theme-driven survival analysis: Topics by Science.gov

Sample records for theme-driven survival analysis

Emotional pain: surviving mental health problems related to childhood experiences.

PubMed

Holm, A L; Bégat, I; Severinsson, E

2009-09-01

Emotional pain is described as intense by women who suffer from borderline personality disorder (BPD), and a high prevalence of reported childhood abuse was found in the literature and in research. The aim of this study was to explore the experiences of women suffering from BPD with focus on emotional pain related to childhood. An explorative design was used. Data were collected from in-depth interviews consisting of women suffering from BPD (n = 13) and an interpretive content analysis was used to analyse the text. The findings revealed two main themes: 'Power' and 'Assessment of vulnerability'. The main theme 'Power' resulted in two categories: 'Surviving the feeling of being forced' and 'Surviving the feeling of having to assume responsibility'. The other main theme 'Assessment of vulnerability' had two categories: 'Surviving the feeling of being victimized' and 'Surviving the feeling of not being loved'. The findings suggest that nursing care need to develop an understanding of how these women endure their emotional pain, and try to survive as fighting spirits and how struggling became their way of life.
A Content Analysis of Online Suicide Notes: Attempted Suicide Versus Attempt Resulting in Suicide.

PubMed

Synnott, John; Ioannou, Maria; Coyne, Angela; Hemingway, Siobhan

2017-09-28

Fifty suicide notes of those who died by suicide and 50 suicide notes of those who survived their suicide attempt were analyzed using Smallest Space Analysis. The core of all suicide notes was discovered to be constructed with the use of four variables: saying goodbye to their audience, feelings of loneliness, method used to attempt suicide, and negative self-image. Furthermore, three different suicide note themes of those who died and three suicide note themes from those who survived were also identified. The analysis revealed that suicide note writers who died by their attempt were more likely to combine a dislike of themselves and a concern for loved ones. The implications of the work in terms of suicide prevention are discussed. © 2017 The American Association of Suicidology.
Revealing common disease mechanisms shared by tumors of different tissues of origin through semantic representation of genomic alterations and topic modeling.

PubMed

Chen, Vicky; Paisley, John; Lu, Xinghua

2017-03-14

Cancer is a complex disease driven by somatic genomic alterations (SGAs) that perturb signaling pathways and consequently cellular function. Identifying patterns of pathway perturbations would provide insights into common disease mechanisms shared among tumors, which is important for guiding treatment and predicting outcome. However, identifying perturbed pathways is challenging, because different tumors can have the same perturbed pathways that are perturbed by different SGAs. Here, we designed novel semantic representations that capture the functional similarity of distinct SGAs perturbing a common pathway in different tumors. Combining this representation with topic modeling would allow us to identify patterns in altered signaling pathways. We represented each gene with a vector of words describing its function, and we represented the SGAs of a tumor as a text document by pooling the words representing individual SGAs. We applied the nested hierarchical Dirichlet process (nHDP) model to a collection of tumors of 5 cancer types from TCGA. We identified topics (consisting of co-occurring words) representing the common functional themes of different SGAs. Tumors were clustered based on their topic associations, such that each cluster consists of tumors sharing common functional themes. The resulting clusters contained mixtures of cancer types, which indicates that different cancer types can share disease mechanisms. Survival analysis based on the clusters revealed significant differences in survival among the tumors of the same cancer type that were assigned to different clusters. The results indicate that applying topic modeling to semantic representations of tumors identifies patterns in the combinations of altered functional pathways in cancer.
Driven and No Regrets: A Qualitative Analysis of Students Earning Baccalaureate Degrees in Three Years

ERIC Educational Resources Information Center

Firmin, Michael W.; Gilson, Krista Merrick

2007-01-01

Using rigorous qualitative research methodology, twenty-four college students receiving their undergraduate degrees in three years were interviewed. Following analysis of the semi-structured interview transcripts and coding, themes emerged, indicating that these students possessed self-discipline, self-motivation, and drive. Overall, the results…
Model-Driven Theme/UML

NASA Astrophysics Data System (ADS)

Carton, Andrew; Driver, Cormac; Jackson, Andrew; Clarke, Siobhán

Theme/UML is an existing approach to aspect-oriented modelling that supports the modularisation and composition of concerns, including crosscutting ones, in design. To date, its lack of integration with model-driven engineering (MDE) techniques has limited its benefits across the development lifecycle. Here, we describe our work on facilitating the use of Theme/UML as part of an MDE process. We have developed a transformation tool that adopts model-driven architecture (MDA) standards. It defines a concern composition mechanism, implemented as a model transformation, to support the enhanced modularisation features of Theme/UML. We evaluate our approach by applying it to the development of mobile, context-aware applications-an application area characterised by many non-functional requirements that manifest themselves as crosscutting concerns.
The themes, institutions, and people of medical education research 1988-2010: content analysis of abstracts from six journals.

PubMed

Rotgans, Jerome I

2012-10-01

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on 10,168 abstracts extracted from the six most influential journals in medical education published since 1988. Twenty-nine major themes were identified, of which student assessment, clinical and communication skills, clinical clerkships, and problem-based learning were the most prominent ones. Some of these themes, such as multiple-choice examinations or computer-assisted instruction seemed to have had their day, whereas other topics, such as the study of clinical clerkships, clinical reasoning, and scholarship in education were on their way up. Medical education research turned out to be a thoroughly international affair to which both US and European research centers contribute. The medical education literature shows an overwhelming emphasis on the preparation of medical students for professional practice. Moreover, the emphasis is very much on the individual student; most research seems to have been conducted with a psychological perspective in mind. It is argued that medical education research would profit from broadening its scope, including sociological, economical, ecological, and system perspectives. These perspectives might bring answers to new questions relevant to the quality of medical education. It is suggested that medical education is in need of moving beyond the conventional effectiveness-driven research approach to a more theory- and discovery-driven approach.
Phenomenological characterization of memory complaints in preclinical and prodromal Alzheimer's disease.

PubMed

Buckley, Rachel F; Ellis, Kathryn A; Ames, David; Rowe, Christopher C; Lautenschlager, Nicola T; Maruff, Paul; Villemagne, Victor L; Macaulay, S Lance; Szoeke, Cassandra; Martins, Ralph N; Masters, Colin L; Savage, Greg; Rainey-Smith, Stephanie R; Rembach, Alan; Saling, Michael M

2015-07-01

To explore the subjective experience of memory change in groups at risk of dementia (those with mild cognitive impairment MCI or high β-amyloid (Aβ+) burden) to determine the existence of potential phenomenological typologies. We recruited 123 healthy controls (HC) and individuals with MCI from the Australian Imaging, Biomarker and Lifestyle (AIBL) study. Sixty-7 (HC = 47,MCI = 20) had Aβ scans available for analysis. Semistructured interviews were administered, transcribed, and meaningful phrases extracted from transcripts. Twelve themes were defined and compared across diagnostic status and Aβ status. MCI endorsed more complaints of burdensome coping strategies, increasing frequency, sense of predomination, poor contextualization, progression, dependency, impact on affect, and dismissive attitudes. HCAβ+ acknowledged a progressive memory decline compared to HCAβ-, while MCIAβ+ expressed more burdensome coping strategies, dismissive attitudes, and dependency comparative to either healthy group. Depression was more likely to be related to complaint themes in HCs, while complaint themes were associated with poorer list-learning performance in individuals with MCI. Complaint themes in those with MCI align with the MCI symptom complex, particularly when accompanied with high Aβ load. Healthy Aβ+ individuals acknowledged progressive memory change, suggesting they are aware of memory changes not yet detectable via neuropsychological measures. Depressive symptomatology associated with HC complaints, suggesting certain themes are affect-driven, while complaints in MCI are associated with organically driven functional impairment. Qualitative analysis of SMCs can inform the earliest clinical manifestations of Alzheimer's disease. Our findings can inform diagnostic approaches to the clinical evaluation of memory complaints in the nondemented elderly. (c) 2015 APA, all rights reserved).
Data-Driven Lead-Acid Battery Prognostics Using Random Survival Forests

DTIC Science & Technology

2014-10-02

Kogalur, Blackstone , & Lauer, 2008; Ishwaran & Kogalur, 2010). Random survival forest is a sur- vival analysis extension of Random Forests (Breiman, 2001...Statistics & probability letters, 80(13), 1056–1064. Ishwaran, H., Kogalur, U. B., Blackstone , E. H., & Lauer, M. S. (2008). Random survival forests. The
User-driven conversations about dialysis through Facebook: A qualitative thematic analysis.

PubMed

Ahmed, Salim; Haines-Saah, Rebecca J; Afzal, Arfan R; Tam-Tham, Helen; Al Mamun, Mohammad; Hemmelgarn, Brenda R; Turin, Tanvir C

2017-04-01

As one of the most popular social networking sites in the world, Facebook has strong potential to enable peer support and the user-driven sharing of health information. We carried out a qualitative thematic analysis of the wall posts of a public Facebook group focused on dialysis to identify some of the major themes discussed. We searched Facebook using the word 'dialysis'. A Facebook group (Dialysis Discussion Uncensored) with the highest number of members was selected amongst publicly available forums related to dialysis and operated in English (http://www.facebook.com/groups/DialysisUncensored). Two researchers independently extracted information on features of the group including purpose, group members and the user-generated posts on the group wall. Posts were further analysed to develop major themes. Characteristics of a Facebook group based on its participants and activities are presented. Three themes are described with representative quotations. In a period of 2 weeks, we found 1257 wall posts with total of 31 636 likes and 15 972 comments. All messages were in English, and the majority of the participants were dialysis patients. However, we observed the participation of family members and care providers as well. Posts were categorized into three major themes: sharing information, seeking and providing emotional and social support and sharing experience. Findings of this study provide an example of how a social networking platform can enable patients and their families to share information and to encourage peer-based support for managing dialysis-related experiences. © 2016 Asian Pacific Society of Nephrology.
Human Papillomavirus Drives Tumor Development Throughout the Head and Neck: Improved Prognosis Is Associated With an Immune Response Largely Restricted to the Oropharynx

PubMed Central

Chakravarthy, Ankur; Henderson, Stephen; Thirdborough, Stephen M.; Ottensmeier, Christian H.; Su, Xiaoping; Lechner, Matt; Feber, Andrew; Thomas, Gareth J.

2016-01-01

Purpose In squamous cell carcinomas of the head and neck (HNSCC), the increasing incidence of oropharyngeal squamous cell carcinomas (OPSCCs) is attributable to human papillomavirus (HPV) infection. Despite commonly presenting at late stage, HPV-driven OPSCCs are associated with improved prognosis compared with HPV-negative disease. HPV DNA is also detectable in nonoropharyngeal (non-OPSCC), but its pathogenic role and clinical significance are unclear. The objectives of this study were to determine whether HPV plays a causal role in non-OPSCC and to investigate whether HPV confers a survival benefit in these tumors. Methods Meta-analysis was used to build a cross-tissue gene-expression signature for HPV-driven cancer. Classifiers trained by machine-learning approaches were used to predict the HPV status of 520 HNSCCs profiled by The Cancer Genome Atlas project. DNA methylation data were similarly used to classify 464 HNSCCs and these analyses were integrated with genomic, histopathology, and survival data to permit a comprehensive comparison of HPV transcript-positive OPSCC and non-OPSCC. Results HPV-driven tumors accounted for 4.1% of non-OPSCCs. Regardless of anatomic site, HPV+ HNSCCs shared highly similar gene expression and DNA methylation profiles; nonkeratinizing, basaloid histopathological features; and lack of TP53 or CDKN2A alterations. Improved overall survival, however, was largely restricted to HPV-driven OPSCCs, which were associated with increased levels of tumor-infiltrating lymphocytes compared with HPV-driven non-OPSCCs. Conclusion Our analysis identified a causal role for HPV in transcript-positive non-OPSCCs throughout the head and neck. Notably, however, HPV-driven non-OPSCCs display a distinct immune microenvironment and clinical behavior compared with HPV-driven OPSCCs. PMID:27863190
Dr Google and the consumer: a qualitative study exploring the navigational needs and online health information-seeking behaviors of consumers with chronic health conditions.

PubMed

Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery David; Emmerton, Lynne

2014-12-02

The abundance of health information available online provides consumers with greater access to information pertinent to the management of health conditions. This is particularly important given an increasing drive for consumer-focused health care models globally, especially in the management of chronic health conditions, and in recognition of challenges faced by lay consumers with finding, understanding, and acting on health information sourced online. There is a paucity of literature exploring the navigational needs of consumers with regards to accessing online health information. Further, existing interventions appear to be didactic in nature, and it is unclear whether such interventions appeal to consumers' needs. Our goal was to explore the navigational needs of consumers with chronic health conditions in finding online health information within the broader context of consumers' online health information-seeking behaviors. Potential barriers to online navigation were also identified. Semistructured interviews were conducted with adult consumers who reported using the Internet for health information and had at least one chronic health condition. Participants were recruited from nine metropolitan community pharmacies within Western Australia, as well as through various media channels. Interviews were audio-recorded, transcribed verbatim, and then imported into QSR NVivo 10. Two established approaches to thematic analysis were adopted. First, a data-driven approach was used to minimize potential bias in analysis and improve construct and criterion validity. A theory-driven approach was subsequently used to confirm themes identified by the former approach and to ensure identified themes were relevant to the objectives. Two levels of analysis were conducted for both data-driven and theory-driven approaches: manifest-level analysis, whereby face-value themes were identified, and latent-level analysis, whereby underlying concepts were identified. We conducted 17 interviews, with data saturation achieved by the 14th interview. While we identified a broad range of online health information-seeking behaviors, most related to information discussed during consumer-health professional consultations such as looking for information about medication side effects. The barriers we identified included intrinsic barriers, such as limited eHealth literacy, and extrinsic barriers, such as the inconsistency of information between different online sources. The navigational needs of our participants were extrinsic in nature and included health professionals directing consumers to appropriate online resources and better filtering of online health information. Our participants' online health information-seeking behaviors, reported barriers, and navigational needs were underpinned by the themes of trust, patient activation, and relevance. This study suggests that existing interventions aimed to assist consumers with navigating online health information may not be what consumers want or perceive they need. eHealth literacy and patient activation appear to be prevalent concepts in the context of consumers' online health information-seeking behaviors. Furthermore, the role for health professionals in guiding consumers to quality online health information is highlighted.
A Topical Trajectory on Survival: an Analysis of Link-Making in a Sequence of Lessons on Evolution

NASA Astrophysics Data System (ADS)

Rocksén, Miranda; Olander, Clas

2017-04-01

This study explores the concept of link-making in relation to communicative strategies applied in the teaching and studying of biological evolution. The analysis focused on video recordings of 11 lessons on biological evolution conducted in a Swedish 9th grade class of students aged 15 years. It reveals how the teacher and students connected classroom conversations, the frequency of references to conversations in whole-class settings, and the development of a theme focusing on species survival and extinction. Detailed examples from the data illustrate how this theme developed from its initiation during the first lesson, through discussion and clarification, to its wrapping up during the last lesson. They further illustrate how students made sense of what the teacher said and wrote, and how the teacher postponed issues, explained and developed topics, provided opportunities for link-making, organised the class, motivated students, and checked their understanding. The study's methodological approach offers a way of including several time dimensions within research. Based on our findings, we conclude that the excerpts examined here did succeed in building `islands of coherence' in the co-construction of curricular content. Moreover, the topical trajectory in relation to species survival provided opportunities for constructing a `scientific story' in the classroom.
Using a SWOT analysis to inform healthy eating and physical activity strategies for a remote First Nations community in Canada.

PubMed

Skinner, Kelly; Hanning, Rhona M; Sutherland, Celine; Edwards-Wheesk, Ruby; Tsuji, Leonard J S

2012-01-01

To plan community-driven health promotion strategies based on a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the healthy eating and physical activity patterns of First Nation (FN) youth. Cross-sectional qualitative and quantitative data used to develop SWOT themes and strategies. Remote, subarctic FN community of Fort Albany, Ontario, Canada. Adult (n = 25) and youth (n = 66, grades 6-11) community members. Qualitative data were collected using five focus groups with adults (two focus groups) and youth (three focus groups), seven individual interviews with adults, and an environmental scan of 13 direct observations of events/locations (e.g., the grocery store). Quantitative data on food/physical activity behaviors were collected using a validated Web-based survey with youth. Themes were identified from qualitative and quantitative data and were analyzed and interpreted within a SWOT matrix. Thirty-two SWOT themes were identified (e.g., accessibility of existing facilities, such as the gymnasium). The SWOT analysis showed how these themes could be combined and transformed into 12 strategies (e.g., expanding and enhancing the school snack/breakfast program) while integrating suggestions from the community. SWOT analysis was a beneficial tool that facilitated the combination of local data and community ideas in the development of targeted health promotion strategies for the FN community of Fort Albany.
The Post-Disaster Survival Scenario as Context for Science Education

ERIC Educational Resources Information Center

Murray, Christopher A.; Murray, Michele L.; Snyder, Kayla S.; Marion, Brooke A.

2016-01-01

The theme of survival in a post-apocalyptic or post-disaster scenario as context for science education is explored in this article. Though this theme is prevalent in a wide variety of popular media, only a small number of educators and researchers report having explored it as a means of engaging students, and there is almost no description of its…
Divorce Is a Part of My Life . . . Resilience, Survival, and Vulnerability: Young Adults' Perception of the Implications of Parental Divorce

ERIC Educational Resources Information Center

Eldar-Avidan, Dorit; Haj-Yahia, Muhammad M.; Greenbaum, Charles W.

2009-01-01

A qualitative study among 22 young adults (20-25 years old) whose parents divorced during their childhood was conducted in Israel, using semi-structured, in-depth, open-ended interviews. Qualitative data analysis led to identification of three profiles, aiming at a grounded theoretical conceptualization. Three core themes were identified: the…
Image Reconstruction is a New Frontier of Machine Learning.

PubMed

Wang, Ge; Ye, Jong Chu; Mueller, Klaus; Fessler, Jeffrey A

2018-06-01

Over past several years, machine learning, or more generally artificial intelligence, has generated overwhelming research interest and attracted unprecedented public attention. As tomographic imaging researchers, we share the excitement from our imaging perspective [item 1) in the Appendix], and organized this special issue dedicated to the theme of "Machine learning for image reconstruction." This special issue is a sister issue of the special issue published in May 2016 of this journal with the theme "Deep learning in medical imaging" [item 2) in the Appendix]. While the previous special issue targeted medical image processing/analysis, this special issue focuses on data-driven tomographic reconstruction. These two special issues are highly complementary, since image reconstruction and image analysis are two of the main pillars for medical imaging. Together we cover the whole workflow of medical imaging: from tomographic raw data/features to reconstructed images and then extracted diagnostic features/readings.
Using Survival Analysis to Understand Patterns of Sustainment within a System-Driven Implementation of Multiple Evidence-Based Practices for Children's Mental Health Services.

PubMed

Brookman-Frazee, Lauren; Zhan, Chanel; Stadnick, Nicole; Sommerfeld, David; Roesch, Scott; Aarons, Gregory A; Innes-Gomberg, Debbie; Bando, Lillian; Lau, Anna S

2018-01-01

Evidence-based practice (EBP) implementation requires substantial resources in workforce training; yet, failure to achieve long-term sustainment can result in poor return on investment. There is limited research on EBP sustainment in mental health services long after implementation. This study examined therapists' continued vs. discontinued practice delivery based on administrative claims for reimbursement for six EBPs [Cognitive Behavioral Interventions for Trauma in Schools (CBITS), Child-Parent Psychotherapy, Managing and Adapting Practices (MAP), Seeking Safety (SS), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), and Positive Parenting Program] adopted in a system-driven implementation effort in public mental health services for children. Our goal was to identify agency and therapist factors associated with a sustained EBP delivery. Survival analysis (i.e., Kaplan-Meier survival functions, log-rank tests, and Cox regressions) was used to analyze 19 fiscal quarters (i.e., approximately 57 months) of claims data from the Prevention and Early Intervention Transformation within the Los Angeles County Department of Mental Health. These data comprised 2,322,389 claims made by 6,873 therapists across 88 agencies. Survival time was represented by the time elapsed from therapists' first to final claims for each practice and for any of the six EBPs. Results indicate that therapists continued to deliver at least one EBP for a mean survival time of 21.73 months (median = 18.70). When compared to a survival curve of the five other EBPs, CBITS, SS, and TP demonstrated a higher risk of delivery discontinuation, whereas MAP and TF-CBT demonstrated a lower risk of delivery discontinuation. A multivariate Cox regression model revealed that agency (centralization and service setting) and therapist (demographics, discipline, and case-mix characteristics) characteristics were significantly associated with risk of delivery discontinuation for any of the six EBPs. This study illustrates a novel application of survival analysis to administrative claims data in system-driven implementation of multiple EBPs. Findings reveal variability in the long-term continuation of therapist-level delivery of EBPs and highlight the importance of both agency and workforce characteristics in the sustained delivery of EBPs. Findings direct the field to potential targets of sustainment interventions (e.g., strategic assignment of therapists to EBP training and strategic selection of EBPs by agencies).
Outcomes of corporate greed.

PubMed

Mohr, W K

1997-01-01

This study is the context portion of a larger study that described the experience of 30 nurses in Texas, USA who worked in for-profit psychiatric hospitals during a documented period of corporate deviance. The objective of the contextual portion was to describe the major findings in 1991-1992 of investigating agencies that probed the scandal. Exploratory descriptive. Over 1,240 pages and 40 hours of corporate records obtained under subpoena, and written and oral testimony before the USA House Select Committee on Children, Youth, and Families. Content analysis, triangulating sources, and comparing as well as cross-checking themes. Four themes: insurance games, dumping patients, patient abuse, and playing with language. Organizational deviance may become more widespread in profit-driven systems of care. Lobbying for whistleblower protection, collective advocacy, and creative educational reforms are used.
Globally-Applicable Predictive Wildfire Model a Temporal-Spatial GIS Based Risk Analysis Using Data Driven Fuzzy Logic Functions

NASA Astrophysics Data System (ADS)

van den Dool, G.

2017-11-01

This study (van den Dool, 2017) is a proof of concept for a global predictive wildfire model, in which the temporal-spatial characteristics of wildfires are placed in a Geographical Information System (GIS), and the risk analysis is based on data-driven fuzzy logic functions. The data sources used in this model are available as global datasets, but subdivided into three pilot areas: North America (California/Nevada), Europe (Spain), and Asia (Mongolia), and are downscaled to the highest resolution (3-arc second). The GIS is constructed around three themes: topography, fuel availability and climate. From the topographical data, six derived sub-themes are created and converted to a fuzzy membership based on the catchment area statistics. The fuel availability score is a composite of four data layers: land cover, wood loads, biomass, biovolumes. As input for the climatological sub-model reanalysed daily averaged, weather-related data is used, which is accumulated to a global weekly time-window (to account for the uncertainty within the climatological model) and forms the temporal component of the model. The final product is a wildfire risk score (from 0 to 1) by week, representing the average wildfire risk in an area. To compute the potential wildfire risk the sub-models are combined usinga Multi-Criteria Approach, and the model results are validated against the area under the Receiver Operating Characteristic curve.
Staying Alive: Problems of Survival.

ERIC Educational Resources Information Center

Stalheim, Bill

1990-01-01

Presented is an approach to the teaching of biological diversity using the theme of survival. Teaching methods for this approach and the advantages of its use are discussed. A suggested course outline is included. (CW)

Theme: The Role of Science in the Agricultural Education Curriculum.

ERIC Educational Resources Information Center

Agricultural Education Magazine, 2002

2002-01-01

Thirteen theme articles discuss integration of science and agriculture, the role of science in agricultural education, biotechnology, agriscience in Tennessee and West Virginia, agriscience and program survival, modernization of agricultural education curriculum, agriscience and service learning, and biotechnology websites. (SK)
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.
Written accounts of living with epilepsy: A thematic analysis.

PubMed

Rawlings, Gregg H; Brown, Ian; Stone, Brendan; Reuber, Markus

2017-07-01

This study examines the subjective experience of living with epilepsy by thematically analyzing participants' written accounts of their condition. Writing is seen as an individual act allowing for private exploration, reflection and expression of thoughts and feelings. Participants (n=20) were recruited from a United Kingdom hospital and from membership-led organizations for individuals living with seizures. Participants were asked to produce four pieces of writing: 1) about their thoughts and feelings about their condition; 2) a letter to their condition; 3) a letter to their younger self; and 4) about a personal value. All writings were analyzed thematically using a theory- and data-driven approach. Five main-themes and 22 sub-themes emerged from the data. Theme 1: 'seizure onset' demonstrated that the development of seizures and subsequent diagnosis was an important event that could change an individuals' identity. Theme 2: 'seizure symptoms' revealed participants externalized their seizures as an intrusive agent with a constant presence in their lives. Theme 3: 'treatment and outcome' reflected medication as an essential means to controlling seizures with subsequent side effects being perceived as a compromise. Theme 4: 'living with epilepsy' explored the consequences of the condition including restrictions and stigma. Theme 5: 'displays of coping' demonstrated that, for the most part, participants were keen to present themselves as living well with epilepsy. The results add to the growing research applying qualitative methodologies to investigate the phenomenology of epilepsy. Qualitative research can improve our understanding and awareness of the condition, as well as inform clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.
Freshman Ethics Course Influences Students' Basic Beliefs.

ERIC Educational Resources Information Center

Appleton, James R.; Wong, Frank T.

1989-01-01

A freshman class called "Educational Odysseys" that bound together four themes and the concern for ethical living is described. The four themes included: the problem of identity; responses to good and evil; the search for success and surviving failure; and cultural diversity and a liberal education. (MLW)
Uncritical and unbalanced coverage of synthetic biology in the Nordic press.

PubMed

Ancillotti, Mirko; Holmberg, Niklas; Lindfelt, Mikael; Eriksson, Stefan

2017-02-01

Synthetic biology will probably have a high impact on a variety of fields, such as healthcare, environment, biofuels, agriculture, and so on. A driving theme in European research policy is the importance of maintaining public legitimacy and support. Media can influence public attitudes and are therefore an important object of study. Through qualitative content analysis, this study investigates the press coverage of synthetic biology in the major Nordic countries between 2009 and 2014. The press coverage was found to be event-driven and there were striking similarities between countries when it comes to framing, language use, and treated themes. Reporters showed a marked dependence on their sources, mainly scientists and stakeholders, who thus drives the media agenda. The media portrayal was very positive, with an optimistic look at future benefits and very little discussion of possible risks.
Studies of Postdisaster Economic Recovery: Analysis, Synthesis, and Assessment

DTIC Science & Technology

1987-06-01

of a large-scale nuclear disaster can be viewed in the aggre- gate as attempting to answer two broad questions: 1. Do resources survive in sufficient...With respect to economic institutional issues in the aftermath of a nuclear disaster , published research has been, almost without exception, speculative...possibilities. There are at least three major themes that per- meate the literature on economic control in the event of a large-scale nuclear disaster . First
Incorporating Temperature-driven Seasonal Variation in Survival, Growth, and Reproduction Models for Small Fish

EPA Science Inventory

Seasonal variation in survival and reproduction can be a large source of prediction uncertainty in models used for conservation and management. A seasonally varying matrix population model is developed that incorporates temperature-driven differences in mortality and reproduction...
Construct-Driven SJTs: Toward an Agenda for Future Research

ERIC Educational Resources Information Center

Lievens, Filip

2017-01-01

A common theme running through recent research on Situational Judgment Tests (SJTs) and this special issue is the aim to improve the measurement of constructs via SJTs. Construct-driven SJTs differ from traditional SJTs in that they present a trait activating situation to test-takers and a more unidimensional set of response options that depict…
Spiritual well-being in long-term colorectal cancer survivors with ostomies.

PubMed

Bulkley, Joanna; McMullen, Carmit K; Hornbrook, Mark C; Grant, Marcia; Altschuler, Andrea; Wendel, Christopher S; Krouse, Robert S

2013-11-01

Spiritual well-being (SpWB) is integral to health-related quality of life. The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Two-hundred-eighty-three long-term (≥ 5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents' greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the three-item SpWB sub-scale. Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as "positive attitude", "I am fortunate", "appreciate life more", and "strength through religious faith". Negative themes, expressed by only 29% of respondents, included "struggling to cope", "not feeling 'normal' ", and "loss". Fifty-five percent of respondents expressed ambivalent themes including "learning acceptance", "an ostomy is the price for survival", "reason to be around despite suffering", and "continuing to cope despite challenges". The majority (64%) had a high SpWB sub-scale score. Although CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes were often mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter connectedness, and belonging. Copyright © 2013 John Wiley & Sons, Ltd.
Integrating ergonomics knowledge into business-driven design projects: The shaping of resource constraints in engineering consultancy.

PubMed

Hall-Andersen, Lene Bjerg; Neumann, Patrick; Broberg, Ole

2016-10-17

The integration of ergonomics knowledge into engineering projects leads to both healthier and more efficient workplaces. There is a lack of knowledge about integrating ergonomic knowledge into the design practice in engineering consultancies. This study explores how organizational resources can pose constraints for the integration of ergonomics knowledge into engineering design projects in a business-driven setting, and how ergonomists cope with these resource constraints. An exploratory case study in an engineering consultancy was conducted. A total of 27 participants were interviewed. Data were collected applying semi-structured interviews, observations, and documentary studies. Interviews were transcribed, coded, and categorized into themes. From the analysis five overall themes emerged as major constituents of resource constraints: 1) maximizing project revenue, 2) payment for ergonomics services, 3) value of ergonomic services, 4) role of the client, and 5) coping strategies to overcome resource constraints. We hypothesize that resource constraints were shaped due to sub-optimization of costs in design projects. The economical contribution of ergonomics measures was not evaluated in the entire life cycle of a designed workplace. Coping strategies included teaming up with engineering designers in the sales process or creating an alliance with ergonomists in the client organization.
Functional analysis of Normalized Difference Vegetation Index curves reveals overwinter mule deer survival is driven by both spring and autumn phenology

PubMed Central

Hurley, Mark A.; Hebblewhite, Mark; Gaillard, Jean-Michel; Dray, Stéphane; Taylor, Kyle A.; Smith, W. K.; Zager, Pete; Bonenfant, Christophe

2014-01-01

Large herbivore populations respond strongly to remotely sensed measures of primary productivity. Whereas most studies in seasonal environments have focused on the effects of spring plant phenology on juvenile survival, recent studies demonstrated that autumn nutrition also plays a crucial role. We tested for both direct and indirect (through body mass) effects of spring and autumn phenology on winter survival of 2315 mule deer fawns across a wide range of environmental conditions in Idaho, USA. We first performed a functional analysis that identified spring and autumn as the key periods for structuring the among-population and among-year variation of primary production (approximated from 1 km Advanced Very High Resolution Radiometer Normalized Difference Vegetation Index (NDVI)) along the growing season. A path analysis showed that early winter precipitation and direct and indirect effects of spring and autumn NDVI functional components accounted for 45% of observed variation in overwinter survival. The effect size of autumn phenology on body mass was about twice that of spring phenology, while direct effects of phenology on survival were similar between spring and autumn. We demonstrate that the effects of plant phenology vary across ecosystems, and that in semi-arid systems, autumn may be more important than spring for overwinter survival. PMID:24733951
The efficacy of chimeric antigen receptor (CAR) immunotherapy in animal models for solid tumors: A systematic review and meta-analysis.

PubMed

Wu, Yingcheng; Xu, Ran; Jia, Keren; Shi, Hui

2017-01-01

Most recently, an emerging theme in the field of tumor immunology predominates: chimeric antigen receptor (CAR) therapy in treating solid tumors. The number of related preclinical trials was surging. However, an evaluation of the effects of preclinical studies remained absent. Hence, a meta-analysis was conducted on the efficacy of CAR in animal models for solid tumors. The authors searched PubMed/Medline, Embase, and Google scholar up to April 2017. HR for survival was extracted based on the survival curve. The authors used fixed effect models to combine the results of all the trials. Heterogeneity was assessed by I-square statistic. Quality assessment was conducted following the Stroke Therapy Academic Industry Roundtable standard. Publication bias was assessed using Egger's test. Eleven trials were included, including 54 experiments with a total of 362 animals involved. CAR immunotherapy significantly improved the survival of animals (HR: 0.25, 95% CI: 0.13-0.37, P < 0.001). The quality assessment revealed that no study reported whether allocation concealment and blinded outcome assessment were conducted, and only five studies implemented randomization. This meta-analysis indicated that CAR therapy may be a potential clinical strategy in treating solid tumors.
Defining the Value Framework for Prostate Brachytherapy using Patient-Centered Outcome Metrics and Time-Driven Activity-Based Costing

PubMed Central

Thaker, Nikhil G.; Pugh, Thomas J.; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E.; Martin, Neil E.; Sio, Terence T.; Kudchadker, Rajat J.; Kaplan, Robert S.; Kuban, Deborah A.; Swanson, David A.; Orio, Peter F.; Zelefsky, Michael J.; Cox, Brett W.; Potters, Louis; Buchholz, Thomas A.; Feeley, Thomas W.; Frank, Steven J.

2017-01-01

PURPOSE Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. METHODS AND MATERIALS Patients with low-risk PCa treated with low-dose rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement (ICHOM) standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to one year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. RESULTS A total of 238 men were eligible for analysis. Median age was 64 (range, 46–81). Median follow-up was 5 years (0.5–12.1). There were no acute grade 3–5 complications. EPIC-50 scores were favorable, with no clinically significant changes from baseline to last follow-up at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. CONCLUSIONS We successfully created a visual framework to define the value of PBT using the ICHOM standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. PMID:26916105
Divorce is a part of my life... resilience, survival, and vulnerability: young adults' perception of the implications of parental divorce.

PubMed

Eldar-Avidan, Dorit; Haj-Yahia, Muhammad M; Greenbaum, Charles W

2009-01-01

A qualitative study among 22 young adults (20-25 years old) whose parents divorced during their childhood was conducted in Israel, using semi-structured, in-depth, open-ended interviews. Qualitative data analysis led to identification of three profiles, aiming at a grounded theoretical conceptualization. Three core themes were identified: the centrality of the family; short- and long-term implications of parental divorce and its relations to supportive coping resources; and perspective at young adulthood. Further analysis led to typifying participants by three profiles, which represent the grounded theoretical conceptualizations: resilience, survival, and vulnerability. The most prominent difference among the profiles was the relationships between participants and their parents, and their perception of ongoing parental responsibility. A thorough discussion of the results and their implications for future research, theory development, and practice are presented.
Survival resonances in an atom-optics system driven by temporally and spatially periodic dissipation

NASA Astrophysics Data System (ADS)

Chai, Shijie; Fekete, Julia; McDowall, Peter; Coop, Simon; Lindballe, Thue; Andersen, Mikkel F.

2018-03-01

We investigate laser-cooled atoms periodically driven by pulsed standing waves of light tuned close to an open atomic transition. This nonunitary system displays survival resonances for certain driving frequencies. The survival resonances emerge as a result of the matter-wave Talbot-Lau effect, similar to the Talbot effect causing quantum resonances in the atom optics δ -kicked rotor. Since the Talbot-Lau effect occurs for incoherent waves, the survival resonances can be observed using thermal atoms. A microlensing effect can enhance the height and incisiveness of the resonances. This may find applications in precision measurements.
Economic Competition, Sustainability, and Survival Endurance: The Extinction of the Dodo, the Easter Island Case, and the Tragedy of the Commons Effect

ERIC Educational Resources Information Center

Moreira, Pedro

2012-01-01

A fast developing industry worldwide, tourism demands a monumental extent of resources, and at times devastates and condemns the very own environments that are fundamental to the economic survival of organizations and the sustainability of travel destinations. The purpose of the study is to link three established scientific themes on survival and…
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.
Vicarious resilience: a new concept in work with those who survive trauma.

PubMed

Hernández, Pilar; Gangsei, David; Engstrom, David

2007-06-01

This study explores the formulation of a new concept: vicarious resilience. It addresses the question of how psychotherapists who work with survivors of political violence or kidnapping are affected by their clients'stories of resilience. It focuses on the psychotherapists' interpretations of their clients' stories, and how they make sense of the impact that these stories have had on their lives. In semistructured interviews, 12 psychotherapists who work with victims of political violence and kidnapping were interviewed about their perceptions of their clients' overcoming of adversity. A phenomenological analysis of the transcripts was used to describe the themes that speak about the effects of witnessing how clients cope constructively with adversity. These themes are discussed to advance the concept of vicarious resilience and how it can contribute to sustaining and empowering trauma therapists.
Cancer Support Needs for African American Breast Cancer Survivors and Caregivers.

PubMed

Haynes-Maslow, Lindsey; Allicock, Marlyn; Johnson, La-Shell

2016-03-01

Improved cancer screening and treatment advances have led to higher cancer survival rates in the United States. However, racial disparities in breast cancer survival persist for African American women who experience lower survival rates than white women. These disparities suggest that unmet needs related to survivorship still exist. This study focuses on the challenges that both African American cancer survivors and caregivers face across the cancer continuum. Five African American focus groups examined cancer survivor and caregiver support needs. Focus groups were recorded, transcribed, and uploaded into Atlas.ti. Thematic content analysis was applied to the text during the coding process. Themes were identified and emphasized based on the research team's integrated and unified final codes. Forty-one African Americans participated in five focus groups: 22 cancer survivors and 19 caregivers. Participants discussed five themes: (1) a culture that discourages the discussion of cancer; (2) lack of support services for African American cancer survivors; (3) lack of support services for cancer caregivers; (4) need for culturally appropriate cancer resources, including resources targeted at African American women; and (5) aspects that were helpful to cancer survivors and caregivers, including connecting with other survivors and caregivers, and having strong social support networks. We gained new insight into the unmet support needs for survivors and caregivers, especially when coping with the cancer experience continuum. While some cancer and caregiver support services exist, our study reveals a great need for services that incorporate the cultural differences that exist across races.

Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community.

PubMed

Shavazi, Masoumeh Abbasi; Morowatisharifabad, Mohammad Ali; Shavazi, Mohammad Taghi Abbasi; Mirzaei, Masoud; Ardekani, Ali Mellat

2016-07-01

Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS). To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr's coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study.
Health Information Exchange as a Complex and Adaptive Construct: Scoping Review.

PubMed

Akhlaq, Ather; Sheikh, Aziz; Pagliari, Claudia

2017-01-25

To understand how the concept of Health Information Exchange (HIE) has evolved over time. Supplementary analysis of data from a systematic scoping review of definitions of HIE from 1900 to 2014, involving temporal analysis of underpinning themes. The search identified 268 unique definitions of HIE dating from 1957 onwards; 103 in scientific databases and 165 in Google. These contained consistent themes, representing the core concept of exchanging health information electronically, as well as fluid themes, reflecting the evolving policy, business, organisational and technological context of HIE (including the emergence of HIE as an organisational 'entity'). These are summarised graphically to show how the concept has evolved around the world with the passage of time. The term HIE emerged in 1957 with the establishment of Occupational HIE, evolving through the 1990s with concepts such as electronic data interchange and mobile computing technology; then from 2006-10 largely aligning with the US Government's health information technology strategy and the creation of HIEs as organisational entities, alongside the broader interoperability imperative, and continuing to evolve today as part of a broader international agenda for sustainable, information-driven health systems. The concept of HIE is an evolving and adaptive one, reflecting the ongoing quest for integrated and interoperable information to improve the efficiency and effectiveness of health systems, in a changing technological and policy environment.
The Differences in Preference for Truth-telling of Patients With Cancer of Different Genders.

PubMed

Chen, Shih-Ying; Wang, Hung-Ming; Tang, Woung-Ru

Patients' personality traits, especially age, gender, and cancer stage, tend to affect doctors' truth-telling methods. However, there is a lack of studies investigating the influence of patients' gender on truth-telling, especially for Asian cultures. The aims of this study were to qualitatively investigate the differences in preferences for truth-telling for patients with cancer of different genders and explore patients' preferences for decision making. For this descriptive qualitative study, in-depth interviews were conducted with 20 patients with cancer (10 men and 10 women) using a semistructured interview guide. All interviews were audiotaped and transcribed verbatim. Data collection and analysis occurred concurrently; content analysis developed categories and themes. Data analysis revealed 2 themes: (1) similar gender preferences for truth-telling and decision making: knowledge of their medical condition, direct and frank truthfulness, and assistance in decision making for subsequent treatment programs, and (2) preferences in truth-telling that differed by gender: women wanted family members present for confirmation of diagnosis, whereas men did not; men preferred truth-telling for only key points of their cancer, whereas women wanted detailed information; and men did not want to know their survival period, whereas women wanted this information. Our study revealed similar gender preferences for truth-telling regarding knowledge and decision making; however, preferences differed for family support, scope of information, and survival time. These findings can serve as a reference for nurses and other healthcare personnel when implementing truth-telling for patients given a diagnosis of cancer. Strategies can be targeted for specific preferences of men and women.
Understanding and Improving Modifiable Cardiovascular Risks within the Air Force

DTIC Science & Technology

2013-10-04

Promotion Model ( HPM ). Findings: The definition of health included exercise, proper eating, sleep, and a spiritual connection, as well as the absence of...to health behaviors, including what it takes to be healthy, knowing oneself, and existing Air Force policies. The HPM did not fully address all of the...was used to arrange the data into data-driven themes. These themes were then compared to the elements of the Health Promotion Model ( HPM
Leadership lessons in global nursing and health from the Nightingale Letter Collection at the University of Alabama at Birmingham.

PubMed

Harper, Doreen C; Davey, Kimberly S; Fordham, Pamela N

2014-03-01

This article analyzes the components of Florence Nightingale's visionary leadership for global health and nursing within the historical context of Great Britain's colonization of India. The descriptive study used the qualitative approach of narrative analysis to analyze selected letters in the Nightingale Letter Collection at the University of Alabama at Birmingham that Nightingale wrote to or about Dr. Thomas Gillham Hewlett, a physician and health officer in Bombay, India. The authors sought to increase understanding of Nightingale's visionary leadership for global nursing and health through a study of the form and content of the letters analyzed as temporally contextualized data, focusing on how the narratives are composed and what is conveyed. Several recurring themes central to Nightingale's leadership on global nursing and health emerge throughout these letters, including health and sanitation reform, collaborative partnerships, data-driven policy development, and advocacy for public health. These themes are illustrated through her letters to and testimony about Dr. Thomas Gillham Hewlett in her vivid descriptions of health education and promotion, data-driven policy documents, public health and sanitation advice, and collaboration with citizens, medicine, policy makers, and governments to improve the health and welfare of the people of India. The focus on leadership in nursing as a global construct highlights the lessons learned from University of Alabama at Birmingham's Nightingale Letter Collection that has relevance for the future of nursing and health care, particularly Nightingale's collaboration with policy leaders, her analysis of data to set policy agendas, and public health reform centered on improving the health and well-being of underserved populations.
Architecture-led Requirements and Safety Analysis of an Aircraft Survivability Situational Awareness System

DTIC Science & Technology

2015-05-01

quality attributes. Prioritization of the utility tree leafs driven by mission goals help the user ensure that critical requirements are well-specified...Methods: State of the Art and Future Directions”, ACM Computing Surveys. 1996. 10 Laitenberger, Oliver , “A Survey of Software Inspection Technologies, Handbook on Software Engineering and Knowledge Engineering”. 2002.
Content analysis of antiretroviral adherence enhancing interview reports.

PubMed

Kamal, Susan; Nulty, Paul; Bugnon, Olivier; Cavassini, Matthias; Schneider, Marie P

2018-05-17

To identify factors associated with low or high antiretroviral (ARV) adherence through computational text analysis of an adherence enhancing programme interview reports. Using text from 8428 interviews with 522 patients, we constructed a term-frequency matrix for each patient, retaining words that occurred at least ten times overall and used in at least six interviews with six different patients. The text included both the pharmacist's and the patient's verbalizations. We investigated their association with an adherence threshold (above or below 90%) using a regularized logistic regression model. In addition to this data-driven approach, we studied the contexts of words with a focus group. Analysis resulted in 7608 terms associated with low or high adherence. Terms associated with low adherence included disruption in daily schedule, side effects, socio-economic factors, stigma, cognitive factors and smoking. Terms associated with high adherence included fixed medication intake timing, no side effects and positive psychological state. Computational text analysis helps to analyze a large corpus of adherence enhancing interviews. It confirms main known themes affecting ARV adherence and sheds light on new emerging themes. Health care providers should be aware of factors that are associated with low or high adherence. This knowledge should reinforce the supporting factors and try to resolve the barriers together with the patient. Copyright © 2018 Elsevier B.V. All rights reserved.
Vitamin D receptor polymorphisms and survival in patients with cutaneous melanoma: a population-based study.

PubMed

Orlow, Irene; Reiner, Anne S; Thomas, Nancy E; Roy, Pampa; Kanetsky, Peter A; Luo, Li; Paine, Susan; Armstrong, Bruce K; Kricker, Anne; Marrett, Loraine D; Rosso, Stefano; Zanetti, Roberto; Gruber, Stephen B; Anton-Culver, Hoda; Gallagher, Richard P; Dwyer, Terence; Busam, Klaus; Begg, Colin B; Berwick, Marianne

2016-01-01

Factors known to affect melanoma survival include age at presentation, sex and tumor characteristics. Polymorphisms also appear to modulate survival following diagnosis. Result from other studies suggest that vitamin D receptor (VDR) polymorphisms (SNPs) impact survival in patients with glioma, renal cell carcinoma, lung, breast, prostate and other cancers; however, a comprehensive study of VDR polymorphisms and melanoma-specific survival is lacking. We aimed to investigate whether VDR genetic variation influences survival in patients with cutaneous melanoma. The analysis involved 3566 incident single and multiple primary melanoma cases enrolled in the international population-based Genes, Environment, and Melanoma Study. Melanoma-specific survival outcomes were calculated for each of 38 VDR SNPs using a competing risk analysis after adjustment for covariates. There were 254 (7.1%) deaths due to melanoma during the median 7.6 years follow-up period. VDR SNPs rs7299460, rs3782905, rs2239182, rs12370156, rs2238140, rs7305032, rs1544410 (BsmI) and rs731236 (TaqI) each had a statistically significant (trend P values < 0.05) association with melanoma-specific survival in multivariate analysis. One functional SNP (rs2239182) remained significant after adjustment for multiple testing using the Monte Carlo method. None of the SNPs associated with survival were significantly associated with Breslow thickness, ulceration or mitosis. These results suggest that the VDR gene may influence survival from melanoma, although the mechanism by which VDR exerts its effect does not seem driven by tumor aggressiveness. Further investigations are needed to confirm our results and to understand the relationship between VDR and survival in the combined context of tumor and host characteristics. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Vitamin D receptor polymorphisms and survival in patients with cutaneous melanoma: a population-based study

PubMed Central

Orlow, Irene; Reiner, Anne S.; Thomas, Nancy E.; Roy, Pampa; Kanetsky, Peter A.; Luo, Li; Paine, Susan; Armstrong, Bruce K.; Kricker, Anne; Marrett, Loraine D.; Rosso, Stefano; Zanetti, Roberto; Gruber, Stephen B.; Anton-Culver, Hoda; Gallagher, Richard P.; Dwyer, Terence; Busam, Klaus; Begg, Colin B.; Berwick, Marianne

2016-01-01

Factors known to affect melanoma survival include age at presentation, sex and tumor characteristics. Polymorphisms also appear to modulate survival following diagnosis. Result from other studies suggest that vitamin D receptor (VDR) polymorphisms (SNPs) impact survival in patients with glioma, renal cell carcinoma, lung, breast, prostate and other cancers; however, a comprehensive study of VDR polymorphisms and melanoma-specific survival is lacking. We aimed to investigate whether VDR genetic variation influences survival in patients with cutaneous melanoma. The analysis involved 3566 incident single and multiple primary melanoma cases enrolled in the international population-based Genes, Environment, and Melanoma Study. Melanoma-specific survival outcomes were calculated for each of 38 VDR SNPs using a competing risk analysis after adjustment for covariates. There were 254 (7.1%) deaths due to melanoma during the median 7.6 years follow-up period. VDR SNPs rs7299460, rs3782905, rs2239182, rs12370156, rs2238140, rs7305032, rs1544410 (BsmI) and rs731236 (TaqI) each had a statistically significant (trend P values < 0.05) association with melanoma-specific survival in multivariate analysis. One functional SNP (rs2239182) remained significant after adjustment for multiple testing using the Monte Carlo method. None of the SNPs associated with survival were significantly associated with Breslow thickness, ulceration or mitosis. These results suggest that the VDR gene may influence survival from melanoma, although the mechanism by which VDR exerts its effect does not seem driven by tumor aggressiveness. Further investigations are needed to confirm our results and to understand the relationship between VDR and survival in the combined context of tumor and host characteristics. PMID:26521212
Contrasting patterns of survival and dispersal in multiple habitats reveal an ecological trap in a food-caching bird.

PubMed

Norris, D Ryan; Flockhart, D T Tyler; Strickland, Dan

2013-11-01

A comprehensive understanding of how natural and anthropogenic variation in habitat influences populations requires long-term information on how such variation affects survival and dispersal throughout the annual cycle. Gray jays Perisoreus canadensis are widespread boreal resident passerines that use cached food to survive over the winter and to begin breeding during the late winter. Using multistate capture-recapture analysis, we examined apparent survival and dispersal in relation to habitat quality in a gray jay population over 34 years (1977-2010). Prior evidence suggests that natural variation in habitat quality is driven by the proportion of conifers on territories because of their superior ability to preserve cached food. Although neither adults (>1 year) nor juveniles (<1 year) had higher survival rates on high-conifer territories, both age classes were less likely to leave high-conifer territories and, when they did move, were more likely to disperse to high-conifer territories. In contrast, survival rates were lower on territories that were adjacent to a major highway compared to territories that did not border the highway but there was no evidence for directional dispersal towards or away from highway territories. Our results support the notion that natural variation in habitat quality is driven by the proportion of coniferous trees on territories and provide the first evidence that high-mortality highway habitats can act as an equal-preference ecological trap for birds. Reproductive success, as shown in a previous study, but not survival, is sensitive to natural variation in habitat quality, suggesting that gray jays, despite living in harsh winter conditions, likely favor the allocation of limited resources towards self-maintenance over reproduction.
To hell and back: excessive drug use, addiction, and the process of recovery in mainstream rock autobiographies.

PubMed

Oksanen, Atte

2012-01-01

Rock autobiographies have become increasingly popular since the 1990s. This article analyzes 31 mainstream rock autobiographies describing a wide variety of legal and illegal substances used and reckless behavior. Narrative analysis shows that books concentrate on recovering from addiction. The majority of writers have participated in some kind of treatment. Rock autobiographies use therapeutic vocabulary and borrow discursive elements from culturally familiar Alcoholics Anonymous texts recounting recovery stories. The analysis shows that drugs and alcohol are not associated with rebellion and authenticity as they once were in rock music. Surviving addiction has become a key theme of rock culture.
Convergence of service, policy, and science toward consumer-driven mental health care.

PubMed

Carroll, Christopher D; Manderscheid, Ronald W; Daniels, Allen S; Compagni, Amelia

2006-12-01

A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future. The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions. The report reviews the relevant public mental health policy and data used in published work. The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system. The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs. Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand. Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where consumer-directed care is delivered in either the private or public health care systems. More research is needed to obtain further evidence on the use of consumer-driven services and their overall effectiveness.
Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

PubMed

Rice, Thomas W; Ishwaran, Hemant; Blackstone, Eugene H; Hofstetter, Wayne L; Kelsen, David P; Apperson-Hansen, Carolyn

2016-11-01

We report analytic and consensus processes that produced recommendations for clinical stage groups (cTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) provided data on 22,123 clinically staged patients with epithelial esophageal cancers. Risk-adjusted survival for each patient was developed using random survival forest analysis from which (1) data-driven clinical stage groups were identified wherein survival decreased monotonically and was distinctive between and homogeneous within groups and (2) data-driven anatomic clinical stage groups based only on cTNM. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced (3) consensus clinical stage groups. Compared with pTNM, cTNM survival was "pinched," with poorer survival for early cStage groups and better survival for advanced ones. Histologic grade was distinctive for data-driven grouping of cT2N0M0 squamous cell carcinoma (SCC) and cT1-2N0M0 adenocarcinoma, but consensus removed it. Grouping was different by histopathologic cell type. For SCC, cN0-1 was distinctive for cT3 but not cT1-2, and consensus removed cT4 subclassification and added subgroups 0, IVA, and IVB. For adenocarcinoma, N0-1 was distinctive for cT1-2 but not cT3-4a, cStage II subgrouping was necessary (T1N1M0 [IIA] and T2N0M0 [IIB]), advanced cancers cT3-4aN0-1M0 plus cT2N1M0 comprised cStage III, and consensus added subgroups 0, IVA, and IVB. Treatment decisions require accurate cStage, which differs from pStage. Understaging and overstaging are problematic, and additional factors, such as grade, may facilitate treatment decisions and prognostication until clinical staging techniques are uniformly applied and improved. © 2016 International Society for Diseases of the Esophagus.
Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals

PubMed Central

Rice, Thomas W.; Ishwaran, Hemant; Blackstone, Eugene H.; Hofstetter, Wayne L.; Kelsen, David P.; Apperson-Hansen, Carolyn

2017-01-01

SUMMARY We report analytic and consensus processes that produced recommendations for clinical stage groups (cTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) provided data on 22,123 clinically staged patients with epithelial esophageal cancers. Risk-adjusted survival for each patient was developed using random survival forest analysis from which (1) data-driven clinical stage groups were identified wherein survival decreased monotonically and was distinctive between and homogeneous within groups and (2) data-driven anatomic clinical stage groups based only on cTNM. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced (3) consensus clinical stage groups. Compared with pTNM, cTNM survival was “pinched,” with poorer survival for early cStage groups and better survival for advanced ones. Histologic grade was distinctive for data-driven grouping of cT2N0M0 squamous cell carcinoma (SCC) and cT1-2N0M0 adenocarcinoma, but consensus removed it. Grouping was different by histopathologic cell type. For SCC, cN0-1 was distinctive for cT3 but not cT1-2, and consensus removed cT4 subclassification and added subgroups 0, IVA, and IVB. For adenocarcinoma, N0-1 was distinctive for cT1-2 but not cT3-4a, cStage II subgrouping was necessary (T1N1M0 [IIA] and T2N0M0 [IIB]), advanced cancers cT3-4aN0-1M0 plus cT2N1M0 comprised cStage III, and consensus added subgroups 0, IVA, and IVB. Treatment decisions require accurate cStage, which differs from pStage. Understaging and overstaging are problematic, and additional factors, such as grade, may facilitate treatment decisions and prognostication until clinical staging techniques are uniformly applied and improved. PMID:27905171
In Pursuit of Theoretical Ground in Behavior Change Support Systems: Analysis of Peer-to-Peer Communication in a Health-Related Online Community.

PubMed

Myneni, Sahiti; Cobb, Nathan; Cohen, Trevor

2016-02-02

Research studies involving health-related online communities have focused on examining network structure to understand mechanisms underlying behavior change. Content analysis of the messages exchanged in these communities has been limited to the "social support" perspective. However, existing behavior change theories suggest that message content plays a prominent role reflecting several sociocognitive factors that affect an individual's efforts to make a lifestyle change. An understanding of these factors is imperative to identify and harness the mechanisms of behavior change in the Health 2.0 era. The objective of this work is two-fold: (1) to harness digital communication data to capture essential meaning of communication and factors affecting a desired behavior change, and (2) to understand the applicability of existing behavior change theories to characterize peer-to-peer communication in online platforms. In this paper, we describe grounded theory-based qualitative analysis of digital communication in QuitNet, an online community promoting smoking cessation. A database of 16,492 de-identified public messages from 1456 users from March 1-April 30, 2007, was used in our study. We analyzed 795 messages using grounded theory techniques to ensure thematic saturation. This analysis enabled identification of key concepts contained in the messages exchanged by QuitNet members, allowing us to understand the sociobehavioral intricacies underlying an individual's efforts to cease smoking in a group setting. We further ascertained the relevance of the identified themes to theoretical constructs in existing behavior change theories (eg, Health Belief Model) and theoretically linked techniques of behavior change taxonomy. We identified 43 different concepts, which were then grouped under 12 themes based on analysis of 795 messages. Examples of concepts include "sleepiness," "pledge," "patch," "spouse," and "slip." Examples of themes include "traditions," "social support," "obstacles," "relapse," and "cravings." Results indicate that themes consisting of member-generated strategies such as "virtual bonfires" and "pledges" were related to the highest number of theoretical constructs from the existing behavior change theories. In addition, results indicate that the member-generated communication content supports sociocognitive constructs from more than one behavior change model, unlike the majority of the existing theory-driven interventions. With the onset of mobile phones and ubiquitous Internet connectivity, online social network data reflect the intricacies of human health behavior as experienced by health consumers in real time. This study offers methodological insights for qualitative investigations that examine the various kinds of behavioral constructs prevalent in the messages exchanged among users of online communities. Theoretically, this study establishes the manifestation of existing behavior change theories in QuitNet-like online health communities. Pragmatically, it sets the stage for real-time, data-driven sociobehavioral interventions promoting healthy lifestyle modifications by allowing us to understand the emergent user needs to sustain a desired behavior change.
Positioning, telling, and performing a male illness: Chronic prostatitis/chronic pelvic pain syndrome.

PubMed

Wood, Nicholas; Qureshi, Annum; Mughal, Fahim

2017-11-01

There is a paucity of illness accounts of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), despite a significant level of prevalence and burden of disease. This qualitative study thus elicited twelve accounts from men suffering with CP/CPPS. Narrative analysis was employed, focusing primarily on narrative content. Three major narrative themes were identified: (1) Medical stories: Blame and shame; (2) The Erratic nature of CP/CPPS; and (3) Ongoing struggles for coping and cures and the Search for meaning. Recommendations were made for health care providers and increasing the internal agency, support and activism of men with this debilitating condition. Statement of contribution What is already known on this subject? One qualitative account of this male illness (CP/CPPS) exists: an IPA study. Five cross-sectional themes: (1) Need for repeated confirmation - disease not life-threatening nor leading inexorably towards cancer; (2) Disturbed sleep and fatigue; (3) Concealing pain and problems - 'normalizing'; (4) Enduring pain by performing activities; and (5) Abrupt mood swings and limited sociality. What does this study add? Narrative analysis adds information as to how this illness is managed and survived over time. It challenges the findings (above) by providing an insider perspective. Novel narrative themes include meaning-making amongst others. Masculine performance and experiences are also crucial to this stigmatized illness. © 2017 The British Psychological Society.
The Environment: Our Children's World.

ERIC Educational Resources Information Center

Black, Maggie, Ed.

1982-01-01

Articles collected in this issue of UNICEF News deal with different aspects of the theme of the child and its environment. Specifically, topics covered include (1) awareness of the kind of world our children will inherit; (2) the survival of an urban child; (3) the survival of a Sahelian rural child as a working member of his farming community;…
Childhood leukaemia survivors' experiences of long-term follow-ups in an endocrine clinic - A focus-group study.

PubMed

Pålsson, Anna; Malmström, Marlene; Follin, Cecilia

2017-02-01

The survival rate after childhood cancer has improved markedly and today more than 80% of patients will survive. Many childhood cancer survivors suffer from late complications due to radiotherapy and chemotherapy. Survivors of Acute Lymphoblastic Leukaemia (ALL), treated with cranial radiotherapy, are at a particularly high risk of having endocrine complications. To illuminate childhood ALL survivors' experiences of a long-term follow-up in an endocrine clinic. Data collection carried out using semi-structured focus-group interviews. Fifteen ALL survivors were included in the study, divided into 4 groups. Data was analysed with conventional qualitative content analysis. The survivors' experiences were captured in the theme: "The need for understanding and support in order to manage daily life". An understanding of their situation, as well as support for managing daily life was fundamental. Lack of understanding and support from the community was connected with a fear for the future. The follow-up at the endocrine clinic was shown to be crucial for increasing the survivors' understanding of late complications. The past feeling of being out of control was replaced with an increased self-confidence. Many leukaemia survivors experienced their daily lives as a struggle and as a complicated issue to cope with. The theme "understanding and support to manage daily life" mirrors how the survivors are in need of knowledge and support in order to handle and understand their complex situation after surviving leukaemia. Offering understanding and support with a holistic approach, may be a way in which to strengthen the survivors' health. Copyright © 2016 Elsevier Ltd. All rights reserved.
Data Sharing For Precision Medicine: Policy Lessons And Future Directions.

PubMed

Blasimme, Alessandro; Fadda, Marta; Schneider, Manuel; Vayena, Effy

2018-05-01

Data sharing is a precondition of precision medicine. Numerous organizations have produced abundant guidance on data sharing. Despite such efforts, data are not being shared to a degree that can trigger the expected data-driven revolution in precision medicine. We set out to explore why. Here we report the results of a comprehensive analysis of data-sharing guidelines issued over the past two decades by multiple organizations. We found that the guidelines overlap on a restricted set of policy themes. However, we observed substantial fragmentation in the policy landscape across specific organizations and data types. This may have contributed to the current stalemate in data sharing. To move toward a more efficient data-sharing ecosystem for precision medicine, policy makers should explore innovative ways to cope with central policy themes such as privacy, consent, and data quality; focus guidance on interoperability, attribution, and public engagement; and promote data-sharing policies that can be adapted to multiple data types.
Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community

PubMed Central

Shavazi, Masoumeh Abbasi; Morowatisharifabad, Mohammad Ali; Shavazi, Mohammad Taghi Abbasi; Mirzaei, Masoud; Ardekani, Ali Mellat

2016-01-01

Background: Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS). Methods: To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr’s coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. Results: The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. Conclusion: The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study. PMID:27382585

Oncology nursing: Finding the balance in a changing health care system.

