginton, Jason S; Beebe, Timothy J

2017-08-04

There exists a paucity of work in the development and testing of theoretical models specific to childhood health disparities even though they have been linked to the prevalence of adult health disparities including high rates of chronic disease. We conducted a systematic review and thematic analysis of existing models of health disparities specific to children to inform development of a unified conceptual framework. We systematically reviewed articles reporting theoretical or explanatory models of disparities on a range of outcomes related to child health. We searched Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus (database inception to 9 July 2015). A metanarrative approach guided the analysis process. A total of 48 studies presenting 48 models were included. This systematic review found multiple models but no consensus on one approach. However, we did discover a fair amount of overlap, such that the 48 models reviewed converged into the unified conceptual framework. The majority of models included factors in three domains: individual characteristics and behaviours (88%), healthcare providers and systems (63%), and environment/community (56%), . Only 38% of models included factors in the health and public policies domain. A disease-agnostic unified conceptual framework may inform integration of existing knowledge of child health disparities and guide future research. This multilevel framework can focus attention among clinical, basic and social science research on the relationships between policy, social factors, health systems and the physical environment that impact children's health outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Thematic analysis of tiles painted by blood and marrow transplant patients during treatment.

PubMed

Mische Lawson, L; Chau, J; Schoel, A

2016-11-01

The majority of research on understanding the illness focuses on analysing the written or verbal content. Thematic analysis of images is a novel qualitative approach that can enhance knowledge of the experience of illness. This study used thematic analysis to examine 171 tiles painted by patients through the Tiles of Hope programme in an outpatient blood and marrow transplant unit. Major themes identified in this study were Faith, Hope, Positive Attitude, Nature and Social Support. These themes provided a better understanding of patients' perceptions in relation to their experience with illness through the art-making process. © 2015 John Wiley & Sons Ltd.

Pharmaceutical strategic purchasing requirements in Iran: Price interventions and the related effective factors

PubMed Central

Bastani, Peivand; Dinarvand, Rasoul; SamadBeik, Mahnaz; Pourmohammadi, Kimia

2016-01-01

Objective: Pharmaceutical access for the poor is an essential factor in developing countries that can be improved through strategic purchasing. This study was conducted to identify the elements affecting price in order to enable insurance organizations to put strategic purchasing into practice. Methods: This was a qualitative study conducted through content analysis with an inductive approach applying a five-stage framework analysis (familiarization, identifying a thematic framework, indexing, mapping, and interpretation). Data analysis was started right after transcribing each interview applying ATLAS.ti. Data were saturated after 32 semi-structured interviews by experts. These key informants were selected purposefully and through snowball sampling. Findings: Findings showed that there are four main themes as Pharmaceutical Strategic Purchasing Requirements in Iran as follows essential and structural factors, international factors, economical factors, and legal factors. Moreover, totally 14 related sub-themes were extracted in this area as the main effective variables. Conclusion: It seems that paying adequate attention to the four present themes and 14 sub-themes affecting price can enable health system policy-makers of developing countries like Iran to make the best decisions through strategic purchasing of drugs by the main insurers in order to improve access and health in the country. PMID:26985434

Andragogical Methods for TESOL Trainers from Action Research in South Korea

ERIC Educational Resources Information Center

Richter, Jesse Jones

2013-01-01

This qualitative study uses action research methodology to investigate the thematic components of English language teacher training programs in the drive to develop a universal model framework. A two-part professional development in-service program in South Korea is used as a platform for the model. Similarities and differences between real and…

Work-Based Learning: In Search of an Effective Model

ERIC Educational Resources Information Center

Sobiechowska, Paula; Maisch, Maire

2006-01-01

This article draws upon 10 years of pedagogic experience in developing and delivering work-based learning programmes within the United Kingdom national social work post-qualifying framework. The article is a retrospective, reflective and thematic account of our work. It briefly outlines the history of post-qualifying social work education and…

How Can I Make Social Studies Move? Pull-out 2.

ERIC Educational Resources Information Center

Nilges, Lynda M.; Gallavan, Nancy P.

1998-01-01

Suggests a four-stage framework that teachers can use to integrate creative dance into the social studies curriculum. Discusses the four stages through the use of a sample dance about tornadoes that complements a thematic social studies unit about the impact of weather and natural disasters upon people and their environments. (CMK)

Responses and Clarifications regarding Science and Worldviews

ERIC Educational Resources Information Center

Gauch, Hugh G., Jr.

2009-01-01

This article responds to the other 10 papers in this thematic issue on science and worldviews and it clarifies some of the points in my lead article. The Bayesian framework provides helpful structure for worldview inquiries by recognizing and integrating both public and personal evidence. Drawing upon the other 10 papers, six kinds of potential…

Thematic Progression Analysis in Teaching Explanation Writing

ERIC Educational Resources Information Center

Yang, Xueqian

2008-01-01

Thematic Progression theory explains textual meanings of how experiential and interpersonal meanings are organized in a linear and coherent way. Employing the rationale of T-P theory, this article analyses a lesson plan of teaching Explanation, and shows that T-P analysis can be employed in teaching writing.

Midwifery participatory curriculum development: Transformation through active partnership.

PubMed

Sidebotham, Mary; Walters, Caroline; Chipperfield, Janine; Gamble, Jenny

2017-07-01

Evolving knowledge and professional practice combined with advances in pedagogy and learning technology create challenges for accredited professional programs. Internationally a sparsity of literature exists around curriculum development for professional programs responsive to regulatory and societal drivers. This paper evaluates a participatory curriculum development framework, adapted from the community development sector, to determine its applicability to promote engagement and ownership during the development of a Bachelor of Midwifery curriculum at an Australian University. The structures, processes and resulting curriculum development framework are described. A representative sample of key curriculum development team members were interviewed in relation to their participation. Qualitative analysis of transcribed interviews occurred through inductive, essentialist thematic analysis. Two main themes emerged: (1) 'it is a transformative journey' and (2) focused 'partnership in action'. Results confirmed the participatory curriculum development process provides symbiotic benefits to participants leading to individual and organisational growth and the perception of a shared curriculum. A final operational model using a participatory curriculum development process to guide the development of accredited health programs emerged. The model provides an appropriate structure to create meaningful collaboration with multiple stakeholders to produce a curriculum that is contemporary, underpinned by evidence and reflective of 'real world' practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Medical student professionalism narratives: a thematic analysis and interdisciplinary comparative investigation.

PubMed

Bernard, Aaron W; Malone, Matthew; Kman, Nicholas E; Caterino, Jeffrey M; Khandelwal, Sorabh

2011-08-12

Professionalism development is influenced by the informal and hidden curriculum. The primary objective of this study was to better understand this experiential learning in the setting of the Emergency Department (ED). Secondarily, the study aimed to explore differences in the informal curriculum between Emergency Medicine (EM) and Internal Medicine (IM) clerkships. A thematic analysis was conducted on 377 professionalism narratives from medical students completing a required EM clerkship from July 2008 through May 2010. The narratives were analyzed using established thematic categories from prior research as well as basic descriptive characteristics. Chi-square analysis was used to compare the frequency of thematic categories to prior research in IM. Finally, emerging themes not fully appreciated in the established thematic categories were created using grounded theory. Observations involving interactions between attending physician and patient were most abundant. The narratives were coded as positive 198 times, negative 128 times, and hybrid 37 times. The two most abundant narrative themes involved manifesting respect (36.9%) and spending time (23.7%). Both of these themes were statistically more likely to be noted by students on EM clerkships compared to IM clerkships. Finally, one new theme regarding cynicism emerged during analysis. This analysis describes an informal curriculum that is diverse in themes. Student narratives suggest their clinical experiences to be influential on professionalism development. Medical students focus on different aspects of professionalism depending on clerkship specialty.

Medical Student Professionalism Narratives: A Thematic Analysis and Interdisciplinary Comparative Investigation

PubMed Central

2011-01-01

Background Professionalism development is influenced by the informal and hidden curriculum. The primary objective of this study was to better understand this experiential learning in the setting of the Emergency Department (ED). Secondarily, the study aimed to explore differences in the informal curriculum between Emergency Medicine (EM) and Internal Medicine (IM) clerkships. Methods A thematic analysis was conducted on 377 professionalism narratives from medical students completing a required EM clerkship from July 2008 through May 2010. The narratives were analyzed using established thematic categories from prior research as well as basic descriptive characteristics. Chi-square analysis was used to compare the frequency of thematic categories to prior research in IM. Finally, emerging themes not fully appreciated in the established thematic categories were created using grounded theory. Results Observations involving interactions between attending physician and patient were most abundant. The narratives were coded as positive 198 times, negative 128 times, and hybrid 37 times. The two most abundant narrative themes involved manifesting respect (36.9%) and spending time (23.7%). Both of these themes were statistically more likely to be noted by students on EM clerkships compared to IM clerkships. Finally, one new theme regarding cynicism emerged during analysis. Conclusions This analysis describes an informal curriculum that is diverse in themes. Student narratives suggest their clinical experiences to be influential on professionalism development. Medical students focus on different aspects of professionalism depending on clerkship specialty. PMID:21838887

A framework for developing rural academic general practices: a qualitative case study in rural Victoria.

PubMed

Brown, J B; Morrison, Tracy; Bryant, Melanie; Kassell, Lisa; Nestel, Debra

2015-01-01

There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research focus thus moving towards functioning as mature academic units. A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners (medical students, interns and registrars) and patients. Three practices hosted 'multi-level learners', two practices hosted one learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to recent literature and the expertise of the research team resulting in the rural academic general practice framework. Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research activity. The framework maps the development of a rural academic practice across these themes in four progressive stages: beginning, emerging, consolidating and established. The data enabled a framework to be constructed to map rural general practice activity with respect to activity characteristic of an academic general practice. The framework offers guidance to practices seeking to transition towards becoming a mature academic practice. The framework also offers guidance to educational institutions and funding bodies to support the development of academic activity in rural general practices. The strengths and limitations of the study design are outlined.

Women's experiences of hormonal therapy for breast cancer: exploring influences on medication-taking behaviour.

PubMed

Cahir, Caitriona; Dombrowski, Stephan U; Kelly, Catherine M; Kennedy, M John; Bennett, Kathleen; Sharp, Linda

2015-11-01

Five to 10 years of adjuvant hormonal therapy is recommended to prevent breast cancer recurrence. This study investigated modifiable influences on adjuvant hormonal therapy medication-taking behaviour (MTB) in women with stage I-III breast cancer. Semi-structured face-to-face interviews among women with stage I-III breast cancer prescribed adjuvant hormonal therapy purposively sampled by their MTB at two cancer centres. Thematic analysis was conducted based on the Framework approach, with the Theoretical Domains Framework (TDF) informing the analysis framework; the TDF is an integrative framework consisting of 14 domains of behavioural change to inform intervention design. Thirty-one women participated in interviews (14 adherent/persistent; 7 non-adherent/persistent; 10 non-persistent). Three domains identified both barriers and enablers to hormonal therapy MTB across the three MTB strata: beliefs about consequences, intentions and goals and behaviour regulation, but their influence was different across the strata. Other domains influenced individual MTB strata. Key enablers for adherent/persistent women were identified within the domain beliefs about consequences (breast cancer recurrence), intentions and goals (high-priority), beliefs about capabilities (side effects) and behaviour regulation (managing medication). Barriers were identified within the domain behaviour regulation (no routine), memory, attention and decision processes (forgetting) and environmental context and resources (stressors) for non-adherent/persistent women and intentions and goals (quality of life), behaviour regulation (temporal self-regulation), reinforcement, beliefs about consequences (non-necessity) and social influences (clinical support) for non-persistent women. This study identified modifiable influences on hormonal therapy MTB. Targeting these influences in clinical practice may improve MTB and hence survival in this population.

Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

PubMed

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The framework can also provide the basis for the development of appropriate corrective measures in the implementation of strategies and policies in public institutions such as public hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

A Thematic Analysis of Edwin L. Godkin's Editorials in the "Nation," 1865-1899.

ERIC Educational Resources Information Center

Lee, Richard W.

This thematic analysis of Edward L. Godkin's editorials appearing in the "Nation" seeks to reveal the major themes on which he wrote and then, by quantitative analysis, to provide some order to the themes and to study the interaction of the themes. Five hundred and twelve editorials, written over a period of 35 years and representing…

A case study of elementary teachers' conceptions of environmental literacy in relationship to a tall grass prairie restoration project

NASA Astrophysics Data System (ADS)

Shume, Teresa Jayne

The purpose of this qualitative case study was to describe seven elementary teachers' conceptions of environmental literacy in relationship to a tall grass prairie restoration project and to explore ways in which the tall grass prairie restoration project for third grade contributed to enhancing educational learning experiences. The research questions were: 1. What are teachers' conceptions of environmental literacy for third grade students? 2. How does the prairie restoration trip contribute to teachers' capacity to teach for environmental literacy of third grade students? 3. What is the pedagogical value of the prairie restoration project? The theoretical frameworks underpinning this study were David Sobel's (1996) model for developmental progression in children's relationships with nature, and the North American Environmental Education Association's (2011) framework for environmental literacy. The first assertion derived from thematic data analysis of interviews, field trip observations, classroom observations, and artifacts was, The participating teachers' visions of environmental literacy for third grade students included components that spanned across a developmentally appropriate progression from cultivating empathy for living things, to fueling discovery of nature, to fostering a sense of responsibility toward the natural world . Components of environmental literacy described by teachers included being at ease in the natural environment, appreciation and respect, wonder and curiosity, awareness and interdependence, sense of agency, responsibility and service, and environmental knowledge. The second assertion stemming from thematic data analysis was, The prairie restoration project and related curriculum have pedagogical value that included and exceeded addressing state science standards. In addition to addressing state science standards identified by teachers, the curriculum related to the prairie restoration project served as an agent of curricular cohesion to integrate a variety of subject areas, developed scientific ways of thinking, provided life experience for children, and fostered authentic learning experiences through concrete connections. It also provided a means to enhance the presence of science and social studies in elementary curriculum. Themes emerging from qualitative data analysis resonated with Sobel's model of progressive stages in children's relationships with nature, and resulted in a tool potentially useful for design of elementary curriculum aimed at developing environmental literacy.

Explorations of Tenth-Grade STS[E] Curricula across Three Provincial Political Landscapes

NASA Astrophysics Data System (ADS)

Phillips, Christina Ann

This thesis focuses on explorations of science, technology, society and the environment (i.e., STS[E]) outcomes/expectations in tenth-grade level science curricula across three Canadian provinces (i.e., Alberta, Manitoba & Ontario) with distinctive provincial political environments at the time of curriculum construction and/or implementation. Document analysis, discourse analysis and a range of theoretical frameworks (i.e., Levinson, 2010; Pedretti & Nazir, 2011 & Krathwohl, 2002) were used to aid in explorations of STS[E] curriculum segments and discourses in each provincial region. More detailed analysis and thematic exploration is presented for each unit associated with climate change as some interesting patterns emerged following initial analysis. My findings are presented as three comparative case studies and represent a small and original contribution to the large body of scholarly research devoted to studies of STS[E] education, where each province represents a unique case that has been explored regarding some aspects the STS[E] curriculum outcomes/expectations and general political culture as well as some other theoretical factors. Findings from this study indicate that Alberta's STS[E] outcomes may be related to Levinson's (2010) 'deliberative' citizenship focus. The following currents from Pedretti and Nazir (2011) appear to be emphasized: logical reasoning, historical, application & design and socio-cultural aligned outcomes when STS[E] is considered as an entity separate from the Alberta curriculum combination of STS and Knowledge. Ontario's STS[E] expectations may align with Levinson's (2010) 'deliberative' or in some select cases a 'deliberative'/'praxis' framework category with some emphasis related to logical reasoning and socio-cultural awareness (Pedretti & Nazir, 2011) in their STS[E] curriculum. The Manitoba STS[E] outcomes may be aligned with a more 'deliberative' approach with some associations that could intersect with the framework categories of 'praxis' or possibly 'dissent and conflict' (Levinson, 2010) and the logical reasoning, socio-cultural and socio-ecojustice currents (Pedretti & Nazir, 2011). General provincial political culture seems to play a limited role in the STS[E] outcomes/expectations as the provinces studied here all tend to align with Levinson's (2010) deliberative citizenship stance (i.e., to varying degrees), with some caveats as explored throughout these cases. A chapter on cross-case analysis follows the three central cases and focuses on the following categories that emerged from this research: STS[E] ontology; STS[E] & citizenship and socio-economic thematic explorations. The final chapter of this thesis focuses on some additional factors and theoretical explorations that may shape STS[E] curricula such as cultural-geographic considerations; educational-political interactions during curriculum construction processes and possible influences from academic scientists. This chapter also provides some recommendations for curriculum development as aligned with case study approaches and provides insights regarding possibilities for future research.

Towards a framework for agent-based image analysis of remote-sensing data

PubMed Central

Hofmann, Peter; Lettmayer, Paul; Blaschke, Thomas; Belgiu, Mariana; Wegenkittl, Stefan; Graf, Roland; Lampoltshammer, Thomas Josef; Andrejchenko, Vera

2015-01-01

Object-based image analysis (OBIA) as a paradigm for analysing remotely sensed image data has in many cases led to spatially and thematically improved classification results in comparison to pixel-based approaches. Nevertheless, robust and transferable object-based solutions for automated image analysis capable of analysing sets of images or even large image archives without any human interaction are still rare. A major reason for this lack of robustness and transferability is the high complexity of image contents: Especially in very high resolution (VHR) remote-sensing data with varying imaging conditions or sensor characteristics, the variability of the objects’ properties in these varying images is hardly predictable. The work described in this article builds on so-called rule sets. While earlier work has demonstrated that OBIA rule sets bear a high potential of transferability, they need to be adapted manually, or classification results need to be adjusted manually in a post-processing step. In order to automate these adaptation and adjustment procedures, we investigate the coupling, extension and integration of OBIA with the agent-based paradigm, which is exhaustively investigated in software engineering. The aims of such integration are (a) autonomously adapting rule sets and (b) image objects that can adopt and adjust themselves according to different imaging conditions and sensor characteristics. This article focuses on self-adapting image objects and therefore introduces a framework for agent-based image analysis (ABIA). PMID:27721916

Towards a framework for agent-based image analysis of remote-sensing data.

PubMed

Hofmann, Peter; Lettmayer, Paul; Blaschke, Thomas; Belgiu, Mariana; Wegenkittl, Stefan; Graf, Roland; Lampoltshammer, Thomas Josef; Andrejchenko, Vera

2015-04-03

Object-based image analysis (OBIA) as a paradigm for analysing remotely sensed image data has in many cases led to spatially and thematically improved classification results in comparison to pixel-based approaches. Nevertheless, robust and transferable object-based solutions for automated image analysis capable of analysing sets of images or even large image archives without any human interaction are still rare. A major reason for this lack of robustness and transferability is the high complexity of image contents: Especially in very high resolution (VHR) remote-sensing data with varying imaging conditions or sensor characteristics, the variability of the objects' properties in these varying images is hardly predictable. The work described in this article builds on so-called rule sets. While earlier work has demonstrated that OBIA rule sets bear a high potential of transferability, they need to be adapted manually, or classification results need to be adjusted manually in a post-processing step. In order to automate these adaptation and adjustment procedures, we investigate the coupling, extension and integration of OBIA with the agent-based paradigm, which is exhaustively investigated in software engineering. The aims of such integration are (a) autonomously adapting rule sets and (b) image objects that can adopt and adjust themselves according to different imaging conditions and sensor characteristics. This article focuses on self-adapting image objects and therefore introduces a framework for agent-based image analysis (ABIA).

Home intervention as a tool for nursing care: evaluation of the satisfaction of the elderly.

PubMed

Nogueira, Iara Sescon; Previato, Giselle Fernanda; Scolari, Giovana Aparecida de Souza; Gomes, Ana Caroline Oliveira; Carreira, Ligia; Baldissera, Vanessa Denardi Antoniassi

2017-04-06

To evaluate the results of home nursing interventions according to the satisfaction of the elderly users. Ex-post facto evaluative, qualitative and descriptive research, conducted from November 2015 to January 2016 with 12 dependent elderly individuals accompanied by an extension project in the city of Maringá, PR, Brazil. Data were collected after home interventions based on the Single-User Treatment Project, by means of semi-structured interviews subjected to content analysis and the theoretical framework of Donabedian. The following thematic categories emerged: "home nursing intervention: synonymous with joy, distraction and bonding" and" home nursing intervention: health and lifestyle transformations". The home nursing interventions had positive results that signal the quality of the provided care.

The Translation of Teachers' Understanding of Gifted Students Into Instructional Strategies for Teaching Science

NASA Astrophysics Data System (ADS)

Park, Soonhye; Steve Oliver, J.

2009-08-01

This study examined how instructional challenges presented by gifted students shaped teachers’ instructional strategies. This study is a qualitative research grounded in a social constructivist framework. The participants were three high school science teachers who were teaching identified gifted students in both heterogeneously- and homogeneously-grouped classrooms. Major data sources are classroom observations and interviews. Data analysis indicated that these science teachers developed content-specific teaching strategies based on their understanding of gifted students, including: (a) instructional differentiation, e.g., thematic units, (b) variety in instructional mode and/or students’ products, (c) student grouping strategies and peer tutoring, (d) individualized support, (e) strategies to manage challenging questions, (f) strategies to deal with the perfectionism, and (g) psychologically safe classroom environments.

The Emotional Experience of Motherhood in Planned Lesbian Families in the South African Context: "… Look How Good a Job I'm Doing, Look How Amazing We Are".

PubMed

Van Ewyk, Jacquetta; Kruger, Lou-Marié

2017-01-01

This article focuses on lesbian mothers' emotional experience of motherhood. It forms part of a larger qualitative and exploratory study with 10 lesbian couples in South Africa on their lived experience of planned motherhood. The study is located in a feminist phenomenological framework. Semi-structured interviews were conducted and interview transcripts were analyzed using thematic analysis. Participants described many different emotions associated with new motherhood: hope, joy, love, anxiety, helplessness, exhaustion, and feeling companionship and togetherness as well as feeling compromised and deprived. Mothers described these emotions but also focused on the development of a new identity, that of being a mother.

Identifying parents' perceptions about physical activity: a qualitative exploration of salient behavioural, normative and control beliefs among mothers and fathers of young children.

PubMed

Hamilton, Kyra; White, Katherine M

2010-11-01

Drawing on the belief-based framework of the Theory of Planned Behaviour, this study employs qualitative methodology involving individual and group interviews to examine the beliefs associated with regular physical activity performance among parents of young children (N = 40). The data were analysed using thematic content analysis. A range of advantages (e.g. improves parenting practices), disadvantages (e.g. interferes with commitments), barriers (e.g. time), and facilitators (e.g. social support) to performing physical activity are identified. Normative pressures are also identified as affecting parents' activity behaviour. These identified beliefs can be used to inform interventions to challenge inactivity among this at-risk group.

Analysing the implemented curriculum of mathematics in preschool education

NASA Astrophysics Data System (ADS)

Zacharos, Konstantinos; Koustourakis, Gerasimos; Papadimitriou, Konstantina

2014-06-01

The purpose of this paper is to contribute to development of research tools for observation and analysis of educational practices used by teachers in preschool classrooms. More specifically, we approached the implemented curriculum of mathematics in Greek preschool education. We analysed the recorded data from a week of teaching practices in eight classrooms of Greek public kindergartens, based on Bernstein's theoretical framework on pedagogic discourse. The results showed that the actual educational practices in the observed classrooms deviated from the objectives of the official new cross-thematic curriculum for teaching mathematics in Greek kindergarten in terms of the form of transmitted mathematical knowledge, the instructional rules and strategies that teachers adopted for teaching mathematics, and the teaching-interactive relationships between preschool teachers and students.

‘I–We’ boundary fluctuations in couple adjustment to rectal cancer and life with a permanent colostomy

PubMed Central

McCarthy, Molly; Fergus, Karen; Miller, Debbie

2016-01-01

This study investigates couples’ adjustment to rectal cancer and a colostomy using the ‘Classification System of Couple Adjustment to Cancer’, a framework delineating fluctuations in couples’ sense of ‘I’ and ‘We’ in response to cancer. Nine couples affected by rectal cancer and adjusting to life with a colostomy were interviewed. A theoretical thematic analysis of the transcripts was conducted; nearly all ‘I–We’ shifts of the Classification System of Couple Adjustment to Cancer were observed – often in unique ways in response to rectal cancer–specific challenges – and one new shift was described. The results provide a novel and experientially grounded means of conceptualizing complex dyadic coping processes. PMID:28070388

Strategies for integrating personalized medicine into healthcare practice.

PubMed

Pritchard, Daryl E; Moeckel, Franziska; Villa, Mary Susan; Housman, Laura T; McCarty, Catherine A; McLeod, Howard L

2017-03-01

Research and innovation in personalized medicine are surging, however, its adoption into clinical practice is comparatively slow. We identify common challenges to the clinical adoption of personalized medicine and provide strategies for addressing these challenges. Our team developed a list of common challenges through a series of group discussions, surveys and interviews, and convened a national summit to discuss solutions for overcoming these challenges. We used a framework approach for thematic analysis. We categorized challenges into five areas of need: education and awareness; patient empowerment; value recognition; infrastructure and information management; and ensuring access to care. We then developed strategies to address these challenges. In order for healthcare to transition into personalized medicine, it is necessary for stakeholders to build momentum by implementing a progression of strategies.

Disability management: organizational diversity and Dutch employment policy.

PubMed

Kopnina, Helen; Haafkens, Joke A

2010-06-01

While Human Resource Managers (HRM) and line managers could play a significant role in the prevention of job-related problems and in promotion of early job-continuation, it is not clear wether the chronically ill workers are recognized as a group. Unlike some other groups, distinguished by gender, age or ethnicity, those with chronic illness are less distinct and may not be included in diversity management programs. The aim of this research is to address theory and evidence in literature about the topic, as well as to inquire whether chronic illness of the employees is 'visible' in practice. For desk research, we used a systematic search strategy involving medical, statistical, management, and social science databases (Web of Science, MedLine, Pub Med, Psych Info, etc.). Research results are based on case studies conducted with the managers and HRM of government and commercial organizations between March 2007 and October 2008 and between October 2008 and April 2009. These case studies were based on open interviews and focus group sessions (for human resource departments) which were consequently analyzed using thematical analysis. For group sessions, we used concept mapping to collect information from two groups of HRM professionals and managers. Secondary analysis included thematic and content analysis of 'best practice' organizations carried out by the Dutch organization Gatekeeper. We have discovered that the chronically ill employees are largely invisible to HRM practitioners, line managers who do not always have the right instruments for implementation of the European or national frameworks. Most practitioners are unaware of the impact of chronic illness in their organizations and in employees work life.

JGME-ALiEM Hot Topics in Medical Education: Analysis of a Multimodal Online Discussion About Team-Based Learning

PubMed Central

Riddell, Jeff; Patocka, Catherine; Lin, Michelle; Sherbino, Jonathan

2017-01-01

Background  Team-based learning (TBL) is an instructional method that is being increasingly incorporated in health professions education, although use in graduate medical education (GME) has been more limited. Objective  To curate and describe themes that emerged from a virtual journal club discussion about TBL in GME, held across multiple digital platforms, while also evaluating the use of social media in online academic discussions. Methods  The Journal of Graduate Medical Education (JGME) and the Academic Life in Emergency Medicine blog facilitated a weeklong, open-access, virtual journal club on the 2015 JGME article “Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching.” Using 4 stimulus questions (hosted on a blog as a starting framework), we facilitated discussions via the blog, Twitter, and Google Hangouts on Air platforms. We evaluated 2-week web analytics and performed a thematic analysis of the discussion. Results  The virtual journal club reached a large international audience as exemplified by the blog page garnering 685 page views from 241 cities in 42 countries. Our thematic analysis identified 4 domains relevant to TBL in GME: (1) the benefits and barriers to TBL; (2) the design of teams; (3) the role of assessment and peer evaluation; and (4) crowdsourced TBL resources. Conclusions  The virtual journal club provided a novel forum across multiple social media platforms, engaging authors, content experts, and the health professions education community in a discussion about the importance, impediments to implementation, available resources, and logistics of adopting TBL in GME. PMID:28261403

What can organisational theory offer knowledge translation in healthcare? A thematic and lexical analysis.

PubMed

Dadich, Ann; Doloswala, Navin

2018-05-10

Despite the relative abundance of frameworks and models to guide implementation science, the explicit use of theory is limited. Bringing together two seemingly disparate fields of research, this article asks, what can organisational theory offer implementation science? This is examined by applying a theoretical lens that incorporates agency, institutional, and situated change theories to understand the implementation of healthcare knowledge into practice. Interviews were conducted with 20 general practitioners (GPs) before and after using a resource to facilitate evidence-based sexual healthcare. Research material was analysed using two approaches - researcher-driven thematic coding and lexical analysis, which was relatively less researcher-driven. The theoretical lens elucidated the complex pathways of knowledge translation. More specifically, agency theory revealed tensions between the GP as agent and their organisations and patients as principals. Institutional theory highlighted the importance of GP-embeddedness within their chosen specialty of general practice; their medical profession; and the practice in which they worked. Situated change theory exposed the role of localised adaptations over time - a metamorphosis. This study has theoretical, methodological, and practical implications. Theoretically, it is the first to examine knowledge translation using a lens premised on agency, institutional, and situated change theories. Methodologically, the study highlights the complementary value of researcher-driven and researcher-guided analysis of qualitative research material. Practically, this study signposts opportunities to facilitate knowledge translation - more specifically, it suggests that efforts to shape clinician practices should accommodate the interrelated influence of the agent and the institution, and recognise that change can be ever so subtle.

The development of thematic materials using project based learning for elementary school

NASA Astrophysics Data System (ADS)

Yuliana, M.; Wiryawan, S. A.; Riyadi

2018-05-01

Teaching materials is one of the important factors in supporting on learning process. This paper discussed about developing thematic materials using project based learning. Thematic materials are designed to make students to be active, creative, cooperative, easy in thinking to solve the problem. The purpose of the research was to develop thematic material using project based learning which used valid variables. The method of research which used in this research was four stages of research and development proposed by Thiagarajan consisting of 4 stages, namely: (1) definition stage, (2) design stage, (3) development stage, and (4) stage of dissemination. The first stage was research and information collection, it was in form of need analysis with questionnaire, observation, interview, and document analysis. Design stage was based on the competencies and indicator. The third was development stage, this stage was used to product validation from expert. The validity of research development involved media validator, material validator, and linguistic validator. The result from the validation of thematic material by expert showed that the overall result had a very good rating which ranged from 1 to 5 likert scale, media validation showed a mean score 4,83, the material validation showed mean score 4,68, and the mean of linguistic validation was e 4,74. It showed that the thematic material using project based learning was valid and feasible to be implemented in the context thematic learning.

Identifying the Ethical Challenges Encountered by Information Technology Professionals Working within the Nevada Casino Industry

ERIC Educational Resources Information Center

Essig, Michael R.

2014-01-01

A thematic analysis qualitative study was used to identify the unethical challenges encountered by Information Technology (IT) professionals working within the Nevada casino industry. Fourteen current and former IT leaders working or who worked in the Nevada casino industry were interviewed. Using thematic analysis, nine themes regarding ethical…

Editors' Introduction to the Thematic Issue: Mad about Methods? Teaching Research Methods in Political Science

ERIC Educational Resources Information Center

Adriaensen, Johan; Kerremans, Bart; Slootmaeckers, Koen

2015-01-01

The contributors to this special issue all seek to address the challenge of teaching research methods to political science students. This introduction aims to provide a concise framework for the various innovations presented throughout this issue, situating them in the wider literature. Particular emphasis is placed on the factors that distinguish…

The First World War in the Literacy-Focused Classroom: Teaching German through Cultural Themes

ERIC Educational Resources Information Center

Redmann, Jennifer; Sederberg, Kathryn

2017-01-01

This article offers approaches to the topic of the First World War at the intermediate and advanced levels of the German curriculum through thematically diverse WWI-era cultural texts. By situating the texts within a multiliteracies framework, the authors demonstrate how this historical and literary content can provide authentic material for…

The "Why" of Who We Are: Exploring the "Culture of Practice" of Ministry of Education, Special Education Occupational Therapists and Physiotherapists

ERIC Educational Resources Information Center

Simmons Carlsson, Carolyn; Hocking, Clare; Wright-St Clair, Valerie

2007-01-01

This qualitative study sought to describe the shared "culture of practice" of a group of Ministry of Education, Special Education occupational therapists and physiotherapists. Data from individual semi-structured interviews, enriched by insider observations, were thematically analysed within a cultural constructs framework. An ethos of…

Exploring the Solar System: A Literature Unit within a Whole Language Context.

ERIC Educational Resources Information Center

Sandel, Lenore

A useful framework for literature-based instruction is the curriculum related literature unit which provides a total resource for content area teaching. Such a unit could be based on the science curriculum, "Exploring the Solar System," and could be developed thematically through topics of space or the solar system. The teacher's initial…

Object and technologies in the working process of an itinerant team in mental health.

PubMed

Eslabão, Adriane Domingues; Pinho, Leandro Barbosa de; Coimbra, Valéria Cristina Christello; Lima, Maria Alice Dias da Silva; Camatta, Marcio Wagner; Santos, Elitiele Ortiz Dos

2017-01-01

Objective To analyze the work object and the technologies in the working process of a Mental Health Itinerant Team in the attention to drug users. Methods Qualitative case study, carried out in a municipality in the South of Brazil. The theoretical framework was the Healthcare Labor Process. The data was collected through participant observation and semi-structured interviews with the professionals of an itinerant team in the year of 2015. For data analysis we used the Thematic Content Analysis. Results In the first empirical category - work object - the user is considered as a focus, bringing new challenges in the team's relationship with the network. In the second category - technologies of the work process - potentialities and contradictions of the team work tools are highlighted. Conclusions As an innovation in the mental health context, the itinerant team brings real possibilities to reinvent the care for the drug user as well as new institutional challenges.

Spatial and thematic assessment of object-based forest stand delineation using an OFA-matrix

NASA Astrophysics Data System (ADS)

Hernando, A.; Tiede, D.; Albrecht, F.; Lang, S.

2012-10-01

The delineation and classification of forest stands is a crucial aspect of forest management. Object-based image analysis (OBIA) can be used to produce detailed maps of forest stands from either orthophotos or very high resolution satellite imagery. However, measures are then required for evaluating and quantifying both the spatial and thematic accuracy of the OBIA output. In this paper we present an approach for delineating forest stands and a new Object Fate Analysis (OFA) matrix for accuracy assessment. A two-level object-based orthophoto analysis was first carried out to delineate stands on the Dehesa Boyal public land in central Spain (Avila Province). Two structural features were first created for use in class modelling, enabling good differentiation between stands: a relational tree cover cluster feature, and an arithmetic ratio shadow/tree feature. We then extended the OFA comparison approach with an OFA-matrix to enable concurrent validation of thematic and spatial accuracies. Its diagonal shows the proportion of spatial and thematic coincidence between a reference data and the corresponding classification. New parameters for Spatial Thematic Loyalty (STL), Spatial Thematic Loyalty Overall (STLOVERALL) and Maximal Interfering Object (MIO) are introduced to summarise the OFA-matrix accuracy assessment. A stands map generated by OBIA (classification data) was compared with a map of the same area produced from photo interpretation and field data (reference data). In our example the OFA-matrix results indicate good spatial and thematic accuracies (>65%) for all stand classes except for the shrub stands (31.8%), and a good STLOVERALL (69.8%). The OFA-matrix has therefore been shown to be a valid tool for OBIA accuracy assessment.

Sharing news of a lung cancer diagnosis with adult family members and friends: a qualitative study to inform a supportive intervention.

PubMed

Ewing, Gail; Ngwenya, Nothando; Benson, John; Gilligan, David; Bailey, Susan; Seymour, Jane; Farquhar, Morag

2016-03-01

Extensive research exists on breaking bad news by clinicians. This study examines perspectives of patients and those accompanying them at diagnosis-giving of subsequently sharing news of lung cancer with adult family/friends, and views of healthcare professionals, to inform development of a supportive intervention. Qualitative interviews with 20 patients, 17 accompanying persons; focus groups and interviews with 27 healthcare professionals from four Thoracic Oncology Units. Intervention development workshops with 24 healthcare professionals and six service users with experience of sharing a cancer diagnosis. Framework thematic analysis. Patients and accompanying persons shared news of lung cancer whilst coming to terms with the diagnosis. They recalled general support from healthcare professionals but not support with sharing bad news. Six elements were identified providing a framework for a potential intervention: 1-people to be told, 2-information to be shared, 3-timing of sharing, 4-responsibility for sharing, 5-methods of telling others and 6-reactions of those told. This study identifies the challenge of sharing bad news and a potential framework to guide delivery of a supportive intervention tailored to individual needs of patients. The identified framework could extend the portfolio of guidance on communication in cancer and potentially in other life-limiting conditions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Reasons for Stopping Exclusive Breastfeeding Between Three and Six Months: A Qualitative Study.

PubMed

Alianmoghaddam, Narges; Phibbs, Suzanne; Benn, Cheryl

Scant published qualitative literature exists focusing on why exclusive breastfeeding rates decline between three and six months. This study aims to develop an understanding of why exclusive breastfeeding tails off so dramatically between three and six months after birth in New Zealand. A generic qualitative methodology was employed in this study and social constructionism selected as the main epistemological framework underpinning the research. This study was carried out between September 2013 and July 2014, involving face-to-face interviews with 30 women who were characterised as highly motivated to complete six months exclusive breastfeeding prior to the birth of their child. In order to gain an in-depth understanding of the research material, thematic analysis of the interview transcripts was completed using manual coding techniques. After thematic analysis of the data four key themes were identified: 1) The good employee/good mother dilemma. 2) Breastfeeding is lovely, but six months exclusively is demanding. 3) Exclusive breastfeeding recommendations should be individualised. 4) Introducing solids early as a cultural practice. Most studies have linked barriers to six months exclusive breastfeeding to difficulties within the mother-infant dyad, as well as negative maternal socioeconomic and socio-demographic characteristics. However, this study has shown that the maintenance of six months exclusive breastfeeding is also challenging for this group of mothers who were socially advantaged, well-educated and highly motivated to breastfeed their babies exclusively for six months. Copyright © 2018 Elsevier Inc. All rights reserved.

Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit.

PubMed

Foster, Mandie; Whitehead, Lisa

2018-01-01

Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.

Thematic Progression in a Cardiologist's Text: Context, Frames and Progression.

ERIC Educational Resources Information Center

Salter, Robert T.

Thematic progression (TP) is examined in the text of a communication between a cardiologist and a general practitioner concerning a patient, offering a clinical diagnosis of the patient's condition. Analysis of the discourse looks at the field, tenor, and mode of the communication as a context for TP. The methods of analysis are first described,…

Using classified Landsat Thematic Mapper data for stratification in a statewide forest inventory

Treesearch

Mark H. Hansen; Daniel G. Wendt

2000-01-01

The 1998 Indiana/Illinois forest inventory (USDA Forest Service, Forest Inventory and Analysis (FIA)) used Landsat Thematic Mapper (TM) data for stratification. Classified images made by the National Gap Analysis Program (GAP) stratified FIA plots into four classes (nonforest, nonforest/ forest, forest/nonforest, and forest) based on a two pixel forest edge buffer zone...

Using Classified Landsat Thematic Mapper Data for Stratification in a Statewide Forest Inventory

Treesearch

Mark H. Hansen; Daniel G. Wendt

2000-01-01

The 1998 Indiana/Illinois forest inventory (USDA Forest Service, Forest Inventory and Analysis (FIA)) used Landsat Thematic Mapper (TM} data for stratification. Classified images made by the National Gap Analysis Program (GAP) stratified FIA plots into four classes (nonforest, nonforest/forest, forest/nonforest, and forest) based on a two pixel forest edge buffer zone...

Thematic Mapper Analysis of Blue Oak (Quercus douglasii) in Central California

Treesearch

Paul A. Lefebvre Jr.; Frank W. Davis; Mark Borchert

1991-01-01

Digital Thematic Mapper (TM) satellite data from September 1986 and December 1985 were analyzed to determine seasonal reflectance properties of blue oak rangeland in the La Panza mountains of San Luis Obispo County. Linear regression analysis was conducted to examine relationships between TM reflectance and oak canopy cover, basal area, and site topographic variables....

Single Session Web-Based Counselling: A Thematic Analysis of Content from the Perspective of the Client

ERIC Educational Resources Information Center

Rodda, S. N.; Lubman, D. I.; Cheetham, A.; Dowling, N. A.; Jackson, A. C.

2015-01-01

Despite the exponential growth of non-appointment-based web counselling, there is limited information on what happens in a single session intervention. This exploratory study, involving a thematic analysis of 85 counselling transcripts of people seeking help for problem gambling, aimed to describe the presentation and content of online…

Assessment of Innovation Competency: A Thematic Analysis of Upper Secondary School Teachers' Talk

ERIC Educational Resources Information Center

Nielsen, Jan Alexis

2015-01-01

The author employed a 3-step qualitative research design with multiple instances of source validation to capture expert teachers' (n = 28) reflections on which manifest signs they would look for when they asses students' innovation competency. The author reports on the thematic analysis of the recorded talk in interaction that occurred in teacher…

Review of 99 self-report measures for assessing well-being in adults: exploring dimensions of well-being and developments over time

PubMed Central

Dieppe, Paul

2016-01-01

Objective Investigators within many disciplines are using measures of well-being, but it is not always clear what they are measuring, or which instruments may best meet their objectives. The aims of this review were to: systematically identify well-being instruments, explore the variety of well-being dimensions within instruments and describe how the production of instruments has developed over time. Design Systematic searches, thematic analysis and narrative synthesis were undertaken. Data sources MEDLINE, EMBASE, EconLit, PsycINFO, Cochrane Library and CINAHL from 1993 to 2014 complemented by web searches and expert consultations through 2015. Eligibility criteria Instruments were selected for review if they were designed for adults (≥18 years old), generic (ie, non-disease or context specific) and available in an English version. Results A total of 99 measures of well-being were included, and 196 dimensions of well-being were identified within them. Dimensions clustered around 6 key thematic domains: mental well-being, social well-being, physical well-being, spiritual well-being, activities and functioning, and personal circumstances. Authors were rarely explicit about how existing theories had influenced the design of their tools; however, the 2 most referenced theories were Diener's model of subjective well-being and the WHO definition of health. The period between 1990 and 1999 produced the greatest number of newly developed well-being instruments (n=27). An illustration of the dimensions identified and the instruments that measure them is provided within a thematic framework of well-being. Conclusions This review provides researchers with an organised toolkit of instruments, dimensions and an accompanying glossary. The striking variability between instruments supports the need to pay close attention to what is being assessed under the umbrella of ‘well-being’ measurement. PMID:27388349

What does 'recovery' mean to people with neck pain? Results of a descriptive thematic analysis.

PubMed

Walton, David M; Macdermid, Joy C; Taylor, Todd

2013-01-01

To describe the meaning of being recovered as perceived by people with chronic mechanical neck pain. To determine the way people with neck pain would describe a recovered state a descriptive thematic approach was used. A nominal focus group technique, written reflections, and one-on-one semi-structured interviews were used to collect sufficient data. Data from the focus groups were analyzed both through vote tallying and thematic analysis. Reflections and interviews were analyzed thematically by two independent researchers. Triangulation and member-checking were employed to establish trustworthiness of results. A total of 35 people, primarily females with neck pain of traumatic origin, participated in this study. Thematic analysis identified 6 themes that adequately described the data: absent or manageable symptoms, having the physical capacity one ought to have, participation in life roles, feeling positive emotions, autonomy & spontaneity, and re-establishing a sense of self. Member checking and triangulation suggested data saturation and accuracy of the generated themes. Recovery from neck pain appears to be informed by factors that fit with existing models of health, quality of life and satisfaction. Basing recovery solely on symptom or activity-level measures risks inaccurate estimates of recovery trajectories from traumatic or non-traumatic neck pain.

Understanding Unintended Consequences and Health Information Technology:. Contribution from the IMIA Organizational and Social Issues Working Group.

PubMed

Kuziemsky, C E; Randell, R; Borycki, E M

2016-11-10

No framework exists to identify and study unintended consequences (UICs) with a focus on organizational and social issues (OSIs). To address this shortcoming, we conducted a literature review to develop a framework for considering UICs and health information technology (HIT) from the perspective of OSIs. A literature review was conducted for the period 2000- 2015 using the search terms "unintended consequences" and "health information technology". 67 papers were screened, of which 18 met inclusion criteria. Data extraction was focused on the types of technologies studied, types of UICs identified, and methods of data collection and analysis used. A thematic analysis was used to identify themes related to UICs. We identified two overarching themes. One was the definition and terminology of how people classify and discuss UICs. Second was OSIs and UICs. For the OSI theme, we also identified four sub-themes: process change and evolution, individual-collaborative interchange, context of use, and approaches to model, study, and understand UICs. While there is a wide body of research on UICs, there is a lack of overall consensus on how they should be classified and reported, limiting our ability to understand the implications of UICs and how to manage them. More mixed-methods research and better proactive identification of UICs remain priorities. Our findings and framework of OSI considerations for studying UICs and HIT extend existing work on HIT and UICs by focusing on organizational and social issues.

A qualitative analysis of Māori and Pacific smokers' views on informed choice and smoking

PubMed Central

Gifford, Heather; Tautolo, El-Shadan; Erick, Stephanie; Hoek, Janet; Gray, Rebecca; Edwards, Richard

2016-01-01

Objectives Tobacco companies frame smoking as an informed choice, a strategy that holds individuals responsible for harms they incur. Few studies have tested this argument, and even fewer have examined how informed indigenous smokers or those from minority ethnicities are when they start smoking. We explored how young adult Māori and Pacific smokers interpreted ‘informed choice’ in relation to smoking. Participants Using recruitment via advertising, existing networks and word of mouth, we recruited and undertook qualitative in-depth interviews with 20 Māori and Pacific young adults aged 18–26 years who smoked. Analyses Data were analysed using an informed-choice framework developed by Chapman and Liberman. We used a thematic analysis approach to identify themes that extended this framework. Results Few participants considered themselves well informed and none met more than the framework's initial two criteria. Most reflected on their unthinking uptake and subsequent addiction, and identified environmental factors that had facilitated uptake. Nonetheless, despite this context, most agreed that they had made an informed choice to smoke. Conclusions The discrepancy between participants' reported knowledge and understanding of smoking's risks, and their assessment of smoking as an informed choice, reflects their view of smoking as a symbol of adulthood. Policies that make tobacco more difficult to use in social settings could help change social norms around smoking and the ease with which initiation and addiction currently occur. PMID:27188813

Indicator-based approach to assess sustainability of current and projected water use in Korea

NASA Astrophysics Data System (ADS)

Kong, I.; Kim, I., Sr.

2016-12-01

Recently occurred failures in water supply system derived from lacking rainfall in Korea has raised severe concerns about limited water resources exacerbated by anthropogenic drivers as well as climatic changes. Since Korea is under unprecedented changes in both social and environmental aspects, it is required to integrate social and environmental changes as well as climate factors in order to consider underlying problems and their upcoming impacts on sustainable water use. In this study, we proposed a framework to assess multilateral aspects in sustainable water use in support of performance-based monitoring. The framework is consisted of four thematic indices (climate, infrastructure, pollution, and management capacity) and subordinate indicators. Second, in order to project future circumstances, climate variability, demographic, and land cover scenarios to 2050 were applied after conducting statistical analysis identifying correlations between indicators within the framework since water crisis are caused by numerous interrelated factors. Assessment was conducted throughout 161 administrative boundaries in Korea at the time of 2010, 2030, and 2050. Third, current and future status in water use were illustrated using GIS-based methodology and statistical clustering (K-means and HCA) to elucidate spatially explicit maps and to categorize administrative regions showing similar phenomenon in the future. Based on conspicuous results shown in spatial analysis and clustering method, we suggested policy implementations to navigate local communities to decide which countermeasures should be supplemented or adopted to increase resiliency to upcoming changes in water use environments.

Understanding Unintended Consequences and Health Information Technology:

PubMed Central

Randell, R.; Borycki, E. M.

2016-01-01

Summary Objective No framework exists to identify and study unintended consequences (UICs) with a focus on organizational and social issues (OSIs). To address this shortcoming, we conducted a literature review to develop a framework for considering UICs and health information technology (HIT) from the perspective of OSIs. Methods A literature review was conducted for the period 2000-2015 using the search terms “unintended consequences” and “health information technology”. 67 papers were screened, of which 18 met inclusion criteria. Data extraction was focused on the types of technologies studied, types of UICs identified, and methods of data collection and analysis used. A thematic analysis was used to identify themes related to UICs. Results We identified two overarching themes. One was the definition and terminology of how people classify and discuss UICs. Second was OSIs and UICs. For the OSI theme, we also identified four sub-themes: process change and evolution, individual-collaborative interchange, context of use, and approaches to model, study, and understand UICs. Conclusions While there is a wide body of research on UICs, there is a lack of overall consensus on how they should be classified and reported, limiting our ability to understand the implications of UICs and how to manage them. More mixed-methods research and better proactive identification of UICs remain priorities. Our findings and framework of OSI considerations for studying UICs and HIT extend existing work on HIT and UICs by focusing on organizational and social issues. PMID:27830231

Why older workers work beyond the retirement age: a qualitative study.

PubMed

Sewdas, Ranu; de Wind, Astrid; van der Zwaan, Lennart G L; van der Borg, Wieke E; Steenbeek, Romy; van der Beek, Allard J; Boot, Cécile R L

2017-08-22

The aims of the present study were to: 1) gain insight into reasons for working beyond the statutory retirement age from older workers' perspectives, and 2) explore how the domains of the research framework Study on Transitions in Employment, Ability and Motivation (STREAM) can be applied to working beyond retirement age. A qualitative research design included individual interviews (n = 15) and three focus groups (n = 18 participants) conducted with older workers aged 65 years and older continuing in a paid job or self-employment. Interview participants were recruited from an existing STREAM cohort study. Focus group participants were recruited from companies and employment agencies. The data were subjected to thematic analysis. The most important motives for working beyond retirement age were maintaining daily routines and financial benefit. Good health and flexible work arrangements were mentioned as important preconditions. The themes emerging from the categorization of the motives and preconditions corresponded to the domains of health, work characteristics, skills and knowledge, and social and financial factors from the STREAM research framework. However, our analysis revealed one additional theme-purpose in life. This study offers important new insights into the various preconditions and motives that influence working beyond retirement age. In addition, the five domains of the STREAM research framework, including the additional domain of 'purpose in life', seem to be applicable to working beyond retirement age. This knowledge contributes to the development of work-related interventions that enhance older workers' motivation to prolong their working lives.