PubMed

Bakker, Debra; Fitch, Margaret I; Green, Esther; Butler, Lorna; Olson, Karin

2006-01-01

Health care restructuring has resulted in significant changes in the workload and work environment for oncology nurses. While recent studies describe the impact of these changes on the general nursing workforce in several countries, there have been no published studies that have focused on worklife issues of Canadian oncology nurses. Therefore, a qualitative study was conducted to gain insight about how oncology nursing has changed over the past decade and how Canadian oncology nurses are managing these changes. Analysis of telephone interviews with 51 practising oncology nurses employed across Canada revealed three major themes. The first theme, "health care milieu", portrayed a picture of the cancer care environment and patient and professional changes that occurred over the past decade. The second theme, "conflicting demands", reflects how the elements of change and social forces have challenged professional oncology nursing practice. The third theme, "finding the way", describes the patterns of behaviour that nurses used to manage the changing health care environment and make meaning out of nurses' work in cancer care. Overall, the findings portray a picture of Canadian oncology nurses in "survival mode". They face many workplace challenges, but are able to keep going "for now" because they find ways to balance their responsibilities on a daily basis and because they know and believe that their specialized nursing knowledge and skills make a difference in patient care.
Qualitative interviews on substance abuse relapse and prevention among female trauma survivors.

PubMed

Harris, Maxine; Fallot, Roger D; Berley, Rebecca Wolfson

2005-10-01

Complex relationships among trauma, substance abuse, and mental disorders raise significant questions for the study of long-term recovery. The purpose of this qualitative study was to examine key themes in sustaining recovery among women with co-occurring disorders who had survived trauma. In semistructured interviews conducted at one of the nine sites of the Women, Co-occurring Disorders, and Violence Study, 27 female trauma survivors described the influences they considered most important in sustaining and hindering their recovery, with an emphasis on recovery from substance abuse. Recurring themes in the interviews were identified. Seven themes emerged from this analysis. Four of these themes supported recovery: connection, self-awareness, a sense of purpose and meaning, and spirituality. Three others served as obstacles to recovery: battles with depression and despair, destructive habits and patterns, and lack of personal control. The women in this study reported that, although caring relationships provided important supports for sustained recovery, some of these same relationships increased emotional stress and conflict and thus may impede recovery. It is important for women and clinicians to place a high priority on the development of boundary management and other relationship skills. In addition, clinicians need to attend to negative feelings such as boredom and loneliness and to help women develop a range of meaningful activities that are consistent with a strong sense of identity. Individual relapse prevention skills by themselves seem insufficient to sustained abstinence.
Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing.

PubMed

Thaker, Nikhil G; Pugh, Thomas J; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E; Martin, Neil E; Sio, Terence T; Kudchadker, Rajat J; Kaplan, Robert S; Kuban, Deborah A; Swanson, David A; Orio, Peter F; Zelefsky, Michael J; Cox, Brett W; Potters, Louis; Buchholz, Thomas A; Feeley, Thomas W; Frank, Steven J

2016-01-01

Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. Patients with low-risk PCa treated with low-dose-rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to 1 year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. A total of 238 men were eligible for analysis. Median age was 64 (range, 46-81). Median followup was 5 years (0.5-12.1). There were no acute Grade 3-5 complications. Expanded Prostate Cancer Index Composite 50 scores were favorable, with no clinically significant changes from baseline to last followup at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. We successfully created a visual framework to define the value of PBT using the International Consortium for Health Outcomes Measurement standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
Proceedings Second Annual Cyber Security and Information Infrastructure Research Workshop

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

Sheldon, Frederick T; Krings, Axel; Yoo, Seong-Moo

2006-01-01

The workshop theme is Cyber Security: Beyond the Maginot Line Recently the FBI reported that computer crime has skyrocketed costing over $67 billion in 2005 alone and affecting 2.8M+ businesses and organizations. Attack sophistication is unprecedented along with availability of open source concomitant tools. Private, academic, and public sectors invest significant resources in cyber security. Industry primarily performs cyber security research as an investment in future products and services. While the public sector also funds cyber security R&D, the majority of this activity focuses on the specific mission(s) of the funding agency. Thus, broad areas of cyber security remain neglectedmore » or underdeveloped. Consequently, this workshop endeavors to explore issues involving cyber security and related technologies toward strengthening such areas and enabling the development of new tools and methods for securing our information infrastructure critical assets. We aim to assemble new ideas and proposals about robust models on which we can build the architecture of a secure cyberspace including but not limited to: * Knowledge discovery and management * Critical infrastructure protection * De-obfuscating tools for the validation and verification of tamper-proofed software * Computer network defense technologies * Scalable information assurance strategies * Assessment-driven design for trust * Security metrics and testing methodologies * Validation of security and survivability properties * Threat assessment and risk analysis * Early accurate detection of the insider threat * Security hardened sensor networks and ubiquitous computing environments * Mobile software authentication protocols * A new "model" of the threat to replace the "Maginot Line" model and more . . .« less
"It's a Burden You Carry": Describing Moral Distress in Emergency Nursing.

PubMed

Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Moon, Michael D; Clark, Paul R; Zavotsky, Kathleen E

2016-01-01

Moral distress in nursing has been studied in many settings, but there is a paucity of research on moral distress as it manifests in the emergency department. One study suggests a correlation between moral distress and aspects of burnout, and other researchers report that nurses have considered leaving their position or even their profession because of moral distress. Further exploration of these issues may provide insight into their effects on ED patient care and the emergency nursing profession. The purpose of this study was to explore the nature of moral distress as it is experienced and described by emergency nurses. A qualitative, exploratory design was employed using semi-structured focus groups for data collection. Using an iterative process, transcripts were analyzed for emerging themes by the research team. Six researchers analyzed the transcripts using a thematic analysis approach. Themes from the data included dysfunctional practice arena, being overwhelmed, and adaptive/maladaptive coping. Participants described, overall, a profound feeling of not being able to provide patient care as they wanted to. Causes of moral distress in emergency nurses are environment driven, not incident driven, as is described in other settings, and include a high-acuity, high-demand, technical environment with insufficient resources. Interventions should be targeted to improve environmental factors that contribute to the moral distress of emergency nurses. Future research should focus on the development and validation of an instrument to measure moral distress in this setting. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
Fertility concerns among child and adolescent cancer survivors and their parents: A qualitative analysis.

PubMed

Ellis, Sarah J; Wakefield, Claire E; McLoone, Jordana K; Robertson, Eden G; Cohn, Richard J

2016-01-01

Cancer diagnoses and treatment may have long-term effects on fertility. Semistructured interviews were administered to young cancer survivors (<20 years) and their parents (n = 97). Fertility related concerns were reported by 45 participants (46.4%). Themes included: distress regarding potential infertility; the effect of infertility on future relationships, self-esteem, and miscommunications/confusion about fertility status; access to fertility testing; and preservation options. Parents also reported challenges regarding how and when it was developmentally appropriate to talk to their children about fertility. The development of comprehensive consumer-driven approaches to managing the fertility concerns of young survivors and their families is essential.
Climate-driven shifts in adult sex ratios via sex reversals: the type of sex determination matters.

PubMed

Bókony, Veronika; Kövér, Szilvia; Nemesházi, Edina; Liker, András; Székely, Tamás

2017-09-19

Sex reversals whereby individuals of one genetic sex develop the phenotype of the opposite sex occur in ectothermic vertebrates with genetic sex-determination systems that are sensitive to extreme temperatures during sexual differentiation. Recent rises in global temperatures have led researchers to predict that sex reversals will become more common, resulting in the distortion of many populations' sex ratios. However, it is unclear whether susceptibility to climate-driven sex-ratio shifts depends on the type of sex determination that varies across species. First, we show here using individual-based theoretical models that XX/XY (male-heterogametic) and ZZ/ZW (female-heterogametic) sex-determination systems can respond differentially to temperature-induced sex reversals. Interestingly, the impacts of climate warming on adult sex ratio (ASR) depend on the effects of both genotypic and phenotypic sex on survival and reproduction. Second, we analyse the temporal changes of ASR in natural amphibian populations using data from the literature, and find that ASR shifted towards males in ZZ/ZW species over the past 60 years, but did not change significantly in XX/XY species. Our results highlight the fact that we need a better understanding of the interactions between genetic and environmental sex-determining mechanisms to predict the responses of ectotherms to climate change and the associated extinction risks.This article is part of the themed issue 'Adult sex ratios and reproductive decisions: a critical re-examination of sex differences in human and animal societies'. © 2017 The Author(s).
Seeking systemic change: risk and protective factors affecting low-income urban youth.

PubMed

Meyerson, David A; Grant, Kathryn E

2014-01-01

This themed issue presents five articles tackling the topic of risk and protective processes affecting children and adolescents living in urban poverty. Through their research, the authors seek understanding of the particular challenges that low-income urban youth face, with the ultimate goal of understanding how best to intervene at various levels of the ecological system. Within this broad theme, studies examine specific stressors, mediators, and moderators that impact the mental health of youth living in urban poverty. The final article presents a data-driven, community-based intervention for this population.
On the detection and attribution of gravity waves generated by the 20 March 2015 solar eclipse

PubMed Central

2016-01-01

Internal gravity waves are generated as adjustment radiation whenever a sudden change in forcing causes the atmosphere to depart from its large-scale balanced state. Such a forcing anomaly occurs during a solar eclipse, when the Moon’s shadow cools part of the Earth’s surface. The resulting atmospheric gravity waves are associated with pressure and temperature perturbations, which in principle are detectable both at the surface and aloft. In this study, surface pressure and temperature data from two UK sites at Reading and Lerwick are examined for eclipse-driven gravity wave perturbations during the 20 March 2015 solar eclipse over northwest Europe. Radiosonde wind data from the same two sites are also analysed using a moving parcel analysis method, to determine the periodicities of the waves aloft. On this occasion, the perturbations both at the surface and aloft are found not to be confidently attributable to eclipse-driven gravity waves. We conclude that the complex synoptic weather conditions over the UK at the time of this particular eclipse helped to mask any eclipse-driven gravity waves. This article is part of the themed issue ‘Atmospheric effects of solar eclipses stimulated by the 2015 UK eclipse’. PMID:27550763
On the detection and attribution of gravity waves generated by the 20 March 2015 solar eclipse.

PubMed

Marlton, G J; Williams, P D; Nicoll, K A

2016-09-28

Internal gravity waves are generated as adjustment radiation whenever a sudden change in forcing causes the atmosphere to depart from its large-scale balanced state. Such a forcing anomaly occurs during a solar eclipse, when the Moon's shadow cools part of the Earth's surface. The resulting atmospheric gravity waves are associated with pressure and temperature perturbations, which in principle are detectable both at the surface and aloft. In this study, surface pressure and temperature data from two UK sites at Reading and Lerwick are examined for eclipse-driven gravity wave perturbations during the 20 March 2015 solar eclipse over northwest Europe. Radiosonde wind data from the same two sites are also analysed using a moving parcel analysis method, to determine the periodicities of the waves aloft. On this occasion, the perturbations both at the surface and aloft are found not to be confidently attributable to eclipse-driven gravity waves. We conclude that the complex synoptic weather conditions over the UK at the time of this particular eclipse helped to mask any eclipse-driven gravity waves.This article is part of the themed issue 'Atmospheric effects of solar eclipses stimulated by the 2015 UK eclipse'. © 2016 The Authors.
The Lived Experience of Iranian Women Confronting Breast Cancer Diagnosis.

PubMed

Mehrabi, Esmat; Hajian, Sepideh; Simbar, Masoomeh; Hoshyari, Mohammad; Zayeri, Farid

2016-03-01

The populations who survive from breast cancer are growing; nevertheless, they mostly encounter with many cancer related problems in their life, especially after early diagnosis and have to deal with these problems. Except for the disease entity, several socio-cultural factors may affect confronting this challenge among patients and the way they deal with. Present study was carried out to prepare clear understanding of Iranian women's lived experiences confronting breast cancer diagnosis and coping ways they applied to deal with it. This study was carried out by using qualitative phenomenological design. Data gathering was done through purposive sampling using semi-structured, in-depth interviews with 18 women who survived from breast cancer. The transcribed interviews were analyzed using Van Manen's thematic analysis approach. Two main themes were emerged from the interviews including "emotional turbulence" and "threat control". The first, comprised three sub themes including uncertainty, perceived worries, and living with fears. The second included risk control, recurrence control, immediate seeking help, seeking support and resource to spirituality. Emotional response was the immediate reflection to cancer diagnosis. However, during post-treatment period a variety of emotions were not uncommon findings, patients' perceptions have been changing along the time and problem-focused coping strategies have replaced. Although women may experience a degree of improvement and adjustment with illness, the emotional problems are not necessarily resolved, they may continue and gradually engender positive outcomes.
In Pursuit of Theoretical Ground in Behavior Change Support Systems: Analysis of Peer-to-Peer Communication in a Health-Related Online Community

PubMed Central

Cobb, Nathan; Cohen, Trevor

2016-01-01

Background Research studies involving health-related online communities have focused on examining network structure to understand mechanisms underlying behavior change. Content analysis of the messages exchanged in these communities has been limited to the “social support” perspective. However, existing behavior change theories suggest that message content plays a prominent role reflecting several sociocognitive factors that affect an individual’s efforts to make a lifestyle change. An understanding of these factors is imperative to identify and harness the mechanisms of behavior change in the Health 2.0 era. Objective The objective of this work is two-fold: (1) to harness digital communication data to capture essential meaning of communication and factors affecting a desired behavior change, and (2) to understand the applicability of existing behavior change theories to characterize peer-to-peer communication in online platforms. Methods In this paper, we describe grounded theory–based qualitative analysis of digital communication in QuitNet, an online community promoting smoking cessation. A database of 16,492 de-identified public messages from 1456 users from March 1-April 30, 2007, was used in our study. We analyzed 795 messages using grounded theory techniques to ensure thematic saturation. This analysis enabled identification of key concepts contained in the messages exchanged by QuitNet members, allowing us to understand the sociobehavioral intricacies underlying an individual’s efforts to cease smoking in a group setting. We further ascertained the relevance of the identified themes to theoretical constructs in existing behavior change theories (eg, Health Belief Model) and theoretically linked techniques of behavior change taxonomy. Results We identified 43 different concepts, which were then grouped under 12 themes based on analysis of 795 messages. Examples of concepts include “sleepiness,” “pledge,” “patch,” “spouse,” and “slip.” Examples of themes include “traditions,” “social support,” “obstacles,” “relapse,” and “cravings.” Results indicate that themes consisting of member-generated strategies such as “virtual bonfires” and “pledges” were related to the highest number of theoretical constructs from the existing behavior change theories. In addition, results indicate that the member-generated communication content supports sociocognitive constructs from more than one behavior change model, unlike the majority of the existing theory-driven interventions. Conclusions With the onset of mobile phones and ubiquitous Internet connectivity, online social network data reflect the intricacies of human health behavior as experienced by health consumers in real time. This study offers methodological insights for qualitative investigations that examine the various kinds of behavioral constructs prevalent in the messages exchanged among users of online communities. Theoretically, this study establishes the manifestation of existing behavior change theories in QuitNet-like online health communities. Pragmatically, it sets the stage for real-time, data-driven sociobehavioral interventions promoting healthy lifestyle modifications by allowing us to understand the emergent user needs to sustain a desired behavior change. PMID:26839162
Polytechnics in a "Postmarket" Environment.

ERIC Educational Resources Information Center

McNae, Denny

2002-01-01

Interviews with chief executive officers of three New Zealand polytechnics elicited themes regarding polytechnics' role in a "postmarket" environment: (1) collaboration is possible amidst fierce competition; (2) change is slow, externally driven, and complex; and (3) the polytechnic sector is in disarray. (Contains 27 references.) (SK)
Chlamydia screening in England: a qualitative study of the narrative behind the policy

PubMed Central

2012-01-01

Background The rationale for the English National Chlamydia Screening Programme (NCSP) has been questioned. There has been little analysis, however, of what drove the NCSP’s establishment and how it was implemented. Such analysis will help inform the future development of the NCSP. This study used a qualitative, theory-driven approach to evaluate the rationale for the NCSP’s establishment and implementation. Methods Semi-structured interviews with 14 experts in chlamydia screening were undertaken. The interview data were analysed with policy documents and commentaries from peer-reviewed journals (published 1996–2010) using the Framework approach. Results Two themes drove the NCSP’s establishment and implementation. The first, chlamydia control, was prominently referenced in documents and interviews. The second theme concerned the potential for chlamydia screening to advance wider improvements in sexual health. In particular, screening was expected to promote sexual health services in primary care and encourage discussion of sexual health with young people. While this theme was only indirectly referenced in policy documents, it was cited by interviewees as a strong influence on implementation in the early years. However, by full rollout of the Programme, a focus on screening volume may have limited the NCSP’s capacity to improve broader aspects of sexual health. Conclusions A combination of explicit and implicit drivers underpinned the Programme’s establishment. This combination may explain why there was widespread support for its introduction and why implementation of the NCSP was inconsistent. The potential to improve young people’s sexual health more comprehensively should be made explicit in future planning of the NCSP. PMID:22545922
Co-victims of Homicide: A Systematic Review of the Literature.

PubMed

Connolly, Jennifer; Gordon, Ronit

2015-10-01

This systematic literature review examines the effects of homicide on surviving family members, the "co-victims" or "survivors" of homicide. A content analysis was conducted on 40 articles identified through a search of the literature. The research samples were predominately located in the United States, but included two U.K. samples, one Jamaican sample, and one sample from Israel. All articles were written in English. Three themes were identified. Nineteen articles explored the psychological, academic, social, occupational, and familial effects of homicide. Thirteen articles considered survivors' grieving process and how it was altered by experiences with the criminal justice system as well as coping strategies used by survivors to deal with their grief. Eight articles explored treatment interventions available to help surviving family members deal with their grief. Key findings from the articles, limitations of the current research, and implications for future research, policy, and practice are included. © The Author(s) 2014.
Fishing for Effective Conservation: Context and Biotic Variation are Keys to Understanding the Survival of Pacific Salmon after Catch-and-Release.

PubMed

Raby, Graham D; Donaldson, Michael R; Hinch, Scott G; Clark, Timothy D; Eliason, Erika J; Jeffries, Kenneth M; Cook, Katrina V; Teffer, Amy; Bass, Arthur L; Miller, Kristina M; Patterson, David A; Farrell, Anthony P; Cooke, Steven J

2015-10-01

Acute stressors are commonly experienced by wild animals but their effects on fitness rarely are studied in the natural environment. Billions of fish are captured and released annually around the globe across all fishing sectors (e.g., recreational, commercial, subsistence). Whatever the motivation, release often occurs under the assumption of post-release survival. Yet, capture by fisheries (hereafter "fisheries-capture") is likely the most severe acute stressor experienced in the animal's lifetime, which makes the problem of physiological recovery and survival of relevance to biology and conservation. Indeed, fisheries managers require accurate estimates of mortality to better account for total mortality from fishing, while fishers desire guidance on strategies for reducing mortality and maintaining the welfare of released fish, to maximize current and future opportunities for fishing. In partnership with stakeholders, our team has extensively studied the effects of catch-and-release on Pacific salmon in both marine and freshwater environments, using biotelemetry and physiological assessments in a combined laboratory-based and field-based approach. The emergent theme is that post-release rates of mortality are consistently context-specific and can be affected by a suite of interacting biotic and abiotic factors. The fishing gear used, location of a fishery, water temperature, and handling techniques employed by fishers each can dramatically affect survival of the salmon they release. Variation among individuals, co-migrating populations, and between sexes all seem to play a role in the response of fish to capture and in their subsequent survival, potentially driven by pre-capture pathogen-load, maturation states, and inter-individual variation in responsiveness to stress. Although some of these findings are fascinating from a biological perspective, they all create unresolved challenges for managers. We summarize our findings by highlighting the patterns that have emerged most consistently, and point to areas of uncertainty that require further research. © The Author 2015. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.
Recommendations for neoadjuvant pathologic staging (ypTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

PubMed

Rice, Thomas W; Ishwaran, Hemant; Kelsen, David P; Hofstetter, Wayne L; Apperson-Hansen, Carolyn; Blackstone, Eugene H

2016-11-01

We report analytic and consensus processes that produced recommendations for neoadjuvant pathologic stage groups (ypTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 7,773 had pathologic assessment after neoadjuvant therapy. Risk-adjusted survival for each patient was developed. Random forest analysis identified data-driven neoadjuvant pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups. An additional analysis produced data-driven anatomic neoadjuvant pathologic stage groups based only on ypT, ypN, and ypM categories. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced consensus neoadjuvant pathologic stage groups. Grade and location were much less discriminating for stage grouping ypTNM than pTNM. Data-driven stage grouping without grade and location produced nearly identical groups for squamous cell carcinoma and adenocarcinoma. However, ypTNM groups and their associated survival differed from pTNM. The need for consensus process was minimal. The consensus groups, identical for both cell types were as follows: ypStage I comprised ypT0-2N0M0; ypStage II ypT3N0M0; ypStage IIIA ypT0-2N1M0; ypStage IIIB ypT3N1M0, ypT0-3N2, and ypT4aN0M0; ypStage IVA ypT4aN1-2, ypT4bN0-2, and ypTanyN3M0; and ypStage IVB ypTanyNanyM1. Absence of equivalent pathologic (pTNM) categories for the peculiar neoadjuvant pathologic categories ypTisN0-3M0 and ypT0N0-3M0, dissimilar stage group compositions, and markedly different early- and intermediate-stage survival necessitated a unified, unique set of stage grouping for patients of either cell type who receive neoadjuvant therapy. © 2016 International Society for Diseases of the Esophagus.
Media framing and construction of childhood obesity: a content analysis of Swedish newspapers.

PubMed

van Hooft, J; Patterson, C; Löf, M; Alexandrou, C; Hilton, S; Nimegeer, A

2018-02-01

Despite lower prevalence than most European countries, childhood obesity is a Swedish public health priority due to its lasting health impacts and socioeconomic patterning. Mass media content influences public and political perceptions of health issues, and media framing of childhood obesity may influence perceptions of its solutions. This study examines framing of childhood obesity in Swedish morning and evening newspapers from 1996 to 2014. Content analysis of 726 articles about childhood obesity published in the five most-circulated Swedish newspapers. Article content coded quantitatively and subjected to statistical analysis, describing relationships between themes and trends over time. Childhood obesity was consistently problematised, primarily in health terms, and linked to socio-economic and geographical factors. The yearly frequency of articles peaked in 2004, followed by a decline, corresponding with evidence about prevalence. Childhood obesity was framed as being driven by individual behaviours more frequently than structural or environmental factors. Structural framings increased over time, but constructions of the problem as driven by individual behaviours, particularly parenting, remained prominent. A relative growth in structural framings of causes and solutions over time, combined with prominent coverage of socio-economic inequalities, might be indicative of public and political amenability towards societal-level solutions, but individual behaviours remain prominent in framing of the issue. Health advocates might incorporate these insights into media engagement.
[Insert Your Science Here] Week: Creating science-driven public awareness campaigns

NASA Astrophysics Data System (ADS)

Mattson, Barbara; Mitchell, Sara; McElvery, Raleigh; Reddy, Francis; Wiessinger, Scott; Skelly, Clare; Saravia, Claire; Straughn, Amber N.; Washington, Dewayne

2018-01-01

NASA Goddard’s in-house Astrophysics Communications Team is responsible for facilitating the production of traditional and social media products to provide understanding and inspiration about NASA’s astrophysics missions and discoveries. Our team is largely driven by the scientific news cycle of launches, mission milestones, anniversaries, and discoveries, which can leave a number of topics behind, waiting for a discovery to be highlighted. These overlooked topics include compelling stories about ongoing research, underlying science, and science not tied to a specific mission. In looking for a way to boost coverage of these unsung topics, we struck upon an idea of creating “theme weeks” which bring together the broader scientific community around a topic, object, or scientific concept. This poster will present the first two of our Goddard-led theme weeks: Pulsar Week and Dark Energy Week. We will describe the efforts involved, our metrics, and the benefits and challenges we encountered. We will also suggest a template for doing this for your own science based on our successes.
Pharmacy practice department chairs' perspectives on part-time faculty members.

PubMed

Fjortoft, Nancy; Winkler, Susan R; Mai, Thy

2012-05-10

To identify the benefits and consequences of having part-time faculty members in departments of pharmacy practice from the department chair's perspective. A stratified purposive sample of 12 pharmacy practice department chairs was selected. Eleven telephone interviews were conducted. Two investigators independently read interview notes and categorized and enumerated responses to determine major themes using content analysis. The investigators jointly reviewed the data and came to consensus on major themes. Benefits of allowing full-time faculty members to reduce their position to part-time included faculty retention and improved individual faculty work/life balance. Consequences of allowing part-time faculty positions included the challenges of managing individual and departmental workloads, the risk of marginalizing part-time faculty members, and the challenges of promotion and tenure issues. All requests to switch to part-time status were faculty-driven and most were approved. There are a variety of benefits and consequences of having part-time faculty in pharmacy practice departments from the chair's perspective. Clear faculty and departmental expectations of part-time faculty members need to be established to ensure optimal success of this working arrangement.

Surviving Sudden Cardiac Arrest: A Pilot Qualitative Survey Study of Survivors.

PubMed

Sawyer, Kelly N; Brown, Frances; Christensen, Roxanne; Damino, Colleen; Newman, Mary M; Kurz, Michael C

2016-06-01

Research describing survivors of sudden cardiac arrest (SCA) has centered on quantifying functional ability, perceived quality of life, and neurocognitive assessment. Many gaps remain, however, regarding survivors' psychosocial perceptions of life in the aftermath of cardiac arrest. An important influence upon those perceptions is the presence of support and its role in a survivor's life. An Internet-based pilot survey study was conducted to gather data from SCA survivors and friends and/or family members (FFMs) representing their support system. The survey was distributed to members of the Sudden Cardiac Arrest Foundation (SCAF) via the Internet by SCAF leadership. Questions included both discrete multiple-choice and open-ended formats. Inductive thematic analyses were completed by three independent researchers trained in qualitative research methodology to identify primary themes consistent among study participants until thematic saturation was achieved. No statistical inferences were made. A total of 205 surveys were returned over the 5-month study period (July to November 2013); nine were received blank, leaving 196 surveys available for review. Major themes identified for survivors (N = 157) include the significance of and desire to share experiences with others; subculture identification (unique experience from those suffering a heart attack); and the need to seek a new normal, both personally and inter-personally. Major themes identified for FFMs (N = 39) include recognition of loved one's memory loss; a lack of information at discharge, including expectations after discharge; and concern for the patient experiencing another cardiac arrest. This pilot, qualitative survey study suggests several common themes important to survivors, and FFMs, of cardiac arrest. These themes may serve as a basis for future patient-centered focus groups and the development of patient-centered guidelines for patients and support persons of those surviving cardiac arrest.
Energy Division annual progress report for period ending September 30, 1976

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

Not Available

1977-04-01

A summmary of the work in each section of the Energy Division at ORNL is given and can be characterized by two themes: (1) environmental assessment, including social and economic considerations, and (2) fuel conservation and energy conversion efficiency. The first theme encompasses the preparation of environmental statements and assessments for nuclear power plants and other energy facilities (Chap. 2) as well as regional analyses of social, economic, and environmental effects due to energy system development patterns (Chap. 3). The second theme characterizes a broad scope of conservation-related work, including efforts to understand energy demand patterns and to develop technologiesmore » and arrangements for reducing these demands (Chap. 4). This theme also encompasses research directed at improving both high- and low-temperature thermodynamic cycles driven by solar, geothermal, or fossil energy sources (Chaps. 5 and 6). A listing of publications and oral presentations complete the report. A separate abstract was prepared for each major section or program. (MCW)« less
Beyond homogenization discourse: Reconsidering the cultural consequences of globalized medical education.

PubMed

Gosselin, K; Norris, J L; Ho, M-J

2016-07-01

Global medical education standards, largely designed in the West, have been promoted across national boundaries with limited regard for cultural differences. This review aims to identify discourses on cultural globalization in medical education literature from non-Western countries. To explore the diversity of discourses related to globalization and culture in the field of medical education, the authors conducted a critical review of medical education research from non-Western countries published in Academic Medicine, Medical Education and Medical Teacher from 2006 to 2014. Key discourses about globalization and culture emerged from a preliminary analysis of this body of literature. A secondary analysis identified inductive sub-themes. Homogenization, polarization and hybridization emerged as key themes in the literature. These findings demonstrate the existence of discourses beyond Western-led homogenization and the co-existence of globalization discourses ranging from homogenization to syncretism to resistance. This review calls attention to the existence of manifold discourses about globalization and culture in non-Western medical education contexts. In refocusing global medical education processes to avoid Western cultural imperialism, it will also be necessary to avoid the pitfalls of other globalization discourses. Moving beyond existing discourses, researchers and educators should work towards equitable, context-sensitive and locally-driven approaches to global medical education.
A perspective on bridging scales and design of models using low-dimensional manifolds and data-driven model inference

PubMed Central

Zenil, Hector; Kiani, Narsis A.; Ball, Gordon; Gomez-Cabrero, David

2016-01-01

Systems in nature capable of collective behaviour are nonlinear, operating across several scales. Yet our ability to account for their collective dynamics differs in physics, chemistry and biology. Here, we briefly review the similarities and differences between mathematical modelling of adaptive living systems versus physico-chemical systems. We find that physics-based chemistry modelling and computational neuroscience have a shared interest in developing techniques for model reductions aiming at the identification of a reduced subsystem or slow manifold, capturing the effective dynamics. By contrast, as relations and kinetics between biological molecules are less characterized, current quantitative analysis under the umbrella of bioinformatics focuses on signal extraction, correlation, regression and machine-learning analysis. We argue that model reduction analysis and the ensuing identification of manifolds bridges physics and biology. Furthermore, modelling living systems presents deep challenges as how to reconcile rich molecular data with inherent modelling uncertainties (formalism, variables selection and model parameters). We anticipate a new generative data-driven modelling paradigm constrained by identified governing principles extracted from low-dimensional manifold analysis. The rise of a new generation of models will ultimately connect biology to quantitative mechanistic descriptions, thereby setting the stage for investigating the character of the model language and principles driving living systems. This article is part of the themed issue ‘Multiscale modelling at the physics–chemistry–biology interface’. PMID:27698038
Scapegoating Public Schools

ERIC Educational Resources Information Center

Shaker, Paul S.; Heilman, Elizabeth E.

2008-01-01

In their popular explanation of No Child Left Behind, journalists and other public voices claim that unruly and inefficient public schools are being brought under the control of effective central authorities by scientific, test-driven accountability. Other popular themes of reform in media include mayoral control of schools, non-educators as…
Predicting analysis time in events-driven clinical trials using accumulating time-to-event surrogate information.

PubMed

Wang, Jianming; Ke, Chunlei; Yu, Zhinuan; Fu, Lei; Dornseif, Bruce

2016-05-01

For clinical trials with time-to-event endpoints, predicting the accrual of the events of interest with precision is critical in determining the timing of interim and final analyses. For example, overall survival (OS) is often chosen as the primary efficacy endpoint in oncology studies, with planned interim and final analyses at a pre-specified number of deaths. Often, correlated surrogate information, such as time-to-progression (TTP) and progression-free survival, are also collected as secondary efficacy endpoints. It would be appealing to borrow strength from the surrogate information to improve the precision of the analysis time prediction. Currently available methods in the literature for predicting analysis timings do not consider utilizing the surrogate information. In this article, using OS and TTP as an example, a general parametric model for OS and TTP is proposed, with the assumption that disease progression could change the course of the overall survival. Progression-free survival, related both to OS and TTP, will be handled separately, as it can be derived from OS and TTP. The authors seek to develop a prediction procedure using a Bayesian method and provide detailed implementation strategies under certain assumptions. Simulations are performed to evaluate the performance of the proposed method. An application to a real study is also provided. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
A Theory-Driven Model of Community College Student Engagement

ERIC Educational Resources Information Center

Schuetz, Pam

2008-01-01

This mixed-methods study develops, operationalizes, and tests a new conceptual model of community college student engagement. Themes emerging from participant observations and semistructured interviews with 30 adult students enrolled at a Large Best Practices Community College (LBPCC) over the 2005-2006 academic year are used to guide selection of…
The Program for Professional Values and Ethics in Medical Education.

ERIC Educational Resources Information Center

Lazarus, Cathy J.; Chauvin, Sheila W.; Rodenhauser, Paul; Whitlock, Robin

2000-01-01

Describes the Program for Professional Values and Ethics in Medical Education (PPVEME) at Tulane University School of Medicine. It brings together students, residents, and faculty into learning teams that teach the other teams about one of five themes: integrity, communication, teamwork, leadership, and service. It emphasizes learner-driven self…
Survivors Perceptions of Recovery following Air Medical Transport Accidents.

PubMed

Jaynes, Cathy L; Valdez, Anna; Hamilton, Megan; Haugen, Krista; Henry, Colin; Jones, Pat; Werman, Howard A; White, Lynn J

2015-01-01

Abstract Objective: Air medical transport (AMT) teams play an essential role in the care of the critically ill and injured. Their work, however, is not without risk. Since the inception of the industry numerous AMT accidents have been reported. The objective of this research is to gain a better understanding of the post-accident sequelae for professionals who have survived AMT accidents. The hope is that this understanding will empower the industry to better support survivors and plan for the contingencies of post-accident recovery. Methods: Qualitative methods were used to explore the experience of flight crew members who have survived an AMT accident. "Accident" was defined using criteria established by the National Transportation Safety Board. Traditional focus group methodology explored the survivors' experiences following the accident. Results: Seven survivors participated in the focus group. Content analysis revealed themes in four major domains that described the experience of survivors: Physical, Psychological, Relational and Financial. Across the themes survivors reported that industry and company response varied greatly, ranging from generous support, understanding and action to make safety improvements, to little response or action and lack of attention to survivor needs. Conclusion: Planning for AMT post-accident response was identified to be lacking in scope and quality. More focused efforts are needed to assist and support the survivors as they regain both their personal and professional lives following the accident. This planning should include all stakeholders in safe transport; the individual crewmember, air medical transport companies, and the industry at large.
Influence of Language and Culture in the Primary Care of Spanish-Speaking Latino Adults with Poorly Controlled Diabetes: A Qualitative Study.

PubMed

Zamudio, Cindy D; Sanchez, Gabriela; Altschuler, Andrea; Grant, Richard W

2017-01-01

We examined the role of language and culture in the interactions between Spanish-speaking Latino patients with poorly controlled diabetes - a fast-growing population in the United States - and their primary care providers. We conducted four focus groups with 36 non-US born Spanish-speaking patients with elevated HbA1c. Participants were insured health plan members with either English-speaking (2 groups) or Spanish-speaking (2 groups) primary care providers. Moderated discussions focused on visit preparation, communication during visit, and role of other care team members. Key themes derived from these discussions were then linked to corresponding Latino cultural constructs. Patients had a mean age of 57.9 (±11.2) years and last measured HbA1c was 8.6% (1.5%). Two communication-related themes (reluctance to switch providers and use of intermediaries) and two visit-related themes (provider-driven visit agendas and problem-based visits) emerged from our analyses. These themes reflected the cultural constructs of confianza (trust), familismo (family), respeto (deference), and simpatía (harmonious relationship). Trust in the patient-provider relationship led many participants to remain with English-speaking providers who treated them well. Patients with either language concordant and discordant providers reported reliance on family or other intermediaries to close communication gaps. Deference to physician expertise and authority led to visit expectations that it is the doctor's job to know what to ask and that visits were intended to address specific, often symptom-driven problems. Spanish-speaking Latino patients' cultural expectations play an important role in framing their primary care interactions. Recognizing culturally influenced visit expectations is an important step toward improving patient-provider communication.
Association between BIM deletion polymorphism and clinical outcome of EGFR-mutated NSCLC patient with EGFR-TKI therapy: A meta-analysis.

PubMed

Ma, Ji-Yong; Yan, Hai-Jun; Gu, Wei

2015-01-01

BIM deletion polymorphism was deemed to be associated with downregulation of BIM, resulting in a decreased apoptosis induced by epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in EGFR mutation-positive non-small cell lung cancer (NSCLC). However, accumulating evidences concerning the association between BIM deletion polymorphism and efficacy of EGFR-TKI and survival in EGFR-mutation-driven NSCLC patient reported contradictory results. A meta-analysis was conducted by combing six original eligible studies including 871 NSCLC patients. Our study showed that BIM deletion polymorphism was significantly associated with poor response to EGFR-TKI therapy in mutant EGFRNSCLC patients (P(h) = 0.309, P(z) = 0.001, OR = 0.39, 95% confidence interval (CI) = 0.23-0.67). Disease control rate (DCR) in mutant EGFRNSCLC patient with treatment of EGFR-TKI was significantly decreased in patients with BIM deletion polymorphism comparing to patients harbored BIM wild variant (P(h) = 0.583, P(Z) = 0.007, OR = 0.46, 95%CI = 0.25-0.85). EGFR mutation-derived NSCLC patient carrying BIM deletion polymorphism had a shorter progression-free survival (PFS; P(h) < 0.001, P(z) < 0.001, hazard ratio (HR) = 1.37, 95%CI = 1.09-1.71) and overall survival (OS; P(h) = 0.90, P(z) = 0.003, HR = 1.25, 95%CI = 1.08-1.45), than those harbored BIM wild variant. These results suggested that BIM deletion polymorphism might be a cause that contributes to primary EGFR-TKI resistance, and it could be used as a genetic predictor for EGFR-TKI outcome and an independent prognostic factor of EGFR mutation-driven NSCLC patient.
Alternative methods for flotation seat cushion use.

DOT National Transportation Integrated Search

1995-05-01

Alternative methods of using flotation seat cushions for water crash survivors were identified at the Civil Aeromedical Institute (CAMI). These methods, tested in the CAMI survival tank and a theme park wave pool, were: 1) two people facing each othe...
Not the Color Purple: Black Feminist Lessons for Educational Caring.

ERIC Educational Resources Information Center

Thompson, Audrey

1998-01-01

Asserts that theories of caring in education have avoided issues of racial imbalance. Reinterprets these themes from a black feminist perspective: moral relevance, primacy of survival, significance of one's standpoint, and the moral power of narrative. (SK)
Analyzing the genes related to Alzheimer's disease via a network and pathway-based approach.

PubMed

Hu, Yan-Shi; Xin, Juncai; Hu, Ying; Zhang, Lei; Wang, Ju

2017-04-27

Our understanding of the molecular mechanisms underlying Alzheimer's disease (AD) remains incomplete. Previous studies have revealed that genetic factors provide a significant contribution to the pathogenesis and development of AD. In the past years, numerous genes implicated in this disease have been identified via genetic association studies on candidate genes or at the genome-wide level. However, in many cases, the roles of these genes and their interactions in AD are still unclear. A comprehensive and systematic analysis focusing on the biological function and interactions of these genes in the context of AD will therefore provide valuable insights to understand the molecular features of the disease. In this study, we collected genes potentially associated with AD by screening publications on genetic association studies deposited in PubMed. The major biological themes linked with these genes were then revealed by function and biochemical pathway enrichment analysis, and the relation between the pathways was explored by pathway crosstalk analysis. Furthermore, the network features of these AD-related genes were analyzed in the context of human interactome and an AD-specific network was inferred using the Steiner minimal tree algorithm. We compiled 430 human genes reported to be associated with AD from 823 publications. Biological theme analysis indicated that the biological processes and biochemical pathways related to neurodevelopment, metabolism, cell growth and/or survival, and immunology were enriched in these genes. Pathway crosstalk analysis then revealed that the significantly enriched pathways could be grouped into three interlinked modules-neuronal and metabolic module, cell growth/survival and neuroendocrine pathway module, and immune response-related module-indicating an AD-specific immune-endocrine-neuronal regulatory network. Furthermore, an AD-specific protein network was inferred and novel genes potentially associated with AD were identified. By means of network and pathway-based methodology, we explored the pathogenetic mechanism underlying AD at a systems biology level. Results from our work could provide valuable clues for understanding the molecular mechanism underlying AD. In addition, the framework proposed in this study could be used to investigate the pathological molecular network and genes relevant to other complex diseases or phenotypes.
Consequences and coping strategies six years after a subarachnoid hemorrhage – A qualitative study

PubMed Central

Törnbom, Karin; Sunnerhagen, Katharina S.; Törnbom, Marie

2017-01-01

Background After a subarachnoid haemorrhage (SAH), continuing impairment is common and may impact the person’s life. There is a lack of knowledge regarding long-term consequences experienced. Purpose To explore experiences of the care and rehabilitation as well as the consequences and strategies used to cope with everyday life six years post SAH. Methods An explorative interview study with a qualitative design. Individual interviews, with open ended questions, using an interview guide were performed with sixteen participants (mean age 63, 8 men, 8 women) six years post SAH. Data was analyzed according to a descriptive thematic analysis, and themes were discovered inductively. Results Two major themes from the analysis, both including four sub-themes, were identified; these themes were consequences of the SAH and coping strategies. Participants were grateful to have survived the SAH and most were satisfied with their acute medical care. If discharged directly from the neurosurgical unit participants can feel abandoned. In contrast, participants who were referred to a rehabilitation clinic felt supported and informed. Cognitive problems, such as impaired memory and mental fatigue, were reported as still present six years post SAH. Coping strategies were; receiving support from family, society, employers, or technical equipment. At work, talking to colleagues and to taking breaks were common. Participants described hiding their symptoms from employers and friends, as well as trying to continue doing tasks in the same manner as prior to the SAH. If this was not possible, some refrained from doing these tasks. They went through a mourning process, fear, and worries. Conclusions Participants reported several long-term consequences which impacted on their daily lives post SAH, and different coping strategies were used to cope with these problems. Participants reported lack of awareness regarding the consequences of SAH and stressed the importance of structured multidisciplinary follow-ups, which mostly is missing. PMID:28854198
Evolution and clinical impact of co-occurring genetic alterations in advanced-stage EGFR-mutant lung cancers. | Office of Cancer Genomics

Cancer.gov

A widespread approach to modern cancer therapy is to identify a single oncogenic driver gene and target its mutant-protein product (for example, EGFR-inhibitor treatment in EGFR-mutant lung cancers). However, genetically driven resistance to targeted therapy limits patient survival. Through genomic analysis of 1,122 EGFR-mutant lung cancer cell-free DNA samples and whole-exome analysis of seven longitudinally collected tumor samples from a patient with EGFR-mutant lung cancer, we identified critical co-occurring oncogenic events present in most advanced-stage EGFR-mutant lung cancers.
The roles of family, culture, and social cognitive variables in the career interests and goals of Asian American college students.

PubMed

Hui, Kayi; Lent, Robert W

2018-01-01

Although family and cultural factors have been assumed to play important roles in the career development of Asian Americans, theory-driven research on this topic remains limited. We examined culturally relevant factors that may contribute to Asian Americans' consideration of fields in which they are overrepresented (e.g., science, technology, engineering) and underrepresented (e.g., education, social science). Drawing from social cognitive career theory, a culture-specific, social cognitive model of career interests and choice was tested in Holland's (1997) Investigative (I) and Social (S) themes. A sample of 802 Asian American undergraduates completed measures of family support, self-efficacy, outcome expectations, interest, and career choice consideration in relation to both Holland themes. Two indicators of acculturation/enculturation (adherence to Asian values and generation status in the United States) were also obtained. The model accounted for a substantial amount of variance in Asian American college students' career consideration in both themes. Family support and acculturation played varying roles, depending on the Holland theme. For example, family support was linked to career choice consideration both directly (in the S theme) and indirectly, via other predictors (in both themes). Contrary to expectations, the acculturation variables did not moderate the relation of family support or interest to career consideration in either theme. We discuss the implications of these findings for efforts to understand and facilitate the career development of Asian American college students. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Driving experience, crashes and traffic citations of teenage beginning drivers.

PubMed

McCartt, Anne T; Shabanova, Veronika I; Leaf, William A

2003-05-01

Teenagers were surveyed by telephone every 6 months from their freshman to senior high school years (N=911). Self-reported crash involvements and citations were examined for each teenager's first year of licensure and first 3500 miles driven. Based on survival analysis, the risk of a first crash during the first month of licensure (0.053) was substantially higher than during any of the next 11 months (mean risk per month: 0.025). The likelihood of a first citation during the first month of licensure (0.023) also was higher than during any of the subsequent 11 months (mean risk per month: 0.012). Similarly, when viewed as a function of cumulative miles driven, the risk of a first crash or citation was highest during the first 500 miles driven after licensure. Fewer parental restrictions (e.g. no nighttime curfew) and a lower grade point average (GPA) were associated with a higher crash risk. Male gender, a lower GPA and living in a rural area were associated with a higher citation rate.
Multi-UAV Collaborative Sensor Management for UAV Team Survivability

DTIC Science & Technology

2006-08-01

Multi-UAV Collaborative Sensor Management for UAV Team Survivability Craig Stoneking, Phil DiBona , and Adria Hughes Lockheed Martin Advanced...Command, Aviation Applied Technology Directorate. REFERENCES [1] DiBona , P., Belov, N., Pawlowski, A. (2006). “Plan-Driven Fusion: Shaping the
Surviving life as a woman: a critical ethnography of violence in the lives of female domestic workers in Malawi.

PubMed

Mkandawire-Valhmu, Lucy; Rodriguez, Rachel; Ammar, Nawal; Nemoto, Keiko

2009-09-01

A common form of employment for low-income third world women is domestic work. The power dynamics in this type of employer-employee relationship may place women at risk for abuse. Our aim in conducting this qualitative inquiry was to describe the experiences of violence in the lives of young female domestic workers in Malawi, a small country in South East Africa. Forty-eight women participated in focus group and individual interviews. "Surviving" was the main theme identified, with women employing creative ways of surviving the challenges they met at various points in their lives. This study provides information that health care professionals could use in assisting women through the process of surviving.

An analysis of whether higher health care spending in the United States versus Europe is 'worth it' in the case of cancer.

PubMed

Philipson, Tomas; Eber, Michael; Lakdawalla, Darius N; Corral, Mitra; Conti, Rena; Goldman, Dana P

2012-04-01

The United States spends more on health care than other developed countries, but some argue that US patients do not derive sufficient benefit from this extra spending. We studied whether higher US cancer care costs, compared with those of ten European countries, were "worth it" by looking at the survival differences for cancer patients in these countries compared to the relative costs of cancer care. We found that US cancer patients experienced greater survival gains than their European counterparts; even after considering higher US costs, this investment generated $598 billion of additional value for US patients who were diagnosed with cancer between 1983 and 1999. The value of that additional survival gain was highest for prostate cancer patients ($627 billion) and breast cancer patients ($173 billion). These findings do not appear to have been driven solely by earlier diagnosis. Our study suggests that the higher-cost US system of cancer care delivery may be worth it, although further research is required to determine what specific tools or treatments are driving improved cancer survival in the United States.
Working in a decentralized system: a threat to health workers' respect and survival in Uganda.

PubMed

Kyaddondo, David; Whyte, Susan Reynolds

2003-01-01

This article contributes to the sparse empirical material on the position of health workers within health sector reform. Using qualitative data gathered in 1999, it shows how staff at rural health units in Tororo and Busia Districts experienced the reforms during the first 5 years of decentralization in Uganda. The analysis builds on a framework proposed by Franco et al. to examine the relation between health sector reform and health worker motivation. However, it diverges from their objective description of the factors determining motivation, giving more emphasis to the subjective perspective of the health workers. The categorical distinction between organizational and cultural/community factors was less relevant for them as actors. Two themes cross-cut their lives inside and outside the health facilities: professional identity, which entailed recognition by both the organization and members of the community; and 'survival strategies', which were necessitated by the desire to maintain a status and lifestyle befitting a professional. Reform weakened workers' positions as professionals and hindered facility-based 'survival strategies' that helped them get by on poor salaries. With an overall fall in remuneration, they were more motivated than ever to establish supplementary sources of income outside the formal government health care system.
Women's Vantage Points and New Realities: A Philosophic Viewing.

ERIC Educational Resources Information Center

Greene, Maxine

Women who are able to acknowledge their distinctive perceptions and to relate them to their lives are the ones most likely to expose the oppressiveness of a power-driven society. Nathaniel Hawthorne's fictional character, Hester Prynne ("The Scarlet Letter") illustrates a crucial theme: a woman's faculty for critical awareness and her ability to…
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.
Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People's Republic of China.

PubMed

Mao, Ningying; Lesher, Beth; Liu, Qifa; Qin, Lei; Chen, Yixi; Gao, Xin; Earnshaw, Stephanie R; McDade, Cheryl L; Charbonneau, Claudie

2016-01-01

Invasive fungal infections (IFIs) require rapid diagnosis and treatment. A decision-analytic model was used to estimate total costs and survival associated with a diagnostic-driven (DD) or an empiric treatment approach in neutropenic patients with hematological malignancies receiving chemotherapy or autologous/allogeneic stem cell transplants in Shanghai, Beijing, Chengdu, and Guangzhou, the People's Republic of China. Treatment initiation for the empiric approach occurred after clinical suspicion of an IFI; treatment initiation for the DD approach occurred after clinical suspicion and a positive IFI diagnostic test result. Model inputs were obtained from the literature; treatment patterns and resource use were based on clinical opinion. Total costs were lower for the DD versus the empiric approach in Shanghai (¥3,232 vs ¥4,331), Beijing (¥3,894 vs ¥4,864), Chengdu, (¥4,632 vs ¥5,795), and Guangzhou (¥8,489 vs ¥9,795). Antifungal administration was lower using the DD (5.7%) than empiric (9.8%) approach, with similar survival rates. Results from one-way and probabilistic sensitivity analyses were most sensitive to changes in diagnostic test sensitivity and IFI incidence; the DD approach dominated the empiric approach in 88% of scenarios. These results suggest that a DD compared to an empiric treatment approach in the People's Republic of China may be cost saving, with similar overall survival in immunocompromised patients with suspected IFIs.
A Focus Group Exploration of Automated Case-Finders to Identify High-Risk Heart Failure Patients Within an Urban Safety Net Hospital.

PubMed

Patterson, Mark E; Miranda, Derick; Schuman, Greg; Eaton, Christopher; Smith, Andrew; Silver, Brad

2016-01-01

Leveraging "big data" as a means of informing cost-effective care holds potential in triaging high-risk heart failure (HF) patients for interventions within hospitals seeking to reduce 30-day readmissions. Explore provider's beliefs and perceptions about using an electronic health record (EHR)-based tool that uses unstructured clinical notes to risk-stratify high-risk heart failure patients. Six providers from an inpatient HF clinic within an urban safety net hospital were recruited to participate in a semistructured focus group. A facilitator led a discussion on the feasibility and value of using an EHR tool driven by unstructured clinical notes to help identify high-risk patients. Data collected from transcripts were analyzed using a thematic analysis that facilitated drawing conclusions clustered around categories and themes. From six categories emerged two themes: (1) challenges of finding valid and accurate results, and (2) strategies used to overcome these challenges. Although employing a tool that uses electronic medical record (EMR) unstructured text as the benchmark by which to identify high-risk patients is efficient, choosing appropriate benchmark groups could be challenging given the multiple causes of readmission. Strategies to mitigate these challenges include establishing clear selection criteria to guide benchmark group composition, and quality outcome goals for the hospital. Prior to implementing into practice an innovative EMR-based case-finder driven by unstructured clinical notes, providers are advised to do the following: (1) define patient quality outcome goals, (2) establish criteria by which to guide benchmark selection, and (3) verify the tool's validity and reliability. Achieving consensus on these issues would be necessary for this innovative EHR-based tool to effectively improve clinical decision-making and in turn, decrease readmissions for high-risk patients.
Recovery From Heart Attack, Biomedicalization, and the Production of a Contingent Health Citizenship.

PubMed

Langdridge, Darren

2017-07-01

In this article, I explore the experience of recovery from a heart attack through an analytic autoethnography. I discuss the tensions inherent in biomedical subjectivities of health and ill-health during cardiac recovery through three key themes: (a) the transfer of responsibility and becoming a subject "at risk," (b) technologies of biomedicine and the disciplining of subjectivities, and (c) the transformation of a body toward a new pharmaceuticalized bodily normal. Through an analysis driven by the biomedicalization thesis of Clarke, alongside work on biopower and the governmentality of health by Foucault, Rose, and Rabinow, I seek to provide new insights into the process of cardiac recovery and the relationship between individual experience and broader socio-political processes. Key to this analysis is a focus on the contingent subjectivities brought into being through biomedicalization that constitute a new form of health citizenship that is otherwise not accounted for in narratives of recovery.
Energy landscape analysis of neuroimaging data

NASA Astrophysics Data System (ADS)

Ezaki, Takahiro; Watanabe, Takamitsu; Ohzeki, Masayuki; Masuda, Naoki

2017-05-01

Computational neuroscience models have been used for understanding neural dynamics in the brain and how they may be altered when physiological or other conditions change. We review and develop a data-driven approach to neuroimaging data called the energy landscape analysis. The methods are rooted in statistical physics theory, in particular the Ising model, also known as the (pairwise) maximum entropy model and Boltzmann machine. The methods have been applied to fitting electrophysiological data in neuroscience for a decade, but their use in neuroimaging data is still in its infancy. We first review the methods and discuss some algorithms and technical aspects. Then, we apply the methods to functional magnetic resonance imaging data recorded from healthy individuals to inspect the relationship between the accuracy of fitting, the size of the brain system to be analysed and the data length. This article is part of the themed issue `Mathematical methods in medicine: neuroscience, cardiology and pathology'.
Pharmacy Practice Department Chairs’ Perspectives on Part-Time Faculty Members

PubMed Central

Winkler, Susan R.; Mai, Thy

2012-01-01

Objective. To identify the benefits and consequences of having part-time faculty members in departments of pharmacy practice from the department chair’s perspective. Methods. A stratified purposive sample of 12 pharmacy practice department chairs was selected. Eleven telephone interviews were conducted. Two investigators independently read interview notes and categorized and enumerated responses to determine major themes using content analysis. The investigators jointly reviewed the data and came to consensus on major themes. Results. Benefits of allowing full-time faculty members to reduce their position to part-time included faculty retention and improved individual faculty work/life balance. Consequences of allowing part-time faculty positions included the challenges of managing individual and departmental workloads, the risk of marginalizing part-time faculty members, and the challenges of promotion and tenure issues. All requests to switch to part-time status were faculty-driven and most were approved. Conclusions. There are a variety of benefits and consequences of having part-time faculty in pharmacy practice departments from the chair’s perspective. Clear faculty and departmental expectations of part-time faculty members need to be established to ensure optimal success of this working arrangement. PMID:22611268
Transformation of the California mental health system: stakeholder-driven planning as a transformational activity.

PubMed

Cashin, Cheryl; Scheffler, Richard; Felton, Mistique; Adams, Neal; Miller, Leonard

2008-10-01

This study describes strategies developed by California counties to transform their mental health systems under the 2004 Mental Health Services Act (MHSA). This voter initiative places a 1% tax on annual incomes over $1 million; tax monies are earmarked to transform county-operated mental health services into systems that are oriented more toward recovery. MHSA implementation itself can be considered "transformational" by balancing greater standardization of mental health service delivery in the state with a locally driven planning process. A qualitative content analysis of the three-year plans submitted by 12 counties to receive funds under MHSA was conducted to identify common themes, as well as innovative approaches. These 12 (out of 58) counties were chosen to represent both small and large counties, as well as geographic diversity, and they represent 62.3% of the state population. This analysis showed that the state guidelines and local planning process generated consistency across counties in establishing full-service partnerships with a "whatever it takes" approach to providing goal-directed services and supports to consumers and their families. There was, however, little convergence around the specific strategies to achieve this vision, reflecting both the local planning process and a relative lack of clear policy and guidance on evidence-based practices. There are many obstacles to the successful implementation of these ambitious plans. However, the state-guided, but stakeholder-driven, transformation in California appears to generate innovative approaches to recovery-oriented services, involve consumers and family members in service planning and delivery, and build community partnerships that create new opportunities for consumers to meet their recovery goals.
Meaning in life: the perspective of long-term care residents.

PubMed

Welsh, Darlene; Moore, Sharon L; Getzlaf, Beverley A

2012-07-01

A qualitative approach was used in the exploration of meaning in life for long-term care (LTC) residents. This hermeneutic phenomenological study, as described by van Manen, was conducted using semi-structured interviews with 11 LTC residents from a rural region in Atlantic Canada. Four themes emerged as enhancing meaning in life for the residents in this study: Connectedness, Survival Despite Declining Functional Capacity, Engaging in "Normal" Activities, and Seeking a Place of Refuge. In this article, we describe the emerging themes and the implications for LTC education, practice, and future research. Copyright 2012, SLACK Incorporated.
Spaceship Earth Revisited.

ERIC Educational Resources Information Center

Pultorak, Robert W.

1981-01-01

Describes a self-paced undergraduate environmental science course focusing on a theme that earth is similar to a spaceship inasmuch as: (1) both possess finite room and resources, and (2) living things are dependent upon life-support systems for continued survival. Includes a list of laboratory and learning activities. (DS)
Strange and scary memories of the intensive care unit: a qualitative, longitudinal study inspired by Ricoeur's interpretation theory.

PubMed

Svenningsen, Helle; Egerod, Ingrid; Dreyer, Pia

2016-10-01

To describe the content of former intensive care unit patients' memories of delusions. Intensive care unit patients often have strange and frightening experiences during the critical stage of illness. Earlier studies have provided small-sample in-depth descriptions of patient experiences in intensive care unit, but large-scale studies are also needed to inform intensive care unit follow-up. The study had a qualitative design using phenomenological hermeneutic analysis inspired by Ricoeur's interpretive theory. Patients were assessed with Confusion Assessment Method of the Intensive Care Unit for delirium in intensive care unit, and after discharge, memories of delusions were described by 114 of 325 patients in face-to-face (after two weeks) and telephone interviews (after two and six months) using the Intensive Care Unit Memory Tool. Four themes emerged: the ever-present family, dynamic spaces, surviving challenges and constant motion. Memories of delusions were a vivid mix of fact and fiction, demonstrating dynamic shifts in time, place and motion, but not dependent on the presence of delirium assessed by Confusion Assessment Method of the Intensive Care Unit. Analysis based on Ricoeurian phenomenological hermeneutics provided insights into themes in intensive care unit patients' memories of delusions. More studies are needed to understand the meaning of memories of delusions, the commonality of themes and the association between delusions and delirium after an intensive care unit stay. Understanding patients' memories of delusions is beneficial to nurses caring for patients that are anxious, upset or agitated. It opens a window to the world of the patient who is unable to communicate due to intubation and general weakness. We recommend the provision of nurse-led intensive care unit follow-up enabling patients to describe and discuss their intensive care unit experiences. © 2016 John Wiley & Sons Ltd.
Pathways to Lung Cancer Diagnosis: A Qualitative Study of Patients and General Practitioners about Diagnostic and Pretreatment Intervals.

PubMed

Rankin, Nicole M; York, Sarah; Stone, Emily; Barnes, David; McGregor, Deborah; Lai, Michelle; Shaw, Tim; Butow, Phyllis N

2017-05-01

Pathways to lung cancer diagnosis and treatment are complex. International evidence shows significant variations in pathways. Qualitative research investigating pathways to lung cancer diagnosis rarely considers both patient and general practitioner views simultaneously. To describe the lung cancer diagnostic pathway, focusing on the perspective of patients and general practitioners about diagnostic and pretreatment intervals. This qualitative study of patients with lung cancer and general practitioners in Australia used qualitative interviews or a focus group in which participants responded to a semistructured questionnaire designed to explore experiences of the diagnostic pathway. The Model of Pathways to Treatment (the Model) was used as a framework for analysis, with data organized into (1) events, (2) processes, and (3) contributing factors for variations in diagnostic and pretreatment intervals. Thirty participants (19 patients with lung cancer and 11 general practitioners) took part. Nine themes were identified during analysis. For the diagnostic interval, these were: (1) taking patient concerns seriously, (2) a sense of urgency, (3) advocacy that is doctor-driven or self-motivated, and (4) referral: "knowing who to refer to." For the pretreatment interval, themes were: (5) uncertainty, (6) psychosocial support for the patient and family before treatment, and (7) communication among the multidisciplinary team and general practitioners. Two cross-cutting themes were: (8) coordination of care and "handing over" the patient, and (9) general practitioner knowledge about lung cancer. Events were perceived as complex, with diagnosis often being revealed over time, rather than as a single event. Contributing factors at patient, system, and disease levels are described for both intervals. Patients and general practitioners expressed similar themes across the diagnostic and pretreatment intervals. Significant improvements could be made to health systems to facilitate better patient and general practitioner experiences of the diagnostic pathway. This novel presentation of patient and general practitioner perspectives indicates that systemic interventions have a role in timely and appropriate referrals to specialist care and coordination of investigations. Systemic interventions may alleviate concerns about urgency of diagnostic workup, communication, and coordination of care as patients transition from primary to specialist care.
"I can't stop worrying about everything"—experiences of rural Bangladeshi women during the first postpartum months.

PubMed

Edhborg, Maigun; Nasreen, Hashima E; Kabir, Zarina Nahar

2015-01-01

Over recent years, researchers have found evidence which indicates that the prevalence of postpartum depressive symptoms crosses cultural boundaries and is reported to be at least as high in non-Western countries as in Western countries. However, qualitative studies about new mothers' experiences from non-Western countries, such as Bangladesh, are rare, particularly in rural areas. This study aims to describe the experiences and concerns of rural Bangladeshi mothers with postpartum depressive symptoms. Open narrative interviews were conducted with 21 mothers with depressive symptoms 2-3 months postpartum, consecutively selected from a longitudinal study about prevalence and risk factors of perinatal depressive symptoms. Inductive content analysis was used to analyse data and three themes emerged: family dynamics, living at the limits of survival, and role of the cultural context after childbirth. These themes were based on six categories and 15 subcategories. The findings show that troublesome family relationships, including intimate partner violence and violence in the family, influenced the mothers' mental well-being. They and their families lived at the limit of survival and the mothers expressed fear and worries about their insecure situation regarding economic difficulties and health problems. They felt sorry for being unable to give their infants a good start in life and sad because they could not always follow the traditional norms related to childbirth. Thus, it is important to focus on the depressive symptoms among new mothers and offer counselling to those showing depressive symptoms, as the cultural traditions do not always alleviate these symptoms in the changing Bangladeshi society today.
Variations on a Theme: As Needs Change, New Models of Critical Friends Groups Emerge

ERIC Educational Resources Information Center

Fahey, Kevin; Ippolito, Jacy

2015-01-01

The Critical Friends Group, a highly articulated model of professional learning, posits that, in order for teachers to learn together in ways that change their practice, the content and nature of their conversations must change (National School Reform Faculty, 2012). The content needs to change from externally driven agendas that address (in a…
The barriers to patient-driven treatment in mental health: why patients may choose to follow their own path.

PubMed

Greenall, Paul

2006-01-01

The paper aims to explore the barriers that currently exist to patient-driven treatment within the field of mental health care and reform. This study represents action learning research using grounded theory to explore a possible causal basis for recidivism related to non-compliance with medication. Interviews addressed concerns from the literature around perceived barriers to patient-driven treatment evidenced by non-compliance with medically recommended pharmaceutical treatment. Results were correlated to look for emergent themes that were used to form the basis for subsequent interview questions. An analysis of the resulting emergent themes illustrated the importance of participatory treatment and coaching rather than medically applied paternalistic care, which is seen as encouraging learned helplessness on the part of patients. Similar helplessness was also revealed in clinicians themselves. Patients' awareness of their own needs and demands for more services place clients and the caregivers at odds over appropriate care in an environment of limited resources. The research was limited to only a small number of interviewees in one institution, all of whom were closely associated with mental illness in various capacities. The grounded theory nature of the research does, however, provide a framework for more research in other institutions to test and further explore some of the findings. The study demonstrated a reinforcement of Maslow's theory of needs hierarchy. The study illustrated a step-wise approach to treatment to decrease the rate of failure and recidivism in mental health care. The provision of a stable living environment was viewed as instrumental in improving patients' compliance with pharmaceutical treatment. An action plan was therefore created to initiate the support of a transitional/emergency house by various community groups in partnership with pharmaceutical manufacturing companies. Recidivism in mental health-created by non-compliance in pharmaceutical treatment, is a major issue in Canada's health care system. This study brings to the forefront issues from a number of perspectives in order to form a course of action in response to its findings.
Drought survival is a threshold function of habitat size and population density in a fish metapopulation.

PubMed

White, Richard S A; McHugh, Peter A; McIntosh, Angus R

2016-10-01

Because smaller habitats dry more frequently and severely during droughts, habitat size is likely a key driver of survival in populations during climate change and associated increased extreme drought frequency. Here, we show that survival in populations during droughts is a threshold function of habitat size driven by an interaction with population density in metapopulations of the forest pool dwelling fish, Neochanna apoda. A mark-recapture study involving 830 N. apoda individuals during a one-in-seventy-year extreme drought revealed that survival during droughts was high for populations occupying pools deeper than 139 mm, but declined steeply in shallower pools. This threshold was caused by an interaction between increasing population density and drought magnitude associated with decreasing habitat size, which acted synergistically to increase physiological stress and mortality. This confirmed two long-held hypotheses, firstly concerning the interactive role of population density and physiological stress, herein driven by habitat size, and secondly, the occurrence of drought survival thresholds. Our results demonstrate how survival in populations during droughts will depend strongly on habitat size and highlight that minimum habitat size thresholds will likely be required to maximize survival as the frequency and intensity of droughts are projected to increase as a result of global climate change. © 2016 John Wiley & Sons Ltd.
Business Education Partnerships: Gearing Up for Economic Survival.

ERIC Educational Resources Information Center

California School Boards, 1983

1983-01-01

This theme issue of "California School Boards," October/November 1983, identifies some of the business-education partnerships in California. After an introduction with an overview of the reasons behind the increased interest in business-education partnerships, are articles on the following: (1) educational reform recommendations by the…
The Struggle to Make Sense of Doctoral Study

ERIC Educational Resources Information Center

Acker, Sandra; Haque, Eve

2015-01-01

Semi-structured, qualitative interviews conducted with an ethno-culturally diverse group of 27 doctoral students in one Canadian university department produced narratives that often featured stories of stress and struggle. Two interrelated themes emerging from the data are highlighted here: surviving financially and dealing with divisions and…

Changing Rural Social Systems: Adaptation and Survival.

ERIC Educational Resources Information Center

Johnson, Nan E., Ed.; Wang, Ching-li, Ed.

This book includes studies of globalization-related social changes in rural areas of the United States and other countries and implications of these studies for sociological theory. Although no chapter focuses exclusively on education, education-related themes include rural school dropouts and intergenerational poverty, the migration of rural…
Outdoorsman, Unit III.

ERIC Educational Resources Information Center

Alberta Dept. of Agriculture, Edmonton.

The third and final unit of the 4-H Outdoorsman Program covers the most advanced and challenging campcraft skills for 4-H members in British Columbia, Alberta, Saskatchewan and Manitoba. Survival camping (including building shelters and finding food), in-depth map-reading and orienteering, game management, hiking themes and recordkeeping are all…
New Instability Mode in A Driven Granular Gas: Athermal and Thermal Convection

NASA Astrophysics Data System (ADS)

Shukla, Priyanka; Alam, Meheboob

2017-11-01

For a thermally-driven granular gas confined between two plates under gravity, we report a new instability mode which is found to be active at very small values of the heat-loss parameter. We show that the origin of this new mode is tied to the ``thermal'' mode of the well-studied Rayleigh-Benard convection. This is dubbed purely elastic instability since it survives even for perfectly elastic collisions (en = 1). The distinction of this new instability mode from its dissipative/athermal counterpart is clarified for the first time. Furthermore, a weakly nonlinear analysis using Stuart-Landau equation has been carried out for both instability modes, and the underlying bifurcation scenario (supercritical/subcritical) from each mode is elucidated. The resulting linear and nonlinear patterns with respect to inelasticity and gravity are compared.
Survival Mode: The Stresses and Strains of Computing Curricula Review

ERIC Educational Resources Information Center

Tan, Grace; Venables, Anne

2008-01-01

In an ideal world, review and changes to computing curricula should be driven solely by academic concerns for the needs of students. The process should be informed by industry accreditation processes and international best practice (Hurst et al., 2001). However, Australian computing curricular review is often driven by the need for financial…
Thirty years of artificial intelligence in medicine (AIME) conferences: A review of research themes.

PubMed

Peek, Niels; Combi, Carlo; Marin, Roque; Bellazzi, Riccardo

2015-09-01

Over the past 30 years, the international conference on Artificial Intelligence in MEdicine (AIME) has been organized at different venues across Europe every 2 years, establishing a forum for scientific exchange and creating an active research community. The Artificial Intelligence in Medicine journal has published theme issues with extended versions of selected AIME papers since 1998. To review the history of AIME conferences, investigate its impact on the wider research field, and identify challenges for its future. We analyzed a total of 122 session titles to create a taxonomy of research themes and topics. We classified all 734 AIME conference papers published between 1985 and 2013 with this taxonomy. We also analyzed the citations to these conference papers and to 55 special issue papers. We identified 30 research topics across 12 themes. AIME was dominated by knowledge engineering research in its first decade, while machine learning and data mining prevailed thereafter. Together these two themes have contributed about 51% of all papers. There have been eight AIME papers that were cited at least 10 times per year since their publication. There has been a major shift from knowledge-based to data-driven methods while the interest for other research themes such as uncertainty management, image and signal processing, and natural language processing has been stable since the early 1990s. AIME papers relating to guidelines and protocols are among the most highly cited. Copyright © 2015 Elsevier B.V. All rights reserved.
The lived experience of surviving breast cancer.

PubMed

Pelusi, J

1997-09-01

To explore women's perspectives of the experience of surviving breast cancer. Descriptive, phenomenologic. A community in the Southwestern United States. Eight women, ages 34-70 (mean = 54.6 years), who had completed breast cancer therapy. Average time since completion of therapy was 7.6 years (range = 2-15 years). Open-ended, audiotaped interviews were transcribed and analyzed using Colaizzi's method. Woman's description of the experience of surviving breast cancer. Nine theme categories were identified from the data: a future of uncertainty, abandonment, sanctuaries along the way, self-transcendence, finding resolution to the financial cost of cancer, mediating expectations of others, survivors' lifelines, circle of influences, and the journey. The themes were developed into an essential structure. The essential structure of the experience of surviving breast cancer is one of facing the unknown and experiencing many losses. At the same time, this journey evolves into one of growth and enlightenment, providing the woman with many unexpected and new opportunities. In searching for the meaning of the journey (which changes over time), one grows and finds comfort and challenge in the midst of uncertainty. The journey affects not only the women themselves but also those around them. Surviving breast cancer evokes many feelings and concerns for the women and those around them. By identifying, acknowledging, and addressing these feelings and concerns, women can find meaning in their journey, which provides comfort and self-growth while facing the unknown future. This journey continues and changes over time, as does the meaning of the journey. An awareness and description of current issues and feelings surrounding survivors of breast cancer can assist the multidisciplinary healthcare team in caring for and supporting women and their families and friends during this experience.
Analysis of IgV gene mutations in B cell chronic lymphocytic leukaemia according to antigen-driven selection identifies subgroups with different prognosis and usage of the canonical somatic hypermutation machinery.

PubMed

Degan, Massimo; Bomben, Riccardo; Bo, Michele Dal; Zucchetto, Antonella; Nanni, Paola; Rupolo, Maurizio; Steffan, Agostino; Attadia, Vincenza; Ballerini, Pier Ferruccio; Damiani, Daniela; Pucillo, Carlo; Poeta, Giovanni Del; Colombatti, Alfonso; Gattei, Valter

2004-07-01

Cases of B-cell chronic lymphocytic leukaemia (B-CLL) with mutated (M) IgV(H) genes have a better prognosis than unmutated (UM) cases. We analysed the IgV(H) mutational status of B-CLL according to the features of a canonical somatic hypermutation (SHM) process, correlating this data with survival. In a series of 141 B-CLLs, 124 cases were examined for IgV(H) gene per cent mutations and skewing of replacement/silent mutations in the framework/complementarity-determining regions as evidence of antigen-driven selection; this identified three B-CLL subsets: significantly mutated (sM), with evidence of antigen-driven selection, not significantly mutated (nsM) and UM, without such evidence and IgV(H) gene per cent mutations above or below the 2% cut-off. sM B-CLL patients had longer survival within the good prognosis subgroup that had more than 2% mutations of IgV(H) genes. sM, nsM and UM B-CLL were also characterized for the biased usage of IgV(H) families, intraclonal IgV(H) gene diversification, preference of mutations to target-specific nucleotides or hotspots, and for the expression of enzymes involved in SHM (translesion DNA polymerase zeta and eta and activation-induced cytidine deaminase). These findings indicate the activation of a canonical SHM process in nsM and sM B-CLLs and underscore the role of the antigen in defining the specific clinical and biological features of B-CLL.
Iowa's Environment.

ERIC Educational Resources Information Center

Ruth, Amy, Ed.

1994-01-01

This theme issue explores the changes in Iowa's environment. When Native Americans lived in Iowa hundreds of years ago, the land was rich in tall grasslands, fertile soil, wildlife, wetlands, and unpolluted waters. When European-American pioneers settled Iowa in 1833, they changed the environment in order to survive. The first article in this…
Therapy-Assisted Growth after Parental Suicide: From a Personal and Professional Perspective.

ERIC Educational Resources Information Center

Dalke, David

1994-01-01

Depicts experiences of two young girls and their coping/growing strategies following father's suicide. Describes hallmarks of meaningful growth and healing as including embracing all confused feelings (guilt, anger, abandonment, embarrassment, sadness, fear of losing surviving parent, and changes). Finds underlying theme of adjustment in…
Different People: Studies in Ethnicity and Education.

ERIC Educational Resources Information Center

Gumbert, Edgar B., Ed.

Originally presented as lectures at Georgia State University in 1982, these three papers address the themes of multiethnic societies in the United States and Great Britain. In the first paper "Identity, Conflict, and Survival Mechanisms for Asian Americans," the author discusses how the observable patterns of mobility through education…
Adult Learning, Education, and the Environment

ERIC Educational Resources Information Center

Clover, Darlene E.; Hill, Robert

2013-01-01

The environment is now a common theme in adult education. However, conversations that swirled around the United Nations Conference on Sustainable Development (Rio+20) in June 2012 suggested major environmental challenges persist, demanding that education, learning, advocacy and activism be augmented to ensure the survival of the planet. In adult…
Evolution: bats, radar, and science (The Remote Sensing Award Lecture)

NASA Technical Reports Server (NTRS)

Atlas, David

1991-01-01

A parallel is drawn between the evolution of the bat and the evolution of the science and technology of radar and remote sensing to illustrate the importance of the role of Darwinian processes in the culture and practice of science and technology, and thus in the survival of their vitality. The lecture touches on several themes of interest to the science community, such as the relation between basic and applied science and engineering; research in academia, industry, and government laboratories; elite scientists; and the survival of a scientific institution.
A second chance at life: people's lived experiences of surviving out-of-hospital cardiac arrest.

PubMed

Forslund, Ann-Sofie; Jansson, Jan-Håkan; Lundblad, Dan; Söderberg, Siv

2017-12-01

There is more to illuminate about people's experiences of surviving out-of-hospital cardiac arrest (OHCA) and how such an event affects people's lives over time. This study aimed to elucidate meanings of people's lived experiences and changes in everyday life during their first year after surviving OHCA. A qualitative, longitudinal design was used. Eleven people surviving OHCA from northern Sweden agreed to participate and were interviewed 6 and 12 months after the event. A phenomenological hermeneutic interpretation was used to analyse the transcribed texts. The structural analysis resulted in two themes: (i) striving to regain one's usual self and (ii) a second chance at life, and subthemes (ia) testing the body, (ib) pursuing the ordinary life, (ic) gratitude for help to survival, (iia) regaining a sense of security with one's body, (iib) getting to know a new self, and (iic) seeking meaning and establishing a future. To conclude, we suggest that people experienced meanings of surviving OHCA over time as striving to regain their usual self and getting a second chance at life. The event affected them in many ways and resulted in a lot of emotions and many things to think about. Participants experienced back-and-forth emotions, when comparing their present lives to both their lives before cardiac arrest and those lives they planned for the future. During their first year, participants' daily lives were still influenced by 'being dead' and returning to life. As time passed, they wanted to resume their ordinary lives and hoped for continued lives filled with meaning and joyous activities. © 2017 Nordic College of Caring Science.
Rock and Roll! Using Classic Rock as a Guide to Fantasy-Theme Analysis

ERIC Educational Resources Information Center

Waite, Lisa

2008-01-01

This article presents an activity which makes use of Don McLean's song "American Pie," to engage students in fantasy-theme analysis. This discussion ultimately demonstrates how reality is constructed to satisfy the views shared by groups and individuals. Fantasy-theme analysis argues that audiences frequently shape their own connotation of an…
Climate driven egg and hatchling mortality threatens survival of eastern Pacific leatherback turtles.

PubMed

Santidrián Tomillo, Pilar; Saba, Vincent S; Blanco, Gabriela S; Stock, Charles A; Paladino, Frank V; Spotila, James R

2012-01-01

Egg-burying reptiles need relatively stable temperature and humidity in the substrate surrounding their eggs for successful development and hatchling emergence. Here we show that egg and hatchling mortality of leatherback turtles (Dermochelys coriacea) in northwest Costa Rica were affected by climatic variability (precipitation and air temperature) driven by the El Niño Southern Oscillation (ENSO). Drier and warmer conditions associated with El Niño increased egg and hatchling mortality. The fourth assessment report of the Intergovernmental Panel on Climate Change (IPCC) projects a warming and drying in Central America and other regions of the World, under the SRES A2 development scenario. Using projections from an ensemble of global climate models contributed to the IPCC report, we project that egg and hatchling survival will rapidly decline in the region over the next 100 years by ∼50-60%, due to warming and drying in northwestern Costa Rica, threatening the survival of leatherback turtles. Warming and drying trends may also threaten the survival of sea turtles in other areas affected by similar climate changes.
The State of Professional Practice and Policy in the English Further Education System: A View from Below

ERIC Educational Resources Information Center

Gleeson, Denis; Hughes, Julie; O'Leary, Matt; Smith, Rob

2015-01-01

This paper addresses a recurring theme regarding the UK's Vocational Education and Training policy in which further education (FE) and training are primarily driven by employer demand. It explores the tensions associated with this process on the everyday working practices of FE practitioners and institutions and its impact on FE's contribution to…
Dancing with the Devil: Information Technology and the New Competition in Higher Education. Jossey-Bass Higher and Adult Education Series.

ERIC Educational Resources Information Center

Katz, Richard N., Ed.

The six chapters of this volume address issues related to emerging technologies and competition as higher education leaders plan for their institutions' development. A preface identifies common themes of the individual papers, including changes in higher education enabled by or driven by information technology, the authors' shared belief that the…
CHD7 Expression Predicts Survival Outcomes in Patients with Resected Pancreatic Cancer

PubMed Central

Colbert, Lauren E.; Petrova, Aleksandra V.; Fisher, Sarah B.; Pantazides, Brooke G.; Madden, Matthew Z.; Hardy, Claire W.; Warren, Matthew D.; Pan, Yunfeng; Nagaraju, Ganji P.; Liu, Elaine A.; Saka, Burcu; Hall, William A.; Shelton, Joseph W.; Gandhi, Khanjan; Pauly, Rini; Kowalski, Jeanne; Kooby, David A.; El-Rayes, Bassel F.; Staley, Charles A.; Adsay, N. Volkan; Curran, Walter J.; Landry, Jerome C.; Maithel, Shishir K.; Yu, David S.

2014-01-01

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with poor outcomes with current therapies. Gemcitabine is the primary adjuvant drug used clinically, but its effectiveness is limited. In this study, our objective was to utilize a rationale-driven approach to identify novel biomarkers for outcome in patients with early-stage resected PDAC treated with adjuvant gemcitabine. Using a synthetic lethal screen in human PDAC cells, we identified 93 genes including 55 genes linked to DNA damage responses (DDR) that demonstrated gemcitabine sensitization when silenced, including CHD7 which functions in chromatin remodeling. CHD7 depletion sensitized PDAC cells to gemcitabine and delayed their growth in tumor xenografts. Moreover, CHD7 silencing impaired ATR-dependent phosphorylation of CHK1 and increased DNA damage induced by gemcitabine. CHD7 was dysregulated, ranking above the 90th percentile in differential expression in a panel of PDAC clinical specimens, highlighting its potential as a biomarker. Immunohistochemical analysis of specimens from 59 resected PDAC patients receiving adjuvant gemcitabine revealed that low CHD7 expression was associated with increased recurrence-free survival (RFS) and overall survival (OS), in univariate and multivariate analyses. Notably, CHD7 expression was not associated with RFS or OS for patients not receiving gemcitabine. Thus, low CHD7 expression was correlated selectively with gemcitabine sensitivity in this patient population. These results supported our rationale-driven strategy to exploit dysregulated DDR pathways in PDAC to identify genetic determinants of gemcitabine sensitivity, identifying CHD7 as a novel biomarker candidate to evaluate further for individualizing PDAC treatment. PMID:24626090
Community mapping and respondent-driven sampling of gay and bisexual men’s communities in Vancouver, Canada

PubMed Central

Forrest, Jamie I; Stevenson, Benjamin; Rich, Ashleigh; Michelow, Warren; Pai, Jayaram; Jollimore, Jody; Raymond, H. Fisher; Moore, David; Hogg, Robert S; Roth, Eric A

2014-01-01

Literature suggests formative research is vital for those using respondent-driven sampling (RDS) to study hidden populations of interest. However, few authors have described in detail how different qualitative methodologies can address the objectives of formative research for understanding the social network properties of the study population, selecting seeds, and adapting survey logistics to best fit the population. In this paper we describe the use of community mapping exercises as a tool within focus groups to collect data on social and sexual network characteristics of gay and bisexual men in the metropolitan area of Vancouver, Canada. Three key themes emerged from analyzing community maps along with other formative research data: (a) connections between physical spaces and social networks of gay and bisexual men, (b) diversity in communities, and (c) substance use connected with formation of sub-communities. We discuss how these themes informed the planning and operations of a longitudinal epidemiological cohort study recruited by RDS. We argue that using community mapping within formative research is a valuable qualitative tool for characterizing network structures of a diverse and differentiated population of gay and bisexual men in a highly developed urban setting. PMID:24512070
Changes in parental self-identity following the death of a child to cancer.

PubMed

O'Connor, Kathleen; Barrera, Maru

2014-01-01

This study explored parental self-identity at 6, 12, and 18 months following the death of a child to cancer. Semi-structured interviews were analyzed using qualitative methodology. Two patterns of parental self-identity emerged: identity reintegration, characterized by 6 associated themes (e.g., positive reframing, focusing on surviving children); and identity disintegration, characterized by 7 associated themes (e.g., negative perceptions of social support, self-destructive thoughts and behaviors). Patterns were stable from 6 to 12 months, but a shift towards identity disintegration was observed at 18 months. These findings suggest a need to support bereaved parents' well-being beyond the first year post-death.

A secondary meta-synthesis of qualitative studies of gender and access to cardiac rehabilitation.

PubMed

Angus, Jan E; King-Shier, Kathryn M; Spaling, Melisa A; Duncan, Amanda S; Jaglal, Susan B; Stone, James A; Clark, Alexander M

2015-08-01

To discuss issues in the theorization and study of gender observed during a qualitative meta-synthesis of influences on uptake of secondary prevention and cardiac rehabilitation services. Women and men can equally benefit from secondary prevention/cardiac rehabilitation and there is a need to understand gender barriers to uptake. Meta-method analysis secondary to meta-synthesis. For the meta-synthesis, a systematic search was performed to identify and retrieve studies published as full papers during or after 1995 and contained: a qualitative research component wholly or in a mixed method design, extractable population specific data or themes for referral to secondary prevention programmes and adults ≥18 years. Databases searched between January 1995-31 October 2011 included: CSA Sociological Abstracts, EBSCOhost CINAHL, EBSCOhost Gender Studies, EBSCOhost Health Source Nursing: Academic Edition, EBSCOhost SPORTDiscus, EBSCOhost SocINDEX. Studies were reviewed against inclusion/exclusion criteria. Included studies were subject to quality appraisal and standardized data extraction. Of 2264 screened articles, 69 were included in the meta-method analysis. Only four studies defined gender or used gender theories. Findings were mostly presented as inherently the characteristic of gendered worldviews of participants. The major themes suggest a mismatch between secondary prevention/cardiac rehabilitation services and consumers' needs, which are usually portrayed as differing according to gender but may also be subject to intersecting influences such as age or socioeconomic status. There is a persistent lack of theoretically informed gender analysis in qualitative literature in this field. Theory-driven gender analysis will improve the conceptual clarity of the evidence base for gender-sensitive cardiac rehabilitation programme development. © 2015 John Wiley & Sons Ltd.
Disorganizing experiences in second- and third-generation holocaust survivors.

PubMed

Scharf, Miri; Mayseless, Ofra

2011-11-01

Second-generation Holocaust survivors might not show direct symptoms of posttraumatic stress disorder or attachment disorganization, but are at risk for developing high levels of psychological distress. We present themes of difficult experiences of second-generation Holocaust survivors, arguing that some of these aversive experiences might have disorganizing qualities even though they do not qualify as traumatic. Based on in-depth interviews with 196 second-generation parents and their adolescent children, three themes of disorganizing experiences carried across generations were identified: focus on survival issues, lack of emotional resources, and coercion to please the parents and satisfy their needs. These themes reflect the frustration of three basic needs: competence, relatedness, and autonomy, and this frustration becomes disorganizing when it involves stability, potency, incomprehensibility, and helplessness. The findings shed light on the effect of trauma over the generations and, as such, equip therapists with a greater understanding of the mechanisms involved.
A qualitative study about the gendered experiences of motherhood and perinatal mortality in mountain villages of Nepal: implications for improving perinatal survival.

PubMed

Paudel, Mohan; Javanparast, Sara; Dasvarma, Gouranga; Newman, Lareen

2018-05-15

We aim to examine the gendered contexts of poor perinatal survival in the remote mountain villages of Nepal. The study setting comprised two remote mountain villages from a mid-western mountain district of Nepal that ranks lowest on the Human Development Index (0.304), and is reported as having the lowest child survival rates in the country. The findings are taken from a larger study of perinatal survival in remote mountain villages of Nepal, conducted through a qualitative methodological approach within a framework of social constructionist and critical theoretical perspectives. Data were collected through in-depth interviews with 42 women and their families, plus a range of healthcare providers (nurses/auxiliary nurses, female health volunteers, support staff, Auxiliary Health Worker and a traditional healer) and other stakeholders from February to June, 2015. Data were analysed with a comprehensive coding process utilising the thematic analysis technique. The social construction of gender is one of the key factors influencing poor perinatal survival in the villages in this study. The key emerging themes from the qualitative data are: (1) Gendered social construct and vulnerability for poor perinatal survival: child marriages, son preference and repeated child bearing; (2) Pregnancy and childbirth in intra-familial dynamics of relationships and power; and (3) Perception of birth as a polluted event: birth in Gotha (cowshed) and giving birth alone. Motherhood among women of a low social position is central to women and their babies experiencing vulnerabilities related to perinatal survival in the mountain villages. Gendered constructions along the continuum from pre-pregnancy to postnatal (girl settlement, a daughter-in-law, ritual pollution about mother and child) create challenges to ensuring perinatal survival in these villages. It is imperative that policies and programmes consider such a context to develop effective working strategies for sustained reduction of future perinatal deaths.
The Perspectives of Former Recipients and Experts on Stigmatization Related to Electroconvulsive Therapy in Denmark. A Focus Group Study.

PubMed

Kring, Iben Sylvia; Bergholt, Maria Daniella; Midtgaard, Julie

2018-05-14

Electroconvulsive therapy (ECT) has existed worldwide for nearly 80 years. Although fast working and potentially life-saving, ECT is regarded as a strongly controversial treatment and stigmatization is frequently mentioned in relation to it. However, no systematic research in this area has taken place so far. The aim of this qualitative study was to explore the experiences and attitudes of former recipients of ECT and of experts professionally involved with ECT in order to identify potential stigmatization. Two focus groups, one comprising four recipients of ECT and the other seven professional experts, were conducted. Data from each focus group was analyzed separately using a framework-analysis. The analysis yielded three major themes for the first focus group interview: 'ambivalent attitudes', 'discrediting and exclusion' and 'survival strategies' and three major themes for the second focus group interview: 'dramatic depictions of ECT', 'an overlooked and rare treatment' and 'anti-stigmatization strategies'. Stigmatizing attitudes and behaviors in relation to ECT are closely related to one's personal and factual knowledge, and there is a great need for multi-facetted approaches if social acceptance and recognition are to be achieved. This study provides new knowledge on a scarcely examined area while also introducing suitable methods for anti-stigmatization and empowerment. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Behavioural defences in animals against pathogens and parasites: parallels with the pillars of medicine in humans

PubMed Central

Hart, Benjamin L.

2011-01-01

No other theme in animal biology seems to be more central than the concept of employing strategies to survive and successfully reproduce. In nature, controlling or avoiding pathogens and parasites is an essential fitness strategy because of the ever-present disease-causing organisms. The disease-control strategies discussed here are: physical avoidance and removal of pathogens and parasites; quarantine or peripheralization of conspecifics that could be carrying potential pathogens; herbal medicine, animal style, to prevent or treat an infection; potentiation of the immune system; and care of sick or injured group members. These strategies are seen as also encompassing the pillars of human medicine: (i) quarantine; (ii) immune-boosting vaccinations; (iii) use of medicinal products; and (iv) caring or nursing. In contrast to animals, in humans, the disease-control strategies have been consolidated into a consistent and extensive medical system. A hypothesis that explains some of this difference between animals and humans is that humans are sick more often than animals. This increase in sickness in humans leading to an extensive, cognitively driven medical system is attributed to an evolutionary dietary transition from mostly natural vegetation to a meat-based diet, with an increase in health-eroding free radicals and a dietary reduction of free-radical-scavenging antioxidants. PMID:22042917
Mechanisms, models and biomarkers in amyotrophic lateral sclerosis

PubMed Central

Turner, Martin R.; Bowser, Robert; Bruijn, Lucie; Dupuis, Luc; Ludolph, Albert; Mcgrath, Michael; Manfredi, Giovanni; Maragakis, Nicholas; Miller, Robert G.; Pullman, Seth L.; Rutkove, Seward B.; Shaw, Pamela J.; Shefner, Jeremy; Fischbeck, Kenneth H.

2014-01-01

The last 30 years have seen a major advance in the understanding of the clinical and pathological heterogeneity of amyotrophic lateral sclerosis (ALS), and its overlap with frontotemporal dementia. Multiple, seemingly disparate biochemical pathways converge on a common clinical syndrome characterized by progressive loss of upper and lower motor neurons. Pathogenic themes in ALS include excitotoxicity, oxidative stress, mitochondrial dysfunction, neuroinflammation, altered energy metabolism, and most recently RNA mis-processing. The transgenic rodent, overexpressing mutant superoxide dismutase-1, is now only one of several models of ALS pathogenesis. The nematode, fruit fly and zebrafish all offer fresh insight, and the development of induced pluripotent stem cell-derived motor neurons holds promise for the screening of candidate therapeutics. The lack of useful biomarkers in ALS contributes to diagnostic delay, and the inability to stratify patients by prognosis may be an important factor in the failure of therapeutic trials. Biomarkers sensitive to disease activity might lessen reliance on clinical measures and survival as trial endpoints and reduce study length. Emerging proteomic markers of neuronal loss and glial activity in cerebrospinal fluid, a cortical signature derived from advanced structural and functional MRI, and the development of more sensitive measurements of lower motor neuron physiology are leading a new phase of biomarker-driven therapeutic discovery. PMID:23678877
Cancer and beyond: the question of survivorship.

PubMed

Breaden, K

1997-11-01

Today, more people are surviving cancer as a result of improved treatment and early diagnosis. In Australia, the 5-year survival rate for persons diagnosed with cancer is now approaching 50%. Although there is a growing population of cancer survivors, little is known about what surviving entails. Traditionally, a survivor has been defined as one who has been disease-free for more than 5 years. However, this definition does not take into account the experience nor the process of survival and the aim of this article is to document the process of surviving cancer as reflected in the experiences of cancer survivors. Using a method of hermeneutic phenomenology (as described by van Manen), the study draws on the stories of six women, who by their definition, are surviving cancer. A discussion of themes has been structured according to the everyday experiences of living in a body and living in time. The women describe a survival process that includes: 'feeling whole again'; 'the body as the house of suspicion'; 'the future in question'; 'changes in time'; 'lucky to be alive'; and 'sharing the journey'.
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…
Between life and death: women's experiences of coming close to death, and surviving a severe postpartum haemorrhage and emergency hysterectomy.

PubMed

Elmir, Rakime; Schmied, Virginia; Jackson, Debra; Wilkes, Lesley

2012-04-01

to describe women's experiences of having an emergency hysterectomy following a severe postpartum haemorrhage. a qualitative research approach was used to guide this study. Data were collected through semi-structured, tape recorded face to face, email internet and telephone interviews. three States in Australia: New South Wales, Victoria and Western Australia. twenty-one Australian women who experienced a severe post partum followed by an emergency hysterectomy participated in the study. The median age of participants at time of interview was 42 years and the median time since having the hysterectomy was four years. a process of inductive analysis revealed the major theme, 'between life and death' and three sub-themes, 'being close to death: bleeding and fear', 'having a hysterectomy: devastation and realisation' and 'reliving the trauma: flashbacks and memories'. formulating a plan of care for women identifiably at risk of PPH and ensuring appropriate follow-up counselling is made, is key to help reduce the emotional and psychological symptoms experienced by these women in the aftermath of severe postpartum haemorrhage and hysterectomy. Copyright © 2011 Elsevier Ltd. All rights reserved.
Immediate Needs and Concerns among Pregnant Women During and after Typhoon Haiyan (Yolanda)

PubMed Central

Sato, Mari; Nakamura, Yasuka; Atogami, Fumi; Horiguchi, Ribeka; Tamaki, Raita; Yoshizawa, Toyoko; Oshitani, Hitoshi

2016-01-01

Introduction: Pregnant and postpartum women are especially vulnerable to natural disasters. These women suffer from increased risk of physical and mental issues including pregnant related problems. Typhoon Haiyan (Yolanda), which hit the Philippines affected a large number of people and caused devastating damages. During and after the typhoon, pregnant women were forced to live in particularly difficult circumstances. The purpose of this study was to determine concerns and problems regarding public health needs and coping mechanisms among pregnant women during and shortly after the typhoon. Methods: This study employed a cross-sectional design utilizing focus group discussions (FGDs). Participants were 53 women (mean age: 26.6 years old; 42 had children) from four affected communities who were pregnant at the time of the typhoon. FGDs were conducted 4 months after the typhoon, from March 19 to 28, 2014, using semi-structured interviews. Data were analyzed using the qualitative content analysis. Result: Three themes were identified regarding problems and concerns during and after the typhoon: 1) having no ideas what is going to happen during the evacuation, 2) lacking essentials to survive, and 3) being unsure of how to deal with health concerns. Two themes were identified as means of solving issues: 1) finding food for survival and 2) avoiding diseases to save my family. As the pregnant women already had several typhoon experiences without any major problems, they underestimated the catastrophic nature of this typhoon. During the typhoon, the women could not ensure their safety and did not have a strong sense of crisis management. They suffered from hunger, food shortage, and poor sanitation. Moreover, though the women had fear and anxiety regarding their pregnancy, they had no way to resolve these concerns. Pregnant women and their families also suffered from common health problems for which they would usually seek medical services. Under such conditions, the pregnant woman cooperated with others for survival and used their knowledge of disease prevention. Discussion: Pregnant women experienced difficulties with evacuation, a lack of minimum survival needs, and attending to their own health issues. Pregnant women were also concerned about needs and health issues of their families, particular, when they had small children. Collecting accurate information regarding the disaster and conducting self-sustainable preparation prior to the disaster among pregnant women will help them to protect their pregnancy status, thereby improving their families’ chance of survival during and after disasters. PMID:26865988
Contextualizing Nature of Science Instruction in Socioscientific Issues

NASA Astrophysics Data System (ADS)

Eastwood, Jennifer Lynne; Sadler, Troy D.; Zeidler, Dana L.; Lewis, Anna; Amiri, Leila; Applebaum, Scott

2012-10-01

The purpose of this study was to investigate the effects of two learning contexts for explicit-reflective nature of science (NOS) instruction, socioscientific issues (SSI) driven and content driven, on student NOS conceptions. Four classes of 11th and 12th grade anatomy and physiology students participated. Two classes experienced a curricular sequence organized around SSI (the SSI group), and two classes experienced a content-based sequence (the Content group). An open-ended NOS questionnaire was administered to both groups at the beginning and end of the school year and analyzed to generate student profiles. Quantitative analyses were performed to compare pre-instruction NOS conceptions between groups as well as pre to post changes within groups and between groups. Both SSI and Content groups showed significant gains in most NOS themes, but between-group gains were not significantly different. Qualitative analysis of post-instruction responses, however, revealed that students in the SSI group tended to use examples to describe their views of the social/cultural NOS. The findings support SSI contexts as effective for promoting gains in students' NOS understanding and suggest that these contexts facilitate nuanced conceptions that should be further explored.
Beyond lip service: Towards human rights-driven guidelines for South African speech-language pathologists.

PubMed

Pascoe, Michelle; Klop, Daleen; Mdlalo, Thandeka; Ndhambi, Mikateko

2018-02-01

Developed with a strong awareness of past injustices, South Africa's progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one's language of choice, but is often perceived as a "Cinderella" right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country.
A protein and mRNA expression-based classification of gastric cancer.

PubMed

Setia, Namrata; Agoston, Agoston T; Han, Hye S; Mullen, John T; Duda, Dan G; Clark, Jeffrey W; Deshpande, Vikram; Mino-Kenudson, Mari; Srivastava, Amitabh; Lennerz, Jochen K; Hong, Theodore S; Kwak, Eunice L; Lauwers, Gregory Y

2016-07-01

The overall survival of gastric carcinoma patients remains poor despite improved control over known risk factors and surveillance. This highlights the need for new classifications, driven towards identification of potential therapeutic targets. Using sophisticated molecular technologies and analysis, three groups recently provided genetic and epigenetic molecular classifications of gastric cancer (The Cancer Genome Atlas, 'Singapore-Duke' study, and Asian Cancer Research Group). Suggested by these classifications, here, we examined the expression of 14 biomarkers in a cohort of 146 gastric adenocarcinomas and performed unsupervised hierarchical clustering analysis using less expensive and widely available immunohistochemistry and in situ hybridization. Ultimately, we identified five groups of gastric cancers based on Epstein-Barr virus (EBV) positivity, microsatellite instability, aberrant E-cadherin, and p53 expression; the remaining cases constituted a group characterized by normal p53 expression. In addition, the five categories correspond to the reported molecular subgroups by virtue of clinicopathologic features. Furthermore, evaluation between these clusters and survival using the Cox proportional hazards model showed a trend for superior survival in the EBV and microsatellite-instable related adenocarcinomas. In conclusion, we offer as a proposal a simplified algorithm that is able to reproduce the recently proposed molecular subgroups of gastric adenocarcinoma, using immunohistochemical and in situ hybridization techniques.
The ecology of snowshoe hares in northern boreal forests [Chapter 6

Treesearch

Karen E. Hodges

2000-01-01

Snowshoe hares exhibit eight to 11 year population fluctuations across boreal North America, typically with an amplitude of 10 to 25 fold. These fluctuations are synchronous across the continent, with the most recent peak densities occurring in 1990 and 1991. The numeric cycle is driven by changes in survival and reproduction, with annual survival of adults...
Between Academic Theory and Folk Wisdom: Local Discourse on Differential Educational Attainment in Fiji.

ERIC Educational Resources Information Center

White, Carmen M.

2001-01-01

In the multiethnic South Pacific nation of Fiji--a former British colony--the impact of Western theoretical hegemony on educational discourse is evident. Results of extensive fieldwork show how themes of achievement motivation, differential valuation of education, and cultural deficit theory combine with surviving colonial discourse and…
Reclaiming Native Education: Activism, Teaching and Leadership.

ERIC Educational Resources Information Center

Stoll, Amy, Ed.

1998-01-01

The bulk of this theme issue of Cultural Survival Quarterly consists of a 41-page "focus" section on indigenous peoples' efforts to regain control of their children's education and on the role of indigenous educators as agents of change. Following an introduction by Nimachia Hernandez and Nicole Thornton, the articles in this section are:…
The Holmes Scholars Network: A Study of the Holmes Group Initiative for the Recruitment and Retention of Minority Faculty.

ERIC Educational Resources Information Center

Cockrell, Karen Sunday; Mitchell, Rosalita D.; Middleton, Julie N.; Campbell, N. Jo

1999-01-01

Explored several Holmes Scholars' perceptions regarding the Holmes Scholars Network's influence upon their career development, examining conditions that affected entry into teaching. Four participant researchers collaboratively examined their personal narratives and research texts. Results found three themes: mapping new destinations, surviving in…
Extension through a New Lens: Creativity and Innovation Now and for the Future

ERIC Educational Resources Information Center

Argabright, Karen; McGuire, Jerry; King, Jeff

2012-01-01

"How can Extension thrive, not just survive?" This question, posited by the 2010 Extension Committee on Organization and Policy (p.1), echoes the literature addressing change within Extension. In this literature, prominent themes emerge reflecting the need for an organizational cultural transformation, aligned with an opportunity for…
The perceived benefit of the disability grant for persons living with HIV in an informal settlement community in the Western Cape, South Africa.

PubMed

Woolgar, Helen Louise; Mayers, Pat M

2014-01-01

For persons living with HIV (PLWH) in limited socioeconomic circumstances in South Africa, social grants for disability have contributed significantly to alleviate poverty, yet there is a risk that recipients may lose these grants once they are clinically stable on antiretroviral therapy (ART). Our qualitative research explored perceptions and experiences of PLWH on ART concerning the social grant for disability and its contribution to health. Three focus groups were conducted with 15 purposively selected participants who attended a primary care clinic in the Western Cape. A thematic data analysis approach revealed two themes: (a) disability grants as a means of survival and (b) disability grants and ART adherence. The disability grant was considered an essential source of income and, for some, the sole means of survival. Participants valued their health more than the income, however, and, despite the risk of losing the grant, remained adherent to ART. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Sims to Teen Second Life: Transition of the SimSavvy Girls to Tech Savvy Isle

ERIC Educational Resources Information Center

Johnson, Barbara Z.; King, Elizabeth; Hayes, Elisabeth

2008-01-01

In its second year, the Tech Savvy Girls Project adopted "Teen Second Life" as a platform for interest-driven learning and designed projects and objects around themes important to them and their futures as technology-using, creative people. By using the building tools in an open-ended virtual world, they were able to pursue interests common to…

Using Parent and Teacher Voices in the Creation of a Western-Based Early Childhood English-Language Program in China

ERIC Educational Resources Information Center

Shimpi, Priya M.; Paik, Jae H.; Wanerman, Todd; Johnson, Rebecca; Li, Hui; Duh, Shinchieh

2015-01-01

The current English-language research and educational program was driven by an initiative to create a more interactive, theme-based bilingual language education model for preschools in Chengdu, China. During a 2-week teacher education program centered at the Experimental Kindergarten of the Chinese Academy of Sciences in Chengdu, China, a team of…
Methodological and practical viewpoints of qualitative-driven mixed method design: the case of decentralisation of primary healthcare services in Nepal.

PubMed

Regmi, Krishna

2018-01-01

Although considerable attention has been paid to the use of quantitative methods in health research, there has been limited focus on decentralisation research using a qualitative-driven mixed method design. Decentralisation presents both a problematic concept and methodological challenges, and is more context-specific and is often multi-dimensional. Researchers often consider using more than one method design when researching phenomena is complex in nature. Aim To explore the effects of decentralisation on the provision of primary healthcare services. Qualitative-driven mixed method design, employing three methods of data collections: focus group discussions (FGDs), semi-structured interviews (SSIs) and participant observations under two components, that is, core component and supplementary components were used. Four FGDs with health service practitioners, three FGDs with district stakeholders, 20 SSIs with health service users and 20 SSIs with national stakeholders were carried out. These were conducted sequentially. NVivo10, a data management program, was utilised to code the field data, employing a content analysis method for searching the underlying themes or concepts in the text material. Findings Both positive and negative experiences related to access, quality, planning, supplies, coordination and supervision were identified. This study suggests some evidence of the effects of decentralisation on health outcomes in general, as well as filling a gap of understanding and examining healthcare through a qualitative-driven mixed methods approach, in particular. Future research in the area of qualitative in-depth understanding of the problems (why decentralisation, why now and what for) would provoke an important data set that benefits the researchers and policy-makers for planning and implementing effective health services.
Culture Writ Electronic: Themes in Television Advertising.

ERIC Educational Resources Information Center

Cheney, Michael R.

A content analysis was made of the advertisements broadcast during a half-hour of prime-time television, in an effort to discern the overt (obvious) and covert (underlying) themes present in television advertising. The analysis revealed an overt theme of a world view of individual determination, initiative, self-confidence and self-reliance, and…
A Fantasy Theme Analysis of Nixon's "Checkers" Speech.

ERIC Educational Resources Information Center

Wells, William T.

1996-01-01

Applies fantasy theme analysis to Richard Nixon's "Checkers" speech. States that three major themes emerge: Nixon as Moral Model, Nixon as the American Dream, and Nixon as Patriot. Points out that each issue responds to allegations of dishonesty that were leveled against him at the time. Argues that Nixon's speech was accepted and…
Death of a Simulated Pediatric Patient: Toward a More Robust Theoretical Framework.

PubMed

McBride, Mary E; Schinasi, Dana Aronson; Moga, Michael Alice; Tripathy, Shreepada; Calhoun, Aaron

2017-12-01

A theoretical framework was recently proposed that encapsulates learner responses to simulated death due to action or inaction in the pediatric context. This framework, however, was developed at an institution that allows simulated death and thus does not address the experience of those centers at which this technique is not used. To address this, we performed a parallel qualitative study with the intent of augmenting the initial framework. We conducted focus groups, using a constructivist grounded theory approach, using physicians and nurses who have experienced a simulated cardiac arrest. The participants were recruited via e-mail. Transcripts were analyzed by coders blinded to the original framework to generate a list of provisional themes that were iteratively refined. These themes were then compared with the themes from the original article and used to derive a consensus model that incorporated the most relevant features of each. Focus group data yielded 7 themes. Six were similar to those developed in the original framework. One important exception was noted; however, those learners not exposed to patient death due to action or inaction often felt that the mannequin's survival was artificial. This additional theme was incorporated into a revised framework. The original framework addresses most aspects of learner reactions to simulated death. Our work suggests that adding the theme pertaining to the lack of realism that can be perceived when the mannequin is unexpectedly saved results in a more robust theoretical framework transferable to centers that do not allow mannequin death.
The Leaning Ivory Tower. Latino Professors in American Universities. SUNY Series in Hispanic Studies.

ERIC Educational Resources Information Center

Padilla, Raymond V., Ed.; Chavez, Rudolfo Chavez, Ed.

Authors represented in this collection challenge the hegemony that is fostered and maintained by the colleges and universities in which these Latino professors function daily. Each of the writers presents the reality of survival in academia. Collectively, these narratives are connected by themes of personal struggle, marginality, and valuing the…
First Person, First Peoples: Native American College Graduates Tell Their Life Stories.

ERIC Educational Resources Information Center

Garrod, Andrew, Ed.; Larimore, Colleen, Ed.

This book presents 13 stories of Native American college students struggling for survival on several planes--intellectual, emotional, physical, spiritual--and striving for success in their own terms in a cultural setting not their own. Although all the students attended Dartmouth College and graduated, the salient common theme of the stories is…
The lived experiences of aboriginal adolescent survivors of childhood cancer during the recovering process in Taiwan: A descriptive qualitative research.

PubMed

Cheng, Ya-Chun; Huang, Chu-Yu; Wu, Wei-Wen; Chang, Shu-Chuan; Lee-Hsieh, Jane; Liang, Shu-Yuan; Cheng, Su-Fen

2016-06-01

The purpose of this study was to understand the experiences of Taiwanese aboriginal adolescent survivors of childhood cancer during the process of recovery. A snowball sampling strategy was used to recruit participants from the pediatrics unit of a medical center in the eastern region of Taiwan. In-depth interviews were conducted with 11 aboriginal adolescent childhood cancer survivors. The data were analyzed using content analysis. The results revealed three major themes with subthemes within each theme. The three major themes are: roots of resilience, transformation and growth, and meaning of traditional rituals for resilience. The three subthemes within "roots of resilience" include: "feeling secure through company of family, care and financial support", "receiving support from the important others and religion" and "learning to self-adjust". The three subthemes revealed within "transformation and growth" are: restructuring the relationship with peers, "appreciating parents' hard work", and "learning to seize the moment". The two subthemes within "meaning of traditional rituals to resilience" include: "feeling blessed with the power of ancestral spirits" and "strengthening ethnic identity". This study provided insight into the experiences of aboriginal adolescents as they recovered from childhood cancer. The experiences made positive impacts by inspiring growth in maturity and consolidating aboriginal ethnic identity. The adolescents were empowered by support from family, friends and clansmen, and by their participation in aboriginal rituals. As healthcare professionals care for the aboriginal adolescents, it is critical to consider this culturally and ethnically specific knowledge/experience of surviving cancer to improve quality of care. Copyright © 2016 Elsevier Ltd. All rights reserved.
The patient experience in community mental health services for older people: a concept mapping approach to support the development of a new quality measure.

PubMed

Wilberforce, Mark; Batten, Eric; Challis, David; Davies, Linda; Kelly, Michael P; Roberts, Chris

2018-06-18

The patient experience is a crucial part of the measurement of service quality. However, instruments to evaluate experiential quality in the community mental health care of older adults are lacking. Before designing a new instrument, clarity is needed about what is to be measured, and how care experiences are articulated by patients. The study aimed to construct a framework to describe older patients' experience of community mental health and social care. Concept mapping blends structured qualitative data collection with quantitative analysis in a mixed method approach. Five activities were undertaken. Patients first identified sentences describing the care experience; a card-sort exercise then grouped these thematically; multidimensional analysis portrayed these data in a map of clusters; interpretation was by patient advisers; finally a new questionnaire was designed. The research involved 22 older people with mental health problems and 29 mental health practitioners, from one region of England. Sixty-seven statements were identified that described the care experience. Analysis of card sort data revealed seven clusters, which were interpreted by patient advisers to the study as: personal qualities and relationships; communication problems; feeling powerless; in-and-out care; bureaucracy; focus on life, not just mental health; and continuity of care. These themes and the component statements were used as a foundation for later work, developing a new measure of the care experience in mental health services for older people. Concept mapping has many strengths as an empirical and participant-driven means for underpinning new measurement instruments. A group of older people identified 67 candidate statements that could act as questionnaire items grouped within seven themes. Future research will establish the psychometric properties of the new measure.
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.
How is NATO Meeting the Challenge of Cyberspace

DTIC Science & Technology

2017-12-21

surveillance cameras. We also saw the first attacks driven by artificial intelligence , and increasing evidence of collusion between state... intelligence services and organized crime networks. Yet it is not the much discussed theme of the economic damage inflicted by cyber crime in the past year that...structural sabotage. Although companies in other countries were also affected by NotPetya, 80 percent of the impact was in Ukraine.1 Intelligence
Driven to Distraction.

PubMed

Strayer, David L; Cooper, Joel M

2015-12-01

We address several themes that emerged in the commentaries related to our target article. First, we consider the relationship between cognitive distraction and crash risk. Second, we discuss the development of our cognitive distraction scale. Third, we weigh issues of self-regulation, appropriate baselines, and satisficing. Finally, we identify several areas where additional research is needed to refine our understanding of driver distraction and crash risk. © 2015, Human Factors and Ergonomics Society.
Content Themes of Alcohol Advertising in U.S. Television-Latent Class Analysis.

PubMed

Morgenstern, Matthis; Schoeppe, Franziska; Campbell, Julie; Braam, Marloes W G; Stoolmiller, Michael; Sargent, James D

2015-09-01

There is little alcohol research that reports on the thematic contents of contemporary alcohol advertisements in U.S. television. Studies of alcohol ads from 2 decades ago did not identify "Partying" as a social theme. Aim of this study was to describe and classify alcohol advertisements aired in national television in terms of contents, airing times, and channel placements and to identify different marketing strategies of alcohol brands. Content analysis of all ads from the top 20 U.S. beer and spirit brands aired between July 2009 and June 2011. These were 581 unique alcohol ads accounting for 272,828 (78%) national television airings. Ads were coded according to predefined definitions of 13 content areas. A latent class analysis (LCA) was conducted to define content cluster themes and determine alcoholic brands that were more likely to exploit these themes. About half of the advertisements (46%) were aired between 3 am and 8 pm, and the majority were placed either in Entertainment (40%) and Sports (38%) channels. Beer ads comprised 64% of the sample, with significant variation in airing times and channels between types of products and brands. LCA revealed 5 content classes that exploited the "Partying," "Quality," "Sports," "Manly," and "Relax" themes. The partying class, indicative of ad messages surrounding partying, love, and sex, was the dominant theme comprising 42% of all advertisements. Ads for alcopops, flavored spirits, and liqueur were more likely to belong to the party class, but there were also some beer brands (Corona, Heineken) where more than 67% of ads exploited this theme. This is the first analysis to identify a partying theme to contemporary alcohol advertising. Future analyses can now determine whether exposure to that or other themes predicts alcohol misuse among youth audiences. Copyright © 2015 by the Research Society on Alcoholism.
Bacteria like sharing their sweets.

PubMed

Cuccui, Jon; Wren, Brendan W

2013-09-01

Protein glycosylation and capsular polysaccharide formation are increasingly recognized as playing central roles in the survival and virulence of bacterial pathogens. In this issue of Molecular Microbiology, structural analysis in Acinetobacter baumannii 17978 revealed that a pentasaccharide that decorates glycoproteins is formed of the same building blocks used for capsule biosynthesis demonstrating split roles for this glycan. Disruption of PglC, the initiating glycosyltransferase responsible for attachment of the first sugar to undecaprenylphosphate abolished glycoprotein production and capsule biosynthesis. Both pathways are demonstrated to be important in biofilm formation and pathogenesis, and disabling their synthesis should provide a useful route for antimicrobial design. Shared polysaccharide usage reduces the genetic and metabolic burden in a bacterial cell and is an emerging theme among bacterial pathogens that need to be energy efficient for their streamlined lifestyle. © 2013 Crown copyright.
Living through a volcanic eruption: Understanding the experience of survivors as a phenomenological existential phenomenon.

PubMed

Warsini, Sri; Mills, Jane; West, Caryn; Usher, Kim

2016-06-01

Mount Merapi in Indonesia is the most active volcano in the world with its 4-6-year eruption cycle. The mountain and surrounding areas are populated by hundreds of thousands of people who live near the volcano despite the danger posed to their wellbeing. The aim of this study was to explore the lived experience of people who survived the most recent eruption of Mount Merapi, which took place in 2010. Investigators conducted interviews with 20 participants to generate textual data that were coded and themed. Three themes linked to the phenomenological existential experience (temporality and relationality) of living through a volcanic eruption emerged from the data. These themes were: connectivity, disconnection and reconnection. Results indicate that the close relationship individuals have with Mount Merapi and others in their neighbourhood outweighs the risk of living in the shadow of an active volcano. This is the first study to analyze the phenomenological existential elements of living through a volcanic eruption. © 2016 Australian College of Mental Health Nurses Inc.
A value-driven mechanism of attentional selection

PubMed Central

Anderson, Brian A.

2013-01-01

Attention selects stimuli for cognitive processing, and the mechanisms that underlie the process of attentional selection have been a major topic of psychological research for over 30 years. From this research, it has been well documented that attentional selection can proceed both voluntarily, driven by visual search goals, and involuntarily, driven by the physical salience of stimuli. In this review, I provide a conceptual framework for attentional control that emphasizes the need for stimulus selection to promote the survival and wellbeing of an organism. I argue that although goal-driven and salience-driven mechanisms of attentional selection fit within this framework, a central component that is missing is a mechanism of attentional selection that is uniquely driven by learned associations between stimuli and rewards. I go on to review recent evidence for such a value-driven mechanism of attentional selection, and describe how this mechanism functions independently of the well-documented salience-driven and goal-driven mechanisms. I conclude by arguing that reward learning modifies the attentional priority of stimuli, allowing them to compete more effectively for selection even when nonsalient and task-irrelevant. PMID:23589803
Semantic Theme Analysis of Pilot Incident Reports

NASA Technical Reports Server (NTRS)

Thirumalainambi, Rajkumar

2009-01-01

Pilots report accidents or incidents during take-off, on flight and landing to airline authorities and Federal aviation authority as well. The description of pilot reports for an incident contains technical terms related to Flight instruments and operations. Normal text mining approaches collect keywords from text documents and relate them among documents that are stored in database. Present approach will extract specific theme analysis of incident reports and semantically relate hierarchy of terms assigning weights of themes. Once the theme extraction has been performed for a given document, a unique key can be assigned to that document to cross linking the documents. Semantic linking will be used to categorize the documents based on specific rules that can help an end-user to analyze certain types of accidents. This presentation outlines the architecture of text mining for pilot incident reports for autonomous categorization of pilot incident reports using semantic theme analysis.
Computational Trials: Unraveling Motility Phenotypes, Progression Patterns, and Treatment Options for Glioblastoma Multiforme

PubMed Central

Raman, Fabio; Scribner, Elizabeth; Saut, Olivier; Wenger, Cornelia; Colin, Thierry; Fathallah-Shaykh, Hassan M.

2016-01-01

Glioblastoma multiforme is a malignant brain tumor with poor prognosis and high morbidity due to its invasiveness. Hypoxia-driven motility and concentration-driven motility are two mechanisms of glioblastoma multiforme invasion in the brain. The use of anti-angiogenic drugs has uncovered new progression patterns of glioblastoma multiforme associated with significant differences in overall survival. Here, we apply a mathematical model of glioblastoma multiforme growth and invasion in humans and design computational trials using agents that target angiogenesis, tumor replication rates, or motility. The findings link highly-dispersive, moderately-dispersive, and hypoxia-driven tumors to the patterns observed in glioblastoma multiforme treated by anti-angiogenesis, consisting of progression by Expanding FLAIR, Expanding FLAIR + Necrosis, and Expanding Necrosis, respectively. Furthermore, replication rate-reducing strategies (e.g. Tumor Treating Fields) appear to be effective in highly-dispersive and moderately-dispersive tumors but not in hypoxia-driven tumors. The latter may respond to motility-reducing agents. In a population computational trial, with all three phenotypes, a correlation was observed between the efficacy of the rate-reducing agent and the prolongation of overall survival times. This research highlights the potential applications of computational trials and supports new hypotheses on glioblastoma multiforme phenotypes and treatment options. PMID:26756205
Do Programs for Runaway and Homeless Youth Work? A Qualitative Exploration From the Perspectives of Youth Clients in Diverse Settings

PubMed Central

Gwadz, Marya; Freeman, Robert M.; Kutnick, Alexandra H.; Silverman, Elizabeth; Ritchie, Amanda S.; Cleland, Charles M.; Leonard, Noelle R.; Srinagesh, Aradhana; Powlovich, Jamie; Bolas, James

2018-01-01

Runaway and homeless youth (RHY) comprise a large population of young people who reside outside the control and protection of parents and guardians and who experience numerous traumas and risk factors, but few buffering resources. Specialized settings have developed to serve RHY, but little is known about their effects. The present cross-sectional qualitative descriptive study, grounded in the positive youth development approach and the Youth Program Quality Assessment model, addressed this gap in the literature. From a larger sample of 29 RHY-specific settings across New York State, RHY ages 16–21 from 11 settings were purposively sampled for semi-structured in-depth interviews on their transitions into homelessness, experiences with settings, and unmet needs (N = 37 RHY). Data were analyzed with a theory-driven and inductive systematic content analysis approach. Half of participants (54%) were female; almost half (49%) identified as non-heterosexual; and 42% were African American/Black, 31% were Latino/Hispanic, and 28% were White/other. Results indicated that because RHY are a uniquely challenged population, distrustful of service settings and professional adults and skilled at surviving independently, the population-tailored approaches found in RHY-specific settings are vital to settings’ abilities to effectively engage and serve RHY. We found the following four major themes regarding the positive effects of settings: (1) engaging with an RHY setting was emotionally challenging and frightening, and thus the experiences of safety and services tailored to RHY needs were critical; (2) instrumental support from staff was vital and most effective when received in a context of emotional support; (3) RHY were skilled at survival on the streets, but benefited from socialization into more traditional systems to foster future independent living; and (4) follow-through and aftercare were needed as RHY transitioned out of services. With respect to gaps in settings, RHY highlighted the following: (1) a desire for better management of tension between youths’ needs for structure and wishes for autonomy and (2) lack of RHY input into program governance. This study advances our understanding of RHY, their service needs, and the ways settings meet these needs, as well as remaining gaps. It underscores the vital, life-changing, and even life-saving role these settings play for RHY. PMID:29725587
Do Programs for Runaway and Homeless Youth Work? A Qualitative Exploration From the Perspectives of Youth Clients in Diverse Settings.