Metacognition in speech and language therapy for children with social (pragmatic) communication disorders: implications for a theory of therapy.

PubMed

Gaile, Jacqueline; Adams, Catherine

2018-01-01

Metacognition is a significant component of complex interventions for children who have developmental language disorders. Research into how metacognition operates in the content or process of developmental language therapy delivery is limited. Identification and description of proposed active therapy components, such as metacognition, may contribute to our understanding of how to deliver complex communication interventions in an optimal manner. To analyse aspects of metacognition during therapy derived from a manualized speech and language intervention (the Social Communication Intervention Programme-SCIP) as delivered to children who have social (pragmatic) communication disorder (SPCD) and to examine the dynamic process of delivering therapy. A purposive sample of eight filmed therapy sessions was selected from the video data corpus of intervention-arm participants within a randomized controlled trial. The child-therapist interactions during therapy sessions from five children (aged between 5;11 and 10;3) in the SCIP trial were transcribed. Filmed sessions represented a variety of communication profiles and SCIP therapy content. Starting from existing theory on metacognition, cycles of iterative analysis were performed using a mixed inductive-deductive qualitative analysis. A preliminary list of metacognitive content embedded in the intervention was developed into a metacognitive coding framework (MCF). A thematic analysis of the identified metacognitive content of the intervention was then carried out across the whole sample. Thematic analysis revealed the presence of metacognition in the content and delivery of SCIP intervention. Four main themes of metacognitive person, task and strategy knowledge, and monitoring/control were identified. Metacognition was a feature of how children's ability to monitor language, pragmatic and social interaction skills, in themselves and other people, was developed. Task design and delivery methods were found to play a particular role in adjusting the metacognitive content of the therapy activities. This study makes explicit the metacognitive content and delivery within a complex developmental communication intervention. Discussion of the findings about metacognitive content provides an explanation of how the skilled speech and language therapist manipulates task demands, person knowledge and therapy methods towards the therapy goal. Clinical applications of the metacognitive framework are discussed. We suggest that the process of making the tacit knowledge of the therapist explicit can contribute to the implementation of complex evidence-based interventions. © 2017 Royal College of Speech and Language Therapists.

"I Need to Do Better, but I Don't Know What to Do": Primary Teachers' Experiences of Talented Young Writers

ERIC Educational Resources Information Center

Easton, Vernitta; Gaffney, Janet S.; Wardman, Janna

2016-01-01

The study investigated New Zealand primary school teachers' understandings and experiences of talented young writers. Data were gathered using semi-structured interviews in Auckland schools. The interview data were thematically analysed using an interpretivist framework. The focus of this report is on the teachers' selection and interpretation of…

Transformation of a Traditional, Freshman Biology, Three-Semester Sequence, to a Two-Semester, Integrated Thematically Organized, and Team-Taught Course

ERIC Educational Resources Information Center

Soto, Julio G.; Everhart, Jerry

2016-01-01

Biology faculty at San José State University developed, piloted, implemented, and assessed a freshmen course sequence based on the macro-to micro-teaching approach that was team-taught, and organized around unifying themes. Content learning assessment drove the conceptual framework of our course sequence. Content student learning increased…

A Framework for Monitoring Transition Systems. OECD Education Working Papers, No. 20

ERIC Educational Resources Information Center

van der Velden, Rolf K.; Wolbers, Maarten H.

2008-01-01

With its publication of the Thematic Review on the Transition from Initial Education to Working Life in 2000, OECD has laid the foundation for the development of indicators regarding the transition from education to work. One of the core activities of OECD's Network B in 2005 and 2006 was to further develop these indicators by establishing a…

Vocational trainees' views and experiences regarding the learning and teaching of communication skills in general practice.

PubMed

Van Nuland, Marc; Thijs, Gabie; Van Royen, Paul; Van den Noortgate, Wim; Goedhuys, Jo

2010-01-01

To explore the views and experiences of general practice (GP) vocational trainees regarding communication skills (CS) and the teaching and learning of these skills. A purposive sample of second and third (final) year GP trainees took part in six focus group (FG) discussions. Transcripts were coded and analysed in accordance with a grounded theory approach by two investigators using Alas-ti software. Finally results were triangulated by means of semi-structured telephone interviews. The analysis led to three thematic clusters: (1) trainees acknowledge the essential importance of communication skills and identified contextual factors influencing the learning and application of these skills; (2) trainees identified preferences for learning and receiving feedback on their communication skills; and (3) trainees perceived that the assessment of communication skills is subjective. These themes are organised into a framework for a better understanding of trainees' communication skills as part of their vocational training. The framework helps in leading to a better understanding of the way in which trainees learn and apply communication skills. The unique context of vocational training should be taken into account when trainees' communication skills are assessed. The teaching and learning should be guided by a learner-centred approach. The framework is valuable for informing curricular reform and future research.

Inverting the power dynamic: The process of first sessions of psychotherapy with therapists of color and non-Latino white patients.

PubMed

Okun, Lia; Chang, Doris F; Kanhai, Gregory; Dunn, Jordan; Easley, Hailey

2017-07-01

The present study is the first to apply Trawalter, Richeson, and Shelton's (2009) stress and coping framework to qualitatively examine interracial interactions in initial sessions of psychotherapy. The sample included 22 dyads: 15 therapists of color administering various treatment modalities to 15 treatment-seeking non-Latino White (NLW) patients and a comparison group of 7 intraracial (NLW-NLW) dyads. In Phase 1, videorecordings of the first session of treatment were analyzed using inductive thematic analysis (TA) to describe patient and therapist behaviors. In Phase 2, a deductive TA approach was used to interpret and cluster those dyadic behaviors according to Trawalter et al.'s (2009) framework. NLW patients paired with therapists of color made more efforts to bridge differences and more often questioned the therapist's professional qualifications compared with those matched with NLW therapists. Therapists of color made more self-disclosures than NLW therapists and maintained a more formal stance, compared with NLW therapists. The deductive TA operationalized 4 of Trawalter and colleagues' (2009) coping responses within a therapeutic framework. Findings highlight the ability of therapists' of color to engage positively with their NLW patients even in the face of challenges to their expertise and credibility. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

From My Own Brother in My Own Home: Children's Experiences and Perceptions Following Alleged Sibling Incest.

PubMed

Katz, Carmit; Hamama, Liat

2015-08-30

Sibling incest is an understudied field despite its high prevalence rates. The current study was designed to characterize the way children describe their experiences and perceptions following alleged sibling incest. The sample consisted of 20 forensic investigations with children who were referred to forensic investigation following suspected sibling incest. The age range of the children was between 6 and 12 years old, including 17 girls and three boys. Thematic analysis was conducted on all the interviews and the children's perceptions greatly echoed the ecological framework while they elaborated on three levels: family level, in which children discussed the context of the abuse and the disclosure; sibling level, in which children discussed their siblings' behaviors and the grooming process; and the child level, in which the children discussed their own behavior during the abuse. The discussion highlights the relevance of the ecological framework to the study's results and stresses the complexity of this phenomenon and the challenges it raises for practitioners in various contexts-child protective, forensic, and clinical. © The Author(s) 2015.

Development of a Conceptual Etiological Model of Treatment Regimen Fatigue Among Patients Engaged in HIV Care: A Qualitative Study.

PubMed

Claborn, Kasey; Miller, Mary Beth; Meier, Ellen; Carbone, Sofia

Treatment regimen fatigue (TRF) is a decreased desire and motivation to maintain vigilance in adhering to treatment, and little is known about TRF in people living with HIV. We aimed to develop a conceptual framework of TRF. Five focus groups were conducted in 2014. Eligible participants were (a) HIV infected, (b) at least 18 years of age, (c) prescribed antiretroviral therapy, and (d) fluent in English. Data were analyzed using thematic analysis. Analyses revealed these themes: patient experiences of TRF; etiological factors at the systems, provider, and patient levels; strategies to manage TRF; consequences of TRF; and protective factors that prevent the occurrence of TRF. The results provided a conceptual framework for future investigations to build on in an effort to improve adherence and retention in HIV care. Study results indicate avenues for intervention at multiple levels (systems, provider, and patient) to reduce treatment burden and improve patient resources and capacity. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

A dementia communication training intervention based on the VERA framework for pre-registration nurses: Part I developing and testing an implementation strategy.

PubMed

Naughton, Corina; Beard, Chloe; Tzouvara, Vasiliki; Pegram, Anne; Verity, Rebecca; Eley, Rhiannon; Hingley, David

2018-04-01

People living with dementia experience progressive difficulty in expressing physical and emotional needs. Health care staff including student nurses require training to develop compensatory communication strategies. However, there is no standardised foundation level dementia communication training within pre-registration curricula. This article describes the theoretical underpinnings and development of a foundation level dementia communication skills training based on the VERA (Validation, Emotion, Reassurance, Activity) framework. The training strategies drew on behavioural change theory using the COM-B model and Gagné's 9 Events of Instruction. The VERA framework was operationalised using a multicomponent teaching strategy. The intervention was refined based on quality improvement Plan-Do-Study-Act cycles with feedback from people living with dementia, facilitators and student nurses. Data collection used semi-structured questionnaires (n = 51) and four focus group (n = 19) interviews with students. Data analysis involved descriptive statistics and thematic analysis. The intervention was a 2.5-hour face-to-face training session delivered at the start of students' older adult unit placement with follow-up reflection sessions during placement. Training was delivered to 51 students, all students described the training as useful and would recommend it to their peers. Elements of the training that were highly valued were: opportunities to express concerns in caring for people with dementia, applying the VERA framework using role play and outlining realistic expectations of VERA. Students recognised the need for on-going training especially for more complex patients. Combining behaviour change and education theory with stakeholder feedback strengthened the development of VERA as a foundation level dementia communication training for pre-registration nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

2017-01-01

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, online survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis,weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Thematic Analysis of the Children's Drawings on Museum Visit: Adaptation of the Kuhn's Method

ERIC Educational Resources Information Center

Kisovar-Ivanda, Tamara

2014-01-01

Researchers are using techniques that allow children to express their perspectives. In 2003, Kuhn developed the method of data collection and analysis which combined thematic drawing and focused, episodic interview. In this article the Kuhn's method is adjusted using the draw and write technique as a research methodology. Reflections on the…

A Vygotskian Perspective on Parent-Child Talk During iPad Story Sharing

ERIC Educational Resources Information Center

Kucirkova, Natalia; Sheehy, Kieron; Messer, David

2015-01-01

This study explores the themes in the talk of two mothers and daughters as they share a self-created story with an iPad app. Vygotsky's theory of learning is applied to inform a thematic analysis and help interpret the learning potential within the observed parent-child exchanges. A deductive-inductive thematic analysis identified three recurring…

Using a Thematic Analysis of Literature to Survey Subfields within Communication Studies

ERIC Educational Resources Information Center

Garner, Johny T.; Ragland, J. Parker

2015-01-01

The activity described by the authors here is a thematic analysis of published articles in a broad area of study. Students search for articles relating to the topic of study in different academic journals that fall in a specific date range. Students record details about the topics covered and theories/methods used. The class then assembles to…

Returning home: resettlement of formerly abducted children in Northern Uganda.

PubMed

Corbin, Joanne N

2008-06-01

This exploratory qualitative study considers the subjective resettlement experiences of children forced into armed conflict in Northern Uganda from the perspectives of 11 former child combatants and 11 adult community members. A thematic analysis was performed on the narrative data. The bioecological model was used to provide a conceptual framework for key themes. Major findings included the overarching impact of ongoing armed conflict on returnees' lives, the important role of the family in supporting children's resettlement, the harassment of former child soldiers by community members, and the community's inability to support systematically the returning children in tangible ways. This study recommends that humanitarian services at all levels strengthen the capacity of families to care for the material and psychoemotional needs of former child soldiers within their communities.

Regionalization in the SUS: implementation process, challenges and perspectives in the critical view of system managers.

PubMed

Carvalho, Andre Luis Bonifácio de; Jesus, Washington Luiz Abreu de; Senra, Isabel Maria Vilas Boas

2017-04-01

This article examines the regionalization process in the Brazilian Health System, identifying frameworks and challenges of this process from critical dialogue on the subject, contextualized by the experience of the management system and in the light of an established theoretical debate in the last decade. We used the thematic content analysis of legal and documentary surveys of the regionalization process in SUS, collated by elements of the historical and political context in the period. As evidence, it appears that the regionalization process has been incremental decentralization/deconcentration of management and health actions and services. There are important challenges, particularly in relation to ensuring access and system governance structure, which contributes to critical thinking and construction of new perspectives by those who lead their implementation.

Communication in pediatric critical care: A proposal for an evidence-informed framework.

PubMed

Carnevale, Franco A; Farrell, Catherine; Cremer, Robin; Séguret, Sylvie; Canouï, Pierre; Leclerc, Francis; Lacroix, Jacques; Hubert, Philippe

2016-03-01

The aim of this investigation was to conduct a comprehensive examination of communication between parents and health care professionals (HCPs) in the pediatric intensive care unit (PICU). A secondary analysis was performed on data from 3 previous qualitative studies, which included 30 physicians, 37 nurses, and 38 parents in France and Quebec (Canada). All three studies examined a mix of cases where children either survived or died. All data referring to communication between parents (and patients when applicable) and HCPs were examined to identity themes that related to communication. Thematic categories for parents and HCPs were developed. Three interrelated dimensions of communication were identified: (1) informational communication, (2) relational communication, and (3) communication and parental coping. Specific themes were identified for each of these 3 dimensions in relation to parental concerns as well as HCP concerns. This investigation builds on prior research by advancing a comprehensive analysis of PICU communication that includes (a) cases where life-sustaining treatments were withdrawn or withheld as well as cases where they were maintained, (b) data from HCPs as well as parents, and (c) investigations conducted in 4 different sites. An evidence-informed conceptual framework is proposed for PICU communication between parents and HCPs. We also outline priorities for the development of practice, education, and research. © The Author(s) 2014.

Healthy or Unhealthy Lifestyle: A Thematic Analysis of Iranian Male Adolescents' Perspectives.

PubMed

Zareiyan, Armin

2017-01-01

Identifying what adolescents perceive as their lifestyle and exploring the factors persuading their decisions to engage in or avoid healthy or unhealthy lifestyle behaviors could improve the ability of healthcare professionals to develop innovative preventive strategies and modify negative health behaviors in adolescents. Hence, the literature on adolescent health-related issues reported by adults showed a rarity of information from adolescents themselves. A qualitative study using the thematic analysis approach was conducted. Data were collected by semi-structured, digitally recorded interviews from 32 male adolescents. Interviews were transcribed verbatim, and after collecting the data, the thematic analysis process was started and conducted in six phases. After data collection, the interview texts were transcribed, and approximately 800 initial codes were extracted. The initial codes were reevaluated to yield 48 main themes. Hence, the final thematic map was created as having 5 overarching themes and 12 subthemes, showing that interviewees emphasized unhealthy lifestyle. The components of unhealthy lifestyle seem important to them because they consider that they could lead a healthy lifestyle through elimination of negative behaviors.

A spotlight on snow leopard conservation in China.

PubMed

Alexander, Justine S; Zhang, Chengcheng; Shi, Kun; Riordan, Philip

2016-07-01

China holds the greatest proportion of the snow leopard's (Panthera uncia) global range and is central to their conservation. The country is also undergoing unprecedented economic growth, which increases both the threats to the snow leopard and the opportunities for its conservation. In this paper we aim to review published literature (from 1950 to 2014) in English and Mandarin on snow leopard ecology and conservation in China in order to identify thematic and geographic research gaps and propose research priorities. We first retrieved all published items that considered snow leopards in China (n = 106). We extracted from these papers 274 reports of snow leopard presence in China. We then reviewed a subset of papers (n = 33) of this literature, which specifically focused on snow leopard ecology and conservation within China. We introduced a thematic framework that allows a structured and comprehensive assessment of findings. This framework recognizes 4 critical and interrelated topics underpinning snow leopard ecology and conservation: habitat (distribution and protected area coverage); prey (distribution and abundance, predator-prey relationships); human interactions (hunting and trade, livestock interactions and conflicts); and the underlying policy context. Significant gains in knowledge as well as research gaps and priorities are discussed with reference to our framework. The modest quantity and limited scope of published research on the snow leopard in China calls for a continued and intensified effort to inform and support national conservation policies. © 2016 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Training needs for research in health inequities among health and demographic researchers from eight African and Asian countries.

PubMed

Haafkens, Joke; Blomstedt, Yulia; Eriksson, Malin; Becher, Heiko; Ramroth, Heribert; Kinsman, John

2014-12-10

To support equity focussed public health policy in low and middle income countries, more evidence and analysis of the social determinants of health inequalities is needed. This requires specific know how among researchers. The INDEPTH Training and Research Centres of Excellence (INTREC) collaboration will develop and provide training on the social determinants of health approach for health researchers from the International Network for the Demographic Evaluation of Populations and Their Health in Low- and Middle-Income Countries (INDEPTH) in Africa and Asia. To identify learning needs among the potential target group, this qualitative study explored what INDEPTH researchers from Ghana, Tanzania, South Africa, Kenya, Indonesia, India, Vietnam, and Bangladesh feel that they want to learn to be able to conduct research on the causes of health inequalities in their country. Using an inductive method, online concept-mapping, participants were asked to generate statements in response to the question what background knowledge they would need to conduct research on the causes of health inequalities in their country, to sort those statements into thematic groups, and to rate them in terms of how important it would be for the INTREC program to offer instruction on each of the statements. Statistical techniques were used to structure statements into a thematic cluster map and average importance ratings of statements/clusters were calculated. Of the 150 invited researchers, 82 participated in the study: 54 from Africa; 28 from Asia. Participants generated 59 statements and sorted them into 6 broader thematic clusters: "assessing health inequalities"; "research design and methods"; "research and policy"; "demography and health inequalities"; "social determinants of health" and "interventions". African participants assigned the highest importance to further training on methods for assessing health inequalities. Asian participants assigned the highest importance to training on research and policy. The identified thematic clusters and statements provide a detailed understanding of what INDEPTH researchers want to learn in order to be able to conduct research on the social determinants of health inequalities. This offers a framework for developing capacity building programs in this emerging field of public health research.

Analysis of thematic mapper simulator data collected over eastern North Dakota

NASA Technical Reports Server (NTRS)

Anderson, J. E. (Principal Investigator)

1982-01-01

The results of the analysis of aircraft-acquired thematic mapper simulator (TMS) data, collected to investigate the utility of thematic mapper data in crop area and land cover estimates, are discussed. Results of the analysis indicate that the seven-channel TMS data are capable of delineating the 13 crop types included in the study to an overall pixel classification accuracy of 80.97% correct, with relative efficiencies for four crop types examined between 1.62 and 26.61. Both supervised and unsupervised spectral signature development techniques were evaluated. The unsupervised methods proved to be inferior (based on analysis of variance) for the majority of crop types considered. Given the ground truth data set used for spectral signature development as well as evaluation of performance, it is possible to demonstrate which signature development technique would produce the highest percent correct classification for each crop type.

Adult attachment interview, thematic analysis, and communicative style in families with substance use disorder.

PubMed

Anolli, Luigi; Balconi, Michela

2002-02-01

The paper examined the Adult Attachment Interview with special reference to thematic and semantic analysis in line with the discourse study (van Dijk, 1997). The hypothesis was that correspondence between the communicative organization of speech and the mental representations of the attachment experiences would be substantial. Eight Adult Attachment Interview transcripts of fathers with a heroin addicted young son were analyzed at two levels, (a) thematic analysis to individuate the topics of their talk applying the structural and semantic study of discourse and (b) enunciative analysis of speech to define their linguistic patterns utilizing a set of linguistic micro- and macro-units. Results showed nine main topics in the Adult Attachment Interview, each of which was characterized by a distinctive linguistic profile. In this perspective this device seems to be effective not only for discriminating attachment styles between subjects but also to identify differences within subjects belonging to the same attachment pattern.

Development of a conceptual framework of health-related quality of life in pressure ulcers: a patient-focused approach.

PubMed

Gorecki, Claudia; Lamping, Donna L; Brown, Julia M; Madill, Anna; Firth, Jill; Nixon, Jane

2010-12-01

Evaluating outcomes such as health-related quality of life is particularly important and relevant in skin conditions such as pressure ulcers where the condition and associated interventions pose substantial burden to patients. Measures to evaluate such outcomes need to be developed by utilising patient-perspective to ensure that content and conceptualisation is relevant to patients. Our aim was to develop a conceptual framework of health-related quality of life in pressure ulcers, based on patients' views about the impact of pressure ulcers and interventions on health-related quality of life to inform the development of a new patient-reported outcome measure. SETTING, PARTICIPANTS AND METHODS: We developed a working conceptual framework based on a previous review of the literature, then used semi-structured qualitative interviews with 30 adults with pressure ulcers (22-94 years) purposively sampled from hospital, community and rehabilitation care settings in England and Northern Ireland to obtain patients' views, and thematic content analysis and review by a multidisciplinary expert group to develop the final conceptual framework. Our conceptual model includes four health-related quality of life domains (symptoms, physical functioning, psychological well-being, social functioning), divided into 13 sub-domains and defined by specific descriptive components. We have identified health-related quality of life outcomes that are important to people with pressure ulcers and developed a conceptual framework using robust and systematic methods, which provides the basis for the development of a new pressure ulcer-specific measure of health-related quality of life. Copyright © 2010 Elsevier Ltd. All rights reserved.

Disability Management: Organizational Diversity and Dutch Employment Policy

PubMed Central

Haafkens, Joke A.

2010-01-01

Introduction While Human Resource Managers (HRM) and line managers could play a significant role in the prevention of job-related problems and in promotion of early job-continuation, it is not clear wether the chronically ill workers are recognized as a group. Unlike some other groups, distinguished by gender, age or ethnicity, those with chronic illness are less distinct and may not be included in diversity management programs. The aim of this research is to address theory and evidence in literature about the topic, as well as to inquire whether chronic illness of the employees is ‘visible’ in practice. Methods For desk research, we used a systematic search strategy involving medical, statistical, management, and social science databases (Web of Science, MedLine, Pub Med, Psych Info, etc.). Research results are based on case studies conducted with the managers and HRM of government and commercial organizations between March 2007 and October 2008 and between October 2008 and April 2009. These case studies were based on open interviews and focus group sessions (for human resource departments) which were consequently analyzed using thematical analysis. For group sessions, we used concept mapping to collect information from two groups of HRM professionals and managers. Secondary analysis included thematic and content analysis of ‘best practice’ organizations carried out by the Dutch organization Gatekeeper. Conclusions We have discovered that the chronically ill employees are largely invisible to HRM practitioners, line managers who do not always have the right instruments for implementation of the European or national frameworks. Most practitioners are unaware of the impact of chronic illness in their organizations and in employees work life. PMID:20383740

Surveyor Management of Hospital Accreditation Program: A Thematic Analysis Conducted in Iran.

PubMed

Teymourzadeh, Ehsan; Ramezani, Mozhdeh; Arab, Mohammad; Rahimi Foroushani, Abbas; Akbari Sari, Ali

2016-05-01

The surveyors in hospital accreditation program are considered as the core of accreditation programs. So, the reliability and validity of the accreditation program heavily depend on their performance. This study aimed to identify the dimensions and factors affecting surveyor management of hospital accreditation programs in Iran. This qualitative study used a thematic analysis method, and was performed in Iran in 2014. The study participants included experts in the field of hospital accreditation, and were derived from three groups: 1. Policy-makers, administrators, and surveyors of the accreditation bureau, the ministry of health and medical education, Iranian universities of medical science; 2. Healthcare service providers, and 3. University professors and faculty members. The data were collected using semi-structured in-depth interviews. Following text transcription and control of compliance with the original text, MAXQDA10 software was used to code, classify, and organize the interviews in six stages. The findings from the analysis of 21 interviews were first classified in the form of 1347 semantic units, 11 themes, 17 sub-themes, and 248 codes. These were further discussed by an expert panel, which then resulted in the emergence of seven main themes - selection and recruitment of the surveyor team, organization of the surveyor team, planning to perform surveys, surveyor motivation and retention, surveyor training, surveyor assessment, and recommendations - as well as 27 sub-themes, and 112 codes. The dimensions and variables affecting the surveyors' management were identified and classified on the basis of existing scientific methods in the form of a conceptual framework. Using the results of this study, it would certainly be possible to take a great step toward enhancing the reliability of surveys and the quality and safety of services, while effectively managing accreditation program surveyors.

Development of an interprofessional competency framework for collaborative practice in Japan.

PubMed

Haruta, Junji; Yoshida, Kazue; Goto, Michiko; Yoshimoto, Hisashi; Ichikawa, Shuhei; Mori, Youhei; Yoshimi, Kenji; Otsuka, Mariko

2018-01-30

Rapid aging of the population necessitates improved collaboration among healthcare professionals. Unfortunately, interprofessional collaboration has yet to be implemented effectively in Japan. Therefore, we aimed to develop an interprofessional competency framework for Japanese healthcare professionals. The project was conducted as a four-step process, starting with initial categorization of potential competency domains,, followed by guiding principle and prototype development, feedback on the prototype, and final consensus. First, authors (JH and MO) collected opinions about competency in interprofessional collaboration at two academic meetings of the Japan Association for Interprofessional Education (JAIPE) and then analyzed the data thematically. Second, a project team consisting of JAIPE and University representatives extracted the domains and statements as prototype 1. Third, seven representatives from professional organizations joined the project team and developed prototype 2. We then called for feedback on the revised prototype 2 at both an open symposium and via public comments. Following revision of prototype 2, a new project team including 20 university, professional organization and health practitioner representatives finally discussed prototype 3, developed the final draft and reached a consensus. In analysis after collecting the data, we extracted 11 themes. We developed four key principles which applied to six domains as prototype 1-3. Finally, our competency framework included two core domains of "Patient-/client-/family-/community-centered" and "Interprofessional communication", and four peripheral domains of "Role contribution", "Facilitation of relationships", "Reflection" and "Understanding of others". We developed an interprofessional competency framework in Japan which consists of two core and four peripheral domains. The interprofessional competency framework is likely to affect the understanding of "high-context" and "relationalism" in Japanese healthcare. We hope that our interprofessional competency framework will encourage the systematic implementation of interprofessional education and collaboration in Japan.

Access to primary health care services for Indigenous peoples: A framework synthesis.

PubMed

Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex

2016-09-30

Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.

Community pharmacists' experiences in mental illness and addictions care: a qualitative study.

PubMed

Murphy, Andrea L; Phelan, Heather; Haslam, Scott; Martin-Misener, Ruth; Kutcher, Stan P; Gardner, David M

2016-01-28

Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists' interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists' experiences with service provision to this population remain. Improving knowledge regarding the pharmacists' experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities. We conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews. Data were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity. Pharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities.

California desert resource inventory using multispectral classification of digitally mosaicked Landsat frames

NASA Technical Reports Server (NTRS)

Bryant, N. A.; Mcleod, R. G.; Zobrist, A. L.; Johnson, H. B.

1979-01-01

Procedures for adjustment of brightness values between frames and the digital mosaicking of Landsat frames to standard map projections are developed for providing a continuous data base for multispectral thematic classification. A combination of local terrain variations in the Californian deserts and a global sampling strategy based on transects provided the framework for accurate classification throughout the entire geographic region.

Spectroradiometric calibration of the Thematic Mapper and multispectral scanner system

NASA Technical Reports Server (NTRS)

Palmer, J. (Principal Investigator); Slater, P.

1984-01-01

Results of an analysis that relates TM saturation level to ground reflectance, calendar date, latitude, and atmospheric conditions are reported. The determination of the spectral reflectance at the entrance pupil of the LANDSAT 4 pupil of the thematic mapper is described.

DESIGNA ND ANALYSIS FOR THEMATIC MAP ACCURACY ASSESSMENT: FUNDAMENTAL PRINCIPLES

EPA Science Inventory

Before being used in scientific investigations and policy decisions, thematic maps constructed from remotely sensed data should be subjected to a statistically rigorous accuracy assessment. The three basic components of an accuracy assessment are: 1) the sampling design used to s...

The development of the Person-Centred Situational Leadership Framework: Revealing the being of person-centredness in nursing homes.

PubMed

Lynch, Brighide M; McCance, Tanya; McCormack, Brendan; Brown, Donna

2018-01-01

To implement and evaluate the effect of using the Person-Centred Situational Leadership Framework to develop person-centred care within nursing homes. Many models of nursing leadership have been developed internationally in recent years but do not fit with the emergent complex philosophy of nursing home care. This study develops the Person-Centred Situational Leadership Framework that supports this philosophy. It forms the theoretical basis of the action research study described in this article. This was a complex action research study using the following multiple methods: nonparticipatory observation using the Workplace Culture Critical Analysis Tool (n = 30); critical and reflective dialogues with participants (n = 39) at time 1 (beginning of study), time 2 (end of study) and time 3 (6 months after study had ended); narratives from residents at time 1 and time 2 (n = 8); focus groups with staff at time 2 (n = 12) and reflective field notes. Different approaches to analyse the data were adopted for the different data sources, and the overall results of the thematic analysis were brought together using cognitive mapping. The Person-Centred Situational Leadership Framework captures seven core attributes of the leader that facilitate person-centredness in others: relating to the essence of being; harmonising actions with the vision; balancing concern for compliance with concern for person-centredness; connecting with the other person in the instant; intentionally enthusing the other person to act; listening to the other person with the heart; and unifying through collaboration, appreciation and trust. This study led to a theoretical contribution in relation to the Person-Centred Practice Framework. It makes an important key contribution internationally to the gap in knowledge about leadership in residential care facilities for older people. The findings can be seen to have significant applicability internationally, across other care settings and contexts. © 2017 John Wiley & Sons Ltd.

Barriers to antiretroviral therapy adherence in developed countries: a qualitative synthesis to develop a conceptual framework for a new patient-reported outcome measure.

PubMed

Engler, Kim; Lènàrt, Andras; Lessard, David; Toupin, Isabelle; Lebouché, Bertrand

2018-05-02

Suboptimal adherence to antiretroviral therapy (ART) remains common. Patient-centered tools are needed to comprehensively assess adherence barriers in HIV clinical practice. Thus, we conducted a research synthesis to produce a conceptual framework for a new patient-reported outcome measure (PRO) for use in routine HIV care in Canada and France. A PRO's conceptual framework graphically represents the concepts to be measured and the potential relationships between them. Towards ensuring the framework's relevance to the target populations' concerns, qualitative studies with HIV-positive adults on barriers to ART adherence in developed countries were synthesized with thematic analysis, attending to the cross-study prevalence and interrelationships of barrier themes. In March 2016, searches within Medline, PsychINFO, and Embase produced 5,284 records. Two reviewers determined the final sample (n = 41). Analysis generated three levels of ART adherence barrier themes. Twenty Level 2 themes and their component subthemes (Level 3) were organized into 6 higher-order themes (Level 1): Cognitive and emotional aspects (100% of studies contributing content -prevalence), Lifestyle factors (95%), Social and material context (95%), Characteristics of ART (90%), Health experience and state (73%), and Healthcare services and system (66%). As to interrelationships, study authors articulated relationships between all higher-order themes (Level 3). Linkages between Level 2 barrier themes showed great variability, from 21% to 95%. Overall, this synthesis contributes an exceptionally detailed conceptual framework and report of ART adherence barriers, applicable to a wide range of PLHIV. It suggests that a key to understanding many barriers is through their interconnections. It also identifies gaps in barrier research. Concerning the new PRO's development, comprehensiveness will need to be weighed against other concerns (e.g., respondent burden) and the provision of barrier-specific guidance for clinically addressing its scores seems essential.

Expanding roles within mental health legislation: an opportunity for professional growth or a missed opportunity?

PubMed

Hurley, J; Linsley, P

2007-09-01

This paper aims to highlight both the necessity, and the way forward for mental health nursing to integrate proposed legislative roles into practice. Argued is that community mental health nursing, historically absent from active participation within mental health law in the UK, is faced with new and demanding roles under proposed changes to the 1983 Mental Health Act of England and Wales. While supporting multidisciplinary training for such roles, the imperative of incorporating nursing specific values into consequent training programs is addressed through the offered educative framework. This framework explores the issues of power, ethics, legislative thematics and application to contemporary service structures.

How women are treated during facility-based childbirth: development and validation of measurement tools in four countries - phase 1 formative research study protocol.

PubMed

Vogel, Joshua P; Bohren, Meghan A; Tunçalp, Özge; Oladapo, Olufemi T; Adanu, Richard M; Baldé, Mamadou Diouldé; Maung, Thae Maung; Fawole, Bukola; Adu-Bonsaffoh, Kwame; Dako-Gyeke, Phyllis; Maya, Ernest Tei; Camara, Mohamed Campell; Diallo, Alfa Boubacar; Diallo, Safiatou; Wai, Khin Thet; Myint, Theingi; Olutayo, Lanre; Titiloye, Musibau; Alu, Frank; Idris, Hadiza; Gülmezoglu, Metin A

2015-07-22

Every woman has the right to dignified, respectful care during childbirth. Recent evidence has demonstrated that globally many women experience mistreatment during labour and childbirth in health facilities, which can pose a significant barrier to women attending facilities for delivery and can contribute to poor birth experiences and adverse outcomes for women and newborns. However there is no clear consensus on how mistreatment of women during childbirth in facilities is defined and measured. We propose using a two-phased, mixed-methods study design in four countries to address these research gaps. This protocol describes the Phase 1 qualitative research activities. We will employ qualitative research methodologies among women, healthcare providers and administrators in the facility catchment areas of two health facilities in each country: Ghana, Guinea, Myanmar and Nigeria. In-depth interviews (IDIs) and focus group discussions (FGDs) will be conducted among women of reproductive age (15-49 years) to explore their perceptions and experiences of facility-based childbirth care, focused on how they were treated by healthcare workers and perceived factors affecting how they were treated. IDIs will also be conducted with healthcare providers of different cadres (e.g.: nurses, midwives, medical officers, specialist obstetricians) and facility administrators working in the selected facilities to explore healthcare providers' perceptions and experiences of facility-based childbirth care and how staff are treated, colleagues and supervisors. Audio recordings will be transcribed and translated to English. Textual data will be analysed using a thematic framework approach and will consist of two levels of analysis: (1) conduct of local analysis workshops with the research assistants in each country; and (2) line-by-line coding to develop a thematic framework and coding scheme. This study serves several roles. It will provide an in-depth understanding of how women are treated during childbirth in four countries and perceived factors associated with this mistreatment. It will also provide data on where and how an intervention could be developed to reduce mistreatment and promote respectful care. The findings from this study will contribute to the development of tools to measure the prevalence of mistreatment of women during facility-based childbirth.

Developing graduate student competency in providing culturally sensitive end of life care in critical care environments - a pilot study of a teaching innovation.

PubMed

Northam, Holly L; Hercelinskyj, Gylo; Grealish, Laurie; Mak, Anita S

2015-11-01

Australia's immigration policy has generated a rich diverse cultural community of staff and patients in critical care environments. Many different cultural perspectives inform individual actions in the context of critical care, including the highly sensitive area of end of life care, with nurses feeling poorly prepared to provide culturally sensitive end of life care. This article describes and evaluates the effectiveness of an educational innovation designed to develop graduate-level critical care nurses' capacity for effective interpersonal communication, as members of a multi-disciplinary team in providing culturally sensitive end-of-life care. A mixed method pilot study was conducted using a curriculum innovation intervention informed by The Excellence in Cultural Experiential Learning and Leadership Program (EXCELL),(1) which is a higher education intervention which was applied to develop the nurses' intercultural communication skills. 12 graduate nursing students studying critical care nursing participated in the study. 42% (n=5) of the participants were from an international background. Information about students' cultural learning was recorded before and after the intervention, using a cultural learning development scale. Student discussions of end of life care were recorded at Week 2 and 14 of the curriculum. The quantitative data was analysed using descriptive statistical analysis and qualitative data was thematically analysed. Students demonstrated an increase in cultural learning in a range of areas in the pre-post surveys including understandings of cultural diversity, interpersonal skills, cross cultural interactions and participating in multicultural groups. Thematic analysis of the end of life discussions revealed an increase in the levels of nurse confidence in approaching end of life care in critical care environments. The EXCELL program provides an effective and supportive educational framework to increase graduate nurses' cultural learning development and competence to manage culturally complex clinical issues such as end of life care, and is recommended as a framework for health care students to learn the skills required to provide culturally competent care in a range of culturally complex health care settings. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Views of Health System Experts on Macro Factors of Induced Demand

PubMed Central

Khorasani, Elahe; Keyvanara, Mahmoud; Karimi, Saeed; Jazi, Marzie Jafarian

2014-01-01

Background: The probability and severity of effects of induced demand are because of the interaction between a range of factors that can affect physicians and patients behavior. It is also affected by the laws of the markets and organizational arrangements for medical services. This article studies major factors that affect the phenomenon of induced demand with the use of experts’ experiences of the Isfahan University of Medical Sciences. Methods: The research is applied a qualitative method. Semi-structured interview was used for data generation. Participants in this study were people who had been informed in this regard and had to be experienced and were known as experts. Purposive sampling was done for data saturation. Seventeen people were interviewed and criteria such as data “reliability of information” and stability were considered. The anonymity of the interviewees was preserved. The data are transcribed, categorized and then used the thematic analysis. Results: In this study, thematic analysis was conducted, and 77 sub-themes and 3 themes were extracted respectively. The three main themes include infrastructural factors, social factors, and organizational structural factors affecting induced demand. Each of these also has some sub-themes. Conclusions: Results of this research present a framework for analyzing the major causes of induced demand. The causes identified here include complexity of medicine, information mismatch between service providers and consumers, clinical uncertainty, false beliefs, advertisements, insufficient supervision, scarcity of clinical guidelines, weakness of education system, and ignorance of medical ethics. These findings help policymakers to investigate the induced demand phenomenon clear-sighted. PMID:25400888

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

PubMed

McDonald, Meghan; Brown, Janine; Knihnitski, Crystal

2018-05-01

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

Forest cover from Landsat Thematic Mapper data for use in the Catahoula anger District geographic information system.

Treesearch

David L. Evans

1994-01-01

A forest cover classification of the Kisatchie National Forest, Catahoula Ranger district, was performed with Landsat Thematic Mapper data. Data base retrievals and map products from this analysis demonstrated use of Landsat for forest management decisions.

Large-area mapping of biodiversity

USGS Publications Warehouse

Scott, J.M.; Jennings, M.D.

1998-01-01

The age of discovery, description, and classification of biodiversity is entering a new phase. In responding to the conservation imperative, we can now supplement the essential work of systematics with spatially explicit information on species and assemblages of species. This is possible because of recent conceptual, technical, and organizational progress in generating synoptic views of the earth's surface and a great deal of its biological content, at multiple scales of thematic as well as geographic resolution. The development of extensive spatial data on species distributions and vegetation types provides us with a framework for: (a) assessing what we know and where we know it at meso-scales, and (b) stratifying the biological universe so that higher-resolution surveys can be more efficiently implemented, coveting, for example, geographic adequacy of specimen collections, population abundance, reproductive success, and genetic dynamics. The land areas involved are very large, and the questions, such as resolution, scale, classification, and accuracy, are complex. In this paper, we provide examples from the United States Gap Analysis Program on the advantages and limitations of mapping the occurrence of terrestrial vertebrate species and dominant land-cover types over large areas as joint ventures and in multi-organizational partnerships, and how these cooperative efforts can be designed to implement results from data development and analyses as on-the-ground actions. Clearly, new frameworks for thinking about biogeographic information as well as organizational cooperation are needed if we are to have any hope of documenting the full range of species occurrences and ecological processes in ways meaningful to their management. The Gap Analysis experience provides one model for achieving these new frameworks.

A qualitative analysis of Māori and Pacific smokers' views on informed choice and smoking.

PubMed

Gifford, Heather; Tautolo, El-Shadan; Erick, Stephanie; Hoek, Janet; Gray, Rebecca; Edwards, Richard

2016-05-17

Tobacco companies frame smoking as an informed choice, a strategy that holds individuals responsible for harms they incur. Few studies have tested this argument, and even fewer have examined how informed indigenous smokers or those from minority ethnicities are when they start smoking. We explored how young adult Māori and Pacific smokers interpreted 'informed choice' in relation to smoking. Using recruitment via advertising, existing networks and word of mouth, we recruited and undertook qualitative in-depth interviews with 20 Māori and Pacific young adults aged 18-26 years who smoked. Data were analysed using an informed-choice framework developed by Chapman and Liberman. We used a thematic analysis approach to identify themes that extended this framework. Few participants considered themselves well informed and none met more than the framework's initial two criteria. Most reflected on their unthinking uptake and subsequent addiction, and identified environmental factors that had facilitated uptake. Nonetheless, despite this context, most agreed that they had made an informed choice to smoke. The discrepancy between participants' reported knowledge and understanding of smoking's risks, and their assessment of smoking as an informed choice, reflects their view of smoking as a symbol of adulthood. Policies that make tobacco more difficult to use in social settings could help change social norms around smoking and the ease with which initiation and addiction currently occur. 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/

Progress in landslide susceptibility mapping over Europe using Tier-based approaches

NASA Astrophysics Data System (ADS)

Günther, Andreas; Hervás, Javier; Reichenbach, Paola; Malet, Jean-Philippe

2010-05-01

The European Thematic Strategy for Soil Protection aims, among other objectives, to ensure a sustainable use of soil. The legal instrument of the strategy, the proposed Framework Directive, suggests identifying priority areas of several soil threats including landslides using a coherent and compatible approach based on the use of common thematic data. In a first stage, this can be achieved through landslide susceptibility mapping using geographically nested, multi-step tiered approaches, where areas identified as of high susceptibility by a first, synoptic-scale Tier ("Tier 1") can then be further assessed and mapped at larger scale by successive Tiers. In order to identify areas prone to landslides at European scale ("Tier 1"), a number of thematic terrain and environmental data sets already available for the whole of Europe can be used as input for a continental scale susceptibility model. However, since no coherent landslide inventory data is available at the moment over the whole continent, qualitative heuristic zonation approaches are proposed. For "Tier 1" a preliminary, simplified model has been developed. It consists of an equally weighting combination of a reduced, continent-wide common dataset of landslide conditioning factors including soil parent material, slope angle and land cover, to derive a landslide susceptibility index using raster mapping units consisting of 1 x 1 km pixels. A preliminary European-wide susceptibility map has thus been produced at 1:1 Million scale, since this is compatible with that of the datasets used. The map has been validated by means of a ratio of effectiveness using samples from landslide inventories in Italy, Austria, Hungary and United Kingdom. Although not differentiated for specific geomorphological environments or specific landslide types, the experimental model reveals a relatively good performance in many European regions at a 1:1 Million scale. An additional "Tier 1" susceptibility map at the same scale and using the same or equivalent thematic data as for the one above has been generated for six French departments using a heuristic, weighting-based multi-criteria evaluation model applied also to raster-cell mapping units. In this experiment, thematic data class weights have been differentiated for two stratification areas, namely mountains and plains, and four main landslide types. Separate susceptibility maps for each landslide type and a combined map for all types have been produced. Results have been validated using BRGM's BDMvT landslide inventory. Unlike "Tier 1", "Tier 2" assessment requires landslide inventory data and additional thematic data on conditioning factors which may not be available for all European countries. For the "Tier 2", a nation-wide quantitative landslide susceptibility assessment has been performed for Italy by applying a statistical model. In this assessment, multivariate analysis was applied using bedrock, soil and climate data together with a number of derivatives from SRTM90 DEM. In addition, separate datasets from a historical landslide inventory were used for model training and validation respectively. The mapping units selected were based on administrative boundaries (municipalities). The performance of this nation-wide, quantitative susceptibility assessment has been evaluated using multi-temporal landslide inventory data. Finally, model limitations for "Tier 1" are discussed, and recommendations for enhanced Tier 1 and Tier 2 models including additional thematic data for conditioning factors are drawn. This project is part of the collaborative research carried out within the European Landslide Expert Group coordinated by JRC in support to the EU Soil Thematic Strategy. It is also supported by the International Programme on Landslides of the International Consortium on Landslides.

Landsat-4 MSS and Thematic Mapper data quality and information content analysis

NASA Technical Reports Server (NTRS)

Anuta, P. E.; Bartolucci, L. A.; Dean, M. E.; Lozano, D. F.; Malaret, E.; Mcgillem, C. D.; Valdes, J. A.; Valenzuela, C. R.

1984-01-01

Landsat-4 Thematic Mapper and Multispectral Scanner data were analyzed to obtain information on data quality and information content. Geometric evaluations were performed to test band-to-band registration accuracy. Thematic Mapper overall system resolution was evaluated using scene objects which demonstrated sharp high contrast edge responses. Radiometric evaluation included detector relative calibration, effects of resampling, and coherent noise effects. Information content evaluation was carried out using clustering, principal components, transformed divergence separability measure, and numerous supervised classifiers on data from Iowa and Illinois. A detailed spectral class analysis (multispectral classification) was carried out on data from the Des Moines, IA area to compare the information content of the MSS and TM for a large number of scene classes.

Strengthening public health pesticide management in countries endemic with malaria or other major vector-borne diseases: an evaluation of three strategies.

PubMed

van den Berg, Henk; Yadav, Rajpal S; Zaim, Morteza

2014-09-18

Public health pesticides has been the mainstay control of vectors of malaria and other diseases, and public health pests, but there is increasing concern over how these pesticides are being managed. Poor pesticide management could lead to risks to human health and the environment, or diminish the effectiveness of interventions. Strategies for strengthening the management of public health pesticides, from manufacture to disposal, should be evaluated to propose future directions. The process and outcomes of three strategies were studied in five regions of the WHO (African Region, Eastern Mediterranean Region, South-East Asia Region, Western Pacific Region, and American Region) and 13 selected countries. These strategies are: regional policy development, in-depth country support and thematic support across countries. Consensus, frameworks and action plans on public health pesticide management were developed at regional level. Country support for situation analysis and national action planning highlighted weaknesses over the entire spectrum of pesticide management practices, mainly related to malaria control. The thematic support on pesticide quality control contributed to structural improvements on a priority issue for malaria control across countries. The three strategies showed promising and complementary results, but guidelines and tools for implementation of the strategies should be further improved. Increased national and international priority should be given to support the development of policy, legislation and capacity that are necessary for sound management of public health pesticides.

Exploring the meaning of parental involvement in physical education for students with developmental disabilities.

PubMed

An, Jihoun; Hodge, Samuel R

2013-04-01

The purpose of this phenomenological inquiry was to explore the experiences and meaning of parental involvement in physical education from the perspectives of the parents of students with developmental disabilities. The stories of four mothers of elementary aged children (3 boys, 1 girl), two mothers and one couple (mother and father) of secondary-aged youth (1 girl, 2 boys) with developmental disabilities, were gathered by using interviews, photographs, school documents, and the researcher's journal. Bronfenbrenner's (2005) ecological system theory provided a conceptual framework to interpret the findings of this inquiry. Three themes emerged from thematic analysis: being an advocate for my child, understanding the big picture, and collaborative partnerships undeveloped in GPE. The findings lend additional support to the need for establishing collaborative partnerships in physical education between home and school environments (An & Goodwin, 2007; Tekin, 2011).

The lived experience of Canadian university students with type 1 diabetes mellitus.

PubMed

Hill, Stephanie; Gingras, Jacqui; Gucciardi, Enza

2013-08-01

The purpose of this study was to examine the lived experiences of university students with type 1 diabetes mellitus. University students participated in a 2-part focus group. Transcripts were analyzed thematically using an open-coding approach. Data analysis was guided by a framework analysis method and emergent themes were triangulated between study authors for validity. Three major themes identified in this study were food issues within the university environment, lack of diabetes awareness on campus and internal struggles related to the participants' relationships with their diabetes. Results illustrate some of the unique challenges that interfere with diabetes self-management, academic performance and quality of life among this sample of university students. Findings can provide insight for diabetes educators and other healthcare practitioners regarding the issues that may interfere with optimal diabetes self-care in this population. Findings also can be used to inform university administrators how to make the university environment more diabetes friendly for its students. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Professional Identity Formation in an Advanced Pharmacy Practice Experience Emphasizing Self-Authorship.

PubMed

Johnson, Jessica L; Chauvin, Sheila

2016-12-25

Objective. To examine the extent to which reflective essays written by graduating pharmacy students revealed professional identity formation and self-authorship development. Design. Following a six-week advanced pharmacy practice experience (APPE) grounded in Baxter-Magolda's Learning Partnerships Model of self-authorship development, students completed a culminating reflective essay on their rotation experiences and professional identity formation. Assessment. Thematic and categorical analysis of 41 de-identified essays revealed nine themes and evidence of all Baxter-Magolda's domains and phases of self-authorship. Analysis also suggested relationships between self-authorship and pharmacist professional identity formation. Conclusion. Results suggest that purposeful structuring of learning experiences can facilitate professional identity formation. Further, Baxter-Magolda's framework for self-authorship and use of the Learning Partnership Model seem to align well with pharmacist professional identify formation. Results of this study could be used by pharmacy faculty members when considering how to fill gaps in professional identity formation in future course and curriculum development.

Professional Identity Formation in an Advanced Pharmacy Practice Experience Emphasizing Self-Authorship

PubMed Central

Chauvin, Sheila

2016-01-01

Objective. To examine the extent to which reflective essays written by graduating pharmacy students revealed professional identity formation and self-authorship development. Design. Following a six-week advanced pharmacy practice experience (APPE) grounded in Baxter-Magolda’s Learning Partnerships Model of self-authorship development, students completed a culminating reflective essay on their rotation experiences and professional identity formation. Assessment. Thematic and categorical analysis of 41 de-identified essays revealed nine themes and evidence of all Baxter-Magolda’s domains and phases of self-authorship. Analysis also suggested relationships between self-authorship and pharmacist professional identity formation. Conclusion. Results suggest that purposeful structuring of learning experiences can facilitate professional identity formation. Further, Baxter-Magolda’s framework for self-authorship and use of the Learning Partnership Model seem to align well with pharmacist professional identify formation. Results of this study could be used by pharmacy faculty members when considering how to fill gaps in professional identity formation in future course and curriculum development. PMID:28179721

Factors influencing when intensive care unit nurses go to the bedside to investigate patient related alarms: A descriptive qualitative study.