PubMed

Gwadz, Marya; Freeman, Robert M; Kutnick, Alexandra H; Silverman, Elizabeth; Ritchie, Amanda S; Cleland, Charles M; Leonard, Noelle R; Srinagesh, Aradhana; Powlovich, Jamie; Bolas, James

2018-01-01

Runaway and homeless youth (RHY) comprise a large population of young people who reside outside the control and protection of parents and guardians and who experience numerous traumas and risk factors, but few buffering resources. Specialized settings have developed to serve RHY, but little is known about their effects. The present cross-sectional qualitative descriptive study, grounded in the positive youth development approach and the Youth Program Quality Assessment model, addressed this gap in the literature. From a larger sample of 29 RHY-specific settings across New York State, RHY ages 16-21 from 11 settings were purposively sampled for semi-structured in-depth interviews on their transitions into homelessness, experiences with settings, and unmet needs ( N = 37 RHY). Data were analyzed with a theory-driven and inductive systematic content analysis approach. Half of participants (54%) were female; almost half (49%) identified as non-heterosexual; and 42% were African American/Black, 31% were Latino/Hispanic, and 28% were White/other. Results indicated that because RHY are a uniquely challenged population, distrustful of service settings and professional adults and skilled at surviving independently, the population-tailored approaches found in RHY-specific settings are vital to settings' abilities to effectively engage and serve RHY. We found the following four major themes regarding the positive effects of settings: (1) engaging with an RHY setting was emotionally challenging and frightening, and thus the experiences of safety and services tailored to RHY needs were critical; (2) instrumental support from staff was vital and most effective when received in a context of emotional support; (3) RHY were skilled at survival on the streets, but benefited from socialization into more traditional systems to foster future independent living; and (4) follow-through and aftercare were needed as RHY transitioned out of services. With respect to gaps in settings, RHY highlighted the following: (1) a desire for better management of tension between youths' needs for structure and wishes for autonomy and (2) lack of RHY input into program governance. This study advances our understanding of RHY, their service needs, and the ways settings meet these needs, as well as remaining gaps. It underscores the vital, life-changing, and even life-saving role these settings play for RHY.

A study of the effect on human mesenchymal stem cells of an atmospheric pressure plasma source driven by different voltage waveforms

NASA Astrophysics Data System (ADS)

Laurita, R.; Alviano, F.; Marchionni, C.; Abruzzo, P. M.; Bolotta, A.; Bonsi, L.; Colombo, V.; Gherardi, M.; Liguori, A.; Ricci, F.; Rossi, M.; Stancampiano, A.; Tazzari, P. L.; Marini, M.

2016-09-01

The effect of an atmospheric pressure non-equilibrium plasma on human mesenchymal stem cells was investigated. A dielectric barrier discharge non-equilibrium plasma source driven by two different high-voltage pulsed generators was used and cell survival, senescence, proliferation, and differentiation were evaluated. Cells deprived of the culture medium and treated with nanosecond pulsed plasma showed a higher mortality rate, while higher survival and retention of proliferation were observed in cells treated with microsecond pulsed plasma in the presence of the culture medium. While a few treated cells showed the hallmarks of senescence, unexpected delayed apoptosis ensued in cells exposed to plasma-treated medium. The plasma treatment did not change the expression of OCT4, a marker of mesenchymal stem cell differentiation.
Biomarker-driven trial in metastatic pancreas cancer: feasibility in a multicenter study of saracatinib, an oral Src inhibitor, in previously treated pancreatic cancer.

PubMed

Arcaroli, John; Quackenbush, Kevin; Dasari, Arvind; Powell, Rebecca; McManus, Martine; Tan, Aik-Choon; Foster, Nathan R; Picus, Joel; Wright, John; Nallapareddy, Sujatha; Erlichman, Charles; Hidalgo, Manuel; Messersmith, Wells A

2012-10-01

Src tyrosine kinases are overexpressed in pancreatic cancers, and the oral Src inhibitor saracatinib has shown antitumor activity in preclinical models of pancreas cancer. We performed a CTEP-sponsored Phase II clinical trial of saracatinib in previously treated pancreas cancer patients, with a primary endpoint of 6-month survival. A Simon MinMax two-stage phase II design was used. Saracatinib (175 mg/day) was administered orally continuously in 28-day cycles. In the unselected portion of the study, 18 patients were evaluable. Only two (11%) patients survived for at least 6 months, and three 6-month survivors were required to move to second stage of study as originally designed. The study was amended as a biomarker-driven trial (leucine rich repeat containing protein 19 [LRRC19] > insulin-like growth factor-binding protein 2 [IGFBP2] "top scoring pairs" polymerase chain reaction [PCR] assay, and PIK3CA mutant) based on preclinical data in a human pancreas tumor explant model. In the biomarker study, archival tumor tissue or fresh tumor biopsies were tested. Biomarker-positive patients were eligible for the study. Only one patient was PIK3CA mutant in a 3' untranslated region (UTR) portion of the gene. This patient was enrolled in the study and failed to meet the 6-month survival endpoint. As the frequency of biomarker-positive patients was very low (<3%), the study was closed. Although we were unable to conclude whether enriching for a subset of second/third line pancreatic cancer patients treated with a Src inhibitor based on a biomarker would improve 6-month survival, we demonstrate that testing pancreatic tumor samples for a biomarker-driven, multicenter study in metastatic pancreas cancer is feasible.
Cost-effectiveness analysis of gemcitabine, S-1 and gemcitabine plus S-1 for treatment of advanced pancreatic cancer based on GEST study.

PubMed

Zhou, Jing; Zhao, Rongce; Wen, Feng; Zhang, Pengfei; Tang, Ruilei; Du, Zedong; He, Xiaofeng; Zhang, Jian; Li, Qiu

2015-04-01

Gemcitabine (GEM) alone, S-1 alone and gemcitabine plus S-1 (GS) have shown a marginal clinical benefit for the treatment of advanced pancreatic cancer. However, there is no clearly defined optimal cost-effectiveness treatment. The objective of this study was to assess the cost-effectiveness of GEM alone, S-1 alone and GS for the treatment of advanced pancreatic cancer based on GEST study for public payers. A decision model compared GEM alone, S-1 alone and GS. Primary base case data were identified using the GEST study and the literatures. Costs were estimated from West China Hospital, Sichuan University, China, and incremental cost-effectiveness ratios (ICERs) were calculated. Survival benefits were reported in quality-adjusted life-months (QALMs). Sensitive analyses were performed by varying potentially modifiable parameters of the model. The base case analysis showed that the GEM cost $21,912 and yielded survival of 6.93 QALMs, S-1 cost $19,371 and yielded survival of 7.90 QALMs and GS cost $22,943 and yielded survival of 7.46 QALMs in the entire treatment. The one-way sensitivity analyses showed that the ICER of S-1 was driven mostly by the S-1 group utility score of stable state compared with GEM, and the GEM group utility score of progressed state played a key role on the ICER of GS compared with GEM. S-1 represents an attractive cost-effective treatment for advanced pancreatic cancer, given the favorable cost per QALM and improvement in clinical efficacy, especially the limited available treatment options.
The Themes, Institutions, and People of Medical Education Research 1988-2010: Content Analysis of Abstracts from Six Journals

ERIC Educational Resources Information Center

Rotgans, Jerome I.

2012-01-01

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on…
Potential Factors Affecting Survival Differ by Run-Timing and Location: Linear Mixed-Effects Models of Pacific Salmonids (Oncorhynchus spp.) in the Klamath River, California

PubMed Central

Quiñones, Rebecca M.; Holyoak, Marcel; Johnson, Michael L.; Moyle, Peter B.

2014-01-01

Understanding factors influencing survival of Pacific salmonids (Oncorhynchus spp.) is essential to species conservation, because drivers of mortality can vary over multiple spatial and temporal scales. Although recent studies have evaluated the effects of climate, habitat quality, or resource management (e.g., hatchery operations) on salmonid recruitment and survival, a failure to look at multiple factors simultaneously leaves open questions about the relative importance of different factors. We analyzed the relationship between ten factors and survival (1980–2007) of four populations of salmonids with distinct life histories from two adjacent watersheds (Salmon and Scott rivers) in the Klamath River basin, California. The factors were ocean abundance, ocean harvest, hatchery releases, hatchery returns, Pacific Decadal Oscillation, North Pacific Gyre Oscillation, El Niño Southern Oscillation, snow depth, flow, and watershed disturbance. Permutation tests and linear mixed-effects models tested effects of factors on survival of each taxon. Potential factors affecting survival differed among taxa and between locations. Fall Chinook salmon O. tshawytscha survival trends appeared to be driven partially or entirely by hatchery practices. Trends in three taxa (Salmon River spring Chinook salmon, Scott River fall Chinook salmon; Salmon River summer steelhead trout O. mykiss) were also likely driven by factors subject to climatic forcing (ocean abundance, summer flow). Our findings underscore the importance of multiple factors in simultaneously driving population trends in widespread species such as anadromous salmonids. They also show that the suite of factors may differ among different taxa in the same location as well as among populations of the same taxa in different watersheds. In the Klamath basin, hatchery practices need to be reevaluated to protect wild salmonids. PMID:24866173
Insurer and employer views on pediatric obesity treatment: a qualitative study.

PubMed

Hampl, S E; Davis, A M; Sampilo, M L; Stephens, K L; Dean, K

2013-04-01

The effectiveness of group-based comprehensive, multidisciplinary (stage 3) pediatric weight management programs is backed by a growing body of literature, yet insurance coverage of these programs is scarce to nonexistent, limiting their reach and long-term survival. The objective of this study was to better understand the perspectives of insurers and large employers on the issue of group-based treatment coverage. The authors performed a qualitative study utilizing structured interviews with these stakeholders, following accepted techniques. Six major themes emerged: cost, program effectiveness, corporate social responsibility, secondary parental (employee) benefits, coverage options and new benefit determination. Future efforts to secure payment for group-based pediatric weight management programs should address these key themes. Copyright © 2012 The Obesity Society.
Job Hunting? It's a Jungle out There! Jungle Survival Guide II.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

This illustrated, jungle-theme book plans a job search. There are three major sections in the book: (1) plan your safari; (2) where to look for jobs; and (3) making contact. Section one includes information on resumes, references, official papers needed for a job, and 11 ideas to help find job openings. Section two suggests finding jobs in state…
Bilingual Schooling and the Survival of Spanish in the United States.

ERIC Educational Resources Information Center

Gaarder, A. Bruce

This volume contains fifteen essays focussing on the themes of (a) bilingual schooling and (b) the role and prospects of the Spanish language in the United States. Eleven of the essays are written in English, and the rest are in Spanish. The essays are: (1) "Rationale of Bilingual Education in the United States," (2) "Organization of the Bilingual…
Health and Learning. Coordinators' Notebook: An International Resource for Early Childhood Development.

ERIC Educational Resources Information Center

Coordinators' Notebook, 1993

1993-01-01

This theme issue deals with the topic of the relationship between health and learning as it applies to the care of the young child. It consists of three parts. The first part is a lengthy article, "Health Care: The Care Required To Survive and Thrive" (J. Evans), explains health and caring environments of young child in the given…
"The Planet Will Not Survive if It's Not a Learning Planet": Sustainable Development within Learning through Life

ERIC Educational Resources Information Center

Walters, Shirley

2010-01-01

This review analyses the report "Learning through Life" from the point of view of the sustainable development theme and from a "South" perspective. The review recognises that the report is written to influence UK policy-makers and practitioners; it has captured the results of a broad-based inquiry, and it therefore has had to…
The impact of CO2-driven ocean acidification on early development and calcification in the sea urchin Strongylocentrotus intermedius.

PubMed

Zhan, Yaoyao; Hu, Wanbin; Zhang, Weijie; Liu, Minbo; Duan, Lizhu; Huang, Xianya; Chang, Yaqing; Li, Cong

2016-11-15

The impact of CO 2 -driven ocean acidification(OA) on early development and calcification in the sea urchin Strongylocentrotus intermedius cultured in northern Yellow Sea was investigated by comparing fertilization success, early cleavage rate, hatching rate of blastulae, larvae survival rate at 70h post-fertilization, larval morphology and calcification under present natural seawater condition (pH=8.00±0.03) and three laboratory-controlled acidified conditions (OA 1 , △pH=-0.3units; OA 2 , △pH=-0.4units; OA 3 , △pH=-0.5units) projected by IPCC for 2100. Results showed that pH decline had no effect on the overall fertilization, however, with decreased pH, delayed early embryonic cleavage, reduced hatching rate of blastulae and four-armed larvae survival rate at 70h post-fertilization, impaired larval symmetry, shortened larval spicules, and corrosion spicule structure were observed in all OA-treated groups as compared to control, which indicated that CO 2 -driven OA affected early development and calcification in S. intermedius negatively. Copyright © 2016 Elsevier Ltd. All rights reserved.
'We have to put up with it--don't we?' The experience of being the registered nurse on duty, managing a violent incident involving an elderly patient: a phenomenological study.

PubMed

Chambers, N

1998-02-01

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

PubMed

Lorentzon, M; Bryant, J

1997-09-01

A historical overview of nurse leadership in the late 19th and late 20th centuries is presented, supported by relevant material from the literature. The 19th century material revealed the following main themes: emphasis on practical and domestic aspects of management; prominent input of religious ideals and social conscience and, autocratic and feminized style of leadership. The main themes in the contemporary literature examined were: role models in history, dysfunctional leadership styles, importance of knowledge, gender as an influencing factor on nurse leadership and threats to the autonomy of nurse leaders. It was concluded that formal nurse professionalization has progressed steadily during the past hundred years with associated evolution of nurse leaders to fit in with contemporary needs. It is hoped that future policies for nursing will encourage decision-making nearer the 'bed-side', more resource-driven care and value-based leadership.
The narratives of abused children who have survived attempted filicide.

PubMed

Katz, Carmit

2013-10-01

Child abuse is a social problem that receives much attention from policy makers, practitioners, and researchers. This alarming phenomenon generates many consequences for children, their families, and society as a whole; one tragic consequence of child abuse is filicide. Because of the unfortunate circumstances surrounding such events, children are hushed by their perpetrators, whether abusers or killers, and we are thus denied the opportunity to hear their voices and to promote understanding of the phenomenon. The aim of the current study is to explore in depth the patterns and themes that can be found in the narratives of children who survived a murder attempt by one of their parents. Content analysis was performed on seven investigative interviews with children using thematic analysis. Five key categories were determined based on the children's narratives: (a) many bad things have happened to me, (b) this was not the first time I was abused by my parent, (c) I am concerned about my parent, (d) I am alive thanks to my siblings, and (e) it is hard to remember what exactly happened. This study contributes to the understanding of child physical abuse and filicide. The discussion integrated conclusions for policy makers and practitioners who seek methods of addressing child abuse as well as determining whether and how filicide can be prevented. Copyright © 2013 Elsevier Ltd. All rights reserved.
Games of lives in surviving childhood brain tumors.

PubMed

Chen, Chin-Mi; Chen, Yueh-Chih; Haase, Joan E

2008-06-01

The purpose of this phenomenological study was to describe the commonality of the lived experience of adolescent and young adult survivors (AYAS) of brain tumors in Taiwan from a sociocultural perspective. Seven AYAS aged 13 to 22 years, who had survived 5 to 10 years from the time of diagnosis, participated in this study. In consideration of their emotional duress, each participant was interviewed only once. The data revealed an essential structure: the game of life. The essential structure included six themes as follows: (a) no longer playing well, (b) wandering on the outer edges of social life, (c) helplessly struggling with role obligations, (d) rationally regulating the meaning of surviving, (e) winning a new social face, and (f) mastering the game of life. The findings suggest how nurses might help AYAS to succeed in psychosocial adjustment.
Knowledge-making distinctions in synthetic biology.

PubMed

O'Malley, Maureen A; Powell, Alexander; Davies, Jonathan F; Calvert, Jane

2008-01-01

Synthetic biology is an increasingly high-profile area of research that can be understood as encompassing three broad approaches towards the synthesis of living systems: DNA-based device construction, genome-driven cell engineering and protocell creation. Each approach is characterized by different aims, methods and constructs, in addition to a range of positions on intellectual property and regulatory regimes. We identify subtle but important differences between the schools in relation to their treatments of genetic determinism, cellular context and complexity. These distinctions tie into two broader issues that define synthetic biology: the relationships between biology and engineering, and between synthesis and analysis. These themes also illuminate synthetic biology's connections to genetic and other forms of biological engineering, as well as to systems biology. We suggest that all these knowledge-making distinctions in synthetic biology raise fundamental questions about the nature of biological investigation and its relationship to the construction of biological components and systems. (c) 2007 Wiley Periodicals, Inc.
A qualitative study exploring how school and community environments shape the food choices of adolescents with overweight/obesity.

PubMed

Watts, Allison W; Lovato, Chris Y; Barr, Susan I; Hanning, Rhona M; Mâsse, Louise C

2015-12-01

This study explored perceived barriers and facilitators to healthful eating in schools and communities among overweight teens who completed an E-health intervention. Twenty-two teens were recruited to a photovoice study and asked to take pictures of things that made it easier or harder to make healthful food choices at school and in their community. Digital photographs were reviewed using semi-structured interviews. Transcribed audio-recordings were analyzed using constant comparative analysis. Similar themes emerged from the school and community environments with food/beverage availability emerging most frequently, followed by peer influence, accessibility/convenience, price, classroom practices, marketing and online influences. Teens described an obesity-promoting environment and perceived very limited healthful options. Policy-driven environmental changes as well as strategies that help teens navigate food choices in their schools and communities are needed to support healthful eating. Copyright © 2015 Elsevier Ltd. All rights reserved.
The influence of marianismo beliefs on physical activity of immigrant Latinas

PubMed Central

D'Alonzo, Karen T.

2011-01-01

Purpose To verify and explicate the impact of marianismo beliefs on the physical activity behaviors of immigrant Latinas. Design/Method Twenty–eight immigrant Latinas, ages 18–40 years, were recruited to participate in two focus group interviews. Data collection and analysis were driven by Spradley’s Developmental Research Sequence (DRS) Results Two domain terms were identified: “Life is too fast here” and “The woman is the center of the family”. Six included terms and five cultural themes were specified. Discussion/Conclusions A combination of marianismo beliefs, acculturation stress, loss of social support and conflicts between collectivist and individualist values combine to adversely influence physical activity behaviors of immigrant Latinas. Implications for Practice Physical activity interventions for Hispanic women should capitalize on the strengths of the marianista, address factors leading to acculturation stress among women and their families and the establishment of bridges of social support among new groups of immigrants. PMID:22294337
A hermeneutic phenomenological study of the experiences of female African American undergraduate engineering students at a predominantly White and an historically Black institution

NASA Astrophysics Data System (ADS)

Frillman, Sharron Ann

2011-12-01

This phenomenological study examined the experiences of twelve female African Americans enrolled as fulltime undergraduate engineering students at North Carolina Agricultural and Technical State University, an historically Black university, and seven female African Americans enrolled as undergraduate engineering students at Purdue University in West Lafayette, Indiana, a traditionally White institution. Interviews provided insights into the "lived" experiences of these young women and the factors they believe have contributed to their success in their respective engineering programs. Data analysis involved coding each participant's responses to interview questions using Atlas.ti, a powerful qualitative data analysis tool. This generated 181 codes that were further categorized into nine emergent themes, indicating the potential for extensive associations among the variables. The emergent themes are as follows: (1) Demographic information/special circumstances, (2) Personal attributes and characteristics, (3) Personal insights, (4) Sense of mission, (5) Sources of negative stress, (6) Success strategies, (7) Various forms of support, (8) Would/would not have made it to where she is now, and (9) Being African American and female in engineering. Analysis of these themes and their relationships led to the development of the Frillman Model of Emergent Themes in Female African American Engineering Students. Success. In addressing similarities and differences, three overriding theme categories emerged. These were: (1) Four personhood themes and dual social identity theme; (2) Environmental input and response theme; and (3) Outcome emergent theme of Would/Would not have made it to where she is now. Recommendations were made for future research to expand upon this exploratory study.
Targeting SREBP-1-driven lipid metabolism to treat cancer

PubMed Central

Guo, Deliang; Bell, Erica Hlavin; Mischel, Paul; Chakravarti, Arnab

2014-01-01

Metabolic reprogramming is a hallmark of cancer. Oncogenic growth signaling regulates glucose, glutamine and lipid metabolism to meet the bioenergetics and biosynthetic demands of rapidly proliferating tumor cells. Emerging evidence indicates that sterol regulatory element-binding protein 1 (SREBP-1), a master transcription factor that controls lipid metabolism, is a critical link between oncogenic signaling and tumor metabolism. We recently demonstrated that SREBP-1 is required for the survival of mutant EGFR-containing glioblastoma, and that this pro-survival metabolic pathway is mediated, in part, by SREBP-1-dependent upregulation of the fatty acid synthesis and low density lipoprotein (LDL) receptor (LDLR). These results have identified EGFR/PI3K/Akt/SREBP-1 signaling pathway that promotes growth and survival in glioblastoma, and potentially other cancer types. Here, we summarize recent insights in the understanding of cancer lipid metabolism, and discuss the evidence linking SREBP-1 with PI3K/Akt signaling-controlled glycolysis and with Myc-regulated glutaminolysis to lipid metabolism. We also discuss the development of potential drugs targeting the SREBP-1-driven lipid metabolism as anti-cancer agents. PMID:23859617

Cardiac stem cell genetic engineering using the alphaMHC promoter.

PubMed

Bailey, Brandi; Izarra, Alberto; Alvarez, Roberto; Fischer, Kimberlee M; Cottage, Christopher T; Quijada, Pearl; Díez-Juan, Antonio; Sussman, Mark A

2009-11-01

Cardiac stem cells (CSCs) show potential as a cellular therapeutic approach to blunt tissue damage and facilitate reparative and regenerative processes after myocardial infarction. Despite multiple published reports of improvement, functional benefits remain modest using normal stem cells delivered by adoptive transfer into damaged myocardium. The goal of this study is to enhance survival and proliferation of CSCs that have undergone lineage commitment in early phases as evidenced by expression of proteins driven by the alpha-myosin heavy chain (alphaMHC) promoter. The early increased expression of survival kinases augments expansion of the cardiogenic CSC pool and subsequent daughter progeny. Normal CSCs engineered with fluorescent reporter protein constructs under control of the alphaMHC promoter show transgene protein expression, confirming activity of the promoter in CSCs. Cultured CSCs from both nontransgenic and cardiac-specific transgenic mice expressing survival kinases driven by the alphaMHC promoter were analyzed to characterize transgene expression following treatments to promote differentiation in culture. Therapeutic genes controlled by the alphaMHC promoter can be engineered into and expressed in CSCs and cardiomyocyte progeny with the goal of improving the efficacy of cardiac stem cell therapy.
The dot{M}-M_* relation of pre-main-sequence stars: a consequence of X-ray driven disc evolution

NASA Astrophysics Data System (ADS)

Ercolano, B.; Mayr, D.; Owen, J. E.; Rosotti, G.; Manara, C. F.

2014-03-01

We analyse current measurements of accretion rates on to pre-main-sequence stars as a function of stellar mass, and conclude that the steep dependence of accretion rates on stellar mass is real and not driven by selection/detection threshold, as has been previously feared. These conclusions are reached by means of statistical tests including a survival analysis which can account for upper limits. The power-law slope of the dot{M}-M_* relation is found to be in the range of 1.6-1.9 for young stars with masses lower than 1 M⊙. The measured slopes and distributions can be easily reproduced by means of a simple disc model which includes viscous accretion and X-ray photoevaporation. We conclude that the dot{M}-M_* relation in pre-main-sequence stars bears the signature of disc dispersal by X-ray photoevaporation, suggesting that the relation is a straightforward consequence of disc physics rather than an imprint of initial conditions.
Low light and low ammonium are key factors for guayule leaf tissue shoot organogenesis and transformation.

PubMed

Dong, Niu; Montanez, Belen; Creelman, Robert A; Cornish, Katrina

2006-02-01

A new method has been developed for guayule tissue culture and transformation. Guayule leaf explants have a poor survival rate when placed on normal MS medium and under normal culture room light conditions. Low light and low ammonium treatment greatly improved shoot organogenesis and transformation from leaf tissues. Using this method, a 35S promoter driven BAR gene and an ubiquitin-3 promoter driven GUS gene (with intron) have been successfully introduced into guayule. These transgenic guayule plants were resistant to the herbicide ammonium-glufosinate and were positive to GUS staining. Molecular analysis showed the expected band and signal in all GUS positive transformants. The transformation efficiency with glufosinate selection ranged from 3 to 6%. Transformation with a pBIN19-based plasmid containing a NPTII gene and then selection with kanamycin also works well using this method. The ratio of kanamycin-resistant calli to total starting explants reached 50% in some experiments.
The Pearling Transition Provides Evidence of Force-Driven Endosomal Tubulation during Salmonella Infection.

PubMed

Gao, Yunfeng; Spahn, Christoph; Heilemann, Mike; Kenney, Linda J

2018-06-19

Bacterial pathogens exploit eukaryotic pathways for their own end. Upon ingestion, Salmonella enterica serovar Typhimurium passes through the stomach and then catalyzes its uptake across the intestinal epithelium. It survives and replicates in an acidic vacuole through the action of virulence factors secreted by a type three secretion system located on Salmonella pathogenicity island 2 (SPI-2). Two secreted effectors, SifA and SseJ, are sufficient for endosomal tubule formation, which modifies the vacuole and enables Salmonella to replicate within it. Two-color, superresolution imaging of the secreted virulence factor SseJ and tubulin revealed that SseJ formed clusters of conserved size at regular, periodic intervals in the host cytoplasm. Analysis of SseJ clustering indicated the presence of a pearling effect, which is a force-driven, osmotically sensitive process. The pearling transition is an instability driven by membranes under tension; it is induced by hypotonic or hypertonic buffer exchange and leads to the formation of beadlike structures of similar size and regular spacing. Reducing the osmolality of the fixation conditions using glutaraldehyde enabled visualization of continuous and intact tubules. Correlation analysis revealed that SseJ was colocalized with the motor protein kinesin. Tubulation of the endoplasmic reticulum is driven by microtubule motors, and in the present work, we describe how Salmonella has coopted the microtubule motor kinesin to drive the force-dependent process of endosomal tubulation. Thus, endosomal tubule formation is a force-driven process catalyzed by Salmonella virulence factors secreted into the host cytoplasm during infection. IMPORTANCE This study represents the first example of using two-color, superresolution imaging to analyze the secretion of Salmonella virulence factors as they are secreted from the SPI-2 type three secretion system. Previous studies imaged effectors that were overexpressed in the host cytoplasm. The present work reveals an unusual force-driven process, the pearling transition, which indicates that Salmonella -induced filaments are under force through the interactions of effector molecules with the motor protein kinesin. This work provides a caution by highlighting how fixation conditions can influence the images observed.
Environmental Control of Phase Transition and Polyp Survival of a Massive-Outbreaker Jellyfish

PubMed Central

Prieto, Laura; Astorga, Diana; Navarro, Gabriel; Ruiz, Javier

2010-01-01

A number of causes have been proposed to account for the occurrence of gelatinous zooplankton (both jellyfish and ctenophore) blooms. Jellyfish species have a complex life history involving a benthic asexual phase (polyp) and a pelagic sexual phase (medusa). Strong environmental control of jellyfish life cycles is suspected, but not fully understood. This study presents a comprehensive analysis on the physicochemical conditions that control the survival and phase transition of Cotylorhiza tuberculata; a scyphozoan that generates large outbreaks in the Mediterranean Sea. Laboratory experiments indicated that the influence of temperature on strobilation and polyp survival was the critical factor controlling the capacity of this species to proliferate. Early life stages were less sensitive to other factors such as salinity variations or the competitive advantage provided by zooxanthellae in a context of coastal eutrophication. Coherently with laboratory results, the presence/absence of outbreaks of this jellyfish in a particular year seems to be driven by temperature. This is the first time the environmental forcing of the mechanism driving the life cycle of a jellyfish has been disentangled via laboratory experimentation. Projecting this understanding to a field population under climatological variability results in a pattern coherent with in situ records. PMID:21072185
High Availability in Optical Networks

NASA Astrophysics Data System (ADS)

Grover, Wayne D.; Wosinska, Lena; Fumagalli, Andrea

2005-09-01

Call for Papers: High Availability in Optical Networks Submission Deadline: 1 January 2006 The Journal of Optical Networking (JON) is soliciting papers for a feature Issue pertaining to all aspects of reliable components and systems for optical networks and concepts, techniques, and experience leading to high availability of services provided by optical networks. Most nations now recognize that telecommunications in all its forms -- including voice, Internet, video, and so on -- are "critical infrastructure" for the society, commerce, government, and education. Yet all these services and applications are almost completely dependent on optical networks for their realization. "Always on" or apparently unbreakable communications connectivity is the expectation from most users and for some services is the actual requirement as well. Achieving the desired level of availability of services, and doing so with some elegance and efficiency, is a meritorious goal for current researchers. This requires development and use of high-reliability components and subsystems, but also concepts for active reconfiguration and capacity planning leading to high availability of service through unseen fast-acting survivability mechanisms. The feature issue is also intended to reflect some of the most important current directions and objectives in optical networking research, which include the aspects of integrated design and operation of multilevel survivability and realization of multiple Quality-of-Protection service classes. Dynamic survivable service provisioning, or batch re-provisioning is an important current theme, as well as methods that achieve high availability at far less investment in spare capacity than required by brute force service path duplication or 100% redundant rings, which is still the surprisingly prevalent practice. Papers of several types are envisioned in the feature issue, including outlook and forecasting types of treatments, optimization and analysis, new concepts for survivability, or papers on availability analysis methods or results. Customer, vendor, and researcher viewpoints and priorities will all be given consideration. Especially valuable to the community would be papers that include or provide measured data on actual reliability and availability performance of optical networking components or systems. The scope of the papers includes, but is not limited to, the following topics: Reliability and availability measurement techniques specific to optical network devices or services. Data on SRLG statistics and frequency of different actual failure causes. Real-life accounts or data on failure and repair rates or projected values for use in availability analysis. Availability analysis methods, especially for survivable networks with reconfigurable or adaptive failure-specific responses. Availability analysis and comparisons of basic schemes for survivability. Differentiated availability schemes. Design for Multiple Quality of Protection. Different schemes for on-demand survivable service provisioning. Basic comparisons or proposals of new survivability mechanisms and architectures. Concepts yielding higher than 1+1 protection switching availability at less than 100% redundancy. Survivable service provisioning in domains of optical transparency: dealing with signal impairments. To submit to this special issue, follow the normal procedure for submission to JON, indicating "Feature Issue: Optical Network Availability" in the "Comments" field of the online submission form. For all other questions relating to this feature issue, please send an e-mail to jon@osa.org, subject line "Feature Issue: Optical Network Availability." Additional information can be found on the JON website: http://www.osa-jon.org/submission/
Survival Trends in Pediatric In-Hospital Cardiac Arrests: An Analysis from Get With The Guidelines-Resuscitation

PubMed Central

Girotra, Saket; Spertus, John A.; Li, Yan; Berg, Robert A.; Nadkarni, Vinay M.; Chan, Paul S.

2013-01-01

BACKGROUND Despite ongoing efforts to improve the quality of pediatric resuscitation, it remains unknown whether survival in children with in-hospital cardiac arrest has improved. METHODS & RESULTS Between 2000 and 2009, we identified children (<18 years) with an in-hospital cardiac arrest at hospitals with ≥ 3 years of participation and ≥ 5 cases annually within the national Get With The Guidelines-Resuscitation registry. Multivariable logistic regression was used to examine temporal trends in survival to discharge. We also explored whether trends in survival were due to improvement in acute resuscitation or post-resuscitation care and examined trends in neurological disability among survivors. Among 1031 children at 12 hospitals, the initial cardiac arrest rhythm was asystole and pulseless electrical activity in 874 children (84.8%) and ventricular fibrillation and pulseless ventricular tachycardia in 157 children (15.2%), with an increase in cardiac arrests due to asystole and pulseless electrical activity over time (P for trend <0.001). Risk-adjusted rates of survival to discharge increased from 14.3% in 2000 to 43.4% in 2009 (adjusted rate ratio per 1-year 1.08; 95% CI [1.01,1.16]; P for trend 0.02). Improvement in survival was largely driven by an improvement in acute resuscitation survival (risk adjusted rates: 42.9% in 2000, 81.2% in 2009; adjusted rate ratio per 1-year: 1.04; 95% CI [1.01,1.08]; P for trend 0.006). Moreover, survival trends were not accompanied by higher rates of neurological disability among survivors over time (unadjusted P for trend 0.32), suggesting an overall increase in the number of survivors without neurological disability over time. CONCLUSION Rates of survival to hospital discharge in children with in-hospital cardiac arrests have improved over the past decade without higher rates of neurological disability among survivors. PMID:23250980
Women’s Perspective of Breast Self-examination

PubMed Central

Pilevarzadeh, Motahare

2016-01-01

Breast cancer is the most prevalent cancer among Iranian women. Early diagnosis of the disease is vitally important in successful treating of it and reducing its mortality and care-cost burden. In our country, the major causes of mortality and other unfavorable complications of the disease are due to late referring of women. Breast Self -Examination (BSE) is a low-cost, low-risk, self-performed screening, which, according to the evidence from the literature improves the prospects for women’s survival. A content analysis with a qualitative approach was conducted in depth on women through semi-structured (individual and group) interviews. Based on the result analysis, one them related to women’s prospect BSE: Including Fearful feeling, with 2 Sub-themes A: Change body image B: Uncertain future. Training courses on breast cancer and BSE screening program for women (vulnerable poor population) is necessary so as to change their beliefs and culture in order to promote this health behavior. PMID:27829828
Content Themes of Alcohol Advertising in US Television — Latent Class Analysis

PubMed Central

Morgenstern, Matthis; Schoeppe, Franziska; Campbell, Julie; Braam, Marloes W.G.; Stoolmiller, Michael; Sargent, James D.

2015-01-01

Background There is little alcohol research that reports on the thematic contents of contemporary alcohol advertisements in US television. Studies of alcohol ads from two decades ago did not identify “partying” as a social theme. Aim of the present study was to describe and classify alcohol advertisements aired in national television in terms of contents, airing times, and channel placements and to identify different marketing strategies of alcohol brands. Methods Content analysis of all ads from the top 20 US beer and spirit brands aired between July 2009 and June 2011. These were 581 unique alcohol ads accounting for 272,828 (78%) national television airings. Ads were coded according to predefined definitions of 13 content areas. A latent class analysis (LCA) was conducted to define content cluster themes and determine alcoholic brands that were more likely to exploit these themes. Results About half of the advertisements (46%) were aired between 3am and 8pm, and the majority were placed either in Entertainment (40%) and Sports (38%) channels. Beer ads comprised 64% of the sample, with significant variation in airing times and channels between types of products and brands. LCA revealed five content classes that exploited the “Partying”, “Quality”, “Sports”, “Manly”, and “Relax” themes. The partying class, indicative of ad messages surrounding partying, love and sex, was the dominant theme, comprising 42% of all advertisements. Ads for alcopops, flavored spirits, and liqueur were more likely to belong to the party class, but there were also some beer brands (Corona, Heineken) where more than 67% of ads exploited this theme. Conclusions This is the first analysis to identify a partying theme to contemporary alcohol advertising. Future analyses can now determine whether exposure to that or other themes predicts alcohol misuse among youth audiences. PMID:26207317
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.
Common spaceborne multicomputer operating system and development environment

NASA Technical Reports Server (NTRS)

Craymer, L. G.; Lewis, B. F.; Hayes, P. J.; Jones, R. L.

1994-01-01

A preliminary technical specification for a multicomputer operating system is developed. The operating system is targeted for spaceborne flight missions and provides a broad range of real-time functionality, dynamic remote code-patching capability, and system fault tolerance and long-term survivability features. Dataflow concepts are used for representing application algorithms. Functional features are included to ensure real-time predictability for a class of algorithms which require data-driven execution on an iterative steady state basis. The development environment supports the development of algorithm code, design of control parameters, performance analysis, simulation of real-time dataflow applications, and compiling and downloading of the resulting application.
Understanding the experiences and quality of life issues of Bahraini women with breast cancer.

PubMed

Jassim, Ghufran A; Whitford, David L

2014-04-01

We explored the experiences of Bahraini women who have survived breast cancer and their perception of quality of life after diagnosis. We conducted in depth, semi-structured face-to-face interviews with twelve women diagnosed with breast cancer. A qualitative method using semi-structured interviews on a purposive sample of 12 Bahraini women with breast cancer was conducted. Similarities and differences in women's experience were identified through thematic analysis of interview transcripts using a constant comparative approach. The themes identified were meaning of cancer and quality of life, spirituality and beliefs about causes of breast cancer, coping mechanisms, impact of illness and change in relationships. Quality of life was framed in terms of the ability to perform daily duties with emphasis on the physical component of quality of life. Themes that differed from previous western studies included a heavy emphasis on spiritual practices for comfort; the use of traditional clothing (hijab and abaya) to hide hair and body changes; the important role played by the family and husband in treatment decisions and concerns regarding satisfying the sexual needs of the husband, which were related to a fear of losing the husband to a second wife. Evil eye, stress and God's punishment were believed to be fundamental causes of the disease. The emotional shock of the initial diagnosis, concerns about whether to reveal the diagnosis and a desire to live a normal life were consistent with previous studies. However, cultural and religious issues such as role of the husband and impact of prayers were also important here. These themes are important to healthcare professionals for ensuring an individualized approach to the treatment of women with breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.
Survival, momentum, and things that make me "me": patients' perceptions of goal setting after stroke.

PubMed

Brown, Melanie; Levack, William; McPherson, Kathryn M; Dean, Sarah G; Reed, Kirk; Weatherall, Mark; Taylor, William J

2014-01-01

Goal setting and patient-centredness are considered fundamental concepts in rehabilitation. However, the best way to involve patients in setting goals remains unclear. The purpose of this study was to explore patient experiences of goal setting in post-acute stroke rehabilitation to further understanding of its application to practice. Thematic analysis was used to analyse interview transcripts from 10 stroke survivors, recruited from 4 rehabilitation units as part of a pilot study investigating the effects of a structured means of eliciting patient-centred goals in post-acute stroke rehabilitation. Three key themes emerged: (1) "A Day by Day Momentum", comprising subordinate themes of "Unpredictability" and "Natural Progression" in which daily progress forwards was seen as an integral part of rehabilitation; (2) "Battle versus Alliance" in which issues of struggle versus support influenced participants' advancement; and (3) "The Special Things", consisting of subordinate themes of "What Makes Me 'Me'" and "Symbolic Achievements" concerning issues defining individuals and their rehabilitation experiences. Patients' discourse around goal setting can differ from the discourse conventionally used by clinicians when describing "best practice" in rehabilitation goal setting. Understanding patients' non-conventional views of goals may assist in supporting and motivating them, thus providing drive for their rehabilitation. Stroke patients think about goals very differently from health professionals. Individual patients have diverse ideas about goals within the context of the uncertainty of stroke, their life as a whole and recovery after formal rehabilitation is completed. To meet these diverse needs, health professionals need to communicate fully with patients to gain an understanding of their experiences of stroke and wider views on goals.
Cancer patients' experiences with nature: Normalizing dichotomous realities.

PubMed

Blaschke, Sarah; O'Callaghan, Clare C; Schofield, Penelope; Salander, Pär

2017-01-01

To explore cancer patients' subjective experiences with nature in order to examine the relevance of nature-based care opportunities in cancer care contexts. The rationale was to describe the underlying mechanisms of this interaction and produce translatable knowledge. Qualitative research design informed by grounded theory. Sampling was initially convenience and then theoretical. Competent adults with any cancer diagnosis were eligible to participate in a semi-structured interview exploring views about the role of nature in their lives. Audio-recorded and transcribed interviews were analyzed using inductive, cyclic, and constant comparative analysis. Twenty cancer patients (9 female) reported detailed description about their experiences with nature from which a typology of five common nature interactions emerged. A theory model was generated constituting a core category and two inter-related themes explaining a normalization process in which patients negotiate their shifting realities (Core Category). Nature functioned as a support structure and nurtured patients' inner and outer capacities to respond and connect more effectively (Theme A). Once enabled and comforted, patients could engage survival and reconstructive maneuvers and explore the consequences of cancer (Theme B). A dynamic relationship was evident between moving away while, simultaneously, advancing towards the cancer reality in order to accept a shifting normality. From a place of comfort and safety, patients felt supported to deal differently and more creatively with the threat and demands of cancer diagnosis, treatment and outlook. New understanding about nature's role in cancer patients' lives calls attention to recognizing additional forms of psychosocial care that encourage patients' own coping and creative processes to deal with their strain and, in some cases, reconstruct everyday lives. Further research is required to determine how nature opportunities can be feasibly delivered in the cancer care setting. Copyright © 2016 Elsevier Ltd. All rights reserved.
Bereavement, post-traumatic stress and post-traumatic growth: through the lenses of positive psychology

PubMed Central

Thomadaki, Olga O.

2017-01-01

ABSTRACT Background: During the past decades we have learned a lot about the psychopathology that can be triggered from adversity, but our knowledge of the qualities developed and processes experienced by people who remain healthy despite having gone through trauma has been limited. A proposed area within positive psychology is the psychology of loss. Psychology of loss emphasizes the study of healthy individuals, the resources they use for adapting to loss, and the ways in which they can transform their losses into personal growth and strength. Under the theoretical umbrella of positive psychology, the construct of post-traumatic growth has also received increased scholarly attention in recent years. Post-traumatic growth is a concept and a construct that reflects the ‘positive psychological change experienced as a result of the struggle with highly challenging life circumstances’ (Tedeschi & Calhoun, 2004). Numerous empirical studies have described the phenomenon after various traumas, including traumatic bereavement, even among children and adolescents (Kilmer et al., 2009). Objective: The qualitative study presented was conducted in the UK, where eight women were interviewed after losing their first child perinatally. This type of bereavement constitutes a traumatic loss and although there is a plethora of research focusing on the resulting parental psychopathology, research on adaptive grief resolution and post-traumatic growth is scarce. Method: The research question was ‘How mothers experience personal growth after a perinatal loss’ and the research methodology employed was interpretative phenomenological analysis (Smith, Flowers, & Larkin, 2009). Results: The analysis revealed four superordinate themes. The first mainly presented the traumatic quality of this type of bereavement and included subthemes such as iatrogenic psychological trauma, while the second presented the multiple losses involved with emerging themes on the amputated object relationship, the socially unrecognized maternal identity and the threatened reproductive ability. The third superordinate theme presented all the coping mechanisms that were activated by participants to work through their loss; emerging themes were rumination and disillusionment, oscillating between action and avoidance, religious and spiritual coping, and the quality of social support as a catalyst. The fourth superordinate theme presented the positive changes that came as a consequence of the experience and their efforts to psychologically survive the loss. The subthemes that emerged in last superordinate theme were growth as an affirmation of the baby’s importance; growth as an outcome of the awareness of personal vulnerability; transformations in self-perception: self-worth and self-efficacy; transformations in perception and attitude: appreciation of life and changed priorities; and transformations in relationships: empathy and companionship. Conclusions: The research findings suggest that following this traumatic loss, mothers, struggling with distress and anguish, can also experience positive transformations. The possible role of counselling psychologists and psychotherapists in this journey of personal positive transformation of bereaved individuals should be further explored and enhanced.
The Executive Woman: Rhetorical Visions in "Management Review," 1951-1981.

ERIC Educational Resources Information Center

Hanson, Gail

To examine the attitudes of management literature toward female managers, 27 articles published in "Management Review" between 1951 and 1981 were subjected to both content analysis and fantasy theme analysis with attention to dramatistic plot elements. Used to identify and categorize prominent themes, content analysis revealed three…
Applications of compact accelerator-driven neutron sources: An updated assessment from the perspective of materials research in Italy

DOE PAGES

Andreani, C.; Anderson, I. S.; Carpenter, J. M.; ...

2014-12-24

In 2005 the International Atomic Energy Agency (IAEA) in Vienna published a report [1] on ‘Development Opportunities of Small and Medium Scale Accelerator Driven Neutron Sources’ which summarized the prospect of smaller sources in supporting the large spallation neutron sources for materials characterization and instrumentation, a theme advocated by Bauer, Clausen, Mank, and Mulhauser in previous publications [2-4]. In 2010 the Union for Compact Accelerator-driven Neutron Sources (UCANS) was established [5], galvanizing cross-disciplinary collaborations on new source and neutronics development and expanded applications based on both slow-neutron scattering and other neutron-matter interactions of neutron energies ranging from 10⁻⁶ to 10²more » MeV [6]. Here, we first cover the recent development of ongoing and prospective projects of compact accelerator-driven neutron sources (CANS) but concentrate on prospective accelerators currently proposed in Italy. Two active R&D topics, irradiation effects on electronics and cultural heritage studies, are chosen to illustrate the impact of state-of-the-art CANS on these programs with respect to the characteristics and complementarity of the accelerator and neutronics systems as well as instrumentation development.« less
Playing at Crusoe: Domestic Imperatives and Models of Motherhood in Robinson Crusoe-Inspired Toys and Novels for Girls

ERIC Educational Resources Information Center

Hicks, Amy

2015-01-01

Carol Ryrie Brink's "Baby Island" (1998/1937) draws directly from Daniel Defoe's Robinson Crusoe (2007/1719) but revises the prototypical castaway novel by depicting two young girls who not only ensure their own survival but also mother four babies while cast away. Preceded by Crusoe-themed toys such as tea sets and paper dolls that…
Approach and rationale to developing an IPM program: Examples of insect management in British Columbia reforestation nurseries

Treesearch

David Trotter

2002-01-01

Insects, weeds, and diseases are a significant part of the production process that nursery growers must consider in order to effectively grow the desired conifer seedling. For the pests and seedlings, the underlying theme is survival, which encompasses 3 major components: stimulus, recognition, and response (Shigo 1991). Thus, the continuation of any system depends on...
Large Synoptic Survey Telescope: From Science Drivers to Reference Design

DTIC Science & Technology

2008-01-01

faint time domain. The LSST design is driven by four main science themes: constraining dark energy and dark matter , taking an inventory of the Solar...Energy and Dark Matter (2) Taking an Inventory of the Solar System (3) Exploring the Transient Optical Sky (4) Mapping the Milky Way Each of these four...Constraining Dark Energy and Dark Matter Current models of cosmology require the exis- tence of both dark matter and dark energy to match observational

Biomarkers: Delivering on the expectation of molecularly driven, quantitative health.

PubMed

Wilson, Jennifer L; Altman, Russ B

2018-02-01

Biomarkers are the pillars of precision medicine and are delivering on expectations of molecular, quantitative health. These features have made clinical decisions more precise and personalized, but require a high bar for validation. Biomarkers have improved health outcomes in a few areas such as cancer, pharmacogenetics, and safety. Burgeoning big data research infrastructure, the internet of things, and increased patient participation will accelerate discovery in the many areas that have not yet realized the full potential of biomarkers for precision health. Here we review themes of biomarker discovery, current implementations of biomarkers for precision health, and future opportunities and challenges for biomarker discovery. Impact statement Precision medicine evolved because of the understanding that human disease is molecularly driven and is highly variable across patients. This understanding has made biomarkers, a diverse class of biological measurements, more relevant for disease diagnosis, monitoring, and selection of treatment strategy. Biomarkers' impact on precision medicine can be seen in cancer, pharmacogenomics, and safety. The successes in these cases suggest many more applications for biomarkers and a greater impact for precision medicine across the spectrum of human disease. The authors assess the status of biomarker-guided medical practice by analyzing themes for biomarker discovery, reviewing the impact of these markers in the clinic, and highlight future and ongoing challenges for biomarker discovery. This work is timely and relevant, as the molecular, quantitative approach of precision medicine is spreading to many disease indications.
The nature of excellent clinicians at an academic health science center: a qualitative study.

PubMed

Mahant, Sanjay; Jovcevska, Vesna; Wadhwa, Anupma

2012-12-01

To understand the nature of excellent clinicians at an academic health science center by exploring how and why excellent clinicians achieve high performance. From 2008 to 2010, the authors conducted a qualitative study using a grounded theory approach. Members of the Clinical Advisory Committee in the Department of Pediatrics at the University of Toronto nominated peers whom they saw as excellent clinicians. The authors then conducted in-depth interviews with the most frequently nominated clinicians. They audio-recorded and transcribed the interviews and coded the transcripts to identify emergent themes. From interviews with 13 peer-nominated, excellent clinicians, a model emerged. Dominant themes fell into three categories: (1) core philosophy, (2) deliberate activities, and (3) everyday practice. Excellent clinicians are driven by a core philosophy defined by high intrinsic motivation and passion for patient care and humility. They refine their clinical skills through two deliberate activities-reflective clinical practice and scholarship. Their high performance in everyday practice is characterized by clinical skills and cognitive ability, people skills, engagement, and adaptability. A rich theory emerged explaining how excellent clinicians, driven by a core philosophy and engaged in deliberate activities, achieve high performance in everyday practice. This theory of the nature of excellent clinicians provides a holistic perspective of individual performance, informs medical education, supports faculty career development, and promotes clinical excellence in the culture of academic medicine.
Building Stories about Sea Level Rise through Interactive Visualizations

NASA Astrophysics Data System (ADS)

Stephens, S. H.; DeLorme, D. E.; Hagen, S. C.

2013-12-01

Digital media provide storytellers with dynamic new tools for communicating about scientific issues via interactive narrative visualizations. While traditional storytelling uses plot, characterization, and point of view to engage audiences with underlying themes and messages, interactive visualizations can be described as 'narrative builders' that promote insight through the process of discovery (Dove, G. & Jones, S. 2012, Proc. IHCI 2012). Narrative visualizations are used in online journalism to tell complex stories that allow readers to select aspects of datasets to explore and construct alternative interpretations of information (Segel, E. & Heer, J. 2010, IEEE Trans. Vis. Comp. Graph.16, 1139), thus enabling them to participate in the story-building process. Nevertheless, narrative visualizations also incorporate author-selected narrative elements that help guide and constrain the overall themes and messaging of the visualization (Hullman, J. & Diakopoulos, N. 2011, IEEE Trans. Vis. Comp. Graph. 17, 2231). One specific type of interactive narrative visualization that is used for science communication is the sea level rise (SLR) viewer. SLR viewers generally consist of a base map, upon which projections of sea level rise scenarios can be layered, and various controls for changing the viewpoint and scenario parameters. They are used to communicate the results of scientific modeling and help readers visualize the potential impacts of SLR on the coastal zone. Readers can use SLR viewers to construct personal narratives of the effects of SLR under different scenarios in locations that are important to them, thus extending the potential reach and impact of scientific research. With careful selection of narrative elements that guide reader interpretation, the communicative aspects of these visualizations may be made more effective. This presentation reports the results of a content analysis of a subset of existing SLR viewers selected in order to comprehensively identify and characterize the narrative elements that contribute to this storytelling medium. The results describe four layers of narrative elements in these viewers: data, visual representations, annotations, and interactivity; and explain the ways in which these elements are used to communicate about SLR. Most existing SLR viewers have been designed with attention to technical usability; however, careful design of narrative elements could increase their overall effectiveness as story-building tools. The analysis concludes with recommendations for narrative elements that should be considered when designing new SLR viewers, and offers suggestions for integrating these components to balance author-driven and reader-driven design features for more effective messaging.
A hermeneutic phenomenological understanding of men's healing from childhood maltreatment.

PubMed

Willis, Danny G; Rhodes, Alison M; Dionne-Odom, James N; Lee, Kayoung; Terreri, Pamela

2015-03-01

To describe and interpret men's experience of healing from childhood maltreatment. Hermeneutic phenomenological. In-depth interviews. Community-based purposive, maximum variation sampling approach. Recruitment occurred through posting flyers and advertisements. Verbatim data were analyzed and themes of the meaning of healing were identified. The meaning of healing was interpreted as "moving beyond suffering." Five themes were identified to capture the multidimensional nature of the phenomenon: (a) breaking through the masculine veneer, (b) finding meaning, (c) choosing to live well, (d) caring for the self using holistic healing methods, and (e) engaging in humanizing relationships. Men who survived childhood maltreatment have needs to heal holistically mind, body, and spirit. Meeting their needs requires the provision of highly compassionate humanistic healing environments and healing-promotive nursing care. © The Author(s) 2014.
One Health/EcoHealth capacity building programs in South and South East Asia: a mixed method rapid systematic review.

PubMed

Chatterjee, Pranab; Chauhan, Abhimanyu Singh; Joseph, Jessy; Kakkar, Manish

2017-09-29

Although One Health (OH) or EcoHealth (EH) have been acknowledged to provide comprehensive and holistic approaches to study complex problems, like zoonoses and emerging infectious diseases, there remains multiple challenges in implementing them in a problem-solving paradigm. One of the most commonly encountered barriers, especially in low- and middle-income countries, is limited capacity to undertake OH/EH inquiries. A rapid review was undertaken to conduct a situation analysis of the existing OH/EH capacity building programs, with a focused analysis of those programs with extensive OH engagement, to help map the current efforts in this area. A listing of the OH/EH projects/initiatives implemented in South Asia (SA) and South East Asia (SEA) was done, followed by analysis of documents related to the projects, available from peer-reviewed or grey literature sources. Quantitative data was extracted using a data extraction format, and a free listing of qualitative themes was undertaken. In SEA, 13 unique OH/EH projects, with 37 capacity building programs, were identified. In contrast, in SA, the numbers were 8 and 11 respectively. In SA, programs were oriented to develop careers in program management, whereas, in SEA, the emphasis was on research. Two thirds of the programs in SEA had extensive OH engagement, whereas only one third of those in SA did. The target for the SEA programs was wider, including a population more representative of OH stakes. SEA program themes reveal utilization of multiple approaches, usually in shorter terms, and are growing towards integration with the traditional curricula. Such convergence of themes was lacking in SA programs. In both regions, the programs were driven by external donor agencies, with minimal local buy-in. There is limited investment in research capacity building in both SA and SEA. The situation appears to be more stark in SA, whilst SEA has been able to use the systematic investment and support to develop the OH/EH agenda and strategize capacity building in the core competencies. In order to effectively address the disease emergence hotspots in these regions, there needs to be strategic funding decisions targeting capacity building in the core OH/EH competencies especially related to transdisciplinarity, systems thinking, and adaptive management.
Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission

DOE PAGES

Parham, Paul E.; Waldock, Joanna; Christophides, George K.; ...

2015-02-16

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is due not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but, perhaps most crucially, the multitude of epidemiological, ecological, and socioeconomic factors that drive VBD transmission, and this complexity has generated considerable debate over the last 10-15 years. Inmore » this article, and Theme Issue, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions, and, crucially, offer some solutions for the field moving forwards. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector-pathogen systems. This Theme Issue seeks to cover both, reflected in the breadth and depth of the topics and VBD-systems considered, itself strongly indicative of the challenging, but necessary, multidisciplinary nature of this research field.« less
Evolution of transcriptional enhancers and animal diversity

PubMed Central

Rubinstein, Marcelo; de Souza, Flávio S. J.

2013-01-01

Deciphering the genetic bases that drive animal diversity is one of the major challenges of modern biology. Although four decades ago it was proposed that animal evolution was mainly driven by changes in cis-regulatory DNA elements controlling gene expression rather than in protein-coding sequences, only now are powerful bioinformatics and experimental approaches available to accelerate studies into how the evolution of transcriptional enhancers contributes to novel forms and functions. In the introduction to this Theme Issue, we start by defining the general properties of transcriptional enhancers, such as modularity and the coexistence of tight sequence conservation with transcription factor-binding site shuffling as different mechanisms that maintain the enhancer grammar over evolutionary time. We discuss past and current methods used to identify cell-type-specific enhancers and provide examples of how enhancers originate de novo, change and are lost in particular lineages. We then focus in the central part of this Theme Issue on analysing examples of how the molecular evolution of enhancers may change form and function. Throughout this introduction, we present the main findings of the articles, reviews and perspectives contributed to this Theme Issue that together illustrate some of the great advances and current frontiers in the field. PMID:24218630
In their own words: A qualitative study of the psychosocial concerns of posttreatment and long-term lung cancer survivors.

PubMed

Rohan, Elizabeth A; Boehm, Jennifer; Allen, Kristine Gabuten; Poehlman, Jon

2016-01-01

Although lung cancer is the deadliest type of cancer, survival rates are improving. To address the dearth of literature about the concerns of lung cancer survivors, the authors conducted 21 in-depth interviews with lung cancer survivors that focused on experiences during diagnosis, treatment, and long-term survivorship. Emergent themes included feeling blamed for having caused their cancer, being stigmatized as throwaways, and long-term survivors' experiencing surprise that they are still alive, given poor overall survival rates. Survivors also desired increased public support. It is imperative for healthcare and public health professionals to learn more about needs of this population.
In their own words: A qualitative study of the psychosocial concerns of posttreatment and long-term lung cancer survivors

PubMed Central

Rohan, Elizabeth A.; Boehm, Jennifer; Allen, Kristine Gabuten; Poehlman, Jon

2017-01-01

Although lung cancer is the deadliest type of cancer, survival rates are improving. To address the dearth of literature about the concerns of lung cancer survivors, the authors conducted 21 in-depth interviews with lung cancer survivors that focused on experiences during diagnosis, treatment, and long-term survivorship. Emergent themes included feeling blamed for having caused their cancer, being stigmatized as throwaways, and long-term survivors’ experiencing surprise that they are still alive, given poor overall survival rates. Survivors also desired increased public support. It is imperative for healthcare and public health professionals to learn more about needs of this population. PMID:26764569
Association between expression of random gene sets and survival is evident in multiple cancer types and may be explained by sub-classification.

PubMed

Shimoni, Yishai

2018-02-01

One of the goals of cancer research is to identify a set of genes that cause or control disease progression. However, although multiple such gene sets were published, these are usually in very poor agreement with each other, and very few of the genes proved to be functional therapeutic targets. Furthermore, recent findings from a breast cancer gene-expression cohort showed that sets of genes selected randomly can be used to predict survival with a much higher probability than expected. These results imply that many of the genes identified in breast cancer gene expression analysis may not be causal of cancer progression, even though they can still be highly predictive of prognosis. We performed a similar analysis on all the cancer types available in the cancer genome atlas (TCGA), namely, estimating the predictive power of random gene sets for survival. Our work shows that most cancer types exhibit the property that random selections of genes are more predictive of survival than expected. In contrast to previous work, this property is not removed by using a proliferation signature, which implies that proliferation may not always be the confounder that drives this property. We suggest one possible solution in the form of data-driven sub-classification to reduce this property significantly. Our results suggest that the predictive power of random gene sets may be used to identify the existence of sub-classes in the data, and thus may allow better understanding of patient stratification. Furthermore, by reducing the observed bias this may allow more direct identification of biologically relevant, and potentially causal, genes.
Epigenetic inactivation of TWIST2 in acute lymphoblastic leukemia modulates proliferation, cell survival and chemosensitivity

PubMed Central

Thathia, Shabnam H.; Ferguson, Stuart; Gautrey, Hannah E.; van Otterdijk, Sanne D.; Hili, Michela; Rand, Vikki; Moorman, Anthony V.; Meyer, Stefan; Brown, Robert; Strathdee, Gordon

2012-01-01

Background Altered regulation of many transcription factors has been shown to be important in the development of leukemia. TWIST2 modulates the activity of a number of important transcription factors and is known to be a regulator of hematopoietic differentiation. Here, we investigated the significance of epigenetic regulation of TWIST2 in the control of cell growth and survival and in response to cytotoxic agents in acute lymphoblastic leukemia. Design and Methods TWIST2 promoter methylation status was assessed quantitatively, by combined bisulfite and restriction analysis (COBRA) and pyrosequencing assays, in multiple types of leukemia and TWIST2 expression was determined by quantitative reverse transcriptase polymerase chain reaction analysis. The functional role of TWIST2 in cell proliferation, survival and response to chemotherapy was assessed in transient and stable expression systems. Results We found that TWIST2 was inactivated in more than 50% of cases of childhood and adult acute lymphoblastic leukemia through promoter hypermethylation and that this epigenetic regulation was especially prevalent in RUNX1-ETV6-driven cases. Re-expression of TWIST2 in cell lines resulted in a dramatic reduction in cell growth and induction of apoptosis in the Reh cell line. Furthermore, re-expression of TWIST2 resulted in increased sensitivity to the chemotherapeutic agents etoposide, daunorubicin and dexamethasone and TWIST2 hypermethylation was almost invariably found in relapsed adult acute lymphoblastic leukemia (91% of samples hypermethylated). Conclusions This study suggests a dual role for epigenetic inactivation of TWIST2 in acute lymphoblastic leukemia, initially through altering cell growth and survival properties and subsequently by increasing resistance to chemotherapy. PMID:22058208
Association between expression of random gene sets and survival is evident in multiple cancer types and may be explained by sub-classification

PubMed Central

2018-01-01

One of the goals of cancer research is to identify a set of genes that cause or control disease progression. However, although multiple such gene sets were published, these are usually in very poor agreement with each other, and very few of the genes proved to be functional therapeutic targets. Furthermore, recent findings from a breast cancer gene-expression cohort showed that sets of genes selected randomly can be used to predict survival with a much higher probability than expected. These results imply that many of the genes identified in breast cancer gene expression analysis may not be causal of cancer progression, even though they can still be highly predictive of prognosis. We performed a similar analysis on all the cancer types available in the cancer genome atlas (TCGA), namely, estimating the predictive power of random gene sets for survival. Our work shows that most cancer types exhibit the property that random selections of genes are more predictive of survival than expected. In contrast to previous work, this property is not removed by using a proliferation signature, which implies that proliferation may not always be the confounder that drives this property. We suggest one possible solution in the form of data-driven sub-classification to reduce this property significantly. Our results suggest that the predictive power of random gene sets may be used to identify the existence of sub-classes in the data, and thus may allow better understanding of patient stratification. Furthermore, by reducing the observed bias this may allow more direct identification of biologically relevant, and potentially causal, genes. PMID:29470520
Finding order in complexity: themes from the career of Dr. Robert F. Wagner

NASA Astrophysics Data System (ADS)

Myers, Kyle J.

2009-02-01

Over the course of his long and productive career, Dr. Robert F. Wagner built a framework for the evaluation of imaging systems based on a task-based, decision theoretic approach. His most recent contributions involved the consideration of the random effects associated with multiple readers of medical images and the logical extension of this work to the problem of the evaluation of multiple competing classifiers in statistical pattern recognition. This contemporary work expanded on familiar themes from Bob's many SPIE presentations in earlier years. It was driven by the need for practical solutions to current problems facing FDA'S Center for Devices and Radiological Health and the medical imaging community regarding the assessment of new computer-aided diagnosis tools and Bob's unique ability to unify concepts across a range of disciplines as he gave order to increasingly complex problems in our field.
Family members' experiences with intensive care unit diaries when the patient does not survive.

PubMed

Johansson, Maria; Wåhlin, Ingrid; Magnusson, Lennart; Runeson, Ingrid; Hanson, Elizabeth

2018-03-01

The aim of the study was to explore how family members experienced the use of a diary when a relative does not survive the stay in the intensive care unit (ICU). A qualitative method with a hermeneutic approach was used. Nine participants who read/wrote eight diaries in total were interviewed. The collected data were analysed using a hermeneutic technique inspired by Geanellos. The analysis revealed an overall theme 'the diary was experienced as a bridge connecting the past with the future', which was a metaphor referring to the temporal aspect where there was the period with the diary up until the patient's death and then the postbereavement period. The diary contributed to both a rational and emotional understanding of the death of the patient and disclosed glimmers of light that still existed before the illness deteriorated. Further, the diary bridged the space between family members themselves and between family and nursing staff. It helped to maintain a feeling of togetherness and engagement in the care of the patient which family members found comforting. Family members of nonsurvivors had a need to have the ICU time explained and expressed. The diary might work as a form of 'survival kit' to gain coherence and understanding; to meet their needs during the hospital stay; and, finally, to act as a bereavement support by processing the death of the patient. © 2017 Nordic College of Caring Science.
Heterogeneities in the case fatality ratio in the West African Ebola outbreak 2013–2016

PubMed Central

Ariyarajah, Archchun; Blake, Isobel M.; Dorigatti, Ilaria; Eckmanns, Tim; Fraser, Christophe; Hinsley, Wes; Jombart, Thibaut; Mills, Harriet L.; Newton, Emily; Nouvellet, Pierre; Perkins, Devin; Riley, Steven; Schumacher, Dirk; Shah, Anita; Van Kerkhove, Maria D.; Dye, Christopher; Ferguson, Neil M.

2017-01-01

The 2013–2016 Ebola outbreak in West Africa is the largest on record with 28 616 confirmed, probable and suspected cases and 11 310 deaths officially recorded by 10 June 2016, the true burden probably considerably higher. The case fatality ratio (CFR: proportion of cases that are fatal) is a key indicator of disease severity useful for gauging the appropriate public health response and for evaluating treatment benefits, if estimated accurately. We analysed individual-level clinical outcome data from Guinea, Liberia and Sierra Leone officially reported to the World Health Organization. The overall mean CFR was 62.9% (95% CI: 61.9% to 64.0%) among confirmed cases with recorded clinical outcomes. Age was the most important modifier of survival probabilities, but country, stage of the epidemic and whether patients were hospitalized also played roles. We developed a statistical analysis to detect outliers in CFR between districts of residence and treatment centres (TCs), adjusting for known factors influencing survival and identified eight districts and three TCs with a CFR significantly different from the average. From the current dataset, we cannot determine whether the observed variation in CFR seen by district or treatment centre reflects real differences in survival, related to the quality of care or other factors or was caused by differences in reporting practices or case ascertainment. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’. PMID:28396479
Hispanic Graduate Students' Mentoring Themes: Gender Roles in a Bicultural Context

ERIC Educational Resources Information Center

Rudolph, Bonnie A.; Castillo, Carlos P.; Garcia, Vanessa G.; Martinez, Alina; Navarro, Fernando

2015-01-01

Male and female focus groups at a Hispanic Serving Institution (HSI) discussed mentoring of Hispanic graduate students. Using Thematic Analysis, investigators identified three main themes: Relationship Initiation and Development, Valued Relationship Qualities, and Context and Barriers. Relationship themes included mentor openness, trust,…
Enabling data-driven provenance in NetCDF, via OGC WPS operations. Climate Analysis services use case.

NASA Astrophysics Data System (ADS)

Mihajlovski, A.; Spinuso, A.; Plieger, M.; Som de Cerff, W.

2016-12-01

Modern Climate analysis platforms provide generic and standardized ways of accessing data and processing services. These are typically supported by a wide range of OGC formats and interfaces. However, the problem of instrumentally tracing the lineage of the transformations occurring on a dataset and its provenance remains an open challenge. It requires standard-driven and interoperable solutions to facilitate understanding, sharing of self-describing data products, fostering collaboration among peers. The CLIPC portal provided us real use case, where the need of an instrumented provenance management is fundamental. CLIPC provides a single point of access for scientific information on climate change. The data about the physical environment which is used to inform climate change policy and adaptation measures comes from several categories: satellite measurements, terrestrial observing systems, model projections and simulations and from re-analyses. This is made possible through the Copernicus Earth Observation Programme for Europe. With a backbone combining WPS and OPeNDAP services, CLIPC has two themes: 1. Harmonized access to climate datasets derived from models, observations and re-analyses 2. A climate impact tool kit to evaluate, rank and aggregate indicators The climate impact tool kit is realised with the orchestration of a number of WPS that ingest, normalize and combine NetCDF files. The WPS allowing this specific computation are hosted by the climate4impact portal, which is a more generic climate data-access and processing service. In this context, guaranteeing validation and reproducibility of results, is a clearly stated requirement to improve the quality of the results obtained by the combined analysis Two core contributions made, are the enabling of a provenance wrapper around WPS services and the enabling of provenance tracing within the NetCDF format, which adopts and extends the W3C's PROV model. To disseminate indicator data and create transformed data products, a standardized provenance, metadata and processing infrastructure is researched for CLIPC. These efforts will lead towards the provision of tools for further web service processing development and optimisation, opening up possibilities to scale and administer abstract users and data driven workflows.
The experience of hepatitis C treatment for people with a history of mental health problems: An interpretative phenomenological analysis.

PubMed

Ware, K; Davies, J; Rowse, G; Whittaker, S

2015-07-01

This qualitative study explores the experience of hepatitis C virus treatment for people with pre-existing mental health problems within a large city hospital. Four men and four women with pre-existing mental health problems who had received hepatitis C virus treatment took part in semi-structured interviews which were analysed using interpretative phenomenological analysis. A central theme of 'Self, stigma and change' was identified which interlinked with three other main themes of 'Coping and responding to treatment', 'Connectedness to others' and 'The impact of information'. These themes and their sub-themes are discussed in relation to existing literature and clinical practice guidelines. © The Author(s) 2013.
Designing for psychological change: individuals' reward and cost valuations in weight management.

PubMed

Hsu, Anne; Blandford, Ann

2014-06-26

Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. We applied a decision theory-based analysis in the domain of weight management to understand the rewards and costs that surround individuals' weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and costs surrounding weight management offers a range of new opportunities for the design of weight management technologies that enhance the encouraging factors and alleviate the discouraging ones.
Modeling workflow to design machine translation applications for public health practice

PubMed Central

Turner, Anne M.; Brownstein, Megumu K.; Cole, Kate; Karasz, Hilary; Kirchhoff, Katrin

2014-01-01

Objective Provide a detailed understanding of the information workflow processes related to translating health promotion materials for limited English proficiency individuals in order to inform the design of context-driven machine translation (MT) tools for public health (PH). Materials and Methods We applied a cognitive work analysis framework to investigate the translation information workflow processes of two large health departments in Washington State. Researchers conducted interviews, performed a task analysis, and validated results with PH professionals to model translation workflow and identify functional requirements for a translation system for PH. Results The study resulted in a detailed description of work related to translation of PH materials, an information workflow diagram, and a description of attitudes towards MT technology. We identified a number of themes that hold design implications for incorporating MT in PH translation practice. A PH translation tool prototype was designed based on these findings. Discussion This study underscores the importance of understanding the work context and information workflow for which systems will be designed. Based on themes and translation information workflow processes, we identified key design guidelines for incorporating MT into PH translation work. Primary amongst these is that MT should be followed by human review for translations to be of high quality and for the technology to be adopted into practice. Counclusion The time and costs of creating multilingual health promotion materials are barriers to translation. PH personnel were interested in MT's potential to improve access to low-cost translated PH materials, but expressed concerns about ensuring quality. We outline design considerations and a potential machine translation tool to best fit MT systems into PH practice. PMID:25445922

Room for improvement: patient, parent, and practitioners' perceptions of foot problems and foot care in juvenile idiopathic arthritis.

PubMed

Hendry, Gordon J; Turner, Debbie E; Lorgelly, Paula K; Woodburn, James

2012-11-01

To explore the perceived impact of disease-related foot problems and foot care in juvenile idiopathic arthritis (JIA) from the perspectives of patients, parents, pediatric rheumatologists, and health professionals. A qualitative study using an interpretative phenomenological approach. Outpatients department, public health service children's hospital. Patients (N=15; 4 adult patients, 2 parents of children with JIA, 3 pediatric rheumatologists, and 6 health professionals) from 2 National Health Service rheumatology centers (1 pediatric and 1 adult). Not applicable. Qualitative outcomes were participants' perceptions elicited using semistructured interviews (telephone or face-to-face) and focus groups using an interpretative phenomenological approach. A data-driven inductive approach to coding and theme development was adopted for transcript analysis. Participants volunteered to take part in a total of 7 interviews and 2 focus groups. The analysis revealed 6 key themes related to the impact of foot problems and perceptions of foot care from respective groups. These were the following: (1) pain, (2) mobility impairment, (3) reduced ability to perform activities of daily living, (4) footwear difficulties, (5) poor referral pathways/delayed access to care, and (6) lack of evidence in support of conservative foot care. Several areas for development of foot care services were identified including a need for improved referral pathways, shorter waiting times for initial consultations, greater attention to patient compliance, and a need for better evidence in support of customized foot orthoses. Several key foot health-related outcomes were identified, which may be of importance for measuring therapeutic response to foot-related interventions. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Development and implementation of a Bayesian-based aquifer vulnerability assessment in Florida

USGS Publications Warehouse

Arthur, J.D.; Wood, H.A.R.; Baker, A.E.; Cichon, J.R.; Raines, G.L.

2007-01-01

The Florida Aquifer Vulnerability Assessment (FAVA) was designed to provide a tool for environmental, regulatory, resource management, and planning professionals to facilitate protection of groundwater resources from surface sources of contamination. The FAVA project implements weights-of-evidence (WofE), a data-driven, Bayesian-probabilistic model to generate a series of maps reflecting relative aquifer vulnerability of Florida's principal aquifer systems. The vulnerability assessment process, from project design to map implementation is described herein in reference to the Floridan aquifer system (FAS). The WofE model calculates weighted relationships between hydrogeologic data layers that influence aquifer vulnerability and ambient groundwater parameters in wells that reflect relative degrees of vulnerability. Statewide model input data layers (evidential themes) include soil hydraulic conductivity, density of karst features, thickness of aquifer confinement, and hydraulic head difference between the FAS and the watertable. Wells with median dissolved nitrogen concentrations exceeding statistically established thresholds serve as training points in the WofE model. The resulting vulnerability map (response theme) reflects classified posterior probabilities based on spatial relationships between the evidential themes and training points. The response theme is subjected to extensive sensitivity and validation testing. Among the model validation techniques is calculation of a response theme based on a different water-quality indicator of relative recharge or vulnerability: dissolved oxygen. Successful implementation of the FAVA maps was facilitated by the overall project design, which included a needs assessment and iterative technical advisory committee input and review. Ongoing programs to protect Florida's springsheds have led to development of larger-scale WofE-based vulnerability assessments. Additional applications of the maps include land-use planning amendments and prioritization of land purchases to protect groundwater resources. ?? International Association for Mathematical Geology 2007.
Cancer of the esophagus and esophagogastric junction: data-driven staging for the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer Cancer Staging Manuals.

PubMed

Rice, Thomas W; Rusch, Valerie W; Ishwaran, Hemant; Blackstone, Eugene H

2010-08-15

Previous American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) stage groupings for esophageal cancer have not been data driven or harmonized with stomach cancer. At the request of the AJCC, worldwide data from 3 continents were assembled to develop data-driven, harmonized esophageal staging for the seventh edition of the AJCC/UICC cancer staging manuals. All-cause mortality among 4627 patients with esophageal and esophagogastric junction cancer who underwent surgery alone (no preoperative or postoperative adjuvant therapy) was analyzed by using novel random forest methodology to produce stage groups for which survival was monotonically decreasing, distinctive, and homogeneous. For lymph node-negative pN0M0 cancers, risk-adjusted 5-year survival was dominated by pathologic tumor classification (pT) but was modulated by histopathologic cell type, histologic grade, and location. For lymph node-positive, pN+M0 cancers, the number of cancer-positive lymph nodes (a new pN classification) dominated survival. Resulting stage groupings departed from a simple, logical arrangement of TNM. Stage groupings for stage I and II adenocarcinoma were based on pT, pN, and histologic grade; and groupings for squamous cell carcinoma were based on pT, pN, histologic grade, and location. Stage III was similar for histopathologic cell types and was based only on pT and pN. Stage 0 and stage IV, by definition, were categorized as tumor in situ (Tis) (high-grade dysplasia) and pM1, respectively. The prognosis for patients with esophageal and esophagogastric junction cancer depends on the complex interplay of TNM classifications as well as nonanatomic factors, including histopathologic cell type, histologic grade, and cancer location. These features were incorporated into a data-driven staging of these cancers for the seventh edition of the AJCC/UICC cancer staging manuals. Copyright (c) 2010 American Cancer Society.
NASA’s Universe of Learning: Engaging Subject Matter Experts to Support Museum Alliance Science Briefings

NASA Astrophysics Data System (ADS)

Marcucci, Emma; Slivinski, Carolyn; Lawton, Brandon L.; Smith, Denise A.; Squires, Gordon K.; Biferno, Anya A.; Lestition, Kathleen; Cominsky, Lynn R.; Lee, Janice C.; Rivera, Thalia; Walker, Allyson; Spisak, Marilyn

2018-06-01

NASA's Universe of Learning creates and delivers science-driven, audience-driven resources and experiences designed to engage and immerse learners of all ages and backgrounds in exploring the universe for themselves. The project is a unique partnership between the Space Telescope Science Institute, Caltech/IPAC, Jet Propulsion Laboratory, Smithsonian Astrophysical Observatory, and Sonoma State University and is part of the NASA SMD Science Activation Collective. The NASA’s Universe of Learning projects pull on the expertise of subject matter experts (scientist and engineers) from across the broad range of NASA Astrophysics themes and missions. One such project, which draws strongly on the expertise of the community, is the NASA’s Universe of Learning Science Briefings, which is done in collaboration with the NASA Museum Alliance. This collaboration presents a monthly hour-long discussion on relevant NASA astrophysics topics or events to an audience composed largely of informal educators from informal learning environments. These professional learning opportunities use experts and resources within the astronomical community to support increased interest and engagement of the informal learning community in NASA Astrophysics-related concepts and events. Briefings are designed to create a foundation for this audience using (1) broad science themes, (2) special events, or (3) breaking science news. The NASA’s Universe of Learning team engages subject matter experts to be speakers and present their science at these briefings to provide a direct connection to NASA Astrophysics science and provide the audience an opportunity to interact directly with scientists and engineers involved in NASA missions. To maximize the usefulness of the Museum Alliance Science Briefings, each briefing highlights resources related to the science theme to support informal educators in incorporating science content into their venues and/or interactions with the public. During this presentation, learn how you can help contribute to the NASA’s Universe of Learning and take part in Science Briefings.
Being Critical: An Account of an Early Career Academic Working within and against Neoliberalism

ERIC Educational Resources Information Center

McLachlan, Fiona

2017-01-01

In 2014 I attended a symposium concerning Early Career Academics (ECAs) in the field of physical education and sport pedagogy. I was struck by the dominance of a particular theme at that symposium--that is, how to obtain a position and survive in academia. The aim of this paper is to use an inciting moment that occurred at this symposium as a…
An Analysis of the Climate Data Initiative's Data Collection

NASA Astrophysics Data System (ADS)

Ramachandran, R.; Bugbee, K.

2015-12-01

The Climate Data Initiative (CDI) is a broad multi-agency effort of the U.S. government that seeks to leverage the extensive existing federal climate-relevant data to stimulate innovation and private-sector entrepreneurship to support national climate-change preparedness. The CDI project is a systematic effort to manually curate and share openly available climate data from various federal agencies. To date, the CDI has curated seven themes, or topics, relevant to climate change resiliency. These themes include Coastal Flooding, Food Resilience, Water, Ecosystem Vulnerability, Human Health, Energy Infrastructure, and Transportation. Each theme was curated by subject matter experts who selected datasets relevant to the topic at hand. An analysis of the entire Climate Data Initiative data collection and the data curated for each theme offers insights into which datasets are considered most relevant in addressing climate resiliency. Other aspects of the data collection will be examined including which datasets were the most visited or popular and which datasets were the most sought after for curation by the theme teams. Results from the analysis of the CDI collection will be presented in this talk.
The science of ecological economics: a content analysis of Ecological Economics, 1989-2004.

PubMed

Luzadis, Valerie A; Castello, Leandro; Choi, Jaewon; Greenfield, Eric; Kim, Sung-kyun; Munsell, John; Nordman, Erik; Franco, Carol; Olowabi, Flavien

2010-01-01

The Ecological Economics journal is a primary source for inquiry on ecological economics and sustainability. To explore the scholarly pursuit of ecological economics, we conducted a content analysis of 200 randomly sampled research, survey, and methodological articles published in Ecological Economics during the 15-year period of 1989-2004. Results of the analysis were used to investigate facets of transdisciplinarity within the journal. A robust qualitative approach was used to gather and examine data to identify themes representing substantive content found within the span of sampled journal papers. The extent to which each theme was represented was counted as well as additional data, such as author discipline, year published, etc. Four main categories were revealed: (1) foundations (self-reflexive themes stemming from direct discussions about ecological economics); (2) human systems, represented by the themes of values, social indicators of well-being, intergenerational distribution, and equity; (3) biophysical systems, including themes, such as carrying capacity and scarcity, energy, and resource use, relating directly to the biophysical aspects of systems; and (4) policy and management encompassing themes of development, growth, trade, accounting, and valuation, as well as institutional structures and management. The results provide empirical evidence for discussing the future direction of ecological economic efforts.
Situation Awareness and Interruption Handling During Medication Administration.

PubMed

Sitterding, Mary Cathryn; Ebright, Patricia; Broome, Marion; Patterson, Emily S; Wuchner, Staci

2014-08-01

Medication administration error remains a leading cause of preventable death. A gap exists in understanding attentional dynamics, such as nurse situation awareness (SA) while managing interruptions during medication administration. The aim was to describe SA during medication administration and interruption handling strategies. A cross-sectional, descriptive design was used. Cognitive task analysis (CTA) methods informed analysis of 230 interruptions. Themes were analyzed by SA level. The nature of the stimuli noticed emerged as a Level 1 theme, in contrast to themes of uncertainty, relevance, and expectations (Level 2 themes). Projected or anticipated interventions (Level 3 themes) reflected workload balance between team and patient foregrounds. The prevalence of cognitive time-sharing during the medication administration process was remarkable. Findings substantiated the importance of the concept of SA within nursing as well as the contribution of CTA in understanding the cognitive work of nursing during medication administration. © The Author(s) 2014.
Profiles of genius and persecution

NASA Astrophysics Data System (ADS)

Falk, Dan

2009-10-01

It is no secret that Jewish scholars have made enormous contributions to science, achieving far more than one might expect given their relatively small numbers. They have also faced a staggering array of obstacles, culminating in the near-total destruction of European Jewry under the Nazis in the Second World War. These two themes - genius and persecution - are the twin currents that flow through Ioan James' compelling Driven to Innovate, uniting a series of profiles that might otherwise be of interest primarily to a more specialized audience.
Access to treatment and educational inequalities in cancer survival.

PubMed

Fiva, Jon H; Hægeland, Torbjørn; Rønning, Marte; Syse, Astri

2014-07-01

The public health care systems in the Nordic countries provide high quality care almost free of charge to all citizens. However, social inequalities in health persist. Previous research has, for example, documented substantial educational inequalities in cancer survival. We investigate to what extent this may be driven by differential access to and utilization of high quality treatment options. Quasi-experimental evidence based on the establishment of regional cancer wards indicates that (i) highly educated individuals utilized centralized specialized treatment to a greater extent than less educated patients and (ii) the use of such treatment improved these patients' survival. Copyright © 2014 Elsevier B.V. All rights reserved.
Fishing Quotas, Induced Allee Effect, and Fluctuation-Driven Extinction.

PubMed

Hastings, Harold M; Radin, Michael; Wiandt, Tamas

2017-01-01

We explore the potential of modifications to standard fishery models (for example Gordon-Schafer-Munro) to help understand events such as the collapse of the North Atlantic cod fishery. In particular we find that quota-driven and similar harvesting strategies induce an effective strong Allee effect (collapse if the population falls below a critical level). In the presence of environmental noise, fish population dynamics is similar to a random walk with (non-linear) drift. The expected survival time (first passage time to collapse) is shown to depend sensitively upon the amount of environmental noise and size of the 'safe zone' between the deterministic steady state population and the critical population level at which the system collapses; more precisely it is exponential in the cube of the size of the safe zone divided by the variance of the noise process. Similar scaling can be expected for more survival in more general systems with multiple steady states. Our calculations imply an amplification effect under which small increases in harvest yield large decreases in expected survival time, and one should be cautious in changes in harvesting, especially in fisheries with poor or limited data and fisheries affected by climate change.
Dync1h1 Mutation Causes Proprioceptive Sensory Neuron Loss and Impaired Retrograde Axonal Transport of Dorsal Root Ganglion Neurons.

PubMed

Zhao, Jing; Wang, Yi; Xu, Huan; Fu, Yuan; Qian, Ting; Bo, Deng; Lu, Yan-Xin; Xiong, Yi; Wan, Jun; Zhang, Xiang; Dong, Qiang; Chen, Xiang-Jun

2016-07-01

Sprawling (Swl) is a radiation-induced mutation which has been identified to have a nine base pair deletion in dynein heavy chain 1 (DYNC1H1: encoded by a single gene Dync1h1). This study is to investigate the phenotype and the underlying mechanism of the Dync1h1 mutant. To display the phenotype of Swl mutant mice, we examined the embryos of homozygous (Swl/Swl) and heterozygous (Swl/+) mice and their postnatal dorsal root ganglion (DRG) of surviving Swl/+ mice. The Swl/+ mice could survive for a normal life span, while Swl/Swl could only survive till embryonic (E) 8.5 days. Excessive apoptosis of Swl/+ DRG neurons was revealed during E11.5-E15.5 days, and the peak rate was at E13.5 days. In vitro study of mutated DRG neurons showed impaired retrograde transport of dynein-driven nerve growth factor (NGF). Mitochondria, another dynein-driven cargo, demonstrated much slower retrograde transport velocity in Swl/+ neurons than in wild-type (WT) neurons. Nevertheless, the Swl, Loa, and Cra mutations did not affect homodimerization of DYNC1H1. The Swl/Swl mutation of Dync1h1 gene led to embryonic mal-development and lethality, whereas the Swl/+ DRG neurons demonstrated deficient retrograde transport in dynein-driven cargos and excessive apoptosis during mid- to late-developmental stages. The underlying mechanism of the mutation may not be due to impaired homodimerization of DYNC1H1. © 2016 John Wiley & Sons Ltd.
Depression in female adolescents: an IPA analysis.

PubMed

Shaw, Samantha K; Dallos, Rudi; Shoebridge, Philip

2009-04-01

Six female adolescents participated in open-ended interviews regarding their experiences of depression. The transcripts of their interviews were explored using Interpretative Phenomenological Analysis (Smith, 1991). The analysis revealed three inter-connected super-ordinate themes which were: communication, hurt self, and difference. These themes centred on communication processes in participants' families and with peers, issues relating to shifts in identity through adolescence, and feelings of being damaged, distressed, and hurt. Amongst a range of potentially relevant perspectives, an attachment theory (Bowlby, 1969) orientation was found to be particularly relevant and helpful in interpreting the themes that captured these young women's experiences. Some implications for clinical practice are discussed.
Methodological challenges in qualitative content analysis: A discussion paper.

PubMed

Graneheim, Ulla H; Lindgren, Britt-Marie; Lundman, Berit

2017-09-01

This discussion paper is aimed to map content analysis in the qualitative paradigm and explore common methodological challenges. We discuss phenomenological descriptions of manifest content and hermeneutical interpretations of latent content. We demonstrate inductive, deductive, and abductive approaches to qualitative content analysis, and elaborate on the level of abstraction and degree of interpretation used in constructing categories, descriptive themes, and themes of meaning. With increased abstraction and interpretation comes an increased challenge to demonstrate the credibility and authenticity of the analysis. A key issue is to show the logic in how categories and themes are abstracted, interpreted, and connected to the aim and to each other. Qualitative content analysis is an autonomous method and can be used at varying levels of abstraction and interpretation. 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
Chemistry in Context: Analysis of Thematic Chemistry Videos Available Online

ERIC Educational Resources Information Center

Christensson, Camilla; Sjöström, Jesper

2014-01-01

United Nations declared 2011 to be the International Year of Chemistry. The Swedish Chemical Society chose twelve themes, one for each month, to highlight the connection of chemistry with everyday life. Examples of themes were fashion, climate change, love, sports, communication, health issues, and food. From the themes various context-based…
Adjuvant NY-ESO-1 vaccine immunotherapy in high-risk resected melanoma: a retrospective cohort analysis.

PubMed

Lattanzi, Michael; Han, Joseph; Moran, Una; Utter, Kierstin; Tchack, Jeremy; Sabado, Rachel Lubong; Berman, Russell; Shapiro, Richard; Huang, Hsin-Hui; Osman, Iman; Bhardwaj, Nina; Pavlick, Anna C

2018-05-18

Cancer-testis antigen NY-ESO-1 is a highly immunogenic melanoma antigen which has been incorporated into adjuvant vaccine clinical trials. Three such early-phase trials were conducted at our center among patients with high-risk resected melanoma. We herein report on the pooled long-term survival outcomes of these patients in comparison to historical controls. All melanoma patients treated at NYU Langone Health under any of three prospective adjuvant NY-ESO-1 vaccine trials were retrospectively pooled into a single cohort. All such patients with stage III melanoma were subsequently compared to historical control patients identified via a prospective institutional database with protocol-driven follow-up. Survival times were calculated using the Kaplan-Meier method, and Cox proportional hazard models were employed to identify significant prognostic factors and control for confounding variables. A total of 91 patients were treated with an NY-ESO-1 vaccine for the treatment of high-risk resected melanoma. Of this group, 67 patients were stage III and were selected for comparative analysis with 123 historical control patients with resected stage III melanoma who received no adjuvant therapy. Among the pooled vaccine cohort (median follow-up 61 months), the estimated median recurrence-free survival was 45 months, while the median overall survival was not yet reached. In the control cohort of 123 patients (median follow-up 30 months), the estimated median recurrence-free and overall survival were 22 and 58 months, respectively. Within the retrospective stage III cohort, NY-ESO-1 vaccine was associated with decreased risk of recurrence (HR = 0.56, p < 0.01) and death (HR = 0.51, p = 0.01). Upon controlling for sub-stage, the adjuvant NY-ESO-1 clinical trial cohort continued to exhibit decreased risk of recurrence (HR = 0.45, p < 0.01) and death (HR = 0.40, p < 0.01). In this small retrospective cohort of resected stage III melanoma patients, adjuvant NY-ESO-1 vaccine immunotherapy was associated with longer recurrence-free and overall survival relative to historical controls. These data support the continued investigation of adjuvant NY-ESO-1 based immunotherapy regimens in melanoma.
Radiobiological Effectiveness of Ultrashort Laser-Driven Electron Bunches: Micronucleus Frequency, Telomere Shortening and Cell Viability.

PubMed

Andreassi, Maria Grazia; Borghini, Andrea; Pulignani, Silvia; Baffigi, Federica; Fulgentini, Lorenzo; Koester, Petra; Cresci, Monica; Vecoli, Cecilia; Lamia, Debora; Russo, Giorgio; Panetta, Daniele; Tripodi, Maria; Gizzi, Leonida A; Labate, Luca

2016-09-01

Laser-driven electron accelerators are capable of producing high-energy electron bunches in shorter distances than conventional radiofrequency accelerators. To date, our knowledge of the radiobiological effects in cells exposed to electrons using a laser-plasma accelerator is still very limited. In this study, we compared the dose-response curves for micronucleus (MN) frequency and telomere length in peripheral blood lymphocytes exposed to laser-driven electron pulse and X-ray radiations. Additionally, we evaluated the effects on cell survival of in vitro tumor cells after exposure to laser-driven electron pulse compared to electron beams produced by a conventional radiofrequency accelerator used for intraoperative radiation therapy. Blood samples from two different donors were exposed to six radiation doses ranging from 0 to 2 Gy. Relative biological effectiveness (RBE) for micronucleus induction was calculated from the alpha coefficients for electrons compared to X rays (RBE = alpha laser/alpha X rays). Cell viability was monitored in the OVCAR-3 ovarian cancer cell line using trypan blue exclusion assay at day 3, 5 and 7 postirradiation (2, 4, 6, 8 and 10 Gy). The RBE values obtained by comparing the alpha values were 1.3 and 1.2 for the two donors. Mean telomere length was also found to be reduced in a significant dose-dependent manner after irradiation with both electrons and X rays in both donors studied. Our findings showed a radiobiological response as mirrored by the induction of micronuclei and shortening of telomere as well as by the reduction of cell survival in blood samples and cancer cells exposed in vitro to laser-generated electron bunches. Additional studies are needed to improve preclinical validation of the radiobiological characteristics and efficacy of laser-driven electron accelerators in the future.
A universal piezo-driven ultrasonic cell microinjection system.

PubMed

Huang, Haibo; Mills, James K; Lu, Cong; Sun, Dong

2011-08-01

Over the past decade, the rapid development of biotechnologies such as gene injection, in-vitro fertilization, intracytoplasmic sperm injection (ICSI) and drug development have led to great demand for highly automated, high precision equipment for microinjection. Recently a new cell injection technology using piezo-driven pipettes with a very small mercury column was proposed and successfully applied in ICSI to a variety of mammal species. Although this technique significantly improves the survival rates of the ICSI process, shortcomings due to the toxicity of mercury and damage to the cell membrane due to large lateral tip oscillations of the injector pipette may limit its application. In this paper, a new cell injection system for automatic batch injection of suspended cells is developed. A new design of the piezo-driven cell injector is proposed for automated suspended cell injection. This new piezo-driven cell injector design relocates the piezo oscillation actuator to the injector pipette which eliminates the vibration effect on other parts of the micromanipulator. A small piezo stack is sufficient to perform the cell injection process. Harmful lateral tip oscillations of the injector pipette are reduced substantially without the use of a mercury column. Furthermore, ultrasonic vibration micro-dissection (UVM) theory is utilized to analyze the piezo-driven cell injection process, and the source of the lateral oscillations of the injector pipette is investigated. From preliminary experiments of cell injection of a large number of zebrafish embryos (n = 200), the injector pipette can easily pierce through the cell membrane at a low injection speed and almost no deformation of the cell wall, and with a high success rate(96%) and survival rate(80.7%) This new injection approach shows good potential for precision injection with less damage to the injected cells.

Intracellular HMGB1 as a novel tumor suppressor of pancreatic cancer

PubMed Central

Kang, Rui; Xie, Yangchun; Zhang, Qiuhong; Hou, Wen; Jiang, Qingping; Zhu, Shan; Liu, Jinbao; Zeng, Dexing; Wang, Haichao; Bartlett, David L; Billiar, Timothy R; Zeh, Herbert J; Lotze, Michael T; Tang, Daolin

2017-01-01

Pancreatic ductal adenocarcinoma (PDAC) driven by oncogenic K-Ras remains among the most lethal human cancers despite recent advances in modern medicine. The pathogenesis of PDAC is partly attributable to intrinsic chromosome instability and extrinsic inflammation activation. However, the molecular link between these two events in pancreatic tumorigenesis has not yet been fully established. Here, we show that intracellular high mobility group box 1 (HMGB1) remarkably suppresses oncogenic K-Ras-driven pancreatic tumorigenesis by inhibiting chromosome instability-mediated pro-inflammatory nucleosome release. Conditional genetic ablation of either single or both alleles of HMGB1 in the pancreas renders mice extremely sensitive to oncogenic K-Ras-driven initiation of precursor lesions at birth, including pancreatic intraepithelial neoplasms, intraductal papillary mucinous neoplasms, and mucinous cystic neoplasms. Loss of HMGB1 in the pancreas is associated with oxidative DNA damage and chromosomal instability characterized by chromosome rearrangements and telomere abnormalities. These lead to inflammatory nucleosome release and propagate K-Ras-driven pancreatic tumorigenesis. Extracellular nucleosomes promote interleukin 6 (IL-6) secretion by infiltrating macrophages/neutrophils and enhance oncogenic K-Ras signaling activation in pancreatic lesions. Neutralizing antibodies to IL-6 or histone H3 or knockout of the receptor for advanced glycation end products all limit K-Ras signaling activation, prevent cancer development and metastasis/invasion, and prolong animal survival in Pdx1-Cre;K-RasG12D/+;Hmgb1−/− mice. Pharmacological inhibition of HMGB1 loss by glycyrrhizin limits oncogenic K-Ras-driven tumorigenesis in mice under inflammatory conditions. Diminished nuclear and total cellular expression of HMGB1 in PDAC patients correlates with poor overall survival, supporting intracellular HMGB1 as a novel tumor suppressor with prognostic and therapeutic relevance in PDAC. PMID:28374746
Differential parental care by adult Mountain Plovers, Charadrius montanus

USGS Publications Warehouse

Dinsmore, S.J.; Knopf, F.L.

2005-01-01

We studied chick survival of the Mountain Plover (Charadrius montanus) in Montana and found that chicks tended by females had higher survival rates than chicks tended by males, and that chick survival generally increased during the nesting season. Differences in chick survival were most pronounced early in the nesting season, and may be related to a larger sample of nests during this period. When compared to information about the nest survival of male- and female-tended plover nests, our chick data suggest a trade-off for adult plovers between the egg and chick phases of reproduction. Because Mountain Plover pairs have clutches at two nests at two different locations and show differential success between the sexes during the egg and chick phases, we offer that the Mountain Plover breeding system favours optimizing annual recruitment in a dynamic ecologic setting driven by annually unpredictable drought, grazing, and predation pressures.
“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
"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.
Overview of NASA's Universe of Learning: An Integrated Astrophysics STEM Learning and Literacy Program

NASA Astrophysics Data System (ADS)

Smith, Denise; Lestition, Kathleen; Squires, Gordon; Biferno, Anya A.; Cominsky, Lynn; Manning, Colleen; NASA's Universe of Learning Team

2018-01-01

NASA's Universe of Learning creates and delivers science-driven, audience-driven resources and experiences designed to engage and immerse learners of all ages and backgrounds in exploring the universe for themselves. The project is the result of a unique partnership between the Space Telescope Science Institute, Caltech/IPAC, Jet Propulsion Laboratory, Smithsonian Astrophysical Observatory, and Sonoma State University, and is one of 27 competitively-selected cooperative agreements within the NASA Science Mission Directorate STEM Activation program. The NASA's Universe of Learning team draws upon cutting-edge science and works closely with Subject Matter Experts (scientists and engineers) from across the NASA Astrophysics Physics of the Cosmos, Cosmic Origins, and Exoplanet Exploration themes. Together we develop and disseminate data tools and participatory experiences, multimedia and immersive experiences, exhibits and community programs, and professional learning experiences that meet the needs of our audiences, with attention to underserved and underrepresented populations. In doing so, scientists and educators from the partner institutions work together as a collaborative, integrated Astrophysics team to support NASA objectives to enable STEM education, increase scientific literacy, advance national education goals, and leverage efforts through partnerships. Robust program evaluation is central to our efforts, and utilizes portfolio analysis, process studies, and studies of reach and impact. This presentation will provide an overview of NASA's Universe of Learning, our direct connection to NASA Astrophysics, and our collaborative work with the NASA Astrophysics science community.
Clinical decision support for genetically guided personalized medicine: a systematic review

PubMed Central

Welch, Brandon M

2013-01-01

Objective To review the literature on clinical decision support (CDS) for genetically guided personalized medicine (GPM). Materials and Methods MEDLINE and Embase were searched from 1990 to 2011. The manuscripts included were summarized, and notable themes and trends were identified. Results Following a screening of 3416 articles, 38 primary research articles were identified. Focal areas of research included family history-driven CDS, cancer management, and pharmacogenomics. Nine randomized controlled trials of CDS interventions for GPM were identified, seven of which reported positive results. The majority of manuscripts were published on or after 2007, with increased recent focus on genotype-driven CDS and the integration of CDS within primary clinical information systems. Discussion Substantial research has been conducted to date on the use of CDS to enable GPM. In a previous analysis of CDS intervention trials, the automatic provision of CDS as a part of routine clinical workflow had been identified as being critical for CDS effectiveness. There was some indication that CDS for GPM could potentially be effective without the CDS being provided automatically, but we did not find conclusive evidence to support this hypothesis. Conclusion To maximize the clinical benefits arising from ongoing discoveries in genetics and genomics, additional research and development is recommended for identifying how best to leverage CDS to bridge the gap between the promise and realization of GPM. PMID:22922173
Hazard Function Estimation with Cause-of-Death Data Missing at Random.

PubMed

Wang, Qihua; Dinse, Gregg E; Liu, Chunling

2012-04-01

Hazard function estimation is an important part of survival analysis. Interest often centers on estimating the hazard function associated with a particular cause of death. We propose three nonparametric kernel estimators for the hazard function, all of which are appropriate when death times are subject to random censorship and censoring indicators can be missing at random. Specifically, we present a regression surrogate estimator, an imputation estimator, and an inverse probability weighted estimator. All three estimators are uniformly strongly consistent and asymptotically normal. We derive asymptotic representations of the mean squared error and the mean integrated squared error for these estimators and we discuss a data-driven bandwidth selection method. A simulation study, conducted to assess finite sample behavior, demonstrates that the proposed hazard estimators perform relatively well. We illustrate our methods with an analysis of some vascular disease data.
Decisional strategy determines whether frame influences treatment preferences for medical decisions.

PubMed

Woodhead, Erin L; Lynch, Elizabeth B; Edelstein, Barry A

2011-06-01

Decision makers are influenced by the frame of information such that preferences vary depending on whether survival or mortality data are presented. Research is inconsistent as to whether and how age impacts framing effects. This paper presents two studies that used qualitative analyses of think-aloud protocols to understand how the type of information used in the decision making process varies by frame and age. In Study 1, 40 older adults, age 65 to 89, and 40 younger adults, age 18 to 24, responded to a hypothetical lung cancer scenario in a within-subject design. Participants received both a survival and mortality frame. Qualitative analyses revealed that two main decisional strategies were used by all participants: one strategy reflected a data-driven decisional process, whereas the other reflected an experience-driven process. Age predicted decisional strategy, with older adults less likely to use a data-driven strategy. Frame interacted with strategy to predict treatment choice; only those using a data-driven strategy demonstrated framing effects. In Study 2, 61 older adults, age 65 to 98, and 63 younger adults, age 18 to 30, responded to the same scenarios as in Study 1 in a between-subject design. The results of Study 1 were replicated, with age significantly predicting decisional strategy and frame interacting with strategy to predict treatment choice. Findings suggest that framing effects may be more related to decisional strategy than to age. (c) 2011 APA, all rights reserved.
Soil-borne pathogens restrict the recruitment of a subtropical tree: a distance-dependent effect.

PubMed

Xu, Meng; Wang, Yongfan; Liu, Yu; Zhang, Zhiming; Yu, Shixiao

2015-03-01

The Janzen-Connell hypothesis suggests that density- and/or distance-dependent juvenile mortality driven by host-specific natural enemies can explain high species diversity in tropical forests. However, such density and distance effects may not occur simultaneously and may not be driven by the same mechanism. Also, reports of attempts to identify and quantify the differences between these processes in tropical forests are scarce. In a primary subtropical forest in China, we (1) experimentally examined the relative influence of the distance to parent trees vs. conspecific seedling density on mortality patterns in Engelhardia fenzelii, (2) tested the role of soil-borne pathogens in driving density- or distance-dependent processes that cause seedling mortality, and (3) inspected the susceptibilities of different tree species to soil biota of E. fenzelii and the effects of soil biota from different tree species on E. fenzelii. The results from these field experiments showed that distance- rather than density-dependent processes driven by soil pathogens strongly affect the seedling survival of this species in its first year. We also observed increased survival of a fungicide treatment for E. fenzelii seedlings in the parent soil but not for the seedlings of the other three species in the E. fenzelii parent soil, or for E. fenzelii seedlings in the parent soil of three other species. This study illustrates how the distance-dependent pattern of seedling recruitment for this species is driven by soil pathogens, a mechanism that likely restricts the dominance of this abundant species.
Mental Health Consumer Experiences and Strategies When Seeking Physical Health Care

PubMed Central

Ewart, Stephanie B.; Bocking, Julia; Happell, Brenda; Platania-Phung, Chris; Stanton, Robert

2016-01-01

People with mental illness have higher rates of physical health problems and consequently live significantly shorter lives. This issue is not yet viewed as a national health priority and research about mental health consumer views on accessing physical health care is lacking. The aim of this study is to explore the experience of mental health consumers in utilizing health services for physical health needs. Qualitative exploratory design was utilized. Semistructured focus groups were held with 31 consumer participants. Thematic analysis revealed that three main themes emerged: scarcity of physical health care, with problems accessing diagnosis, advice or treatment for physical health problems; disempowerment due to scarcity of physical health care; and tenuous empowerment describing survival resistance strategies utilized. Mental health consumers were concerned about physical health and the nonresponsive health system. A specialist physical health nurse consultant within mental health services should potentially redress this gap in health care provision. PMID:28462330
The search for and analysis of direct samples of early Solar System aqueous fluids.

PubMed

Zolensky, Michael E; Bodnar, Robert J; Yurimoto, Hisayoshi; Itoh, Shoichi; Fries, Marc; Steele, Andrew; Chan, Queenie H-S; Tsuchiyama, Akira; Kebukawa, Yoko; Ito, Motoo

2017-05-28

We describe the current state of the search for direct, surviving samples of early, inner Solar System fluids-fluid inclusions in meteorites. Meteoritic aqueous fluid inclusions are not rare, but they are very tiny and their characterization is at the state of the art for most analytical techniques. Meteoritic fluid inclusions offer us a unique opportunity to study early Solar System brines in the laboratory. Inclusion-by-inclusion analyses of the trapped fluids in carefully selected samples will, in the immediate future, provide us detailed information on the evolution of fluids as they interacted with anhydrous solid materials. Thus, real data can replace calculated fluid compositions in thermochemical calculations of the evolution of water and aqueous reactions in comets, asteroids, moons and the terrestrial planets.This article is part of the themed issue 'The origin, history and role of water in the evolution of the inner Solar System'. © 2017 The Author(s).
Physiotherapy students' conceptions of skill at the beginning of their Bachelor studies.

PubMed

Kurunsaari, Merja; Piirainen, Arja; Tynjälä, Päivi

2015-05-01

Skills have recently received widespread attention in education policy documents and discussions. This article reports the results of research on Bachelor's degree physiotherapy students' conceptions of skill at the beginning of their studies. The aim of the present study was to examine how beginning students understand skill, and the focus was on conceptions of skill in general rather than on any particular skills. The participants of the study were 35 physiotherapy students. The data were gathered within the first two weeks of their university studies. Specifically, requested essays written by the students were analyzed using the phenomenographic approach. The data-driven analysis yielded four descriptive categories which reflect the students' conceptions of skill: (1) Talents; (2) Skills requiring individual practice; (3) Skills requiring social practice; and (4) Competence requiring collaboration. The categories form a hierarchy. The differences between the categories are described along seven themes of variation. The themes were named: (1) Acquisition; (2) Emotions; (3) Motivation; (4) Reflection; (5) Evaluation; (6) Agency; and (7) Social Environment. This hierarchical system of categories sheds new light on students' understanding of the skill. The findings can be used as a basis for planning physiotherapy curricula, especially for designing skills education and training, and for supporting students along their educational path, especially in offering opportunities for students to reflect on their skill conceptions. Ultimately, physiotherapy students' awareness of different skill conceptions and developing their skills to advise and treat will benefit patients.
Scheduling the Stork: Media Portrayals of Women's and Physicians' Reasons for Elective Cesarean Delivery.

PubMed

Campo-Engelstein, Lisa; Howland, Lauren E; Parker, Wendy M; Burcher, Paul

2015-06-01

Media interest in cesarean delivery has grown in recent years driven both by rising cesarean delivery rates and the decision by the American College of Obstetrics and Gynecology (ACOG) to permit elective cesarean (EC) delivery. A content analysis of United States newspaper and magazine articles from 2000 to 2013 (n = 131 articles) was completed to understand how the news media portrays ECs. The majority of articles (71.8%) emphasized reasons to support women having an EC, while 38.2 percent of the articles exhibited themes of physician support for ECs. Relatively few articles mentioned reasons against ECs either from the women's perspective (11.5%) or the practitioners' (3.8%). The most common themes given for women choosing ECs were convenience/scheduling (48.9%), avoidance of pain or fear of labor (29.8%), and physical harm to women from vaginal birth (17.6%). Doctors' perspectives were less prevalent in the media than women's perspectives, but when mentioned they were almost exclusively in support of ECs for reasons including avoiding malpractice (28.2%), avoiding physical harm to the woman or baby (16.8%), and timing/scheduling (14.5%). Media coverage suggests ECs are widely accepted by both women and doctors, with women choosing an EC mainly for convenience/scheduling and fear. However, 43 percent of doctors surveyed by ACOG said they were not willing to perform the procedure, and surveys report that mothers rarely request an EC. © 2015 Wiley Periodicals, Inc.
Impact of Health Information Exchange on Emergency Medicine Clinical Decision Making.

PubMed

Gordon, Bradley D; Bernard, Kyle; Salzman, Josh; Whitebird, Robin R

2015-12-01

The objective of the study was to understand the immediate utility of health information exchange (HIE) on emergency department (ED) providers by interviewing them shortly after the information was retrieved. Prior studies of physician perceptions regarding HIE have only been performed outside of the care environment. Trained research assistants interviewed resident physicians, physician assistants and attending physicians using a semi-structured questionnaire within two hours of making a HIE request. The responses were recorded, then transcribed for qualitative analysis. The transcribed interviews were analyzed for emerging qualitative themes. We analyzed 40 interviews obtained from 29 providers. Primary qualitative themes discovered included the following: drivers for requests for outside information; the importance of unexpected information; historical lab values as reference points; providing context when determining whether to admit or discharge a patient; the importance of information in refining disposition; improved confidence of provider; and changes in decisions for diagnostic imaging. ED providers are driven to use HIE when they're missing a known piece of information. This study finds two additional impacts not previously reported. First, providers sometimes find additional unanticipated useful information, supporting a workflow that lowers the threshold to request external information. Second, providers sometimes report utility when no changes to their existing plan are made as their confidence is increased based on external records. Our findings are concordant with previous studies in finding exchanged information is useful to provide context for interpreting lab results, making admission decisions, and prevents repeat diagnostic imaging.
The culture of academic medicine: faculty perceptions of the lack of alignment between individual and institutional values.

PubMed

Pololi, Linda; Kern, David E; Carr, Phyllis; Conrad, Peter; Knight, Sharon

2009-12-01

Energized, talented faculty are essential to achieving the missions of academic medical centers (AMCs) in education, research and health care. The alignment of individuals' values with workplace experiences are linked to meaningfulness of work and productivity. To determine faculty values and their alignment with institutional values. A qualitative hypothesis-generating interview study to understand the professional experiences of faculty and organizational approach in five AMCs that were nationally representative in regional and organizational characteristics. Analysis was inductive and data driven. Using stratified, purposeful sampling, we interviewed 96 male and female faculty at different career stages (early career, plateaued, senior faculty and those who had left academic medicine) and diverse specialties (generalists, medical and surgical subspecialists, and research scientists). Dominant themes that emerged from the data. Faculty described values relating to excellence in clinical care, community service (including care for the underserved and disadvantaged), teaching, intellectual rigor/freedom and discovery, all values that mirror the stated missions of AMCs. However, many faculty also described behaviors that led them to conclude that their AMCs, in practice, undervalued excellence in clinical care, and their social and educational missions. Themes were seen across gender, career stage, race and discipline, except that female leaders appeared more likely than male leaders to identify incongruence of individual values and organizational practices. In this study of five diverse medical schools, faculty values were well aligned with stated institutional missions; however, many perceived that institutional behaviors were not always aligned with individual faculty values.
How Attending Physician Preceptors Negotiate Their Complex Work Environment: A Collective Ethnography.

PubMed

Lemaire, Jane B; Wallace, Jean E; Sargious, Peter M; Bacchus, Maria; Zarnke, Kelly; Ward, David R; Ghali, William A

2017-12-01

To generate an empiric, detailed, and updated view of the attending physician preceptor role and its interface with the complex work environment. In 2013, the authors conducted a modified collective ethnography with observations of internal medicine medical teaching unit preceptors from two university hospitals in Canada. Eleven observers conducted 32 observations (99.5 hours) of 26 preceptors (30 observations [93.5 hours] of 24 preceptors were included in the analysis). An inductive thematic approach was used to analyze the data with further axial coding to identify connections between themes. Four individuals coded the main data set; differences were addressed through discussion to achieve consensus. Three elements or major themes of the preceptor role were identified: (1) competence or the execution of traditional physician competencies, (2) context or the extended medical teaching unit environment, and (3) conduct or the manner of acting or behaviors and attitudes in the role. Multiple connections between the elements emerged. The preceptor role appeared to depend on the execution of professional skills (competence) but also was vulnerable to contextual factors (context) independent of these skills, many of which were unpredictable. This vulnerability appeared to be tempered by preceptors' use of adaptive behaviors and attitudes (conduct), such as creativity, interpersonal skills, and wellness behaviors. Preceptors not only possess traditional competencies but also enlist additional behaviors and attitudes to deal with context-driven tensions and to negotiate their complex work environment. These skills could be incorporated into role training, orientation, and mentorship.
Latina food patterns in the United States: a qualitative metasynthesis.

PubMed

Gerchow, Lauren; Tagliaferro, Barbara; Squires, Allison; Nicholson, Joey; Savarimuthu, Stella M; Gutnick, Damara; Jay, Melanie

2014-01-01

Obesity disproportionately affects Latinas living in the United States, and cultural food patterns contribute to this health concern. The aim of this study was to synthesize the qualitative results of research regarding Latina food patterns in order to (a) identify common patterns across Latino culture and within Latino subcultures and (b) inform future research by determining gaps in the literature. A systematic search of three databases produced 13 studies (15 manuscripts) that met the inclusion criteria for review. The Critical Appraisal Skills Program tool and the recommendations of Squires for evaluating translation methods in qualitative research were applied to appraise study quality. Authors coded through directed content analysis and an adaptation of the Joanna Briggs Institute Qualitative Assessment and Review Instrument coding template to extract themes. Coding focused on food patterns, obesity, population breakdown, immigration, acculturation, and barriers and facilitators to healthy eating. Other themes and categories emerged from this process to complement this approach. Major findings included the following: (a) Immigration driven changes in scheduling, food choice, socioeconomic status, and family dynamics shape the complex psychology behind healthy food choices for Latina women; (b) in Latina populations, barriers and facilitators to healthy lifestyle choices around food are complex; and (c) there is a clear need to differentiate Latino populations by country of origin in future qualitative studies on eating behavior. Healthcare providers need to recognize the complex influences behind eating behaviors among immigrant Latinas in order to design effective behavior change and goal-setting programs to support healthy lifestyles.
Critical thinking and creativity in nursing: learners' perspectives.

PubMed

Chan, Zenobia C Y

2013-05-01

Although the development of critical thinking and the development of creativity are major areas in nursing programme, little has been explored about learners' perspectives towards these two concepts, especially in Chinese contexts. This study aimed to reveal nursing learners' perspectives on creativity and critical thinking. Qualitative data collection methods were adopted, namely group interviews and concept map drawings. The process of data collection was conducted in private rooms at a University. 36 nursing students from two problem-based learning classes were recruited in two groups for the study. After data collection, content analysis with axial coding approach was conducted to explore the narrative themes, to summarise the main ideas, and to make valid inferences from the connections among critical thinking, creativity, and other exogenous variables. Based on the findings, six major themes were identified: "revisiting the meanings of critical thinking"; "critical thinking and knowledge: partners or rivals?"; "is critical thinking criticising?"; "revising the meanings of creativity"; "creativity and experience: partners or rivals?"; and "should creativity be practical?". This study showed that learners had diverse perspectives towards critical thinking and creativity, and their debate on these two domains provided implications on nursing education, since the voices of learners are crucial in teaching. By closing the gap between learners and educators, this study offered some insights on nursing education in the new curriculum, in particular to co-construct nursing knowledge which is student-driven, and to consider students' voices towards understanding and applying creativity and critical thinking in nursing. Copyright © 2012 Elsevier Ltd. All rights reserved.
Teaching Business Ethics in the Global South: Control, Resistance, and Phronesis

ERIC Educational Resources Information Center

Karam, Charlotte M.; Sidani, Yusuf M.; Showail, Sammy

2015-01-01

We explore academic literature on business ethics education and critically compare the themes emerging from different contexts. Outlining guidelines for analysis based on Southern Theory, we conduct a content analysis on a selection of English, peer-reviewed articles and then critically compare emergent themes from across the…
Surviving neoliberalism, maintaining values: Community health mergers in Victoria, Australia.

PubMed

Roussy, Véronique; Livingstone, Charles

2018-04-01

Independent, not-for-profit community health services in the state of Victoria, Australia, provide one of that country's few models of comprehensive primary health care (PHC). Recent amalgamations among some such agencies created regional-sized community health organisations, in a departure from this sector's traditionally small local structure. This study explored the motivations, desired outcomes, and decision-making process behind these mergers. Qualitative exploratory study was based on 26 semistructured interviews with key informants associated with 2 community health mergers, which took place in 2014 in Victoria, Australia. Thematic data analysis was influenced by concepts derived from institutional theory. Becoming bigger by merging was viewed as the best way to respond to mounting external pressures, such as increasingly neoliberal funding mechanisms, perceived as threatening survival. Desired outcomes were driven by comprehensive PHC values, and related to creating organisational capacity to continue providing quality services to disadvantaged communities. This study offers insights into decision-making processes geared towards protecting the comprehensiveness of PHC service delivery for disadvantaged communities, ensuring financial viability, and surviving neoliberal economic policy whilst preserving communitarian values. These are relevant to an international audience, within a global context of rising health inequities, increasingly tight fiscal environments, and growing neoliberal influences on health policymaking and funding. Copyright © 2018 John Wiley & Sons, Ltd.

How equity is addressed in clinical practice guidelines: a content analysis

PubMed Central

Shi, Chunhu; Tian, Jinhui; Wang, Quan; Petkovic, Jennifer; Ren, Dan; Yang, Kehu; Yang, Yang

2014-01-01

Objectives Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). Setting Content analysis of methodological publications. Eligibility criteria for selecting studies Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs. Data sources We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes. Primary outcomes The primary outcomes were methodological themes and processes on how to address equity issues in guideline development. Results 8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes (‘scoping questions’, ‘searching relevant evidence’, ‘appraising evidence and recommendations’, ‘formulating recommendations’, ‘monitoring implementation’, ‘providing a flow chart to include equity in CPGs’, and ‘others: reporting of guidelines and comments from stakeholders’ for CPG developers and ‘assessing the quality of CPGs’ for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above. Conclusions For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual. PMID:25479795
2012 Holocaust Days of Remembrance

NASA Image and Video Library

2012-04-24

Holocaust survivor Anne Levy of Metairie, La., speaks to Stennis Space Center employees during a Holocaust Days of Remembrance program April 24, 2012. The 22nd annual observance of the Holocaust for the Stennis community focused on the theme 'Choosing to Act: Stories of Rescue.' Levy was a four-year-old child in Poland when the Nazis invaded the country in 1939. She and her family survived in a Warsaw ghetto for two years before escaping.
Vision, Invention, Intervention: Celebrating Adult Education. Conference Proceedings. Papers from the Annual Conference of the Standing Conference on University Teaching and Research in the Education of Adults (25th, Winchester, England, United Kingdom, July 11-13, 1995).

ERIC Educational Resources Information Center

Bryant, Ian, Ed.

The papers in these proceedings include a number of themes such as enduring and progressive social change, good practice and positive outcomes, and strategies of survival, resistance and subversion. They are: "Achievement, Personal Development, and Positive Outcomes" (Viv Anderson); "Raising Standards" (Paul Armstrong);…
A comparative analysis of Science-Technology-Society standards in elementary, middle and high school state science curriculum frameworks

NASA Astrophysics Data System (ADS)

Tobias, Karen Marie

An analysis of curriculum frameworks from the fifty states to ascertain the compliance with the National Science Education Standards for integrating Science-Technology-Society (STS) themes is reported within this dissertation. Science standards for all fifty states were analyzed to determine if the STS criteria were integrated at the elementary, middle, and high school levels of education. The analysis determined the compliance level for each state, then compared each educational level to see if the compliance was similar across the levels. Compliance is important because research shows that using STS themes in the science classroom increases the student's understanding of the concepts, increases the student's problem solving skills, increases the student's self-efficacy with respect to science, and students instructed using STS themes score well on science high stakes tests. The two hypotheses for this study are: (1) There is no significant difference in the degree of compliance to Science-Technology-Society themes (derived from National Science Education Standards) between the elementary, middle, and high school levels. (2) There is no significant difference in the degree of compliance to Science-Technology-Society themes (derived from National Science Education Standards) between the elementary, middle, and high school level when examined individually. The Analysis of Variance F ratio was used to determine the variance between and within the three educational levels. This analysis addressed hypothesis one. The Analysis of Variance results refused to reject the null hypothesis, meaning there is significant difference in the compliance to STS themes between the elementary, middle and high school educational levels. The Chi-Square test was the statistical analysis used to compare the educational levels for each individual criterion. This analysis addressed hypothesis two. The Chi-Squared results showed that none of the states were equally compliant with each individual criterion across the elementary, middle, and high school levels. The National Science Education Standards were created with the input of thousands of people and over twenty scientific and educational societies. The standards were tested in numerous classrooms and showed an increase in science literacy for the students. With the No Child Left Behind legislation and Project 2061, the attainment of a science literate society will be helped by the adoption of the NSES standards and the STS themes into the American classrooms.
Spiritually based intervention to increase colorectal cancer screening among African Americans: screening and theory-based outcomes from a randomized trial.

PubMed

Holt, Cheryl L; Litaker, Mark S; Scarinci, Isabel C; Debnam, Katrina J; McDavid, Chastity; McNeal, Sandre F; Eloubeidi, Mohamad A; Crowther, Martha; Bolland, John; Martin, Michelle Y

2013-08-01

Colorectal cancer screening has clear benefits in terms of mortality reduction; however, it is still underutilized and especially among medically underserved populations, including African Americans, who also suffer a disproportionate colorectal cancer burden. This study consisted of a theory-driven (health belief model) spiritually based intervention aimed at increasing screening among African Americans through a community health advisor-led educational series in 16 churches. Using a randomized design, churches were assigned to receive either the spiritually based intervention or a nonspiritual comparison, which was the same in every way except that it did not contain spiritual/religious content and themes. Trained and certified peer community health advisors in each church led a series of two group educational sessions on colorectal cancer and screening. Study enrollees completed a baseline, 1-month, and 12-month follow-up survey at their churches. The interventions had significant pre-post impact on awareness of all four screening modalities, and self-report receipt of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. There were no significant study group differences in study outcomes, with the exception of fecal occult blood test utilization, whereas those in the nonspiritual intervention reported significantly greater pre-post change. Both of these community-engaged, theory-driven, culturally relevant approaches to increasing colorectal cancer awareness and screening appeared to have an impact on study outcomes. Although adding spiritual/religious themes to the intervention was appealing to the audience, it may not result in increased intervention efficacy.
Underdeveloped Themes in Qualitative Research: Relationship With Interviews and Analysis.