PubMed

Despins, Laurel A

2017-12-01

This study examines what prompts the intensive care unit (ICU) nurse to go to the patient's bedside to investigate an alarm and the influences on the nurse's determination regarding how quickly this needs to occur. A qualitative descriptive design guided data collection and analysis. Individual semi-structured interviews were conducted. Thematic analysis guided by the Patient Risk Detection Theoretical Framework was applied to the data. Four specialty intensive care units in an academic medical center. ICU nurses go the patient's bedside in response to an alarm to catch patient deterioration and avert harm. Their determination of the immediacy of patient risk and their desire to prioritize their bedside investigations to true alarms influences how quickly they proceed to the bedside. Ready visual access to physiological data and waveform configurations, experience, teamwork, and false alarms are important determinants in the timing of ICU nurses' bedside alarm investigations. Copyright © 2017 Elsevier Ltd. All rights reserved.

A theory-informed qualitative exploration of social and environmental determinants of physical activity and dietary choices in adolescents with intellectual disabilities in their final year of school.

PubMed

Stevens, Gemma; Jahoda, Andrew; Matthews, Lynsay; Hankey, Catherine; Melville, Craig; Murray, Heather; Mitchell, Fiona

2018-01-01

The prevalence of obesity is higher in those with intellectual disabilities than the general population. The aim of the study was to understand the determinants of physical activity and dietary patterns in this population during their final year of school. Qualitative data were generated from 10 interviews with adolescents with mild-moderate intellectual disabilities. Data were analysed using deductive thematic analysis, employing Self-Determination Theory as a theoretical framework. Adolescents' environment and social interactions play a pivotal role in influencing physical activity and dietary patterns. Three themes emerged from the analysis: situatedness, motivation and wider environmental influences. School structure, high self-efficacy and social connectedness facilitate increased physical activity and healthier diet in adolescents with intellectual disabilities. Home life, low self-efficacy and a lack of social connectedness can serve as a barrier to PA and a healthy diet. © 2017 John Wiley & Sons Ltd.

Limiting the consumption of sugar sweetened beverages in Mexico's obesogenic environment: a qualitative policy review and stakeholder analysis.

PubMed

Moise, Nathalie; Cifuentes, Enrique; Orozco, Emanuel; Willett, Walter

2011-11-01

Mexico is building a legal framework to address its childhood obesity epidemic. Sugar sweetened beverages (SSB) in the school environment represent a major policy challenge. We addressed the following questions: What barriers inhibit political attention to SSB and childhood obesity? What political instruments, international and national, exist to guide agenda setting in Mexico? What opportunities exist for policy adoption? We conducted a systematic review of international and national legal instruments concerned with SSB consumption. We traced process, conducting interviews with key informants. Thematic analysis helped us identify barriers and opportunities for public health interventions. We found 11 national policy instruments, but detected implementation gaps and weak fiscal policies on SSB consumption in schools: limited drinking water infrastructure, SSB industry interests, and regulatory ambiguities addressing reduction of sugar in beverages. Public policy should target marketing practices and taxation. The school environment remains a promising target for policy. Access to safe drinking water must complement comprehensive and multi-sector policy approaches to reduce access to SSB.

Analysing news media coverage of the 2015 Nepal earthquake using a community capitals lens: implications for disaster resilience.

PubMed

Dhakal, Subas P

2018-04-01

South Asia is one of the regions of the world most vulnerable to natural disasters. Although news media analyses of disasters have been conducted frequently in various settings globally, there is little research on populous South Asia. This paper begins to fill this gap by evaluating local and foreign news media coverage of the earthquake in Nepal on 25 April 2015. It broadens the examination of news media coverage of disaster response beyond traditional framing theory, utilising community capitals (built, cultural, financial, human, natural, political, and social) lens to perform a thematic content analysis of 405 news items. Overall, financial and natural capital received the most and the least emphasis respectively. Statistically significant differences between local and foreign news media were detected vis-à-vis built, financial, and political capital. The paper concludes with a discussion of the social utility of news media analysis using the community capitals framework to inform disaster resilience. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

A qualitative analysis of parental decision making for childhood immunisation.

PubMed

Marshall, S; Swerissen, H

1999-10-01

Achieving high rates of childhood immunisation is an important public health aim. Currently, however, immunisation uptake in Australia is disappointing. This qualitative study investigated the factors that influence parental decision making for childhood immunisation, and whether parents' experiences were better conceptualised in terms of static subjective expected utility models or in terms of a more dynamic process. Semi-structured in-depth interviews were conducted with 20 predominantly middle-class mothers--17 immunizers and three non-immunizers, in Melbourne, Victoria, in 1997. The data were then examined using thematic analysis. The results suggested that for these participants the decision regarding childhood immunization was better conceptualized as a dynamic process. The decision required initial consideration, implementation then maintenance. If a better understanding of immunization decision making is to be achieved, future studies must look beyond static frameworks. Clearer insight into the dynamic nature of immunization decision making should assist in the identification of more effective methods of promoting childhood immunization to groups at risk of non-compliance.

Core Didactic Thematics and Methodology in Business Spanish: Developing Leadership with Integrity as a Priority for Language for the Professions and Specific Purposes

ERIC Educational Resources Information Center

Doyle, Michael S.

2017-01-01

Business Spanish typically teaches the vocabulary, content, and context of the functional areas of business, and how to conduct business in a cultural setting. But it should do more than just that. Leadership with integrity should be primed and personalized as a signature and integrative core value that frameworks any ensuing learning of the…

A Thematic Analysis of Theoretical Models for Translational Science in Nursing: Mapping the Field

PubMed Central

Mitchell, Sandra A.; Fisher, Cheryl A.; Hastings, Clare E.; Silverman, Leanne B.; Wallen, Gwenyth R.

2010-01-01

Background The quantity and diversity of conceptual models in translational science may complicate rather than advance the use of theory. Purpose This paper offers a comparative thematic analysis of the models available to inform knowledge development, transfer, and utilization. Method Literature searches identified 47 models for knowledge translation. Four thematic areas emerged: (1) evidence-based practice and knowledge transformation processes; (2) strategic change to promote adoption of new knowledge; (3) knowledge exchange and synthesis for application and inquiry; (4) designing and interpreting dissemination research. Discussion This analysis distinguishes the contributions made by leaders and researchers at each phase in the process of discovery, development, and service delivery. It also informs the selection of models to guide activities in knowledge translation. Conclusions A flexible theoretical stance is essential to simultaneously develop new knowledge and accelerate the translation of that knowledge into practice behaviors and programs of care that support optimal patient outcomes. PMID:21074646

Spectroradiometric calibration of the thematic mapper and multispectral scanner system

NASA Technical Reports Server (NTRS)

Palmer, J. M.; Slater, P. N.

1983-01-01

The results of an analysis that relates thematic mapper (TM) saturation level to ground reflectance, calendar date, latitude, and atmospheric condition is provided. A revised version of the preprint included with the last quarterly report is also provided for publication in the IEEE Transactions on Geoscience and Remote Sensing.

What Medical Students Say about Psychiatry: Results of a Reflection Exercise

ERIC Educational Resources Information Center

Brenner, Adam M.

2011-01-01

Objective: The author describes the results of a reflection exercise for psychiatry clerkship students. Method: The author performed a qualitative analysis on 100 "reflection" papers written by medical students in their psychiatry clerkship and identified the most prominent thematic content. Results: The most common thematic content involved…

Managing resources in NHS dentistry: using health economics to inform commissioning decisions.

PubMed

Holmes, Richard D; Steele, Jimmy; Exley, Catherine E; Donaldson, Cam

2011-05-31

The aim of this study is to develop, apply and evaluate an economics-based framework to assist commissioners in their management of finite resources for local dental services. In April 2006, Primary Care Trusts in England were charged with managing finite dental budgets for the first time, yet several independent reports have since criticised the variability in commissioning skills within these organisations. The study will explore the views of stakeholders (dentists, patients and commissioners) regarding priority setting and the criteria used for decision-making and resource allocation. Two inter-related case studies will explore the dental commissioning and resource allocation processes through the application of a pragmatic economics-based framework known as Programme Budgeting and Marginal Analysis. The study will adopt an action research approach. Qualitative methods including semi-structured interviews, focus groups, field notes and document analysis will record the views of participants and their involvement in the research process. The first case study will be based within a Primary Care Trust where mixed methods will record the views of dentists, patients and dental commissioners on issues, priorities and processes associated with managing local dental services. A Programme Budgeting and Marginal Analysis framework will be applied to determine the potential value of economic principles to the decision-making process. A further case study will be conducted in a secondary care dental teaching hospital using the same approach. Qualitative data will be analysed using thematic analysis and managed using a framework approach. The recent announcement by government regarding the proposed abolition of Primary Care Trusts may pose challenges for the research team regarding their engagement with the research study. However, whichever commissioning organisations are responsible for resource allocation for dental services in the future; resource scarcity is highly likely to remain an issue. Wider understanding of the complexities of priority setting and resource allocation at local levels are important considerations in the development of dental commissioning processes, national oral health policy and the future new dental contract which is expected to be implemented in April 2014.

Funding and remuneration of interdisciplinary primary care teams in Canada: a conceptual framework and application.

PubMed

Wranik, W Dominika; Haydt, Susan M; Katz, Alan; Levy, Adrian R; Korchagina, Maryna; Edwards, Jeanette M; Bower, Ian

2017-05-15

Reliance on interdisciplinary teams in the delivery of primary care is on the rise. Funding bodies strive to design financial environments that support collaboration between providers. At present, the design of financial arrangements has been fragmented and not based on evidence. The root of the problem is a lack of systematic evidence demonstrating the superiority of any particular financial arrangement, or a solid understanding of options. In this study we develop a framework for the conceptualization and analysis of financial arrangements in interdisciplinary primary care teams. We use qualitative data from three sources: (i) interviews with 19 primary care decision makers representing 215 clinics in three Canadian provinces, (ii) a research roundtable with 14 primary care decision makers and/or researchers, and (iii) policy documents. Transcripts from interviews and the roundtable were coded thematically and a framework synthesis approach was applied. Our conceptual framework differentiates between team level funding and provider level remuneration, and characterizes the interplay and consonance between them. Particularly the notions of hierarchy, segregation, and dependence of provider incomes, and the link between funding and team activities are introduced as new clarifying concepts, and their implications explored. The framework is applied to the analysis of collaboration incentives, which appear strongest when provider incomes are interdependent, funding is linked to the team as a whole, and accountability does not have multiple lines. Emergent implementation issues discussed by respondents include: (i) centrality of budget negotiations; (ii) approaches to patient rostering; (iii) unclear funding sources for space and equipment; and (iv) challenges with community engagement. The creation of patient rosters is perceived as a surprisingly contentious issue, and the challenges of funding for space and equipment remain unresolved. The development and application of a conceptual framework is an important step to the systematic study of the best performing financial models in the context of interdisciplinary primary care. The identification of optimal financial arrangements must be contextualized in terms of feasibility and the implementation environment. In general, financial hierarchy, both overt and covert, is considered a barrier to collaboration.

Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis.

PubMed

Moullin, Joanna C; Sabater-Hernández, Daniel; Benrimoj, Shalom I

2016-08-25

Multiple studies have explored the implementation process and influences, however it appears there is no study investigating these influences across the stages of implementation. Community pharmacy is attempting to implement professional services (pharmaceutical care and other health services). The use of implementation theory may assist the achievement of widespread provision, support and integration. The objective was to investigate professional service implementation in community pharmacy to contextualise and advance the concepts of a generic implementation framework previously published. Purposeful sampling was used to investigate implementation across a range of levels of implementation in community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a framework methodology. Data was charted using implementation stages as overarching themes and each stage was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation. Six stages emerged, labelled as development or discovery, exploration, preparation, testing, operation and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences (pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified. The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely. Evaluations were lacking. The process of implementation and five overarching influences of professional services implementation in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences, factors influencing implementation varied across the implementation stages. It is proposed at each stage, for each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.

Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework: Perceptions of stakeholders.

PubMed

Maluka, Stephen; Kamuzora, Peter; San Sebastián, Miguel; Byskov, Jens; Ndawi, Benedict; Hurtig, Anna-Karin

2010-12-01

In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania. The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees. Individual interviews were carried out with different categories of actors and stakeholders in the district. The interview guide consisted of a series of questions, asking respondents to describe their perceptions regarding each condition of the Accountability for Reasonableness framework in terms of priority setting. Interviews were analysed using thematic framework analysis. Documentary data were used to support, verify and highlight the key issues that emerged. Almost all stakeholders viewed Accountability for Reasonableness as an important and feasible approach for improving priority-setting and health service delivery in their context. However, a few aspects of Accountability for Reasonableness were seen as too difficult to implement given the socio-political conditions and traditions in Tanzania. Respondents mentioned: budget ceilings and guidelines, low level of public awareness, unreliable and untimely funding, as well as the limited capacity of the district to generate local resources as the major contextual factors that hampered the full implementation of the framework in their context. This study was one of the first assessments of the applicability of Accountability for Reasonableness in health care priority-setting in Tanzania. The analysis, overall, suggests that the Accountability for Reasonableness framework could be an important tool for improving priority-setting processes in the contexts of resource-poor settings. However, the full implementation of Accountability for Reasonableness would require a proper capacity-building plan, involving all relevant stakeholders, particularly members of the community since public accountability is the ultimate aim, and it is the community that will live with the consequences of priority-setting decisions.

A systematic review of service-learning in medical education: 1998-2012.

PubMed

Stewart, Trae; Wubbena, Zane C

2015-01-01

PHENOMENON: In the United States, the Affordable Care Act has increased the need for community-centered pedagogy for medical education such as service-learning, wherein students connect academic curriculum and reflections to address a community need. Yet heterogeneity among service-learning programs suggests the need for a framework to understand variations among service-learning programs in medical education. A qualitative systematic review of literature on service-learning and medical education was conducted for the period between 1998 and 2012. A two-stage inclusion criteria process resulted in articles (n = 32) on service-learning and Doctor of Medicine or Doctor of Osteopathic Medicine being included for both coding and analysis. Focused and selective coding were employed to identify recurring themes and subthemes from the literature. The findings of the qualitative thematic analysis of service-learning variation in medical education identified a total of seven themes with subthemes. The themes identified from the analysis were (a) geographic location and setting, (b) program design, (c) funding, (d) participation, (e) program implementation, (f) assessment, and (g) student outcomes. Insights: This systematic review of literature confirmed the existence of program heterogeneity among service-learning program in medical education. However, the findings of this study provide key insights into the nature of service-learning in medical education building a framework for which to organize differences among service-learning programs. A list of recommendations for future areas of inquiry is provided to guide future research.

Aligning Education With Health Care Transformation: Identifying a Shared Mental Model of "New" Faculty Competencies for Academic Faculty.

PubMed

Gonzalo, Jed D; Ahluwalia, Amarpreet; Hamilton, Maria; Wolf, Heidi; Wolpaw, Daniel R; Thompson, Britta M

2018-02-01

To develop a potential competency framework for faculty development programs aligned with the needs of faculty in academic health centers (AHCs). In 2014 and 2015, the authors interviewed 23 health system leaders and analyzed transcripts using constant comparative analysis and thematic analysis. They coded competencies and curricular concepts into subcategories. Lead investigators reviewed drafts of the categorization themes and subthemes related to gaps in faculty knowledge and skills, collapsed and combined competency domains, and resolved disagreements via discussion. Through analysis, the authors identified four themes. The first was core functional competencies and curricular domains for conceptual learning, including patient-centered care, health care processes, clinical informatics, population and public health, policy and payment, value-based care, and health system improvement. The second was the need for foundational competency domains, including systems thinking, change agency/management, teaming, and leadership. The third theme was paradigm shifts in how academic faculty should approach health care, categorized into four areas: delivery, transformation, provider characteristics and skills, and education. The fourth theme was the need for faculty to be aware of challenges in the culture of AHCs as an influential context for change. This broad competency framework for faculty development programs expands existing curricula by including a comprehensive scope of health systems science content and skills. AHC leaders can use these results to better align faculty education with the real-time needs of their health systems. Future work should focus on optimal prioritization and methods for teaching.

Comparison of existing digital image analysis systems for the analysis of Thematic Mapper data

NASA Technical Reports Server (NTRS)

Likens, W. C.; Wrigley, R. C.

1984-01-01

Most existing image analysis systems were designed with the Landsat Multi-Spectral Scanner in mind, leaving open the question of whether or not these systems could adequately process Thematic Mapper data. In this report, both hardware and software systems have been evaluated for compatibility with TM data. Lack of spectral analysis capability was not found to be a problem, though techniques for spatial filtering and texture varied. Computer processing speed and data storage of currently existing mini-computer based systems may be less than adequate. Upgrading to more powerful hardware may be required for many TM applications.

Developing an evaluation framework for consumer-centred collaborative care of depression using input from stakeholders.

PubMed

McCusker, Jane; Yaffe, Mark; Sussman, Tamara; Kates, Nick; Mulvale, Gillian; Jayabarathan, Ajantha; Law, Susan; Haggerty, Jeannie

2013-03-01

To develop a framework for research and evaluation of collaborative mental health care for depression, which includes attributes or domains of care that are important to consumers. A literature review on collaborative mental health care for depression was completed and used to guide discussion at an interactive workshop with pan-Canadian participants comprising people treated for depression with collaborative mental health care, as well as their family members; primary care and mental health practitioners; decision makers; and researchers. Thematic analysis of qualitative data from the workshop identified key attributes of collaborative care that are important to consumers and family members, as well as factors that may contribute to improved consumer experiences. The workshop identified an overarching theme of partnership between consumers and practitioners involved in collaborative care. Eight attributes of collaborative care were considered to be essential or very important to consumers and family members: respectfulness; involvement of consumers in treatment decisions; accessibility; provision of information; coordination; whole-person care; responsiveness to changing needs; and comprehensiveness. Three inter-related groups of factors may affect the consumer experience of collaborative care, namely, organizational aspects of care; consumer characteristics and personal resources; and community resources. A preliminary evaluation framework was developed and is presented here to guide further evaluation and research on consumer-centred collaborative mental health care for depression.

Methods and impact of engagement in research, from theory to practice and back again: early findings from the Patient-Centered Outcomes Research Institute.

PubMed

Forsythe, Laura; Heckert, Andrea; Margolis, Mary Kay; Schrandt, Suzanne; Frank, Lori

2018-01-01

Since 2012, PCORI has been funding patient-centered comparative effectiveness research with a requirement for engaging patients and other stakeholders in the research, a requirement that is unique among the US funders of clinical research. This paper presents PCORI's evaluation framework for assessing the short- and long-term impacts of engagement; describes engagement in PCORI projects (types of stakeholders engaged, when in the research process they are engaged and how they are engaged, contributions of their engagement); and identifies the effects of engagement on study design, processes, and outcomes selection, as reported by both PCORI-funded investigators and patient and other stakeholder research partners. Detailed quantitative and qualitative information collected annually from investigators and their partners was analyzed via descriptive statistics and cross-sectional qualitative content and thematic analysis, and compared against the outcomes expected from the evaluation framework and its underlying conceptual model. The data support the role of engaged research partners in refinements to the research questions, selection of interventions to compare, choice of study outcomes and how they are measured, contributions to strategies for recruitment, and ensuring studies are patient-centered. The evaluation framework and the underlying conceptual model are supported by results to date. PCORI will continue to assess the effects of engagement as the funded projects progress toward completion, dissemination, and uptake into clinical decision making.

Methodology Series Module 10: Qualitative Health Research

PubMed Central

Setia, Maninder Singh

2017-01-01

Although quantitative designs are commonly used in clinical research, some studies require qualitative methods. These designs are different from quantitative methods; thus, researchers should be aware of data collection methods and analyses for qualitative research. Qualitative methods are particularly useful to understand patient experiences with the treatment or new methods of management or to explore issues in detail. These methods are useful in social and behavioral research. In qualitative research, often, the main focus is to understand the issue in detail rather than generalizability; thus, the sampling methods commonly used are purposive sampling; quota sampling; and snowball sampling (for hard to reach groups). Data can be collected using in-depth interviews (IDIs) or focus group discussions (FGDs). IDI is a one-to-one interview with the participant. FGD is a method of group interview or discussion, in which more than one participant is interviewed at the same time and is usually led by a facilitator. The commonly used methods for data analysis are: thematic analysis; grounded theory analysis; and framework analysis. Qualitative data collection and analysis require special expertise. Hence, if the reader plans to conduct qualitative research, they should team up with a qualitative researcher. PMID:28794545

Methodology Series Module 10: Qualitative Health Research.

PubMed

Setia, Maninder Singh

2017-01-01

Although quantitative designs are commonly used in clinical research, some studies require qualitative methods. These designs are different from quantitative methods; thus, researchers should be aware of data collection methods and analyses for qualitative research. Qualitative methods are particularly useful to understand patient experiences with the treatment or new methods of management or to explore issues in detail. These methods are useful in social and behavioral research. In qualitative research, often, the main focus is to understand the issue in detail rather than generalizability; thus, the sampling methods commonly used are purposive sampling; quota sampling; and snowball sampling (for hard to reach groups). Data can be collected using in-depth interviews (IDIs) or focus group discussions (FGDs). IDI is a one-to-one interview with the participant. FGD is a method of group interview or discussion, in which more than one participant is interviewed at the same time and is usually led by a facilitator. The commonly used methods for data analysis are: thematic analysis; grounded theory analysis; and framework analysis. Qualitative data collection and analysis require special expertise. Hence, if the reader plans to conduct qualitative research, they should team up with a qualitative researcher.

Meta-analysis, complexity, and heterogeneity: a qualitative interview study of researchers' methodological values and practices.

PubMed

Lorenc, Theo; Felix, Lambert; Petticrew, Mark; Melendez-Torres, G J; Thomas, James; Thomas, Sian; O'Mara-Eves, Alison; Richardson, Michelle

2016-11-16

Complex or heterogeneous data pose challenges for systematic review and meta-analysis. In recent years, a number of new methods have been developed to meet these challenges. This qualitative interview study aimed to understand researchers' understanding of complexity and heterogeneity and the factors which may influence the choices researchers make in synthesising complex data. We conducted interviews with a purposive sample of researchers (N = 19) working in systematic review or meta-analysis across a range of disciplines. We analysed data thematically using a framework approach. Participants reported using a broader range of methods and data types in complex reviews than in traditional reviews. A range of techniques are used to explore heterogeneity, but there is some debate about their validity, particularly when applied post hoc. Technical considerations of how to synthesise complex evidence cannot be isolated from questions of the goals and contexts of research. However, decisions about how to analyse data appear to be made in a largely informal way, drawing on tacit expertise, and their relation to these broader questions remains unclear.

Refining the Concepts of Self-quantification Needed for Health Self-management. A Thematic Literature Review.

PubMed

Almalki, Manal; Gray, Kathleen; Martin-Sanchez, Fernando J

2017-01-09

Questions like 'How is your health? How are you feeling? How have you been?' now can be answered in a different way due to innovative health self-quantification apps and devices. These apps and devices generate data that enable individuals to be informed and more responsible about their own health. The aim of this paper is to review studies on health SQ, firstly, exploring the concepts that are associated with the users' interaction with and around data for managing health; and secondly, the potential benefits and challenges that are associated with the use of such data to maintain or promote health, as well as their impact on the users' certainty or confidence in taking effective actions upon such data. To answer these questions, we conducted a comprehensive literature review to build our study sample. We searched a number of electronic bibliographic databases including Scopus, Web of Science, Medline, and Google Scholar. Thematic analysis was conducted for each study to find all the themes that are related to our research aims. In the reviewed literature, conceptualisation of health SQ is messy and inconsistent. Personal tracking, personal analytics, personal experimentation, and personal health activation are different concepts within the practice of health SQ; thus, a new definition and structure is proposed to set out boundaries between them. Using the data that are generated by SQS for managing health has many advantages but also poses many challenges. Inconsistency in conceptualisation of health SQ - as well as the challenges that users experience in health self-management - reveal the need for frameworks that can describe the users' health SQ practice in a holistic and consistent manner. Our ongoing work toward developing these frameworks will help researchers in this domain to gain better understanding of this practice, and will enable more systematic investigations which are needed to improve the use of SQS and their data in health self-management.

A framework for outcome-level evaluation of in-service training of health care workers.

PubMed

O'Malley, Gabrielle; Perdue, Thomas; Petracca, Frances

2013-10-01

In-service training is a key strategic approach to addressing the severe shortage of health care workers in many countries. However, there is a lack of evidence linking these health care worker trainings to improved health outcomes. In response, the United States President's Emergency Plan for AIDS Relief's Human Resources for Health Technical Working Group initiated a project to develop an outcome-focused training evaluation framework. This paper presents the methods and results of that project. A general inductive methodology was used for the conceptualization and development of the framework. Fifteen key informant interviews were conducted to explore contextual factors, perceived needs, barriers and facilitators affecting the evaluation of training outcomes. In addition, a thematic analysis of 70 published articles reporting health care worker training outcomes identified key themes and categories. These were integrated, synthesized and compared to several existing training evaluation models. This formed an overall typology which was used to draft a new framework. Finally, the framework was refined and validated through an iterative process of feedback, pilot testing and revision. The inductive process resulted in identification of themes and categories, as well as relationships among several levels and types of outcomes. The resulting framework includes nine distinct types of outcomes that can be evaluated, which are organized within three nested levels: individual, organizational and health system/population. The outcome types are: (1) individual knowledge, attitudes and skills; (2) individual performance; (3) individual patient health; (4) organizational systems; (5) organizational performance; (6) organizational-level patient health; (7) health systems; (8) population-level performance; and (9) population-level health. The framework also addresses contextual factors which may influence the outcomes of training, as well as the ability of evaluators to determine training outcomes. In addition, a group of user-friendly resources, the Training Evaluation Framework and Tools (TEFT) were created to help evaluators and stakeholders understand and apply the framework. Feedback from pilot users suggests that using the framework and accompanying tools may support outcome evaluation planning. Further assessment will assist in strengthening guidelines and tools for operationalization.

A framework for outcome-level evaluation of in-service training of health care workers

PubMed Central

2013-01-01

Background In-service training is a key strategic approach to addressing the severe shortage of health care workers in many countries. However, there is a lack of evidence linking these health care worker trainings to improved health outcomes. In response, the United States President’s Emergency Plan for AIDS Relief’s Human Resources for Health Technical Working Group initiated a project to develop an outcome-focused training evaluation framework. This paper presents the methods and results of that project. Methods A general inductive methodology was used for the conceptualization and development of the framework. Fifteen key informant interviews were conducted to explore contextual factors, perceived needs, barriers and facilitators affecting the evaluation of training outcomes. In addition, a thematic analysis of 70 published articles reporting health care worker training outcomes identified key themes and categories. These were integrated, synthesized and compared to several existing training evaluation models. This formed an overall typology which was used to draft a new framework. Finally, the framework was refined and validated through an iterative process of feedback, pilot testing and revision. Results The inductive process resulted in identification of themes and categories, as well as relationships among several levels and types of outcomes. The resulting framework includes nine distinct types of outcomes that can be evaluated, which are organized within three nested levels: individual, organizational and health system/population. The outcome types are: (1) individual knowledge, attitudes and skills; (2) individual performance; (3) individual patient health; (4) organizational systems; (5) organizational performance; (6) organizational-level patient health; (7) health systems; (8) population-level performance; and (9) population-level health. The framework also addresses contextual factors which may influence the outcomes of training, as well as the ability of evaluators to determine training outcomes. In addition, a group of user-friendly resources, the Training Evaluation Framework and Tools (TEFT) were created to help evaluators and stakeholders understand and apply the framework. Conclusions Feedback from pilot users suggests that using the framework and accompanying tools may support outcome evaluation planning. Further assessment will assist in strengthening guidelines and tools for operationalization. PMID:24083635

A Framework to Assess Where and How Children Connect to Nature.

PubMed

Giusti, Matteo; Svane, Ulrika; Raymond, Christopher M; Beery, Thomas H

2017-01-01

The design of the green infrastructure in urban areas largely ignores how people's relation to nature, or human-nature connection (HNC), can be nurtured. One practical reason for this is the lack of a framework to guide the assessment of where people, and more importantly children, experience significant nature situations and establish nature routines. This paper develops such a framework. We employed a mixed-method approach to understand what qualities of nature situations connect children to nature (RQ1), what constitutes children's HNC (RQ2), and how significant nature situations and children's HNC relate to each other over time (RQ3). We first interviewed professionals in the field of connecting children to nature ( N = 26), performed inductive thematic analysis of these interviews, and then further examined the inductive findings by surveying specialists ( N = 275). We identified 16 qualities of significant nature situations (e.g., "awe," "engagement of senses," "involvement of mentors") and 10 abilities that constitute children's HNC (e.g., "feeling comfortable in natural spaces," "feeling attached to natural spaces," "taking care of nature"). We elaborated three principles to answer our research questions: (1) significant nature situations are various and with differing consequences for children's HNC; (2) children's HNC is a complex embodied ability; (3) children's HNC progresses over time through diverse nature routines. Together, these findings form the Assessment framework for Children's Human Nature Situations (ACHUNAS). ACHUNAS is a comprehensive framework that outlines what to quantify or qualify when assessing "child-nature connecting" environments. It guides the assessment of where and how children connect to nature, stimulating both the design of nature-connecting human habitats as well as pedagogical approaches to HNC.

A Framework to Assess Where and How Children Connect to Nature

PubMed Central

Giusti, Matteo; Svane, Ulrika; Raymond, Christopher M.; Beery, Thomas H.

2018-01-01

The design of the green infrastructure in urban areas largely ignores how people's relation to nature, or human-nature connection (HNC), can be nurtured. One practical reason for this is the lack of a framework to guide the assessment of where people, and more importantly children, experience significant nature situations and establish nature routines. This paper develops such a framework. We employed a mixed-method approach to understand what qualities of nature situations connect children to nature (RQ1), what constitutes children's HNC (RQ2), and how significant nature situations and children's HNC relate to each other over time (RQ3). We first interviewed professionals in the field of connecting children to nature (N = 26), performed inductive thematic analysis of these interviews, and then further examined the inductive findings by surveying specialists (N = 275). We identified 16 qualities of significant nature situations (e.g., “awe,” “engagement of senses,” “involvement of mentors”) and 10 abilities that constitute children's HNC (e.g., “feeling comfortable in natural spaces,” “feeling attached to natural spaces,” “taking care of nature”). We elaborated three principles to answer our research questions: (1) significant nature situations are various and with differing consequences for children's HNC; (2) children's HNC is a complex embodied ability; (3) children's HNC progresses over time through diverse nature routines. Together, these findings form the Assessment framework for Children's Human Nature Situations (ACHUNAS). ACHUNAS is a comprehensive framework that outlines what to quantify or qualify when assessing “child-nature connecting” environments. It guides the assessment of where and how children connect to nature, stimulating both the design of nature-connecting human habitats as well as pedagogical approaches to HNC. PMID:29354088

Fostering Students' Conceptual Knowledge in Biology in the Context of German National Education Standards

NASA Astrophysics Data System (ADS)

Förtsch, Christian; Dorfner, Tobias; Baumgartner, Julia; Werner, Sonja; von Kotzebue, Lena; Neuhaus, Birgit J.

2018-04-01

The German National Education Standards (NES) for biology were introduced in 2005. The content part of the NES emphasizes fostering conceptual knowledge. However, there are hardly any indications of what such an instructional implementation could look like. We introduce a theoretical framework of an instructional approach to foster students' conceptual knowledge as demanded in the NES (Fostering Conceptual Knowledge) including instructional practices derived from research on single core ideas, general psychological theories, and biology-specific features of instructional quality. First, we aimed to develop a rating manual, which is based on this theoretical framework. Second, we wanted to describe current German biology instruction according to this approach and to quantitatively analyze its effectiveness. And third, we aimed to provide qualitative examples of this approach to triangulate our findings. In a first step, we developed a theoretically devised rating manual to measure Fostering Conceptual Knowledge in videotaped lessons. Data for quantitative analysis included 81 videotaped biology lessons of 28 biology teachers from different German secondary schools. Six hundred forty students completed a questionnaire on their situational interest after each lesson and an achievement test. Results from multilevel modeling showed significant positive effects of Fostering Conceptual Knowledge on students' achievement and situational interest. For qualitative analysis, we contrasted instruction of four teachers, two with high and two with low student achievement and situational interest using the qualitative method of thematic analysis. Qualitative analysis revealed five main characteristics describing Fostering Conceptual Knowledge. Therefore, implementing Fostering Conceptual Knowledge in biology instruction seems promising. Examples of how to implement Fostering Conceptual Knowledge in instruction are shown and discussed.

Similarity extraction mechanism concerning historical personalities based on SQL queries in an RDBMS environment

NASA Astrophysics Data System (ADS)

Barouchou, Alexandra; Dendrinos, Markos

2015-02-01

An interesting issue in the domain of history of science and ideas is the concept of similarity of historical personalities. Similar objects of research of philosophers and scientists indicate prospective influences, caused either from one another's reading or meetings, communication or even cooperation. Key methodological role in the surfacing of the sought similarities play the keywords extracted from their works as well as their placement in a philosophical and scientific term taxonomy. The case study examined in the framework of this paper concerns scientists and philosophers, who lived in ancient Greece or Renaissance periods and dealt, in at least one work, with the subject God. All the available data (scientists, studies, recorded relations between scientists, keywords, and thematic hierarchy) have been organized in an RDBMS environment, aiming at the emergence of similarities and influences between scientists through properly created SQL queries based on date and thematic hierarchy criteria.

The computer treatment of remotely sensed data: An introduction to techniques which have geologic applications. [image enhancement and thematic classification in Brazil

NASA Technical Reports Server (NTRS)

Parada, N. D. J. (Principal Investigator); Paradella, W. R.; Vitorello, I.

1982-01-01

Several aspects of computer-assisted analysis techniques for image enhancement and thematic classification by which LANDSAT MSS imagery may be treated quantitatively are explained. On geological applications, computer processing of digital data allows, possibly, the fullest use of LANDSAT data, by displaying enhanced and corrected data for visual analysis and by evaluating and assigning each spectral pixel information to a given class.

Stakeholder consultation on tracking in UK veterinary degrees: part 2.

PubMed

Crowther, E; Hughes, K; Handel, I; Whittington, R; Pryce, M; Warman, S; Rhind, S; Baillie, S

2014-07-26

There is ongoing debate in the profession as to whether veterinary students should focus on one (or a small number of) species during their undergraduate training (ie, track). This paper presents the qualitative data from surveys evaluating UK stakeholder opinion on introducing partial tracking (whereby students continue to qualify able to practise in all species) and full tracking (students qualify in a limited number of species with restricted registration). Surveys were distributed to practitioners, students and university staff; 1061 responses were completed. Thematic framework analysis was conducted on the free-text responses; responses were coded to a hierarchical framework developed inductively from the data. Six major themes were identified: choice, flexibility, competency and knowledge, stakeholder implications, specialisation and 'what is a vet?'. The majority of the themes related to both full and partial tracking, usually being more pronounced in full tracking. The theme 'choice' is particularly important in light of the study's quantitative findings on students' awareness of the profession and their career aspirations (presented in a previous paper); should tracking be implemented, veterinary schools will need to take a proactive role in educating and assisting students while making career choices. British Veterinary Association.

Factors related to reducing free sugar intake among white ethnic adults in the UK: a qualitative study.

PubMed

Rawahi, Said Harith Al; Asimakopoulou, Koula; Newton, Jonathon Timothy

2018-01-01

To determine the barriers and enablers to behavioural change to reduce free sugar intake related to dental caries in a sample of UK adults who identify their ethnicity as White. Qualitative study comprising semi-structured interviews of 27 participants. Interviews were recorded, transcribed and analysed using thematic analysis methods. The Capability-Opportunity-Motivation-Behaviour model (COM-B) and the Theoretical Domains Framework (TDF) were used to guide the derivation of themes. Data saturation occurred at 27 interviews. The COM-B Model and TDF domains captured various factors that may influence the consumption of free sugar. TDF elements which are reflected in the study are: Knowledge; Psychological skills; Memory, attention, and decision processes; Behavioural regulation; Physical skills; Social influence; Environmental context and resources; Social and professional role and identity; Beliefs about capabilities; Beliefs about consequence; Intentions and goals reinforcement; and Emotions. COM-B Model elements which are reflected in the study are: psychological capabilities, physical capabilities, social opportunities, physical opportunities, reflective motivation, and automatic motivation. The COM-B model and TDF framework provided a comprehensive account of the barriers and facilitators of reducing sugar intake among white ethnic groups.

A framework for the role of Registered Nurses in the specialty practice of rehabilitation nursing in Australia.

PubMed

Pryor, Julie; Smith, Clair

2002-08-01

This study sought to explore systematically the role of Registered Nurses working in rehabilitation in Australia. Rehabilitation has been identified as an important aspect of health care. However, evidence of a comprehensive investigation of the nurses' role in rehabilitation cannot be found. From Australia, in particular, no research has been published in this area. This study used a qualitative approach by engaging 13 nurses in one-to-one interviews and a further 21 in focus group discussions. Thematic analysis was conducted on the interview and focus group data. Seven domains of practice were identified and are suggested as a framework for the specialty practice of rehabilitation nursing. They capture the 'how' and 'what' of rehabilitation nursing practice. Central to this practice is a rehabilitative approach to patient care, teaching and coaching, and continual assessment. The nurses explained in detail how these aspects of rehabilitation nursing differentiate their practice from that of their acute care colleagues. The rehabilitative approach is one of a variety of approaches to nursing care, but should not be seen as the exclusive domain of rehabilitation nurses. Rehabilitation belongs in every nurse's toolkit.

The New South Wales Allied Health Workplace Learning Study: barriers and enablers to learning in the workplace.

PubMed

Lloyd, Bradley; Pfeiffer, Daniella; Dominish, Jacqueline; Heading, Gaynor; Schmidt, David; McCluskey, Annie

2014-03-25

Workplace learning refers to continuing professional development that is stimulated by and occurs through participation in workplace activities. Workplace learning is essential for staff development and high quality clinical care. The purpose of this study was to explore the barriers to and enablers of workplace learning for allied health professionals within NSW Health. A qualitative study was conducted with a purposively selected maximum variation sample (n =46) including 19 managers, 19 clinicians and eight educators from 10 allied health professions. Seven semi-structured interviews and nine focus groups were audio-recorded and transcribed. The 'framework approach' was used to guide the interviews and analysis. Textual data were coded and charted using an evolving thematic framework. Key enablers of workplace learning included having access to peers, expertise and 'learning networks', protected learning time, supportive management and positive staff attitudes. The absence of these key enablers including heavy workload and insufficient staffing were important barriers to workplace learning. Attention to these barriers and enablers may help organisations to more effectively optimise allied health workplace learning. Ultimately better workplace learning may lead to improved patient, staff and organisational outcomes.

The pillars of well-constructed simulated patient programs: A qualitative study with experienced educators.

PubMed

Pritchard, Shane A; Blackstock, Felicity C; Keating, Jennifer L; Nestel, Debra

2017-11-01

The inclusion of simulated patients (SPs) in health professional education is growing internationally. However, there is limited evidence for best practice in SP methodology. This study investigated how experienced SP educators support SPs in providing SP-based education for health professional students. Experienced SP educators were identified via relevant professional associations, peer-reviewed publications, and peer referral. Semi-structured individual interviews were conducted via telephone. Data were analyzed independently by three researchers using principles of inductive thematic analysis. Four themes were identified that represent the key structural components of SP programs considered by educators seeking to optimize learning for health professional students in SP programs: managing SPs by operationalizing an effective program, selecting SPs by rigorously screening for suitability, preparing SPs by educating for a specific scenario, and directing SPs by leading safe and meaningful interactions. Within these components, subthemes were described, with considerable variation in approaches. Key structural components to SP programs were consistently described by experienced SP educators who operationalize them. A framework has been proposed to assist educators in designing high-quality SP programs that support SPs and learners. Future research is required to evaluate and refine this framework and other evidence-based resources for SP educators.

The New South Wales Allied Health Workplace Learning Study: barriers and enablers to learning in the workplace

PubMed Central

2014-01-01

Background Workplace learning refers to continuing professional development that is stimulated by and occurs through participation in workplace activities. Workplace learning is essential for staff development and high quality clinical care. The purpose of this study was to explore the barriers to and enablers of workplace learning for allied health professionals within NSW Health. Methods A qualitative study was conducted with a purposively selected maximum variation sample (n = 46) including 19 managers, 19 clinicians and eight educators from 10 allied health professions. Seven semi-structured interviews and nine focus groups were audio-recorded and transcribed. The ‘framework approach’ was used to guide the interviews and analysis. Textual data were coded and charted using an evolving thematic framework. Results Key enablers of workplace learning included having access to peers, expertise and ‘learning networks’, protected learning time, supportive management and positive staff attitudes. The absence of these key enablers including heavy workload and insufficient staffing were important barriers to workplace learning. Conclusion Attention to these barriers and enablers may help organisations to more effectively optimise allied health workplace learning. Ultimately better workplace learning may lead to improved patient, staff and organisational outcomes. PMID:24661614

Desistance From Intimate Partner Violence: A Conceptual Model and Framework for Practitioners for Managing the Process of Change.

PubMed

Walker, Kate; Bowen, Erica; Brown, Sarah; Sleath, Emma

2015-09-01

Intimate partner violence (IPV) is an international issue that social and criminal justice workers will encounter regularly. It has been identified that men can, and do stop using, or desist from, IPV although it is unclear how this process of change develops. This article introduces a conceptual model to outline how the process of desistance evolves and what it encompasses. Using thematic analysis of interview data from partner-violent men, survivors, and treatment facilitators, the resulting model demonstrates that the process of change is a dynamic one where men's use of, and cessation from, violence needs to be understood within the context of each individual's life. Three global themes were developed: (a) lifestyle behaviors (violent): what is happening in the men's lives when they use violence; (b) catalysts for change: the triggers and transitions required to initiate the process of change; and (c) lifestyle behaviors (non-violent): what is different in the men's lives when they have desisted from IPV. The purpose of this model is to offer a framework for service providers to assist them to manage the process of change in partner-violent men. © The Author(s) 2014.

Teaching social responsibility through community service-learning in predoctoral dental education.

PubMed

Brondani, Mario A

2012-05-01

Social responsibility refers to one's sense of duty to the society in which he or she lives. The Professionalism and Community Service (PACS) dental module at the University of British Columbia is based upon community service-learning and helps dental students to understand the challenges faced by vulnerable segments of the population as they actively reflect on experiences gathered from didactic and experiential activities. This article aims to illustrate the extent to which PACS has fostered awareness of social responsibility through the British Columbia Ministry of Education's Performance Standards Framework for Social Responsibility. Reflections were gathered from students in all four years of the D.M.D. program and were analyzed thematically in three categories of the framework: Contribution to the Classroom and Community, Value of Diversity in the Community, and Exercise of Responsibilities. The constant comparison analysis of the reflective qualitative data revealed that the students directly or indirectly addressed these three categories in their reflections as they synthesized their understanding of community issues and their collaborative roles as socially responsible members of the dental profession. Follow-up studies are needed to explore the impact of community-based dental education upon students' perceptions and understanding of social responsibility and professionalism regarding underserved communities.

A Model of How Different Biology Experts Explain Molecular and Cellular Mechanisms

PubMed Central

Trujillo, Caleb M.; Anderson, Trevor R.; Pelaez, Nancy J.

2015-01-01

Constructing explanations is an essential skill for all science learners. The goal of this project was to model the key components of expert explanation of molecular and cellular mechanisms. As such, we asked: What is an appropriate model of the components of explanation used by biology experts to explain molecular and cellular mechanisms? Do explanations made by experts from different biology subdisciplines at a university support the validity of this model? Guided by the modeling framework of R. S. Justi and J. K. Gilbert, the validity of an initial model was tested by asking seven biologists to explain a molecular mechanism of their choice. Data were collected from interviews, artifacts, and drawings, and then subjected to thematic analysis. We found that biologists explained the specific activities and organization of entities of the mechanism. In addition, they contextualized explanations according to their biological and social significance; integrated explanations with methods, instruments, and measurements; and used analogies and narrated stories. The derived methods, analogies, context, and how themes informed the development of our final MACH model of mechanistic explanations. Future research will test the potential of the MACH model as a guiding framework for instruction to enhance the quality of student explanations. PMID:25999313

The meaning of "independence" for older people in different residential settings.

PubMed

Hillcoat-Nallétamby, Sarah

2014-05-01

Drawing on older people's understandings of "independence" and Collopy's work on autonomy, the article elaborates an interpretive framework of the concept in relation to 3 residential settings-the private dwelling-home, the extra-care, and the residential-care settings. Data include 91 qualitative interviews with frail, older people living in each setting, collected as part of a larger Welsh study. Thematic analysis techniques were employed to identify patterns in meanings of independence across settings and then interpreted using Collopy's conceptualizations of autonomy, as well as notions of space and interdependencies. Independence has multiple meanings for older people, but certain meanings are common to all settings: Accepting help at hand; doing things alone; having family, friends, and money as resources; and preserving physical and mental capacities. Concepts of delegated, executional, authentic, decisional, and consumer autonomy, as well as social interdependencies and spatial and social independence, do provide appropriate higher order interpretive constructs of these meanings across settings. A broader interpretive framework of "independence" should encompass concepts of relative independence, autonomy(ies), as well as spatial and social independence, and can provide more nuanced interpretations of structured dependency and institutionalization theories when applied to different residential settings.

Exploring the role of classroom-based learning in professional identity formation of family practice residents using the experiences, trajectories, and reifications framework.

PubMed

Chen, Luke Y C; Hubinette, Maria M

2017-08-01

Classroom-based learning such as academic half day has undervalued social aspects. We sought to explore its role in the professional identity development of family medicine residents. In this case study, residents and faculty from four training sites in the University of British Columbia Department of Family Practice were interviewed. The "experiences, trajectories, and reifications (ETR) framework" was used as a sensitizing tool for modified inductive (thematic) analysis of the transcripts. Classroom-based learning provided a different context for residents' interpretation of their clinical experiences, characterized as a "home base" for rotating urban residents, and a connection to a larger academic community for residents in rural training sites. Both these aspects were important in creating a positive trajectory of professional identity formation. Teaching directed at the learning needs of family physicians, and participation of family practice faculty as teachers and role models was a precipitation of a curriculum "centered in family medicine." Interactions between family medicine residents and faculty in the classroom facilitated the necessary engagements to reify a shared understanding of the discipline of family practice. Classroom-based learning has substantial impact on professional identity formation at an individual and collective level.

“It is not the diet; it is the mental part we need help with.” A multilevel analysis of psychological, emotional, and social well-being in obesity

PubMed Central

Rand, Kathryn; Vallis, Michael; Aston, Megan; Price, Sheri; Piccinini-Vallis, Helena; Rehman, Laurene; Kirk, Sara F.L.

2017-01-01

ABSTRACT In this research, we explored the psychological, emotional, and social experiences of individuals living with obesity, and perceptions of health care providers. We conducted a theoretical thematic analysis using two theoretical frameworks applied to transcripts from a previous qualitative study. Themes from a mental well-being framework were subsequently categorized under five environmental levels of the Social-Ecological Model (SEM). Key mental well-being themes appeared across all levels of the SEM, except the policy level. For the individual environment, one main theme was food as a coping mechanism and source of emotional distress. In the interpersonal environment, two themes were (a) blame and shame by family members and friends because of their weight and (b) condemnation and lack of support from health professionals. In the organizational environment, one main theme was inadequate support for mental well-being issues in obesity management programmes. In the community environment, one major theme the negative mental well-being impact of the social stigma of obesity. An overarching theme of weight stigma and bias further shaped the predominant themes in each level of the SEM. Addressing weight stigma and bias, and promoting positive mental well-being are two important areas of focus for supportive management of individuals living with obesity. PMID:28418818

A new simple six-step model to promote recruitment to RCTs was developed and successfully implemented.

PubMed

Realpe, Alba; Adams, Ann; Wall, Peter; Griffin, Damian; Donovan, Jenny L

2016-08-01

How a randomized controlled trial (RCT) is explained to patients is a key determinant of recruitment to that trial. This study developed and implemented a simple six-step model to fully inform patients and to support them in deciding whether to take part or not. Ninety-two consultations with 60 new patients were recorded and analyzed during a pilot RCT comparing surgical and nonsurgical interventions for hip impingement. Recordings were analyzed using techniques of thematic analysis and focused conversation analysis. Early findings supported the development of a simple six-step model to provide a framework for good recruitment practice. Model steps are as follows: (1) explain the condition, (2) reassure patients about receiving treatment, (3) establish uncertainty, (4) explain the study purpose, (5) give a balanced view of treatments, and (6) Explain study procedures. There are also two elements throughout the consultation: (1) responding to patients' concerns and (2) showing confidence. The pilot study was successful, with 70% (n = 60) of patients approached across nine centers agreeing to take part in the RCT, so that the full-scale trial was funded. The six-step model provides a promising framework for successful recruitment to RCTs. Further testing of the model is now required. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

"It is not the diet; it is the mental part we need help with." A multilevel analysis of psychological, emotional, and social well-being in obesity.

PubMed

Rand, Kathryn; Vallis, Michael; Aston, Megan; Price, Sheri; Piccinini-Vallis, Helena; Rehman, Laurene; Kirk, Sara F L

2017-12-01

In this research, we explored the psychological, emotional, and social experiences of individuals living with obesity, and perceptions of health care providers. We conducted a theoretical thematic analysis using two theoretical frameworks applied to transcripts from a previous qualitative study. Themes from a mental well-being framework were subsequently categorized under five environmental levels of the Social-Ecological Model (SEM). Key mental well-being themes appeared across all levels of the SEM, except the policy level. For the individual environment, one main theme was food as a coping mechanism and source of emotional distress. In the interpersonal environment, two themes were (a) blame and shame by family members and friends because of their weight and (b) condemnation and lack of support from health professionals. In the organizational environment, one main theme was inadequate support for mental well-being issues in obesity management programmes. In the community environment, one major theme the negative mental well-being impact of the social stigma of obesity. An overarching theme of weight stigma and bias further shaped the predominant themes in each level of the SEM. Addressing weight stigma and bias, and promoting positive mental well-being are two important areas of focus for supportive management of individuals living with obesity.