PubMed

Connelly, Lynne M; Peltzer, Jill N

2016-01-01

In this methodological article, the authors address the problem of underdeveloped themes in qualitative studies they have reviewed. Various possible reasons for underdeveloped themes are examined, and suggestions offered. Each problem area is explored, and literature support is provided. The suggestions that are offered are supported by the literature as well. The problem with underdeveloped themes in certain articles is related to 3 interconnected issues: (a) lack of clear relationship to the underlying research method, (b) an apparent lack of depth in interviewing techniques, and (c) lack of depth in the analysis. Underdeveloped themes in a qualitative study can lead to a lack of substantive findings that have meaningful implications for practice, research, and the nursing profession, as well as the rejection of articles for publication. Fully developed themes require knowledge about the paradigm of qualitative research, the methodology that is proposed, the effective techniques of interviewing that can produce rich data with examples and experiences, and analysis that goes beyond superficial reporting of what the participants have said. Analytic problem areas include premature closure, anxiety about how to analyze, and confusion about categories and themes. Effective qualitative research takes time and effort and is not as easy as is sometimes presumed. The usefulness of findings depends on researchers improving their research skills and practices. Increasingly researchers are using qualitative research to explore clinically important issues. As consumers of research or members of a research team, clinical nurse specialists need to understand the nature of this research that can provide in-depth insight and meaning.
Recommendations for pathologic staging (pTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

PubMed

Rice, T W; Ishwaran, H; Hofstetter, W L; Kelsen, D P; Apperson-Hansen, C; Blackstone, E H

2016-11-01

We report analytic and consensus processes that produced recommendations for pathologic stage groups (pTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 13,300 without preoperative therapy had pathologic assessment after esophagectomy or endoscopic treatment. Risk-adjusted survival for each patient was developed using random survival forest analysis to identify data-driven pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced consensus pathologic stage groups. For pT1-3N0M0 squamous cell carcinoma (SCC) and pT1-2N0M0 adenocarcinoma, pT was inadequate for grouping; subcategorizing pT1 and adding histologic grade enhanced staging; cancer location improved SCC staging. Consensus eliminated location for pT2N0M0 and pT3N0M0G1 SCC groups, and despite similar survival, restricted stage 0 to pTis, excluding pT1aN0M0G1. Metastases markedly reduced survival; pT, pN, and pM sufficiently grouped advanced cancers. Stage IIA and IIB had different compositions for SCC and adenocarcinoma, but similar survival. Consensus stage IV subgrouping acknowledged pT4N+ and pN3 cancers had poor survival, similar to pM1. Anatomic pathologic stage grouping, based on pTNM only, produced identical consensus stage groups for SCC and adenocarcinoma at the cost of homogeneity in early groups. Pathologic staging can neither direct pre-treatment decisions nor aid in prognostication for treatment other than esophagectomy or endoscopic therapy. However, it provides a clean, single therapy reference point for esophageal cancer. © 2016 International Society for Diseases of the Esophagus.
Qualitative Data Analysis for Health Services Research: Developing Taxonomy, Themes, and Theory

PubMed Central

Bradley, Elizabeth H; Curry, Leslie A; Devers, Kelly J

2007-01-01

Objective To provide practical strategies for conducting and evaluating analyses of qualitative data applicable for health services researchers. Data Sources and Design We draw on extant qualitative methodological literature to describe practical approaches to qualitative data analysis. Approaches to data analysis vary by discipline and analytic tradition; however, we focus on qualitative data analysis that has as a goal the generation of taxonomy, themes, and theory germane to health services research. Principle Findings We describe an approach to qualitative data analysis that applies the principles of inductive reasoning while also employing predetermined code types to guide data analysis and interpretation. These code types (conceptual, relationship, perspective, participant characteristics, and setting codes) define a structure that is appropriate for generation of taxonomy, themes, and theory. Conceptual codes and subcodes facilitate the development of taxonomies. Relationship and perspective codes facilitate the development of themes and theory. Intersectional analyses with data coded for participant characteristics and setting codes can facilitate comparative analyses. Conclusions Qualitative inquiry can improve the description and explanation of complex, real-world phenomena pertinent to health services research. Greater understanding of the processes of qualitative data analysis can be helpful for health services researchers as they use these methods themselves or collaborate with qualitative researchers from a wide range of disciplines. PMID:17286625
Qualitative data analysis for health services research: developing taxonomy, themes, and theory.

PubMed

Bradley, Elizabeth H; Curry, Leslie A; Devers, Kelly J

2007-08-01

To provide practical strategies for conducting and evaluating analyses of qualitative data applicable for health services researchers. DATA SOURCES AND DESIGN: We draw on extant qualitative methodological literature to describe practical approaches to qualitative data analysis. Approaches to data analysis vary by discipline and analytic tradition; however, we focus on qualitative data analysis that has as a goal the generation of taxonomy, themes, and theory germane to health services research. We describe an approach to qualitative data analysis that applies the principles of inductive reasoning while also employing predetermined code types to guide data analysis and interpretation. These code types (conceptual, relationship, perspective, participant characteristics, and setting codes) define a structure that is appropriate for generation of taxonomy, themes, and theory. Conceptual codes and subcodes facilitate the development of taxonomies. Relationship and perspective codes facilitate the development of themes and theory. Intersectional analyses with data coded for participant characteristics and setting codes can facilitate comparative analyses. Qualitative inquiry can improve the description and explanation of complex, real-world phenomena pertinent to health services research. Greater understanding of the processes of qualitative data analysis can be helpful for health services researchers as they use these methods themselves or collaborate with qualitative researchers from a wide range of disciplines.
Revenue-Generating Language Programs at Canadian Post-Secondary Institutions: Emerging Themes from a Documentation Analysis

ERIC Educational Resources Information Center

Eaton, Sarah Elaine; Goddard, J. Tim

2008-01-01

This presentation identifies emerging themes in a study combining documentation analysis (Atkinson & Coffey, 2004) and interviews that examine policy statements, promotional materials and various institutional documents from selected English as a Second Language (ESL) programs at one Canadian University. It looks at how and why ESL programs…
Introduction: energy and the subsurface.

PubMed

Christov, Ivan C; Viswanathan, Hari S

2016-10-13

This theme issue covers topics at the forefront of scientific research on energy and the subsurface, ranging from carbon dioxide (CO2) sequestration to the recovery of unconventional shale oil and gas resources through hydraulic fracturing. As such, the goal of this theme issue is to have an impact on the scientific community, broadly, by providing a self-contained collection of articles contributing to and reviewing the state-of-the-art of the field. This collection of articles could be used, for example, to set the next generation of research directions, while also being useful as a self-study guide for those interested in entering the field. Review articles are included on the topics of hydraulic fracturing as a multiscale problem, numerical modelling of hydraulic fracture propagation, the role of computational sciences in the upstream oil and gas industry and chemohydrodynamic patterns in porous media. Complementing the reviews is a set of original research papers covering growth models for branched hydraulic crack systems, fluid-driven crack propagation in elastic matrices, elastic and inelastic deformation of fluid-saturated rock, reaction front propagation in fracture matrices, the effects of rock mineralogy and pore structure on stress-dependent permeability of shales, topographic viscous fingering and plume dynamics in porous media convection.This article is part of the themed issue 'Energy and the subsurface'. © 2016 The Author(s).
Introduction: energy and the subsurface

PubMed Central

Viswanathan, Hari S.

2016-01-01

This theme issue covers topics at the forefront of scientific research on energy and the subsurface, ranging from carbon dioxide (CO2) sequestration to the recovery of unconventional shale oil and gas resources through hydraulic fracturing. As such, the goal of this theme issue is to have an impact on the scientific community, broadly, by providing a self-contained collection of articles contributing to and reviewing the state-of-the-art of the field. This collection of articles could be used, for example, to set the next generation of research directions, while also being useful as a self-study guide for those interested in entering the field. Review articles are included on the topics of hydraulic fracturing as a multiscale problem, numerical modelling of hydraulic fracture propagation, the role of computational sciences in the upstream oil and gas industry and chemohydrodynamic patterns in porous media. Complementing the reviews is a set of original research papers covering growth models for branched hydraulic crack systems, fluid-driven crack propagation in elastic matrices, elastic and inelastic deformation of fluid-saturated rock, reaction front propagation in fracture matrices, the effects of rock mineralogy and pore structure on stress-dependent permeability of shales, topographic viscous fingering and plume dynamics in porous media convection. This article is part of the themed issue ‘Energy and the subsurface’. PMID:27597784
Piecing the puzzle together: case studies of international research in health-promoting sports clubs.

PubMed

Kokko, Sami; Donaldson, Alex; Geidne, Susanna; Seghers, Jan; Scheerder, Jeroen; Meganck, Jeroen; Lane, Aoife; Kelly, Bridget; Casey, Meghan; Eime, Rochelle; Villberg, Jari; Kannas, Lasse

2016-03-01

This paper seeks to review the current international health-promoting sports club (HPSC) research, drawing together findings based on case studies from various countries to illustrate the status of HPSCs. In addition, future challenges for HPSC research and implementation are considered. The review includes six case studies from five countries. In summary, there are two major research themes in this area, namely 'research into HPSC activity' and 'research into HPSC networks'. The first theme investigates the extent to which sports clubs and/or national sports organisations invest in health promotion (HP) - both in policy and practice. The latter theme is driven by an intention to widen the scope of HPSCs to reach novel internal actors, like parents, siblings, etc., and/or external non-sporting bodies, like communities, schools, etc. The future challenges for HPSC research require a better understanding of the motives, barriers and capacities of sports clubs and coaches. Sports organisations, clubs and coaches generally support the intent of the HPSC concept, but even with the best evidence- or theory-based HP programmes/guidelines/standards, nothing will happen in practice if the nature and capacities of sports clubs are not better acknowledged. Therefore, a call for embracing implementation science is finally made to enhance implementation. © The Author(s) 2015.
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.
Molecular evidence of Zn chelation of the procaspase activating compound B-PAC-1 in B cell lymphoma.

PubMed

Sarkar, Aloke; Balakrishnan, Kumudha; Chen, Jefferson; Patel, Viralkumar; Neelapu, Sattva S; McMurray, John S; Gandhi, Varsha

2016-01-19

The resistance of apoptosis in cancer cells is pivotal for their survival and is typically ruled by mutations or dysregulation of core apoptotic cascade. Mantle cell lymphoma (MCL) is a non-Hodgkin's B-cell malignancy expressing higher anti-apoptotic proteins providing survival advantage. B-PAC-1, a procaspase activating compound, induces apoptosis by sequestering Zn bound to procaspase-3, but the amino acids holding Zn in Caspase-3 is not known. Here we show that reintroduction of WT caspase-3 or 7 in Caspase3-7 double knock-out (DKO) mouse embryonic fibroblasts (MEF) promoted B-PAC-1 to induce apoptosis (27-43%), but not in DKO MEFs or MEFs expressing respective Casp3-7 catalytic mutants (12-13%). Using caspase-6 and -9 exosite analysis, we identified and mutated predicted Zn-ligands in caspase-3 (H108A, C148S and E272A) and overexpressed into DKO MEFs. Mutants carrying E272A abrogated Zn-reversal of apoptosis induced by B-PAC-1 via higher XIAP and smac expressions but not in H108A or C148S mutants. Co-immunoprecipitation analysis revealed stronger XIAP-caspase-3 interaction suggesting a novel mechanism of impulsive apoptosis resistance by disrupting predicted Zn-ligands in caspase-3. B-PAC-1 sponsored apoptosis in MCL cell lines (30-73%) via caspase-3 and PARP cleavages accompanied by loss of Mcl-1 and IAPs including XIAP while Zn substantially abrogated B-PAC-1-driven apoptosis (18-36%). In contrary, Zn is dispensable to inhibit staurosporin, bendamustine, ABT199 or MK206-induced apoptosis. Consistent to cell lines, B-PAC-1 stimulated cell death in primary B-lymphoma cells via caspase-3 cleavage with decline in both Mcl-1 and XIAP. This study underscores the first genetic evidence that B-PAC-1 driven apoptosis is mediated via Zn chelation.
Female competition and aggression: interdisciplinary perspectives

PubMed Central

Stockley, Paula; Campbell, Anne

2013-01-01

This paper introduces a Theme Issue combining interdisciplinary perspectives in the study of female competition and aggression. Despite a history of being largely overlooked, evidence is now accumulating for the widespread evolutionary significance of female competition. Here, we provide a synthesis of contributions to this Theme Issue on humans and other vertebrates, and highlight directions for future research. Females compete for resources needed to survive and reproduce, and for preferred mates. Although female aggression takes diverse forms, under most circumstances relatively low-risk competitive strategies are favoured, most probably due to constraints of offspring production and care. In social species, dominance relationships and threats of punishment can resolve social conflict without resort to direct aggression, and coalitions or alliances may reduce risk of retaliation. Consistent with these trends, indirect aggression is a low cost but effective form of competition among young women. Costs are also minimized by flexibility in expression of competitive traits, with aggressive behaviour and competitive signalling tailored to social and ecological conditions. Future research on female competition and the proximate mediators of female aggression will be greatly enhanced by opportunities for interdisciplinary exchange, as evidenced by contributions to this Theme Issue. PMID:24167303
Does climate change explain the decline of a trans-Saharan Afro-Palaearctic migrant?

PubMed

Pearce-Higgins, J W; Yalden, D W; Dougall, T W; Beale, C M

2009-03-01

There is an urgent need to understand how climate change will impact on demographic parameters of vulnerable species. Migrants are regarded as particularly vulnerable to climate change; phenological mismatch has resulted in the local decline of one passerine, whilst variations in the survival of others have been related to African weather conditions. However, there have been few demographic studies on trans-Saharan non-passerine migrants, despite these showing stronger declines across Europe than passerines. We therefore analyse the effects of climate on the survival and productivity of common sandpipers Actitis hypoleucos, a declining non-passerine long-distant migrant using 28 years' data from the Peak District, England. Adult survival rates were significantly negatively correlated with winter North Atlantic Oscillation (NAO), being lower when winters were warm and wet in western Europe and cool and dry in northwest Africa. Annual variation in the productivity of the population was positively correlated with June temperature, but not with an index of phenological mismatch. The 59% population decline appears largely to have been driven by reductions in adult survival, with local productivity poorly correlated with subsequent population change, suggesting a low degree of natal philopatry. Winter NAO was not significantly correlated with adult survival rates in a second, Scottish Borders population, studied for 12 years. Variation in climatic conditions alone does not therefore appear to be responsible for common sandpiper declines. Unlike some passerine migrants, there was no evidence for climate-driven reductions in productivity, although the apparent importance of immigration in determining local recruitment complicates the assessment of productivity effects. We suggest that further studies to diagnose common sandpiper declines should focus on changes in the condition of migratory stop-over or wintering locations. Where possible, these analyses should be repeated for other declining migrants.
Barriers to Effective Implementation of Programs for the Prevention of Workplace Violence in Hospitals.

PubMed

Blando, James; Ridenour, Marilyn; Hartley, Daniel; Casteel, Carri

2015-01-01

Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.
Barriers to Effective Implementation of Programs for the Prevention of Workplace Violence in Hospitals.

PubMed

Blando, James; Ridenour, Marilyn; Hartley, Daniel; Casteel, Carri

2014-12-04

Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.
Community-based preparedness programmes and the 2009 Australian bushfires: policy implications derived from applying theory.

PubMed

MacDougall, Colin; Gibbs, Lisa; Clark, Rachel

2014-04-01

The Victorian Country Fire Authority in Australia runs the Community Fireguard (CFG) programme to assist individuals and communities in preparing for fire. The objective of this qualitative research was to understand the impact of CFG groups on their members' fire preparedness and response during the 2009 Australian bushfires. Social connectedness emerged as a strong theme, leading to an analysis of data using social capital theory. The main strength of the CFG programme was that it was driven by innovative community members; however, concerns arose regarding the extent to which the programme covered all vulnerable areas, which led the research team to explore the theory of diffusion of innovation. The article concludes by stepping back from the evaluation and using both applied theories to reflect on broad options for community fire preparedness programmes in general. The exercise produced two contrasting options for principles underlying community fire preparedness programmes. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Contrasting beliefs about screening for mental disorders among UK military personnel returning from deployment to Afghanistan.

PubMed

Keeling, M; Knight, T; Sharp, D; Fertout, M; Greenberg, N; Chesnokov, M; Rona, R J

2012-12-01

The objective of the study was to elicit beliefs and experiences of the value of a screening programme for mental illness among UK military personnel. Three months after returning from Afghanistan 21 army personnel participated in a qualitative study about mental health screening. One-to-one interviews were conducted and recorded. Data-driven thematic analysis was used. Researchers identified master themes represented by extracts of text from the 21 complete transcripts. Participants made positive remarks on the advantages of screening. Noted barriers to seeking help included: unwillingness to receive advice, a wish to deal with any problems themselves and a belief that military personnel should be strong enough to cope with any difficulties. Participants believed that overcoming barriers to participating in screening and seeking help would be best achieved by making screening compulsory. Although respondents were positive about a screening programme for mental illness, the barriers to seeking help for mental illness appear deep rooted and reinforced by the value ascribed to hardiness.
Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers.

PubMed

Shannon, K; Kerr, T; Bright, V; Gibson, K; Tyndall, M W

2008-02-01

Previous studies have described links between violence, decreased condom use and drug sharing among intimate partners, though limited information exists about the predictors of drug sharing among female sex workers and their clients. The following analysis explored the association between sharing illicit drugs with clients and sexual and drug-related harms among survival sex workers. A total of 198 women participated in interview-administered questionnaires and confidential HIV testing. Of the total, 117 (59%) reported sharing drugs with clients/johns in the last six months and crack cocaine was the primary drug shared (n=108). In logistic regression analysis, sharing drugs with clients/johns was associated with borrowing a used crack pipe (AOR=5.63; 95%CI: 2.71-9.44; p<0.001), intensive/daily crack cocaine smoking (AOR=3.78; 95%CI:1.60-8.92; p<0.002), inconsistent condom use by a client/john (AOR=3.17; 95%CI:1.48-6.77; p<0.003) and having a recent bad date (verbal harassment, physical and/or sexual assault) (AOR=2.71; 95%CI:1.17-6.32; p=0.021). Sharing illicit drugs with clients/johns may be a crucial risk marker for increased violence and sexual and drug-related harms among survival sex workers. HIV prevention and harm reduction initiatives targeting both women and clients/johns are urgently needed, including enhanced support for community and peer-driven sex work initiatives, to address some of the structural facilitators for HIV transmission.
Anti-apoptotic A1 is not essential for lymphoma development in Eµ-Myc mice but helps sustain transplanted Eµ-Myc tumour cells.

PubMed

Mensink, Mark; Anstee, Natasha S; Robati, Mikara; Schenk, Robyn L; Herold, Marco J; Cory, Suzanne; Vandenberg, Cassandra J

2018-03-01

The transcription factor c-MYC regulates a multiplicity of genes involved in cellular growth, proliferation, metabolism and DNA damage response and its overexpression is a hallmark of many tumours. Since MYC promotes apoptosis under conditions of stress, such as limited availability of nutrients or cytokines, MYC-driven cells are very much dependent on signals that inhibit cell death. Stress signals trigger apoptosis via the pathway regulated by opposing fractions of the BCL-2 protein family and previous genetic studies have shown that the development of B lymphoid tumours in Eµ-Myc mice is critically dependent on expression of pro-survival BCL-2 relatives MCL-1, BCL-W and, to a lesser extent, BCL-X L , but not BCL-2 itself, and that sustained growth of these lymphomas is dependent on MCL-1. Using recently developed mice that lack expression of all three functional pro-survival A1 genes, we show here that the kinetics of lymphoma development in Eµ-Myc mice and the competitive repopulation capacity of Eµ-Myc haemopoietic stem and progenitor cells is unaffected by the absence of A1. However, conditional loss of a single remaining functional A1 gene from transplanted A1-a -/- A1-b fl/fl A1-c -/- Eµ-Myc lymphomas slowed their expansion, significantly extending the life of the transplant recipients. Thus, A1 contributes to the survival of malignant Eµ-Myc-driven B lymphoid cells. These results strengthen the case for BFL-1, the human homologue of A1, being a valid target for drug development for MYC-driven tumours.
Analysis of High School Physics, Chemistry and Biology Curriculums in Terms of Scientific Literacy Themes

ERIC Educational Resources Information Center

Erdogan, Melek Nur; Koseoglu, Fitnat

2012-01-01

The purpose of this study is to analyze 9th grade physics, chemistry and biology curriculums, which were implemented by the Ministry of Education since the academic year 2008-2009, in terms of scientific literacy themes and the balance of these themes and also to examine the quality of statements about objectives. Physics, chemistry, and biology…
Climate drives adaptive genetic responses associated with survival in big sagebrush (Artemisia tridentata)

USGS Publications Warehouse

Chaney, Lindsay; Richardson, Bryce A.; Germino, Matthew J.

2017-01-01

A genecological approach was used to explore genetic variation for survival in Artemisia tridentata(big sagebrush). Artemisia tridentata is a widespread and foundational shrub species in western North America. This species has become extremely fragmented, to the detriment of dependent wildlife, and efforts to restore it are now a land management priority. Common-garden experiments were established at three sites with seedlings from 55 source-populations. Populations included each of the three predominant subspecies, and cytotype variations. Survival was monitored for 5 years to assess differences in survival between gardens and populations. We found evidence of adaptive genetic variation for survival. Survival within gardens differed by source-population and a substantial proportion of this variation was explained by seed climate of origin. Plants from areas with the coldest winters had the highest levels of survival, while populations from warmer and drier sites had the lowest levels of survival. Survival was lowest, 36%, in the garden that was prone to the lowest minimum temperatures. These results suggest the importance of climatic driven genetic differences and their effect on survival. Understanding how genetic variation is arrayed across the landscape, and its association with climate can greatly enhance the success of restoration and conservation.
Common themes in microbial pathogenicity revisited.

PubMed Central

Finlay, B B; Falkow, S

1997-01-01

Bacterial pathogens employ a number of genetic strategies to cause infection and, occasionally, disease in their hosts. Many of these virulence factors and their regulatory elements can be divided into a smaller number of groups based on the conservation of similar mechanisms. These common themes are found throughout bacterial virulence factors. For example, there are only a few general types of toxins, despite a large number of host targets. Similarly, there are only a few conserved ways to build the bacterial pilus and nonpilus adhesins used by pathogens to adhere to host substrates. Bacterial entry into host cells (invasion) is a complex mechanism. However, several common invasion themes exist in diverse microorganisms. Similarly, once inside a host cell, pathogens have a limited number of ways to ensure their survival, whether remaining within a host vacuole or by escaping into the cytoplasm. Avoidance of the host immune defenses is key to the success of a pathogen. Several common themes again are employed, including antigenic variation, camouflage by binding host molecules, and enzymatic degradation of host immune components. Most virulence factors are found on the bacterial surface or secreted into their immediate environment, yet virulence factors operate through a relatively small number of microbial secretion systems. The expression of bacterial pathogenicity is dependent upon complex regulatory circuits. However, pathogens use only a small number of biochemical families to express distinct functional factors at the appropriate time that causes infection. Finally, virulence factors maintained on mobile genetic elements and pathogenicity islands ensure that new strains of pathogens evolve constantly. Comprehension of these common themes in microbial pathogenicity is critical to the understanding and study of bacterial virulence mechanisms and to the development of new "anti-virulence" agents, which are so desperately needed to replace antibiotics. PMID:9184008
Construction of negative images of menstruation in Indian TV commercials.

PubMed

Yagnik, Arpan Shailesh

2012-01-01

Menstruation is a perfectly normal physiological process; however, it is problematized in TV commercials. In the current study, a thematic analysis of 50 Indian TV commercials was conducted to identify the latent themes. Social captivity, restrictions, professional inefficiency, and physical and mental discomfort emerged as major themes after the analysis. The knowledge that manufacturers use such themes for image building and creating a conducive buying environment may prevent the reinforcement of menstrual taboos in Indian society. It can also guide the manufacturers in ideating and creating positive and healthier ways of advertising female hygiene products.
Self-assembling peptide-based building blocks in medical applications

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

Acar, Handan; Srivastava, Samanvaya; Chung, Eun Ji

Peptides and peptide-conjugates, comprising natural and synthetic building blocks, are an increasingly popular class of biomaterials. Self-assembled nanostructures based on peptides and peptide-conjugates offer advantages such as precise selectivity and multifunctionality that can address challenges and limitations in the clinic. In this review article, we discuss recent developments in the design and self-assembly of various nanomaterials based on peptides and peptide-conjugates for medical applications, and categorize them into two themes based on the driving forces of molecular self-assembly. First, we present the self-assembled nanostructures driven by the supramolecular interactions between the peptides, with or without the presence of conjugates. Themore » studies where nanoassembly is driven by the interactions between the conjugates of peptide-conjugates are then presented. Particular emphasis is given to in vivo studies focusing on therapeutics, diagnostics, immune modulation and regenerative medicine. Finally, challenges and future perspectives are presented.« less
Codevelopment of conceptual understanding and critical attitude: toward a systemic analysis of the survival blanket

NASA Astrophysics Data System (ADS)

Viennot, Laurence; Décamp, Nicolas

2016-01-01

One key objective of physics teaching is the promotion of conceptual understanding. Additionally, the critical faculty is universally seen as a central quality to be developed in students. In recent years, however, teaching objectives have placed stronger emphasis on skills than on concepts, and there is a risk that conceptual structuring may be disregarded. The question therefore arises as to whether it is possible for students to develop a critical stance without a conceptual basis, leading in turn to the issue of possible links between the development of conceptual understanding and critical attitude. In an in-depth study to address these questions, the participants were seven prospective physics and chemistry teachers. The methodology included a ‘teaching interview’, designed to observe participants’ responses to limited explanations of a given phenomenon and their ensuing intellectual satisfaction or frustration. The explanatory task related to the physics of how a survival blanket works, requiring a full and appropriate system analysis of the blanket. The analysis identified five recurrent lines of reasoning and linked these to judgments of adequacy of explanation, based on metacognitive/affective (MCA) factors, intellectual (dis)satisfaction and critical stance. Recurrent themes and MCA factors were used to map the intellectual dynamics that emerged during the interview process. Participants’ critical attitude was observed to develop in strong interaction with their comprehension of the topic. The results suggest that most students need to reach a certain level of conceptual mastery before they can begin to question an oversimplified explanation, although one student’s replies show that a different intellectual dynamics is also possible. The paper ends with a discussion of the implications of these findings for future research and for decisions concerning teaching objectives and the design of learning environments.
Ultrasonography-driven combination antibiotic therapy with tigecycline significantly increases survival among patients with neutropenic enterocolitis following cytarabine-containing chemotherapy for the remission induction of acute myeloid leukemia.

PubMed

Pugliese, Novella; Salvatore, Paola; Iula, Dora Vita; Catania, Maria Rosaria; Chiurazzi, Federico; Della Pepa, Roberta; Cerchione, Claudio; Raimondo, Marta; Giordano, Claudia; Simeone, Luigia; Caruso, Simona; Pane, Fabrizio; Picardi, Marco

2017-07-01

Neutropenic enterocolitis (NEC) is an abdominal infection reported primarily in patients with acute myeloid leukemia (AML) following chemotherapy, especially cytarabine, a notable efficacious cytotoxic agent for AML remission. Specific data regarding the impact of different cytarabine schedules and/or antibacterial regimens for NEC are sparse. The aim of the study was to identify the predictors of outcome within 30 days of NEC onset. NEC episodes were retrospectively pinpointed among 440 patients with newly diagnosed AML hospitalized in our Institution, over a 10-year period, for receiving chemotherapy protocols with 100-6000 mg/m 2 daily of cytarabine. Two subgroups, survivors versus nonsurvivors, were compared by using logistic regression analysis. NEC was documented in 100 of 420 (23.8%) analyzed patients: 42.5% had received high-dose cytarabine, whereas 19% and 15% intermediate-dose and standard-dose cytarabine, respectively (P < 0.001). The 30-day NEC attributable mortality rate was 23%. In univariate analysis, antileukemic protocols containing robust dosages of cytarabine were significantly associated with high mortality (P < 0.001); whereas, standard-dose cytarabine and prompt initiation (at the ultrasonographic appearance of intestinal mural thickening) of NEC therapy with antibiotic combinations including tigecycline were significantly associated with low mortality. In multivariate analysis, high-dose cytarabine-containing chemotherapy was the independent predictor of poor outcome (odds ratio [OR]: 0.109; 95% confidence interval [CI]: 0.032-0.364; P < 0.001), whereas ultrasonography-driven NEC therapy with antibiotic regimens including tigecycline was associated with a favorable outcome (OR: 13.161; 95% CI: 1.587-109.17; P = 0.017). Chemotherapy schedules with robust dosages of cytarabine for AML remission are associated with a high rate of NEC incidence and attributable. Vigorous antibacterial therapy, triggered off pathologic ultrasonographic findings, with drug combinations which have broad antimicrobial coverage and good gut penetration, specifically those also including tigecycline, may be effective in improving 30-day survival rate after NEC onset. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Selective suppression of autocatalytic caspase-3 driven by two-step transcriptional amplified human telomerase reverse transcriptase promoter on ovarian carcinoma growth in vitro and in mice.

PubMed

Song, Yue; Xin, Xing; Xia, Zhijun; Zhai, Xingyue; Shen, Keng

2014-07-01

The objective of our study was to construct recombinant adenovirus (rAd) AdHTVP2G5-rev-casp3, which expresses autocatalytic caspase-3 driven by human telomerase reverse transcriptase promoter (hTERTp) with a two-step transcription amplification (TSTA) system and investigate its antitumor effects on ovarian cancer in vitro and in vivo. Fluorescent detection was used to detect EGFP expression in various cells. Cell viabilities were determined using the Cell Counting Kit-8 and flow cytometry. RT-PCR and immunoblotting assays were used to detect cellular apoptotic activities. Tumor growth and survival of tumor-bearing mice were studied. The hTERTp-TSTA system showed the strongest activity in hTERT-positive cancer cells when compared with hTERTp and cytomeglovirus promoter (CMVp). In contrast, it showed no activity in hTERT‑negative HUVECs. AdHTVP2G5‑rev-casp3 markedly suppressed the survival of AO cells in a dose-dependent modality with a viability rate of 17.8 ± 3.5% at an MOI of 70, which was significantly lower than that by AdHT-rev-casp3 and Ad-rev-casp3 (rAds which express rev-caspase-3 driven by hTERTp and CMVp, respectively). In contrast, AdHTVP2G5‑rev-casp3 induced little HUVEC death with a viability rate of 92.7 ± 5.2% at the same MOI. Additionally, AdHTVP2G5-rev-casp3 (MOI=70) caused significant apoptosis in AO cells with an apoptotic rate of 42%. The tumor growth suppression rate of AdHTVP2G5-rev-casp3 was 81.52%, significantly higher than that of AdHT-rev-casp3 (54.94%) or Ad-rev-casp3 (21.35%). AdHTVP2G5-rev-casp3 significantly improved the survival of tumor-bearing mice with little liver damage, with a mean survival of 258 ± 28 days. These results showed that AdHTVP2G5-rev-casp3 caused effective apoptosis with significant tumor selectivity, strongly suppressed tumor growth and improved mouse survival with little liver toxicity. It can be a potent therapeutic agent for tumor targeted treatment of ovarian cancer.
Decreased mortality of lake michigan chinook salmon after bacterial kidney disease challenge: Evidence for pathogen-driven selection?

USGS Publications Warehouse

Purcell, M.K.; Murray, A.L.; Elz, A.; Park, L.K.; Marcquenski, S.V.; Winton, J.R.; Alcorn, S.W.; Pascho, R.J.; Elliott, D.G.

2008-01-01

In the late 1960s, Chinook salmon Oncorhynchus tshawytscha from the Green River, Washington, were successfully introduced into Lake Michigan. During spring from1988 to 1992, large fish die-offs affecting Chinook salmon occurred in the lake. Multiple ecological factors probably contributed to the severity of the fish kills, but the only disease agent found regularly was Renibacterium salmoninarum, the causative agent of bacterial kidney disease. in this study, survival after challenge by R. salmoninarum was compared between two Chinook salmon stocks: a Lake Michigan stock from Wisconsin (WI) and the progenitor stock from the Green River. We found that the WI stock had significantly greater survival than the Green River stock. Next, the WI and Green River stocks were exposed to the marine pathogen Listonella anguillarum (formerly Vibrio anguillarum), one of the causative agents of vibriosis; survival after this challenge was significantly poorer for the WI stock than for the Green River stock. A close genetic relationship between the Green River and WI stocks was confirmed by analyzing 13 microsatellite loci. These results collectively suggest that disease susceptibility of Lake Michigan Chinook salmon has diverged from that of the source population, possibly in response to pathogen-driven selection. ?? Copyright by the American Fisheries Society 2008.
RANK rewires energy homeostasis in lung cancer cells and drives primary lung cancer

PubMed Central

Rao, Shuan; Sigl, Verena; Wimmer, Reiner Alois; Novatchkova, Maria; Jais, Alexander; Wagner, Gabriel; Handschuh, Stephan; Uribesalgo, Iris; Hagelkruys, Astrid; Kozieradzki, Ivona; Tortola, Luigi; Nitsch, Roberto; Cronin, Shane J.; Orthofer, Michael; Branstetter, Daniel; Canon, Jude; Rossi, John; D'Arcangelo, Manolo; Botling, Johan; Micke, Patrick; Fleur, Linnea La; Edlund, Karolina; Bergqvist, Michael; Ekman, Simon; Lendl, Thomas; Popper, Helmut; Takayanagi, Hiroshi; Kenner, Lukas; Hirsch, Fred R.; Dougall, William

2017-01-01

Lung cancer is the leading cause of cancer deaths. Besides smoking, epidemiological studies have linked female sex hormones to lung cancer in women; however, the underlying mechanisms remain unclear. Here we report that the receptor activator of nuclear factor-kB (RANK), the key regulator of osteoclastogenesis, is frequently expressed in primary lung tumors, an active RANK pathway correlates with decreased survival, and pharmacologic RANK inhibition reduces tumor growth in patient-derived lung cancer xenografts. Clonal genetic inactivation of KRasG12D in mouse lung epithelial cells markedly impairs the progression of KRasG12D-driven lung cancer, resulting in a significant survival advantage. Mechanistically, RANK rewires energy homeostasis in human and murine lung cancer cells and promotes expansion of lung cancer stem-like cells, which is blocked by inhibiting mitochondrial respiration. Our data also indicate survival differences in KRasG12D-driven lung cancer between male and female mice, and we show that female sex hormones can promote lung cancer progression via the RANK pathway. These data uncover a direct role for RANK in lung cancer and may explain why female sex hormones accelerate lung cancer development. Inhibition of RANK using the approved drug denosumab may be a therapeutic drug candidate for primary lung cancer. PMID:29118048
Decreased mortality of Lake Michigan Chinook salmon after bacterial kidney disease challenge: evidence for pathogen-driven selection?

PubMed

Purcell, Maureen K; Murray, Anthony L; Elz, Anna; Park, Linda K; Marcquenski, Susan V; Winton, James R; Alcorn, Stewart W; Pascho, Ronald J; Elliott, Diane G

2008-12-01

In the late 1960s, Chinook salmon Oncorhynchus tshawytscha from the Green River, Washington, were successfully introduced into Lake Michigan. During spring from 1988 to 1992, large fish die-offs affecting Chinook salmon occurred in the lake. Multiple ecological factors probably contributed to the severity of the fish kills, but the only disease agent found regularly was Renibacterium salmoninarum, the causative agent of bacterial kidney disease. In this study, survival after challenge by R. salmoninarum was compared between two Chinook salmon stocks: a Lake Michigan stock from Wisconsin (WI) and the progenitor stock from the Green River. We found that the WI stock had significantly greater survival than the Green River stock. Next, the WI and Green River stocks were exposed to the marine pathogen Listonella anguillarum (formerly Vibrio anguillarum), one of the causative agents of vibriosis; survival after this challenge was significantly poorer for the WI stock than for the Green River stock. A close genetic relationship between the Green River and WI stocks was confirmed by analyzing 13 microsatellite loci. These results collectively suggest that disease susceptibility of Lake Michigan Chinook salmon has diverged from that of the source population, possibly in response to pathogen-driven selection.
BIRC3 is a biomarker of mesenchymal habitat of glioblastoma, and a mediator of survival adaptation in hypoxia-driven glioblastoma habitats.

PubMed

Wang, Dapeng; Berglund, Anders E; Kenchappa, Rajappa S; MacAulay, Robert J; Mulé, James J; Etame, Arnold B

2017-08-24

Tumor hypoxia is an established facilitator of survival adaptation and mesenchymal transformation in glioblastoma (GBM). The underlying mechanisms that direct hypoxia-mediated survival in GBM habitats are unclear. We previously identified BIRC3 as a mediator of therapeutic resistance in GBM to standard temozolomide (TMZ) chemotherapy and radiotherapy (RT). Here we report that BIRC3 is a biomarker of the hypoxia-mediated adaptive mesenchymal phenotype of GBM. Specifically, in the TCGA dataset elevated BIRC3 gene expression was identified as a superior and selective biomarker of mesenchymal GBM versus neural, proneural and classical subtypes. Further, BIRC3 protein was highly expressed in the tumor cell niches compared to the perivascular niche across multiple regions in GBM patient tissue microarrays. Tumor hypoxia was found to mechanistically induce BIRC3 expression through HIF1-alpha signaling in GBM cells. Moreover, in human GBM xenografts robust BIRC3 expression was noted within hypoxic regions of the tumor. Importantly, selective inhibition of BIRC3 reversed therapeutic resistance of GBM cells to RT in hypoxic microenvironments through enhanced activation of caspases. Collectively, we have uncovered a novel role for BIRC3 as a targetable biomarker and mediator of hypoxia-driven habitats in GBM.
"I'm Really Glad This Is Developmental": Autism and Social Comparisons--An Interpretative Phenomenological Analysis

ERIC Educational Resources Information Center

Huws, Jaci C.; Jones, Robert S. P.

2015-01-01

The present qualitative study comprised interviews with nine young people with autism (aged 16-21 years) about their perceptions of autism. Using interpretative phenomenological analysis, three underlying themes were illuminated, and all these formed the superordinate theme Making Comparisons: (a) Changes over time: "I'm really glad this…
A Network Text Analysis of David Ayer's "Fury"

ERIC Educational Resources Information Center

Hunter, Starling David; Smith, Susan

2015-01-01

Network Text Analysis (NTA) involves the creation of networks of words and/or concepts from linguistic data. Its key insight is that the position of words and concepts in a text network provides vital clues to the central and underlying themes of the text as a whole. Recent research has relied on inductive approaches to identify these themes. In…
Content Analysis of the 20 Most Influential Articles in "PIQ"

ERIC Educational Resources Information Center

Cho, Yonjoo; Park, Sunyoung

2012-01-01

The purpose of this study is to examine key research themes in human performance technology (HPT) through content analysis of the 20 most influential articles identified in Cho, Jo, Park, Kang, and Chen (2011). Three questions guiding this inquiry are: (1) What are the key themes of the 20 most influential articles in "PIQ", (2) What information…
Visual Representations of Sexual Violence in Online News Outlets

PubMed Central

Schwark, Sandra

2017-01-01

To study visual representations of sexual violence, photographs accompanying German Internet news articles that appeared between January 2013 and March 2015 (N = 42) were subjected to thematic analysis. Two main themes, consisting of several sub-themes, emerged from the data. The first theme was “rape myths,” illustrating a stereotypical view of sexual violence. It consisted of three sub-themes: “beauty standards,” referring to the fact that all women in our sample fit western beauty standards, “physical violence,” as most images implied some form of physical violence, and finally “location,” suggesting that rape only happens in secluded outdoor areas. These findings suggest that the images from our sample perpetuate certain rape myths. The second theme was “portrayal of victimhood,” referring to the way victims of sexual violence were portrayed in photographs. The analysis of the sub-theme “passivity” showed that these portrayals fit a certain stereotype: the women were shown to be weak and helpless rather than individuals with agency and able to leave their status as a victim. Further sub-themes were “background,” “organization of space,” “camera perspective,” and “lighting.” We discuss these findings in relation to possibly reinforcing rape myths in society and as an issue in creating a biased perception of women who have experienced sexual violence. PMID:28559870
Pink salmon ( Oncorhynchus gorbuscha) marine survival rates reflect early marine carbon source dependency

NASA Astrophysics Data System (ADS)

Kline, Thomas C., Jr.; Boldt, Jennifer L.; Farley, Edward V., Jr.; Haldorson, Lewis J.; Helle, John H.

2008-05-01

Marine survival rate (the number of adult salmon returning divided by the number of salmon fry released) of pink salmon runs propagated by Prince William Sound, Alaska (PWS) salmon hatcheries is highly variable resulting in large year-to-year run size variation, which ranged from ∼20 to ∼50 million during 1998-2004. Marine survival rate was hypothesized to be determined during their early marine life stage, a time period corresponding to the first growing season after entering the marine environment while they are still in coastal waters. Based on the predictable relationships of 13C/ 12C ratios in food webs and the existence of regional 13C/ 12C gradients in organic carbon, 13C/ 12C ratios of early marine pink salmon were measured to test whether marine survival rate was related to food web processes. Year-to-year variation in marine survival rate was inversely correlated to 13C/ 12C ratios of early marine pink salmon, but with differences among hatcheries. The weakest relationship was for pink salmon from the hatchery without historic co-variation of marine survival rate with other PWS hatcheries or wild stocks. Year-to-year variation in 13C/ 12C ratio of early marine stage pink salmon in combination with regional spatial gradients of 13C/ 12C ratio measured in zooplankton suggested that marine survival was driven by carbon subsidies of oceanic origin (i.e., oceanic zooplankton). The 2001 pink salmon cohort had 13C/ 12C ratios that were very similar to those found for PWS carbon, i.e., when oceanic subsidies were inferred to be nil, and had the lowest marine survival rate (2.6%). Conversely, the 2002 cohort had the highest marine survival (9.7%) and the lowest mean 13C/ 12C ratio. These isotope patterns are consistent with hypotheses that oceanic zooplankton subsidies benefit salmon as food subsidies, or as alternate prey for salmon predators. Oceanic subsidies are manifestations of significant exchange of material between PWS and the Gulf of Alaska. Given that previously observed inter-decadal cycles of oceanic zooplankton abundance were climatically driven, exchange between PWS and the Gulf of Alaska may be an important process for effecting synoptic changes in marine populations of higher trophic levels, and thus an important consideration for climate-change models and scenarios.

Public reaction to the UK government strategy on childhood obesity in England: A qualitative and quantitative summary of online reaction to media reports.

PubMed

Gregg, Rebecca; Patel, Ajay; Patel, Sumaiya; O'Connor, Laura

2017-04-01

This work aimed to summarise public real-time reaction to the publication of the UK government childhood obesity strategy by applying a novel research design method. We used a netnographic technique to carry out thematic analysis of user-generated comments to online newspaper articles related to the strategy. We examined likes/dislikes associated with comments as a proxy of agreement of the wider community with identified themes. To examine media influence on the comments we carried out thematic analysis of online media headlines published about the strategy, and compared these themes with themes identified from comments. Three newspaper articles and 1704 associated comments were included. Three parent themes were identified: paternalism/libertarianism, lobbyist influence and, anecdotal solutions. The comments were largely negative (94%). Commenters were split as to individual responsibilities and the role of the government, some felt that lobbyist influence had won out over the nation's health and others offered non-evidence based solutions. The ten most liked and disliked comments reflected themes identified in our main analysis. There was parity between themes that emerged from comments and from headlines. This summary of public reaction to the obesity strategy publication may aid translation of public views and receptiveness into practice and inform subsequent government action and policy. Furthermore, the process applied herein may provide a means of informal public engagement. Copyright © 2017 Elsevier B.V. All rights reserved.
Asian Indians in America: The influence of values and culture on mental health.

PubMed

Chandra, Rohit M; Arora, Lily; Mehta, Urvakhsh M; Asnaani, Anu; Radhakrishnan, Rajiv

2016-08-01

Asian Indians represent a significant portion of the largest growing race of Asians in the past decade in the United States. This selective review examines major cultural themes related to first- and second-generation Asian Indians living in the United States as they impact psychological and psychiatric dysfunction in this population. Specifically, we review the impact of Asian Indian culture on mental health, discuss the impact of acculturation and ethnic identity development on the mental health of Indian-Americans, and focus on typical mental health problems of Asian Indian adolescents, women and elderly in America. Finally, we provide a brief overview of empirically-supported treatment approaches and cultural considerations for additional treatments relevant to this population. This review is intended to provide an important foundation for more systematic empirically-driven investigation into better understanding how Asian Indian cultural themes impact mental health for Indian-Americans, and how to develop effective treatments for these issues in this cultural group. Copyright © 2015 Elsevier B.V. All rights reserved.
Hazard Function Estimation with Cause-of-Death Data Missing at Random

PubMed Central

Wang, Qihua; Dinse, Gregg E.; Liu, Chunling

2010-01-01

Hazard function estimation is an important part of survival analysis. Interest often centers on estimating the hazard function associated with a particular cause of death. We propose three nonparametric kernel estimators for the hazard function, all of which are appropriate when death times are subject to random censorship and censoring indicators can be missing at random. Specifically, we present a regression surrogate estimator, an imputation estimator, and an inverse probability weighted estimator. All three estimators are uniformly strongly consistent and asymptotically normal. We derive asymptotic representations of the mean squared error and the mean integrated squared error for these estimators and we discuss a data-driven bandwidth selection method. A simulation study, conducted to assess finite sample behavior, demonstrates that the proposed hazard estimators perform relatively well. We illustrate our methods with an analysis of some vascular disease data. PMID:22267874
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.
Analysis of Voyager Observed High-Energy Electron Fluxes in the Heliosheath Using MHD Simulations

NASA Technical Reports Server (NTRS)

Washimi, Haruichi; Webber, W. R.; Zank, Gary P.; Hu, Qiang; Florinski, Vladimir; Adams, James; Kubo, Yuki

2011-01-01

The Voyager spacecraft (V1 and V2) observed electrons of 6-14 MeV in the heliosheath which showed several incidences of flux variation relative to a background of gradually increasing flux with distance from the Sun. The increasing flux of background electrons is thought to result from inward radial diffusion. We compare the temporal electron flux variation with dynamical phenomena in the heliosheath that are obtained from our MHD simulations. Because our simulation is based on V2 observed plasma data before V2 crossed the termination shock, this analysis is effective up to late 2008, i.e., about a year after the V2-crossing, during which disturbances, driven prior to the crossing time, survived in the heliosheath. Several electron flux variations correspond to times directly associated with interplanetary shock events. One noteworthy example corresponds to various times associated with the March 2006 interplanetary shock, these being the collision with the termination shock, the passage past the V1 spacecraft, and the collision with the region near the heliopause, as identified by W.R. Webber et al. for proton/helium of 7-200 MeV. Our simulations indicate that all other electron flux variations, except one, correspond well to the times when a shock-driven magneto-sonic pulse and its reflection in the heliosheath either passed across V1/V2, or collided with the termination shock or with the plasma sheet near the heliopause. This result suggests that variation in the electron flux should be due to either direct or indirect effects of magnetosonic pulses in the heliosheath driven by interplanetary shocks
Mapping the Themes, Impact, and Cohesion of Creativity Research over the Last 25 Years

ERIC Educational Resources Information Center

Williams, Rich; Runco, Mark A.; Berlow, Eric

2016-01-01

This article describes the themes found in the past 25 years of creativity research. Computational methods and network analysis were used to map keyword theme development across ~1,400 documents and ~5,000 unique keywords from 1990 (the first year keywords are available in Web of Science) to 2015. Data were retrieved from Web of Science using the…
Measuring the Dynamics of Climate Change Communication in Mass Media and Social Networks with Computer-Assisted Content Analysis

NASA Astrophysics Data System (ADS)

Kirilenko, A.; Stepchenkova, S.

2012-12-01

To date, multiple authors have examined media representations of and public attitudes towards climate change, as well as how these representations and attitudes differ from scientific knowledge on the issue of climate change. Content analysis of newspaper publications, TV news, and, recently, Internet blogs has allowed for identification of major discussion themes within the climate change domain (e.g., newspaper trends, comparison of climate change discourse in different countries, contrasting liberal vs. conservative press). The majority of these studies, however, have processed texts manually, limiting textual population size, restricting the analysis to a relatively small number of themes, and using time-expensive coding procedures. The use of computer-assisted text analysis (CATA) software is important because the difficulties with manual processing become more severe with an increased volume of data. We developed a CATA approach that allows a large body of text materials to be surveyed in a quantifiable, objective, transparent, and time-efficient manner. While staying within the quantitative tradition of content analysis, the approach allows for an interpretation of the public discourse closer to one of more qualitatively oriented methods. The methodology used in this study contains several steps: (1) sample selection; (2) data preparation for computer processing and obtaining a matrix of keyword frequencies; (3) identification of themes in the texts using Exploratory Factor Analysis (EFA); (4) combining identified themes into higher order themes using Confirmatory Factor Analysis (CFA); (5) interpretation of obtained public discourse themes using factor scores; and (6) tracking the development of the main themes of the climate change discourse through time. In the report, we concentrate on two examples of CATA applied to study public perception of climate change. First example is an analysis of temporal change in public discourse on climate change. Applying CATA to a conservatively selected sample of 4043 articles published on climate change in The New York Times from 1995, we found a considerable change in major topics of discussion. One of the most significant tendencies is a gradual decline in the volume of material within the "Science" topic and an expansion of themes classified under the "Politics" topic. The second example is the analysis of public ability to detect climate change, in which we used a database of over 1 million Twitter messages on climate change that we have collected. We compared the intensity of tweeting on climate change with the "common-sense climate index" by Hansen et al (1999) and found that the weather extremes experienced at a certain location is immediately reflected in the number of tweets discussing climate change originating from that location. Although the CATA approach certainly has its limitations, we are convinced that it has a number of advantages over manual processing: it is able to analyze large textual bodies, is more time efficient, has a higher level of detail, enhances the richness of interpretation, and is able to reliably track discourse development through time.
Factors affecting planned return to work after trauma: A prospective descriptive qualitative and quantitative study.

PubMed

Folkard, S S; Bloomfield, T D; Page, P R J; Wilson, D; Ricketts, D M; Rogers, B A

2016-12-01

The use of patient reported outcome measures (PROMs) in trauma is limited. The aim of this pilot study is to evaluate qualitative responses and factors affecting planned return to work following significant trauma, for which there is currently a poor evidence base. National ethical approval was obtained for routine prospective PROMs data collection, including EQ-5D, between Sept 2013 and March 2015 for trauma patients admitted to the Sussex Major Trauma Centre (n=92). 84 trauma patients disclosed their intended return to work at discharge. Additional open questions asked 'things done well' and 'things to be improved'. EQ-5D responses were valued using the time trade-off method. Statistical analysis between multiple variables was completed by ANOVA, and with categorical categories by Chi squared analysis. Only 18/68 of patients working at admission anticipated returning to work within 14days post-discharge. The injury severity scores (ISS) of those predicting return to work within two weeks and those predicting return to work longer than two weeks were 14.17 and 13.59, respectively. Increased physicality of work showed a trend towards poorer return to work outcomes, although non-significant in Chi-squared test in groups predicting return in less than or greater than two weeks (4.621, p=0.2017ns). No significant difference was demonstrated in the comparative incomes of patients with different estimated return to work outcomes (ANOVA r 2 =0.001, P=0.9590ns). EQ-5D scores were higher in those predicting return to work within two weeks when compared to greater than two weeks. Qualitative thematic content analysis of open responses was possible for 66/92 of respondents. Prominent positive themes were: care, staff, professionalism, and communication. Prominent negative themes were: food, ward response time, and communication. This pilot study highlights the importance of qualitative PROMs analysis in leading patient-driven improvements in trauma care. We provide standard deviations for ISS scores and EQ-5D scores in our general trauma cohort, for use in sample size calculations for further studies analysing factors affecting return to work after trauma. Crown Copyright Â© 2016. Published by Elsevier Ltd. All rights reserved.
Persistence patterns of mathematics and science majors: A profile of highly motivated freshmen

NASA Astrophysics Data System (ADS)

Gonzales, Erin E.

Despite an increasing demand for college graduates skilled in science, technology, engineering, and mathematics ("STEM") fields, a substantial number of students who choose these majors leave after taking their first-year "gateway" math and science coursework. Research has shown GPA to be a salient predictor of persistence in STEM majors: Students who earn high grades in gateway courses are more likely to continue, and those who earn low grades are more likely to leave. However, a small number of students defy that expectation: Despite a low gateway course GPA, they persist not just to the sophomore year but all the way to graduation. The purpose of this study was to determine what other experiences, motivations, or attributes aside from academic performance influence these students to persist. A qualitative approach was taken with the use of semi-structured interviews, which provided a means for analysis based on insights directly from students. An invitation was sent to a cohort of graduating math and science majors at a large public institution, and 10 eligible volunteers were chosen to participate. A thematic analysis was conducted to seek common themes in the students' interviews regarding their experiences in their gateway coursework, their feelings towards their chosen major, their beliefs about their academic proficiency, their motivations for continuing in their major, and other prominent characteristics they attributed to their persistence. Five themes were found: Ambition, dedication, achievement, culture shock, and resilience. Of the five themes, four are attributes of the students themselves: Ambition, dedication, achievement, and resilience. The fifth, culture shock, is something that happened to them, although it does contain information about the students insofar as how they handled the situation. The end result was the identification of a specific group of students: High achievers majoring in math and science who are self-driven and independent, as well as confident in their abilities. A student fitting this profile is likely to persist in a math or science major despite any initial setbacks they may endure in the first year of coursework. In terms of application, institutions can implement initiatives for incoming freshmen to orient them to their STEM majors and guide them in understanding the attitudes, motivations, and practices that will help them succeed.
Understanding Collaborative Leadership in Theory and Practice

ERIC Educational Resources Information Center

Lawrence, Randee Lipson

2017-01-01

This final chapter provides a synthesis and analysis of the major themes in the previous chapters. Definitions of collaborative leadership are explored along with theoretical underpinnings, characteristics, and common themes. Implications for adult education are discussed.
Themes of grief.

PubMed

Carter, S L

1989-01-01

A thematic analysis of 30 narrative accounts of bereavement revealed nine themes that included five core themes in bereavement--being stopped, hurting, missing, holding, and seeking; three meta-themes about bereavement--change, expectations, and inexpressibility; and a contextual theme--personal history. The themes were compared with three theoretical perspectives on bereavement by Freud, Kübler-Ross, and one defined as existential-phenomenological. Features of bereavement that are dissimilar or unaddressed by the theoretical perspectives were: (a) the quality of grief's changing character, including "waves" and intense pain which may be triggered years after the death; (b) holding, an individual process of preserving the fact and meaning of the loved one's existence; (c) expectations, both social and personal, as to how the bereaved should be overlaying the experience; and (d) the critical importance of personal history in affecting the quality and meaning of individual bereavement.
Conflict in the intensive care unit: Nursing advocacy and surgical agency.

PubMed

Pecanac, Kristen E; Schwarze, Margaret L

2018-02-01

Nurses and surgeons may experience intra-team conflict during decision making about the use of postoperative life-sustaining treatment in the intensive care unit due to their perceptions of professional roles and responsibilities. Nurses have a sense of advocacy-a responsibility to support the patient's best interest; surgeons have a sense of agency-a responsibility to keep the patient alive. The objectives were to (1) describe the discourse surrounding the responsibilities of nurses and surgeons, as "advocates" and "agents," and (2) apply these findings to determine how differences in role responsibilities could foster conflict during decision making about postoperative life-sustaining treatment in the intensive care unit. Articles, books, and professional documents were explored to obtain descriptions of nurses' and surgeons' responsibilities to their patients. Using discourse analysis, responsibilities were grouped into themes and then compared for potential for conflict. Ethical considerations: No data were collected from human participants and ethical review was not required. The texts were analyzed by a surgeon and a nurse to minimize profession-centric biases. Four themes in nursing discourse were identified: responsibility to support patient autonomy regarding treatment decisions, responsibility to protect the patient from the physician, responsibility to act as an intermediary between the physician and the patient, and the responsibility to support the well-being of the patient. Three themes in surgery discourse were identified personal responsibility for the patient's outcome, commitment to patient survival, and the responsibility to prevent harm to the patient from surgery. These responsibilities may contribute to conflict because each profession is working toward different goals and each believes they know what is best for the patient. It is not clear from the existing literature that either profession understands each other's responsibilities. Interventions that improve understanding of each profession's responsibilities may be helpful to reduce intra-team conflict in the intensive care unit.
Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery.

PubMed

Kilcullen, Meegan; Ireland, Susan

2017-05-11

Neonatology has made significant advances in the last 30 years. Despite the advances in treatments, not all neonates survive and a palliative care model is required within the neonatal context. Previous research has focused on the barriers of palliative care provision. A holistic approach to enhancing palliative care provision should include identifying both facilitators and barriers. A strengths-based approach would allow barriers to be addressed while also enhancing facilitators. The current study qualitatively explored perceptions of neonatal nurses about facilitators and barriers to delivery of palliative care and also the impact of the regional location of the unit. The study was conducted at the Townsville Hospital, which is the only regional tertiary neonatal unit in Australia. Semi-structured interviews were conducted with a purposive sample of eight neonatal nurses. Thematic analysis of the data was conducted within a phenomenological framework. Six themes emerged regarding family support and staff factors that were perceived to support the provision of palliative care of a high quality. Staff factors included leadership, clinical knowledge, and morals, values, and beliefs. Family support factors included emotional support, communication, and practices within the unit. Five themes emerged from the data that were perceived to be barriers to providing quality palliative care. Staff perceived education, lack of privacy, isolation, staff characteristics and systemic (policy, and procedure) factors to impact upon palliative care provision. The regional location of the unit also presented unique facilitators and barriers to care. This study identified and explored facilitators and barriers in the delivery of quality palliative care for neonates in a regional tertiary setting. Themes identified suggested that a strengths-approach, which engages and amplifies facilitating factors while identified barriers are addressed or minimized, would be successful in supporting quality palliative care provision in the neonatal care setting. Study findings will be used to inform clinical education and practice.
Hypoxia tolerance in reptiles, amphibians, and fishes: life with variable oxygen availability.

PubMed

Bickler, Philip E; Buck, Leslie T

2007-01-01

The ability of fishes, amphibians, and reptiles to survive extremes of oxygen availability derives from a core triad of adaptations: profound metabolic suppression, tolerance of ionic and pH disturbances, and mechanisms for avoiding free-radical injury during reoxygenation. For long-term anoxic survival, enhanced storage of glycogen in critical tissues is also necessary. The diversity of body morphologies and habitats and the utilization of dormancy have resulted in a broad array of adaptations to hypoxia in lower vertebrates. For example, the most anoxia-tolerant vertebrates, painted turtles and crucian carp, meet the challenge of variable oxygen in fundamentally different ways: Turtles undergo near-suspended animation, whereas carp remain active and responsive in the absence of oxygen. Although the mechanisms of survival in both of these cases include large stores of glycogen and drastically decreased metabolism, other mechanisms, such as regulation of ion channels in excitable membranes, are apparently divergent. Common themes in the regulatory adjustments to hypoxia involve control of metabolism and ion channel conductance by protein phosphorylation. Tolerance of decreased energy charge and accumulating anaerobic end products as well as enhanced antioxidant defenses and regenerative capacities are also key to hypoxia survival in lower vertebrates.
mTORC1-Mediated Inhibition of 4EBP1 Is Essential for Hedgehog Signaling-Driven Translation and Medulloblastoma.

PubMed

Wu, Chang-Chih; Hou, Shirui; Orr, Brent A; Kuo, Bryan R; Youn, Yong Ha; Ong, Taren; Roth, Fanny; Eberhart, Charles G; Robinson, Giles W; Solecki, David J; Taketo, Makoto M; Gilbertson, Richard J; Roussel, Martine F; Han, Young-Goo

2017-12-18

Mechanistic target of rapamycin (MTOR) cooperates with Hedgehog (HH) signaling, but the underlying mechanisms are incompletely understood. Here we provide genetic, biochemical, and pharmacologic evidence that MTOR complex 1 (mTORC1)-dependent translation is a prerequisite for HH signaling. The genetic loss of mTORC1 function inhibited HH signaling-driven growth of the cerebellum and medulloblastoma. Inhibiting translation or mTORC1 blocked HH signaling. Depleting 4EBP1, an mTORC1 target that inhibits translation, alleviated the dependence of HH signaling on mTORC1. Consistent with this, phosphorylated 4EBP1 levels were elevated in HH signaling-driven medulloblastomas in mice and humans. In mice, an mTORC1 inhibitor suppressed medulloblastoma driven by a mutant SMO that is inherently resistant to existing SMO inhibitors, prolonging the survival of the mice. Our study reveals that mTORC1-mediated translation is a key component of HH signaling and an important target for treating medulloblastoma and other cancers driven by HH signaling. Copyright © 2017 Elsevier Inc. All rights reserved.
Understanding the experiences of fathers of children with congenital heart disease: An interpretative phenomenological analysis.

PubMed

Gower, Carla; Higgins, Aiveen; Doherty, Nicola; McCormack, David

2017-09-01

Little is known about the experiences of fathers of children with congenital heart disease. Using interpretative phenomenological analysis, the lived experiences of six fathers were explored. Two master themes emerged: 'relinquishing and reclaiming control' and 'living in the shadow of illness'. Subordinate themes included playing the support act, a pragmatic/emotional dichotomy, and becoming the child's protector. Other themes included living in limbo and redefining 'normality' to encompass the condition. Theoretical links are made between these findings and existing literature while clinical implications include the need to involve fathers in decision-making and to respect their need to maintain control.
The personal experience of dysmenorrhoea: an interpretative phenomenological analysis.

PubMed

Burbeck, Rachel; Willig, Carla

2014-10-01

This study explored six women's experiences of primary dysmenorrhoea using semi-structured interviews analysed using interpretative phenomenological analysis. Rather than focusing on pain, participants broadened the study focus to coping with the menstrual process as a whole. This was seen to be mediated by menstrual taboos and by the theme of 'order', arising from a strong feeling of a menstrual timetable and the need for rational explanation. Another theme was pain as a separate entity, which was connected to the theme of order. Placing dysmenorrhoea in its context may be useful for health-care professionals treating women with the condition. © The Author(s) 2013.
A Snapshot in Time: Themes, Tags and International Reach--An Analysis of the Journal of International Research in Early Childhood Education

ERIC Educational Resources Information Center

Pendergast, Donna; Twigg, Danielle

2015-01-01

A thematic content analysis of the seven issues (35 papers and two editorials) of the "International Research in Early Childhood Education" ("IRECE") journal published by Monash University in Melbourne, Victoria was conducted to explore the themes over its five years of publication. Publications were grouped into defined data…
Exploring factors influencing health-seeking decisions and retention in childhood cancer treatment programmes: perspectives of parents in Ghana.

PubMed

Renner, Lorna Awo; McGill, Deborah

2016-09-01

Developing countries such as Ghana have very poor childhood cancer survival rates. There is a need to determine reasons for late presentation and treatment abandonment which are major causes of poor survival. Understanding these issues could inform effective strategies for childhood cancer control in resource-constrained settings. To explore factors influencing parental decision-making for children with cancer in Ghana with regard to health seeking and retention in treatment, in order to provide information that will guide Public Health interventions for childhood cancer control. This exploratory qualitative study was conducted based on an interpretative epistemology using a social constructionist approach. Purposive sampling of parents attending the Paediatric Oncology Unit, Korle Bu Teaching Hospital in Accra, Ghana was undertaken. Twelve semi-structured moderate interviews and two small focus group discussions with a total of seven participants were undertaken. Data analysis was through thematic content analysis. Five major themes emerged. Knowledge and perceptions revealed a total lack of appropriate knowledge prior to diagnosis. Health-seeking behaviour was determined by interplay of individual and environmental factors. Orthodox medical treatment was largely perceived favourably. The impact of cancer on parents and children included psychological, physical and socioeconomic effects. Financial, spiritual and psychosocial support helped in coping. Parents recommended public education and health financing to address the major barriers. Broad social determinants and experiences influence parental decision making for children with cancer. This implies Health Promotion strategies with multi-sectorial involvement will be required for effective implementation of the National Strategy for Cancer Control. Funded by authors.
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

Cell Survival Signaling in Neuroblastoma

PubMed Central

Megison, Michael L.; Gillory, Lauren A.; Beierle, Elizabeth A.

2013-01-01

Neuroblastoma is the most common extracranial solid tumor of childhood and is responsible for over 15% of pediatric cancer deaths. Neuroblastoma tumorigenesis and malignant transformation is driven by overexpression and dominance of cell survival pathways and a lack of normal cellular senescence or apoptosis. Therefore, manipulation of cell survival pathways may decrease the malignant potential of these tumors and provide avenues for the development of novel therapeutics. This review focuses on several facets of cell survival pathways including protein kinases (PI3K, AKT, ALK, and FAK), transcription factors (NF-κB, MYCN and p53), and growth factors (IGF, EGF, PDGF, and VEGF). Modulation of each of these factors decreases the growth or otherwise hinders the malignant potential of neuroblastoma, and many therapeutics targeting these pathways are already in the clinical trial phase of development. Continued research and discovery of effective modulators of these pathways will revolutionize the treatment of neuroblastoma. PMID:22934706
Survival in macaroni penguins and the relative importance of different drivers: individual traits, predation pressure and environmental variability

PubMed Central

Horswill, Catharine; Matthiopoulos, Jason; Green, Jonathan A; Meredith, Michael P; Forcada, Jaume; Peat, Helen; Preston, Mark; Trathan, Phil N; Ratcliffe, Norman

2014-01-01

Understanding the demographic response of free-living animal populations to different drivers is the first step towards reliable prediction of population trends. Penguins have exhibited dramatic declines in population size, and many studies have linked this to bottom-up processes altering the abundance of prey species. The effects of individual traits have been considered to a lesser extent, and top-down regulation through predation has been largely overlooked due to the difficulties in empirically measuring this at sea where it usually occurs. For 10 years (2003–2012), macaroni penguins (Eudyptes chrysolophus) were marked with subcutaneous electronic transponder tags and re-encountered using an automated gateway system fitted at the entrance to the colony. We used multistate mark–recapture modelling to identify the different drivers influencing survival rates and a sensitivity analysis to assess their relative importance across different life stages. Survival rates were low and variable during the fledging year (mean = 0·33), increasing to much higher levels from age 1 onwards (mean = 0·89). We show that survival of macaroni penguins is driven by a combination of individual quality, top-down predation pressure and bottom-up environmental forces. The relative importance of these covariates was age specific. During the fledging year, survival rates were most sensitive to top-down predation pressure, followed by individual fledging mass, and finally bottom-up environmental effects. In contrast, birds older than 1 year showed a similar response to bottom-up environmental effects and top-down predation pressure. We infer from our results that macaroni penguins will most likely be negatively impacted by an increase in the local population size of giant petrels. Furthermore, this population is, at least in the short term, likely to be positively influenced by local warming. More broadly, our results highlight the importance of considering multiple causal effects across different life stages when examining the survival rates of seabirds. PMID:24846695
Sustaining the Bering Ecosystem: A Social Science Research Plan

NASA Astrophysics Data System (ADS)

Fitzhugh, B.; Huntington, H. P.; Pete, M. C.; Sepez, J. A.

2007-12-01

The Bering Sea is changing from an ice-dominated to an increasingly open water system. The over-arching goal of the NSF-supported Bering Ecosystem Study (BEST) is to understand the effects of climate variability and change on the Bering Sea ecosystem. To the people who are simultaneously a part of that ecosystem and rely on its productivity for life and work, climate change and its effects are among the top concerns. Sustaining the Bering Ecosystem articulates a vision and approaches for social science research as a component of the BEST Program (www.arcus.org/bering). This science plan seeks to initiate research to elucidate the dynamic relationship between the Bering Sea ecosystem and the humans who constitute an integral component of that system. To do so, this plan delineates a research program focused on three broad themes: 1. Impacts on humans: how past, current, and possible future changes in the Bering Sea ecosystem affect the health and well-being of people living and depending on this region for subsistence, employment, and cultural survival. 2. Human impacts: how changing human uses of the Bering Sea region affect the natural cycles of this ecosystem by moderating and/or accelerating systemic changes. 3. Dynamics of human and non-human natural systems: how the human-environmental dynamic has changed through time and may change in the future due to internal and external opportunities and pressures. These themes are developed in the context of a community-driven approach based on the concerns, goals, and interests of Bering Sea residents and other stakeholders of the region. This plan has been drafted through the collaboration of Bering Sea residents (primarily Alaska Natives) and non-resident stakeholders, social scientists, and natural scientists to focus efforts around research questions important to stakeholders, which in various ways center on issues of sustainability (of resources, economic opportunities, ways of life, and culture itself). The research envisioned by this plan will provide a foundation for resident communities, regional corporations and tribal councils, industry stakeholders, resource managers and policy makers at various levels to plan for and face the future with less uncertainty. To accomplish this goal, research must be developed with attention to concrete and practical outcomes. In this social science effort, and in the broader Bering Sea Ecosystem Study (BEST) of which it is a part, synergies must be explored that harness the strengths of multiple disciplines toward common purposes. For this reason, the research anticipated in this plan will: - generally involve interdisciplinary teams and projects that include a modeling component; - may focus on more than one of the defined research themes; and - require collaboration and partnership with Native and non-Native residents and stakeholders in the Bering Sea.
It Happened to Me: A Qualitative Analysis of Boys' Narratives About Child Sexual Abuse.

PubMed

Foster, Jennifer M

2017-10-01

Previous research on children's narratives about sexual abuse written predominately by girls uncovered several themes, including: (a) memories of the abuse, (b) the disclosure and subsequent events, and (c) the healing journey and a meta-theme titled "fear and safety." This follow-up study explored how boys describe their life prior to, during, and after sexual abuse in the form of trauma narratives and if there are distinctive features of boys' experiences that differ from those of girls. Analysis of narratives written by males ages 3 to 17 (N = 19) found that boys ascribe to the same themes as the initial research but also have experiences and perspectives that are unique to being male survivors. This article focuses on the first two themes: memories of the abuse and the disclosure and subsequent events. Gender differences are discussed along with recommendations for prevention of male sexual abuse.
Image of nursing held by nursing students according to gender: a qualitative study.

PubMed

Karabacak, Ükke; Uslusoy, Esin; Alpar, Şule Ecevit; Bahçecik, Nefise

2012-12-01

This paper is a report of a study to determine the nursing images of female and male nursing students. The study used a qualitative research design to determine nursing images of male (n = 20) and female (n = 20) nursing students. To analyse the data, the method used content analysis. Statements were organized under three categories and seven themes after content analysis. The first category, nursing concept, incorporates the two themes of: (i) female or sister; (ii) job definition. The second category, choosing, incorporates the four themes of: (i) Desire of Others; (ii) Guarantee of Work; (iii) Being Helpful to Others; and (iv) Limited to Academic Achievement. The third category, Gender, incorporates the one theme of: (i) Gendered Approach. Male students have started to take part in nursing programs relatively recently; therefore, more research is needed in the fields of academic accomplishments of male students. © 2012 Wiley Publishing Asia Pty Ltd.
Intellectual disability in cerebral palsy: a population-based retrospective study.

PubMed

Reid, Susan M; Meehan, Elaine M; Arnup, Sarah J; Reddihough, Dinah S

2018-07-01

A population-based observational study design was used to describe the epidemiology of intellectual disability in cerebral palsy (CP) in terms of clinical and neuroimaging associations, and to report the impact of intellectual disability on utilization of health services and length of survival. Population CP registry data were used to retrospectively assess the frequency of intellectual disability and strength of associations between intellectual disability and mobility, epilepsy, vision, hearing, communication, and neuroimaging patterns (n=1141). Data linkage was undertaken to assess usage of hospital inpatient and emergency department services. Survival analysis was performed in a 30-year birth cohort (n=3248). Intellectual disability, present in 45% of the cohort, was associated with non-ambulation (47% vs 8%), later walking (mean 2y 7mo vs 1y 9mo), hypotonic (8% vs 1%) or dyskinetic (9% vs 5%) CP, a quadriplegic pattern of motor impairment (42% vs 5%), epilepsy (52% vs 12%), more emergency and multi-day hospital admissions, and reduced 35-year survival (96% vs 71%). Grey matter injuries (13% vs 6%), malformations (18% vs 6%), and miscellaneous neuroimaging patterns (12% vs 4%) were more common in people with intellectual disability. Intellectual disability adds substantially to the overall medical complexity in CP and may increase health and mortality disparities. Cerebral maldevelopments and grey matter injuries are associated with higher intellectual disability rates. Health care is more 'crisis-driven' and 'reactive' in children with co-occurring intellectual disability. Length of survival is reduced in individuals with CP and co-occurring intellectual disability. © 2018 Mac Keith Press.
Impact of socioeconomic status and rurality on early outcomes and mid-term survival after CABG: insights from a multicentre registry.

PubMed

Shi, William Y; Yap, Cheng-Hon; Newcomb, Andrew E; Hayward, Philip A; Tran, Lavinia; Reid, Christopher M; Smith, Julian A

2014-08-01

We examined whether socioeconomic status and rurality influenced outcomes after coronary surgery. We identified 14,150 patients undergoing isolated coronary surgery. Socioeconomic and rurality data was obtained from the Australian Bureau of Statistics and linked to patients' postcodes. Outcomes were compared between categories of socioeconomic disadvantage (highest versus lowest quintiles, n= 3150 vs. 2469) and rurality (major cities vs. remote, n=9598 vs. 839). Patients from socioeconomically-disadvantaged areas experienced a greater burden of cardiovascular risk factors including diabetes, obesity and current smoking. Thirty-day mortality (disadvantaged 1.6% vs. advantaged 1.6%, p>0.99) was similar between groups as was late survival (7 years: 83±0.9% vs. 84±1.0%, p=0.79). Those from major cities were less likely to undergo urgent surgery. There was similar 30-day mortality (major cities: 1.6% vs. remote: 1.5%, p=0.89). Patients from major cities experienced improved survival at seven years (84±0.5% vs. 79±2.0%, p=0.010). Propensity-analysis did not show socioeconomic status or rurality to be associated with late outcomes. Patients presenting for coronary artery surgery from different socioeconomic and geographic backgrounds exhibit differences in their clinical profile. Patients from more rural and remote areas appear to experience poorer long-term survival, though this may be partially driven by the population's clinical profile. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
Eating to live or living to eat? Exploring the causal attributions of self-perceived food addiction.

PubMed

Ruddock, Helen K; Dickson, Joanne M; Field, Matt; Hardman, Charlotte A

2015-12-01

Previous studies indicate that many people perceive themselves to be addicted to food. However, little is known about how the concept of 'food addiction' is defined amongst members of the lay public. The current study examined beliefs about the cognitive and behavioural manifestations of food addiction. Participants (N = 210) completed an internet-delivered questionnaire in which they indicated whether or not they perceived themselves to be a food addict and provided a brief explanation for their response. Over a quarter of participants (28%) perceived themselves to be food addicts and self-diagnosis was predicted by increased BMI and younger age, but not by gender. Thematic analysis was conducted to explore the causal attributions provided by self-perceived food addicts and non-addicts. Six characteristics were identified: 1) Reward-driven eating (i.e. eating for psychological rather than physiological reasons), 2) A functional or psychological preoccupation with food, 3) A perceived lack of self-control around food, 4) Frequent food cravings, 5) Increased weight or an unhealthy diet, and 6) A problem with a specific type of food. The emergent themes, and their frequency, did not differ between self-perceived food addicts and non-addicts. However, self-perceived food addicts and non-addicts reported divergent cognitions, behaviours and attitudes within each common theme. This study is the first to provide qualitative insight into beliefs about food addiction in both self-perceived food addicts and non-addicts. The findings appear to reflect a view of food addiction that is identifiable through several core behaviours. Copyright © 2015 Elsevier Ltd. All rights reserved.
Adipose tissue transcriptomic signature highlights the pathological relevance of extracellular matrix in human obesity

PubMed Central

Henegar, Corneliu; Tordjman, Joan; Achard, Vincent; Lacasa, Danièle; Cremer, Isabelle; Guerre-Millo, Michèle; Poitou, Christine; Basdevant, Arnaud; Stich, Vladimir; Viguerie, Nathalie; Langin, Dominique; Bedossa, Pierre; Zucker, Jean-Daniel; Clement, Karine

2008-01-01

Background Investigations performed in mice and humans have acknowledged obesity as a low-grade inflammatory disease. Several molecular mechanisms have been convincingly shown to be involved in activating inflammatory processes and altering cell composition in white adipose tissue (WAT). However, the overall importance of these alterations, and their long-term impact on the metabolic functions of the WAT and on its morphology, remain unclear. Results Here, we analyzed the transcriptomic signature of the subcutaneous WAT in obese human subjects, in stable weight conditions and after weight loss following bariatric surgery. An original integrative functional genomics approach was applied to quantify relations between relevant structural and functional themes annotating differentially expressed genes in order to construct a comprehensive map of transcriptional interactions defining the obese WAT. These analyses highlighted a significant up-regulation of genes and biological themes related to extracellular matrix (ECM) constituents, including members of the integrin family, and suggested that these elements could play a major mediating role in a chain of interactions that connect local inflammatory phenomena to the alteration of WAT metabolic functions in obese subjects. Tissue and cellular investigations, driven by the analysis of transcriptional interactions, revealed an increased amount of interstitial fibrosis in obese WAT, associated with an infiltration of different types of inflammatory cells, and suggest that phenotypic alterations of human pre-adipocytes, induced by a pro-inflammatory environment, may lead to an excessive synthesis of ECM components. Conclusion This study opens new perspectives in understanding the biology of human WAT and its pathologic changes indicative of tissue deterioration associated with the development of obesity. PMID:18208606
Impact of systemic targeted agents on the clinical outcomes of patients with brain metastases

PubMed Central

Johnson, Adam G.; Ruiz, Jimmy; Hughes, Ryan; Page, Brandi R.; Isom, Scott; Lucas, John T.; McTyre, Emory R.; Houseknecht, Kristin W.; Ayala-Peacock, Diandra N.; Bourland, Daniel J.; Hinson, William H.; Laxton, Adrian W.; Tatter, Stephen B.; Debinski, Waldemar; Watabe, Kounosuke; Chan, Michael D.

2015-01-01

Background To determine the clinical benefits of systemic targeted agents across multiple histologies after stereotactic radiosurgery (SRS) for brain metastases. Methods Between 2000 and 2013, 737 patients underwent upfront SRS for brain metastases. Patients were stratified by whether or not they received targeted agents with SRS. 167 (23%) received targeted agents compared to 570 (77%) that received other available treatment options. Time to event data were summarized using Kaplan-Meier plots, and the log rank test was used to determine statistical differences between groups. Results Patients who received SRS with targeted agents vs those that did not had improved overall survival (65% vs. 30% at 12 months, p < 0.0001), improved freedom from local failure (94% vs 90% at 12 months, p = 0.06), improved distant failure-free survival (32% vs. 18% at 12 months, p = 0.0001) and improved freedom from whole brain radiation (88% vs. 77% at 12 months, p = 0.03). Improvement in freedom from local failure was driven by improvements seen in breast cancer (100% vs 92% at 12 months, p < 0.01), and renal cell cancer (100% vs 88%, p = 0.04). Multivariate analysis revealed that use of targeted agents improved all cause mortality (HR = 0.6, p < 0.0001). Conclusions Targeted agent use with SRS appears to improve survival and intracranial outcomes. PMID:26087184
RKIP and HMGA2 regulate breast tumor survival and metastasis through lysyl oxidase and syndecan-2.

PubMed

Sun, M; Gomes, S; Chen, P; Frankenberger, C A; Sankarasharma, D; Chung, C H; Chada, K K; Rosner, M R

2014-07-03

Elucidating targets of physiological tumor metastasis suppressors can highlight key signaling pathways leading to invasion and metastasis. To identify downstream targets of the metastasis suppressor Raf-1 kinase inhibitory protein (RKIP/PEBP1), we utilized an integrated approach based upon statistical analysis of tumor gene expression data combined with experimental validation. Previous studies from our laboratory identified the architectural transcription factor and oncogene, high mobility group AT-hook 2 (HMGA2), as a target of inhibition by RKIP. Here we identify two signaling pathways that promote HMGA2-driven metastasis. Using both human breast tumor cells and an MMTV-Wnt mouse breast tumor model, we show that RKIP induces and HMGA2 inhibits expression of miR-200b; miR-200b directly inhibits expression of lysyl oxidase (LOX), leading to decreased invasion. RKIP also inhibits syndecan-2 (SDC2), which is aberrantly expressed in breast cancer, via downregulation of HMGA2; but this mechanism is independent of miR-200. Depletion of SDC2 induces apoptosis and suppresses breast tumor growth and metastasis in mouse xenografts. RKIP, LOX and SDC2 are coordinately regulated and collectively encompass a prognostic signature for metastasis-free survival in ER-negative breast cancer patients. Taken together, our findings reveal two novel signaling pathways targeted by the metastasis suppressor RKIP that regulate remodeling of the extracellular matrix and tumor survival.
Perceived Maternal Behavioral Control, Infant Behavior, and Milk Supply: A Qualitative Study.

PubMed

Peacock-Chambers, Elizabeth; Dicks, Kaitlin; Sarathy, Leela; Brown, Allison A; Boynton-Jarrett, Renée

Disparities persist in breastfeeding exclusivity and duration despite increases in breastfeeding initiation. The objective of this study was to examine factors that influence maternal decision making surrounding infant feeding practices over time in a diverse inner-city population. We conducted a prospective qualitative study with 20 mothers recruited from 2 urban primary care clinics. Participants completed open-ended interviews and demographic questionnaires in English or Spanish administered at approximately 2 weeks and 6 months postpartum. Transcripts were analyzed using a combined technique of inductive (data-driven) and deductive (theory-driven, based on the Theory of Planned Behavior) thematic analysis using 3 independent coders and iterative discussion to reach consensus. All women initiated breastfeeding, and 65% reported perceived insufficient milk (PIM). An association between PIM and behavioral control emerged as the overarching theme impacting early breastfeeding cessation and evolved over time. Early postpartum, PIM evoked maternal distress-strong emotional responses to infant crying and need to control infant behaviors. Later, mothers accepted a perceived lack of control over milk supply with minimal distress or as a natural process. Decisions to stop breastfeeding occurred through an iterative process, informed by trials of various strategies and observations of subsequent changes in infant behavior, strongly influenced by competing psychosocial demands. Infant feeding decisions evolve over time and are influenced by perceptions of control over infant behavior and milk supply. Tailored anticipatory guidance is needed to provide time-sensitive strategies to cope with challenging infant behaviors and promote maternal agency over breastfeeding in low-income populations.
Quality versus quantity: The complexities of quality of life determinations for neonatal nurses.

PubMed

Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

2017-11-01

The ability to save the life of an extremely premature baby has increased substantially over the last decade. This survival, however, can be associated with unfavourable outcomes for both baby and family. Questions are now being asked about quality of life for survivors of extreme prematurity. Quality of life is rightly deemed to be an important consideration in high technology neonatal care; yet, it is notoriously difficult to determine or predict. How does one define and operationalise what is considered to be in the best interest of a surviving extremely premature baby, especially when the full extent of the outcomes might not be known for several years? The research investigates the caregiving dilemmas often faced by neonatal nurses when caring for extremely premature babies. This article explores the issues arising for neonatal nurses when they considered the philosophical and ethical questions about quality of life in babies ≤24 weeks gestation. Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Ethical processes and procedures have been adhered to by the researchers. A qualitative approach was used to analyse the data. The theme 'difficult choices' was generated which comprised three sub-themes: 'damaged through survival', 'the importance of the brain' and 'families are important'. The results show that neonatal nurses believed that quality of life was an important consideration; yet they experienced significant inner conflict and uncertainty when asked to define or suggest specific elements of quality of life, or to suggest how it might be determined. It was even more difficult for the nurses to say when an extremely premature baby's life possessed quality. Their previous clinical and personal experiences led the nurses to believe that the quality of the family's life was important, and possibly more so than the quality of life of the surviving baby. This finding contrasts markedly with much of the existing literature in this field. Quality of life for extremely premature babies was an important consideration for neonatal nurses; however, they experienced difficulty deciding how to operationalise such considerations in their everyday clinical practice.
Why is it so hard to implement change? A qualitative examination of barriers and facilitators to distribution of naloxone for overdose prevention in a safety net environment.

PubMed

Drainoni, Mari-Lynn; Koppelman, Elisa A; Feldman, James A; Walley, Alexander Y; Mitchell, Patricia M; Ellison, Jacqueline; Bernstein, Edward

2016-10-18

The increase in opioid overdose deaths has become a national public health crisis. Naloxone is an important tool in opioid overdose prevention. Distribution of nasal naloxone has been found to be a feasible, and effective intervention in community settings and may have potential high applicability in the emergency department, which is often the initial point of care for persons at high risk of overdose. One safety net hospital introduced an innovative policy to offer take-home nasal naloxone via a standing order to ensure distribution to patients at risk for overdose. The aims of this study were to examine acceptance and uptake of the policy and assess facilitators and barriers to implementation. After obtaining pre-post data on naloxone distribution, we conducted a qualitative study. The PARiHS framework steered development of the qualitative guide. We used theoretical sampling in order to include the range of types of emergency department staff (50 total). The constant comparative method was initially used to code the transcripts and identify themes; the themes that emerged from the coding were then mapped back to the evidence, context and facilitation constructs of the PARiHS framework. Acceptance of the policy was good but uptake was low. Primary themes related to facilitators included: real-world driven intervention with philosophical, clinician and leadership support; basic education and training efforts; availability of resources; and ability to leave the ED with the naloxone kit in hand. Barriers fell into five general categories: protocol and policy; workflow and logistical; patient-related; staff roles and responsibilities; and education and training. The actual implementation of a new innovation in healthcare delivery is largely driven by factors beyond acceptance. Despite support and resources, implementation was challenging, with low uptake. While the potential of this innovation is unknown, understanding the experience is important to improve uptake in this setting and offer possible solutions for other facilities to address the opioid overdose crisis. Use of the PARiHS framework allowed us to recognize and understand key evidence, contextual and facilitation barriers to the successful implementation of the policy and to identify areas for improvement.
Trends in safety pharmacology: posters presented at the annual meetings of the Safety Pharmacology Society 2001-2010.

PubMed

Redfern, William S; Valentin, Jean-Pierre

2011-01-01

The inaugural meeting of the Safety Pharmacology Society (SPS) was in 2001, soon after ICH S7A had been adopted. The 10th anniversary is an appropriate milestone at which to analyse trends in the science and themes of safety pharmacology, as reflected in posters presented at the annual meetings. The source information was the poster abstract booklets from each of the first ten annual meetings. The number of posters rose steadily from 34 in 2001 to 201 in 2010. The proportion of posters containing in vitro data has remained constant throughout the decade at ~30%. In terms of organ functions, themes relating to the cardiovascular system (CVS) have always generated the majority of posters, remaining above 60% of the total for the last 9years. The dominant theme has been around 'QT liability'. This peaked in 2003 at 68% of all posters presented, around the time of the ICHS7B discussions, and has remained above 30% thereafter. Apart from 2003 (dipping to 4%), CNS-related posters have remained steady at 11-17% throughout the decade. Respiratory-related posters have remained at 5-8% over the last 5years. Gastrointestinal (GI)-related posters have contributed 2-6% throughout the decade, and renal-related posters 1-3%. Posters on combined organ assessments have appeared in recent years. The relative emphasis on the different organ functions is broadly proportional to the causes of candidate drug attrition preclinically, whereas both CNS and GI are under-represented when considering their contribution to significant adverse effects during clinical development. Trends are either regulatory-driven (e.g. increase in posters on abuse-dependence liability since EMEA/CHMP/SWP/94227/2004), technology-driven (e.g. automated hERG assay; left ventricular function; non-invasive CVS measurements; stem cells, etc.), or relate to the predictive ability of safety pharmacology data (e.g. clinical translation initiatives; concordance between in vitro and in vivo preclinical data; integrated risk assessment; PK-PD relationships, etc.). Copyright © 2011 Elsevier Inc. All rights reserved.
The first powerful steps in strategic development.

PubMed

Chang, Y N; Platt, W

1986-11-01

In an ever-changing business climate, the need for strategically oriented management increases, for the organization that is insensitive and unresponsive to its environment will not survive. The authors of this "Action Plan" examine the challenges facing the health industry and outline a series of actions for initiating strategic-driven management.
Human Performance in Continuous Operations: Volume 1. Human Performance Guidelines

DTIC Science & Technology

1979-12-01

seemingly capable of enduring unusual degrees of stress and fatigue when nec- essary. When a soldier is driven by the motivation to survive, by exemplary...Vulnerabilities to degradation --Artillery 470 PS4 -?--- -. Armor Task Vulnerabilit.y The pattern of vulnurabihlties Ior tank platoon personnel (tl’Fiure 8. 2
Climate variability drives population cycling and synchrony

Treesearch

Lars Y. Pomara; Benjamin Zuckerberg

2017-01-01

Aim There is mounting concern that climate change will lead to the collapse of cyclic population dynamics, yet the influence of climate variability on population cycling remains poorly understood. We hypothesized that variability in survival and fecundity, driven by climate variability at different points in the life cycle, scales up from...
Divergent oviposition preferences of sister species are not driven by nest survival: The evidence for neutrality

EPA Science Inventory

Both adaptive and neutral trait evolution can contribute to divergence, but the relative contributions of the two remain unclear. Oviposition preference, a trait that has been demonstrated to contribute to divergence among populations, is often presumed to be an adaptive trait. F...
Myc-Driven Glycolysis Is a Therapeutic Target in Glioblastoma.

PubMed

Tateishi, Kensuke; Iafrate, A John; Ho, Quan; Curry, William T; Batchelor, Tracy T; Flaherty, Keith T; Onozato, Maristela L; Lelic, Nina; Sundaram, Sudhandra; Cahill, Daniel P; Chi, Andrew S; Wakimoto, Hiroaki

2016-09-01

Deregulated Myc drives an oncogenic metabolic state, including pseudohypoxic glycolysis, adapted for the constitutive production of biomolecular precursors to feed rapid tumor cell growth. In glioblastoma, Myc facilitates renewal of the tumor-initiating cell reservoir contributing to tumor maintenance. We investigated whether targeting the Myc-driven metabolic state could be a selectively toxic therapeutic strategy for glioblastoma. The glycolytic dependency of Myc-driven glioblastoma was tested using (13)C metabolic flux analysis, glucose-limiting culture assays, and glycolysis inhibitors, including inhibitors of the NAD(+) salvage enzyme nicotinamide phosphoribosyl-transferase (NAMPT), in MYC and MYCN shRNA knockdown and lentivirus overexpression systems and in patient-derived glioblastoma tumorspheres with and without MYC/MYCN amplification. The in vivo efficacy of glycolyic inhibition was tested using NAMPT inhibitors in MYCN-amplified patient-derived glioblastoma orthotopic xenograft mouse models. Enforced Myc overexpression increased glucose flux and expression of glycolytic enzymes in glioblastoma cells. Myc and N-Myc knockdown and Myc overexpression systems demonstrated that Myc activity determined sensitivity and resistance to inhibition of glycolysis. Small-molecule inhibitors of glycolysis, particularly NAMPT inhibitors, were selectively toxic to MYC/MYCN-amplified patient-derived glioblastoma tumorspheres. NAMPT inhibitors were potently cytotoxic, inducing apoptosis and significantly extended the survival of mice bearing MYCN-amplified patient-derived glioblastoma orthotopic xenografts. Myc activation in glioblastoma generates a dependency on glycolysis and an addiction to metabolites required for glycolysis. Glycolytic inhibition via NAMPT inhibition represents a novel metabolically targeted therapeutic strategy for MYC or MYCN-amplified glioblastoma and potentially other cancers genetically driven by Myc. Clin Cancer Res; 22(17); 4452-65. ©2016 AACR. ©2016 American Association for Cancer Research.

Acquaintance Rape: Applying Crime Scene Analysis to the Prediction of Sexual Recidivism.

PubMed

Lehmann, Robert J B; Goodwill, Alasdair M; Hanson, R Karl; Dahle, Klaus-Peter

2016-10-01

The aim of the current study was to enhance the assessment and predictive accuracy of risk assessments for sexual offenders by utilizing detailed crime scene analysis (CSA). CSA was conducted on a sample of 247 male acquaintance rapists from Berlin (Germany) using a nonmetric, multidimensional scaling (MDS) Behavioral Thematic Analysis (BTA) approach. The age of the offenders at the time of the index offense ranged from 14 to 64 years (M = 32.3; SD = 11.4). The BTA procedure revealed three behavioral themes of hostility, criminality, and pseudo-intimacy, consistent with previous CSA research on stranger rape. The construct validity of the three themes was demonstrated through correlational analyses with known sexual offending measures and criminal histories. The themes of hostility and pseudo-intimacy were significant predictors of sexual recidivism. In addition, the pseudo-intimacy theme led to a significant increase in the incremental validity of the Static-99 actuarial risk assessment instrument for the prediction of sexual recidivism. The results indicate the potential utility and validity of crime scene behaviors in the applied risk assessment of sexual offenders. © The Author(s) 2015.
A qualitative phenomenological analysis of the subjective experience and understanding of the at risk mental state

PubMed Central

Brew, Benjamin; Shannon, Ciaran; Storey, Lesley; Boyd, Adrian; Mulholland, Ciaran

2017-01-01

ABSTRACT Over recent years there has been a growing interest in identifying the early stages of psychosis. The At Risk Mental State (ARMS) is characteristic of the prodromal stages of psychosis and its identification gives rise to a number of clinical and research opportunities including early intervention and prevention of psychosis. This study employs interpretative phenomenological analysis to gain insights into the subjective experience and individuals understanding of the development of their ARMS. Five participants took part and provided information on the experience of symptoms, life prior to onset of their ARMS and their understanding of symptoms and their development through a semi structured interview. From the analysis of transcripts eight themes emerged which were common across participants accounts. Three themes of experience (disturbed world/disturbed self, disconnection with the world, thunderstruck) and five themes of understanding (absence of understanding, use of others, identity, forming links, fragmented understanding) were identified. Themes are explored in detail and discussed in relation to existing literature and theory. Clinical implications, directions for future research, and limitations are discussed within. PMID:28689474
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.
A Synthesis of Spiritual Intelligence Themes from Islamic and Western Philosophical Perspectives.

PubMed

Hanefar, Shamsiah Banu; Sa'ari, Che Zarrina; Siraj, Saedah

2016-12-01

Spiritual intelligence is an emerging term that is widely discussed and accepted as one of the main components that addresses and solves many life problems. Nonetheless there is no specific study being done to synthesize the spiritual intelligence themes from Western and Islamic philosophical perspectives. This research aimed to identify common spiritual intelligence themes from these two perspectives and elucidated its contents by the view of two well-known Islamic scholars; al-Ghazali and Hasan Langgulung. Seven spiritual intelligence themes were identified through thematic analysis; meaning/purpose of life, consciousness, transcendence, spiritual resources, self-determination, reflection-soul purification and spiritual coping with obstacles. These findings will be the groundwork for centered theory of spiritual intelligence themes that synthesize the Islamic and Western philosophical perspectives. It is hoped that this study will contribute significantly to the development of valid and reliable spiritual intelligence themes beyond the social and cultural boundaries.
Spatial Dynamics of the Blue Crab Spawning Stock in the Gulf of Mexico: Local Processes Driving Regional Patterns.

NASA Astrophysics Data System (ADS)

Darnell, M. Z.

2016-02-01

Female blue crabs undertake a critical spawning migration seaward, migrating from low-salinity mating habitat to high-salinity waters of the lower estuaries and coastal ocean, where larval survival is highest. This migration occurs primarily through ebb tide transport, driven by an endogenous circatidal rhythm in vertical swimming that is modulated by behavioral responses to environmental cues. Blue crabs are typically considered an estuarine species and fisheries are managed on a state-by-state basis. Yet recent evidence from state and regional fishery independent survey programs suggests that the spawning migration can take females substantial distances offshore (>150 km), and that offshore waters are important spawning grounds for female blue crabs in the Gulf of Mexico. This is especially true in areas where freshwater inflow is high, resulting in low estuarine and coastal salinities. In low-salinity, high-inflow areas (e.g., Louisiana), spawning occurs further offshore while in high-salinity, low-inflow areas (e.g., South Texas), spawning takes place primarily within the estuary. Regional patterns in spawning locations both inshore and offshore are driven by interactions between behavioral mechanisms and local oceanographic conditions during the spawning migration. These environmentally driven differences in spawning locations have implications for larval survival and population connectivity, and emphasize the need for interjurisdictional assessment and management of the blue crab spawning stock.
Space Station Systems Analysis Study. Volume 1: Executive summary, part 1 and 2

NASA Technical Reports Server (NTRS)

1977-01-01

The elements of space station programs required to support an operational base theme, a space laboratory theme, and advanced missions relatable to public needs/national interests are defined. Missions satisfying the foregoing requirements are identified, program scenarios/options are established. System options are evaluated for a selected number of program options. Subsystem analysis and programmatic comparisons are performed for selected primary concepts.
Racism, Power, and Place: A Critical Discourse Analysis of Online Commentary Associated with the Establishment of Culturally-Themed Housing for Black Men

ERIC Educational Resources Information Center

Patton, Lori D.; Sharp, Sacha; Sánchez, Berenice

2017-01-01

A critical discourse analysis of comments written in response to an online article related to the University of Connecticut's announcement about the ScHOLA2RS House, a culturally-themed residential program to retain and support African American male students is presented. Following this announcement, articles were published in various online media…
Registered nurses' experiences of daily work, a balance between strain and stimulation: a qualitative study.

PubMed

Hallin, Karin; Danielson, Ella

2007-09-01

The challenges in the health care have given rise to a highly stressful work situation and a more complicated role for registered nurses (RNs). Qualitative studies about daily work as a whole is limited. It is therefore vital for future development of nursing knowledge and nursing education to recurrently investigate RNs' experiences of their ability to grasp and manage their daily work situation and to promote a high quality of care. The aim of this study was to describe RNs' experiences of their daily work. This follow up study was carried out involving 15 Swedish RNs 6 years after their graduation. Interviews, conducted with conversational strategy, were chosen for the data collection and content analysis was used to handle the interview texts. The analysis resulted in a main theme 'to balance strain and stimulation', two themes and seven sub-themes. The first theme 'a stressful work situation' consisted of the sub-themes: 'to meet all demands', 'to be insufficient', 'to be unsure of oneself', and 'too little contact with patient'. The second theme 'a stimulating work situation' consisted of the sub-themes: 'to encounter patients and health care staff is enriching', 'to have the situation under control', and 'to have the skills necessary to be independent'. A pattern emerged throughout the themes, which showed that due to the increasing number of patients RNs' capacity for management, prioritising and planning out of team work, and performing exacting documentation diminished. The RNs' daily work has been illustrated as a scale of balance that oscillated between strain and stimulation; an oscillation towards strain could lead to a vicious circle. The RNs need support from the start through nursing education and continuously in profession. This is a crucial issue for nursing education and health care sector.
Diet of upper paleolithic modern humans: evidence from microwear texture analysis.

PubMed

El Zaatari, Sireen; Hublin, Jean-Jacques

2014-04-01

This article presents the results of the occlusal molar microwear texture analysis of 32 adult Upper Paleolithic modern humans from a total of 21 European sites dating to marine isotope stages 3 and 2. The occlusal molar microwear textures of these specimens were analyzed with the aim of examining the effects of the climatic, as well as the cultural, changes on the diets of the Upper Paleolithic modern humans. The results of this analysis do not reveal any environmentally driven dietary shifts for the Upper Paleolithic hominins indicating that the climatic and their associated paleoecological changes did not force these humans to significantly alter their diets in order to survive. However, the microwear texture analysis does detect culturally related changes in the Upper Paleolithic humans' diets. Specifically, significant differences in diet were found between the earlier Upper Paleolithic individuals, i.e., those belonging to the Aurignacian and Gravettian contexts, and the later Magdalenian ones, such that the diet of the latter group was more varied and included more abrasive foods compared with those of the former. Copyright © 2014 Wiley Periodicals, Inc.
Spatial Paradigm for Information Retrieval and Exploration

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

The SPIRE system consists of software for visual analysis of primarily text based information sources. This technology enables the content analysis of text documents without reading all the documents. It employs several algorithms for text and word proximity analysis. It identifies the key themes within the text documents. From this analysis, it projects the results onto a visual spatial proximity display (Galaxies or Themescape) where items (documents and/or themes) visually close to each other are known to have content which is close to each other. Innovative interaction techniques then allow for dynamic visual analysis of large text based information spaces.
SPIRE1.03. Spatial Paradigm for Information Retrieval and Exploration

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

Adams, K.J.; Bohn, S.; Crow, V.

The SPIRE system consists of software for visual analysis of primarily text based information sources. This technology enables the content analysis of text documents without reading all the documents. It employs several algorithms for text and word proximity analysis. It identifies the key themes within the text documents. From this analysis, it projects the results onto a visual spatial proximity display (Galaxies or Themescape) where items (documents and/or themes) visually close to each other are known to have content which is close to each other. Innovative interaction techniques then allow for dynamic visual analysis of large text based information spaces.
Tobacco coverage in print media: the use of timing and themes by tobacco control supporters and opposition before a failed tobacco tax initiative

PubMed Central

Shelton, Sarah C; Moreland-Russell, Sarah; Luke, Douglas A

2009-01-01

Objective Tobacco control policies gained ground nationwide in 2006, with voters in nine states approving legislation to strengthen clean indoor air policies and increase tobacco excise taxes. Despite having the second lowest cigarette tax rate in the nation, Missouri was unsuccessful in passing its 2006 ballot initiative to raise the tax. An important way to encourage health-related policy change such as increasing tobacco taxes is through media coverage of tobacco issues. We examined how tobacco issues were presented in Missouri's print media leading up to the 2006 election. Methods This study analysed 1263 articles with tobacco content published in 187 Missouri newspapers in the year before the election. Articles were coded for general and tobacco-related characteristics including article type (news story, editorial, letter to the editor), tobacco control position (pro, neutral, anti) and article theme (economic, health, political). Results Most articles were news stories (73.6%) and pro-tobacco control (63.8%). The proportion of anti-tobacco control articles increased significantly (χ2=104.9, p<0.001) the month before the election, driven by an increase in economically themed articles. Economic articles were published more often in counties with less voter support for the tax (F=5.68, p<0.01). Finally, tobacco control position varied significantly across article types (χ2=148.3, p<0.01), with letters to the editor being anti-tobacco control most often. Conclusion The media have a critical role in promoting public health goals and presenting health issues which influences formation of health policies. Tobacco control advocates must consider public opinion, opposition pressure, timing and themes in tobacco-related media coverage when promoting policy change. PMID:19965799
Tobacco coverage in print media: the use of timing and themes by tobacco control supporters and opposition before a failed tobacco tax initiative.

PubMed

Harris, Jenine K; Shelton, Sarah C; Moreland-Russell, Sarah; Luke, Douglas A

2010-02-01

Tobacco control policies gained ground nationwide in 2006, with voters in nine states approving legislation to strengthen clean indoor air policies and increase tobacco excise taxes. Despite having the second lowest cigarette tax rate in the nation, Missouri was unsuccessful in passing its 2006 ballot initiative to raise the tax. An important way to encourage health-related policy change such as increasing tobacco taxes is through media coverage of tobacco issues. We examined how tobacco issues were presented in Missouri's print media leading up to the 2006 election. This study analysed 1263 articles with tobacco content published in 187 Missouri newspapers in the year before the election. Articles were coded for general and tobacco-related characteristics including article type (news story, editorial, letter to the editor), tobacco control position (pro, neutral, anti) and article theme (economic, health, political). Most articles were news stories (73.6%) and pro-tobacco control (63.8%). The proportion of anti-tobacco control articles increased significantly (chi(2)=104.9, p<0.001) the month before the election, driven by an increase in economically themed articles. Economic articles were published more often in counties with less voter support for the tax (F=5.68, p<0.01). Finally, tobacco control position varied significantly across article types (chi(2)=148.3, p<0.01), with letters to the editor being anti-tobacco control most often. The media have a critical role in promoting public health goals and presenting health issues which influences formation of health policies. Tobacco control advocates must consider public opinion, opposition pressure, timing and themes in tobacco-related media coverage when promoting policy change.
Predicting Survival within the Lung Cancer Histopathological Hierarchy Using a Multi-Scale Genomic Model of Development

PubMed Central

Liu, Hongye; Kho, Alvin T; Kohane, Isaac S; Sun, Yao

2006-01-01

Background The histopathologic heterogeneity of lung cancer remains a significant confounding factor in its diagnosis and prognosis—spurring numerous recent efforts to find a molecular classification of the disease that has clinical relevance. Methods and Findings Molecular profiles of tumors from 186 patients representing four different lung cancer subtypes (and 17 normal lung tissue samples) were compared with a mouse lung development model using principal component analysis in both temporal and genomic domains. An algorithm for the classification of lung cancers using a multi-scale developmental framework was developed. Kaplan–Meier survival analysis was conducted for lung adenocarcinoma patient subgroups identified via their developmental association. We found multi-scale genomic similarities between four human lung cancer subtypes and the developing mouse lung that are prognostically meaningful. Significant association was observed between the localization of human lung cancer cases along the principal mouse lung development trajectory and the corresponding patient survival rate at three distinct levels of classical histopathologic resolution: among different lung cancer subtypes, among patients within the adenocarcinoma subtype, and within the stage I adenocarcinoma subclass. The earlier the genomic association between a human tumor profile and the mouse lung development sequence, the poorer the patient's prognosis. Furthermore, decomposing this principal lung development trajectory identified a gene set that was significantly enriched for pyrimidine metabolism and cell-adhesion functions specific to lung development and oncogenesis. Conclusions From a multi-scale disease modeling perspective, the molecular dynamics of murine lung development provide an effective framework that is not only data driven but also informed by the biology of development for elucidating the mechanisms of human lung cancer biology and its clinical outcome. PMID:16800721
Comparing the application of two theoretical frameworks to describe determinants of adverse medical device event reporting: secondary analysis of qualitative interview data.

PubMed

Desveaux, Laura; Gagliardi, Anna R

2018-06-04

Post-market surveillance of medical devices is reliant on physician reporting of adverse medical device events (AMDEs). Few studies have examined factors that influence whether and how physicians report AMDEs, an essential step in the development of behaviour change interventions. This study was a secondary analysis comparing application of the Theoretical Domains Framework (TDF) and the Tailored Implementation for Chronic Diseases (TICD) framework to identify potential behaviour change interventions that correspond to determinants of AMDE reporting. A previous study involving qualitative interviews with Canadian physicians that implant medical devices identified themes reflecting AMDE reporting determinants. In this secondary analysis, themes that emerged from the primary analysis were independently mapped to the TDF and TICD. Determinants and corresponding intervention options arising from both frameworks (and both mappers) were compared. Both theoretical frameworks were useful for identifying interventions corresponding to behavioural determinants of AMDE reporting. Information or education strategies that provide evidence about AMDEs, and audit and feedback of AMDE data were identified as interventions to target the theme of physician beliefs; improving information systems, and reminder cues, prompts and awards were identified as interventions to address determinants arising from the organization or systems themes; and modifying financial/non-financial incentives and sharing data on outcomes associated with AMDEs were identified as interventions to target device market themes. Numerous operational challenges were encountered in the application of both frameworks including a lack of clarity about how directly relevant to themes the domains/determinants should be, how many domains/determinants to select, if and how to resolve discrepancies across multiple mappers, and how to choose interventions from among the large number associated with selected domains/determinants. Given discrepancies in mapping themes to determinants/domains and the resulting interventions offered by the two frameworks, uncertainty remains about how to choose interventions that best match behavioural determinants in a given context. Further research is needed to provide more nuanced guidance on the application of TDF and TICD for a broader audience, which is likely to increase the utility and uptake of these frameworks in practice.
Evidence gaps in advanced cancer care: community-based clinicians' perspectives and priorities for CER.

PubMed

Lowry, Sarah J; Loggers, Elizabeth T; Bowles, Erin J A; Wagner, Edward H

2012-05-01

Although much effort has focused on identifying national comparative effectiveness research (CER) priorities, little is known about the CER priorities of community-based practitioners treating patients with advanced cancer. CER priorities of managed care-based clinicians may be valuable as reflections of both payer and provider research interests. We conducted mixed methods interviews with 10 clinicians (5 oncologists and 5 pharmacists) at 5 health plans within the Health Maintenance Organization Cancer Research Network. We asked, "What evidence do you most wish you had when treating patients with advanced cancer" and questioned participants on their impressions and knowledge of CER and pragmatic clinical trials (PCTs). We conducted qualitative analyses to identify themes across interviews. Ninety percent of participants had heard of CER, 20% had heard of PCTs, and all rated CER/PCTs as highly relevant to patient and health plan decision making. Each participant offered between 3 and 10 research priorities. Half (49%) involved head-to-head treatment comparisons; another 20% involved comparing different schedules or dosing regimens of the same treatment. The majority included alternative outcomes to survival (eg, toxicity, quality of life, noninferiority). Participants cited several limitations to existing evidence, including lack of generalizability, funding biases, and rapid development of new treatments. Head-to-head treatment comparisons remain a major evidence need among community- based oncology clinicians, and CER/PCTs are highly valued methods to address the limitations of traditional randomized trials, answer questions of cost-effectiveness or noninferiority, and inform data-driven dialogue and decision making by all stakeholders.
A Critical Analysis of Global Competition in Higher Education: Synthesizing Themes

ERIC Educational Resources Information Center

Portnoi, Laura M.; Bagley, Sylvia S.

2014-01-01

In this final chapter of the volume, the editors synthesize key themes that emerge from the preceding chapters. They also highlight the contributions the authors make through emphasizing critical perspectives and the tension between global and local forces.
Evidence that human immunoglobulin M rheumatoid factors can Be derived from the natural autoantibody pool and undergo an antigen driven immune response in which somatically mutated rheumatoid factors have lower affinities for immunoglobulin G Fc than their germline counterparts.

PubMed

Carayannopoulos, M O; Potter, K N; Li, Y; Natvig, J B; Capra, J D

2000-04-01

The question of whether immunoglobulin (Ig)M rheumatoid factors (RF) arise as the result of an abnormal expansion of already existing clones producing natural autoantibodies or emerge as new clones that are somatically mutated owing to an antigen driven immune response has never been conclusively answered. In this study, an inhibition ELISA was utilized to measure the affinities of recombinant antibodies using VH segments reverted back to their closest germline counterparts (germline revertants). In all cases, the somatically mutated parental RFs had a decreased affinity for immunoglobulin (Ig)G Fc compared to the germline revertant, indicating that the antibodies in the germline configuration had the higher affinities. This demonstrates that somatic mutation is not a prerequisite to generate disease associated antibodies. The presence of mutations in the parental IgM RFS suggests that these cells had been involved in a germinal centre reaction. As the germinal centre is the conventional site of the acquisition of mutations during an antigen driven response, these data suggest a role for germinal centres in the generation of the antibody diversity in addition to the selection of higher affinity antibodies. Assuming that only antigen selected cells survive deletion, these data support the hypothesis that IgM RFS can be derived from the natural autoantibody repertoire and result from an antigen driven response. Mechanisms controlling the survival of B cells based on the affinity/avidity of the immunoglobulin receptor are shown to be functional in patients with rheumatoid arthritis.
Effect of insertion method and postinsertion time interval prior to force application on the removal torque of orthodontic miniscrews.

PubMed

Sharifi, Maryam; Ghassemi, Amirreza; Bayani, Shahin

2015-01-01

Success of orthodontic miniscrews in providing stable anchorage is dependent on their stability. The purpose of this study was to assess the effect of insertion method and postinsertion time interval on the removal torque of miniscrews as an indicator of their stability. Seventy-two miniscrews (Jeil Medical) were inserted into the femoral bones of three male German Shepherd dogs and assigned to nine groups of eight miniscrews. Three insertion methods, including hand-driven, motor-driven with 5.0-Ncm insertion torque, and motor-driven with 20.0-Ncm insertion torque, were tested. Three time intervals of 0, 2, and 6 weeks between miniscrew insertion and removal were tested as well. Removal torque values were measured in newton centimeters by a removal torque tester (IMADA). Data were analyzed by one-way analysis of variance (ANOVA) followed by the Bonferroni post hoc test at a .05 level of significance. A miniscrew survival rate of 93% was observed in this study. The highest mean value of removal torque among the three postinsertion intervals (2.4 ± 0.59 Ncm) was obtained immediately after miniscrew insertion with a statistically significant difference from the other two time intervals (P < .001). Insertion were observed in this regard (P = .46). The stability of miniscrews was not affected by the insertion method. However, of the postinsertion time intervals, the highest removal torque values were obtained immediately after insertion.
RANK rewires energy homeostasis in lung cancer cells and drives primary lung cancer.

PubMed

Rao, Shuan; Sigl, Verena; Wimmer, Reiner Alois; Novatchkova, Maria; Jais, Alexander; Wagner, Gabriel; Handschuh, Stephan; Uribesalgo, Iris; Hagelkruys, Astrid; Kozieradzki, Ivona; Tortola, Luigi; Nitsch, Roberto; Cronin, Shane J; Orthofer, Michael; Branstetter, Daniel; Canon, Jude; Rossi, John; D'Arcangelo, Manolo; Botling, Johan; Micke, Patrick; Fleur, Linnea La; Edlund, Karolina; Bergqvist, Michael; Ekman, Simon; Lendl, Thomas; Popper, Helmut; Takayanagi, Hiroshi; Kenner, Lukas; Hirsch, Fred R; Dougall, William; Penninger, Josef M

2017-10-15

Lung cancer is the leading cause of cancer deaths. Besides smoking, epidemiological studies have linked female sex hormones to lung cancer in women; however, the underlying mechanisms remain unclear. Here we report that the receptor activator of nuclear factor-kB (RANK), the key regulator of osteoclastogenesis, is frequently expressed in primary lung tumors, an active RANK pathway correlates with decreased survival, and pharmacologic RANK inhibition reduces tumor growth in patient-derived lung cancer xenografts. Clonal genetic inactivation of KRas G12D in mouse lung epithelial cells markedly impairs the progression of KRas G12D -driven lung cancer, resulting in a significant survival advantage. Mechanistically, RANK rewires energy homeostasis in human and murine lung cancer cells and promotes expansion of lung cancer stem-like cells, which is blocked by inhibiting mitochondrial respiration. Our data also indicate survival differences in KRas G12D -driven lung cancer between male and female mice, and we show that female sex hormones can promote lung cancer progression via the RANK pathway. These data uncover a direct role for RANK in lung cancer and may explain why female sex hormones accelerate lung cancer development. Inhibition of RANK using the approved drug denosumab may be a therapeutic drug candidate for primary lung cancer. © 2017 Rao et al.; Published by Cold Spring Harbor Laboratory Press.

Pre-disposition and epigenetics govern variation in bacterial survival upon stress.

PubMed

Ni, Ming; Decrulle, Antoine L; Fontaine, Fanette; Demarez, Alice; Taddei, Francois; Lindner, Ariel B

2012-01-01

Bacteria suffer various stresses in their unpredictable environment. In response, clonal populations may exhibit cell-to-cell variation, hypothetically to maximize their survival. The origins, propagation, and consequences of this variability remain poorly understood. Variability persists through cell division events, yet detailed lineage information for individual stress-response phenotypes is scarce. This work combines time-lapse microscopy and microfluidics to uniformly manipulate the environmental changes experienced by clonal bacteria. We quantify the growth rates and RpoH-driven heat-shock responses of individual Escherichia coli within their lineage context, stressed by low streptomycin concentrations. We observe an increased variation in phenotypes, as different as survival from death, that can be traced to asymmetric division events occurring prior to stress induction. Epigenetic inheritance contributes to the propagation of the observed phenotypic variation, resulting in three-fold increase of the RpoH-driven expression autocorrelation time following stress induction. We propose that the increased permeability of streptomycin-stressed cells serves as a positive feedback loop underlying this epigenetic effect. Our results suggest that stochasticity, pre-disposition, and epigenetic effects are at the source of stress-induced variability. Unlike in a bet-hedging strategy, we observe that cells with a higher investment in maintenance, measured as the basal RpoH transcriptional activity prior to antibiotic treatment, are more likely to give rise to stressed, frail progeny.
Body size and extinction risk in terrestrial mammals above the species level.

PubMed

Tomiya, Susumu

2013-12-01

Mammalian body mass strongly correlates with life history and population properties at the scale of mouse to elephant. Large body size is thus often associated with elevated extinction risk. I examined the North American fossil record (28-1 million years ago) of 276 terrestrial genera to uncover the relationship between body size and extinction probability above the species level. Phylogenetic comparative analysis revealed no correlation between sampling-adjusted durations and body masses ranging 7 orders of magnitude, an observation that was corroborated by survival analysis. Most of the ecological and temporal groups within the data set showed the same lack of relationship. Size-biased generic extinctions do not constitute a general feature of the Holarctic mammalian faunas in the Neogene. Rather, accelerated loss of large mammals occurred during intervals that experienced combinations of regional aridification and increased biomic heterogeneity within continents. The latter phenomenon is consistent with the macroecological prediction that large geographic ranges are critical to the survival of large mammals in evolutionary time. The frequent lack of size selectivity in generic extinctions can be reconciled with size-biased species loss if extinctions of large and small mammals at the species level are often driven by ecological perturbations of different spatial and temporal scales, while those at the genus level are more synchronized in time as a result of fundamental, multiscale environmental shifts.
An investigation of the international literature on nurse practitioner private practice models.

PubMed

Currie, J; Chiarella, M; Buckley, T

2013-12-01

To investigate and synthesize the international literature surrounding nurse practitioner (NP) private practice models in order to provide an exposition of commonalities and differences. NP models of service delivery have been established internationally and most are based in the public healthcare system. In recent years, opportunities for the establishment of NP private practice models have evolved, facilitated by changes in legislation and driven by identification of potential patient need. To date, NP private practice models have received less attention in the literature and, to the authors' knowledge, this is the first international investigation of NP private practice models. Integrative literature review. A literature search was undertaken in October 2012. Database sources utilized included Medical Literature Analyses and Retrieval (MEDLINE), the Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Scopus and the Cochrane Database of Systematic Reviews (CDSR). The grey literature was also searched. The following Medical Subject Headings (MeSH) and search terms used both individually and in combination included nurse practitioners; private practice; joint practice; collaboration; and insurance, health and reimbursement. Once literature had been identified, a thematic analysis was undertaken to extract themes. Thirty manuscripts and five publications from the grey literature were included in the final review. Private practice NP roles were identified in five countries, with the majority of the literature emanating from the USA. The thematic analysis resulted in the identification of five themes: reimbursement, collaborative arrangements, legislation, models of care and acceptability. Proportionally, there are very few NPs engaged in private practice internationally. The most common NP private practice models were community based, with NPs working in clinic settings, either alone or with other health professionals. Challenges in the context of legislation and financial reimbursement were identified in each country where private practice is being undertaken. © 2013 International Council of Nurses.
Designing for Psychological Change: Individuals’ Reward and Cost Valuations in Weight Management

PubMed Central

Blandford, Ann

2014-01-01

Background Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. Objective We applied a decision theory–based analysis in the domain of weight management to understand the rewards and costs that surround individuals’ weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. Methods We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. Results The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). Conclusions A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and costs surrounding weight management offers a range of new opportunities for the design of weight management technologies that enhance the encouraging factors and alleviate the discouraging ones. PMID:24972304
Surviving in a frozen desert: environmental stress physiology of terrestrial Antarctic arthropods.

PubMed

Teets, Nicholas M; Denlinger, David L

2014-01-01

Abiotic stress is one of the primary constraints limiting the range and success of arthropods, and nowhere is this more apparent than Antarctica. Antarctic arthropods have evolved a suite of adaptations to cope with extremes in temperature and water availability. Here, we review the current state of knowledge regarding the environmental physiology of terrestrial arthropods in Antarctica. To survive low temperatures, mites and Collembola are freeze-intolerant and rely on deep supercooling, in some cases supercooling below -30°C. Also, some of these microarthropods are capable of cryoprotective dehydration to extend their supercooling capacity and reduce the risk of freezing. In contrast, the two best-studied Antarctic insects, the midges Belgica antarctica and Eretmoptera murphyi, are freeze-tolerant year-round and rely on both seasonal and rapid cold-hardening to cope with decreases in temperature. A common theme among Antarctic arthropods is extreme tolerance of dehydration; some accomplish this by cuticular mechanisms to minimize water loss across their cuticle, while a majority have highly permeable cuticles but tolerate upwards of 50-70% loss of body water. Molecular studies of Antarctic arthropod stress physiology are still in their infancy, but several recent studies are beginning to shed light on the underlying mechanisms that govern extreme stress tolerance. Some common themes that are emerging include the importance of cuticular and cytoskeletal rearrangements, heat shock proteins, metabolic restructuring and cell recycling pathways as key mediators of cold and water stress in the Antarctic.
Taking One for the Team: Examining the Effects of Childhood Cancer on the Parental Subsystem-Part 2.

PubMed

Moules, Nancy J; Estefan, Andrew; McCaffrey, Graham; Tapp, Dianne M; Strother, Douglas

2016-11-01

In this Part 2 of a three-part research paper, we further our interpretations from our hermeneutic study examining how having a child who has experienced cancer had an impact on the relationship between the parents. In Part 1, we identified the focus of the study and provided background to the topic. We also described the research question, method, and design before offering an interpretive analysis of couples whose relationships survived, thrived, or demised. In this article, we extend the interpretations under an overarching theme of "taking one for the team." Here, we discuss issues of changes in focus and roles, and the notions of tag teaming, protection, intimacy, and grieving. We examine the phenomenon of putting relationships on hold, then finding reclamation later. In Part 3, we offer implications of these findings for other parents in similar situations and for health care professionals working with these families. © The Author(s) 2016.
"It's like pay or don't have it and now I'm doing without": the voice of transitional uninsured former foster youth.