An Analysis of the Thematic Content of Televised Beer Commercials.

ERIC Educational Resources Information Center

Funkhouser, Edward

After summarizing the widespread occurrence and male orientation of television beer advertising, this paper describes a study of the thematic content of beer commercials. Two-hundred and six beer advertisements which appeared on WTBS, the USA Network, and ESPN between September 1983 and September 1985 were studied. Event-specific ads and those in…

Forest/non-forest stratification in Georgia with Landsat Thematic Mapper data

Treesearch

William H. Cooke

2000-01-01

Geographically accurate Forest Inventory and Analysis (FIA) data may be useful for training, classification, and accuracy assessment of Landsat Thematic Mapper (TM) data. Minimum expectation for maps derived from Landsat data is accurate discrimination of several land cover classes. Landsat TM costs have decreased dramatically, but acquiring cloud-free scenes at...

Communicative Tools and Modes in Thematic Preschool Work

ERIC Educational Resources Information Center

Ahlskog-Björkman, Eva; Björklund, Camilla

2016-01-01

This study focuses on teachers' ways of mediating meaning through communicative tools and modes in preschool thematic work. A socio-cultural perspective is used for analysis on how tools and modes are provided for children to make use of for communicative purposes. The research questions are: (1) what communicative tools do teachers use in their…

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

ERIC Educational Resources Information Center

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

2016-01-01

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

From bricks to buildings: adapting the Medical Research Council framework to develop programs of research in simulation education and training for the health professions.

PubMed

Haji, Faizal A; Da Silva, Celina; Daigle, Delton T; Dubrowski, Adam

2014-08-01

Presently, health care simulation research is largely conducted on a study-by-study basis. Although such "project-based" research generates a plethora of evidence, it can be chaotic and contradictory. A move toward sustained, thematic, theory-based programs of research is necessary to advance knowledge in the field. Recognizing that simulation is a complex intervention, we present a framework for developing research programs in simulation-based education adapted from the Medical Research Council (MRC) guidance. This framework calls for an iterative approach to developing, refining, evaluating, and implementing simulation interventions. The adapted framework guidance emphasizes: (1) identification of theory and existing evidence; (2) modeling and piloting interventions to clarify active ingredients and identify mechanisms linking the context, intervention, and outcomes; and (3) evaluation of intervention processes and outcomes in both the laboratory and real-world setting. The proposed framework will aid simulation researchers in developing more robust interventions that optimize simulation-based education and advance our understanding of simulation pedagogy.

'When you are homeless, you are not thinking about your medication, but your food, shelter or heat for the night': behavioural determinants of homeless patients' adherence to prescribed medicines.

PubMed

Paudyal, V; MacLure, K; Buchanan, C; Wilson, L; Macleod, J; Stewart, D

2017-07-01

This study aimed to explore behavioural determinants of homeless patients' adherence to prescribed medicines using Theoretical Domains Framework (TDF). A qualitative study using semi-structured, face-to-face interviews. Participants were recruited from a homelessness primary healthcare centre in Aberdeen, United Kingdom (UK). Face-to-face interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview data was conducted using the Framework Approach based on the Theoretical Domains Framework. National Health Service ethical and Research and Development (R&D) approval was obtained. Twenty-five patients were interviewed, at which point data saturation was achieved. A total of 13 out of 14 Theoretical Domains Framework domains were identified that explained the determinants of adherence or non-adherence to prescribed medicines. These included: 'beliefs about consequences' (e.g. non-adherence leading to poor health); 'goals' of therapy (e.g. being a 'normal' person with particular reference to methadone adherence); and 'environmental context and resources' (e.g. stolen medicines and the lack of secure storage). Obtaining food and shelter was higher priority than access and adherence to prescribed medicines while being homeless. Behavioural determinants of non-adherence identified in this study were mostly related to participants' homelessness and associated lifestyle. Results are relevant to developing behaviour change interventions targeting non-adherent homeless patients and to the education of healthcare professionals serving this vulnerable population. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Developing a framework for successful research partnerships in global health.

PubMed

Larkan, Fiona; Uduma, Ogenna; Lawal, Saheed Akinmayọwa; van Bavel, Bianca

2016-05-06

The Centre for Global Health, Trinity College Dublin has as one of its goals, strengthening health systems in developing countries. In realising this goal we work across more than 40 countries with third-level, civil society, government, private sector and UN partners. Each of these requires that different relationships be established. Good principles must guide all global health research partnerships. An exploratory research project was undertaken with research partners of, and staff within, the Centre for Global Health. The aim was to build an evidence-based framework. An inductive exploratory research process was undertaken using a grounded theory approach in three consecutive phases: Phase I: An open-ended questionnaire was sent via email to all identified partners. Phase II: A series of consultative meetings were held with the staff of the Centre for Global Health. Phase III: Data sets from Phases I and II were applied to the development of a unifying framework. Data was analysed using grounded theory three stage thematic analysis - open, axial and selective coding. Relational and operational aspects of partnership were highlighted as being relevant across every partnership. Seven equally important core concepts emerged (focus, values, equity, benefit, leadership, communication and resolution), and are described and discussed here. Of these, two (leadership and resolution) are less often considered in existing literature on partnerships. Large complex partnerships can work well if all parties are agreed in advance to a common minimum programme, have been involved from the design stage, and have adequate resources specifically allocated. Based on this research, a framework for partnerships has been developed and is shared.

The Natural Hospital Environment: a Socio-Technical-Material perspective.

PubMed

Fernando, Juanita; Dawson, Linda

2014-02-01

This paper introduces two concepts into analyses of information security and hospital-based information systems-- a Socio-Technical-Material theoretical framework and the Natural Hospital Environment. The research is grounded in a review of pertinent literature with previously published Australian (Victoria) case study data to analyse the way clinicians work with privacy and security in their work. The analysis was sorted into thematic categories, providing the basis for the Natural Hospital Environment and Socio-Technical-Material framework theories discussed here. Natural Hospital Environments feature inadequate yet pervasive computer use, aural privacy shortcomings, shared workspace, meagre budgets, complex regulation that hinders training outcomes and out-dated infrastructure and are highly interruptive. Working collaboratively in many cases, participants found ways to avoid or misuse security tools, such as passwords or screensavers for patient care. Workgroup infrastructure was old, architecturally limited, haphazard in some instances, and was less useful than paper handover sheets to ensure the quality of patient care outcomes. Despite valiant efforts by some participants, they were unable to control factors influencing the privacy of patient health information in public hospital settings. Future improvements to hospital-based organisational frameworks for e-health can only be made when there is an improved understanding of the Socio-Technical-Material theoretical framework and Natural Hospital Environment contexts. Aspects within control of clinicians and administrators can be addressed directly although some others are beyond their control. An understanding and acknowledgement of these issues will benefit the management and planning of improved and secure hospital settings. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Exploring end user adoption and maintenance of a telephone-based physical activity counseling service for individuals with physical disabilities using the Theoretical Domains Framework.

PubMed

Tomasone, Jennifer R; Arbour-Nicitopoulos, Kelly P; Pila, Eva; Lamontagne, Marie-Eve; Cummings, Isabelle; Latimer-Cheung, Amy E; Routhier, François

2017-06-01

In Canada, two counseling services are offered to facilitate physical activity participation among persons with physical disabilities, yet both have encountered concerns related to the recruitment and retainment of clients. The purpose of this paper is to explore factors related to service adoption among nonusers, and the barriers and facilitators to maintaining service participation among adopters. Individuals who had never enrolled in the services (nonusers, n = 13) as well as current/previous service clients (adopters, n = 26) participated in interviews based on the Theoretical Domains Framework. Transcripts were subjected to deductive thematic analysis according to participant group. Fifteen themes relating to service adoption within 10 of the 12 theoretical domains were identified for nonusers, while 23 themes relating to maintenence of service participation were identified across all 12 theoretical domains for adopters. The findings provide strategies to improve recruitment, adoption, and retention of clients in counseling services and to enhance the experiences of targeted service users. Implications for Rehabiliation Peer support and education for equipment use should be built into physical activity programs to encourage participation among persons with physical disabilities. Programs that encourage physical activity among individuals with disabilities should be designed by practitioners to be responsive to a variety of needs, which are addressed in the program's advertisements and offerings. The Theoretical Domains Framework is a useful framework for providing valuable insight about clients' experiences of adoption and maintenance of a behavior change service, suggesting merit in other rehabilitation settings.

Study of Spectral/Radiometric Characteristics of the Thematic Mapper for Land Use Applications

NASA Technical Reports Server (NTRS)

Malila, W. A. (Principal Investigator); Metzler, M. D. (Principal Investigator)

1985-01-01

An investigation conducted in support of the LANDSAT 4/5 Image Data Quality Analysis (LIDQA) Program is discussed. Results of engineering analyses of radiometric, spatial, spectral, and geometric properties of the Thematic Mapper systems are summarized; major emphasis is placed on the radiometric analysis. Details of the analyses are presented in appendices, which contain three of the eight technical papers produced during this investigation; these three, together, describe the major activities and results of the investigation.

Third cycle university studies in Europe in the field of agricultural engineering and in the emerging discipline of biosystems engineering.

PubMed

Ayuga, F; Briassoulis, D; Aguado, P; Farkas, I; Griepentrog, H; Lorencowicz, E

2010-01-01

The main objectives of European Thematic Network entitled 'Education and Research in Agricultural for Biosystems Engineering in Europe (ERABEE-TN)' is to initiate and contribute to the structural development and the assurance of the quality assessment of the emerging discipline of Biosystems Engineering in Europe. ERABEE is co-financed by the European Community in the framework of the LLP Programme. The partnership consists of 35 participants from 27 Erasmus countries, out of which 33 are Higher Education Area Institutions (EDU) and 2 are Student Associations (ASS). 13 Erasmus participants (e.g. Thematic Networks, Professional Associations, and Institutions from Brazil, Croatia, Russia and Serbia) are also involved in the Thematic Network through synergies. To date, very few Biosystems Engineering programs exist in Europe and those that are initiated are at a very primitive stage of development. The innovative and novel goal of the Thematic Network is to promote this critical transition, which requires major restructuring in Europe, exploiting along this direction the outcomes accomplished by its predecessor; the USAEE-TN (University Studies in Agricultural Engineering in Europe). It also aims at enhancing the compatibility among the new programmes of Biosystems Engineering, aiding their recognition and accreditation at European and International level and facilitating greater mobility of skilled personnel, researchers and students. One of the technical objectives of ERABEE is dealing with mapping and promoting the third cycle studies (including European PhDs) and supporting the integration of research at the 1st and 2nd cycle regarding European Biosystems Engineering university studies. During the winter 2008 - spring 2009 period, members of ERABEE conducted a survey on the contemporary status of doctoral studies in Europe, and on a possible scheme for promotion of cooperation and synergies in the framework of the third cycle of studies and the European Doctorate in Biosystems Engineering in Europe. This paper presents the results of the survey. The legal regulations and their extent on the different countries concerning the third cycle are presented, along with the current structure of third cycle studies. The evolution and adaptation to the new EHEA in each country is also considered. Information was also gathered on the emerging topics of the Biosystems Engineering field and how these topics could be addressed by the new doctoral programmes at the European level.

A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan.

PubMed

Hashmi, Furqan K; Hassali, Mohamed Azmi; Khalid, Adnan; Saleem, Fahad; Aljadhey, Hisham; Babar, Zaheer Ud Din; Bashaar, Mohammad

2017-07-19

In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan.

Strategies for Building Peer Surgical Coaching Relationships.

PubMed

Beasley, Heather L; Ghousseini, Hala N; Wiegmann, Douglas A; Brys, Nicole A; Pavuluri Quamme, Sudha R; Greenberg, Caprice C

2017-04-19

Peer surgical coaching is a promising approach for continuing professional development. However, scant guidance is available for surgeons seeking to develop peer-coaching skills. Executive coaching research suggests that effective coaches first establish a positive relationship with their coachees by aligning role and process expectations, establishing rapport, and cultivating mutual trust. To identify the strategies used by peer surgical coaches to develop effective peer-coaching relationships with their coachees. Drawing on executive coaching literature, a 3-part framework was developed to examine the strategies peer surgical coaches (n = 8) used to initially cultivate a relationship with their coachees (n = 11). Eleven introductory 1-hour meetings between coaching pairs participating in a statewide surgical coaching program were audiorecorded, transcribed, and coded on the basis of 3 relationship-building components. Once coded, thematic analysis was used to organize coded strategies into thematic categories and subcategories. Data were collected from October 10, 2014, to March 20, 2015. Data analysis took place from May 26, 2015, to July 20, 2016. Strategies and potentially counterproductive activities for building peer-coaching relationships in the surgical context to inform the future training of surgical coaches. Coaches used concrete strategies to align role and process expectations about the coaching process, to establish rapport, and to cultivate mutual trust with their coachees during introductory meetings. Potential coaching pitfalls are identified that could interfere with each of the 3 relationship-building components. Peer-nominated surgical coaches were provided with training on abstract concepts that underlie effective coaching practices in other fields. By identifying the strategies used by peer surgical coaches to operationalize these concepts, empirically based strategies to inform other surgical coaching programs are provided.

Methods for the thematic synthesis of qualitative research in systematic reviews

PubMed Central

Thomas, James; Harden, Angela

2008-01-01

Background There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. Methods We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. Results We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses. Conclusion We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing. PMID:18616818

On the societal nature of praxis and organic research

NASA Astrophysics Data System (ADS)

Roth, Wolff-Michael

2016-03-01

In its focus on social practices, the feature article presents an interesting theoretical framework for rethinking not only where and how knowing and learning in science education exhibit themselves but also we might change our own research practice. The framework is not new to me, as I have advocated it explicitly for more than 15 years. But over time it became apparent to me that some particularities of participation in practice may be grounded more strongly in an orientation towards the societal nature of any human praxis. In this forum contribution, I present a theoretical approach built on societal-historical activity theory that also takes activism as a major category for theorizing participation. This approach not only covers the extent of the social practice framework but also allows us to make thematic the production of inequity and restrictions to access science and engineering that are characteristic of many societies.

What Factors Affect Voluntary Uptake of Community-Based Health Insurance Schemes in Low- and Middle-Income Countries? A Systematic Review and Meta-Analysis.

PubMed

Dror, David Mark; Hossain, S A Shahed; Majumdar, Atanu; Pérez Koehlmoos, Tracey Lynn; John, Denny; Panda, Pradeep Kumar

2016-01-01

This research article reports on factors influencing initial voluntary uptake of community-based health insurance (CBHI) schemes in low- and middle-income countries (LMIC), and renewal decisions. Following PRISMA protocol, we conducted a comprehensive search of academic and gray literature, including academic databases in social science, economics and medical sciences (e.g., Econlit, Global health, Medline, Proquest) and other electronic resources (e.g., Eldis and Google scholar). Search strategies were developed using the thesaurus or index terms (e.g., MeSH) specific to the databases, combined with free text terms related to CBHI or health insurance. Searches were conducted from May 2013 to November 2013 in English, French, German, and Spanish. From the initial search yield of 15,770 hits, 54 relevant studies were retained for analysis of factors influencing enrolment and renewal decisions. The quantitative synthesis (informed by meta-analysis) and the qualitative analysis (informed by thematic synthesis) were compared to gain insight for an overall synthesis of findings/statements. Meta-analysis suggests that enrolments in CBHI were positively associated with household income, education and age of the household head (HHH), household size, female-headed household, married HHH and chronic illness episodes in the household. The thematic synthesis suggests the following factors as enablers for enrolment: (a) knowledge and understanding of insurance and CBHI, (b) quality of healthcare, (c) trust in scheme management. Factors found to be barriers to enrolment include: (a) inappropriate benefits package, (b) cultural beliefs, (c) affordability, (d) distance to healthcare facility, (e) lack of adequate legal and policy frameworks to support CBHI, and (f) stringent rules of some CBHI schemes. HHH education, household size and trust in the scheme management were positively associated with member renewal decisions. Other motivators were: (a) knowledge and understanding of insurance and CBHI, (b) healthcare quality, (c) trust in scheme management, and (d) receipt of an insurance payout the previous year. The barriers to renewal decisions were: (a) stringent rules of some CBHI schemes, (b) inadequate legal and policy frameworks to support CBHI and (c) inappropriate benefits package. The demand-side factors positively affecting enrolment in CBHI include education, age, female household heads, and the socioeconomic status of households. Moreover, when individuals understand how their CBHI functions they are more likely to enroll and when people have a positive claims experience, they are more likely to renew. A higher prevalence of chronic conditions or the perception that healthcare is of good quality and nearby act as factors enhancing enrolment. The perception that services are distant or deficient leads to lower enrolments. The second insight is that trust in the scheme enables enrolment. Thirdly, clarity about the legal or policy framework acts as a factor influencing enrolments. This is significant, as it points to hitherto unpublished evidence that governments can effectively broaden their outreach to grassroots groups that are excluded from social protection by formulating supportive regulatory and policy provisions even if they cannot fund such schemes in full, by leveraging people's willingness to exercise voluntary and contributory enrolment in a community-based health insurance.

An Initial Analysis of LANDSAT-4 Thematic Mapper Data for the Discrimination of Agricultural, Forested Wetland, and Urban Land Covers

NASA Technical Reports Server (NTRS)

Quattrochi, D. A.

1984-01-01

An initial analysis of LANDSAT 4 Thematic Mapper (TM) data for the discrimination of agricultural, forested wetland, and urban land covers is conducted using a scene of data collected over Arkansas and Tennessee. A classification of agricultural lands derived from multitemporal LANDSAT Multispectral Scanner (MSS) data is compared with a classification of TM data for the same area. Results from this comparative analysis show that the multitemporal MSS classification produced an overall accuracy of 80.91% while the TM classification yields an overall classification accuracy of 97.06% correct.

Impact of action primes on implicit processing of thematic and functional similarity relations: evidence from eye-tracking.

PubMed

Pluciennicka, Ewa; Wamain, Yannick; Coello, Yann; Kalénine, Solène

2016-07-01

The aim of this study was to specify the role of action representations in thematic and functional similarity relations between manipulable artifact objects. Recent behavioral and neurophysiological evidence indicates that while they are all relevant for manipulable artifact concepts, semantic relations based on thematic (e.g., saw-wood), specific function similarity (e.g., saw-axe), and general function similarity (e.g., saw-knife) are differently processed, and may relate to different levels of action representation. Point-light displays of object-related actions previously encoded at the gesture level (e.g., "sawing") or at the higher level of action representation (e.g., "cutting") were used as primes before participants identified target objects (e.g., saw) among semantically related and unrelated distractors (e.g., wood, feather, piano). Analysis of eye movements on the different objects during target identification informed about the amplitude and the timing of implicit activation of the different semantic relations. Results showed that action prime encoding impacted the processing of thematic relations, but not that of functional similarity relations. Semantic competition with thematic distractors was greater and earlier following action primes encoded at the gesture level compared to action primes encoded at higher level. As a whole, these findings highlight the direct influence of action representations on thematic relation processing, and suggest that thematic relations involve gesture-level representations rather than intention-level representations.

Thematization in EFL Students' Composition Writing and Its Relation to Academic Experience

ERIC Educational Resources Information Center

Jalilifar, Alireza

2010-01-01

This study made frequency and functional analysis of thematization in English students' compositions in Shahid Chamran University. Ninety students were selected and divided into three groups, followed by a homogeneity test (Fowler and Coe, 1976). An educated native speaker was also used as a criterion measure. Then, they were asked to narrate…

GPs’ opinions of health assessment instruments for people with intellectual disabilities: a qualitative study

PubMed Central

Bakker-van Gijssel, Esther J; Hartman, Tim C olde; Lucassen, Peter LBJ; van den Driessen Mareeuw, Francine; Dees, Marianne K; Assendelft, Willem JJ; van Schrojenstein Lantman-de Valk, Henny MJ

2017-01-01

Background GPs provide health care to people with intellectual disabilities (ID). People with ID find it difficult to express themselves concerning health-related matters. Applying health assessments is an effective method to reveal health needs, and can play a role in prevention and health promotion. Aim The aim of this qualitative study was to explore GPs’ considerations about applying a health assessment for people with ID. Design and setting This focus group study was conducted among a selection of Dutch GPs. Method An interview guide was developed. All discussions were audiorecorded and transcribed. Analysis was performed using the framework analysis approach. Two researchers independently applied open coding and identified a thematic framework. This framework and the summaries of views per theme were discussed in the research team. Results After four focus groups, with 23 GPs, saturation was reached. Three main themes evolved: health assessments in relation to GPs’ responsibility; the usefulness and necessity of health assessments; and barriers to using health assessments on people with ID. A health assessment instrument for people with ID can help GPs to focus on certain issues that are not so common in the general population. GPs are motivated to use such a tool if it is scientifically tested, and results in significant health gains. However, GPs identify barriers at the level of GP, patient, and organisation. Conclusion Most GPs in the focus groups consider providing medical care to people with ID their responsibility and indicate that a health assessment instrument could be a valuable tool. In order to deliver good care, they need education and support. Many barriers need to be overcome before a health assessment instrument can be implemented. PMID:27993898

Barriers and enablers to delivery of the Healthy Kids Check: an analysis informed by the Theoretical Domains Framework and COM-B model

PubMed Central

2014-01-01

Background More than a fifth of Australian children arrive at school developmentally vulnerable. To counteract this, the Healthy Kids Check (HKC), a one-off health assessment aimed at preschool children, was introduced in 2008 into Australian general practice. Delivery of services has, however, remained low. The Theoretical Domains Framework, which provides a method to understand behaviours theoretically, can be condensed into three core components: capability, opportunity and motivation, and the COM-B model. Utilising this system, this study aimed to determine the barriers and enablers to delivery of the HKC, to inform the design of an intervention to promote provision of HKC services in Australian general practice. Methods Data from 6 focus group discussions with 40 practitioners from general practices in socio-culturally diverse areas of Melbourne, Victoria, were analysed using thematic analysis. Results Many practitioners expressed uncertainty regarding their capabilities and the practicalities of delivering HKCs, but in some cases HKCs had acted as a catalyst for professional development. Key connections between immunisation services and delivery of HKCs prompted practices to have systems of recall and reminder in place. Standardisation of methods for developmental assessment and streamlined referral pathways affected practitioners’ confidence and motivation to perform HKCs. Conclusion Application of a systematic framework effectively demonstrated how a number of behaviours could be targeted to increase delivery of HKCs. Interventions need to target practice systems, the support of office staff and referral options, as well as practitioners’ training. Many behavioural changes could be applied through a single intervention programme delivered by the primary healthcare organisations charged with local healthcare needs (Medicare Locals) providing vital links between general practice, community and the health of young children. PMID:24886520

Classifying health information technology patient safety related incidents - an approach used in Wales.

PubMed

Warm, D; Edwards, P

2012-01-01

Interest in the field of patient safety incident reporting and analysis with respect to Health Information Technology (HIT) has been growing over recent years as the development, implementation and reliance on HIT systems becomes ever more prevalent. One of the rationales for capturing patient safety incidents is to learn from failures in the delivery of care and must form part of a feedback loop which also includes analysis; investigation and monitoring. With the advent of new technologies and organizational programs of delivery the emphasis is increasingly upon analyzing HIT incidents. This thematic review had two objectives, to test the applicability of a framework specifically designed to categorize HIT incidents and to review the Welsh incidents as communicated via the national incident reporting system in order to understand their implications for healthcare. The incidents were those reported as IT/ telecommunications failure/ overload. Incidents were searched for within a national reporting system using a standardized search strategy for incidents occurring between 1(st) January 2009 and 31(st) May 2011. 149 incident reports were identified and classified. The majority (77%) of which were machine related (technical problems) such as access problems; computer system down/too slow; display issues; and software malfunctions. A further 10% (n = 15) of incidents were down to human-computer interaction issues and 13% (n = 19) incidents, mainly telephone related, could not be classified using the framework being tested. On the basis of this review of incidents, it is recommended that the framework be expanded to include hardware malfunctions and the wrong record retrieved/missing data associated with a machine output error (as opposed to human error). In terms of the implications for clinical practice, the incidents reviewed highlighted critical issues including the access problems particularly relating to the use of mobile technologies.

Development of a conceptual framework of health-related quality of life in locally recurrent rectal cancer.

PubMed

Harji, D P; Koh, C; Solomon, M; Velikova, G; Sagar, P M; Brown, J

2015-11-01

The surgical management of locally recurrent rectal cancer (LRRC) has become widely accepted to afford cure and improve quality of life in this subset of patients. Thus far, traditional surgical and oncological markers have been used to highlight the success of surgical intervention. The use of patient-reported outcomes, specifically health-related quality of life (HRQoL), is sparse in these patients. This may be in part due to the lack of well-designed, validated instruments. This study identifies HRQoL issues relevant to patients undergoing surgery for LRRC, with the aim of developing a conceptual framework of HRQoL specific to LRRC to enable measurement of patient-reported outcomes in this cohort of patients. Qualitative focus groups were undertaken at two institutions to identify relevant HRQoL themes. The principles of thematic content analysis were used to analysis data. NViVo10 was used to analyse data. Twenty-one patients participated in six consecutive focus groups. Two patterns of themes emerged related to HRQoL and healthcare service delivery and utilization. Identified themes related to HRQoL included symptoms, sexual function, psychological impact, role and social functioning and future perspective. Under healthcare service and delivery and utilization the subdomain of disease management, treatment expectations and healthcare professionals were identified. This is the first qualitative study undertaken exclusively in patients with LRRC to ascertain relevant HRQoL outcomes. The impact of LRRC on patients is wide-ranging and extends beyond traditional HRQoL outcomes. The study operationalizes the identified outcomes into a conceptual framework, which will provide the basis for the development of a LRRC-specific patient-reported outcome measure. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

Depression, Social Isolation, and the Lived Experience of Dancing in Disadvantaged Adults.

PubMed

Murrock, Carolyn J; Graor, Christine Heifner

2016-02-01

This qualitative study described the lived experience of dancing as it related to depression and social isolation in 16 disadvantaged adults who completed a 12-week dance intervention. It is the first qualitative study to explore the experience of dance as an adjunct therapy, depression, and social isolation. A descriptive phenomenological framework consisted of two focus groups using semi-structured interviews. A Giorgian approach guided thematic analysis. Four themes emerged: (1) dance for myself and health, (2) social acceptance, (3) connection with others: a group, and (4) not wanting to stop: unexpected benefits from dancing. As the participants continued to dance, they developed a sense of belonging and group identity, which may have maintained group involvement and contributed to reducing depression and social isolation. Thus, dancing is a complementary therapy that should be considered when working with adults with depression and social isolation. Copyright © 2015 Elsevier Inc. All rights reserved.

The politics of HPV vaccination policy formation in the United States.

PubMed

Abiola, Sara E; Colgrove, James; Mello, Michelle M

2013-08-01

This article explores the political dimensions of policy formation for the human papillomavirus (HPV) vaccine through case studies of six states: California, Indiana, New Hampshire, New York, Texas, and Virginia. Using thematic content analysis of semistructured key informant interviews with policy stakeholders, newspaper articles, and archival materials, we describe the trajectory of public health policy developments for HPV immunization and analyze key influences on policy outcomes through the theoretical lens of the Multiple Streams framework. Specifically, we examine factors influencing the extent to which HPV was perceived as a problem meriting policy action; political forces that facilitated and impeded policy adoption, including interest-group opposition and structural and ideological features of the states' political environments; and factors affecting which policy alternatives received consideration. We find that effective policy entrepreneurship played a critical role in determining policy outcomes. We conclude by discussing lessons from the case of HPV vaccination for future efforts to craft vaccination policies.

Stillbirth and stigma: the spoiling and repair of multiple social identities.

PubMed

Brierley-Jones, Lyn; Crawley, Rosalind; Lomax, Samantha; Ayers, Susan

This study investigated mothers' experiences surrounding stillbirth in the United Kingdom, their memory making and sharing opportunities, and the effect these opportunities had on them. Qualitative data were generated from free text responses to open-ended questions. Thematic content analysis revealed that "stigma" was experienced by most women and Goffman's (1963) work on stigma was subsequently used as an analytical framework. Results suggest that stillbirth can spoil the identities of "patient," "mother," and "full citizen." Stigma was reported as arising from interactions with professionals, family, friends, work colleagues, and even casual acquaintances. Stillbirth produces common learning experiences often requiring "identity work" (Murphy, 2012). Memory making and sharing may be important in this work and further research is needed. Stigma can reduce the memory sharing opportunities for women after stillbirth and this may explain some of the differential mental health effects of memory making after stillbirth that is documented in the literature.

Globalization and Health: developing the journal to advance the field.

PubMed

Martin, Greg; MacLachlan, Malcolm; Labonté, Ronald; Larkan, Fiona; Vallières, Frédérique; Bergin, Niamh

2016-03-09

Founded in 2005, Globalization and Health was the first open access global health journal. The journal has since expanded the field, and its influence, with the number of downloaded papers rising 17-fold, to over 4 million. Its ground-breaking papers, leading authors -including a Nobel Prize winner- and an impact factor of 2.25 place it among the top global health journals in the world. To mark the ten years since the journal's founding, we, members of the current editorial board, undertook a review of the journal's progress over the last decade. Through the application of an inductive thematic analysis, we systematically identified themes of research published in the journal from 2005 to 2014. We identify key areas the journal has promoted and consider these in the context of an existing framework, identify current gaps in global health research and highlight areas we, as a journal, would like to see strengthened.

Using social marketing to understand the family dinner with working mothers.

PubMed

Martinasek, Mary P; DeBate, Rita D; Walvoord, Ashley G; Melton, Stephanie T; Himmelgreen, David; Allen, Tammy D; McDermott, Robert J

2010-01-01

The family dinner is a valued tradition that affords opportunities for social interaction and attachment, as well as sharing events of the day, role modeling, connectedness, and problem solving. Guided by the social-marketing framework, this study explored factors associated with the frequency of the family dinner among working mothers with children ages 8-11 years. A qualitative design was used, employing focus groups and Atlas-ti software for thematic analysis. Lack of time, cost, and exhaustion/lack of energy emerged as barriers. Working mothers indicated that a youth-based organization operating as a community partner could increase the frequency of the family dinner by helping with homework completion during after-school care, thereby providing mothers with the time necessary to prepare dinner. This research identified both community partners and working mothers as valued resources for prevention strategies. Interventions developed to increase family dinner frequency should emphasize the perceived value while decreasing the costs/barriers.

Structural Violence in Health Care: Lived Experience of Street-Based Female Commercial Sex Workers in Kathmandu.

PubMed

Basnyat, Iccha

2017-01-01

Thirty-five in-depth, semi-structured interviews were conducted with female, street-based, commercial sex workers in Kathmandu, Nepal. The framework of structural violence guided this study in identifying the structural context that impacts the female sex workers' lives and may cause harm to their health. Structural violence in health care was revealed through thematic analysis as (a) discrimination, (b) forced choice, and (c) limitations to health information sources. Lived experiences highlight how the sex workers engaged with structural limitations in health care access, services, and utilization. Structural violence conveys a message about who is entitled to health care and what a society emphasizes and expects regarding acceptable health behavior. Examining the structural violence highlighted how the sex workers negotiated, understood, and engaged with structural limitations in health care access, services, and utilization. © The Author(s) 2015.

Successful ageing by whose definition? Views of older, spiritually affiliated women.

PubMed

McCann Mortimer, Patricia; Ward, Lynn; Winefield, Helen

2008-12-01

Researchers have pointed to significant omissions in Rowe and Kahn's model of successful ageing and their lack of consultation with older people. This study examined late mid-life and older women's views of successful ageing. In-depth interviews were conducted with 14 women aged 60-89 years. Participants who identified themselves as spiritual and religious, or spiritual only and not religious, were recruited using the 'snowball technique'. Thematic analyses were conducted within an Interpretive Phenomenological Analysis framework. Participants described multiple dimensions of successful ageing with 15 subthemes grouped into three overarching categories of personal agency, social value and quality of life/quality of death. Participants' multidimensional views of successful ageing were broader than Rowe and Kahn's model and included the need to have a degree of autonomy over the place and manner of the last phase of life and final days (successful dying).

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

PubMed

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

2015-02-20

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

Smart Sustainable Islands VS Smart Sustainable Cities

NASA Astrophysics Data System (ADS)

Pantazis, D. N.; Moussas, V. C.; Murgante, B.; Daverona, A. C.; Stratakis, P.; Vlissidis, N.; Kavadias, A.; Economou, D.; Santimpantakis, K.; Karathanasis, B.; Kyriakopoulou, V.; Gadolou, E.

2017-09-01

This paper has several aims: a) the presentation of a critical analysis of the terms "smart sustainable cities" and "smart sustainable islands" b) the presentation of a number of principles towards to the development methodological framework of concepts and actions, in a form of a manual and actions guide, for the smartification and sustainability of islands. This kind of master plan is divided in thematic sectors (key factors) which concern the insular municipalities c) the creation of an island's smartification and sustainability index d) the first steps towards the creation of a portal for the presentation of our smartification actions manual, together with relative resources, smart applications examples, and, in the near future the first results of our index application in a number of Greek islands and e) the presentation of some proposals of possible actions towards their sustainable development and smartification for the municipalities - islands of Paros and Antiparos in Greece, as case studies.

Connection, regulation, and care plan innovation: a case study of four nursing homes.

PubMed

Colón-Emeric, Cathleen S; Lekan-Rutledge, Deborah; Utley-Smith, Queen; Ammarell, Natalie; Bailey, Donald; Piven, Mary L; Corazzini, Kirsten; Anderson, Ruth A

2006-01-01

We describe how connections among nursing home staff impact the care planning process using a complexity science framework. We completed six-month case studies of four nursing homes. Field observations (n = 274), shadowing encounters (n = 69), and in-depth interviews (n = 122) of 390 staff at all levels were conducted. Qualitative analysis produced a conceptual/thematic description and complexity science concepts were used to produce conceptual insights. We observed that greater levels of staff connection were associated with higher care plan specificity and innovation. Connection of the frontline nursing staff was crucial for (1) implementation of the formal care plan and (2) spontaneous informal care planning responsive to changing resident needs. Although regulations could theoretically improve cognitive diversity and information flow in care planning, we observed instances of regulatory oversight resulting in less specific care plans and abandonment of an effective care planning process. Interventions which improve staff connectedness may improve resident outcomes.

Mathematical knowledge in teaching of fraction concepts using diagrammatical approach

NASA Astrophysics Data System (ADS)

Veloo, Palanisamy Kathir; Puteh, Marzita

2017-05-01

Teachers need various types of knowledge in order to deliver various fraction concepts at elementary level. In this paper, Balls' framework (2008) or, Mathematical Knowledge for Teaching (MKT) is used as benchmark guideline. This paper investigates and explores component of MKT knowledge among eight experienced teachers of the primary school. Data was collected using paper pencil test, interview and video recording. This paper, narrowed to teacher's knowledge and their practices while teaching of various fractions concepts using diagrammatical approach in present of MKT. The data gathered from teachers were analyzed using thematic analysis techniques. The results indicated that teachers lack various components of MKT knowledge as a proposal by various researchers and assumed that teaching as procedural more than enough due to lack of deep understanding of mathematics and the various types of MKT is not required due to the present of practices in the mathematics classroom.

Managing health worker migration: a qualitative study of the Philippine response to nurse brain drain

PubMed Central

2012-01-01

Background The emigration of skilled nurses from the Philippines is an ongoing phenomenon that has impacted the quality and quantity of the nursing workforce, while strengthening the domestic economy through remittances. This study examines how the development of brain drain-responsive policies is driven by the effects of nurse migration and how such efforts aim to achieve mind-shifts among nurses, governing and regulatory bodies, and public and private institutions in the Philippines and worldwide. Methods Interviews and focus group discussions were conducted to elicit exploratory perspectives on the policy response to nurse brain drain. Interviews with key informants from the nursing, labour and immigration sectors explored key themes behind the development of policies and programmes that respond to nurse migration. Focus group discussions were held with practising nurses to understand policy recipients’ perspectives on nurse migration and policy. Results Using the qualitative data, a thematic framework was created to conceptualize participants’ perceptions of how nurse migration has driven the policy development process. The framework demonstrates that policymakers have recognised the complexity of the brain drain phenomenon and are crafting dynamic policies and programmes that work to shift domestic and global mindsets on nurse training, employment and recruitment. Conclusions Development of responsive policy to Filipino nurse brain drain offers a glimpse into a domestic response to an increasingly prominent global issue. As a major source of professionals migrating abroad for employment, the Philippines has formalised efforts to manage nurse migration. Accordingly, the Philippine paradigm, summarised by the thematic framework presented in this paper, may act as an example for other countries that are experiencing similar shifts in healthcare worker employment due to migration. PMID:23249411

A conceptual framework toward identifying and analyzing challenges to the advancement of pharmacy.

PubMed

Bader, Lina R; McGrath, Simon; Rouse, Michael J; Anderson, Claire

Pharmacists and health care professionals are faced with increasing and changing health care needs around the world. To meet these demands, they are required to continuously upgrade and develop their professions. Reprofessionalization is therefore crucial to the successful delivery of health services, but traditional theories might provide little practical guidance to evaluating the overall status of a profession. This study proposes a new conceptual framework of three interrelated professional sectors: education, regulation and practice, and uses it to identify and analyze challenges facing the pharmacy profession in Jordan. A multiple-method qualitative study comprised of semi-structured interviews and focus groups was conducted in Amman, Jordan. To explore and identify the challenges, a purposively recruited cross-sector sample of 53 key informants, stakeholders and pharmacists were interviewed. Interview transcripts were translated and analyzed using QSR NVivo 10. Thematic analysis identified eight main challenges facing pharmacy in Jordan. The original participants were then invited to participate in focus groups, the purpose of which was to validate the interview findings, map them against the conceptual framework and discuss recommendations for development. The eight validated challenges span the following areas: graduates preparedness for practice, pharmacy education accreditation and quality assurance, pre-registration requirements, workforce development, workforce planning, remuneration and wage rate, pharmacy assistants, and Pharm.D. pharmacists. Focus group participants used the framework to map each of the challenges to the primary sector-to-sector disconnect that they perceived to explain it. A list of recommendations addressing each of the challenges was also devised. The framework was found to offer valuable insight as an explanatory and diagnostic tool in policy-relevant research. By emphasizing the processual and contextual nature of reprofessionalization, the framework presents an alternative approach to traditional theories. This study also raises important questions regarding the status of pharmacy in Jordan and aims to provide guidance for local development and much-needed reprofessionalization drives. Copyright © 2016 Elsevier Inc. All rights reserved.

How Has the Presence of Zimbabwe's Victim-Friendly Court and Relevant Child Protection Policy and Legal Frameworks Affected the Management of Intrafamilial Child Sexual Abuse in Zimbabwe? The Case of Marondera District.

PubMed

Musiwa, Anthony Shuko

2018-06-01

The study intended to assess, based on the perceptions of Victim-Friendly Court (VFC) professionals in Marondera District in Zimbabwe, how the presence of the VFC and relevant child protection policy and legal frameworks has affected the management of Intrafamilial Child Sexual Abuse (ICSA) in Zimbabwe. Sem-istructured questionnaires were administered to 25 professionals from 13 VFC agencies in Marondera, while one-on-one semi-structured interviews were conducted with 15 key informants who included five ICSA survivors and their respective five caregivers as well as five key community child protection committee members. All 40 participants were selected using purposive sampling. Data were analyzed manually using thematic analysis, descriptive analysis, and document analysis. The study showed that the VFC manages ICSA through prevention, protection, treatment, and support interventions, and that its mandate is guided by key child protection policy and legal frameworks, particularly the National Action Plan for Orphaned and Vulnerable Children and the Children's Act (Chapter 5:06). The presence of these mechanisms is perceived to have resulted in increased awareness of ICSA, realization of effective results, increased reporting of ICSA, and enhanced coordination among VFC agencies. However, the same frameworks are perceived to be fraught with gaps and inconsistencies, too prescriptive, incoherent with some key aspects of the National Constitution and international child rights standards, and poorly resourced for effective implementation. All this has negatively affected the management of ICSA. Therefore, the Government of Zimbabwe should consistently review these systems to make them responsive to the ever-evolving factors associated with ICSA. Also, alignment with the National Constitution, full domestication of global child rights instruments, and routine collection of better statistics for evidence-based policy- and decision-making, and for better monitoring of progress and evaluation of outcomes, are necessary for positive results. Non-governmental stakeholders too should chip in with human, technical, and financial resources to enhance effective management of the social problem.

Counselling patients about behaviour change: the challenge of talking about diet.

PubMed

Phillips, Katie; Wood, Fiona; Spanou, Clio; Kinnersley, Paul; Simpson, Sharon A; Butler, Christopher C

2012-01-01

As obesity levels increase, opportunistic behaviour change counselling from primary care clinicians in consultations about healthy eating is ever more important. However, little is known about the approaches clinicians take with patients. To describe the content of simulated consultations on healthy eating in primary care, and compare this with the content of smoking cessation consultations. Qualitative study of 23 audiotaped simulated healthy eating and smoking cessation consultations between an actor and primary care clinicians (GPs and nurses) within a randomised controlled trial looking at behaviour change counselling. Consultations were audiotaped and transcribed verbatim, then analysed inductively using thematic analysis. A thematic framework was developed by all authors and applied to the data. The content of healthy eating consultations was contrasted with that given for smoking cessation. There was a lack of consistency and clarity when clinicians discussed healthy eating compared with smoking; in smoking cessation consultations, the content was clearer to both the clinician and patient. There was a lack of specificity about what dietary changes should be made, how changes could be achieved, and how progress could be monitored. Barriers to change were addressed in more depth within the smoking cessation consultations than within the healthy eating encounters. At present, dietary counselling by clinicians in primary care does not typically contain consistent, clear suggestions for specific change, how these could be achieved, and how progress would be monitored. This may contribute to limited uptake and efficacy of dietary counselling in primary care.

Land-cover change in the Lower Mississippi Valley, 1973-2000

USGS Publications Warehouse

Karstensen, Krista A.; Sayler, Kristi L.

2009-01-01

The Land Cover Trends is a research project focused on understanding the rates, trends, causes, and consequences of contemporary United States land-use and land-cover change. The project is coordinated by the Geographic Analysis and Monitoring Program of the U.S. Geological Survey (USGS) in conjunction with the U.S. Environmental Protection Agency (EPA) and the National Aeronautics and Space Administration (NASA). Using the EPA Level III ecoregions as the geographic framework, scientists process geospatial data collected between 1973 and 2000 were processed to characterize ecosystem responses to land-use changes. The 27-year study period was divided into four temporal periods: 1973 to1980, 1980 to 1986, 1986 to 1992, 1992 to 2000 and overall from 1973 to 2000. General land-cover classes for these periods were interpreted from Landsat Multispectral Scanner, Thematic Mapper, and Enhanced Thematic Mapper Plus imagery to categorize and evaluate land-cover change using a modified Anderson Land Use Land Cover Classification System (Anderson and others, 1976) for image interpretation.The rates of land-cover change were estimated using a stratified, random sampling of 10-kilometer (km) by 10-km blocks allocated within each ecoregion. For each sample block, satellite images were used to interpret land-cover change. The sample block data then were incorporated into statistical analyses to generate an overall change matrix for the ecoregion. These change statistics are applicable for different levels of scale, including total change for the individual sample blocks and change estimates for the entire ecoregion.

Network methods to support user involvement in qualitative data analyses: an introduction to Participatory Theme Elicitation.

PubMed

Best, Paul; Badham, Jennifer; Corepal, Rekesh; O'Neill, Roisin F; Tully, Mark A; Kee, Frank; Hunter, Ruth F

2017-11-23

While Patient and Public Involvement (PPI) is encouraged throughout the research process, engagement is typically limited to intervention design and post-analysis stages. There are few approaches to participatory data analyses within complex health interventions. Using qualitative data from a feasibility randomised controlled trial (RCT), this proof-of-concept study tests the value of a new approach to participatory data analysis called Participatory Theme Elicitation (PTE). Forty excerpts were given to eight members of a youth advisory PPI panel to sort into piles based on their perception of related thematic content. Using algorithms to detect communities in networks, excerpts were then assigned to a thematic cluster that combined the panel members' perspectives. Network analysis techniques were also used to identify key excerpts in each grouping that were then further explored qualitatively. While PTE analysis was, for the most part, consistent with the researcher-led analysis, young people also identified new emerging thematic content. PTE appears promising for encouraging user led identification of themes arising from qualitative data collected during complex interventions. Further work is required to validate and extend this method. ClinicalTrials.gov, ID: NCT02455986 . Retrospectively Registered on 21 May 2015.

Behavioural interventions for weight management in pregnancy: a systematic review of quantitative and qualitative data.

PubMed

Campbell, Fiona; Johnson, Maxine; Messina, Josie; Guillaume, Louise; Goyder, Elizabeth

2011-06-22

There is a rising prevalence of excessive weight gain in pregnancy and an increasing number of pregnant women who are overweight or obese at the start of the pregnancy. Excessive weight gain during pregnancy is associated with adverse maternal and neonatal consequences and increases the risk of long-term obesity. Pregnancy therefore may be a key time to prevent excessive weight gain and improve the health of women and their unborn child. This systematic review sought to assess the effectiveness of behavioural interventions to prevent excessive weight gain in pregnancy and explore the factors that influence intervention effectiveness. We undertook a systematic review of quantitative and qualitative evidence. This included a meta-analysis of controlled trials of diet and physical activity interventions to prevent excessive weight gain during pregnancy and a thematic synthesis of qualitative studies that investigated the views of women on weight management during pregnancy. A thorough search of eleven electronic bibliographic databases, reference lists of included studies, relevant review articles and experts in the field were contacted to identify potentially relevant studies.Two independent reviewers extracted data. RevMan software was used to perform the meta-analyses. Qualitative data was subject to thematic analysis. Both quantitative and qualitative data were aligned using a matrix framework. Five controlled trials and eight qualitative studies were included. The overall pooled effect size found no significant difference in gestational weight gain amongst participants in the intervention group compared with the control group (mean difference -0.28 95% CI -0.64 to 0.09). The study designs, participants and interventions all varied markedly and there was significant heterogeneity within this comparison in the meta-analysis (I2 67%). Subgroup and sensitivity analysis did not identify contextual elements that influenced the effectiveness of the intervention.In a thematic analysis of the qualitative studies, three major themes emerged relating to women's views of weight management in pregnancy: pregnancy as a time of transition and change, conflicting and contradictory messages and a perceived lack of control. When the results of both quantitative and qualitative data were aligned it was clear that some of the barriers that women described in achieving healthy weight gain in pregnancy were not addressed by the interventions evaluated. This may have contributed to the limited effectiveness of the interventions. Despite intense and often tailored interventions there was no statistically significant effect on weight gain during pregnancy. Inadequate and often contradictory information regarding healthy weight management was reported by women in qualitative studies and this was addressed in the interventions but this in itself was insufficient to lead to reduced weight gain. Multiple types of interventions, including community based strategies are needed to address this complex health problem.

1985 ACSM-ASPRS Fall Convention, Indianapolis, IN, September 8-13, 1985, Technical Papers

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

Not Available

1985-01-01

Papers are presented on Landsat image data quality analysis, primary data acquisition, cartography, geodesy, land surveying, and the applications of satellite remote sensing data. Topics discussed include optical scanning and interactive color graphics; the determination of astrolatitudes and astrolongitudes using x, y, z-coordinates on the celestial sphere; raster-based contour plotting from digital elevation models using minicomputers or microcomputers; the operational techniques of the GPS when utilized as a survey instrument; public land surveying and high technology; the use of multitemporal Landsat MSS data for studying forest cover types; interpretation of satellite and aircraft L-band synthetic aperture radar imagery; geological analysismore » of Landsat MSS data; and an interactive real time digital image processing system. Consideration is given to a large format reconnaissance camera; creating an optimized color balance for TM and MSS imagery; band combination selection for visual interpretation of thematic mapper data for resource management; the effect of spatial filtering on scene noise and boundary detail in thematic mapper imagery; the evaluation of the geometric quality of thematic mapper photographic data; and the analysis and correction of Landsat 4 and 5 thematic mapper sensor data.« less

LANDSAT-4 MSS and Thematic Mapper data quality and information content analysis

NASA Technical Reports Server (NTRS)

Anuta, P.; Bartolucci, L.; Dean, E.; Lozano, F.; Malaret, E.; Mcgillem, C. D.; Valdes, J.; Valenzuela, C.

1984-01-01

LANDSAT-4 thematic mapper (TM) and multispectral scanner (MSS) data were analyzed to obtain information on data quality and information content. Geometric evaluations were performed to test band-to-band registration accuracy. Thematic mapper overall system resolution was evaluated using scene objects which demonstrated sharp high contrast edge responses. Radiometric evaluation included detector relative calibration, effects of resampling, and coherent noise effects. Information content evaluation was carried out using clustering, principal components, transformed divergence separability measure, and supervised classifiers on test data. A detailed spectral class analysis (multispectral classification) was carried out to compare the information content of the MSS and TM for a large number of scene classes. A temperature-mapping experiment was carried out for a cooling pond to test the quality of thermal-band calibration. Overall TM data quality is very good. The MSS data are noisier than previous LANDSAT results.

Keeping the "continuous" in continuous quality improvement: exploring perceived outcomes of CQI program use in community pharmacy.

PubMed

Boyle, Todd A; Bishop, Andrea C; Duggan, Kellie; Reid, Carolyn; Mahaffey, Thomas; MacKinnon, Neil J; Mahaffey, Amelia

2014-01-01

Given the significant potential of continuous quality improvement (CQI) programs in enhancing overall levels of patient safety, community pharmacies in North America are under increasing pressure to have a formal and documented CQI program in place. However, while such initiatives may seem great on paper, in practice the outcomes of such programs to community pharmacy practice remain unclear. To explore the perceived outcomes identified by community pharmacies that adopted and actively used a standardized (i.e., common across pharmacies) CQI program for at least 1 year and to develop a framework for how such outcomes were achieved. A multi-site study of SafetyNET-Rx, a standardized and technologically sophisticated (e.g., online reporting of medication errors to a national database) CQI program, involving community pharmacies in Nova Scotia, Canada, was performed. During the summer and fall of 2011, 22 interviews were conducted with the CQI facilitators in 12 Nova Scotia community pharmacies; equally split between independent/banners and corporate chains. Of the CQI facilitators, 14 were pharmacists, while the remaining eight were pharmacy technicians. Thematic analysis following the procedures presented by Braun and Clarke was adopted to identify and explore the major outcomes. Results of the thematic analysis highlighted a number of perceived outcomes from the use of a standardized CQI program in community pharmacies, specifically: (1) perceived reduction in the number of medication errors that were occurring in the pharmacy, (2) increased awareness/confidence of individual actions related to dispensing, (3) increased understanding of the dispensing and related processes/workflow, (4) increased openness to talking about medication errors among pharmacy staff, and (5) quality and safety becoming more entrenched in the workflow (e.g., staff is more aware of their roles and responsibilities in patient safety and confident that the dispensing processes are safe and reliable). In achieving such outcomes, pharmacies had to balance customizing the CQI program to address a number of operational challenges, with ensuring that the core standardized components remained in place. This research identified the perceived outcomes of CQI program use by CQI facilitators. Additionally, the findings are incorporated into a framework for CQI implementation that can be used by pharmacy managers, corporate head offices, and regulatory authorities to leverage greater CQI adoption and success. Copyright © 2014 Elsevier Inc. All rights reserved.

A Needs-led Framework for Understanding the Impact of Caring for a Family Member With Dementia.

PubMed

Pini, Simon; Ingleson, Emma; Megson, Molly; Clare, Linda; Wright, Penny; Oyebode, Jan R

2018-03-19

Approximately half the care for people with dementia is provided by families. It is therefore imperative that research informs ways of maintaining such care. In this study, we propose that a needs-led approach can provide a useful, novel means of conceptualizing the impact of caring on the lives of family carers. Our aim was to develop and present a needs-led framework for understanding how providing care impacts on carers' fulfilment of needs. In this qualitative study, we conducted 42 semistructured interviews with a purposively diverse sample of family carers to generate nuanced contextualized accounts of how caring impacted on carers' lives. Our inductive thematic analysis focused upon asking: "What need is being impacted here?" in order to generate a needs-led framework for understanding. Nine themes were widely endorsed. Each completed the sentence: "Being a carer impacts on fulfilling my need to/for….": Freedom; feel close to my relative; feel in control of my life; be my own person; protect my relative; share/express my thoughts and feelings; take care of myself; feel connected to the people around me; get things done. These needs echo those from other research areas, with relational needs emerging as particularly central. The needs-led approach offers a perspective that is able to capture both stresses and positive aspects of caregiving. We recommend that clinical interviewing using Socratic questioning to discover human needs that are being impacted by caring would provide a valuable starting point for care planning.

Challenges in the Ethical Review of Peer Support Interventions

PubMed Central

Simmons, David; Bunn, Christopher; Nakwagala, Fred; Safford, Monika M.; Ayala, Guadalupe X.; Riddell, Michaela; Graffy, Jonathan; Fisher, Edwin B.

2015-01-01

PURPOSE Ethical review processes have become increasingly complex. We have examined how 8 collaborating diabetes peer-support clinical trials were assessed by ethics committees. METHODS The ethical reviews from the 8 peer-support studies were collated and subjected to a thematic analysis. We mapped the recommendations of local Institutional Review Boards and ethics committees onto the “4+1 ethical framework” (autonomy, beneficence, non-maleficence, and justice, along with concern for their scope of application). RESULTS Ethics committees did not consistently focus on tasks within the 4+1 framework: many conducted reviews of scientific, organizational, and administrative activities. Of the 20 themes identified across the ethical reviews, only 4 fell within the scope of the 4+1 framework. Variation in processes and requirements for ethics committees were particularly evident between study countries. Some of the consent processes mandated by ethical review boards were disproportionate for peer support, increased participant burden, and reduced the practicality of testing an ethical intervention. Across the 8 studies, ethics committees’ reviews included the required elements to ensure participant safety; however, they created a range of hurdles that in some cases delayed the research and required consent processes that could hinder the spontaneity and/or empathy of peer support. CONCLUSION Ethics committees should avoid repeating the work of other trusted agencies and consider the ethical validity of “light touch” consent procedures for peer-support interventions. The investigators propose an ethical framework for research on peer support. PMID:26304976

The Experiences of Well-Being of Palliative Care Patients in Malaysia: A Thematic Analysis.

PubMed

Beng, Tan Seng; Chin, Loh Ee; Guan, Ng Chong; Ann, Yee Hway; Wu, Cathie; Kuan, Wong Sook; Jane, Lim Ee; Khee, Saw Shier; Meng, Christopher Boey Chiong

2015-08-01

A qualitative study was conducted with semistructured interviews to explore the experiences of well-being in 15 adult palliative care inpatients of University Malaya Medical Center, Kuala Lumpur, Malaysia. The results were thematically analyzed. Six basic themes were generated (1) positive attitude, (2) positive cognitions, (3) positive emotions, (4) positive engagement, (5) positive relationships, and (6) positive circumstances. The Seeds Model was conceptualized from the analysis. This model may inform the development of interventions in the enhancement of well-being of palliative care patients. © The Author(s) 2014.

An Analysis LANDSAT-4 Thematic Mapper Geometric Properties

NASA Technical Reports Server (NTRS)

Walker, R. E.; Zobrist, A. L.; Bryant, N. A.; Gokhman, B.; Friedman, S. Z.; Logan, T. L.

1984-01-01

LANDSAT Thematic Mapper P-data of Washington, D. C., Harrisburg, PA, and Salton Sea, CA are analyzed to determine magnitudes and causes of error in the geometric conformity of the data to known Earth surface geometry. Several tests of data geometry are performed. Intraband and interband correlation and registration are investigated, exclusive of map based ground truth. The magnitudes and statistical trends of pixel offsets between a single band's mirror scans (due to processing procedures) are computed, and the inter-band integrity of registration is analyzed. A line to line correlation analysis is included.

Nursing education reform in South Africa – lessons from a policy analysis study

PubMed Central

Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C.

2014-01-01

Background Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. Objective We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. Design We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. Results The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. Conclusions The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised. PMID:25537941

Nursing education reform in South Africa--lessons from a policy analysis study.

PubMed

Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C

2014-01-01

Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised.

Statistical analysis of Thematic Mapper Simulator data for the geobotanical discrimination of rock types in southwest Oregon

NASA Technical Reports Server (NTRS)

Morrissey, L. A.; Weinstock, K. J.; Mouat, D. A.; Card, D. H.

1984-01-01

An evaluation of Thematic Mapper Simulator (TMS) data for the geobotanical discrimination of rock types based on vegetative cover characteristics is addressed in this research. A methodology for accomplishing this evaluation utilizing univariate and multivariate techniques is presented. TMS data acquired with a Daedalus DEI-1260 multispectral scanner were integrated with vegetation and geologic information for subsequent statistical analyses, which included a chi-square test, an analysis of variance, stepwise discriminant analysis, and Duncan's multiple range test. Results indicate that ultramafic rock types are spectrally separable from nonultramafics based on vegetative cover through the use of statistical analyses.

Spatio-Temporal Modelling of Dust Transport over Surface Mining Areas and Neighbouring Residential Zones.

PubMed

Matejicek, Lubos; Janour, Zbynek; Benes, Ludek; Bodnar, Tomas; Gulikova, Eva

2008-06-06

Projects focusing on spatio-temporal modelling of the living environment need to manage a wide range of terrain measurements, existing spatial data, time series, results of spatial analysis and inputs/outputs from numerical simulations. Thus, GISs are often used to manage data from remote sensors, to provide advanced spatial analysis and to integrate numerical models. In order to demonstrate the integration of spatial data, time series and methods in the framework of the GIS, we present a case study focused on the modelling of dust transport over a surface coal mining area, exploring spatial data from 3D laser scanners, GPS measurements, aerial images, time series of meteorological observations, inputs/outputs form numerical models and existing geographic resources. To achieve this, digital terrain models, layers including GPS thematic mapping, and scenes with simulation of wind flows are created to visualize and interpret coal dust transport over the mine area and a neighbouring residential zone. A temporary coal storage and sorting site, located near the residential zone, is one of the dominant sources of emissions. Using numerical simulations, the possible effects of wind flows are observed over the surface, modified by natural objects and man-made obstacles. The coal dust drifts with the wind in the direction of the residential zone and is partially deposited in this area. The simultaneous display of the digital map layers together with the location of the dominant emission source, wind flows and protected areas enables a risk assessment of the dust deposition in the area of interest to be performed. In order to obtain a more accurate simulation of wind flows over the temporary storage and sorting site, 3D laser scanning and GPS thematic mapping are used to create a more detailed digital terrain model. Thus, visualization of wind flows over the area of interest combined with 3D map layers enables the exploration of the processes of coal dust deposition at a local scale. In general, this project could be used as a template for dust-transport modelling which couples spatial data focused on the construction of digital terrain models and thematic mapping with data generated by numerical simulations based on Reynolds averaged Navier-Stokes equations.

Spatio-Temporal Modelling of Dust Transport over Surface Mining Areas and Neighbouring Residential Zones

PubMed Central

Matejicek, Lubos; Janour, Zbynek; Benes, Ludek; Bodnar, Tomas; Gulikova, Eva

2008-01-01

Projects focusing on spatio-temporal modelling of the living environment need to manage a wide range of terrain measurements, existing spatial data, time series, results of spatial analysis and inputs/outputs from numerical simulations. Thus, GISs are often used to manage data from remote sensors, to provide advanced spatial analysis and to integrate numerical models. In order to demonstrate the integration of spatial data, time series and methods in the framework of the GIS, we present a case study focused on the modelling of dust transport over a surface coal mining area, exploring spatial data from 3D laser scanners, GPS measurements, aerial images, time series of meteorological observations, inputs/outputs form numerical models and existing geographic resources. To achieve this, digital terrain models, layers including GPS thematic mapping, and scenes with simulation of wind flows are created to visualize and interpret coal dust transport over the mine area and a neighbouring residential zone. A temporary coal storage and sorting site, located near the residential zone, is one of the dominant sources of emissions. Using numerical simulations, the possible effects of wind flows are observed over the surface, modified by natural objects and man-made obstacles. The coal dust drifts with the wind in the direction of the residential zone and is partially deposited in this area. The simultaneous display of the digital map layers together with the location of the dominant emission source, wind flows and protected areas enables a risk assessment of the dust deposition in the area of interest to be performed. In order to obtain a more accurate simulation of wind flows over the temporary storage and sorting site, 3D laser scanning and GPS thematic mapping are used to create a more detailed digital terrain model. Thus, visualization of wind flows over the area of interest combined with 3D map layers enables the exploration of the processes of coal dust deposition at a local scale. In general, this project could be used as a template for dust-transport modelling which couples spatial data focused on the construction of digital terrain models and thematic mapping with data generated by numerical simulations based on Reynolds averaged Navier-Stokes equations. PMID:27879911

A thematic review and a policy-analysis agenda of Electronic Health Records in the Greek National Health System.

PubMed

Emmanouilidou, Maria; Burke, Maria

2013-01-01

The increasing pressure to improve healthcare outcomes and reduce costs is driving the current agenda of governments at worldwide level and calls for a fundamental reform of the status quo of health systems. This is especially the case with the Greek NHS (National Health System), a system in continuous crisis, and with the recent ongoing financial turbulence under intensive scrutiny. Technological innovations and Electronic Health Records (EHR) in particular, are recognised as key enablers in mitigating the existing burdens of healthcare. As a result, EHR is considered a core component in technology-driven reform processes. Nonetheless, the successful implementation and adoption of EHR proves to be a challenging task due to a mixture of technological, organisational and political issues. Drawing upon experiences within the European Union (EU) healthcare setting and the Greek NHS the paper proposes a conceptual framework as a policy-analysis agenda for EHR interventions in Greece. While the context of discussion is Greece, the paper aims to also derive useful insights to healthcare policy-makers around the globe. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Wellbeing in retirement villages: eudaimonic challenges and opportunities.

PubMed

Chandler, Rebecca C; Robinson, Oliver C

2014-12-01

A retirement village consists of a collection of privately owned or leased flats or maisonettes for elderly adults that are supported by a central hub that provides catering, medical care and social activities. There have been studies of the psychological experience and impacts of such environments, however, there is lack of research that links the retirement village experience to overarching theories of eudaimonic wellbeing, and that uses qualitative methods to find out about how wellbeing manifests for the individual. This study used Ryff's (1989) model of wellbeing as a framework for analysis, while aiming to gain an in-depth understanding of the experiences and sources of wellbeing in residents of two retirement villages in the South East of England. Semi-structured interviews were carried out with 18 residents. Thematic analysis revealed a dialectical tension to retirement village living: while facilitating all six core components of eudaimonic wellbeing as conceptualized by Ryff's model, individuals living within the retirement villages also experience challenges to wellbeing on the same dimensions. An integrative model of these tensions between positive and negative experiences is presented and discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

"Not Brain-washed, but Heart-washed": A Qualitative Analysis of Benevolent Sexism in the Anti-Choice Stance.

PubMed

Duerksen, Kari N; Lawson, Karen L

2017-12-01

In recent years, anti-choice dialog has shifted from a focus on the fetus to a focus on the woman. This new movement constructs itself as positive and pro-woman, while perpetuating harmful stereotypes about women and the effects of abortion. Research has shown a relationship between benevolent sexism (beliefs that women are morally pure creatures in need of protection and nurturing) and restrictive attitudes towards abortion, although no research has qualitatively explored this relationship. The present study seeks to explore this by interpreting the content of one-on-one interviews with Canadian individuals holding an anti-choice stance through the theoretical framework of benevolent sexism. Thematic analysis of the interviews revealed three main themes: (1) protective paternalism, (2) complementary gender differentiation, and (3) the categorization of women. These themes connect strongly with benevolent sexism, providing evidence that abortion is still a stigmatized procedure. This stigma has shifted from viewing women who have abortions in an overtly negative way to viewing them as pitiable and poor decision makers.

Leadership Strategies for Maintaining Profitability in a Volatile Crude Oil Market

NASA Astrophysics Data System (ADS)

Braimoh, Lucky Anderson

Volatile crude oil prices significantly affect the profitability of crude oil firms. The purpose of this single case study was to explore strategies some crude oil and gas business leaders used to remain profitable during periods of crude oil price volatility. The target population comprised 8 crude oil and gas business leaders located in Calgary, Canada, whose company remained profitable despite crude oil price volatility. The transformational leadership theory formed the conceptual framework for the study. Data were collected through the use of semistructured face-to-face interviews, company reports, and field notes. Data analysis involved a modified Van Kamm method, which included descriptive coding, a sequential review of the interview transcripts, and member checking. Based on methodological triangulation and thematic analysis, 5 themes emerged from the study, including communication and engagement; motivation and empowerment; measurement, monitoring, and control; self-awareness and humility; and efficiency and optimization. The implications for social change include the potential for crude oil and gas companies in Calgary, Canada to manage production costs, ensure earnings and profitability, and thus improve the socioeconomic well-being of Calgary indigenes through improved employment opportunities.

Using social constructionist thinking in training social workers living and working under threat of political violence.

PubMed

Shamai, Michal

2003-10-01

This article describes and analyzes an intervention program with social workers living and working in a situation of uncertainty created by political violence such as war and terrorism. The author used a social constructionist perspective as a theoretical framework, emphasizing the effect of the social and political context in constructing the experience and a recognition of the personal and professional knowledge acquired in the daily experience. The author used qualitative methods to evaluate the process and outcome. The narrative-holistic analysis focused on reconstructing meaning and adapting it to the new situation, the main thrust of the program. From the thematic analysis four main themes emerged: (1) loss as a result of political violence; (2) meaning of strength and weakness in situations of political violence; (3) preparation for terrorist attacks; and (4) definition of a safe place. The outcome evaluation describes the meaning of this kind of training program to the participants. The specific context of the training program is discussed as well as possibilities of using it in different contexts.

The Swedish duty hour enigma.

PubMed

Sundberg, Kristina; Frydén, Hanna; Kihlström, Lars; Nordquist, Jonas

2014-01-01

The Swedish resident duty hour limit is regulated by Swedish and European legal frameworks. With a maximum average of 40 working hours per week, the Swedish duty hour regulation is one of the most restrictive in the world. At the same time, the effects of resident duty hour limits have been neither debated nor researched in the Swedish context. As a result, little is known about the Swedish conceptual framework for resident duty hours, their restriction, or their outcomes: we call this "the Swedish duty hour enigma." This situation poses a further question: How do Swedish residents themselves construct a conceptual framework for duty hour restrictions? A case study was conducted at Karolinska University Hospital, Stockholm--an urban, research-intensive hospital setting. Semi-structured interviews were carried out with 34 residents currently in training in 6 specialties. The empirical data analysis relied on theoretical propositions and was conducted thematically using a pattern-matching technique. The interview guide was based on four main topics: the perceived effect of duty hour restrictions on (1) patient care, (2) resident education, (3) resident well-being, and (4) research. The residents did not perceive the volume of duty hours to be the main determinant of success or failure in the four contextual domains of patient care, resident education, resident well-being, and research. Instead, they emphasized resident well-being and a desire for flexibility. According to Swedish residents' conceptual framework on duty hours, the amount of time spent on duty is not a proxy for the quality of resident training. Instead, flexibility, organization, and scheduling of duty hours are considered to be the factors that have the greatest influence on resident well-being, quality of learning, and opportunities to attain the competence needed for independent practice.

Spatially explicit land-use and land-cover scenarios for the Great Plains of the United States

USGS Publications Warehouse

Sohl, Terry L.; Sleeter, Benjamin M.; Sayler, Kristi L.; Bouchard, Michelle A.; Reker, Ryan R.; Bennett, Stacie L.; Sleeter, Rachel R.; Kanengieter, Ronald L.; Zhu, Zhi-Liang

2012-01-01

The Great Plains of the United States has undergone extensive land-use and land-cover change in the past 150 years, with much of the once vast native grasslands and wetlands converted to agricultural crops, and much of the unbroken prairie now heavily grazed. Future land-use change in the region could have dramatic impacts on ecological resources and processes. A scenario-based modeling framework is needed to support the analysis of potential land-use change in an uncertain future, and to mitigate potentially negative future impacts on ecosystem processes. We developed a scenario-based modeling framework to analyze potential future land-use change in the Great Plains. A unique scenario construction process, using an integrated modeling framework, historical data, workshops, and expert knowledge, was used to develop quantitative demand for future land-use change for four IPCC scenarios at the ecoregion level. The FORE-SCE model ingested the scenario information and produced spatially explicit land-use maps for the region at relatively fine spatial and thematic resolutions. Spatial modeling of the four scenarios provided spatial patterns of land-use change consistent with underlying assumptions and processes associated with each scenario. Economically oriented scenarios were characterized by significant loss of natural land covers and expansion of agricultural and urban land uses. Environmentally oriented scenarios experienced modest declines in natural land covers to slight increases. Model results were assessed for quantity and allocation disagreement between each scenario pair. In conjunction with the U.S. Geological Survey's Biological Carbon Sequestration project, the scenario-based modeling framework used for the Great Plains is now being applied to the entire United States.

Interprofessional communication training: benefits to practicing pharmacists.

PubMed

Luetsch, Karen; Rowett, Debra

2015-10-01

Interprofessional communication skills are important for pharmacists to build collaborative relationships with other health professionals, integrate into healthcare teams, maximise their effectiveness in patient care in addressing complex care needs and meet the demands of health care reforms. This qualitative study explores clinical pharmacists' experiences and reflections after completing a learning and practice module which introduced them to a framework for successful interprofessional communication. The postgraduate clinical pharmacy program at The University of Queensland and the clinical pharmacy practice environments of forty-eight hospital and seven community based pharmacists. A learning and practice module outlining a framework for successful interprofessional communication was designed and integrated into a postgraduate clinical pharmacy program. Enrolled pharmacists applied newly learnt communication skills in pro-actively initiated, clinical discussions with a health professional in their practice environment. They provided written reflections on their experiences which were analysed using thematic analysis. Pharmacists' perceptions of the impact of applying the communication framework during their interaction with a health professional in their practice setting. Themes which emerged from reflections described pharmacists' confidence and capabilities to successfully conduct a clinical discussion with a health professional after initial apprehension and nervousness about the scheduled interaction. The application of the communication framework enhanced their perception of their professional identity, credibility and ability to build a collaborative working relationship with other health professionals. Pharmacists perceived that a learning and practice module for successful interprofessional practice integrated into a postgraduate clinical pharmacy program enhanced their interprofessional communication skills. The development of pro-active, interprofessional communication skills has the potential to increase interprofessional collaboration and pharmacists' personal role satisfaction. Pharmacists also observed it added value to their professional contribution in health care teams when addressing the demands of increasingly complex health care needs and reforms.

Exploring the components of physician volunteer engagement: a qualitative investigation of a national Canadian simulation-based training programme

PubMed Central

Sarti, Aimee J; Sutherland, Stephanie; Landriault, Angele; DesRosier, Kirk; Brien, Susan; Cardinal, Pierre

2017-01-01

Objectives Conceptual clarity on physician volunteer engagement is lacking in the medical literature. The aim of this study was to present a conceptual framework to describe the elements which influence physician volunteer engagement and to explore volunteer engagement within a national educational programme. Setting The context for this study was the Acute Critical Events Simulation (ACES) programme in Canada, which has successfully evolved into a national educational programme, driven by physician volunteers. From 2010 to 2014, the programme recruited 73 volunteer healthcare professionals who contributed to the creation of educational materials and/or served as instructors. Method A conceptual framework was constructed based on an extensive literature review and expert consultation. Secondary qualitative analysis was undertaken on 15 semistructured interviews conducted from 2012 to 2013 with programme directors and healthcare professionals across Canada. An additional 15 interviews were conducted in 2015 with physician volunteers to achieve thematic saturation. Data were analysed iteratively and inductive coding techniques applied. Results From the physician volunteer data, 11 themes emerged. The most prominent themes included volunteer recruitment, retention, exchange, recognition, educator network and quasi-volunteerism. Captured within these interrelated themes were the framework elements, including the synergistic effects of emotional, cognitive and reciprocal engagement. Behavioural engagement was driven by these factors along with a cue to action, which led to contributions to the ACES programme. Conclusion This investigation provides a preliminary framework and supportive evidence towards understanding the complex construct of physician volunteer engagement. The need for this research is particularly important in present day, where growing fiscal constraints create challenges for medical education to do more with less. PMID:28645956

Exploring the components of physician volunteer engagement: a qualitative investigation of a national Canadian simulation-based training programme.

PubMed

Sarti, Aimee J; Sutherland, Stephanie; Landriault, Angele; DesRosier, Kirk; Brien, Susan; Cardinal, Pierre

2017-06-23

Conceptual clarity on physician volunteer engagement is lacking in the medical literature. The aim of this study was to present a conceptual framework to describe the elements which influence physician volunteer engagement and to explore volunteer engagement within a national educational programme. The context for this study was the Acute Critical Events Simulation (ACES) programme in Canada, which has successfully evolved into a national educational programme, driven by physician volunteers. From 2010 to 2014, the programme recruited 73 volunteer healthcare professionals who contributed to the creation of educational materials and/or served as instructors. A conceptual framework was constructed based on an extensive literature review and expert consultation. Secondary qualitative analysis was undertaken on 15 semistructured interviews conducted from 2012 to 2013 with programme directors and healthcare professionals across Canada. An additional 15 interviews were conducted in 2015 with physician volunteers to achieve thematic saturation. Data were analysed iteratively and inductive coding techniques applied. From the physician volunteer data, 11 themes emerged. The most prominent themes included volunteer recruitment, retention, exchange, recognition, educator network and quasi-volunteerism. Captured within these interrelated themes were the framework elements, including the synergistic effects of emotional, cognitive and reciprocal engagement. Behavioural engagement was driven by these factors along with a cue to action, which led to contributions to the ACES programme. This investigation provides a preliminary framework and supportive evidence towards understanding the complex construct of physician volunteer engagement. The need for this research is particularly important in present day, where growing fiscal constraints create challenges for medical education to do more with less. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Culturally Targeted Strategies for Diabetes Prevention in Minority Populations: A Systematic Review and Framework

PubMed Central

Lagisetty, Pooja A.; Priyadarshini, Shubadra; Terrell, Stephanie; Hamati, Mary; Landgraf, Jessica; Chopra, Vineet; Heisler, Michele

2017-01-01

Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize four key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with four domains (FiLLM: Facilitating [i.e., delivering] Interventions through Language, Location and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were randomized controlled trials, and 22 were quasi-experimental trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved Hemoglobin A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least three culturally targeted domains. Seven studies used all four domains and were all successful. The least utilized domain was delivery (4/34) of the intervention’s key educational message. Conclusions Culturally tailoring interventions across the four domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain. Registration (PROSPERO registration: CRD42015016914) PMID:28118127

Deriving a Framework for a Systems Approach to Agitated Patient Care in the Emergency Department.

PubMed

Wong, Ambrose H; Ruppel, Halley; Crispino, Lauren J; Rosenberg, Alana; Iennaco, Joanne D; Vaca, Federico E

2018-05-01

The rising agitated patient population presenting to the emergency department (ED) has caused increasing safety threats for health care workers and patients. Development of evidence-based strategies has been limited by the lack of a structured framework to examine agitated patient care in the ED. In this study, a systems approach from the patient safety literature was used to derive a comprehensive theoretical framework for addressing ED patient agitation. A mixed-methods approach was used with ED staff members at an academic site and a community site of a regional health care network. Participants consisted of resident and attending physicians, physician assistants/nurse practitioners, nurses, technicians, and security officers. After a simulated agitated patient encounter to prime participants, uniprofessional and interprofessional focus groups were conducted, followed by a structured thematic analysis using a grounded theory approach. Quantitative data consisted of surveys of violence exposure and attitudes toward patient aggression and management. Data saturation was reached with 57 participants. Violence exposure was higher for technicians, nurses, and officers. Conflicting priorities and management challenges occurred due to four main interconnected elements: perceived complex patient motivations; a patient care paradox between professional duty and personal safety; discordant interprofessional dynamics mitigated by respect and trust; and logistical challenges impeding care delivery and long-term outcomes. Using a systems approach, five interconnected levels of ED agitated patient care delivery were identified: patient, staff, team, ED microsystem, and health care macrosystem. These care dimensions were synthesized to form a novel patient safety-based framework that can help guide future research, practice, and policy. Copyright © 2018 The Joint Commission. Published by Elsevier Inc. All rights reserved.

The Swedish duty hour enigma

PubMed Central

2014-01-01

Background The Swedish resident duty hour limit is regulated by Swedish and European legal frameworks. With a maximum average of 40 working hours per week, the Swedish duty hour regulation is one of the most restrictive in the world. At the same time, the effects of resident duty hour limits have been neither debated nor researched in the Swedish context. As a result, little is known about the Swedish conceptual framework for resident duty hours, their restriction, or their outcomes: we call this “the Swedish duty hour enigma.” This situation poses a further question: How do Swedish residents themselves construct a conceptual framework for duty hour restrictions? Methods A case study was conducted at Karolinska University Hospital, Stockholm – an urban, research-intensive hospital setting. Semi-structured interviews were carried out with 34 residents currently in training in 6 specialties. The empirical data analysis relied on theoretical propositions and was conducted thematically using a pattern-matching technique. The interview guide was based on four main topics: the perceived effect of duty hour restrictions on (1) patient care, (2) resident education, (3) resident well-being, and (4) research. Results The residents did not perceive the volume of duty hours to be the main determinant of success or failure in the four contextual domains of patient care, resident education, resident well-being, and research. Instead, they emphasized resident well-being and a desire for flexibility. Conclusions According to Swedish residents’ conceptual framework on duty hours, the amount of time spent on duty is not a proxy for the quality of resident training. Instead, flexibility, organization, and scheduling of duty hours are considered to be the factors that have the greatest influence on resident well-being, quality of learning, and opportunities to attain the competence needed for independent practice. PMID:25559074

[Assessing program sustainability in public health organizations: a tool-kit application in Haiti].

PubMed

Ridde, V; Pluye, P; Queuille, L

2006-10-01

Public health stakeholders are concerned about program sustainability. However, they usually conceive sustainability in accordance with financial criteria for at least one reason. No simple frameworks are operationally and theoretically sound enough to globally evaluate program sustainability. The present paper aims to describe an application of one framework assessment tool used to evaluate the sustainability level and process of a Nutritional Care Unit managed by a Swiss humanitarian agency to fight against severe child malnutrition in a Haitian area. The managing agency is committed to put this Unit back into the structure of a local public hospital. The evaluation was performed within the sustainability framework proposed in a former article. Data were collected with a combination of tools, semi-structured interviews (n=33, medical and support staff from the agency and the hospital), participatory observation and document review. Data concerned the four characteristics of organizational routines (memory, adaptation, values and rules) enabling assess to the level of sustainability. In addition, data were related to three types of events distinguishing routinization processes from implementation processes: specific events of routinization, routinization-implementation joint events, and specific events of implementation. Data analysis was thematic and results were validated by actors through a feed-back session and written comments. The current level of sustainability of the Nutritional Care Unit within the Hospital is weak: weak memory, high adaptation, weak sharing of values and rules. This may be explained by the sustainability process, and the absence of specific routinization events. The relevance of such processes is reasonable, while it has been strongly challenged in the troublesome Haitian context. Riots have been widespread over the last years, creating difficulties for the Hospital. This experience suggests the proposed framework and sustainability assessment tools are useful when the context permits scrutinization of program sustainability.

Qualitative Analysis of Parental Observations on Quality of Life in Australian Children with Down Syndrome.

PubMed

Murphy, Nada; Epstein, Amy; Leonard, Helen; Davis, Elise; Reddihough, Dinah; Whitehouse, Andrew; Jacoby, Peter; Bourke, Jenny; Williams, Katrina; Downs, Jenny

There are many challenges to health, functioning, and participation for children with Down syndrome; yet, the quality-of-life (QOL) domains important for this group have never been clearly articulated. This study investigated parental observations to identify QOL domains in children with Down syndrome and determined whether domains differed between children and adolescents. The sample comprised 17 families whose child with Down syndrome was aged 6 to 18 years. Primary caregivers took part in semistructured telephone interviews to explore aspects of their child's life that were satisfying or challenging. Qualitative thematic analysis was implemented using a grounded theory framework to identify domains. The coded data set was divided into 2 groups (childhood and adolescence) at 3 age cut points to observe whether differences existed between the coded domains and domain elements: (1) 6 to 11 years with 12 to 18 years; (2) 6 to 13 years with 14 to 18 years; and (3) 6 to 15 years with 16 to 18 years. Eleven domains were identified: physical health, behavior and emotion, personal value, communication, movement and physical activity, routines and predictability, independence and autonomy, social connectedness and relationships, variety of activities, nature and outdoors, and access to services. No differences in domains and domain elements were identified across childhood and adolescence. Our data form a preliminary framework from which to design investigations of the child's perspectives on life quality and suggest a range of necessary supports and services.

Applying findings from a systematic review of workplace-based e-learning: implications for health information professionals.

PubMed

Booth, Andrew; Carroll, Christopher; Papaioannou, Diana; Sutton, Anthea; Wong, Ruth

2009-03-01

To systematically review the UK published literature on e-learning in the health workplace and to apply the findings to one of the most prolific UK e-learning initiatives in the health sector--the National Library for Health Facilitated Online Learning Interactive Opportunity (FOLIO) Programme. Sensitive searches were conducted across ASSIA, Australian Education Index, British Education Index, cinahl, CSA Abstracts, Dissertation Abstracts, Emerald, ERIC, IBSS, Index to Theses, LISA, MEDLINE, PSYCINFO and Social Science Citation Index. Additional citations were identified from reference lists of included studies and of relevant reviews; citation tracking and contact with experts. Twenty-nine studies met the inclusion criteria and were coded and analysed using thematic analysis as described by Miles & Huberman (Qualitative Data Analysis: A Sourcebook of New Methods. Newbury Park, CA: Sage, 1984). Five broad themes were identified from the 29 included studies: (i) peer communication; (ii) flexibility; (iii) support; (iv) knowledge validation; and (v) course presentation and design. These broad themes were supported by a total of eleven sub-themes. Components from the FOLIO Programme were analysed and existing and proposed developments were mapped against each sub-theme. This provides a valuable framework for ongoing course development. Librarians involved in delivering and supporting e-learning can benefit from applying the findings from the systematic review to existing programmes, exemplified by the FOLIO Programme. The resultant framework can also be used in developing new e-learning programmes.

Evaluating Bang for the Buck: A Cost-Effectiveness Comparison Between Individual Interviews and Focus Groups Based on Thematic Saturation Levels

ERIC Educational Resources Information Center

Namey, Emily; Guest, Greg; McKenna, Kevin; Chen, Mario

2016-01-01

Evaluators often use qualitative research methods, yet there is little evidence on the comparative cost-effectiveness of the two most commonly employed qualitative methods--in-depth interviews (IDIs) and focus groups (FGs). We performed an inductive thematic analysis of data from 40 IDIs and 40 FGs on the health-seeking behaviors of African…

Social and Emotional Learning Competencies and Cross-Thematic Curriculum-Related Skills of Greek Students: A Multifactorial and Triangulation Analysis

ERIC Educational Resources Information Center

Tsolou, Olympia; Margaritis, Vasileios

2013-01-01

The cross-thematic curriculum (CTC) for school education has recently been implemented so that the quality of the Greek educational system is improved. This study aimed at assessing social and emotional learning competencies and CTC-related skills of 541 Greek students aged 11-13. Data triangulation was also used for validating these findings,…

Do not blame the driver: a systems analysis of the causes of road freight crashes.

PubMed

Newnam, Sharon; Goode, Natassia

2015-03-01

Although many have advocated a systems approach in road transportation, this view has not meaningfully penetrated road safety research, practice or policy. In this study, a systems theory-based approach, Rasmussens's (1997) risk management framework and associated Accimap technique, is applied to the analysis of road freight transportation crashes. Twenty-seven highway crash investigation reports were downloaded from the National Transport Safety Bureau website. Thematic analysis was used to identify the complex system of contributory factors, and relationships, identified within the reports. The Accimap technique was then used to represent the linkages and dependencies within and across system levels in the road freight transportation industry and to identify common factors and interactions across multiple crashes. The results demonstrate how a systems approach can increase knowledge in this safety critical domain, while the findings can be used to guide prevention efforts and the development of system-based investigation processes for the heavy vehicle industry. A research agenda for developing an investigation technique to better support the application of the Accimap technique by practitioners in road freight transportation industry is proposed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prenatal whole exome sequencing: the views of clinicians, scientists, genetic counsellors and patient representatives.

PubMed

Quinlan-Jones, Elizabeth; Kilby, Mark D; Greenfield, Sheila; Parker, Michael; McMullan, Dominic; Hurles, Matthew E; Hillman, Sarah C

2016-10-01

Focus groups were conducted with individuals involved in prenatal diagnosis to determine their opinions relating to whole exome sequencing in fetuses with structural anomalies. Five representatives of patient groups/charities (PRGs) and eight clinical professionals (CPs) participated. Three focus groups occurred (the two groups separately and then combined). Framework analysis was performed to elicit themes. A thematic coding frame was identified based on emerging themes. Seven main themes (consent, analysis, interpretation/reinterpretation of results, prenatal issues, uncertainty, incidental findings and information access) with subthemes emerged. The main themes were raised by both groups, apart from 'analysis', which was raised by CPs only. Some subthemes were raised by PRGs and CPs (with different perspectives). Others were raised either by PRGs or CPs, showing differences in patient/clinician agendas. Prenatal consent for whole exome sequencing is not a 'perfect' process, but consent takers should be fully educated regarding the test. PRGs highlighted issues involving access to results, feeling that women want to know all information. PRGs also felt that patients want reinterpretation of results over time, whilst CPs felt that interpretation should be performed at the point of testing only. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

Examining the media portrayal of obesity through the lens of the Common Sense Model of Illness Representations.

PubMed

De Brún, Aoife; McCarthy, Mary; McKenzie, Kenneth; McGloin, Aileen

2015-01-01

This study examined the Irish media discourse on obesity by employing the Common Sense Model of Illness Representations. A media sample of 368 transcripts was compiled from newspaper articles (n = 346), radio discussions (n = 5), and online news articles (n = 17) on overweight and obesity from the years 2005, 2007, and 2009. Using the Common Sense Model and framing theory to guide the investigation, a thematic analysis was conducted on the media sample. Analysis revealed that the behavioral dimensions of diet and activity levels were the most commonly cited causes of and interventions in obesity. The advertising industry was blamed for obesity, and there were calls for increased government action to tackle the issue. Physical illness and psychological consequences of obesity were prevalent in the sample, and analysis revealed that the economy, regardless of its state, was blamed for obesity. These results are discussed in terms of expectations of audience understandings of the issue and the implications of these dominant portrayals and framings on public support for interventions. The article also outlines the value of a qualitative analytical framework that combines the Common Sense Model and framing theory in the investigation of illness narratives.

Shifting the balance: conceptualising empowerment in individuals with spinal cord injury.

PubMed

Rohatinsky, Noelle; Goodridge, Donna; Rogers, Marla R; Nickel, Darren; Linassi, Gary

2017-03-01

Empowerment is believed to be an essential element in self-management of disease and the promotion of self-efficacy, and can be defined as the ability of individuals to increase control over aspects of their lives. In contrast, powerlessness in individuals with chronic illness can occur when they perceive that they lack the capacity, authority or resources to affect an outcome. Individuals with spinal cord injuries (SCIs) are at risk for powerlessness and have the potential to become empowered, but these concepts have not been explored within their context. The purpose of this study was to explore how individuals with SCI enact the empowerment process using Lord's (1991) process of empowerment framework. This study used a secondary analysis of a data set obtained from a mixed methods study exploring access to health and social care for 23 persons with SCI in Saskatchewan, Canada. The primary study data were collected from September 2012 to January 2013. The secondary analysis of data utilised a deductive thematic analysis approach and findings were conceptualised and applied to a model that represents the shift in balance between powerlessness and empowerment in individuals with SCI. © 2016 John Wiley & Sons Ltd.

Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis.

PubMed

Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I

2018-04-01

Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.

Implementing accountability for reasonableness framework at district level in Tanzania: a realist evaluation.

PubMed

Maluka, Stephen; Kamuzora, Peter; Sansebastián, Miguel; Byskov, Jens; Ndawi, Benedict; Olsen, Øystein E; Hurtig, Anna-Karin

2011-02-10

Despite the growing importance of the Accountability for Reasonableness (A4R) framework in priority setting worldwide, there is still an inadequate understanding of the processes and mechanisms underlying its influence on legitimacy and fairness, as conceived and reflected in service management processes and outcomes. As a result, the ability to draw scientifically sound lessons for the application of the framework to services and interventions is limited. This paper evaluates the experiences of implementing the A4R approach in Mbarali District, Tanzania, in order to find out how the innovation was shaped, enabled, and constrained by the interaction between contexts, mechanisms and outcomes. This study draws on the principles of realist evaluation -- a largely qualitative approach, chiefly concerned with testing and refining programme theories by exploring the complex interactions of contexts, mechanisms, and outcomes. Mixed methods were used in data collection, including individual interviews, non-participant observation, and document reviews. A thematic framework approach was adopted for the data analysis. The study found that while the A4R approach to priority setting was helpful in strengthening transparency, accountability, stakeholder engagement, and fairness, the efforts at integrating it into the current district health system were challenging. Participatory structures under the decentralisation framework, central government's call for partnership in district-level planning and priority setting, perceived needs of stakeholders, as well as active engagement between researchers and decision makers all facilitated the adoption and implementation of the innovation. In contrast, however, limited local autonomy, low level of public awareness, unreliable and untimely funding, inadequate accountability mechanisms, and limited local resources were the major contextual factors that hampered the full implementation. This study documents an important first step in the effort to introduce the ethical framework A4R into district planning processes. This study supports the idea that a greater involvement and accountability among local actors through the A4R process may increase the legitimacy and fairness of priority-setting decisions. Support from researchers in providing a broader and more detailed analysis of health system elements, and the socio-cultural context, could lead to better prediction of the effects of the innovation and pinpoint stakeholders' concerns, thereby illuminating areas that require special attention to promote sustainability.

Faculty verbal evaluations reveal strategies used to promote medical student performance

PubMed Central

Hauer, Karen E.; Mazotti, Lindsay; O'Brien, Bridget; Hemmer, Paul A.; Tong, Lowell

2011-01-01

Background Preceptors rarely follow medical students' developing clinical performance over time and across disciplines. This study analyzes preceptors' descriptions of longitudinal integrated clerkship (LIC) students' clinical development and their identification of strategies to guide students' progress. Methods We used a common evaluation framework, reporter-interpreter-manager-educator, to guide multidisciplinary LIC preceptors' discussions of students' progress. We conducted thematic analysis of transcripts from preceptors' (seven longitudinal ambulatory preceptors per student) quarterly group discussions of 15 students' performance over one year. Results All students' clinical development progressed, although most experienced obstacles. Lack of structure in the history and physical exam commonly obstructed progression. Preceptors used templates for data gathering, and modeling or experiences in the inpatient setting to provide time and solidify structure. To advance students' knowledge acquisition, many preceptors identified focused learning topics with their students; to promote application of knowledge, preceptors used reasoning strategies to teach the steps involved in synthesizing clinical data. Preceptors shared accountability for helping students advance as the LIC allowed them to follow students' response to teaching strategies. Discussion These results depict preceptors' perceptions of LIC students' developmental continuum and illustrate how multidisciplinary preceptors can use a common evaluation framework to identify strategies to improve performance and follow students' performance longitudinally. PMID:21629669

Place of family in recovery models for those with a mental illness.

PubMed

Reupert, Andrea; Maybery, Darryl; Cox, Merrilee; Scott Stokes, Eileen

2015-12-01

Within the context of mental illness, there is an acknowledgement that the social environment is critical to recovery. Nonetheless, how family roles and interactions are presented in recovery frameworks is unclear. This systematic review sought to: (i) identify how family is defined in recovery models, and (ii) synthesize how family relationships and roles are incorporated into recovery models for those with a mental illness. A systematic search of electronic databases was conducted for peer reviewed, English language papers published between 1980 to April 2013, from Ovid MEDLINE, PsycINFO, Proquest, CINAHL plus and Web of Knowledge. Studies were included if they presented a recovery framework and include primary data from people with a mental illness where family was incorporated. A narrative thematic analysis was conducted on the eligible 31 studies, using inductive, open coding techniques. Eight studies did not define what was meant by 'family' while 10 studies focused exclusively on an individual's relationships with parents; six papers collected parenting demographics. Family roles included being a (adult) child, parent, spouse and being part of a 'family'. Family interactions involved being passive recipients of family support, caring for elderly parents and children and reciprocal, give and take relationships. Family interactions and roles offer the opportunity to both facilitate and impede recovery. © 2015 Australian College of Mental Health Nurses Inc.

The impact of Masters education in manual and manipulative therapy and the 'knowledge acquisition model'.

PubMed

Perry, Jo; Green, Ann; Harrison, Karen

2011-06-01

This study aimed to explore the professional and personal impact that a clinical Masters program of manipulative therapy education had on the lives of individuals who had undertaken the course and was a follow-on study of participants' career pathways following Masters education (Green et al., 2008). Seven graduates from the program took part in a focus group. The narrative data obtained was independently verified prior to two researchers conducting a systematic, thematic content analysis. Three key themes were identified and the 'knowledge acquisition model' developed. Findings revealed that studying at Master's level is a 'life changing' and rewarding experience that develops individuals in three key domains; professionally, personally and intellectually. During Masters education students described a journey of multi-compartmental development whereby their knowledge-base was challenged and their existing cognitive framework deconstructed. Progression through the program resulted in the development of a new, clearer framework for thinking and understanding that extended, universally, into all aspects of their lives; clinically, managerially, emotionally, politically and intellectually. Participants also described two cultures for career progression in the UK National Health Service (NHS). Findings could help students considering undertaking Masters level education, employers and clinical mentors of these practitioners and academic educators. Copyright © 2010 Elsevier Ltd. All rights reserved.

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal’s self-regulatory model

PubMed Central

Heffernan, Eithne; Coulson, Neil S.; Henshaw, Helen; Barry, Johanna G.; Ferguson, Melanie A

2017-01-01

Objective This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined. Design Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure. Study sample Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling. Results Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one’s hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages. Conclusions This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework. PMID:26754550

"At My Age … ": Defining Sexual Wellness in Mid- and Later Life.

PubMed

Syme, Maggie L; Cohn, Tracy J; Stoffregen, Sydney; Kaempfe, Hanna; Schippers, Desiree

2018-04-18

Sexual wellness is integral to quality of life across the life span, despite ageist stereotypes suggesting sexual expression ends at midlife. However, conceptualizing sexual wellness in mid- and later life is complicated by a dysfunction-based narrative, lack of a sex-positive aging framework, and existing measures that are age irrelevant and limited in scope. This study aimed to address these limitations by providing a conceptualization of sexual wellness grounded in definitions from midlife and older adults. A sample of 373 midlife and older adults (M = 60, SD = 5.84) in the United States provided a definition of sexual wellness. Using thematic analysis, multiple researchers coded qualitative responses, and results suggested a biopsychosocial-cultural framework. Findings reflect that midlife and older adults provide multifaceted definitions inclusive of various behavioral experiences, including disengaging from sex. They are also keenly aware of physical and psychological limitations and strengths, and emphasize mutual experiences and synchronicity. Midlife and older adults also reflect on age, drawing comparisons to different phases of life and often displaying adaptability in adjusting expectations. When conceptualizing sexual wellness in this population it is imperative to capture this multidimensionality, include those who are not actively engaging in sex, and be aware of the influence of ageist and dys/function narratives.

Binary constructs of forensic psychiatric nursing: a pilot study.

PubMed

Mason, T; Dulson, J; King, L

2009-03-01

The aim was to develop an Information Gathering Schedule (IGS) relevant to forensic psychiatric nursing in order to establish the perceived differences in the three levels of security, high, medium and low. Perceived differences in the role constructs of forensic psychiatric nursing is said to exist but the evidence is qualitative or anecdotal. This paper sets out a pilot study beginning in 2004 relating to the development of two rating scales for inclusion into an IGS to acquire data on the role constructs of nurses working in these environments. Following a thematic analysis from the literature two sets of binary frameworks were constructed and a number of questions/statements relating to them were tested. The Thurstone Scaling test was applied to compute medians resulting in a reduction to 48 and 20 items for each respective framework. Two 7-point Likert scales were constructed and test-retest procedures were applied on a sample population of forensic psychiatric nurses. Student's t-test was conducted on the data and the results suggest that the IGS is now suitable for application on a larger study. The IGS was piloted on a small sample of forensic psychiatric nurses. The two scales were validated to coefficient values ranging from 0.7 to 0.9. Amendments were made and the IGS was considered acceptable.

Health, energy vulnerability and climate change: a retrospective thematic analysis of primary care trust policies and practices.

PubMed

Richardson, J; Kagawa, F; Nichols, A

2009-12-01

To review publicly available documents produced by primary care trusts (PCTs) to assess the extent to which local activity and planning consider energy vulnerability, climate change and sustainability. Retrospective thematic content analysis of publicly available materials located on PCT websites. Thematic content analysis of publicly available materials was undertaken by two researchers over a 6-month period in 2008. These materials were obtained from the websites of 30 PCTs in England. Materials included annual reports, plans, policies and strategy documents. Of the 30 PCT websites studied, four were found to have an absence of content related to climate change, energy vulnerability and sustainability. Of the remaining 26 PCT websites, consistent themes were found: strategic initiatives, joint working with other agencies, promoting sustainable communities, and targeted actions. Evidence of good examples in sustainable development was predominantly limited to policy statements and strategic aims; evidence of action was limited. As champions of the public health agenda, PCT action on sustainability should be integral to all aspects of organizational governance.

Evaluation of SLAR and simulated thematic mapper MSS data for forest cover mapping using computer-aided analysis techniques

NASA Technical Reports Server (NTRS)

Hoffer, R. M.; Dean, M. E.; Knowlton, D. J.; Latty, R. S.

1982-01-01

Kershaw County, South Carolina was selected as the study site for analyzing simulated thematic mapper MSS data and dual-polarized X-band synthetic aperture radar (SAR) data. The impact of the improved spatial and spectral characteristics of the LANDSAT D thematic mapper data on computer aided analysis for forest cover type mapping was examined as well as the value of synthetic aperture radar data for differentiating forest and other cover types. The utility of pattern recognition techniques for analyzing SAR data was assessed. Topics covered include: (1) collection and of TMS and reference data; (2) reformatting, geometric and radiometric rectification, and spatial resolution degradation of TMS data; (3) development of training statistics and test data sets; (4) evaluation of different numbers and combinations of wavelength bands on classification performance; (5) comparison among three classification algorithms; and (6) the effectiveness of the principal component transformation in data analysis. The collection, digitization, reformatting, and geometric adjustment of SAR data are also discussed. Image interpretation results and classification results are presented.

A cognitive perspective on health systems integration: results of a Canadian Delphi study.

PubMed

Evans, Jenna M; Baker, G Ross; Berta, Whitney; Barnsley, Jan

2014-05-19

Ongoing challenges to healthcare integration point toward the need to move beyond structural and process issues. While we know what needs to be done to achieve integrated care, there is little that informs us as to how. We need to understand how diverse organizations and professionals develop shared knowledge and beliefs - that is, we need to generate knowledge about normative integration. We present a cognitive perspective on integration, based on shared mental model theory, that may enhance our understanding and ability to measure and influence normative integration. The aim of this paper is to validate and improve the Mental Models of Integrated Care (MMIC) Framework, which outlines important knowledge and beliefs whose convergence or divergence across stakeholder groups may influence inter-professional and inter-organizational relations. We used a two-stage web-based modified Delphi process to test the MMIC Framework against expert opinion using a random sample of participants from Canada's National Symposium on Integrated Care. Respondents were asked to rate the framework's clarity, comprehensiveness, usefulness, and importance using seven-point ordinal scales. Spaces for open comments were provided. Descriptive statistics were used to describe the structured responses, while open comments were coded and categorized using thematic analysis. The Kruskall-Wallis test was used to examine cross-group agreement by level of integration experience, current workplace, and current role. In the first round, 90 individuals responded (52% response rate), representing a wide range of professional roles and organization types from across the continuum of care. In the second round, 68 individuals responded (75.6% response rate). The quantitative and qualitative feedback from experts was used to revise the framework. The re-named "Integration Mindsets Framework" consists of a Strategy Mental Model and a Relationships Mental Model, comprising a total of nineteen content areas. The Integration Mindsets Framework draws the attention of researchers and practitioners to how various stakeholders think about and conceptualize integration. A cognitive approach to understanding and measuring normative integration complements dominant cultural approaches and allows for more fine-grained analyses. The framework can be used by managers and leaders to facilitate the interpretation, planning, implementation, management and evaluation of integration initiatives.

A scoping review of spatial cluster analysis techniques for point-event data.

PubMed

Fritz, Charles E; Schuurman, Nadine; Robertson, Colin; Lear, Scott

2013-05-01

Spatial cluster analysis is a uniquely interdisciplinary endeavour, and so it is important to communicate and disseminate ideas, innovations, best practices and challenges across practitioners, applied epidemiology researchers and spatial statisticians. In this research we conducted a scoping review to systematically search peer-reviewed journal databases for research that has employed spatial cluster analysis methods on individual-level, address location, or x and y coordinate derived data. To illustrate the thematic issues raised by our results, methods were tested using a dataset where known clusters existed. Point pattern methods, spatial clustering and cluster detection tests, and a locally weighted spatial regression model were most commonly used for individual-level, address location data (n = 29). The spatial scan statistic was the most popular method for address location data (n = 19). Six themes were identified relating to the application of spatial cluster analysis methods and subsequent analyses, which we recommend researchers to consider; exploratory analysis, visualization, spatial resolution, aetiology, scale and spatial weights. It is our intention that researchers seeking direction for using spatial cluster analysis methods, consider the caveats and strengths of each approach, but also explore the numerous other methods available for this type of analysis. Applied spatial epidemiology researchers and practitioners should give special consideration to applying multiple tests to a dataset. Future research should focus on developing frameworks for selecting appropriate methods and the corresponding spatial weighting schemes.

The nature and origin of mineral coatings on volcanic rocks of the Black Mountain, Stonewall Mountain and Kane Springs Wash volcanic centers in southern Nevada

NASA Technical Reports Server (NTRS)

Taranik, J. V.; Noble, D. D.; Hsu, L. C.; Hutsinpiller, A.

1986-01-01

Four LANDSAT thematic mapping scenes in southern Nevada were requested at two different acquisition times in order to assess the effect of vegetation on the signature of the volcanic units. The remote sensing data acquisition and analysis portion are nearly completed. The LANDSAT thematic mapping data is of good quality, and image analysis techniques are so far successful in delineating areas with distinct spectral characteristics. Spectrally distinct areas were correlated with variations in surface coating and lithologies of the volcanic rocks.

Thematic mapper data analysis

NASA Technical Reports Server (NTRS)

Settle, M.; Chavez, P.; Kieffer, H. H.; Everett, J. R.; Kahle, A. B.; Kitcho, C. A.; Milton, N. M.; Mouat, D. A.

1983-01-01

The geological applications of remote sensing technology are discussed, with emphasis given to the analysis of data from the Thematic Mapper (TM) instrument onboard the Landsat 4 satellite. The flight history and design characteristics of the Landsat 4/TM are reviewed, and some difficulties endountered in the interpretation of raw TM data are discussed, including: the volume of data; residual noise; detector-to-detector striping; and spatial misregistration between measurements. Preliminary results of several geological, lithological, geobotanical mapping experiments are presented as examples of the geological applications of the TM, and some areas for improving the guality of TM imagery are identified.

A study of thematic content in hospital mission statements: a question of values.

PubMed

Williams, Jaime; Smythe, William; Hadjistavropoulos, Thomas; Malloy, David C; Martin, Ronald

2005-01-01

We examined the content of Canadian hospital mission statements using thematic content analysis. The mission statements that we studied varied in terms of both content and length. Although there was some content related to goals designed to ensure organizational visibility, survival, and competitiveness, the domain of values predominated over our entire coding structure. The primary value-related theme that emerged concerned the importance of patient care.

What Factors Affect Voluntary Uptake of Community-Based Health Insurance Schemes in Low- and Middle-Income Countries? A Systematic Review and Meta-Analysis

PubMed Central

Hossain, S. A. Shahed; Pérez Koehlmoos, Tracey Lynn; John, Denny

2016-01-01

Introduction This research article reports on factors influencing initial voluntary uptake of community-based health insurance (CBHI) schemes in low- and middle-income countries (LMIC), and renewal decisions. Methods Following PRISMA protocol, we conducted a comprehensive search of academic and gray literature, including academic databases in social science, economics and medical sciences (e.g., Econlit, Global health, Medline, Proquest) and other electronic resources (e.g., Eldis and Google scholar). Search strategies were developed using the thesaurus or index terms (e.g., MeSH) specific to the databases, combined with free text terms related to CBHI or health insurance. Searches were conducted from May 2013 to November 2013 in English, French, German, and Spanish. From the initial search yield of 15,770 hits, 54 relevant studies were retained for analysis of factors influencing enrolment and renewal decisions. The quantitative synthesis (informed by meta-analysis) and the qualitative analysis (informed by thematic synthesis) were compared to gain insight for an overall synthesis of findings/statements. Results Meta-analysis suggests that enrolments in CBHI were positively associated with household income, education and age of the household head (HHH), household size, female-headed household, married HHH and chronic illness episodes in the household. The thematic synthesis suggests the following factors as enablers for enrolment: (a) knowledge and understanding of insurance and CBHI, (b) quality of healthcare, (c) trust in scheme management. Factors found to be barriers to enrolment include: (a) inappropriate benefits package, (b) cultural beliefs, (c) affordability, (d) distance to healthcare facility, (e) lack of adequate legal and policy frameworks to support CBHI, and (f) stringent rules of some CBHI schemes. HHH education, household size and trust in the scheme management were positively associated with member renewal decisions. Other motivators were: (a) knowledge and understanding of insurance and CBHI, (b) healthcare quality, (c) trust in scheme management, and (d) receipt of an insurance payout the previous year. The barriers to renewal decisions were: (a) stringent rules of some CBHI schemes, (b) inadequate legal and policy frameworks to support CBHI and (c) inappropriate benefits package. Conclusion and Policy Implications The demand-side factors positively affecting enrolment in CBHI include education, age, female household heads, and the socioeconomic status of households. Moreover, when individuals understand how their CBHI functions they are more likely to enroll and when people have a positive claims experience, they are more likely to renew. A higher prevalence of chronic conditions or the perception that healthcare is of good quality and nearby act as factors enhancing enrolment. The perception that services are distant or deficient leads to lower enrolments. The second insight is that trust in the scheme enables enrolment. Thirdly, clarity about the legal or policy framework acts as a factor influencing enrolments. This is significant, as it points to hitherto unpublished evidence that governments can effectively broaden their outreach to grassroots groups that are excluded from social protection by formulating supportive regulatory and policy provisions even if they cannot fund such schemes in full, by leveraging people’s willingness to exercise voluntary and contributory enrolment in a community-based health insurance. PMID:27579731

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

PubMed

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

2009-04-01

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

The development of a framework for high-quality, sustainable and accessible rural private therapy under the Australian National Disability Insurance Scheme.

PubMed

Dew, Angela; Barton, Rebecca; Ragen, Jo; Bulkeley, Kim; Iljadica, Alexandra; Chedid, Rebecca; Brentnall, Jennie; Bundy, Anita; Lincoln, Michelle; Gallego, Gisselle; Veitch, Craig

2016-12-01

The Australian National Disability Insurance Scheme (NDIS) will provide people with individual funding with which to purchase services such as therapy from private providers. This study developed a framework to support rural private therapists to meet the anticipated increase in demand. The study consisted of three stages utilizing focus groups, interviews and an online expert panel. Participants included private therapists delivering services in rural New South Wales (n = 28), disability service users (n = 9) and key representatives from a range of relevant consumer and service organizations (n = 16). We conducted a thematic analysis of focus groups and interview data and developed a draft framework which was subsequently refined based on feedback from stakeholders. The framework highlights the need for a 'rural-proofed' policy context in which service users, therapists and communities engage collaboratively in a therapy pathway. This collaborative engagement is supported by enablers, including networks, resources and processes which are influenced by the drivers of time, cost, opportunity and motivation. The framework identifies factors that will facilitate delivery of high-quality, sustainable, individualized private therapy services for people with a disability in rural Australia under the NDIS and emphasizes the need to reconceptualize the nature of private therapy service delivery. Implications for Rehabilitation Rural private therapists need upskilling to work with individuals with disability who have individual funding such as that provided by the Australian National Disability Insurance Scheme. Therapists working in rural communities need to consider alternative ways of delivering therapy to individuals with disability beyond the traditional one-on-one therapy models. Rural private therapists need support to work collaboratively with individuals with disability and the local community. Rural private therapists should harness locally available and broader networks, resources and processes to meet the needs and goals of individuals with disability.

"What is meant by public?": Stakeholder views on strengthening impacts of public reporting of hospital performance data.

PubMed

Canaway, Rachel; Bismark, Marie; Dunt, David; Prang, Khic-Houy; Kelaher, Margaret

2018-04-01

Public reporting of hospital performance data is a developing area that is gaining increased attention. This is the first study to explore a range of stakeholder opinions on how such public reporting could be strengthened in Australia. Thirty-four semi-structured interviews were conducted with a purposive sample of expert healthcare consumer, provider and purchaser informants who worked in a variety of senior roles and had knowledge of or involvement in public reporting of hospital data within the public or private healthcare sectors. Informants from all Australian states, territory and national jurisdictions participated. Thematic analysis was used to gain an overview of experts' opinions to inform policy and systems-development for strengthening foundational frameworks for public reporting of health services performance. Themes arising were synthesised to generate explanatory figures to highlight key areas for strengthening public reporting. Our findings suggest that in Australia there is a lack of agreement on what the objectives and who the audience are for public reporting of hospital performance data. Without this shared understanding it is difficult to strengthen frameworks and impacts of public reporting. When developing frameworks for public reporting of hospital data in Australia, more explicit definition of what or who are the 'public' is needed along with identification of barriers, desired impacts, data needs, and data collection/reporting/feedback mechanisms. All relevant stakeholders should be involved in design of public reporting frameworks. Offering multiple systems of public reporting, each tailored to particular audiences, might enable greater impact of reporting towards improved hospital quality and safety, and consumer knowledge to inform treatment decisions. This study provides an overview of perspectives, but further research is warranted to develop PR frameworks that can generate greatest impacts for the needs of various audiences. Copyright © 2018 Elsevier Ltd. All rights reserved.

Implementation of a consumer-focused eHealth intervention for people with moderate-to-high cardiovascular disease risk: protocol for a mixed-methods process evaluation.

PubMed

Coorey, Genevieve M; Neubeck, Lis; Usherwood, Timothy; Peiris, David; Parker, Sharon; Lau, Annie Y S; Chow, Clara; Panaretto, Kathryn; Harris, Mark; Zwar, Nicholas; Redfern, Julie

2017-01-11

Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understanding how, why and among whom such strategies have an effect can help determine the requirements for implementing them at a scale. This paper aims to detail a process evaluation that will (1) assess implementation fidelity of a multicomponent eHealth intervention; (2) determine its effective features; (3) explore contextual factors influencing and maintaining user engagement; and (4) describe barriers, facilitators, preferences and acceptability of such interventions. Mixed-methods sequential design to derive, examine, triangulate and report data from multiple sources. Quantitative data from 3 sources will help to inform both sampling and content framework for the qualitative data collection: (1) surveys of patients and general practitioners (GPs); (2) software analytics; (3) programme delivery records. Qualitative data from interviews with patients and GPs, focus groups with patients and field notes taken by intervention delivery staff will be thematically analysed. Concurrent interview data collection and analysis will enable a thematic framework to evolve inductively and inform theory building, consistent with a realistic evaluation perspective. Eligible patients are those at moderate-to-high CVD risk who were randomised to the intervention arm of a randomised controlled trial of an eHealth intervention and are contactable at completion of the follow-up period; eligible GPs are the primary healthcare providers of these patients. Ethics approval has been received from the University of Sydney Human Research Ethics Committee and the Aboriginal Health and Medical Research Council (AH&MRC) of New South Wales. Results will be disseminated via scientific forums including peer-reviewed publications and national and international conferences. ANZCTR 12613000715774. 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/.

Contextualized analysis of a needs assessment using the Theoretical Domains Framework: a case example in endocrinology

PubMed Central

2014-01-01

Background The Theoretical Domains Framework (TDF) is a set of 14 domains of behavior change that provide a framework for the critical issues and factors influencing optimal knowledge translation. Considering that a previous study has identified optimal knowledge translation techniques for each TDF domain, it was hypothesized that the TDF could be used to contextualize and interpret findings from a behavioral and educational needs assessment. To illustrate this hypothesis, findings and recommendations drawn from a 2012 national behavioral and educational needs assessment conducted with healthcare providers who treat and manage Growth and Growth Hormone Disorders, will be discussed using the TDF. Methods This needs assessment utilized a mixed-methods research approach that included a combination of: [a] data sources (Endocrinologists (n:120), Pediatric Endocrinologists (n:53), Pediatricians (n:52)), [b] data collection methods (focus groups, interviews, online survey), [c] analysis methodologies (qualitative - analyzed through thematic analysis, quantitative - analyzed using frequencies, cross-tabulations, and gap analysis). Triangulation was used to generate trustworthy findings on the clinical practice gaps of endocrinologists, pediatric endocrinologists, and general pediatricians in their provision of care to adult patients with adult growth hormone deficiency or acromegaly, or children/teenagers with pediatric growth disorders. The identified gaps were then broken into key underlying determinants, categorized according to the TDF domains, and linked to optimal behavioral change techniques. Results The needs assessment identified 13 gaps, each with one or more underlying determinant(s). Overall, these determinants were mapped to 9 of the 14 TDF domains. The Beliefs about Consequences domain was identified as a contributing determinant to 7 of the 13 challenges. Five of the gaps could be related to the Skills domain, while three were linked to the Knowledge domain. Conclusions The TDF categorization of the needs assessment findings allowed recommendation of appropriate behavior change techniques for each underlying determinant, and facilitated communication and understanding of the identified issues to a broader audience. This approach provides a means for health education researchers to categorize gaps and challenges identified through educational needs assessments, and facilitates the application of these findings by educators and knowledge translators, by linking the gaps to recommended behavioral change techniques. PMID:25060235

Contextualized analysis of a needs assessment using the Theoretical Domains Framework: a case example in endocrinology.

PubMed

Lazure, Patrice; Bartel, Robert C; Biller, Beverly M K; Molitch, Mark E; Rosenthal, Stephen M; Ross, Judith L; Bernsten, Brock D; Hayes, Sean M

2014-07-24

The Theoretical Domains Framework (TDF) is a set of 14 domains of behavior change that provide a framework for the critical issues and factors influencing optimal knowledge translation. Considering that a previous study has identified optimal knowledge translation techniques for each TDF domain, it was hypothesized that the TDF could be used to contextualize and interpret findings from a behavioral and educational needs assessment. To illustrate this hypothesis, findings and recommendations drawn from a 2012 national behavioral and educational needs assessment conducted with healthcare providers who treat and manage Growth and Growth Hormone Disorders, will be discussed using the TDF. This needs assessment utilized a mixed-methods research approach that included a combination of: [a] data sources (Endocrinologists (n:120), Pediatric Endocrinologists (n:53), Pediatricians (n:52)), [b] data collection methods (focus groups, interviews, online survey), [c] analysis methodologies (qualitative - analyzed through thematic analysis, quantitative - analyzed using frequencies, cross-tabulations, and gap analysis). Triangulation was used to generate trustworthy findings on the clinical practice gaps of endocrinologists, pediatric endocrinologists, and general pediatricians in their provision of care to adult patients with adult growth hormone deficiency or acromegaly, or children/teenagers with pediatric growth disorders. The identified gaps were then broken into key underlying determinants, categorized according to the TDF domains, and linked to optimal behavioral change techniques. The needs assessment identified 13 gaps, each with one or more underlying determinant(s). Overall, these determinants were mapped to 9 of the 14 TDF domains. The Beliefs about Consequences domain was identified as a contributing determinant to 7 of the 13 challenges. Five of the gaps could be related to the Skills domain, while three were linked to the Knowledge domain. The TDF categorization of the needs assessment findings allowed recommendation of appropriate behavior change techniques for each underlying determinant, and facilitated communication and understanding of the identified issues to a broader audience. This approach provides a means for health education researchers to categorize gaps and challenges identified through educational needs assessments, and facilitates the application of these findings by educators and knowledge translators, by linking the gaps to recommended behavioral change techniques.

Increasing community capacity to prevent childhood obesity: challenges, lessons learned and results from the Romp & Chomp intervention.

PubMed

de Groot, Florentine P; Robertson, Narelle M; Swinburn, Boyd A; de Silva-Sanigorski, Andrea M

2010-08-31

Obesity is a major public health issue; however, only limited evidence is available about effective ways to prevent obesity, particularly in early childhood. Romp & Chomp was a community-wide obesity prevention intervention conducted in Geelong Australia with a target group of 12,000 children aged 0-5 years. The intervention had an environmental and capacity building focus and we have recently demonstrated that the prevalence of overweight/obesity was lower in intervention children, post-intervention. Capacity building is defined as the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion and the aim of this study was to determine if the capacity of the Geelong community, represented by key stakeholder organisations, to support healthy eating and physical activity for young children was increased after Romp & Chomp. A mixed methods evaluation with three data sources was utilised. 1) Document analysis comprised assessment of the documented formative and intervention activities against a capacity building framework (five domains: Partnerships, Leadership, Resource Allocation, Workforce Development, and Organisational Development); 2) Thematic analysis of key informant interviews (n = 16); and 3) the quantitative Community Capacity Index Survey. Document analysis showed that the majority of the capacity building activities addressed the Partnerships, Resource Allocation and Organisational Development domains of capacity building, with a lack of activity in the Leadership and Workforce Development domains. The thematic analysis revealed the establishment of sustainable partnerships, use of specialist advice, and integration of activities into ongoing formal training for early childhood workers. Complex issues also emerged from the key informant interviews regarding the challenges of limited funding, high staff turnover, changing governance structures, lack of high level leadership and unclear communication strategies. The Community Capacity Index provided further evidence that the project implementation network achieved a moderate level of capacity. Romp & Chomp increased the capacity of organisations, settings and services in the Geelong community to support healthy eating and physical activity for young children. Despite this success there are important learnings from this mixed methods evaluation that should inform current and future community-based public health and health promotion initiatives. ANZCTRN12607000374460.

Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project.

PubMed

Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

2014-10-01

The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity 'assets' and 'needs', and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations' resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for strengthening universities' capacity include: refining HPSR+A vision, mainstreaming the subject into under- and post-graduate teaching, developing emerging leaders and aligning HPSR+A capacity strengthening within the wider organizational development. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project

PubMed Central

Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

2014-01-01

The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity ‘assets’ and ‘needs’, and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations’ resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for strengthening universities’ capacity include: refining HPSR+A vision, mainstreaming the subject into under- and post-graduate teaching, developing emerging leaders and aligning HPSR+A capacity strengthening within the wider organizational development. PMID:24038107

Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis.

PubMed

Ahmed, Tanvir; Long, Thanh Nguyen; Huong, Phan Thi; Stewart, Donald Edwin

2015-01-29

Hai Phong, located in northern Vietnam, has become a high HIV prevalence province among Injecting Drug Users (IDUs) since the infection shifted from the southern to the northern region of the country. Previous research indicates high levels of drug and sex related risk behaviour especially among younger IDUs. Our recent qualitative research provides a deeper understanding of HIV risk behaviour and highlights views and experiences of IDUs relating to drug injecting and sharing practices. Fifteen IDUs participated in semi-structured interviews conducted in September-October, 2012. Eligible participants were selected from those recruited in a larger scale behavioural research project and identified through screening questions. Interviews were conducted by two local interviewers in Vietnamese and were audiotaped. Ethical procedures, including informed consent and participants' understanding of their right to skip and withdraw, were applied. Transcripts were translated and double checked. The data were categorised and coded according to themes. Thematic analysis was conducted and a qualitative data analysis thematic framework was used. Qualitative analysis highlighted situational circumstances associated with HIV risks among IDUs in Hai Phong and revealed three primary themes: (i) places for injecting, (ii) injecting drugs in small groups, and (iii) sharing practices. Our results showed that shared use of jointly purchased drugs and group injecting were widespread among IDUs without adequate recognition of these as HIV risk behaviours. Frequent police raids generated a constant fear of arrest. As a consequence, the majority preferred either rail lines or isolated public places for injection, while some injected in their own or a friend's home. Price, a heroin crisis, and strong group norms encouraged collective preparation and group injecting. Risk practices were enhanced by a number of factors: the difficulty in getting new syringes, quick withdrawal management, punitive attitudes, fear of arrest/imprisonment, lack of resources, incorrect self-assessment, and risk denial. Some of the IDU participants emphasised self-care attitudes which should be encouraged to minimise HIV transmission risk. The IDUs' experiences in Hai Phong identified through our data broaden our qualitative understanding about the HIV transmission risk among IDUs and emphasize the need to strengthen harm reduction services in Vietnam.

Analyzing the research in Integrative & Complementary Medicine by means of science mapping.

PubMed

Moral-Muñoz, J A; Cobo, M J; Peis, E; Arroyo-Morales, M; Herrera-Viedma, E

2014-04-01

The research in the Complementary and Alternative Medicine (CAM) field is analyzed according to the journals indexed in ISI Web of Science. Science Mapping Analysis (SMA) is used to provide and overview of the conceptual evolution of the CAM field. The software SciMAT is used to detect and visualize the hidden themes and their evolution over a consecutive span of years. It combines SMA and performance analysis. Twenty one journals related to CAM were analyzed, in four consecutive periods from 1974 to 2011. Strategic diagrams and the thematic evolution of CAM, together with performance indicators (h-index), were obtained. The results show that CAM research has focused on seven main thematic areas: MEDICINAL-PLANTS, CHIROPRACTIC-AND-LOW-BACK-PAIN, ACUPUNCTURE-AND-PAIN, CELL-PROCESSES-AND-DISEASES, LIPID-PEROXIDATION and DIABETES-AND-INSULIN. The research output could be used by the scientific community to identify thematic areas on which interest is focused. Copyright © 2014 Elsevier Ltd. All rights reserved.

Qualitative thematic analysis of the phenomenology of near-death experiences.

PubMed

Cassol, Helena; Pétré, Benoît; Degrange, Sophie; Martial, Charlotte; Charland-Verville, Vanessa; Lallier, François; Bragard, Isabelle; Guillaume, Michèle; Laureys, Steven

2018-01-01

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers' (NDErs) lives. Previous studies have shown that NDEs memories are phenomenologically rich. In the present study, we therefore aimed to extract the common themes (referred to as "features" in the NDE literature) reported by NDErs by analyzing all the concepts stored in the narratives of their experiences. A qualitative thematic analysis has been carried out on 34 cardiac arrest survivors' NDE narratives. Our results shed the light on the structure of the narratives by identifying 10 "time-bounded" themes which refer to isolated events encountered during the NDE and 1 "transversal" theme which characterizes the whole narrative and generally appears as a retrospective comment of self-reflection on the experience. The division of narratives into themes provides us with detailed information about the vocabulary used by NDErs to describe their experience. This established thematic method enables a rigorous description of the phenomenon, ensuring the inclusion of all self-reported manifestations of themes in narratives.

Value to Whom? The Patient Voice in the Value Discussion.

PubMed

Perfetto, Eleanor M; Oehrlein, Elisabeth M; Boutin, Marc; Reid, Sarah; Gascho, Eric

2017-02-01

Professional societies and other organizations have recently taken a visible role trying to define treatment value via value frameworks and assessments, providing payer or provider recommendations, and potentially impacting patient access. Patient perspectives routinely differ from those of other stakeholders. Yet, it is not always apparent that patients were engaged in value framework development or assessment. To describe the development and content of the National Health Council's (NHC's) Rubric, a tool that includes criteria for evaluation of value frameworks specifically with regard to patient-centeredness and meaningful patient engagement. The NHC held a multistakeholder, invitational roundtable in Washington, DC, in 2016. Participants reviewed existing patient-engagement rubrics, discussed experiences with value frameworks, debated and thematically grouped hallmark patient-centeredness characteristics, and developed illustrative examples of the characteristics. These materials were organized into the rubric, and subsequently vetted via multistakeholder peer review. The resulting rubric describes six domains of patient-centered value frameworks: partnership, transparency, inclusiveness, diversity, outcomes, and data sources. Each domain includes specific examples illustrating how patient engagement and patient-centeredness can be operationalized in value framework processes. The NHC multistakeholder roundtable's recommendations are captured in the NHC's Rubric to assess value framework and model patient-centeredness and patient engagement. The Rubric is a tool that will be refined over time on the basis of feedback from patient, patient group, framework developer, and other stakeholder-use experiences. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Parental perspectives of screening for adverse childhood experiences in pediatric primary care.

PubMed

Conn, Anne-Marie; Szilagyi, Moira A; Jee, Sandra H; Manly, Jody T; Briggs, Rahil; Szilagyi, Peter G

2018-03-01

Pediatricians recognize a need to mitigate the negative impact that adverse childhood experiences (ACEs) can have on health and development. However, ACEs screening and interventions in primary care pediatrics may be inhibited by concerns about parental perceptions. We assessed parent perspectives of screening for ACEs in the pediatric primary care setting, to understand their views on the potential impact of their ACEs on their parenting and to identify opportunities for pediatric anticipatory guidance. We used purposive sampling to recruit parents of children <6 years receiving care at an urban, pediatric clinic. Semistructured questions guided 1:1 interviews that were later coded by multiple researchers to verify reliability. A thematic framework approach guided analysis and identified main themes and subthemes. We reached thematic saturation after 15 parent interviews, which consistently revealed 3 interrelated themes. First, parents strongly supported ACEs screening as a bridge to needed services, and they recommended using a trauma-sensitive, person-centered approach in pediatric practices. Second, parents understood the intergenerational impact of ACEs and expressed a desire to break the cycle of adversity. Finally, parents saw their child's pediatrician as a potential change-agent who could provide support to meet their parenting goals. Parents want to discuss their ACEs and receive help and guidance from pediatricians. Furthermore, they perceive their child's pediatrician as having an important role to play in meeting their parenting goals. It is important to ensure that pediatricians have the training, skills and familiarity with available resources to meet parental expectations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Influences on vaginal birth after caesarean section: A qualitative study of Taiwanese women.

PubMed

Chen, Mei-Man; McKellar, Lois; Pincombe, Jan

2017-04-01

Vaginal birth is a safe mode of birth for most women who have had a prior caesarean with a transverse incision. Despite the evidence, most Taiwanese women who have had a previous caesarean are rarely offered the opportunity to consider any possibility other than a repeat caesarean. This study explored factors affecting Taiwanese women's decisionmaking regarding vaginal birth after cesarean. Ajzen's Theory of Planned Behaviour provided the theoretical framework to underpin the study, which adopted an interpretive descriptive methodology. Sequential semi-structured interviews were conducted with 29 women who had a previous caesarean and were pregnant between 34 and 38 weeks gestation, ten women who attempted vaginal birth in the third to fifth day postpartum, and 25 women in the fourth week postpartum. Boyatzis' method of thematic analysis was used to identify themes and codes. This paper reports the findings of the prenatal interviews with 29 participants. The major factor influencing women's decision-making was to avoid negative outcomes for themselves and their babies. Three thematic codes describe influences on the women's decisions: 'past experience of childbirth', 'anticipating the next experience of normal birth' and 'contemplation on the process of childbirth'. Women who have had a previous caesarean section are prepared to have a vaginal birth but are not always supported to carry out this decision. Changing the models of antenatal care is recommended as a strategy to overcome this difficulty therefore empowering women to make a meaningful choice about VBAC after a CS. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Structural Forces and the Production of TB-related Stigma among Haitians in Two Contexts

PubMed Central

Coreil, Jeannine; Mayard, Gladys; Simpson, Kelly M; Lauzardo, Michael; Zhu, Yiliang; Weiss, Mitchell

2012-01-01

In recent years renewed interest in health-related stigma has underscored the importance of better understanding the structural underpinnings of stigma processes. This study investigated the influence of sociocultural context on perceived components of tuberculosis-related stigma in non-affected persons by comparing Haitians living in South Florida, USA, with Haitians residing in Léogane Commune, Haiti. Using the methods of cultural epidemiology, a two-phase study based on fieldwork between 2004–07 collected ethnographic data on the cultural context and components of tuberculosis (TB) stigma, and administered a stigma scale developed specifically for these populations. Thematic analysis of stigma components expressed in interviews, focus groups and observation revealed commonalities as well as distinctive emphases of TB stigma in the two comparison groups. Factor analyses of stigma scale scores confirmed the thematic differences revealed in ethnographic findings and highlight the influence of political and economic factors in shaping the meaning and experience of illness. Perceived components of TB stigma among Haitians in South Florida incorporated aspects of Haitian identity as a negatively stereotyped minority community within the larger society, while in Haiti, stigma was associated primarily with poverty, malnutrition, and HIV co-infection. Discussion of findings focuses on the social production of perceived and anticipated stigma as it is influenced by structural forces including the influences of politics, economics, institutional policies, and health service delivery structures. The findings also demonstrate the value of a transnational framework encompassing both sending and receiving countries for understanding TB related stigma in immigrant communities. PMID:20724052

Processing and analysis of commercial satellite image data of the nuclear accident near Chernobyl, U.S.S.R.

USGS Publications Warehouse

Sadowski, Franklin G.; Covington, Steven J.

1987-01-01

Advanced digital processing techniques were applied to Landsat-5 Thematic Mapper (TM) data and SPOT highresolution visible (HRV) panchromatic data to maximize the utility of images of a nuclear powerplant emergency at Chernobyl in the Soviet Ukraine. The images demonstrate the unique interpretive capabilities provided by the numerous spectral bands of the Thematic Mapper and the high spatial resolution of the SPOT HRV sensor.

Assessing performance of Botswana’s public hospital system: the use of the World Health Organization Health System Performance Assessment Framework

PubMed Central

Seitio-Kgokgwe, Onalenna; Gauld, Robin DC; Hill, Philip C; Barnett, Pauline

2014-01-01

Background: Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF). We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods: This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40) and senior officers from stakeholder organizations (N= 14), and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results: The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion: While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved useful in this study. PMID:25279380

The Use of Thematic Mapper Data for Land Cover Discrimination: Preliminary Results from the UK Satmap Programme

NASA Technical Reports Server (NTRS)

Jackson, M. J.; Baker, J. R.; Townshend, J. R. G.; Gayler, J. E.; Hardy, J. R.

1984-01-01

In assessing the accuracy of classification techniques for Thematic Mapper data the consistency of the detector-to-detector response is critical. Preliminary studies were undertaken, therefore, to assess the significance of this factor for the TM. The overall structure of the band relationships can be examined by principal component analysis. In order to examine the utility of the Thematic Mapper data more carefully, six different land cover classes approximately Anderson level 1 were selected. These included an area of water from the sediment-laden Mississippi, woodland, agricultural land and urban land. A plume class was also selected which includes the plume of smoke emanating from the power station and drifting over the Mississippi river.

'You only have one chance to get it right': A qualitative study of relatives' experiences of caring at home for a family member with terminal cancer.

PubMed

Totman, Jonathan; Pistrang, Nancy; Smith, Susan; Hennessey, Susan; Martin, Jonathan

2015-06-01

Relatives looking after a terminally ill family member at home face numerous challenges. Studies into relatives' experiences of home caregiving have been criticised for their descriptive nature and lack of theoretical underpinnings. To explore the emotional challenges faced by home caregivers, and their experiences of healthcare professionals, from the perspective of existential psychology. A qualitative study using semi-structured interviews. Transcripts were analysed thematically using the Framework approach. The study took place within an inner-city London hospice. Participants (n = 15) were recently bereaved adult relatives of cancer patients who cared for their family member at home. Participants' experiences of being a caregiver and of professional support were highly varied. The analysis generated 15 themes which were organised into a framework based on Yalom's four 'existential conditions': responsibility (e.g. 'being the linchpin of care'; 'you only have one chance to get it right'), isolation (e.g. 'being on my own', 'being held in mind'), death (e.g. 'knowing but not knowing') and meaningfulness (e.g. 'giving something back', 'acceptance and gratitude'). Healthcare professionals were perceived as influential in both helping and hindering relatives in meeting the challenges they faced. Existential psychology provides a theoretical perspective from which to understand the psychological complexity of the emotional challenges home caregivers face and a framework which may usefully inform research and clinical practice. Professionals' attentiveness to caregivers' needs can have powerful effects in assuaging anxiety, reducing isolation and enabling relatives to connect with the meaningfulness of caregiving. © The Author(s) 2015.

Culturally Targeted Strategies for Diabetes Prevention in Minority Population.

PubMed

Lagisetty, Pooja A; Priyadarshini, Shubadra; Terrell, Stephanie; Hamati, Mary; Landgraf, Jessica; Chopra, Vineet; Heisler, Michele

2017-02-01

Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize 4 key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with 4 domains (FiLLM: Facilitating [ie, delivering] Interventions Through Language, Location, and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were RCTs, and 22 were QE trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least 3 culturally targeted domains. Seven studies used all 4 domains and were all successful. The least utilized domain was delivery (4/34) of the intervention's key educational message. Conclusions Culturally tailoring interventions across the 4 domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain.

A Needs-led Framework for Understanding the Impact of Caring for a Family Member With Dementia

PubMed Central

Pini, Simon; Ingleson, Emma; Megson, Molly; Wright, Penny; Oyebode, Jan R

2018-01-01

Abstract Background and Objectives Approximately half the care for people with dementia is provided by families. It is therefore imperative that research informs ways of maintaining such care. In this study, we propose that a needs-led approach can provide a useful, novel means of conceptualizing the impact of caring on the lives of family carers. Our aim was to develop and present a needs-led framework for understanding how providing care impacts on carers’ fulfilment of needs. Design and Methods In this qualitative study, we conducted 42 semistructured interviews with a purposively diverse sample of family carers to generate nuanced contextualized accounts of how caring impacted on carers’ lives. Our inductive thematic analysis focused upon asking: “What need is being impacted here?” in order to generate a needs-led framework for understanding. Results Nine themes were widely endorsed. Each completed the sentence: “Being a carer impacts on fulfilling my need to/for….”: Freedom; feel close to my relative; feel in control of my life; be my own person; protect my relative; share/express my thoughts and feelings; take care of myself; feel connected to the people around me; get things done. Discussion and Implications These needs echo those from other research areas, with relational needs emerging as particularly central. The needs-led approach offers a perspective that is able to capture both stresses and positive aspects of caregiving. We recommend that clinical interviewing using Socratic questioning to discover human needs that are being impacted by caring would provide a valuable starting point for care planning. PMID:29562360

Implementing Peer Learning in Clinical Education: A Framework to Address Challenges In the "Real World".

PubMed

Tai, Joanna Hong Meng; Canny, Benedict J; Haines, Terry P; Molloy, Elizabeth K

2017-01-01

Phenomenon: Peer learning has many benefits and can assist students in gaining the educational skills required in future years when they become teachers themselves. Peer learning may be particularly useful in clinical learning environments, where students report feeling marginalized, overwhelmed, and unsupported. Educational interventions often fail in the workplace environment, as they are often conceived in the "ideal" rather than the complex, messy real world. This work sought to explore barriers and facilitators to implementing peer learning activities in a clinical curriculum. Previous peer learning research results and a matrix of empirically derived peer learning activities were presented to local clinical education experts to generate discussion around the realities of implementing such activities. Potential barriers and limitations of and strategies for implementing peer learning in clinical education were the focus of the individual interviews. Thematic analysis of the data identified three key considerations for real-world implementation of peer learning: culture, epistemic authority, and the primacy of patient-centered care. Strategies for peer learning implementation were also developed from themes within the data, focusing on developing a culture of safety in which peer learning could be undertaken, engaging both educators and students, and establishing expectations for the use of peer learning. Insights: This study identified considerations and strategies for the implementation of peer learning activities, which took into account both educator and student roles. Reported challenges were reflective of those identified within the literature. The resultant framework may aid others in anticipating implementation challenges. Further work is required to test the framework's application in other contexts and its effect on learner outcomes.

Atmospheric modeling related to Thematic Mapper scan geometry. [atmospheric effects on satellite-borne photography of LANDSAT D

NASA Technical Reports Server (NTRS)

Malila, W. A.; Gleason, J. M.; Cicone, R. C.

1976-01-01

A simulation study was carried out to characterize atmospheric effects in LANDSAT-D Thematic Mapper data. In particular, the objective was to determine if any differences would result from using a linear vs. a conical scanning geometry. Insight also was gained about the overall effect of the atmosphere on Thematic Mapper signals, together with the effects of time of day. An added analysis was made of the geometric potential for direct specular reflections (sun glint). The ERIM multispectral system simulation model was used to compute inband Thematic Mapper radiances, taking into account sensor, atmospheric, and surface characteristics. Separate analyses were carried out for the thermal band and seven bands defined in the reflective spectral region. Reflective-region radiances were computed for 40 deg N, 0 deg, and 40 deg S latitudes; June, Mar., and Dec. days; and 9:30 and 11:00 AM solar times for both linear and conical scan modes. Also, accurate simulations of solar and viewing geometries throughout Thematic Mapper orbits were made. It is shown that the atmosphere plays an important role in determining Thematic Mapper radiances, with atmospheric path radiance being the major component of total radiances for short wavelengths and decreasing in importance as wavelength increases. Path radiance is shown to depend heavily on the direct radiation scattering angle and on haze content. Scan-angle-dependent variations were shown to be substantial, especially for the short-wavelength bands.

Older people and 'active ageing': Subjective aspects of ageing actively.

PubMed

Stenner, Paul; McFarquhar, Tara; Bowling, Ann

2011-04-01

Following a critical overview of the active ageing concept, a thematic decomposition of 42 transcribed interviews with British people aged 72 years and over indicates that active ageing is understood in relation to physical, cognitive, psychological and social factors, but that these co-exist in complex combinations. The notion of activity in active ageing is grasped in relation to an active/passive distinction which emphasizes the enhancement or diminishment of concrete powers of activity. A 'challenge and response' framework is suggested for future research on active ageing.

Le conte Africain: L'univers de l'oralite dans le systeme de l'enseignement

NASA Astrophysics Data System (ADS)

Belpassi, Paola

1994-05-01

According to current interpretations, the stories preserved in the African oral tradition constitute a rich source of themes for the purposes of moral education. The stories focusing on the relationship between brother and sister, for example, develop the theme of how each individual must find a balance between consanguineous and marital relationships. The author also explores other keys to the interpretation of these stories and argues that they could profitably be used within the framework of a multicultural educational programme, on account of their linguistic, narrative and thematic richness.

Preferences of Young Adults Regarding Dissemination of Online Vitamin D Information.

PubMed

Goodman, Samantha Erin; Sheeshka, Judy

2016-12-01

To explore strategies for disseminating online information about vitamin D to young adults. Participants were 50 males and females aged 18-25 years, living in Ontario, Canada. Eight focus groups (4 male; 4 female) were conducted; participants also completed a socio-demographic questionnaire. Audio files were transcribed verbatim; thematic analysis was used to identify key themes. Thematic analysis revealed that an effective educational intervention geared towards this population should be simple, brief, interesting, personally relevant, credible, and include incentives. Feedback regarding intervention methodology could be used to inform interventions aiming to increase intake of vitamin D or other nutrients among young adults.

Gaining qualitative insight into the subjective experiences of adherers to an exercise referral scheme: A thematic analysis.

PubMed

Eynon, Michael John; O'Donnell, Christopher; Williams, Lynn

2016-07-01

Nine adults who had completed an exercise referral scheme participated in a semi-structured interview to uncover the key psychological factors associated with adherence to the scheme. Through thematic analysis, an exercise identity emerged to be a major factor associated with adherence to the scheme, which was formed of a number of underpinning constructs including changes in self-esteem, changes in self-efficacy and changes in self-regulatory strategies. Also, an additional theme of transitions in motivation to exercise was identified, showing participants' motivation to alter from extrinsic to intrinsic reasons to exercise during the scheme.

Enjoyment of exercise among people with arthritis: An inductive thematic analysis.

PubMed

Kibblewhite, Julia R; Treharne, Gareth J; Stebbings, Simon; Hegarty, Roisin Sm

2017-09-01

Past research into exercise among people with long-term health conditions has paid surprisingly little attention to the concept of enjoyment. This study explored enjoyment of exercise among people with arthritis. Semi-structured interviews were held with 12 participants aged 20-85 years. The transcripts were analysed using inductive thematic analysis. Four themes were identified: enjoyment of exercise in relation to other people, benefits of exercise in relation to enjoyment, working around barriers to enjoy exercise and finding an enjoyable balance to exercise. These themes highlight the relevance of enjoyment and how it could feature in advice about exercise for people with arthritis.

Internet suicide in Japan: a qualitative content analysis of a suicide bulletin board.

PubMed

Ikunaga, Ai; Nath, Sanjay R; Skinner, Kenneth A

2013-04-01

Netto shinju, or Internet group suicide, is a contemporary form of Japanese suicide where strangers connect on the Internet and make plans to commit suicide together. In the past decade, numerous incidents have occurred whereby young Japanese make contact on the Internet, exchange tips on suicide methods, and make plans to meet offline for group/individual suicide. A systematic qualitative content/thematic analysis of online communications posted on a popular Japanese suicide bulletin board yielded a textured, thematic understanding of this phenomenon. Themes identified reflected Shneidman's theory of suicide but with an emphasis on interpersonal concerns that are embedded in Japanese culture.

Conflating Time and Energy: Views From Older Adults in Lower Socioeconomic Status Areas on Physical Activity.

PubMed

Devereux-Fitzgerald, Angela; Powell, Rachael; French, David P

2018-05-24

Perceptions of time and energy and their role in physical activity engagement were examined in older adults living in lower socioeconomic status areas. Semistructured interviews were conducted with 19 participants aged 67-94 years. A thematic framework analysis identified four themes: Time is Energy (older adults conflate time and energy in relation to physical activity), Reduced Day (engaging in activities outside a certain time frame is deemed unacceptable), Being Given Enough Time (need for time to socialize and go at own pace), and Seasonal Impact (seasonal differences affecting access). Enjoyment appears to mitigate the perceived energy drain and increase the capacity for physical activities for many. Conflation of time and energy may explain observed discrepancies between older adults' actual and perceived available time. Having locally based physical activities means less time/energy is required to attend, leaving more resources for physical activity itself. A limited availability of resources in lower socioeconomic status areas is therefore problematic.

Patient Participation in Chronic Pain Management Through Social Media: A Clinical Study.

PubMed

Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando

2016-01-01

Chronic pain places a significant burden on individuals as well as health services. Long wait lists to access public clinical pain management services can result, and health outcomes deteriorate. Innovative technologies, such as social media provide opportunities to support self-management within the participatory health framework. This paper aims to investigate patients' perceptions towards using social media while waiting for clinic access, with a particular focus on therapeutic affordances. Seventeen wait-listed patients underwent intervention using various social media resources as part of self-management. Thematic content analysis of semi-structured interviews examined patients' perceptions about social media use and participation. Three therapeutic affordances were most evident in the qualitative data: exploration, connection and narration. Barriers to participation were also identified, such as 'specificity of the resources'. Findings suggest social media are perceived positively. However, there is also the need to balance a desire to deliver evidence-based practice with patient-preferences in shared-decision making about social media use.

Some like it mellow: on gay men complicating pornography discourses.

PubMed

Corneau, Simon; van der Meulen, Emily

2014-01-01

Despite the proliferation of writing on pornography generally, much of the literature that focuses on gay pornography specifically conforms to either a pro- or anti-porn framework. This overly simplistic dichotomy positions pornography as a homogeneous construct, albeit one that is either "good" or "bad." Even theorists who situate pornography on a continuum, with erotica at one end and hardcore at the other, tend to reify these discourses. Further, it is not uncommon for researchers to draw conclusions about the effects of pornography consumption without defining exactly what pornography is. This ethnographic research draws on qualitative interviews with 20 consumers' of gay pornography in Toronto, Canada. By using a thematic analysis to document the ways in which gay men define, distinguish, and conceptualize gay pornography, five definitional categories were developed: Mellow; Commercial; Raunch; Amateur; and Bareback. These broad conceptualizations are discussed in reference to writing on gay pornography. Our research results emphasize the importance of clear definitions of pornography within pornography research.

Stigma Experiences in Marginalized People Living With HIV Seeking Health Services and Resources in Canada.

PubMed

Donnelly, Leeann R; Bailey, Lauren; Jessani, Abbas; Postnikoff, Jonathan; Kerston, Paul; Brondani, Mario

HIV stigma may prevent people from obtaining a timely diagnosis and engaging in life-saving care. It may also prevent those who are HIV infected from seeking health and education resources, particularly if they are from marginalized communities. We inductively explored the roots of stigma and its impact on health services and resource seeking as experienced by HIV-infected members of marginalized communities in Vancouver, British Columbia, Canada, using a community-based participatory research framework. Five peer-facilitated focus groups were conducted with 33 Aboriginal, Latino, Asian, and African participants. Thematic analysis of the experiences revealed four dominant themes: beginnings of stigma, tensions related to disclosure, experiences of service seeking, and beyond HIV stigma and discrimination. Persons living with HIV from Aboriginal and refugee communities continue to experience disproportionate rates of stigma and discrimination. Fear remains a prime obstacle influencing these groups' abilities and willingness to access care in various settings. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Death and caring for dying patients: exploring first-year nursing students' descriptive experiences.

PubMed

Ek, Kristina; Westin, Lars; Prahl, Charlotte; Osterlind, Jane; Strang, Susann; Bergh, Ingrid; Hammarlund, Kina

2014-10-01

To describe first-year nursing students' experiences of witnessing death and providing end-of-life care. This study is part of a larger longitudinal project. Interviews (n=17) were conducted with nursing students at the end of their first year of education. To analyse the interviews (lived-experience descriptions), a thematic analysis, 'a search for meaning' ( Van Manen, 1997 ) was applied. The results are presented within the framework of four separate themes: (1) The thought of death is more frightening than the actual experience, (2) Daring to approach the dying patient and offering something of oneself, (3) The experience of not sufficing in the face of death and (4) Being confronted with one's own feelings. Nursing students require continuous support and opportunity to reflect and discuss their experiences about caring for dying patients and confronting death throughout the entirety of their education. In addition, teachers and clinical supervisors need to give support using reflective practice to help students to develop confidence in their capacity for caring for dying patients.

More Than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy.

PubMed

Kern-Godal, Ann; Brenna, Ida Halvorsen; Arnevik, Espen Ajo; Ravndal, Edle

2016-01-01

Inclusion of horse-assisted therapy (HAT) in substance use disorder (SUD) treatment is rarely reported. Our previous studies show improved treatment retention and the importance of the patient-horse relationship. This qualitative study used thematic analysis, within a social constructionist framework, to explore how eight patients experienced contextual aspects of HAT's contribution to their SUD treatment. Participants described HAT as a "break from usual treatment". However, four interrelated aspects of this experience, namely "change of focus", "activity", "identity", and "motivation," suggest HAT is more than just a break from usual SUD treatment. The stable environment is portrayed as a context where participants could construct a positive self: one which is useful, responsible, and accepted; more fundamentally, a different self from the "patient/self" receiving treatment for a problem. The implications extend well beyond animal-assisted or other adjunct therapies. Their relevance to broader SUD policy and treatment practices warrants further study.

Body-related envy: a social comparison perspective in sport and exercise.

PubMed

Pila, Eva; Stamiris, Angela; Castonguay, Andree; Sabiston, Catherine M

2014-02-01

These three studies sought to better understand experiences of body-related envy and to examine the association with motivation and exercise behavior in young adult males and females. In an interview study, participants (N = 11) discussed body-related envy within a framework of social comparison. In Study 2, a thematic content analysis was conducted on self-reported narratives of body-related envy experiences reported by 288 participants. Themes of body-related envy triggers, cognitions, and cognitive and behavioral outcomes were identified. Findings from Studies 1 and 2 highlighted the possible link between body-related envy and exercise motivation and behavior. Study 3 tested these associations with males and females (N = 595) who completed a self-report questionnaire. In the structural equation model, body-related envy was positively associated with external, introjected, and identified regulations, and identified regulation was positively associated with exercise behavior. Taken together, the importance of body-related envy in the experience of cognitive, affective, and behavioral outcomes related to sport and exercise contexts is highlighted.

What are community nurses experiences of assessing frailty and assisting in planning subsequent interventions?

PubMed

Britton, Hannah

2017-09-02

With an ageing population and increasing focus on community care, this study aimed to explore the experiences of community nurses in assessing frailty and planning interventions around frailty. Six community nurses were recruited for face-to-face semi-structured interviews as part of this qualitative study which was underpinned by a competence framework ( Royal College of Nursing, 2009 ). Thematic analysis was used and frailty was identified as an emerging topic within practice. Participants discussed several aspects associated with frailty; however, some uncertainty around the concept of frailty and its definition was noted, particularly for staff who had received limited frailty training. Participants had a growing awareness of frailty in practice, but challenges-including time constraints and staffing within some roles, a perception of limited services to support older people, and for some a lack of confidence and training-presented barriers to frailty assessment. The Rockwood frailty scale was used by participants within practice, but evidence suggested it was felt to lack validity within the community setting.

Adherence and Recursive Perception Among Young Adults with Cystic Fibrosis.

PubMed

Oddleifson, D August; Sawicki, Gregory S

2017-04-01

Adherence to prescribed treatment is a pressing issue for adolescents and young adults with cystic fibrosis (CF). This paper presents two narratives from the thematic analysis of unstructured interviews with 14 adolescents, young adults, and older adults living with CF. Through a new identity-based framework termed recursive perception that draws focus on how an individual perceives how others view them, it explores the social context of adherence and self-care among young adults with CF. It demonstrates that an individual's understanding of self and desire to maintain a certain image for peers can be deeply embedded in adherence and self-care patterns, leading individuals to feel they need to choose between tending to their health needs and living their lives. This suggests that current biomedical innovation in CF care must be complemented with renewed efforts to find effective means to empower young adults with CF to successfully navigate the social challenges of their illness and avoid the pitfalls of nonadherence that can lead to a permanent worsening of their health condition.

Lesbians’ Constructions of Depression

PubMed Central

Barnard, Amy

2009-01-01

Lesbians are a marginalized group of women living in a heteronormative society. This study describes lesbians’ subjective experiences of depression, and identifies the ways that dominant and alternative discourses shaped their understandings of depression and sexuality. Twelve self-identified lesbians participated in up to three in-depth interviews conducted over a nine month period. Thematic analysis led to themes that explicated their physical and emotional descriptions of depression; identified troubled interpersonal relationships as a primary source of depression; and the means implemented to cope with depression, including taking medication, engagement in therapy, developing social support networks, and discovering their own spirituality. Depression and sexuality were understood within the framework of the dominant discourses of (1) medical model (2) dysfunctional family and (3) organized religion; and the alternative discourses of (1) lesbian identity, (2) alternative families and (3) spirituality. Nurses in clinical practice can assist depressed lesbians clients by bolstering explorations of spirituality and the development of strong support networks within the lesbian and gay communities. Politically, institutionalized heteronormativity must be attacked at every level. PMID:19350435

Internationalising the nursing curriculum using a Community of Inquiry Framework and blended learning.

PubMed

Stephens, Melanie; Hennefer, Dawn

2013-05-01

The study examined how computer mediated tools, blended with traditional forms of teaching activity supported undergraduate pre-registration nursing students on international placement and for those students unable to go out into the world, how could this world be brought to their home campus? The researchers sought to examine whether synchronous online face to face contact using Skype, improved support and communication for students nursing overseas and if cultural awareness was developed for those nursing students who stayed on native soil. Data was collected using focus groups and online questionnaires. Themes arising from the thematic analysis of the narratives included operational issues, pastoral care, academic and peer support and cultural awareness and development. The use of Blended Learning tools such as Skype and weblogs were found to be extremely beneficial as a form of online communication and support for students undertaking an international placement. In relation to cultural awareness further work is required. Copyright © 2012 Elsevier Ltd. All rights reserved.

More Than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy

PubMed Central

Kern-Godal, Ann; Brenna, Ida Halvorsen; Arnevik, Espen Ajo; Ravndal, Edle

2016-01-01

Inclusion of horse-assisted therapy (HAT) in substance use disorder (SUD) treatment is rarely reported. Our previous studies show improved treatment retention and the importance of the patient–horse relationship. This qualitative study used thematic analysis, within a social constructionist framework, to explore how eight patients experienced contextual aspects of HAT’s contribution to their SUD treatment. Participants described HAT as a “break from usual treatment”. However, four interrelated aspects of this experience, namely “change of focus”, “activity”, “identity”, and “motivation,” suggest HAT is more than just a break from usual SUD treatment. The stable environment is portrayed as a context where participants could construct a positive self: one which is useful, responsible, and accepted; more fundamentally, a different self from the “patient/self” receiving treatment for a problem. The implications extend well beyond animal-assisted or other adjunct therapies. Their relevance to broader SUD policy and treatment practices warrants further study. PMID:27746677

Access to properly fitting personal protective equipment for female construction workers.

PubMed

Onyebeke, Lynn C; Papazaharias, Demetrios M; Freund, Alice; Dropkin, Jonathan; McCann, Michael; Sanchez, Sadie H; Hashim, Dana; Meyer, John D; Lucchini, Roberto G; Zuckerman, Norman C

2016-11-01

Previous literature suggests that most personal protective equipment (PPE) for construction is designed for males and does not accommodate female anthropometry. We conducted a pilot study to identify whether female construction workers currently have adequate access to properly fitting PPE. Semi-structured focus group interviews were conducted with union female carpenters, laborers, and ironworkers. Researchers coded focus group transcriptions and extracted major themes using thematic framework analysis. Participants (n = 23) had a mean of 15.1 years of construction experience (range 3-34.5 years). A majority reported fit problems for many types of PPE (gloves, harnesses, safety vests, work boots, outerwear), generally noting that the equipment provided by contractors was too large. Other emergent themes included female workers purchasing their own PPE, exposure to various safety hazards from poorly fitted PPE, and perceived indifferent safety culture. Female construction workers continue to have difficulty accessing properly fitting PPE. Am. J. Ind. Med. 59:1032-1040, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The role of learning disability nurses in promoting cervical screening uptake in women with intellectual disabilities: A qualitative study.

PubMed

Lloyd, Jennifer L; Coulson, Neil S

2014-06-01

Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women with intellectual disabilities to access cervical screening in order to examine their role in promoting attendance and elucidate potential barriers and facilitators to uptake. Ten participants recruited from a specialist learning disability service completed a semi-structured interview and data were analysed using experiential thematic analysis. Identified individual barriers included limited health literacy, negative attitudes and beliefs and competing demands; barriers attributed to primary care professionals included time pressures, limited exposure to people with intellectual disabilities and lack of appropriate knowledge, attitudes and skills. Attendance at cervical screening was facilitated by prolonged preparation work undertaken by learning disability nurses, helpful clinical behaviours in the primary care context and effective joint working. © The Author(s) 2014.

Core communication components along the cancer care process: the perspective of breast cancer patients.

PubMed

Prades, Joan; Ferro, Tàrsila; Gil, Francisco; Borras, Josep M

2014-10-01

This study sought to assess the impact of health care professional (HCP) communication on breast cancer patients across the acute care process as perceived by patients. Methodological approach was based on eight focus groups conducted with a sample of patients (n = 37) drawn from 15 Spanish Regions; thematic analysis was undertaken using the National Cancer Institute (NCI) framework of HCP communication as the theoretical basis. Relevant results of this study were the identification of four main communication components: (1) reassurance in coping with uncertainty after symptom detection and prompt access until confirmed diagnosis; (2) fostering involvement before delivering treatments, by anticipating information on practical and emotional illness-related issues; (3) guidance on the different therapeutic options, through use of clinical scenarios; and, (4) eliciting the feeling of emotional exhaustion after ending treatments and addressing the management of potential treatment-related effects. These communication-related components highlighted the need for a comprehensive approach in this area of cancer care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adding Value to the Health Care System: Identifying Value-Added Systems Roles for Medical Students.

PubMed

Gonzalo, Jed D; Graaf, Deanna; Johannes, Bobbie; Blatt, Barbara; Wolpaw, Daniel R

To catalyze learning in Health Systems Science and add value to health systems, education programs are seeking to incorporate students into systems roles, which are not well described. The authors sought to identify authentic roles for students within a range of clinical sites and explore site leaders' perceptions of the value of students performing these roles. From 2013 to 2015, site visits and interviews with leadership from an array of clinical sites (n = 30) were conducted. Thematic analysis was used to identify tasks and benefits of integrating students into interprofessional care teams. Types of systems roles included direct patient benefit activities, including monitoring patient progress with care plans and facilitating access to resources, and clinic benefit activities, including facilitating coordination and improving clinical processes. Perceived benefits included improved value of the clinical mission and enhanced student education. These results elucidate a framework for student roles that enhance learning and add value to health systems.

Social and psychological creativity in gay male midlife identity management.

PubMed

Hajek, Christopher

2016-06-01

This study utilizes a qualitative thematic analysis methodology and a social identity theory framework to explore ways in which early midlife gay men report enhancing their social identities through social and psychological creativity. Face-to-face, semi-structured interviews were conducted with forty early midlife gay men (aged 40-53) in four US cities. Men discussed the collective and individual essences of their age and gay identities, including attitudes, beliefs, and behaviours that they embraced to self-enhance at midlife. These discussions emphasized differences from the younger gay outgroup, often in the context of intergenerational interaction. Identified were three strategies (and seven substrategies) that summarized the ways that interviewees constructed their identities in the interest of self-enhancement, specifically in the context of intergenerational comparisons with younger gay men. These strategies may be considered as extensions to social creativity strategies presented in Tajfel and Turner's (Psychology of intergroup relations. Chicago, IL: Nelson, 1986: 7) social identity theory. © 2015 The British Psychological Society.

Parent-to-parent support for parents with children who are deaf or hard of hearing: a conceptual framework.

PubMed

Henderson, Rebecca J; Johnson, Andrew; Moodie, Sheila

2014-12-01

Parent-to-parent support for parents with children who are deaf or hard of hearing (D/HH) is identified as an important component of Early Hearing Detection and Intervention (EHDI) programs for children with hearing loss. The specific aim of this review was to identify the constructs and components of parent-to-parent support for parents of children who are D/HH. An extensive scoping literature review identified 39 peer-reviewed articles published from 2000 to 2014. Studies were selected and reviewed based on standardized procedures. Data were identified, extracted, and organized into libraries of thematic and descriptive content. A conceptual framework of parent-to-parent support for parents of children who are D/HH was developed and presented in a comprehensive, bidirectional informational graphic. The constructs and components of the conceptual framework are (a) well-being: parent, family, and child; (b) knowledge: advocacy, system navigation, and education; and (c) empowerment: confidence and competence. The findings from this scoping review led to the development of a structured conceptual framework of parent-to-parent support for parents of children who are D/HH. The conceptual framework provides an important opportunity to explore and clearly define the vital contribution of parents in EHDI programs.

Facilitators and barriers to non-medical prescribing - A systematic review and thematic synthesis.

PubMed

Graham-Clarke, Emma; Rushton, Alison; Noblet, Timothy; Marriott, John

2018-01-01

Non-medical prescribing has the potential to deliver innovative healthcare within limited finances. However, uptake has been slow, and a proportion of non-medical prescribers do not use the qualification. This systematic review aimed to describe the facilitators and barriers to non-medical prescribing in the United Kingdom. The systematic review and thematic analysis included qualitative and mixed methods papers reporting facilitators and barriers to independent non-medical prescribing in the United Kingdom. The following databases were searched to identify relevant papers: AMED, ASSIA, BNI, CINAHL, EMBASE, ERIC, MEDLINE, Open Grey, Open access theses and dissertations, and Web of Science. Papers published between 2006 and March 2017 were included. Studies were quality assessed using a validated tool (QATSDD), then underwent thematic analysis. The protocol was registered with PROSPERO (CRD42015019786). Of 3991 potentially relevant identified studies, 42 were eligible for inclusion. The studies were generally of moderate quality (83%), and most (71%) were published 2007-2012. The nursing profession dominated the studies (30/42). Thematic analysis identified three overarching themes: non-medical prescriber, human factors, and organisational aspects. Each theme consisted of several sub-themes; the four most highly mentioned were 'medical professionals', 'area of competence', 'impact on time' and 'service'. Sub-themes were frequently interdependent on each other, having the potential to act as a barrier or facilitator depending on circumstances. Addressing the identified themes and subthemes enables strategies to be developed to support and optimise non-medical prescribing. Further research is required to identify if similar themes are encountered by other non-medical prescribing groups than nurses and pharmacists.

LANDSAT D instrument module study

NASA Technical Reports Server (NTRS)

1976-01-01

Spacecraft instrument module configurations which support an earth resource data gathering mission using a thematic mapper sensor were examined. The differences in size of these two experiments necessitated the development of two different spacecraft configurations. Following the selection of the best-suited configurations, a validation phase of design, analysis and modelling was conducted to verify feasibility. The chosen designs were then used to formulate definition for a systems weight, a cost range for fabrication and interface requirements for the thematic mapper (TM).

Patients-people-place: developing a framework for researching organizational culture during health service redesign and change.

PubMed

Gale, Nicola K; Shapiro, Jonathan; McLeod, Hugh S T; Redwood, Sabi; Hewison, Alistair

2014-08-20

Organizational culture is considered by policy-makers, clinicians, health service managers and researchers to be a crucial mediator in the success of implementing health service redesign. It is a challenge to find a method to capture cultural issues that is both theoretically robust and meaningful to those working in the organizations concerned. As part of a comparative study of service redesign in three acute hospital organizations in England, UK, a framework for collecting data reflective of culture was developed that was informed by previous work in the field and social and cultural theory. As part of a larger mixed method comparative case study of hospital service redesign, informed by realist evaluation, the authors developed a framework for researching organisational culture during health service redesign and change. This article documents the development of the model, which involved an iterative process of data analysis, critical interdisciplinary discussion in the research team, and feedback from staff in the partner organisations. Data from semi-structured interviews with 77 key informants are used to illustrate the model. In workshops with NHS partners to share and debate the early findings of the study, organizational culture was identified as a key concept to explore because it was perceived to underpin the whole redesign process. The Patients-People-Place framework for studying culture focuses on three thematic areas ('domains') and three levels of culture in which the data could be organised. The framework can be used to help explain the relationship between observable behaviours and cultural artefacts, the values and habits of social actors and the basic assumptions underpinning an organization's culture in each domain. This paper makes a methodological contribution to the study of culture in health care organizations. It offers guidance and a practical approach to investigating the inherently complex phenomenon of culture in hospital organizations. The Patients-People-Place framework could be applied in other settings as a means of ensuring the three domains and three levels that are important to an organization's culture are addressed in future health service research.

Concepts of ‘personalization’ in personalized medicine: implications for economic evaluation

PubMed Central

Rogowski, Wolf; Payne, Katherine; Schnell-Inderst, Petra; Manca, Andrea; Rochau, Ursula; Jahn, Beate; Alagoz, Oguzhan; Leidl, Reiner; Siebert, Uwe

2015-01-01

Context This paper assesses if, and how, existing methods for economic evaluation are applicable to the evaluation of PM and if not, where extension to methods may be required. Method Structured workshop with a pre-defined group of experts (n=47), run using a modified nominal group technique. Workshop findings were recorded using extensive note taking and summarised using thematic data analysis. The workshop was complemented by structured literature searches. Results The key finding emerging from the workshop, using an economic perspective, was that two distinct, but linked, interpretations of the concept of PM exist (personalization by ‘physiology’ or ‘preferences’). These interpretations involve specific challenges for the design and conduct of economic evaluations. Existing evaluative (extra-welfarist) frameworks were generally considered appropriate for evaluating PM. When ‘personalization’ is viewed as using physiological biomarkers, challenges include: representing complex care pathways; representing spill-over effects; meeting data requirements such as evidence on heterogeneity; choosing appropriate time horizons for the value of further research in uncertainty analysis. When viewed as tailoring medicine to patient preferences, further work is needed regarding: revealed preferences, e.g. treatment (non)adherence; stated preferences, e.g. risk interpretation and attitude; consideration of heterogeneity in preferences; and the appropriate framework (welfarism vs. extra-welfarism) to incorporate non-health benefits. Conclusion Ideally, economic evaluations should take account of both interpretations of PM and consider physiology and preferences. It is important for decision makers to be cognizant of the issues involved with the economic evaluation of PM to appropriately interpret the evidence and target future research funding. PMID:25249200

Promoting resilience among parents and caregivers of children with cancer.

PubMed

Rosenberg, Abby R; Baker, K Scott; Syrjala, Karen L; Back, Anthony L; Wolfe, Joanne

2013-06-01

Promoting resilience is an aspect of psychosocial care that affects patient and whole-family well-being. There is little consensus about how to define or promote resilience during and after pediatric cancer. The aims of this study were (1) to review the resilience literature in pediatric cancer settings; (2) to qualitatively ascertain caregiver-reported perceptions of resilience; and (3) to develop an integrative model of fixed and mutable factors of resilience among family members of children with cancer, with the goal of enabling better study and promotion of resilience among pediatric cancer families. The study entailed qualitative analysis of small group interviews with eighteen bereaved parents and family members of children with cancer treated at Seattle Children's Hospital. Small-group interviews were conducted with members of each bereaved family. Participant statements were coded for thematic analysis. An integrative, comprehensive framework was then developed. Caregivers' personal appraisals of the cancer experience and their child's legacy shape their definitions of resilience. Described factors of resilience include baseline characteristics (i.e., inherent traits, prior expectations of cancer), processes that evolve over time (i.e., coping strategies, social support, provider interactions), and psychosocial outcomes (i.e., post-traumatic growth and lack of psychological distress). These elements were used to develop a testable model of resilience among family members of children with cancer. Resilience is a complex construct that may be modifiable. Once validated, the proposed framework will not only serve as a model for clinicians, but may also facilitate the development of interventions aimed at promoting resilience in family members of children with cancer.

Promoting Resilience among Parents and Caregivers of Children with Cancer

PubMed Central

Baker, K. Scott; Syrjala, Karen L.; Back, Anthony L.; Wolfe, Joanne

2013-01-01

Abstract Background Promoting resilience is an aspect of psychosocial care that affects patient and whole-family well-being. There is little consensus about how to define or promote resilience during and after pediatric cancer. Objectives The aims of this study were (1) to review the resilience literature in pediatric cancer settings; (2) to qualitatively ascertain caregiver-reported perceptions of resilience; and (3) to develop an integrative model of fixed and mutable factors of resilience among family members of children with cancer, with the goal of enabling better study and promotion of resilience among pediatric cancer families. Methods The study entailed qualitative analysis of small group interviews with eighteen bereaved parents and family members of children with cancer treated at Seattle Children's Hospital. Small-group interviews were conducted with members of each bereaved family. Participant statements were coded for thematic analysis. An integrative, comprehensive framework was then developed. Results Caregivers' personal appraisals of the cancer experience and their child's legacy shape their definitions of resilience. Described factors of resilience include baseline characteristics (i.e., inherent traits, prior expectations of cancer), processes that evolve over time (i.e., coping strategies, social support, provider interactions), and psychosocial outcomes (i.e., post-traumatic growth and lack of psychological distress). These elements were used to develop a testable model of resilience among family members of children with cancer. Conclusions Resilience is a complex construct that may be modifiable. Once validated, the proposed framework will not only serve as a model for clinicians, but may also facilitate the development of interventions aimed at promoting resilience in family members of children with cancer. PMID:23646887

Contestations and complexities of nurses' participation in policy-making in South Africa.

PubMed

Ditlopo, Prudence; Blaauw, Duane; Penn-Kekana, Loveday; Rispel, Laetitia C

2014-01-01

There has been increased emphasis globally on nurses' involvement in health policy and systems development. However, there has been limited scholarly attention on nurses' participation in policy-making in South Africa. This paper analyses the dynamics, strengths, and weaknesses of nurses' participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD) remuneration policy. Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software. The study found that nurses' participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses' participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses' views and inputs were considered and incorporated. The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association.

Medicine shortages in Australia: causes, impact and management strategies in the community setting.

PubMed

Tan, Yee Xi; Moles, Rebekah J; Chaar, Betty B

2016-10-01

Background Medicine shortages are an ongoing global problem. The Therapeutic Goods Administration (TGA) dedicated a website for monitoring of medicine shortages in Australia in May 2014, as part of the Medicine Shortage Information Initiative. This study aimed to explore the views of pharmacists regarding medicine shortages in the community setting and the impact of the TGA website in Australia. Setting Community pharmacies in New South Wales, Australia. Method Twenty semi-structured interviews were conducted with community pharmacists. Data collected were analysed thematically utilising the framework analysis method. Main outcome measure Qualitative analysis conducted using the framework approach. Results Findings clearly indicated that medicine shortages were experienced on a regular basis, but most participants were unaware of the TGA website. Medicine shortages reportedly impacted both pharmacists and consumers; and various workarounds were undertaken to manage the issue. The "price disclosure policy" was found to be a prominent contributing factor in emerging shortages. Suggestions were made for ways to improve the growing occurrence of shortages. Conclusion Overall, the study found that there was a lack of familiarity with the TGA website, despite experiencing regular shortages of medicines in practice. Also highlighted, was the importance of pharmacists prioritising patient care over business decisions. To reduce prescribing of out-of-stock medicines notifying doctors about shortages was also considered important, to allow for early action to be taken at higher levels of the supply chain. Findings of this study may help direct future policy-making around the world, as medicine shortages is a problem shared by healthcare providers in most countries around the world.

Contestations and complexities of nurses’ participation in policy-making in South Africa

PubMed Central

Ditlopo, Prudence; Blaauw, Duane; Penn-Kekana, Loveday; Rispel, Laetitia C.

2014-01-01

Background There has been increased emphasis globally on nurses’ involvement in health policy and systems development. However, there has been limited scholarly attention on nurses’ participation in policy-making in South Africa. Objective This paper analyses the dynamics, strengths, and weaknesses of nurses’ participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD) remuneration policy. Design Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software. Results The study found that nurses’ participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses’ participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses’ views and inputs were considered and incorporated. Conclusions The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association. PMID:25537938

Impact of gender on decisions to participate in faecal immunochemical test-based colorectal cancer screening: a qualitative study.

PubMed

Clarke, Nicholas; Gallagher, Pamela; Kearney, Patricia M; McNamara, Deirdre; Sharp, Linda

2016-12-01

Faecal immunochemical tests (FITs) are increasingly being used in population-based colorectal cancer-screening programmes. Uptake of FIT is lower in men than women; however, the reasons for this are not well understood. We aimed to explore gender differences in influences on decisions to participate in FIT screening. This is a qualitative study using in-depth face-to-face interviews of four groups of screening invitees (male and female screening users and male and female screening non-users), purposively sampled from the database of a population-based FIT screening programme. Recruitment continued until saturation was reached. Interviews were audio recorded and transcribed verbatim. Thematic analysis using the framework approach was employed with the theoretical domains framework guiding analysis. Forty-seven screening invitees were interviewed. Six theoretical domains influenced screening uptake: 'environmental context and resources', 'beliefs about capabilities', 'beliefs about consequences', 'emotions', 'social influences' and 'knowledge'. Male non-users were often fatalistic, less knowledgeable and misinformed about cancer and FIT screening compared with other groups. Female non-users expressed negative attitudes, beliefs and emotions towards FIT screening, cancer, social influences and the medical profession and were over-confident about their health. Negative attitudes and emotions to screening dominated non-user decision-making but differed by gender. Opportunities to improve uptake in men and women exist. Greater national discussions on the benefits of FIT screening, and development of screening materials tackling negative attitudes and beliefs while recognising male/female differences, may improve screening uptake. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Synthesizing diverse evidence: the use of primary qualitative data analysis methods and logic models in public health reviews.

PubMed

Baxter, S; Killoran, A; Kelly, M P; Goyder, E

2010-02-01

The nature of public health evidence presents challenges for conventional systematic review processes, with increasing recognition of the need to include a broader range of work including observational studies and qualitative research, yet with methods to combine diverse sources remaining underdeveloped. The objective of this paper is to report the application of a new approach for review of evidence in the public health sphere. The method enables a diverse range of evidence types to be synthesized in order to examine potential relationships between a public health environment and outcomes. The study drew on previous work by the National Institute for Health and Clinical Excellence on conceptual frameworks. It applied and further extended this work to the synthesis of evidence relating to one particular public health area: the enhancement of employee mental well-being in the workplace. The approach utilized thematic analysis techniques from primary research, together with conceptual modelling, to explore potential relationships between factors and outcomes. The method enabled a logic framework to be built from a diverse document set that illustrates how elements and associations between elements may impact on the well-being of employees. Whilst recognizing potential criticisms of the approach, it is suggested that logic models can be a useful way of examining the complexity of relationships between factors and outcomes in public health, and of highlighting potential areas for interventions and further research. The use of techniques from primary qualitative research may also be helpful in synthesizing diverse document types. Copyright 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Stakeholders in support systems for self-care for chronic illness: the gap between expectations and reality regarding their identity, roles and relationships.

PubMed

Pumar-Méndez, María J; Mujika, Agurtzane; Regaira, Elena; Vassilev, Ivaylo; Portillo, Mari Carmen; Foss, Christina; Todorova, Elka; Roukova, Poli; Ruud Knutsen, Ingrid A; Serrano, Manuel; Lionis, Christos; Wensing, Michel; Rogers, Anne

2017-06-01

The spread of self-care holds the promise of containing chronic illness burden. Falling within the framework of a FP7 collaborative research project, this paper reports the views of key informants from six countries regarding who the main stakeholders are at different levels in the support system for self-care for patients with chronic illness (SSSC) and how they accomplish their role and collaborate. 90 Interviews with purposefully selected key informants from Bulgaria, Greece, the Netherlands, Norway, Spain and United Kingdom were conducted. Interviews involved government and local authorities, politicians, academics, health professionals and private sector representatives. Interviewers followed an expert opinion-based guide. Analysis involved a cross-country examination with thematic analysis and framework method techniques. Key informants described the ideal SSSC as inclusive, interdependent and patient-centred. The following main stakeholders in SSSC were identified: patients, governments, health-care professionals, associations, private companies and the media. In the current SSSCs, collaboration among stakeholders within and across different levels was said to be lacking. Patients were seen as playing a passive subordinate role based on the following: their own attitudes; the paternalistic and medicalized attitudes of the health-care professionals; their misrepresentation by patient associations; and their exposure to the damaging influences of media and industries. Making SSSC patient-centred constitutes the greatest challenge for European authorities. Strategies must be revised for promoting patient participation. They should undergo changes so as to promote industry and media social responsibility and patient association advocacy capacity. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

PubMed

Knüppel, Hannes; Mertz, Marcel; Schmidhuber, Martina; Neitzke, Gerald; Strech, Daniel

2013-08-01

Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary.

Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis

PubMed Central

Knüppel, Hannes; Schmidhuber, Martina; Neitzke, Gerald

2013-01-01

Background Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. Methods and Findings To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Conclusions Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary PMID:23966839

Outcomes and impact of community-based rehabilitation programmes in Chinese communities.

PubMed

Chung, Eva Y; Packer, Tanya L

2017-04-01

To identify the most common and most valued outcomes of community-based rehabilitation (CBR) in Chinese communities and to map these to the CBR evaluation framework. A multiple, embedded case study design was used. Four CBR programmes in China met the criteria for inclusion and participated. Data collection, via participant "story telling", followed the procedures of the most significant change technique (MSC) over a period for five months. Content analysis with thematic coding was used to detect the common significant changes described in "top-rated" stories and in the entire pool of stories. Meta-analysis using the CBR framework was carried out to enrich the understanding of programme outcomes. A total of 101 stories were collected in the two rounds of story collection from the four programmes. Aggregated results demonstrated that, across all programmes, 78.21% of stories focused on changes in people with disabilities, 9.9% described aspects of programme development, 8.91% reported on outcomes related to CBR workers, and only 2.97% were focused on advocacy. When mapped against the elements of the CBR framework the MSCs among these four programmes were (1) psychosocial changes, (2) increased family participation and (3) improved physical functioning. CBR practice in Chinese communities remains orientated towards an approach of functional rehabilitation rather than community-based inclusive development. Implications for rehabilitation Community-based rehabilitation is a strategy for community-based inclusive development. Commonly reported significant outcomes of community-based rehabilitation programmes in China focus on changes in psychosocial and physical status of people with disabilities and family participation. Community-based rehabilitation in China continues to focus on traditional rehabilitation. New efforts and directions are needed to also include goals of equity and community inclusion. Further efforts to promote the use of CBR guideline with the goal of facilitating inclusion and equal participation are strongly recommended.

Facilitating professional liaison in collaborative care for depression in UK primary care; a qualitative study utilising normalisation process theory.

PubMed

Coupe, Nia; Anderson, Emma; Gask, Linda; Sykes, Paul; Richards, David A; Chew-Graham, Carolyn

2014-05-01

Collaborative care (CC) is an organisational framework which facilitates the delivery of a mental health intervention to patients by case managers in collaboration with more senior health professionals (supervisors and GPs), and is effective for the management of depression in primary care. However, there remains limited evidence on how to successfully implement this collaborative approach in UK primary care. This study aimed to explore to what extent CC impacts on professional working relationships, and if CC for depression could be implemented as routine in the primary care setting. This qualitative study explored perspectives of the 6 case managers (CMs), 5 supervisors (trial research team members) and 15 general practitioners (GPs) from practices participating in a randomised controlled trial of CC for depression. Interviews were transcribed verbatim and data was analysed using a two-step approach using an initial thematic analysis, and a secondary analysis using the Normalisation Process Theory concepts of coherence, cognitive participation, collective action and reflexive monitoring with respect to the implementation of CC in primary care. Supervisors and CMs demonstrated coherence in their understanding of CC, and consequently reported good levels of cognitive participation and collective action regarding delivering and supervising the intervention. GPs interviewed showed limited understanding of the CC framework, and reported limited collaboration with CMs: barriers to collaboration were identified. All participants identified the potential or experienced benefits of a collaborative approach to depression management and were able to discuss ways in which collaboration can be facilitated. Primary care professionals in this study valued the potential for collaboration, but GPs' understanding of CC and organisational barriers hindered opportunities for communication. Further work is needed to address these organisational barriers in order to facilitate collaboration around individual patients with depression, including shared IT systems, facilitating opportunities for informal discussion and building in formal collaboration into the CC framework. ISRCTN32829227 30/9/2008.

A feasibility study of dementia communication training based on the VERA framework for pre-registration nurses: Part II impact on student experience.

PubMed

Naughton, Corina; Beard, Chloe; Tzouvara, Vasiliki; Pegram, Anne; Verity, Rebecca; Eley, Rhiannon; Hingley, David

2018-04-01

People living with dementia have complex communication needs, especially during acute hospital admissions. The VERA framework (validation, emotion, reassurance, activity) was designed to promote person centred communication between student nurses and people living with dementia, but there is limited evaluation of its impact. To measure the impact of dementia communication training (based on VERA) plus older adult unit (OAU) placement on students' ability to recognise opportunities for person centred (PC) communication compared to OAU placement alone. A control pre-post-study design was used. Dementia communication training plus follow-up during OAU placement was delivered to 51 students (5 OAU, two hospitals) while 66 students (7 OAUs, five hospitals) acted as controls. The primary outcome was students' ability to recognise PC communication assessed using case vignettes. Data were collected using electronic survey and focus group interviews. Data analysis used independent non-parametric Mann-Whitney U test and thematic analysis. In total 52 students (response rate 40%) completed surveys at the end of placements (38 intervention, 14 control group students). In the intervention group, participants were significantly more likely to identify PC responses with a mean score of 10.5 (SD 3.0) compared with 7.5 (SD 3.0) in the control group (p = 0.006). In focus group interviews (n = 19 students), the main themes were connecting with patients, VERA in practice, communication challenges, and learning environment. VERA was described as a flexible approach that added to participants' communication toolkit. The learning environment, complexity of patients and organisational resources were important contextual factors. The VERA framework has potential as a foundation level dementia communication training intervention, but it requires more rigorous testing. Nursing can lead the way in developing and embedding evidence-based, interdisciplinary dementia communication training in preregistration curricula. Copyright © 2018 Elsevier Ltd. All rights reserved.

What helps or hinders midwives to implement physical activity guidelines for obese pregnant women? A questionnaire survey using the Theoretical Domains Framework.

PubMed

McParlin, Catherine; Bell, Ruth; Robson, Stephen C; Muirhead, Colin R; Araújo-Soares, Vera

2017-06-01

to investigate barriers and facilitators to physical activity (PA) guideline implementation for midwives when advising obese pregnant women. a cross-sectional, self-completion, anonymous questionnaire was designed using the Theoretical Domains Framework. this framework was developed to evaluate the implementation of guidelines by health care professionals. A total of 40 questions were included. These were informed by previous research on pregnant women's and midwives views, knowledge and attitudes to PA, and supported by national evidence based guidelines. Demographic information and free text comments were also collected. three diverse NHS Trusts in the North East of England. all midwives employed by two hospital Trusts and the community midwives from the third Trust (n=375) were invited to participate. mean domain scores were calculated. Factor and regression analysis were performed to describe which theoretical domains may be influencing practice. Free text comments were analysed thematically. 192 (53%) questionnaires were returned. Mean domain scores were highest for social professional role and knowledge, and lowest for skills, beliefs about capabilities and behaviour regulation. Regression analysis indicated that skills and memory/attention/decision domains had a statistically significant influence on midwives discussing PA with obese pregnant women and advising them accordingly. Midwives comments indicated that they felt it was part of their role to discuss PA with all pregnant women but felt they lacked the skills and resources to do so effectively. midwives seem to have the necessary knowledge about the need/importance of PA advice for obese women and believe it is part of their role, but perceive they lack necessary skills and resources, and do not plan or prioritise the discussion regarding PA with obese pregnant woman. designing interventions that improve skills, promote routine enquiry regarding PA and provide resources (eg. information, referral pathways) may help improve midwives' PA advice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Changing Beliefs about Trauma: A Qualitative Study of Cognitive Processing Therapy.

PubMed

Price, Jennifer L; MacDonald, Helen Z; Adair, Kathryn C; Koerner, Naomi; Monson, Candice M

2016-03-01

Controlled qualitative methods complement quantitative treatment outcome research and enable a more thorough understanding of the effects of therapy and the suspected mechanisms of action. Thematic analyses were used to examine outcomes of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) in a randomized controlled trial of individuals diagnosed with military-related PTSD (n = 15). After sessions 1 and 11, participants wrote "impact statements" describing their appraisals of their trauma and beliefs potentially impacted by traumatic events. Trained raters coded each of these statements using a thematic coding scheme. An analysis of thematic coding revealed positive changes over the course of therapy in participants' perspective on their trauma and their future, supporting the purported mechanisms of CPT. Implications of this research for theory and clinical practice are discussed.

Analyzing thematic maps and mapping for accuracy

USGS Publications Warehouse

Rosenfield, G.H.

1982-01-01

Two problems which exist while attempting to test the accuracy of thematic maps and mapping are: (1) evaluating the accuracy of thematic content, and (2) evaluating the effects of the variables on thematic mapping. Statistical analysis techniques are applicable to both these problems and include techniques for sampling the data and determining their accuracy. In addition, techniques for hypothesis testing, or inferential statistics, are used when comparing the effects of variables. A comprehensive and valid accuracy test of a classification project, such as thematic mapping from remotely sensed data, includes the following components of statistical analysis: (1) sample design, including the sample distribution, sample size, size of the sample unit, and sampling procedure; and (2) accuracy estimation, including estimation of the variance and confidence limits. Careful consideration must be given to the minimum sample size necessary to validate the accuracy of a given. classification category. The results of an accuracy test are presented in a contingency table sometimes called a classification error matrix. Usually the rows represent the interpretation, and the columns represent the verification. The diagonal elements represent the correct classifications. The remaining elements of the rows represent errors by commission, and the remaining elements of the columns represent the errors of omission. For tests of hypothesis that compare variables, the general practice has been to use only the diagonal elements from several related classification error matrices. These data are arranged in the form of another contingency table. The columns of the table represent the different variables being compared, such as different scales of mapping. The rows represent the blocking characteristics, such as the various categories of classification. The values in the cells of the tables might be the counts of correct classification or the binomial proportions of these counts divided by either the row totals or the column totals from the original classification error matrices. In hypothesis testing, when the results of tests of multiple sample cases prove to be significant, some form of statistical test must be used to separate any results that differ significantly from the others. In the past, many analyses of the data in this error matrix were made by comparing the relative magnitudes of the percentage of correct classifications, for either individual categories, the entire map or both. More rigorous analyses have used data transformations and (or) two-way classification analysis of variance. A more sophisticated step of data analysis techniques would be to use the entire classification error matrices using the methods of discrete multivariate analysis or of multiviariate analysis of variance.

Family members' influence on family meal vegetable choices

PubMed Central

Wenrich, Tionni R.; Brown, J. Lynne; Miller-Day, Michelle; Kelley, Kevin J.; Lengerich, Eugene J.

2010-01-01

Objective Characterize the process of family vegetable selection (especially cruciferous, deep orange, and dark green leafy vegetables); demonstrate the usefulness of Exchange Theory (how family norms and past experiences interact with rewards and costs) for interpreting the data. Design Eight focus groups, two with each segment (men/women vegetable-likers/dislikers based on a screening form). Participants completed a vegetable intake form. Setting Rural Appalachian Pennsylvania. Participants 61 low-income, married/cohabiting men (n=28) and women (n=33). Analysis Thematic analysis within Exchange Theory framework for qualitative data. Descriptive analysis, t-tests and chi-square tests for quantitative data. Results Exchange Theory proved useful for understanding that regardless of sex or vegetable-liker/disliker status, meal preparers see more costs than rewards to serving vegetables. Past experience plus expectations of food preparer role and of deference to family member preferences supported a family norm of serving only vegetables acceptable to everyone. Emphasized vegetables are largely ignored due to unfamiliarity; family norms prevented experimentation and learning through exposure. Conclusions and Implications Interventions to increase vegetable consumption of this audience could 1) alter family norms about vegetables served, 2) change perceptions of past experiences, 3) reduce social and personal costs of serving vegetables and 4) increase tangible and social rewards of serving vegetables. PMID:20452288

Tobacco industry globalization and global health governance: towards an interdisciplinary research agenda

PubMed Central

Lee, Kelley; Eckhardt, Jappe; Holden, Chris

2016-01-01

Shifting patterns of tobacco production and consumption, and the resultant disease burden worldwide since the late twentieth century, prompted efforts to strengthen global health governance through adoption of the Framework Convention on Tobacco Control. While the treaty is rightfully considered an important achievement, to address a neglected public health issue through collective action, evidence suggests that tobacco industry globalization continues apace. In this article, we provide a systematic review of the public health literature and reveal definitional and measurement imprecision, ahistorical timeframes, transnational tobacco companies and the state as the primary units and levels of analysis, and a strong emphasis on agency as opposed to structural power. Drawing on the study of globalization in international political economy and business studies, we identify opportunities to expand analysis along each of these dimensions. We conclude that this expanded and interdisciplinary research agenda provides the potential for fuller understanding of the dual and dynamic relationship between the tobacco industry and globalization. Deeper analysis of how the industry has adapted to globalization over time, as well as how the industry has influenced the nature and trajectory of globalization, is essential for building effective global governance responses. This article is published as part of a thematic collection dedicated to global governance. PMID:28458910

Tobacco industry globalization and global health governance: towards an interdisciplinary research agenda.

PubMed

Lee, Kelley; Eckhardt, Jappe; Holden, Chris

2016-01-01

Shifting patterns of tobacco production and consumption, and the resultant disease burden worldwide since the late twentieth century, prompted efforts to strengthen global health governance through adoption of the Framework Convention on Tobacco Control. While the treaty is rightfully considered an important achievement, to address a neglected public health issue through collective action, evidence suggests that tobacco industry globalization continues apace. In this article, we provide a systematic review of the public health literature and reveal definitional and measurement imprecision, ahistorical timeframes, transnational tobacco companies and the state as the primary units and levels of analysis, and a strong emphasis on agency as opposed to structural power. Drawing on the study of globalization in international political economy and business studies, we identify opportunities to expand analysis along each of these dimensions. We conclude that this expanded and interdisciplinary research agenda provides the potential for fuller understanding of the dual and dynamic relationship between the tobacco industry and globalization. Deeper analysis of how the industry has adapted to globalization over time, as well as how the industry has influenced the nature and trajectory of globalization, is essential for building effective global governance responses. This article is published as part of a thematic collection dedicated to global governance.

Bread and Shoulders: Reversing the Downward Spiral, a Qualitative Analyses of the Effects of a Housing First-Type Program in France.

PubMed

Rhenter, Pauline; Moreau, Delphine; Laval, Christian; Mantovani, Jean; Albisson, Amandine; Suderie, Guillaume; Boucekine, Mohamed; Tinland, Aurelie; Loubière, Sandrine; Greacen, Tim; Auquier, Pascal; Girard, Vincent

2018-03-14

This paper is a qualitative analysis of the effects of accompagnement , a support framework, on recovery trajectories of people with long-term homelessness and severe psychiatric disorders during 24 months in a Housing First-type program in France. A comprehensive methodology based on grounded theory was used to construct an interview guide, conduct multiple interviews with 35 Housing First participants sampled for heterogeneity, and produce memos on their trajectories before and after entering the program based on interview information. Thematic analysis of a representative subsample ( n = 13) of memos identified 12 objective factors and 6 subjective factors key to the recovery process. An in-depth re-analysis of the memos generated four recovery themes: (1) the need for secure space favorable to self-reflexivity; (2) a "honeymoon" effect; (3) the importance of even weak social ties; (4) support from and hope among peers. Three challenges to recovery were identified: (1) finding a balance between protection and risk; (2) breaking downward spirals; (3) bifurcating the trajectory. This study provides new insight into the recovery process, understood as a non-linear transformation of an experience-the relationship between objective life conditions and subjective perception of those conditions-which reinforces protective support over risk elements.

Bread and Shoulders: Reversing the Downward Spiral, a Qualitative Analyses of the Effects of a Housing First-Type Program in France

PubMed Central

Rhenter, Pauline; Moreau, Delphine; Laval, Christian; Mantovani, Jean; Albisson, Amandine; Suderie, Guillaume; Boucekine, Mohamed; Tinland, Aurelie; Loubière, Sandrine; Greacen, Tim; Auquier, Pascal; Girard, Vincent

2018-01-01

This paper is a qualitative analysis of the effects of accompagnement, a support framework, on recovery trajectories of people with long-term homelessness and severe psychiatric disorders during 24 months in a Housing First-type program in France. A comprehensive methodology based on grounded theory was used to construct an interview guide, conduct multiple interviews with 35 Housing First participants sampled for heterogeneity, and produce memos on their trajectories before and after entering the program based on interview information. Thematic analysis of a representative subsample (n = 13) of memos identified 12 objective factors and 6 subjective factors key to the recovery process. An in-depth re-analysis of the memos generated four recovery themes: (1) the need for secure space favorable to self-reflexivity; (2) a “honeymoon” effect; (3) the importance of even weak social ties; (4) support from and hope among peers. Three challenges to recovery were identified: (1) finding a balance between protection and risk; (2) breaking downward spirals; (3) bifurcating the trajectory. This study provides new insight into the recovery process, understood as a non-linear transformation of an experience—the relationship between objective life conditions and subjective perception of those conditions—which reinforces protective support over risk elements. PMID:29538346

Exploring stigmatisation among people diagnosed with either bipolar disorder or borderline personality disorder: a critical realist analysis.

PubMed

Bonnington, Oliver; Rose, Diana

2014-12-01

This study explores experiences of stigma and discrimination amongst people diagnosed with bipolar disorder (BD) or borderline personality disorder (BPD). Inspired by Margaret Archer's morphogenetic sequence and the ontological depth of critical realism, a temporal framework for stigmatisation, incorporating structure and agency, is developed and used to situate these experiences. A literature review found very little existing research on the subjective experience of stigma amongst these diagnostic groups. Indeed, most mental illness stigma research is quantitative and focussed on schizophrenia and depression. In-depth interviews were conducted with twenty-nine people diagnosed with BD or BPD, along with five 'friendship' mini-focus groups within the UK. Participants were recruited via charities and participant networking. Using thematic analysis, along with abductive and retroductive inference, experiences and anticipation of stigma and discrimination for participants with one of the two diagnoses in various contexts of social interaction were found to coincide with 'four faces' of oppression: cultural imperialism (pathologisation, normalisation and stereotyping), powerlessness, marginalisation and violence. Such experiences implied a range of antecedent social and cultural structures. Implications for the stigma concept are discussed. Copyright © 2014. Published by Elsevier Ltd.

Communicating immunization science: the genesis and evolution of the National Network for Immunization Information.

PubMed

Ledford, Christy J W; Willett, Kristen L; Kreps, Gary L

2012-01-01

For 10 years, the National Network for Immunization Information (NNii) has pursued its goal to "provide the public, health professionals, policy makers, and the media with up-to-date, scientifically valid information related to immunizations to help them understand the issues and to make informed decisions." This investigation provides a critical evaluation of the strategic communication planning and implementation of NNii from conception to present day. The study uses a case study methodology, developing a systematic analysis of organizational documents, the media environment, and in-depth interviews by applying Weick's model of organizing as an interpretive framework. Iterative data analysis included open coding, axial coding, and thematic saturation. Themes were compared with phases of strategic communication and present study propositions. Major themes identified included the organization's informative nature, funding credibility, nonbranding, reflective evaluation, collaborative partnerships, and media strategy. NNii meets the requirements of requisite variety, nonsummativity, and organizational flexibility proposed by Weick's model of organizing. However, a lack of systematic evaluation of organization goals prevents it from adapting communication tactics and strategies. In addition, the authors recommend that NNii, while maintaining its informative nature, adopt persuasive strategies to attract and retain the attention of its target audiences.

"I'm not abusing or anything": patient-physician communication about opioid treatment in chronic pain.

PubMed

Matthias, Marianne S; Krebs, Erin E; Collins, Linda A; Bergman, Alicia A; Coffing, Jessica; Bair, Matthew J

2013-11-01

To characterize clinical communication about opioids through direct analysis of clinic visits and in-depth interviews with patients. This was a pilot study of 30 patients with chronic pain, who were audio-recorded in their primary care visits and interviewed after the visit about their pain care and relationship with their physicians. Emergent thematic analysis guided data interpretation. Uncertainties about opioid treatment for chronic pain, particularly addiction and misuse, play an important role in communicating about pain treatment. Three patterns of responding to uncertainty emerged in conversations between patients and physicians: reassurance, avoiding opioids, and gathering additional information. Results are interpreted within the framework of Problematic Integration theory. Although it is well-established that opioid treatment for chronic pain poses numerous uncertainties, little is known about how patients and their physicians navigate these uncertainties. This study illuminates ways in which patients and physicians face uncertainty communicatively and collaboratively. Acknowledging and confronting the uncertainties inherent in chronic opioid treatment are critical communication skills for patients taking opioids and their physicians. Many of the communication behaviors documented in this study may serve as a model for training patients and physicians to communicate effectively about opioids. Published by Elsevier Ireland Ltd.

Male suicide among construction workers in Australia: a qualitative analysis of the major stressors precipitating death.

PubMed

Milner, Allison; Maheen, Humaira; Currier, Dianne; LaMontagne, Anthony D

2017-06-19

Suicide rates among those employed in male-dominated professions such as construction are elevated compared to other occupational groups. Thus far, past research has been mainly quantitative and has been unable to identify the complex range of risk and protective factors that surround these suicides. We used a national coronial database to qualitatively study work and non-work related influences on male suicide occurring in construction workers in Australia. We randomly selected 34 cases according to specific sampling framework. Thematic analysis was used to develop a coding structure on the basis of pre-existing theories in job stress research. The following themes were established on the basis of mutual consensus: mental health issues prior to death, transient working experiences (i.e., the inability to obtain steady employment), workplace injury and chronic illness, work colleagues as a source of social support, financial and legal problems, relationship breakdown and child custody issues, and substance abuse. Work and non-work factors were often interrelated pressures prior to death. Suicide prevention for construction workers needs to take a systematic approach, addressing work-level factors as well as helping those at-risk of suicide.

Communication between oncologists and lymphoma survivors during follow-up consultations: A qualitative analysis

PubMed Central

Franco, Kara; Shuk, Elyse; Philip, Errol; Blanch-Hartigan, Danielle; Parker, Patricia A.; Matasar, Matthew; Horwitz, Steven; Kissane, David; Banerjee, Smita C.; Bylund, Carma L.

2017-01-01

Cancer survivors often experience both short- and long-term challenges as a result of their cancer treatment. Many patients report feeling “lost in transition” following cancer treatment. The oncologist plays a key role in helping the patient to transition to survivorship. The purpose of this paper is to provide a descriptive understanding of the clinical care delivered during follow-up visits for lymphoma patients transitioning from active therapy into survivorship. We used thematic text analysis to identify themes in transcripts of audio recordings of 21 physicians and their patients in follow-up visits within 3 years of completing lymphoma treatment. Conversations between oncologists and patients during follow-up visits addressed a variety of themes, including specific health concerns, follow-up care, health promotion, prior treatment and test results, overall health status, emotional communication and affective tone, post-treatment rehabilitation, discussions occurring in the patient’s physical examination, and social issues. However, the frequency with which these themes were discussed varied. In addition, there did not appear to be a consistent framework for these visits. The varied nature of the follow-up visits analyzed in this study suggests the need for increased structure in survivorship-care consultations. PMID:28358241

Everyday life for users of electric wheelchairs - a qualitative interview study.

PubMed

Blach Rossen, Camilla; Sørensen, Bodil; Würtz Jochumsen, Bente; Wind, Gitte

2012-09-01

The aim of this paper is to explore how users of electric wheelchairs experience their everyday life and how their electric wheelchairs influence their daily occupation. Occupation is defined as a personalized dynamic interaction between person, task and environment, and implies the value and meaning attached. Nine semi-structured interviews were conducted with experienced electric wheelchair users. ValMo was used as the theoretical framework for both interviewing and the analysis. The transcribed interviews were analysed using thematic analysis. Findings revealed key elements in electric wheelchair users' experience of how the use of a wheelchair influences everyday life and occupation. Four central themes emerged from the participants' experiences 1) The functionality of the wheelchair, 2) The wheelchair as an extension of the body, 3) The wheelchair and social life, and 4) The wheelchair and identity issues. The themes were interrelated and show how all levels of occupation were influenced both in a positive and negative way, and how it affected identity. It is essential that professionals working with electric wheelchair users are aware of how all levels of occupation and identity are influenced by using a wheelchair. This will assist professionals in supporting the users living an autonomous and meaningful life.

The role of a food policy coalition in influencing a local food environment: an Australian case study.

PubMed

McCartan, Julia; Palermo, Claire

2017-04-01

To explore how an Australian rural food policy coalition acts to influence a local food environment, focusing specifically on its composition, functions and processes as well as its food-related strategies and policy outputs. A qualitative case study approach was undertaken. Three sources were used to triangulate data: eleven semi-structured in-depth interviews with coalition members, analysis of thirty-seven documents relating to the coalition and observation at one coalition meeting. Data were analysed using a thematic and constant comparison approach. Community Coalition Action Theory provided a theoretical framework from which to interpret findings. Two rural local government areas on the south-eastern coast of Victoria, Australia. Eleven members of the food policy coalition. Five themes emerged from the data analysis. The themes described the coalition's leadership processes, membership structure, function to pool resources for food system advocacy, focus on collaborative cross-jurisdictional strategies and ability to influence policy change. This Australian case study demonstrates that with strong leadership, a small-sized core membership and focus on collaborative strategies, food policy coalitions may be a mechanism to positively influence local food environments.

SARS and hospital priority setting: a qualitative case study and evaluation.

PubMed

Bell, Jennifer A H; Hyland, Sylvia; DePellegrin, Tania; Upshur, Ross E G; Bernstein, Mark; Martin, Douglas K

2004-12-19

Priority setting is one of the most difficult issues facing hospitals because of funding restrictions and changing patient need. A deadly communicable disease outbreak, such as the Severe Acute Respiratory Syndrome (SARS) in Toronto in 2003, amplifies the difficulties of hospital priority setting. The purpose of this study is to describe and evaluate priority setting in a hospital in response to SARS using the ethical framework 'accountability for reasonableness'. This study was conducted at a large tertiary hospital in Toronto, Canada. There were two data sources: 1) over 200 key documents (e.g. emails, bulletins), and 2) 35 interviews with key informants. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Participants described the types of priority setting decisions, the decision making process and the reasoning used. Although the hospital leadership made an effort to meet the conditions of 'accountability for reasonableness', they acknowledged that the decision making was not ideal. We described good practices and opportunities for improvement. 'Accountability for reasonableness' is a framework that can be used to guide fair priority setting in health care organizations, such as hospitals. In the midst of a crisis such as SARS where guidance is incomplete, consequences uncertain, and information constantly changing, where hour-by-hour decisions involve life and death, fairness is more important rather than less.

Unifying a fragmented effort: a qualitative framework for improving international surgical teaching collaborations.

PubMed

Fallah, Parisa Nicole; Bernstein, Mark

2017-09-07

Access to adequate surgical care is limited globally, particularly in low- and middle-income countries (LMICs). To address this issue, surgeons are becoming increasingly involved in international surgical teaching collaborations (ISTCs), which include educational partnerships between surgical teams in high-income countries and those in LMICs. The purpose of this study is to determine a framework for unifying, systematizing, and improving the quality of ISTCs so that they can better address the global surgical need. A convenience sample of 68 surgeons, anesthesiologists, physicians, residents, nurses, academics, and administrators from the U.S., Canada, and Norway was used for the study. Participants all had some involvement in ISTCs and came from multiple specialties and institutions. Qualitative methodology was used, and participants were interviewed using a pre-determined set of open-ended questions. Data was gathered over two months either in-person, over the phone, or on Skype. Data was evaluated using thematic content analysis. To organize and systematize ISTCs, participants reported a need for a centralized/systematized process with designated leaders, a universal data bank of current efforts/progress, communication amongst involved parties, full-time administrative staff, dedicated funds, a scholarly approach, increased use of technology, and more research on needs and outcomes. By taking steps towards unifying and systematizing ISTCs, the quality of ISTCs can be improved. This could lead to an advancement in efforts to increase access to surgical care worldwide.

Which Social Values Are Considered in Iranian Health System?

PubMed

Rashidian, Arash; Arab, Mohammad; Vaez Mahdavi, Mohammadreza; Ashtarian, Koimars; Mostafavi, Hakimeh

2018-05-01

Health systems have a set of limited resources for meeting the needs of communities. Health priority setting based on criteria and values is inevitable in such situation. This paper aims to identify the social values that are considered in Iranian health system. This qualitative study was conducted in 3 steps including collecting national documents and literature review, interviewing key informants, and a 2 round Delphi. Interviews and documents were analyzed through thematic framework analysis. Statistical guidance was applied for determining consensus cut-off in Delphi technique. Five social values including freedom of choice, equity, solidarity, severity of disease(s), and burden of disease(s) were considered more important than other values in the health priority setting decisions. Moreover, 2 non-value based factors including conflict of interest and lobbying had a high effect on decision making. Most health policy makers decide based on Egalitarian school, but restriction of resources in the country decreases the outcome. Moreover, personal judgments and preferences sometimes affect their decisions. It seems that developing a value-based framework and making it as a national guidance could have affirmative effect on health administers decisions. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A Focus Group Study Exploring Student Nurse's Experiences of an Educational Intervention Focuse don Working with People with a Diagnosis of Personality Disorder.

PubMed

Stacey, G; Baldwin, V; Thompson, B; Aubeeluck, A

2018-05-21

Negative attitudes exist in practice towards those with a diagnosis of personality disorder. Preregistration training offers the opportunity to address this by developing understanding of the diagnosis, confidence in working with people with the diagnosis and empowering new nurses to challenge prevailing attitudes. Attempts to integrate and evaluate specific educational interventions of this nature into pre-registration nurse education have not been explored elsewhere. To explore preregistration nurses' experience of a programme of training focused on personality disorder and their perception of its influence on attitudes, understanding of clients and their experience of practice. A qualitative study using thematic analysis of two focus groups of pre-registration mental health nursing students. Evidence of positive attitudes and confidence to supportively challenge negative attitudes in practice were found. Students showed a shift away from a focus on changing the perceived 'difficult' behaviour of a client towards an understanding of their own emotional responses to the behaviours. The Knowledge and Understanding Framework training shows potential for students to change attitudes and develop progressive practice working with people with personality disorder. The integration of the Knowledge and Understanding Framework should be considered as part of preregistration training. Further research into the sustained influence of the training post registration is required. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The impact of non-motor manifestations of Parkinson's disease on partners: understanding and application of chronic sorrow theory.

PubMed

Mercer, Christine J

2015-09-01

Parkinson's disease (PD) can cause many emotions, including grief and a sense of isolation for both the person with PD (referred to as Parkinsonian) and their partner. Such ongoing grief and emotional turmoil can be termed chronic sorrow. The aim of this research is to present accounts of partners' perspectives, analysed in the context of chronic sorrow theory, to offer health professionals an insight into the impact of non-motor PD symptoms on partners. A group of partners of Parkinsonians provided the data through individual stories. These stories were subjected to thematic analysis, using a seven-step process leading to the establishment of themes. Caregiver burden and chronic sorrow is not related to providing physical care, but the emotional care of attempting to minimise the effect of PD, coping with disturbance to sleep, and helping the Parkinsonian to maintain as much independence as possible. Contributors to this article found chronic sorrow theory provided a framework for understanding their emotions. Sharing their experiences with others provided an opportunity to be heard, and enabled them to make sense of individual situations. Chronic sorrow theory provides a useful framework for both partners of Parkinsonians in understanding their emotional responses, and for health professionals in considering the challenges partners face in coping with living with a person with PD.

Outcomes of newly practicing nurses who applied principles of holistic comfort theory during the transition from school to practice: a qualitative study.

PubMed

Goodwin, Miki; Candela, Lori

2013-06-01

The aim of this qualitative study was to explore if newly practicing nurses benefited from learning holistic comfort theory during their baccalaureate education, and to provide a conceptual framework to support the transition from school to practice. The study was conducted among graduates of an accelerated baccalaureate nursing program where holistic comfort theory was embedded as a learner-centered philosophy across the curriculum. A phenomenological process using van Manen's qualitative methodology in education involving semi-structured interviews and thematic analysis was used. The nurses recalled what holistic comfort meant to them in school, and described the lived experience of assimilating holistic comfort into their attitudes and behaviors in practice. Themes were established and a conceptual framework was developed to better understand the nurses' lived experiences. Results showed that holistic comfort was experienced as a constructive approach to transcend unavoidable difficulties during the transition from school to practice. Participants described meaningful learning and acquisition of self-strengthening behaviors using holistic comfort theory. Holistic comfort principles were credited for easing nurses into the realities of work and advocating for best patient outcomes. Patient safety and pride in patient care were incidental positive outcomes. The study offers new insights about applying holistic comfort to prepare nurses for the realities of practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Health professionals' perceptions of feeding-related quality of life in children with quadriplegic cerebral palsy.

PubMed

Morrow, A M; Quine, S; Craig, J C

2007-09-01

Our aim was to identify the major determinants of feeding-related quality of life (QoL) in children with quadriplegic cerebral palsy (QCP) from the perspective of health professionals to provide a framework for comprehensive clinical evaluation of health status in this group. A trained facilitator conducted five semi-structured focus groups during September and November 2003. Participants were recruited through the two paediatric hospitals in Sydney and community-based services, and included general and specialist paediatricians (n = 18), nurses (n = 15) and allied health professionals (n = 13), with an 80% response rate. All sessions were audio- and videotaped. NVIVO software was used to facilitate thematic analysis of the transcribed audiotapes. Responses clustered into five themes: delivery of health services, parent-child interaction, the child's physical and emotional well-being, and social participation. Participants thought the QoL of child and parent was inseparable. Parent-child interaction, delivery of services and physical well-being were the topics which prompted most participant interaction. These findings did not vary across disciplines. Health professionals identified five domains which provide a framework within which clinicians may comprehensively evaluate the health status of children with QCP and feeding difficulties. These five domains may also be used to inform a new feeding-related QoL instrument for use in this group of patients.

A characterization of clinical questions asked by rehabilitation therapists.

PubMed

Kloda, Lorie Andrea; Bartlett, Joan C

2014-04-01

This study explored the information needs of rehabilitation therapists (occupational therapists, physical therapists, and speech-language pathologists) working with patients who have had strokes in order to characterize their clinical questions, defined as their formalized information needs arising in the context of everyday clinical practice. The researchers took a constructivist, interpretive approach, in which fifteen rehabilitation therapists working in various settings were recruited. Data were gathered using diaries, followed by diary-guided interviews, and thematically analyzed using template analysis. Rehabilitation therapists' clinical questions were characterized as having one or more of twelve foci and containing one or more of eight possible structural elements. Findings demonstrate that the evidence-based practice framework currently applied for questions relating to rehabilitation is inadequate for representing rehabilitation therapists' clinical questions. A new framework that is more comprehensive and descriptive is proposed. Librarians working with students and clinicians in rehabilitation can employ knowledge of the twelve foci and the question structure for rehabilitation to guide the reference interview. Instruction on question formulation in evidence-based practice can employ the revised structure for rehabilitation, offering students and clinicians an alternative to the traditional patient, intervention, comparison, outcome (PICO) structure. Information products, including bibliographic databases and synopsis services, can tailor their interfaces according to question foci and prompt users to enter search terms corresponding to any of the eight possible elements found in rehabilitation therapists' clinical questions.

Hearing Parents' Appraisals of Parenting a Deaf or Hard-of-Hearing Child: Application of a Positive Psychology Framework.

PubMed

Szarkowski, Amy; Brice, Patrick J

2016-07-01

Hearing parents of deaf and hard-of-hearing children face unique challenges and stressors, the understanding of which has been the focus of numerous studies; yet, relatively little is known about their positive experiences. Using a qualitative purposive sampling design, interviews were conducted with 11 hearing parents (8 mothers, 3 fathers) exploring parents' positive appraisals of their experiences in raising a child who is deaf or hard of hearing (D/HH). Interviews were transcribed and a thematic analysis was conducted, which allowed the researchers to identify themes and patterns in the parents' appraisals. Nine key themes emerged, which characterized parents' positive perceptions of raising a child who is D/HH: knowing the child, appreciating everyday positives, increasing involvement with the child, relishing the highs, taking less for granted, letting go, learning, advocating, and experiencing personal growth A positive psychology framework was employed to foster understanding of the interview findings and their implications. When asked about the positive aspects of raising a D/HH child, hearing parents were readily able to identify ways in which their parenting experience had been enhanced and their lives improved as a result of their unique situations. The implications of these findings are discussed. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Setting healthcare priorities in hospitals: a review of empirical studies

PubMed Central

Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

2015-01-01

Priority setting research has focused on the macro (national) and micro (bedside) level, leaving the meso (institutional, hospital) level relatively neglected. This is surprising given the key role that hospitals play in the delivery of healthcare services and the large proportion of health systems resources that they absorb. To explore the factors that impact upon priority setting at the hospital level, we conducted a thematic review of empirical studies. A systematic search of PubMed, EBSCOHOST, Econlit databases and Google scholar was supplemented by a search of key websites and a manual search of relevant papers’ reference lists. A total of 24 papers were identified from developed and developing countries. We applied a policy analysis framework to examine and synthesize the findings of the selected papers. Findings suggest that priority setting practice in hospitals was influenced by (1) contextual factors such as decision space, resource availability, financing arrangements, availability and use of information, organizational culture and leadership, (2) priority setting processes that depend on the type of priority setting activity, (3) content factors such as priority setting criteria and (4) actors, their interests and power relations. We observe that there is need for studies to examine these issues and the interplay between them in greater depth and propose a conceptual framework that might be useful in examining priority setting practices in hospitals. PMID:24604831

Qualitative thematic analysis of the phenomenology of near-death experiences

PubMed Central

Degrange, Sophie; Martial, Charlotte; Charland-Verville, Vanessa; Lallier, François; Bragard, Isabelle; Guillaume, Michèle; Laureys, Steven

2018-01-01

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers’ (NDErs) lives. Previous studies have shown that NDEs memories are phenomenologically rich. In the present study, we therefore aimed to extract the common themes (referred to as “features” in the NDE literature) reported by NDErs by analyzing all the concepts stored in the narratives of their experiences. A qualitative thematic analysis has been carried out on 34 cardiac arrest survivors’ NDE narratives. Our results shed the light on the structure of the narratives by identifying 10 “time-bounded” themes which refer to isolated events encountered during the NDE and 1 “transversal” theme which characterizes the whole narrative and generally appears as a retrospective comment of self-reflection on the experience. The division of narratives into themes provides us with detailed information about the vocabulary used by NDErs to describe their experience. This established thematic method enables a rigorous description of the phenomenon, ensuring the inclusion of all self-reported manifestations of themes in narratives. PMID:29444184

Health care needs assessment among adolescents in correctional institutions in Zambia: an ethical analysis.

PubMed

Kumwenda, Maureen; Nzala, Selestine; Zulu, Joseph M

2017-08-22

While health care needs assessments have been conducted among juveniles or adolescents by researchers in developed countries, assessments using an ethics framework particularly in developing countries are lacking. We analysed the health care needs among adolescents at the Nakambala Correctional Institution in Zambia, using the Beauchamp and Childress ethics framework. The ethics approach facilitated analysis of moral injustices or dilemmas triggered by health care needs at the individual (adolescent) level. The research team utilized 35 in-depth interviews with juveniles, 6 key informant interviews and 2 focus group discussions to collect data. We analysed the data using thematic analysis. The use of three sources of data facilitated triangulation of data. Common health problems included HIV/AIDS, STIs, flu, diarrhoea, rashes, and malaria. Although there are some health promotion strategies at the Nakambala Approved School, the respondents classified the health care system as inadequate. The unfavourable social context which included clouded rooms and lack of adolescent health friendly services unfairly exposed adolescents to several health risks and behaviours thus undermining the ethics principle of social justice. In addition, the limited prioritisation of adolescent centres by the stakeholders and erratic funding also worsened injustices by weakening the health care system. Whereas the inadequate medical and drug supplies, shortage of health workers in the nearby health facilities and weak referral systems excluded the juveniles from enjoying maximum health benefits thus undermining adolescents' wellbeing or beneficence. Inadequate medical and drug supplies as well as non-availability of adolescent friendly health services at the nearest health facility did not only affect social justice and beneficence ethics principles but also threatened juveniles' privacy, liberty and confidentiality as well as autonomy with regard to health service utilisation. Adequately addressing the health needs in correctional institutions may require adopting an ethics framework in conducting health needs assessment. An ethics approach is important because it facilitates understanding of moral dilemmas that arise due to health needs. Furthermore, strategies for addressing health needs related to one ethics principle may have a positive ripple effect over other health needs as the principles are intertwined thus facilitating a comprehensive response to health needs.

Analysis of an international collaboration for capacity building of human resources for eye care: case study of the college-college VISION 2020 LINK.

PubMed

Mwangi, Nyawira; Zondervan, Marcia; Bascaran, Covadonga

2017-03-14

There is an extreme health workforce shortage in Eastern, Central, and Southern Africa. Shortage of eye care workers impedes effective implementation of prevention of blindness programs. The World Health Organization has identified education, partnership, leadership, financing, and policy as intertwined interventions that are critical to resolving this crisis on the long term. The VISION 2020 LINK between the College of Ophthalmology of Eastern, Central, and Southern Africa and the Royal College of Ophthalmologists in the United Kingdom aims to increase the quantity and quality of eye care training in East, Central, and Southern Africa through a focus on five strategic areas: fellowship examination for ophthalmologists, training the trainers, curriculum development for residents in ophthalmology and ophthalmic clinical officers, continuous professional development (CPD), and mentoring program for young ophthalmologists. This study examined how education and partnership can be linked to improve eye care, through an evaluation of this north-south link based on its own targets and established frameworks to guide north-south links. An exploratory qualitative case study design was used. Twenty-nine link representatives were recruited through purposive sampling and snowballing. Face-to-face interviews were conducted using a semi-structured interview schedule that incorporated the components of a successful link from an existing framework. Documents pertaining to the link were also examined. Thematic analysis was used for data analysis. The findings revealed that the perception to the contribution of the link to eye care in the region is generally positive. Process indicators showed that the targets in three strategic objectives of the link have been achieved. Framework-based evaluation also showed that the link is successful. Mutual learning and development of friendships were the most commonly identified success factors. Inadequate awareness of the link by college members is a key challenge. The study concludes that the link is active and evolving and has achieved most of its targets. Further developments should be directed to influence health system strengthening in Eastern, Central, and Southern Africa more strategically. The study recommends expansion of the scope of collaboration to involve multiple health system building blocks.

The impact of soil degradation on soil functioning in Europe

NASA Astrophysics Data System (ADS)

Montanarella, Luca

2010-05-01

The European Commission has presented in September 2006 its Thematic Strategy for Soil Protection.The Thematic Strategy for Soil Protection consists of a Communication from the Commission to the other European Institutions, a proposal for a framework Directive (a European law), and an Impact Assessment. The Communication (COM(2006) 231) sets the frame. It defines the relevant soil functions for Europe and identifies the major threats. It explains why further action is needed to ensure a high level of soil protection, sets the overall objective of the Strategy and explains what kind of measures must be taken. It establishes a ten-year work program for the European Commission. The proposal for a framework Directive (COM(2006) 232) sets out common principles for protecting soils across the EU. Within this common framework, the EU Member States will be in a position to decide how best to protect soil and how use it in a sustainable way on their own territory. The Impact Assessment (SEC (2006) 1165 and SEC(2006) 620) contains an analysis of the economic, social and environmental impacts of the different options that were considered in the preparatory phase of the strategy and of the measures finally retained by the Commission. Since 2006 a large amount of new evidence has allowed to further document the extensive negative impacts of soil degradation on soil functioning in Europe. Extensive soil erosion, combined with a constant loss of soil organic carbon, have raised attention to the important role soils are playing within the climate change related processes. Other important processes are related to the loss of soil biodiversity, extensive soil sealing by housing and infrastructure, local and diffuse contamination by agricultural and industrial sources, compaction due to unsustainable agricultural practices and salinization by unsustainable irrigation practices. The extended impact assessment by the European Commission has attempted to quantify in monetary terms the actual economic impact of soil degradation in Europe.The total costs of soil degradation that could be assessed for erosion, organic matter decline, salinisation, landslides and contamination on the basis of available data, would be up to €38 billion annually for EU25. These estimates are necessarily wide ranging due to the lack of sufficient quantitative and qualitative data. Future research activities will have to address, in multidisciplinary teams, the social and economic aspects of soil degradation in Europe, in order to come up with more reliable estimates of the economic impact of soil degradation. A more reliable and updated system of indicators needs to be developed in order to cover the full cycle of the Driving forces-Pressures-State-Impact-Response (DPSIR) framework. Recent developments towards a new soil monitoring system for Europe will be presented as well as some of the recent outputs of the European Soil Data Centre (ESDAC).

Spectral characterization of biophysical characteristics in a boreal forest - Relationship between Thematic Mapper band reflectance and leaf area index for Aspen

NASA Technical Reports Server (NTRS)

Badhwar, G. D.; Macdonald, R. B.; Hall, F. G.; Carnes, J. G.

1986-01-01

Results from analysis of a data set of simultaneous measurements of Thematic Mapper band reflectance and leaf area index are presented. The measurements were made over pure stands of Aspen in the Superior National Forest of northern Minnesota. The analysis indicates that the reflectance may be sensitive to the leaf area index of the Aspen early in the season. The sensitivity disappears as the season progresses. Based on the results of model calculations, an explanation for the observed relationship is developed. The model calculations indicate that the sensitivity of the reflectance to the Aspen overstory depends on the amount of understory present.

Body image after mastectomy: A thematic analysis of younger women's written accounts.

PubMed

Grogan, Sarah; Mechan, Jayne

2017-09-01

This study investigated younger women's body image after mastectomy. In all, 49 women, aged 29-53 years (mean age: 39 years) who had had bilateral ( n = 8) or unilateral ( n = 41) mastectomy responded to open-ended questions online. Inductive thematic analysis revealed that aesthetics were less important than survival between diagnosis and mastectomy. Following mastectomy, women negotiated new body identities. Treatment effects such as weight gain were significant concerns. However, impacts on body confidence varied, and some participants rejected mainstream body shape ideals and reported feeling proud of their scars. Implications for supporting younger women post-mastectomy, including promotion of body acceptance, are discussed.

Change Detection Analysis in Urban and Suburban Areas Using Landsat Thematic Mapper data: Case of Huntsville, Alabama

NASA Technical Reports Server (NTRS)

Kuan, Dana; Fahsi, A.; Steinfeld S.; Coleman, T.

1998-01-01

Two Landsat Thematic Mapper (TM) images, from July 1984 and July 1992, were used to identify land use/cover changes in the urban and suburban fringe of the city of Huntsville, Alabama. Image difference was the technique used to quantify the change between the two dates. The eight-year period showed a 16% change, mainly from agricultural lands to urban areas generated by the settlement of industrial, commercial, and residential areas. Visual analysis of the change map (i.e., difference image) supported this phenomenon by showing that most changes were occurring in the vicinity of the major roads and highways across the city.

Regional analysis of tertiary volcanic Calderas (western U.S.) using Landsat Thematic Mapper imagery

NASA Technical Reports Server (NTRS)

Spatz, David M.; Taranik, James V.

1989-01-01

The Landsat Thematic Mapper (TM) imagery of the Basin and Range province of southern Nevada was analyzed to identify and map volcanic rock assemblages at three Tertiary calderas. It was found that the longer-wavelength visible and the NIR TM Bands 3, 5, and 7 provide more effective lithologic discrimination than the shorter-wavelength bands, due partly to deeper penetration of the longer-wavelength bands, resulting in more lithologically driven radiances. Shorter-wavelength TM Bands 1 and 2 are affected more by surficial weathering products including desert varnish which may or may not provide an indirect link to lithologic identity. Guidelines for lithologic analysis of volcanic terrains using Landsat TM imagery are outlined.

Extracting samples of high diversity from thematic collections of large gene banks using a genetic-distance based approach

PubMed Central

2010-01-01

Background Breeding programs are usually reluctant to evaluate and use germplasm accessions other than the elite materials belonging to their advanced populations. The concept of core collections has been proposed to facilitate the access of potential users to samples of small sizes, representative of the genetic variability contained within the gene pool of a specific crop. The eventual large size of a core collection perpetuates the problem it was originally proposed to solve. The present study suggests that, in addition to the classic core collection concept, thematic core collections should be also developed for a specific crop, composed of a limited number of accessions, with a manageable size. Results The thematic core collection obtained meets the minimum requirements for a core sample - maintenance of at least 80% of the allelic richness of the thematic collection, with, approximately, 15% of its size. The method was compared with other methodologies based on the M strategy, and also with a core collection generated by random sampling. Higher proportions of retained alleles (in a core collection of equal size) or similar proportions of retained alleles (in a core collection of smaller size) were detected in the two methods based on the M strategy compared to the proposed methodology. Core sub-collections constructed by different methods were compared regarding the increase or maintenance of phenotypic diversity. No change on phenotypic diversity was detected by measuring the trait "Weight of 100 Seeds", for the tested sampling methods. Effects on linkage disequilibrium between unlinked microsatellite loci, due to sampling, are discussed. Conclusions Building of a thematic core collection was here defined by prior selection of accessions which are diverse for the trait of interest, and then by pairwise genetic distances, estimated by DNA polymorphism analysis at molecular marker loci. The resulting thematic core collection potentially reflects the maximum allele richness with the smallest sample size from a larger thematic collection. As an example, we used the development of a thematic core collection for drought tolerance in rice. It is expected that such thematic collections increase the use of germplasm by breeding programs and facilitate the study of the traits under consideration. The definition of a core collection to study drought resistance is a valuable contribution towards the understanding of the genetic control and the physiological mechanisms involved in water use efficiency in plants. PMID:20576152

Ten Years of Simulation in Healthcare: A Thematic Analysis of Editorials.

PubMed

Nestel, Debra

2017-10-01

In this commentary, I review 38 articles published as editorials in Simulation in Healthcare from inception to April 2016. Of the 27 authors, there was a predominance of medical doctors (63%), male authors (67%), and work originating in the United States (86%). The founding Editor-in-Chief Dr David Gaba contributed to half of the editorials. Using inductive thematic analysis, the following five themes were identified: "embedding" simulation, simulation responding to clinical practice, educational considerations for simulation, research practices, and communicating leadership and scholarship about the community. After thematic analysis, the theoretical notion of communities of practice was used to make further meaning of the themes. This theorizing process reveals that editorial content aligns with the features of an evolving community of practice. The editorials seem to have responded to and shaped contemporary simulation practices. The editorial is a powerful forum in which to frame issues relevant to the healthcare simulation community. As the founding Editor-in-Chief, Gaba has made an extraordinary contribution to the Society for Simulation in Healthcare, in these editorials and the broader healthcare simulation community. Under the leadership of the Editor-in-Chief, Dr Mark Scerbo, I am confident that the editorial voice will continue in the true spirit of scholarship.

The mechanisms of action underlying the efficacy of psychological nightmare treatments: A systematic review and thematic analysis of discussed hypotheses.

PubMed

Rousseau, Andréanne; Belleville, Geneviève

2018-06-01

Studies of psychotherapeutic treatments for nightmares have yielded support for their effectiveness. However, no consensus exists to explain how they work. This study combines a systematic review with a qualitative thematic analysis to identify and categorize the existing proposed mechanisms of action (MAs) of nightmare treatments. The systematic review allowed for a great number of scholarly publications on supported psychological treatments for nightmares to be identified. Characteristics of the study and citations regarding potential MAs were extracted using a standardized coding grid. Then, thematic analysis allowed citations to be grouped under six different categories of possible MAs according to their similarities and differences. Results reveal that an increased sense of mastery was the most often cited hypothesis to explain the efficacy of nightmare psychotherapies. Other mechanisms included emotional processing leading to modification of the fear structure, modification of beliefs, restoration of sleep functions, decreased arousal, and prevention of avoidance. An illustration of the different variables involved in the treatment of nightmares is proposed. Different avenues for operationalization of these MAs are put forth to enable future research on nightmare treatments to measure and link them to efficacy measures, and test the implications of the illustration. Copyright © 2017 Elsevier Ltd. All rights reserved.

Virtual Knowledge Brokering: Describing the Roles and Strategies Used by Knowledge Brokers in a Pediatric Physiotherapy Virtual Community of Practice.

PubMed

Hurtubise, Karen; Rivard, Lisa; Héguy, Léa; Berbari, Jade; Camden, Chantal

2016-01-01

Knowledge transfer in pediatric rehabilitation is challenging and requires active, multifaceted strategies. The use of knowledge brokers (KBs) is one such strategy noted to promote clinician behavior change. The success of using KBs to transfer knowledge relies on their ability to adapt to ever-changing clinical contexts. In addition, with the rapid growth of online platforms as knowledge transfer forums, KBs must become effective in virtual environments. Although the role of KBs has been studied in various clinical contexts, their emerging role in specific online environments designed to support evidence-based behavior change has not yet been described. Our objective is to describe the roles of, and strategies used by, four KBs involved in a virtual community of practice to guide and inform future online KB interventions. A descriptive design guided this study and a thematic content analysis process was used to analyze online KB postings. The Promoting Action on Research in Health Sciences knowledge transfer framework and online andragogical learning theories assisted in the coding. A thematic map was created illustrating the links between KBs' strategies and emerging roles in the virtual environment. We analyzed 95 posts and identified three roles: 1) context architect: promoting a respectful learning environment, 2) knowledge sharing promoter: building capacity, and 3) linkage creator: connecting research-to-practice. Strategies used by KBs reflected invitational, constructivism, and connectivism approaches, with roles and strategies changing over time. This study increases our understanding of the actions of KBs in virtual contexts to foster uptake of research evidence in pediatric physiotherapy. Our results provide valuable information about the knowledge and skills required by individuals to fulfill this role in virtual environments.

An eighteen-month follow-up of a pilot parent-delivered play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder and their playmates.

PubMed

Cantrill, Alycia; Wilkes-Gillan, Sarah; Bundy, Anita; Cordier, Reinie; Wilson, Nathan J

2015-06-01

Children with attention deficit hyperactivity disorder (ADHD) experience significant ongoing social difficulties which occur in multiple contexts. Interventions designed to improve these social difficulties have demonstrated minimal effectiveness. Thus, there is a clear need to establish interventions that are effective in addressing the social difficulties of children with ADHD across contexts and in the long term. To examine the long-term effectiveness and appropriateness of a pilot parent-delivered intervention designed to improve the social play skills of children with ADHD and their playmates. Participants included five children with ADHD who had completed the intervention 18-months prior, their typically developing playmates and mothers of children with ADHD. Blinded ratings from the Test of Playfulness were used to measure children's social play: post-intervention and 18-months following the intervention in the home and clinic. Wilcoxon signed-ranks and Cohen's-d calculations were used to measure effectiveness. Parents' perspectives of the appropriateness of the intervention were explored through semi-structured interviews and data were analysed thematically. The social play skills of children with ADHD and their playmates were maintained following the intervention in the home and clinic. Thematic analysis revealed four core-themes against an intervention appropriateness framework: new parenting tools, a social shift, adapting strategies over time and the next developmental challenge. The parent-delivered intervention demonstrated long-term effectiveness and appropriateness for improving children's social play skills. These preliminary results are promising as maintaining treatment effects and achieving generalisation across contexts has remained an unachieved goal for most psycho-social interventions. © 2015 Occupational Therapy Australia.

Comparison of Analytic Hierarchy Process, Catastrophe and Entropy techniques for evaluating groundwater prospect of hard-rock aquifer systems

NASA Astrophysics Data System (ADS)

Jenifer, M. Annie; Jha, Madan K.

2017-05-01

Groundwater is a treasured underground resource, which plays a central role in sustainable water management. However, it being hidden and dynamic in nature, its sustainable development and management calls for precise quantification of this precious resource at an appropriate scale. This study demonstrates the efficacy of three GIS-based multi-criteria decision analysis (MCDA) techniques, viz., Analytic Hierarchy Process (AHP), Catastrophe and Entropy in evaluating groundwater potential through a case study in hard-rock aquifer systems. Using satellite imagery and relevant field data, eight thematic layers (rainfall, land slope, drainage density, soil, lineament density, geology, proximity to surface water bodies and elevation) of the factors having significant influence on groundwater occurrence were prepared. These thematic layers and their features were assigned suitable weights based on the conceptual frameworks of AHP, Catastrophe and Entropy techniques and then they were integrated in the GIS environment to generate an integrated raster layer depicting groundwater potential index of the study area. The three groundwater prospect maps thus yielded by these MCDA techniques were verified using a novel approach (concept of 'Dynamic Groundwater Potential'). The validation results revealed that the groundwater potential predicted by the AHP technique has a pronounced accuracy of 87% compared to the Catastrophe (46% accuracy) and Entropy techniques (51% accuracy). It is concluded that the AHP technique is the most reliable for the assessment of groundwater resources followed by the Entropy method. The developed groundwater potential maps can serve as a scientific guideline for the cost-effective siting of wells and the effective planning of groundwater development at a catchment or basin scale.

Exploring the Effectiveness of Mandatory Premarital Screening and Genetic Counselling Programmes for β-Thalassaemia in the Middle East: A Scoping Review.

PubMed

Saffi, Marwa; Howard, Natasha

2015-01-01

β-Thalassaemia is a common genetic blood disorder in the Middle Eastern region. Mandatory premarital screening and genetic counselling (PMSGC) programmes are implemented in 8 Middle East countries to reduce at-risk marriages and thus disease prevalence. A scoping review was conducted to explore the effectiveness of these programmes. The 6-stage scoping framework of Arksey and O'Malley [Int J Soc Res Methodol 2005;8:19-32] was used. Reported outcomes were analysed per country, with success defined as achieving a 65% reduction in at-risk marriages and/or thalassaemia-affected births. Emergent enablers and barriers were analysed thematically. Twenty-one sources were included from the 1,348 identified, discussing 7 country programmes, with 95% (20/21) published during 2003-2013. Five publications each were included for Iran and Saudi Arabia, 3 for Turkey, 2 each for Bahrain and Iraq (Kurdistan), and 1 for the United Arab Emirates, plus 2 multi-country evaluations. No programme achieved a 65% at-risk marriage cancellation rate. Though data on thalassaemia-affected birth reductions were minimal, programmes in Iran, Turkey and Iraq reported at least 65% reductions. A thematic analysis found that screening timing, access to prenatal detection and abortion, socio-religious issues, awareness and counselling affected decisions. This review found that PMSGC programmes were unsuccessful in discouraging at-risk marriages but successful in reducing the prevalence of affected births in countries providing prenatal detection and therapeutic abortion. A life cycle approach to prevention, incorporation of school screening, awareness campaigns, reconsideration of therapeutic abortion, and screening and counselling of couples married prior to programme inception are likely to improve the effectiveness of such programmes in the Middle Eastern region. © 2015 S. Karger AG, Basel.

Land-Cover Change in the Central Irregular Plains, 1973-2000

USGS Publications Warehouse

Karstensen, Krista A.

2009-01-01

Spearheaded by the Geographic Analysis and Monitoring Program of the U.S. Geological Survey (USGS) in collaboration with the U.S. Environmental Protection Agency (EPA) and the National Aeronautics and Space Administration (NASA), the Land Cover Trends is a research project focused on understanding the rates, trends, causes, and consequences of contemporary United States land-use and land-cover change. Using the EPA Level III ecoregions as the geographic framework, scientists process geospatial data collected between 1973 and 2000 to characterize ecosystem responses to land-use changes. The 27-year study period was divided into five temporal periods: 1973-1980, 1980-1986, 1986-1992, 1992-2000 and 1973-2000. General land-cover classes for these periods were interpreted from Landsat Multispectral Scanner, Thematic Mapper, and Enhanced Thematic Mapper Plus imagery to categorize land-cover change and evaluate using a modified Anderson Land Use Land Cover Classification System for image interpretation. The rates of land-cover change are estimated using a stratified, random sampling of 10-kilometer (km) by 10-km blocks allocated within each ecoregion. For each sample block, satellite images are used to interpret land-cover change. Additionally, historical aerial photographs from similar timeframes and other ancillary data such as census statistics and published literature are used. The sample block data are then incorporated into statistical analyses to generate an overall change matrix for the ecoregion. These change statistics are applicable for different levels of scale, including total change for the individual sample blocks and change estimates for the entire ecoregion. The results illustrate that there is no single profile of land-cover change but instead point to geographic variability that results from land uses within ecoregions continuously adapting to various factors including environmental, technological, and socioeconomic.

Methodological and Epistemological Considerations in Utilizing Qualitative Inquiry to Develop Interventions.

PubMed

Duggleby, Wendy; Williams, Allison

2016-01-01

The purpose of this article is to discuss methodological and epistemological considerations involved in using qualitative inquiry to develop interventions. These considerations included (a) using diverse methodological approaches and (b) epistemological considerations such as generalization, de-contextualization, and subjective reality. Diverse methodological approaches have the potential to inform different stages of intervention development. Using the development of a psychosocial hope intervention for advanced cancer patients as an example, the authors utilized a thematic study to assess current theories/frameworks and interventions. However, to understand the processes that the intervention needed to target to affect change, grounded theory was used. Epistemological considerations provided a framework to understand and, further, critique the intervention. Using diverse qualitative methodological approaches and examining epistemological considerations were useful in developing an intervention that appears to foster hope in patients with advanced cancer. © The Author(s) 2015.

Influences on selection of assistive technology for young children in South Africa: perspectives from rehabilitation professionals.

PubMed

van Niekerk, Karin; Dada, Shakila; Tönsing, Kerstin

2017-12-20

Selection of assistive technology for young children is a complex process. Within a context with limited resources, such as South Africa, research is needed to determine the factors influencing the assistive technology selection process, as these could ultimately either facilitate or hinder the availability and accessibility of affordable, adaptable, acceptable, and high quality assistive technology for this age group. Two asynchronous online focus groups were conducted with 16 rehabilitation professionals to identify the factors they perceived to influence the selection and provision of assistive technology to young children within the South African context. A process of deductive thematic analysis was followed by inductive analysis of the data. Components of the Assistive Technology Device Selection Framework were used as themes to guide the deductive analysis, followed by inductive analysis to create subthemes. The important role of the professional was highlighted in negotiating all the factors to consider in the assistive technology selection and provision process. Adaptation of the Assistive Technology Device Selection Framework is suggested in order to facilitate application to low resourced contexts, such as South Africa. Implications for rehabilitation Assistive technology selection is a complex process with factors pertaining to the users (child and family) of the assistive technology, as well as the rehabilitation professional recommending the assistive technology influencing the process. Although it may be an important factor, the availability of financial resources to purchase assistive technology is not the only determining factor in providing appropriate assistive technology to young children in contexts with limited resources. Formalized support, such as reflective supervision or mentorship programs should be facilitated and utilized by recommending professionals. Home and school visits during assessment ensure a good match between assistive technology and users within the particular context. Facilitating the availability of assistive technology for trial during assessment and/or for a period afterwards will increase the likelihood that appropriate recommendations for assistive technology are made.

Patient experience in the emergency department: inconsistencies in the ethic and duty of care.

PubMed

Moss, Cheryle; Nelson, Katherine; Connor, Margaret; Wensley, Cynthia; McKinlay, Eileen; Boulton, Amohia

2015-01-01

To understand how people who present on multiple occasions to the emergency department experience their health professionals' moral comportment (ethic of care and duty of care); and to understand the consequences of this for 'people who present on multiple occasions' ongoing choices in care. People (n = 34) with chronic illness who had multiple presentations were interviewed about the role that emergency departments played within their lives and health-illness journey. Unprompted, all participants shared views about the appropriateness or inappropriateness of the care they received from the health professionals in the emergency departments they had attended. These responses raised the imperative for specific analysis of the data regarding the need for and experience of an ethic of care. Qualitative description of interview data (stage 3 of a multimethod study). The methods included further analysis of existing interviews, exploration of relevant literature, use of Tronto's ethic of care as a theoretical framework for analysis, thematic analysis of people who present on multiple occasions' texts and explication of health professionals' moral positions in relation to present on multiple occasions' experiences. Four moral comportment positions attributed by the people who present on multiple occasions to the health professionals in emergency department were identified: 'sustained and enmeshed ethic and duty of care', 'consistent duty of care', 'interrupted or mixed duty and ethic of care', and 'care in breach of both the ethic and duty of care'. People who present on multiple occasions are an important group of consumers who attend the emergency department. Tronto's phases/moral elements in an ethic of care are useful as a framework for coding qualitative texts. Investigation into the bases, outcomes and contextual circumstances that stimulate the different modes of moral comportment is needed. Findings carry implications for emergency department care of people who present on multiple occasions and for emergency department health professionals to increase awareness of their moral comportment in care. © 2014 John Wiley & Sons Ltd.

Protocol for a thematic synthesis to identify key themes and messages from a palliative care research network.

PubMed

Nicholson, Emma; Murphy, Tara; Larkin, Philip; Normand, Charles; Guerin, Suzanne

2016-10-21

Research networks that facilitate collaborative research are increasing both regionally and globally and such collaborations contribute greatly to knowledge transfer particularly in health research. The Palliative Care Research Network is an Irish-based network that seeks to create opportunities and engender a collaborative environment to encourage innovative research that is relevant for policy and practice. The current review outlines a methodology to identify cross-cutting messages to identify how dissemination outputs can be optimized to ensure that key messages from this research reaches all knowledge users. Preferred reporting items for systematic review and meta-analysis protocol guidelines will inform the search and analysis plan to ensure that the synthesis of the data is as rigorous as possible. An approach based on critical interpretative synthesis will be adapted to include a thematic synthesis for the identification of higher-order themes and messages from a body of dissemination products generated by the Palliative Care Research Network. The thematic synthesis outlined in the present protocol offers a novel method of synthesising data from a focused research network that employs a variety of dissemination materials as a means of identifying key themes and messages from a specific body of research. The high-level themes and messages will be identified from the thematic synthesis, widely disseminated and targeted towards a range of stakeholders and knowledge users such as carers, health and social care professionals, policy makers and researchers.

Development of an Interdisciplinary Team Communication Framework and Quality Metrics for Home-Based Medical Care Practices.

PubMed

Fathi, Roya; Sheehan, Orla C; Garrigues, Sarah K; Saliba, Debra; Leff, Bruce; Ritchie, Christine S

2016-08-01

The unique needs of homebound adults receiving home-based medical care (HBMC) (ie, home-based primary care and home-based palliative care services) are ideally provided by interdisciplinary care teams (IDTs) that provide coordinated care. The composition of team members from an array of organizations and the unique dimension of providing care in the home present specific challenges to timely access and communication of patient care information. The objective of this work was to develop a conceptual framework and corresponding quality indicators (QIs) that assess how IDT members for HBMC practices access and communicate key patient information with each other. A systematic review of peer-reviewed and gray literature was performed to inform a framework for care coordination in the home and the development of candidate QIs to assess processes by which all IDT members optimally access and use patient information. A technical expert panel (TEP) participated in a modified Delphi process to assess the validity and feasibility of each QI and to identify which would be most suitable for testing in the field. Thematic analysis of literature revealed 4 process themes for how HBMC practices might engage in high-quality care coordination: using electronic medical records, conducting interdisciplinary team meetings, sharing standardized patient assessments, and communicating via secure e-messaging. Based on these themes, 9 candidate QIs were developed to reflect these processes. Three candidate QIs were assessed by the TEP as valid and feasible to measure in an HBMC practice setting. These indicators focused on use of IDT meetings, standardized patient assessments, and secure e-messaging. Translating the complex issue of care coordination into QIs will improve care delivered to vulnerable home-limited adults who receive HBMC. Guided by the literature, we developed a framework to reflect optimal care coordination in the home setting and identified 3 candidate QIs to field-test in HBMC practices. Published by Elsevier Inc.

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

PubMed Central

Eisingerich, Andreas B

2016-01-01

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

Examining hospital pharmacists' goals for medication counseling within the communication accommodation theoretical framework.

PubMed

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2016-01-01

Medication counseling opportunities are key times for pharmacists to speak to patients about their medications and any changes made during their hospital stay. Communication Accommodation Theory (CAT) posits that an individual's goals drive their communication behavior. The way in which pharmacists communicate with patients may be determined by the goals they set for these medication counseling sessions. To examine hospital pharmacists' goals in patient medication counseling within the CAT framework. Hospital pharmacist focus groups were held in two teaching hospitals. Interested pharmacists attended a focus group designed to elicit their goals in patient medication counseling. Focus groups were audio recorded and transcribed verbatim. NVivo(®) software was used to assist in coding and organization. The codes were reviewed for reliability by pharmacists independent of the focus groups. An inductive thematic analysis was applied to the data. Six 1 h focus groups were conducted with a total of 24 pharmacists participating. Saturation of information was achieved after four focus groups. Greater than 80% consensus was achieved for reliability of the identified codes. Patient-centered themes constructed from these codes were to build rapport, to empower patients and to improve patients' experience, health and safety. Exemplars provided by pharmacists for the goals of building rapport and empowering patients were aligned with five CAT communication behaviors (approximation, interpretability, discourse management, emotional expression and interpersonal control). Patient-centered goals described by hospital pharmacists for medication counseling aligned well with CAT behaviors necessary for effective communication. Further research using the CAT framework to examine the effectiveness of hospital pharmacist-patient exchanges that include both participants' perspectives is required to better understand how well pharmacists communicate with patients. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-10-24

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

Patients' views on priority setting in neurosurgery: A qualitative study.

PubMed

Gunaratnam, Caroline; Bernstein, Mark

2016-01-01

Accountability for Reasonableness is an ethical framework which has been implemented in various health care systems to improve and evaluate the fairness of priority setting. This framework is grounded on four mandatory conditions: relevance, publicity, appeals, and enforcement. There have been few studies which have evaluated the patient stakeholders' acceptance of this framework; certainly no studies have been done on patients' views on the prioritization system for allocating patients for operating time in a system with pressure on the resource of inpatient beds. The aim of this study is to examine neurosurgical patients' views on the prioritization of patients for operating theater (OT) time on a daily basis at a tertiary and quaternary referral neurosurgery center. Semi-structured face-to-face interviews were conducted with thirty-seven patients, recruited from the neurosurgery clinic at Toronto Western Hospital. Family members and friends who accompanied the patient to their clinic visit were encouraged to contribute to the discussion. Interviews were audio recorded, transcribed verbatim, and subjected to thematic analysis using open and axial coding. Overall, patients are supportive of the concept of a priority-setting system based on fairness, but felt that a few changes would help to improve the fairness of the current system. These changes include lowering the level of priority given to volume-funded cases and providing scheduled surgeries that were previously canceled a higher level of prioritization. Good communication, early notification, and rescheduling canceled surgeries as soon as possible were important factors that directly reflected the patients' confidence level in their doctor, the hospital, and the health care system. This study is the first clinical qualitative study of patients' perspective on a prioritization system used for allocating neurosurgical patients for OT time on a daily basis in a socialized not-for-profit health care system with fixed resources.

Life impact of ankle fractures: qualitative analysis of patient and clinician experiences.

PubMed

McPhail, Steven M; Dunstan, Joel; Canning, Julie; Haines, Terry P

2012-11-21

Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

A conceptual framework for healthy eating behavior in ecuadorian adolescents: a qualitative study.

PubMed

Verstraeten, Roosmarijn; Van Royen, Kathleen; Ochoa-Avilés, Angélica; Penafiel, Daniela; Holdsworth, Michelle; Donoso, Silvana; Maes, Lea; Kolsteren, Patrick

2014-01-01

The objective of this study was to identify factors influencing eating behavior of Ecuadorian adolescents - from the perspective of parents, school staff and adolescents - to develop a conceptual framework for adolescents' eating behavior. Twenty focus groups (N=144 participants) were conducted separately with adolescents aged 11-15 y (n (focus groups)=12, N (participants)=80), parents (n=4, N=32) and school staff (n=4, N=32) in rural and urban Ecuador. A semi-structured questioning route was developed based on the 'Attitude, Social influences and Self-efficacy' model and the socio-ecological model to assess the relevance of behavioral and environmental factors in low- and middle-income countries. Two researchers independently analyzed verbatim transcripts for emerging themes, using deductive thematic content analysis. Data were analyzed using NVivo 8. All groups recognized the importance of eating healthily and key individual factors in Ecuadorian adolescents' food choices were: financial autonomy, food safety perceptions, lack of self-control, habit strength, taste preferences and perceived peer norms. Environmental factors included the poor nutritional quality of food and its easy access at school. In their home and family environment, time and convenience completed the picture as barriers to eating healthily. Participants acknowledged the impact of the changing socio-cultural environment on adolescents' eating patterns. Availability of healthy food at home and financial constraints differed between settings and socio-economic groups. Our findings endorse the importance of investigating behavioral and environmental factors that influence and mediate healthy dietary behavior prior to intervention development. Several culture-specific factors emerged that were incorporated into a conceptual framework for developing health promotion interventions in Ecuador.

Informatics competencies for nurse leaders: protocol for a scoping review.

PubMed

Kassam, Iman; Nagle, Lynn; Strudwick, Gillian

2017-12-14

Globally, health information technologies are now being used by nurses in a variety of settings. However, nurse leaders often do not have the necessary strategic and tactical informatics competencies to adequately ensure their effective adoption and use. Although informatics competencies and competency frameworks have been identified and developed, to date there has not been review or consolidation of the work completed in this area. In order to address this gap, a scoping review is being conducted. The objectives of this scoping review are to: (1) identify informatics competencies of relevance to nurse leaders, (2) identify frameworks or theories that have been used to develop informatics competencies for nurse leaders, (3) identify instruments used to assess the informatics competencies of nurse leaders and (4) examine the psychometric properties of identified instruments. Using the Arksey and O'Malley five-step framework, a literature review will be conducted using a scoping review methodology. The search will encompass academic and grey literature and include two primary databases and five secondary databases. Identified studies and documents will be independently screened for eligibility by two reviewers. Data from the studies and documents will be extracted and compiled into a chart. Qualitative data will be subject to a thematic analysis and descriptive statistics applied to the quantitative data. Ethical approval was not required for this study. Results will be used to inform a future study designed to validate an instrument used to evaluate informatics competencies for nurse leaders within a Canadian context. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

How do small groups make decisions? : A theoretical framework to inform the implementation and study of clinical competency committees.

PubMed

Chahine, Saad; Cristancho, Sayra; Padgett, Jessica; Lingard, Lorelei

2017-06-01

In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees' competence. However, we currently lack a theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees.This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and evidence-based papers related to small group decision-making. The search was conducted using Google Scholar, Web of Science, MEDLINE, ERIC, and PsycINFO for relevant literature. Using a thematic analysis, two researchers (SC & JP) met four times between April-June 2016 to consolidate the literature included in this review.Three theoretical orientations towards group decision-making emerged from the review: schema, constructivist, and social influence. Schema orientations focus on how groups use algorithms for decision-making. Constructivist orientations focus on how groups construct their shared understanding. Social influence orientations focus on how individual members influence the group's perspective on a decision. Moderators of decision-making relevant to all orientations include: guidelines, stressors, authority, and leadership.Clinical competency committees are the mechanisms by which groups of clinicians will be in charge of interpreting multiple assessment data points and coming to a shared decision about trainee competence. The way in which these committees make decisions can have huge implications for trainee progression and, ultimately, patient care. Therefore, there is a pressing need to build the science of how such group decision-making works in practice. This synthesis suggests a preliminary organizing framework that can be used in the implementation and study of clinical competency committees.

Barriers to help-seeking in men diagnosed with benign colorectal diseases.

PubMed

Oberoi, Devesh V; Jiwa, Moyez; McManus, Alexandra; Hodder, Rupert

2015-01-01

To explore the help-seeking pathway for lower bowel symptoms in men diagnosed with benign bowel diseases. Semi-structured interviews were conducted. The data were analyzed thematically using Andersen's Model of Patient Delay as the theoretical framework. The major delaying factors were attribution of symptoms to self-limiting conditions, failure to make time to visit a GP, low expectation of help from the GP, fear of cancer diagnosis and embarrassment. The major causes of delay in help-seeking were related to the participants, whereas factors associated with treatment delay were less prominent in diagnostic delay.