PubMed

Kruszka, Bonnie J; Lindell, Deborah; Killion, Cheryl; Criss, Sam

2012-02-01

Twenty-four thousand American youth lose Medicaid entitlements after discharge from foster care annually. The circumstance of being uninsured is a formidable barrier to health care that leaves the youth vulnerable to unmet health care needs. Given that foster youth often develop physical and/or mental health problems as a result of abuse or neglect, continuous access to health care is especially important. This descriptive phenomenology study explores the lived experience of transitional uninsured former foster youth. Nine uninsured former foster youth were recruited from a nonprofit community organization in an urban county and interviewed using semistructured interviews. Four themes identified from the analysis were (a) "Surviving the real world": emancipation without essential documentation; (b) "It's not always going to be fine": managing mental and physical health without health care insurance; (c) "Roadblocks": barriers to securing health care insurance; and (d) "Just not knowing": Medicaid eligible albeit without health care insurance.
All for the Winner: An Analysis of the Characterization of Male Gamblers in Hong Kong Movies with Gambling Theme

ERIC Educational Resources Information Center

Chan, Chi Chuen; Ohtsuka, Keis

2011-01-01

This study aims to investigate the characterization of male gamblers in popular Hong Kong movies in the past 50 years. A total of nine Hong Kong films with gambling themes were selected for analysis. The criteria for selection of the films were as follows: the movies in which the protagonists are portrayed by well known Hong Kong actors that…
"My Greatest Joy and My Greatest Heart Ache:" Parents' Own Words on How Having a Child in the Autism Spectrum Has Affected Their Lives and Their Families' Lives

ERIC Educational Resources Information Center

Myers, Barbara J.; Mackintosh, Virginia H.; Goin-Kochel, Robin P.

2009-01-01

Parents of children in the autism spectrum wrote an open-ended answer via an online questionnaire to the question, "How has your child in the autism spectrum affected your life and your family's life?" (N = 493). Using a qualitative content analysis, 15 negative themes and 9 positive themes were identified. Themes are subsumed into five clusters:…
Polygenic Score × Intervention Moderation: an Application of Discrete-Time Survival Analysis to Model the Timing of First Marijuana Use Among Urban Youth.

PubMed

Musci, Rashelle J; Fairman, Brian; Masyn, Katherine E; Uhl, George; Maher, Brion; Sisto, Danielle Y; Kellam, Sheppard G; Ialongo, Nicholas S

2018-01-01

The present study examines the interaction between a polygenic score and an elementary school-based universal preventive intervention trial and its effects on a discrete-time survival analysis of time to first smoking marijuana. Research has suggested that initiation of substances is both genetically and environmentally driven (Rhee et al., Archives of general psychiatry 60:1256-1264, 2003; Verweij et al., Addiction 105:417-430, 2010). A previous work has found a significant interaction between the polygenic score and the same elementary school-based intervention with tobacco smoking (Musci et al., in press). The polygenic score reflects the contribution of multiple genes and has been shown in prior research to be predictive of smoking cessation, tobacco use, and marijuana use (Uhl et al., Molecular Psychiatry 19:50-54, 2014). Using data from a longitudinal preventive intervention study (N = 678), we examined age of first marijuana use from sixth grade to age 18. Genetic data were collected during emerging adulthood and were genotyped using the Affymetrix 6.0 microarray (N = 545). The polygenic score was computed using these data. Discrete-time survival analysis was employed to test for intervention main and interaction effects with the polygenic score. We found main effect of the polygenic score approaching significance, with the participants with higher polygenic scores reporting their first smoking marijuana at an age significantly later than controls (p = .050). We also found a significant intervention × polygenic score interaction effect at p = .003, with participants at the higher end of the polygenic score benefiting the most from the intervention in terms of delayed age of first use. These results suggest that genetics may play an important role in the age of first use of marijuana and that differences in genetics may account for the differential effectiveness of classroom-based interventions in delaying substance use experimentation.
Content Analysis of Trends in Print Magazine Tobacco Advertisements.

PubMed

Banerjee, Smita; Shuk, Elyse; Greene, Kathryn; Ostroff, Jamie

2015-07-01

To provide a descriptive and comparative content analysis of tobacco print magazine ads, with a focus on rhetorical and persuasive themes. Print tobacco ads for cigarettes, cigars, e-cigarettes, moist snuff, and snus (N = 171) were content analyzed for the physical composition/ad format (e.g., size of ad, image, setting, branding, warning label) and the content of the ad (e.g., rhetorical themes, persuasive themes). The theme of pathos (that elicits an emotional response) was most frequently utilized for cigarette (61%), cigar (50%), and moist snuff (50%) ads, and the theme of logos (use of logic or facts to support position) was most frequently used for e-cigarette (85%) ads. Additionally, comparative claims were most frequently used for snus (e.g., "spit-free," "smoke-free") and e-cigarette ads (e.g., "no tobacco smoke, only vapor," "no odor, no ash"). Comparative claims were also used in cigarette ads, primarily to highlight availability in different flavors (e.g., "bold," "menthol"). This study has implications for tobacco product marketing regulation, particularly around limiting tobacco advertising in publications with a large youth readership and prohibiting false or misleading labels, labeling, and advertising for tobacco products, such as modified risk (unless approved by the FDA) or therapeutic claims.
“An Effect That is Deeper Than Beating” Family Violence in Jordanian Women

PubMed Central

Morse, Diane S; Paldi, Yael; Egbarya, Samah Salaime; Clark, Cari Jo

2012-01-01

This study informs healthcare approaches to gender-based family violence through focus groups with Jordanian women. The authors conducted a thematic qualitative analysis of 12 focus groups among 70 married, divorced, or widowed women about their experiences and beliefs regarding family violence. Five themes relevant to healthcare providers were identified. Three of the themes addressed participant-perceived causes of gender-based family violence: 1) unmet gender role expectations, 2) stigma and social norms, and 3) extended family roles. The fourth theme reflects effects on victims. The fifth theme reflects protective qualities and help seeking behaviors. The themes identified in the analysis reveal multiple ways that gender-based family violence can contribute to health problems and that it can be kept secret by Jordanian women as patients. Potential clues are described for the violence which may not be typically explored in a medical encounter. Additional ways that Jordanian families may seek help from other family or clergy instead of police and family violence agencies are described. Implications of these results for healthcare providers who care both for Jordanians and Arab immigrants in Western cultures are discussed. PMID:22329396
Whale song analyses using bioinformatics sequence analysis approaches

NASA Astrophysics Data System (ADS)

Chen, Yian A.; Almeida, Jonas S.; Chou, Lien-Siang

2005-04-01

Animal songs are frequently analyzed using discrete hierarchical units, such as units, themes and songs. Because animal songs and bio-sequences may be understood as analogous, bioinformatics analysis tools DNA/protein sequence alignment and alignment-free methods are proposed to quantify the theme similarities of the songs of false killer whales recorded off northeast Taiwan. The eighteen themes with discrete units that were identified in an earlier study [Y. A. Chen, masters thesis, University of Charleston, 2001] were compared quantitatively using several distance metrics. These metrics included the scores calculated using the Smith-Waterman algorithm with the repeated procedure; the standardized Euclidian distance and the angle metrics based on word frequencies. The theme classifications based on different metrics were summarized and compared in dendrograms using cluster analyses. The results agree with earlier classifications derived by human observation qualitatively. These methods further quantify the similarities among themes. These methods could be applied to the analyses of other animal songs on a larger scale. For instance, these techniques could be used to investigate song evolution and cultural transmission quantifying the dissimilarities of humpback whale songs across different seasons, years, populations, and geographic regions. [Work supported by SC Sea Grant, and Ilan County Government, Taiwan.
Evidence-based medicine teaching requirements in the USA: taxonomy and themes.

PubMed

Shaughnessy, Allen F; Torro, John R; Frame, Kara A; Bakshi, Munish

2016-05-01

In the USA, recent changes to oversight of residency training codify the requirements for teaching evidence-based medicine and information mastery (lifelong learning) knowledge, skills, and attitudes. The goal of this project is to determine current requirements for teaching of evidence-based medicine (EBM) and information mastery (IM) in specialty residency education in the USA. The project was a qualitative thematic analysis using content analysis. The source of the requirements for EBM and IM were the "milestone" statements for all 28 major specialties and transition year programs. Milestone descriptors related to EBM/IM were extracted and codes were developed and applied to each descriptor by four researchers. The resulting codes were coalesced into themes and tested against the milestone descriptors. The coding process identified 15 content areas comprising five themes. Two themes related to the knowledge and skills of EBM and three themes related to the knowledge, skills, and attitudes of IM. EBM themes encompassed basic critical appraisal skills and knowledge of clinical epidemiology principles and statistics. IM themes centered on identifying one's information needs for patient-specific information, using information sources, and using current awareness services to remain abreast of changes in medicine. In general, they align well with the Sicily Statement on Evidence-Based Practice. No specialty required competence in all areas. New training requirements for specialties in the USA require the development of both classic EBM skills as well as skills for managing information. However, there is marked variation in the requirements among specific specialties. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.
Written accounts of living with psychogenic nonepileptic seizures: A thematic analysis.

PubMed

Rawlings, Gregg H; Brown, Ian; Stone, Brendan; Reuber, Markus

2017-08-01

Qualitative studies examining lived experiences of psychogenic nonepileptic seizures (PNES) have predominantly relied on datasets collected using clinical or research interviews. This study pursued a different approach by investigating individuals' written accounts of their condition. Participants (n=19) were recruited from membership-led organisations for individuals living with seizures and from a United Kingdom hospital. Participants were instructed to produce four pieces of writing: 1) about their thoughts and feelings about their condition; 2) a letter to their condition; 3) a letter to their younger self; and 4) about a personal value. All writings were analysed using thematic analysis. Six main-themes emerged from the data. Theme 1: 'living with PNES' demonstrated that all participants presented the condition as having a debilitating effect. Theme 2: 'Emotions' revealed that individuals were struggling with anxiety, low mood and self-worth. Theme 3: 'Seizure symptoms' showed variability was a prominent feature in the description of ictal events. Theme 4: 'Treatment and outcomes' demonstrated that individual's perception of diagnosis and therapy differed greatly. Theme 5: 'Causation and development' revealed that the majority of participants spontaneously reported experiencing a traumatic event in the past. Theme 6: 'Lack of understanding' by themselves, the public and healthcare professionals appeared to pose considerable challenges to participants. Qualitative research has an important role to play for improving our understanding of PNES. The findings contribute to the literature by highlighting the nature of stigma that people with PNES experience, and also their proneness to demonstrate problems with self-worth. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Indigenous migration dynamics in the Ecuadorian Amazon: a longitudinal and hierarchical analysis.

PubMed

Davis, Jason; Sellers, Samuel; Gray, Clark; Bilsborrow, Richard

2017-01-01

Amazonian indigenous populations are approaching a critical stage in their history in which increasing education and market integration, rapid population growth and degradation of natural resources threaten the survival of their traditions and livelihoods. A topic that has hardly been touched upon in this context is migration and population mobility. We address this by analysing a unique longitudinal dataset from the Ecuadorian Amazon on the spatial mobility of five indigenous groups and mestizo co-residents. Analyses reveal traditional and new forms of population mobility and migrant selectivity, including gendered forms of marriage migration and rural-urban moves driven by education. These results illustrate a dynamic present and an uncertain future for indigenous populations in which rural, natural-resource-based lifeways may well be sustained but with increasing links to urban areas.
Teachers Get Personal about Teaching to Survive NCLB

ERIC Educational Resources Information Center

Bunting, Carolyn

2007-01-01

So much of teaching is now driven by data (i.e., test scores) and dictated by "best practices" that teachers are losing confidence in their own creativity. Yet, despite these unfortunate consequences of No Child Left Behind (NCLB), the important work of teachers remains unchanged. That work is the work of connecting personally and…
Innovative Math for Liberal Arts Majors

ERIC Educational Resources Information Center

Strasser, Nora

2011-01-01

An innovative Math for Liberal Arts course was designed to provide liberal arts students with the life skills necessary to survive in the 21st century. The course emphasizes application driven mathematics. This course has been successful in changing students' perceptions of the usefulness of the course and improving student success rate as well as…
Music Education for Life: Music Assessment, Part 1--What and Why

ERIC Educational Resources Information Center

Shuler, Scott C.

2011-01-01

Assessment is both essential and a potentially powerful positive force. Music teachers need to provide assessment evidence to survive in today's data-driven school environment. However, the more important reasons they must assess are to improve their professional effectiveness as teachers, to improve student learning, and to help them advocate for…
A Thematic Analysis of Online Discussion Boards for Brachial Plexus Injury.

PubMed

Morris, Marie T; Daluiski, Aaron; Dy, Christopher J

2016-08-01

Patients with brachial plexus injury (BPI) and their family members contribute to Internet discussion groups dedicated to BPI. We hypothesized that a thematic analysis of posts from BPI Internet discussion groups would reveal common themes related to the BPI patient experience, providing topics for patient education and counseling. Internet discussion boards were identified using the search term "brachial plexus injury support group" in Google, Bing, and Yahoo! search engines. Two discussion boards had substantially more posts than other Web sites and were chosen for analyses. Posts from January 1, 2015, through January 1, 2016, were examined. Using an iterative and established process, 2 investigators (M.T.M. and C.J.D) independently analyzed each post using thematic analysis in 3 steps (open coding, axial coding, and selective coding) to determine common themes. In this process, each post was reviewed 3 times. A total of 328 posts from the 2 leading discussion boards were analyzed. Investigators reached a consensus on themes for all posts. One central theme focused on emotional aspects of BPI. Four other central themes regarding information support were identified: BPI disease, BPI treatment, recovery after BPI treatment, and process of seeking care for BPI. Examination of posts on Internet support groups for BPI revealed recurring concerns, questions, and opinions of patients and their family members. The most common themes related to disease information, treatment, recovery, and the emotional element of BPI. These findings provide a helpful starting point in refining topics for patient education and support that are targeted on patients' interests and concerns. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Voice hearing within the context of hearers' social worlds: an interpretative phenomenological analysis.

PubMed

Mawson, Amy; Berry, Katherine; Murray, Craig; Hayward, Mark

2011-09-01

Research has found relational qualities of power and intimacy to exist within hearer-voice interactions. The present study aimed to provide a deeper understanding of the interpersonal context of voice hearing by exploring participants' relationships with their voices and other people in their lives. This research was designed in consultation with service users and employed a qualitative, phenomenological, and idiographic design using semi-structured interviews. Ten participants, recruited via mental health services, and who reported hearing voices in the previous week, completed the interviews. These were transcribed verbatim and analysed using interpretative phenomenological analysis. Five themes resulted from the analysis. Theme 1: 'person and voice' demonstrated that participants' voices often reflected the identity, but not always the quality of social acquaintances. Theme 2: 'voices changing and confirming relationship with the self' explored the impact of voice hearing in producing an inferior sense-of-self in comparison to others. Theme 3: 'a battle for control' centred on issues of control and a dilemma of independence within voice relationships. Theme 4: 'friendships facilitating the ability to cope' and theme 5: 'voices creating distance in social relationships' explored experiences of social relationships within the context of voice hearing, and highlighted the impact of social isolation for voice hearers. The study demonstrated the potential role of qualitative research in developing theories of voice hearing. It extended previous research by highlighting the interface between voices and the social world of the hearer, including reciprocal influences of social relationships on voices and coping. Improving voice hearers' sense-of-self may be a key factor in reducing the distress caused by voices. ©2010 The British Psychological Society.
Adjustment of Adaptive Gain with Bounded Linear Stability Analysis to Improve Time-Delay Margin for Metrics-Driven Adaptive Control

NASA Technical Reports Server (NTRS)

Bakhtiari-Nejad, Maryam; Nguyen, Nhan T.; Krishnakumar, Kalmanje Srinvas

2009-01-01

This paper presents the application of Bounded Linear Stability Analysis (BLSA) method for metrics driven adaptive control. The bounded linear stability analysis method is used for analyzing stability of adaptive control models, without linearizing the adaptive laws. Metrics-driven adaptive control introduces a notion that adaptation should be driven by some stability metrics to achieve robustness. By the application of bounded linear stability analysis method the adaptive gain is adjusted during the adaptation in order to meet certain phase margin requirements. Analysis of metrics-driven adaptive control is evaluated for a linear damaged twin-engine generic transport model of aircraft. The analysis shows that the system with the adjusted adaptive gain becomes more robust to unmodeled dynamics or time delay.
Granulocyte Colony-Stimulating Factor Use after Autologous Peripheral Blood Stem Cell Transplantation: Comparison of Two Practices.

PubMed

Singh, Amrita D; Parmar, Sapna; Patel, Khilna; Shah, Shreya; Shore, Tsiporah; Gergis, Usama; Mayer, Sebastian; Phillips, Adrienne; Hsu, Jing-Mei; Niesvizky, Ruben; Mark, Tomer M; Pearse, Roger; Rossi, Adriana; van Besien, Koen

2018-02-01

Administration of granulocyte colony-stimulating factor (G-CSF) after autologous peripheral blood stem cell transplantation (PBSCT) is generally recommended to reduce the duration of severe neutropenia; however, data regarding the optimal timing of G-CSFs post-transplantation are limited and conflicting. This retrospective study was performed at NewYork-Presbyterian/Weill Cornell Medical Center between November 5, 2013, and August 9, 2016, of adult inpatient autologous PBSCT recipients who received G-CSF empirically starting on day +5 (early) versus on those who received G-CSF on day +12 only if absolute neutrophil count (ANC) was <0.5 × 10 9 /L (ANC-driven). G-CSF was dosed at 300 µg in patients weighing <75 kg and 480 µg in those weighing ≥75 kg. One hundred consecutive patients underwent autologous PBSCT using either the early (n = 50) or ANC-driven (n = 50) G-CSF regimen. Patient and transplantation characteristics were comparable in the 2 groups. In the ANC-driven group, 24% (n = 12) received G-CSF on day +12 and 60% (n = 30) started G-CSF earlier due to febrile neutropenia or at the physician's discretion, 6% (n = 3) started after day +12 at the physician's discretion, and 10% (n = 5) did not receive any G-CSF. The median start day of G-CSF therapy was day +10 in the ANC-driven group versus day +5 in the early group (P < .0001). For the primary outcome, the median time to neutrophil engraftment was 12 days (interquartile range [IQR] 11-13 days) in the early group versus 13 days (IQR, 12-14 days) in the ANC-driven group (P = .07). There were no significant between-group differences in time to platelet engraftment, 1-year relapse rate, or 1-year overall survival. The incidence of febrile neutropenia was 74% in the early group versus 90% in the ANC-driven group (P = .04); however, there was no significant between-group difference in the incidence of positive bacterial cultures or transfer to the intensive care unit. The duration of G-CSF administration until neutrophil engraftment was 6 days in the early group versus 3 days in the ANC-driven group (P < .0001). The median duration of post-transplantation hospitalization was 15 days (IQR, 14-19 days) in the early group versus 16 days (IQR, 15-22 days) in the ANC-driven group (P = .28). Our data show that early initiation of G-CSF (on day +5) and ANC-driven initiation of G-CSF following autologous PBSCT were associated with a similar time to neutrophil engraftment, length of stay post-transplantation, and 1-year overall survival. Published by Elsevier Inc.
The learner as co-creator: A new peer review and self-assessment feedback form created by student nurses.

PubMed

Duers, Lorraine E

2017-11-01

Engagement with peer review and self-assessment is not always regarded by student nurses as an activity that results in a positive learning experience. Literature indicates that withdrawal from the learning process becomes attractive to individuals affected by a negative experience of peer review. Literature also provides examples of student nurses' feeling 'torn to shreds' during the process of peer review, resulting in loss of confidence and self-esteem. An influencing factor in such situations appears to be the absence of specific learner-driven criteria against which student nurses can assess peer and self-performance. The idea was thus ignited, that creation and utilisation of a learner-driven feedback form might potentially prevent, or at least minimise, the possibility of negative peer review experience. Set within the context of a pre-registration nursing programme, within a Higher Education institution, student nurses (n=25), created a peer review/self-assessment feedback form. Its potential cross-discipline, global applicability is reasonably speculated. Purposive sampling, followed by Stratified Random sampling, maximised participant variation. Data collection took place on 34 occasions, utilising focus group discussions using Nominal Group Technique, a practical task which was video recorded for mediating artefact purposes, and individual interviews. Analysis was concept and theme driven. The study found that participants desired a new feedback form that specifically asks the evaluator to judge human qualities, such as 'compassion' and 'kindness', in addition to the skills and knowledge criteria that any peer review or self-assessment form used currently had incorporated. Providing the participants with the opportunity to develop criteria, against which performance could be measured, with emphasis being afforded to student inclusivity and resultant shift in power balance from the educator to the learner, embraces the idea of teaching and learning in the 21st Century. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Econometrics and Psychometrics: A Survey of Communalities

ERIC Educational Resources Information Center

Goldberger, Arthur S.

1971-01-01

Several themes which are common to both econometrics and psychometrics are surveyed. The themes are illustrated by reference to permanent income hypotheses, simultaneous equation models, adaptive expectations and partial adjustment schemes, and by reference to test score theory, factor analysis, and time-series models. (Author)
Virtual Invisibility: Race and "Communication Education"

ERIC Educational Resources Information Center

Hendrix, Katherine Grace; Wilson, Cicely

2014-01-01

Articles published in "Communication Education" ("CE") from 2000 to 2013 yielded four major themes: teacher/instructor to student communication, public speaking, technology, and identity. An analysis of the articles within each major theme revealed a notable absence of research investigating the experiences of students of color…
Exploring workplace violence among home care workers in a consumer-driven home health care program.

PubMed

Nakaishi, Lindsay; Moss, Helen; Weinstein, Marc; Perrin, Nancy; Rose, Linda; Anger, W Kent; Hanson, Ginger C; Christian, Mervyn; Glass, Nancy

2013-10-01

Nominal research has examined sexual harassment and workplace violence against home care workers within consumer-driven home care models such as those offered in Oregon. This study examined home care workers' experiences of violence while providing care to consumer employers, the patients who hire and manage home care workers. Focus groups and interviews were conducted in Oregon with 83 home care workers, 99 Oregon Department of Human Services (DHS) employees, and 11 consumer employers. Home care workers reported incidents of workplace physical violence (44%), psychological abuse (65%), sexual harassment (41%), and sexual violence (14%). Further, three themes were identified that may increase the risk of workplace violence: (1) real and perceived barriers to reporting violence; (2) tolerance of violence; and (3) limited training to prevent violence. To ensure worker safety while maintaining quality care, safety policies and training for consumer employers, state DHS employees, and home care workers must be developed. Copyright 2013, SLACK Incorporated.
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.
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.
Targeting glutamine metabolism in multiple myeloma enhances BIM binding to BCL-2 eliciting synthetic lethality to venetoclax.

PubMed

Bajpai, R; Matulis, S M; Wei, C; Nooka, A K; Von Hollen, H E; Lonial, S; Boise, L H; Shanmugam, M

2016-07-28

Multiple myeloma (MM) is a plasma cell malignancy that is largely incurable due to development of resistance to therapy-elicited cell death. Nutrients are intricately connected to maintenance of cellular viability in part by inhibition of apoptosis. We were interested to determine if examination of metabolic regulation of BCL-2 proteins may provide insight on alternative routes to engage apoptosis. MM cells are reliant on glucose and glutamine and withdrawal of either nutrient is associated with varying levels of apoptosis. We and others have demonstrated that glucose maintains levels of key resistance-promoting BCL-2 family member, myeloid cell leukemic factor 1 (MCL-1). Cells continuing to survive in the absence of glucose or glutamine were found to maintain expression of MCL-1 but importantly induce pro-apoptotic BIM expression. One potential mechanism for continued survival despite induction of BIM could be due to binding and sequestration of BIM to alternate pro-survival BCL-2 members. Our investigation revealed that cells surviving glutamine withdrawal in particular, enhance expression and binding of BIM to BCL-2, consequently sensitizing these cells to the BH3 mimetic venetoclax. Glutamine deprivation-driven sensitization to venetoclax can be reversed by metabolic supplementation with TCA cycle intermediate α-ketoglutarate. Inhibition of glucose metabolism with the GLUT4 inhibitor ritonavir elicits variable cytotoxicity in MM that is marginally enhanced with venetoclax treatment, however, targeting glutamine metabolism with 6-diazo-5-oxo-l-norleucine uniformly sensitized MM cell lines and relapse/refractory patient samples to venetoclax. Our studies reveal a potent therapeutic strategy of metabolically driven synthetic lethality involving targeting glutamine metabolism for sensitization to venetoclax in MM.
Targeting glutamine metabolism in multiple myeloma enhances BIM binding to BCL-2 eliciting synthetic lethality to venetoclax

PubMed Central

Bajpai, R; Matulis, SM; Wei, C; Nooka, AK; Von Hollen, HE; Lonial, S; Boise, LH; Shanmugam, M

2016-01-01

Multiple myeloma (MM) is a plasma cell malignancy that is largely incurable due to development of resistance to therapy-elicited cell death. Nutrients are intricately connected to maintenance of cellular viability in part by inhibition of apoptosis. We were interested to determine if examination of metabolic regulation of BCL-2 proteins may provide insight on alternative routes to engage apoptosis. MM cells are reliant on glucose and glutamine and withdrawal of either nutrient is associated with varying levels of apoptosis. We and others have demonstrated that glucose maintains levels of key resistance-promoting BCL-2 family member, myeloid cell leukemic factor 1 (MCL-1). Cells continuing to survive in the absence of glucose or glutamine were found to maintain expression of MCL-1 but importantly induce pro-apoptotic BIM expression. One potential mechanism for continued survival despite induction of BIM could be due to binding and sequestration of BIM to alternate pro-survival BCL-2 members. Our investigation revealed that cells surviving glutamine withdrawal in particular, enhance expression and binding of BIM to BCL-2, consequently sensitizing these cells to the BH3 mimetic venetoclax. Glutamine deprivation-driven sensitization to venetoclax can be reversed by metabolic supplementation with TCA cycle intermediate α-ketoglutarate. Inhibition of glucose metabolism with the GLUT4 inhibitor ritonavir elicits variable cytotoxicity in MM that is marginally enhanced with venetoclax treatment, however, targeting glutamine metabolism with 6-diazo-5-oxo-l-norleucine uniformly sensitized MM cell lines and relapse/refractory patient samples to venetoclax. Our studies reveal a potent therapeutic strategy of metabolically driven synthetic lethality involving targeting glutamine metabolism for sensitization to venetoclax in MM. PMID:26640142
Regulatory role of hexosamine biosynthetic pathway on hepatic cancer stem cell marker CD133 under low glucose conditions

NASA Astrophysics Data System (ADS)

Lin, Shu-Hai; Liu, Tengfei; Ming, Xiaoyan; Tang, Zhi; Fu, Li; Schmitt-Kopplin, Philippe; Kanawati, Basem; Guan, Xin-Yuan; Cai, Zongwei

2016-02-01

Cancer was hypothesized to be driven by cancer stem cells (CSCs), but the metabolic determinants of CSC-like phenotype still remain elusive. Here, we present that hexosamine biosynthetic pathway (HBP) at least in part rescues cancer cell fate with inactivation of glycolysis. Firstly, metabolomic analysis profiled cellular metabolome in CSCs of hepatocellular carcinoma using CD133 cell-surface marker. The metabolic signatures of CD133-positive subpopulation compared to CD133-negative cells highlighted HBP as one of the distinct metabolic pathways, prompting us to uncover the role of HBP in maintenance of CSC-like phenotype. To address this, CSC-like phenotypes and cell survival were investigated in cancer cells under low glucose conditions. As a result, HBP inhibitor azaserine reduced CD133-positive subpopulation and CD133 expression under high glucose condition. Furthermore, treatment of N-Acetylglucosamine in part restores CD133-positive subpopulation when either 2.5 mM glucose in culture media or glycolytic inhibitor 2-deoxy-D-glucose in HCC cell lines was applied, enhancing CD133 expression as well as promoting cancer cell survival. Together, HBP might be a key metabolic determinant in the functions of hepatic CSC marker CD133.
The meaning of food and eating among home parenteral nutrition-dependent adults with intestinal failure: a qualitative inquiry.

PubMed

Winkler, Marion F; Wetle, Terrie; Smith, Carol; Hagan, Elizabeth; O'Sullivan Maillet, Julie; Touger-Decker, Riva

2010-11-01

Using content and interpretative phenomenological analysis, we explored the meaning of food and eating from the perspective of adults receiving home parenteral nutrition (PN). The aim of this research was to obtain a deeper understanding of how issues related to food and eating influence quality of life (QOL). Semistructured telephone interviews were conducted between May 2006 and January 2007 with 24 adults with intestinal failure and home PN dependency. The analysis revealed themes relevant to eating behaviors, hunger and thirst, strategies for dining in restaurants, and a perception of wasting money because of malabsorbed food. Three patterns of eating emerged: eating for survival, eating for health benefits, and eating for socialization. A proposed model illustrates how these eating patterns are linked to QOL. Being able to eat and enjoy food is an important ingredient for good self-reported QOL. Measurements of QOL for this population may be enhanced with inclusion of a food and eating domain. The social and emotional context of food and mealtimes is an important component to address in the nutrition care plan for PN-dependent adults. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
Commercially sexually exploited youths' health care experiences, barriers, and recommendations: A qualitative analysis.

PubMed

Ijadi-Maghsoodi, Roya; Bath, Eraka; Cook, Mekeila; Textor, Lauren; Barnert, Elizabeth

2018-02-01

The current study sought to understand commercially sexually exploited (CSE) youths' health care experiences, barriers to care, and recommendations for improving health care services. We conducted focus groups (N=5) with 18 CSE youth from February 2015 through May 2016 at two group homes serving CSE youth in Southern California. We performed thematic content analysis to identify emergent themes about CSE youths' perspectives on health care. Youth described facilitators to care, including availability of services such as screening for sexually transmitted infections, knowledge about sexual health, and a strong motivation to stay healthy. Barriers included feeling judged, concerns about confidentiality, fear, perceived low quality of services, and self-reliance. Overall, youth emphasized self-reliance and "street smarts" for survival and de-emphasized "victimhood," which shaped their interactions with health care, and recommended that health providers develop increased understanding of CSE youth. Our findings suggest that providers and community agencies can play an essential role in raising awareness of the needs of CSE youth and meet their health needs through creating a non-judgmental environment in health care settings that validates the experiences of these youth. Published by Elsevier Ltd.
Transforming user needs into functional requirements for an antibiotic clinical decision support system: explicating content analysis for system design.

PubMed

Bright, T J

2013-01-01

Many informatics studies use content analysis to generate functional requirements for system development. Explication of this translational process from qualitative data to functional requirements can strengthen the understanding and scientific rigor when applying content analysis in informatics studies. To describe a user-centered approach transforming emergent themes derived from focus group data into functional requirements for informatics solutions and to illustrate these methods to the development of an antibiotic clinical decision support system (CDS). THE APPROACH CONSISTED OF FIVE STEPS: 1) identify unmet therapeutic planning information needs via Focus Group Study-I, 2) develop a coding framework of therapeutic planning themes to refine the domain scope to antibiotic therapeutic planning, 3) identify functional requirements of an antibiotic CDS system via Focus Group Study-II, 4) discover informatics solutions and functional requirements from coded data, and 5) determine the types of information needed to support the antibiotic CDS system and link with the identified informatics solutions and functional requirements. The coding framework for Focus Group Study-I revealed unmet therapeutic planning needs. Twelve subthemes emerged and were clustered into four themes; analysis indicated a need for an antibiotic CDS intervention. Focus Group Study-II included five types of information needs. Comments from the Barrier/Challenge to information access and Function/Feature themes produced three informatics solutions and 13 functional requirements of an antibiotic CDS system. Comments from the Patient, Institution, and Domain themes generated required data elements for each informatics solution. This study presents one example explicating content analysis of focus group data and the analysis process to functional requirements from narrative data. Illustration of this 5-step method was used to develop an antibiotic CDS system, resolving unmet antibiotic prescribing needs. As a reusable approach, these techniques can be refined and applied to resolve unmet information needs with informatics interventions in additional domains.
Density-dependent coral recruitment displays divergent responses during distinct early life-history stages

PubMed Central

Evensen, Nicolas R.; Gómez-Lemos, Luis A.; Babcock, Russell C.

2017-01-01

Population growth involves demographic bottlenecks that regulate recruitment success during various early life-history stages. The success of each early life-history stage can vary in response to population density, interacting with intrinsic (e.g. behavioural) and environmental (e.g. competition, predation) factors. Here, we used the common reef-building coral Acropora millepora to investigate how density-dependence influences larval survival and settlement in laboratory experiments that isolated intrinsic effects, and post-settlement survival in a field experiment that examined interactions with environmental factors. Larval survival was exceptionally high (greater than 80%) and density-independent from 2.5 to 12 days following spawning. By contrast, there was a weak positive effect of larval density on settlement, driven by gregarious behaviour at the highest density. When larval supply was saturated, settlement was three times higher in crevices compared with exposed microhabitats, but a negative relationship between settler density and post-settlement survival in crevices and density-independent survival on exposed surfaces resulted in similar recruit densities just one month following settlement. Moreover, a negative relationship was found between turf algae and settler survival in crevices, whereas gregarious settlement improved settler survival on exposed surfaces. Overall, our findings reveal divergent responses by coral larvae and newly settled recruits to density-dependent regulation, mediated by intrinsic and environmental interactions. PMID:28573015
Essential roles of FoxM1 in Ras-induced liver cancer progression and in cancer cells with stem cell features.

PubMed

Kopanja, Dragana; Pandey, Akshay; Kiefer, Megan; Wang, Zebin; Chandan, Neha; Carr, Janai R; Franks, Roberta; Yu, Dae-Yeul; Guzman, Grace; Maker, Ajay; Raychaudhuri, Pradip

2015-08-01

Overexpression of FoxM1 correlates with poor prognosis in hepatocellular carcinoma (HCC). Moreover, the Ras-signaling pathway is found to be ubiquitously activated in HCC through epigenetic silencing of the Ras-regulators. We investigated the roles of FoxM1 in Ras-driven HCC, and on HCC cells with stem-like features. We employed a transgenic mouse model that expresses the oncogenic Ras in the liver. That strain was crossed with a strain that harbor floxed alleles of FoxM1 and the MxCre gene that allows conditional deletion of FoxM1. FoxM1 alleles were deleted after development of HCC, and the effects on the tumors were analyzed. Also, FoxM1 siRNA was used in human HCC cell lines to determine its role in the survival of the HCC cells with stem cell features. Ras-driven tumors overexpress FoxM1. Deletion of FoxM1 inhibits HCC progression. There was increased accumulation of reactive oxygen species (ROS) in the FoxM1 deleted HCC cells. Moreover, FoxM1 deletion caused a disproportionate loss of the CD44+ and EpCAM+ HCC cells in the tumors. We show that FoxM1 directly activates expression of CD44 in human HCC cells. Moreover, the human HCC cells with stem cell features are addicted to FoxM1 for ROS-regulation and survival. Our results provide genetic evidence for an essential role of FoxM1 in the progression of Ras-driven HCC. In addition, FoxM1 is required for the expression of CD44 in HCC cells. Moreover, FoxM1 plays a critical role in the survival of the HCC cells with stem cell features by regulating ROS. Published by Elsevier B.V.
Nightmare Themes: An Online Study of Most Recent Nightmares and Childhood Nightmares.

PubMed

Schredl, Michael; Göritz, Anja S

2018-03-15

Even though the common diagnostic criteria (ICSD-3, DSM-5) acknowledge that nightmares do not only contain anxiety/fear (definition of the ICD-10) but also other emotions such as grief, disgust, and anger, the definition of a nightmare still focuses on threats to survival, security, or physical integrity. However, empirical studies on nightmare content in larger samples are scarce. The current study elicited 1,216 of the most recent nightmares including childhood nightmares of a population-based sample. The findings show that nightmares encompass a diversity of different topics, being chased, physical aggression, including death/injury of close persons. Infrequent themes like being the aggressor and suicide are of special interest as they might be related to waking-life psychopathology. The variety of nightmare topics clearly indicate that current definitions of nightmare content are too narrow. Future studies should look into nightmare content of persons in whom nightmare disorder has been diagnosed. © 2018 American Academy of Sleep Medicine.
Mother-caregiver expectations for function among survivors of childhood brain tumors

PubMed Central

Barakat, Lamia P.; Ulrich, Connie M.; Jones, Nora L.; Deatrick, Janet A.

2015-01-01

Purpose Children diagnosed with brain tumors increasingly survive to adulthood, although they do so with needs often requiring continued parental caregiving. We sought to describe the nature of caregivers’ expectations about survivors’ function and how expectations connect to ongoing management and decision-making. Methods Forty-five qualitative interviews with mother-caregivers were conducted and coded for themes related to expectations for their adolescent/young adult children living post-childhood brain tumors. Results Five main themes emerged as integral to mother-caregiver expectations: realizing a difference in the survivor, noticing limitations to independence in the survivor, memories of learning about clinical prognoses as understood from consent meetings and education, managing these realizations, and acknowledging unresolved challenges. Conclusions Caregiver expectations are influenced by both initial clinical interactions and contemporary family dynamics and require individual- and family-specific survivorship planning. As caregiver expectations can influence management behaviors that impact outcomes and possibly independence, implications for clinician-caregiver shared decision-making are substantial. PMID:26556212
Understanding the Life Histories of Pregnant-Involved Young Aboriginal Women With Substance Use Experiences in Three Canadian Cities.

PubMed

Shahram, Sana Z; Bottorff, Joan L; Kurtz, Donna L M; Oelke, Nelly D; Thomas, Victoria; Spittal, Patricia M

2017-01-01

Despite attention paid to substance use during pregnancy, understandings of young Aboriginal women's experiences based on their perspectives have been virtually absent in the published literature. This study's objective was to understand the life experiences of pregnant-involved young Aboriginal women with alcohol and drugs. Semi-structured interviews to gather life histories were conducted with 23 young Aboriginal women who had experiences with pregnancy, and alcohol and drug use. Transcribed interviews were analyzed for themes to describe the social and historical contexts of women's experiences and their self-representations. The findings detail women's strategies for survival, inner strength, and capacities for love, healing, and resilience. Themes included the following: intersectional identities, life histories of trauma (abuse, violence, and neglect; intergenerational trauma; separations and connections), the ever-presence of alcohol and drugs, and the highs and lows of pregnancy and mothering. The findings have implications for guiding policy and interventions for supporting women and their families. © The Author(s) 2016.

Disrupted lives: investigating coping strategies for non-healing leg ulcers.

PubMed

Hopkins, Alison

The aim of this study was to explore the lived experience of people who have non-healing venous ulcers using hermeneutic phenomenology. Unstructured interviews were carried out with five people who also completed a diary. Interpretative phenomenological analysis was utilized to identify themes and patterns. The core themes identified through analysis were biographical disruption, ways of coping, social implications and therapeutic relationships. The emergent themes reveal the impact of chronicity in participants' experience of chronic leg ulcers, their various emotional and problem-focused coping strategies and the positive role the district nurse plays in their lives. This study places leg ulceration within the body of literature on chronicity, linking nursing theory with the insights offered from health psychology.
Examining ISIS Support and Opposition Networks on Twitter

DTIC Science & Technology

2016-01-01

interactive communities of Twitter users , lexical analysis that can identify key themes and content for large data sets, and social network analysis...Twitter data, we lexically analyzed the content and key themes of users who mostly employ Daesh versus those who mostly use Islamic State in their tweets...As predicted, we found that frequent users of Daesh had content that was highly critical of ISIS, with users using such terms as Terrorist Daesh
The orchestration of occupation: the dance of mothers.

PubMed

Larson, E A

2000-01-01

This article describes the relationship of mothers' orchestration of daily occupations, the specialized maternal work of parenting a child with a disability, and the mother's subjective well-being. Mothers' daily occupations and subjective well-being were studied using multiple in-depth interviews, participant observation of a day's round of occupations, and scales of well-being. Data were treated to a recursive analysis, which included theoretical notes generated during transcriptions that identified important themes and additional points of inquiry, line-by-line coding of transcripts, and theoretical sorting of codes and regrouping, recoding. To account for patterns in the data, a relational analysis was conducted that included the generation of metaphors. Emergent findings of this analysis identified the mothers' guiding occupational motif and eight processes of orchestration in their daily routines. The occupational motif, the embrace of paradox, directed the mother's orchestration of daily occupations. The orchestration processes included planning, organizing, balancing, anticipating, interpreting, forecasting, perspective shifting, and meaning making. Examples illustrate the maternally driven and child-sensitive nature of these processes. In their daily rounds, the mothers studied were attentive to the manner and method with which they interacted with their children to produce child-contingent occupations commensurate with their values of being a good mother. Using these orchestration processes, mothers made sense of their past, designed their present, and planned for their future within their daily occupational rounds for themselves and family members.
A novel untargeted metabolomics correlation-based network analysis incorporating human metabolic reconstructions

PubMed Central

2013-01-01

Background Metabolomics has become increasingly popular in the study of disease phenotypes and molecular pathophysiology. One branch of metabolomics that encompasses the high-throughput screening of cellular metabolism is metabolic profiling. In the present study, the metabolic profiles of different tumour cells from colorectal carcinoma and breast adenocarcinoma were exposed to hypoxic and normoxic conditions and these have been compared to reveal the potential metabolic effects of hypoxia on the biochemistry of the tumour cells; this may contribute to their survival in oxygen compromised environments. In an attempt to analyse the complex interactions between metabolites beyond routine univariate and multivariate data analysis methods, correlation analysis has been integrated with a human metabolic reconstruction to reveal connections between pathways that are associated with normoxic or hypoxic oxygen environments. Results Correlation analysis has revealed statistically significant connections between metabolites, where differences in correlations between cells exposed to different oxygen levels have been highlighted as markers of hypoxic metabolism in cancer. Network mapping onto reconstructed human metabolic models is a novel addition to correlation analysis. Correlated metabolites have been mapped onto the Edinburgh human metabolic network (EHMN) with the aim of interlinking metabolites found to be regulated in a similar fashion in response to oxygen. This revealed novel pathways within the metabolic network that may be key to tumour cell survival at low oxygen. Results show that the metabolic responses to lowering oxygen availability can be conserved or specific to a particular cell line. Network-based correlation analysis identified conserved metabolites including malate, pyruvate, 2-oxoglutarate, glutamate and fructose-6-phosphate. In this way, this method has revealed metabolites not previously linked, or less well recognised, with respect to hypoxia before. Lactate fermentation is one of the key themes discussed in the field of hypoxia; however, malate, pyruvate, 2-oxoglutarate, glutamate and fructose-6-phosphate, which are connected by a single pathway, may provide a more significant marker of hypoxia in cancer. Conclusions Metabolic networks generated for each cell line were compared to identify conserved metabolite pathway responses to low oxygen environments. Furthermore, we believe this methodology will have general application within metabolomics. PMID:24153255
Decision fatigue: A conceptual analysis.

PubMed

Pignatiello, Grant A; Martin, Richard J; Hickman, Ronald L

2018-03-01

Decision fatigue is an applicable concept to healthcare psychology. Due to a lack of conceptual clarity, we present a concept analysis of decision fatigue. A search of the term "decision fatigue" was conducted across seven research databases, which yielded 17 relevant articles. The authors identified three antecedent themes (decisional, self-regulatory, and situational) and three attributional themes (behavioral, cognitive, and physiological) of decision fatigue. However, the extant literature failed to adequately describe consequences of decision fatigue. This concept analysis provides needed conceptual clarity for decision fatigue, a concept possessing relevance to nursing and allied health sciences.
Transitioning to a Data Driven Mental Health Practice: Collaborative Expert Sessions for Knowledge and Hypothesis Finding.

PubMed

Menger, Vincent; Spruit, Marco; Hagoort, Karin; Scheepers, Floor

2016-01-01

The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard Process for Data Mining (CRISP-DM), suitable for conducting expert sessions that focus on finding new knowledge and hypotheses in collaboration with local workforce. Our proposed specification that we name CRISP-IDM is evaluated in a case study at the psychiatry department of the University Medical Center Utrecht. Expert interviews were conducted to identify seven research themes in the psychiatry department, which were researched in cooperation with local health care professionals using data visualization as a modeling tool. During 19 expert sessions, two results that were directly implemented and 29 hypotheses for further research were found, of which 24 were not imagined during the initial expert interviews. Our work demonstrates the viability and benefits of involving work floor people in the analyses and the possibility to effectively find new knowledge and hypotheses using our CRISP-IDM method.
Interactive communication with the public: qualitative exploration of the use of social media by food and health organizations.

PubMed

Shan, Liran Christine; Panagiotopoulos, Panagiotis; Regan, Áine; De Brún, Aoife; Barnett, Julie; Wall, Patrick; McConnon, Áine

2015-01-01

To examine the use and impact of social media on 2-way communication between consumers and public organizations in the food safety and nutrition area. In-depth qualitative study conducted between October, 2012 and January, 2013, using semi-structured interviews in the United Kingdom and Ireland. Sixteen professionals worked on the public interface within 5 national organizations with a role in communicating on food safety and nutrition issues in this thematic analysis. Five main themes were identified: gradual shift toward social media-based queries and complaints; challenges and limitations of social media to deal with queries and complaints; benefits of using social media in query and complaint services; content redesign driven by social media use; and using social media to learn more about consumers. Social media penetrated and brought new opportunities to food organizations' interactions with the public. Given the increasing use of social media by the public, food organizations need to explore such new opportunities for communication and research. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Interconnection: A qualitative analysis of adjusting to living with renal cell carcinoma

PubMed Central

LEAL, ISABEL; MILBURY, KATHRIN; ENGEBRETSON, JOAN; MATIN, SURENA; JONASCH, ERIC; TANNIR, NIZAR; WOOD, CHRISTOPHER G.; COHEN, LORENZO

2017-01-01

Objective Adjusting to cancer is an ongoing process, yet few studies explore this adjustment from a qualitative perspective. The aim of our qualitative study was to understand how patients construct their experience of adjusting to living with cancer. Method Qualitative analysis was conducted of written narratives collected from four separate writing sessions as part of a larger expressive writing clinical trial with renal cell carcinoma patients. Thematic analysis and constant comparison were employed to code the primary patterns in the data into themes until thematic saturation was reached at 37 participants. A social constructivist perspective informed data interpretation. Results Interconnection described the overarching theme underlying the process of adjusting to cancer and involved four interrelated themes: (1) discontinuity—feelings of disconnection and loss following diagnosis; (2) reorientation—to the reality of cancer psychologically and physically; (3) rebuilding—struggling through existential distress to reconnect; and (4) expansion—finding meaning in interconnections with others. Participants related a dialectical movement in which disruption and loss catalyzed an ongoing process of finding meaning. Significance of results Our findings suggest that adjusting to living with cancer is an ongoing, iterative, nonlinear process. The dynamic interactions between the different themes in this process describe the transformation of meaning as participants move through and revisit prior themes in response to fluctuating symptoms and medical news. It is important that clinicians recognize the dynamic and ongoing process of adjusting to cancer to support patients in addressing their unmet psychosocial needs throughout the changing illness trajectory. PMID:28262086
Interconnection: A qualitative analysis of adjusting to living with renal cell carcinoma.

PubMed

Leal, Isabel; Milbury, Kathrin; Engebretson, Joan; Matin, Surena; Jonasch, Eric; Tannir, Nizar; Wood, Christopher G; Cohen, Lorenzo

2018-04-01

ABSTRACTObjective:Adjusting to cancer is an ongoing process, yet few studies explore this adjustment from a qualitative perspective. The aim of our qualitative study was to understand how patients construct their experience of adjusting to living with cancer. Qualitative analysis was conducted of written narratives collected from four separate writing sessions as part of a larger expressive writing clinical trial with renal cell carcinoma patients. Thematic analysis and constant comparison were employed to code the primary patterns in the data into themes until thematic saturation was reached at 37 participants. A social constructivist perspective informed data interpretation. Interconnection described the overarching theme underlying the process of adjusting to cancer and involved four interrelated themes: (1) discontinuity-feelings of disconnection and loss following diagnosis; (2) reorientation-to the reality of cancer psychologically and physically; (3) rebuilding-struggling through existential distress to reconnect; and (4) expansion-finding meaning in interconnections with others. Participants related a dialectical movement in which disruption and loss catalyzed an ongoing process of finding meaning. Our findings suggest that adjusting to living with cancer is an ongoing, iterative, nonlinear process. The dynamic interactions between the different themes in this process describe the transformation of meaning as participants move through and revisit prior themes in response to fluctuating symptoms and medical news. It is important that clinicians recognize the dynamic and ongoing process of adjusting to cancer to support patients in addressing their unmet psychosocial needs throughout the changing illness trajectory.
Application of Bounded Linear Stability Analysis Method for Metrics-Driven Adaptive Control

NASA Technical Reports Server (NTRS)

Bakhtiari-Nejad, Maryam; Nguyen, Nhan T.; Krishnakumar, Kalmanje

2009-01-01

This paper presents the application of Bounded Linear Stability Analysis (BLSA) method for metrics-driven adaptive control. The bounded linear stability analysis method is used for analyzing stability of adaptive control models, without linearizing the adaptive laws. Metrics-driven adaptive control introduces a notion that adaptation should be driven by some stability metrics to achieve robustness. By the application of bounded linear stability analysis method the adaptive gain is adjusted during the adaptation in order to meet certain phase margin requirements. Analysis of metrics-driven adaptive control is evaluated for a second order system that represents a pitch attitude control of a generic transport aircraft. The analysis shows that the system with the metrics-conforming variable adaptive gain becomes more robust to unmodeled dynamics or time delay. The effect of analysis time-window for BLSA is also evaluated in order to meet the stability margin criteria.
Comparative Effectiveness of Cancer Control and Survival After Robot Assisted versus Open Radical Prostatectomy

PubMed Central

Hu, Jim H.; O’Malley, Padraic; Chughtai, Bilal; Isaacs, Abby; Mao, Jialin; Wright, Jason D.; Hershman, Dawn; Sedrakyan, Art

2017-01-01

Introduction Robot-assisted surgery has been rapidly adopted in the U.S. for prostate cancer (PCa). Its adoption has been driven by market forces and patient preference, and debate continues regarding whether it offers improved outcomes to justify higher cost relative to open surgery. We examined comparative effectiveness of robot assisted (RARP) versus open radical prostatectomy (ORP) in cancer control and survival in a nationally representative population. Materials and Methods Population based observational cohort study of PCa patients undergoing RARP and ORP during 2003–2012 captured in Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Propensity score matching and time to event analysis was used to compare all-cause mortality, prostate cancer-specific mortality and use of additional treatment following surgery. Results 6,430 RARP and 9,161 ORP performed during 2003–2012 were identified. RARP increased in use from 13.6% to 72.6% in 2003–2004 to 72.6% in 2011–2012. After median follow-up of 6.5 years (IQR 5.2–7.9), RARP was associated with equivalent risk of all-cause mortality (Hazard Ratio [HR] 0.85, [0.72–1.01]) and similar cancer-specific mortality (HR 0.85, [0.50–1.43]) versus ORP. RARP was also associated with less use of additional treatment (HR 0.78, [0. 70–0.86]). Conclusions RARP has comparable intermediate cancer control, as evidenced by less use of additional postoperative cancer therapies and equivalent cancer-specific and overall survival. Longer-term follow-up is needed to assess for differences in PCa-specific survival, which was similar during intermediate follow-up. Our findings have significant quality and cost implications and provide reassurance regarding the adoption of more expensive technology in absence of randomized controlled trials. PMID:27720782
Themes of Hope and Healing: Infertile Couples' Experiences of Adoption.

ERIC Educational Resources Information Center

Daniluk, Judith C.; Hurtig-Mitchell, Joss

2003-01-01

Using qualitative approach, authors explored the experiences of becoming parents through adoption after unsuccessful infertility treatments. Analysis of data revealed three overarching themes. Findings are discussed in terms of their implications for counselors who work with infertile couples considering adoption, clients engaged in adoption…
A religiously affiliated health care system in today's competitive market: a success story.

PubMed

King, J G

1984-09-01

In today's competitive health care market, not-for-profit religiously affiliated health care systems face multiple challenges for survival. Their mission of providing for the effective and efficient delivery of quality health care and health-related services for the benefit of individuals, families, and society and a philosophy of maintaining a Christian emphasis in all endeavors conflicts with many of the current competitive themes in health care. The successful system profiled here is Evangelical Health Systems (EHS), a not-for-profit organization affiliated with the United Church of Christ.
A Thematic Analysis of Online Discussion Boards for Vasectomy.

PubMed

Samplaski, Mary K

2018-01-01

To examine posts on Internet discussion groups related to vasectomies, and identify common ideas through a structured theme analysis. Internet discussion boards were identified using the search term "vasectomy." Three discussion boards were identified as having the most posts and were chosen for analysis. Using an iterative and structured analysis process, each post was analyzed using thematic analysis in 3 steps (open coding, axial coding, and selective coding) to determine common themes. A total of 129 posts were analyzed. The most common posts related to changes in sexual function after vasectomy. The second most common theme was pain after vasectomy. There were also posts about considerations before vasectomy, planning for postvasectomy care, what to expect after vasectomy, potential issues after vasectomy and how to manage these, and feelings about vasectomy. Some of the information present did not have a factual basis. Posts dedicated to postvasectomy pain and sexual dysfunction were of the highest quantity. There was no medical provider input to these discussion boards. Educational efforts should be targeted to these areas and should include a health-care professional. Copyright © 2017 Elsevier Inc. All rights reserved.
Behavioural fever is a synergic signal amplifying the innate immune response.

PubMed

Boltaña, Sebastian; Rey, Sonia; Roher, Nerea; Vargas, Reynaldo; Huerta, Mario; Huntingford, Felicity Anne; Goetz, Frederick William; Moore, Janice; Garcia-Valtanen, Pablo; Estepa, Amparo; Mackenzie, S

2013-09-07

Behavioural fever, defined as an acute change in thermal preference driven by pathogen recognition, has been reported in a variety of invertebrates and ectothermic vertebrates. It has been suggested, but so far not confirmed, that such changes in thermal regime favour the immune response and thus promote survival. Here, we show that zebrafish display behavioural fever that acts to promote extensive and highly specific temperature-dependent changes in the brain transcriptome. The observed coupling of the immune response to fever acts at the gene-environment level to promote a robust, highly specific time-dependent anti-viral response that, under viral infection, increases survival. Fish that are not offered a choice of temperatures and that therefore cannot express behavioural fever show decreased survival under viral challenge. This phenomenon provides an underlying explanation for the varied functional responses observed during systemic fever. Given the effects of behavioural fever on survival and the fact that it exists across considerable phylogenetic space, such immunity-environment interactions are likely to be under strong positive selection.
Dam operations affect route-specific passage and survival of juvenile Chinook salmon at a main-stem diversion dam

USGS Publications Warehouse

Perry, Russell W.; Kock, Tobias J.; Couter, Ian I; Garrison, Thomas M; Hubble, Joel D; Child, David B

2016-01-01

Diversion dams can negatively affect emigrating juvenile salmon populations because fish must pass through the impounded river created by the dam, negotiate a passage route at the dam and then emigrate through a riverine reach that has been affected by reduced river discharge. To quantify the effects of a main-stem diversion dam on juvenile Chinook salmon in the Yakima River, Washington, USA, we used radio telemetry to understand how dam operations and river discharge in the 18-km reach downstream of the dam affected route-specific passage and survival. We found evidence of direct mortality associated with dam passage and indirect mortality associated with migration through the reach below the dam. Survival of fish passing over a surface spill gate (the west gate) was positively related to river discharge, and survival was similar for fish released below the dam, suggesting that passage via this route caused little additional mortality. However, survival of fish that passed under a sub-surface spill gate (the east gate) was considerably lower than survival of fish released downstream of the dam, with the difference in survival decreasing as river discharge increased. The probability of fish passing the dam via three available routes was strongly influenced by dam operations, with passage through the juvenile fish bypass and the east gate increasing with discharge through those routes. By simulating daily passage and route-specific survival, we show that variation in total survival is driven by river discharge and moderated by the proportion of fish passing through low-survival or high-survival passage routes.
Barriers and Strategies for Healthy Food Choices among American Indian Tribal College Students: A Qualitative Analysis.

PubMed

Keith, Jill F; Stastny, Sherri; Brunt, Ardith; Agnew, Wanda

2018-06-01

American Indian and Alaskan Native individuals experience disproportionate levels of chronic health conditions such as type 2 diabetes and overweight and obesity that are influenced by dietary patterns and food choices. Understanding factors that influence healthy food choices among tribal college students can enrich education and programs that target dietary intake. To build an understanding of factors that influence healthy food choices among tribal college students at increased risk for college attrition. A nonexperimental cohort design was used for qualitative descriptive analysis. Participants (N=20) were purposively sampled, newly enrolled, academically underprepared tribal college students enrolled in a culturally relevant life skills course at an upper Midwest tribal college between September 2013 and May 2015. Participant demographic characteristics included various tribal affiliations, ages, and number of dependents. Participant responses to qualitative research questions about dietary intake, food choices, self-efficacy for healthy food choices, psychosocial determinants, and barriers to healthy food choices during telephone interviews were used as measures. Qualitative analysis included prestudy identification of researcher bias/assumptions, audiorecording and transcription, initial analysis (coding), secondary analysis (sorting and identifying meaning), and verification (comparative pattern analysis). Qualitative analysis revealed a variety of themes and subthemes about healthy food choices. Main themes related to barriers included taste, food gathering and preparation, and difficulty clarifying healthy food choices. Main themes related to strategies included taste, cultural traditions and practices, and personal motivation factors. Qualitative analysis identified barrier and strategy themes that may assist nutrition and dietetics practitioners working with tribal/indigenous communities, tribal college educators and health specialists, and tribal community health workers who target health and dietary intake of American Indian and Alaskan Native students. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Changes in Siblings Over Time After the Death of a Brother or Sister From Cancer.

PubMed

Akard, Terrah Foster; Skeens, Micah A; Fortney, Christine A; Dietrich, Mary S; Gilmer, Mary Jo; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Wray, Sarah; Gerhardt, Cynthia A

2018-02-27

Limited research has examined the impact of a child's death from cancer on siblings. Even less is known about how these siblings change over time. This study compared changes in siblings 1 (T1) and 2 (T2) years after the death of a brother or sister from cancer based on bereaved parent and sibling interviews. Participants across 3 institutions represented 27 families and included bereaved mothers (n = 21), fathers (n = 15), and siblings (n = 26) ranging from 8 to 17 years old. Participants completed semistructured interviews. Content analysis identified emerging themes and included frequency counts of participant responses. McNemar tests examined differences in the frequency of responses between T1 and T2 data. Participants reported similar types of changes in bereaved siblings at both time points, including changes in sibling relationships, life perspectives, their personal lives, and school performance. A new theme of "openness" emerged at T2. Frequencies of responses differed according to mother, father, or sibling informant. Overall, participants less frequently reported changes at T2 versus T1. Compared with findings in the first year, participants reported greater sibling maturity at follow-up. Overall changes in bereaved siblings continued over 2 years with less frequency over time, with the exception of increases in maturity and openness. Providers can educate parents regarding the impact of death of a brother or sister over time. Nurses can foster open communication in surviving grieving siblings and parents as potential protective factors in families going through their grief.
An exploratory study of end-of-life prognostic communication needs as reported by widowed fathers due to cancer.

PubMed

Park, Eliza M; Check, Devon K; Yopp, Justin M; Deal, Allison M; Edwards, Teresa P; Rosenstein, Donald L

2015-11-01

Effective physician communication about prognosis is a critical aspect of quality care for families affected by terminal illness. This is particularly important for spousal caregivers of terminally ill parents of dependent children, who may have unique needs for communication about anticipated death. The objective of this study was to explore end-of-life prognostic communication experiences reported by bereaved fathers whose wives died from cancer. From October 2012 to November 2013 we surveyed widowed fathers whose wives died from cancer through an open-access educational website. The survey included the following open-ended questions regarding prognostic communication: 'What is the most important thing you would like us to know about whether/how your wife's doctors communicated with you about her anticipated death? What do you wish had been different, if anything?' We performed traditional content analysis of responses. Two researchers coded and categorized the data. Two hundred forty-four men responded to the survey questions on prognostic communication. Major themes addressed by respondents were the importance of clear and honest communication and physician bedside manner. They also identified unmet information needs, including wanting to know prognosis sooner. Relevant sub-themes included death coming as a surprise, avoidance, and caregiver regret. Surviving spouses due to cancer can provide important insights for health care providers about optimum prognostic communication at the end of life. Increased physician attention to the communication preferences of both patients and their partners may improve bereavement outcomes for family members. Copyright © 2015 John Wiley & Sons, Ltd.
Assessing Strategies to Manage Work and Life Balance of Athletic Trainers Working in the National Collegiate Athletic Association Division I Setting

PubMed Central

Mazerolle, Stephanie M.; Pitney, William A.; Casa, Douglas J.; Pagnotta, Kelly D.

2011-01-01

Abstract Context: Certified athletic trainers (ATs) working at the National Collegiate Athletic Association Division I level experience challenges balancing their professional and personal lives. However, an understanding of the strategies ATs use to promote a balance between their professional and personal lives is lacking. Objective: To identify the strategies ATs employed in the Division I setting use to establish a balance between their professional and personal lives. Design: Qualitative investigation using inductive content analysis. Setting: Athletic trainers employed at Division I schools from 5 National Athletic Trainers' Association districts. Patients or Other Participants: A total of 28 (15 women, 13 men) ATs aged 35 ± 9 years volunteered for the study. Data Collection and Analysis: Asynchronous electronic interviews with follow-up phone interviews. Data were analyzed using inductive content analysis. Peer review, member checking, and data-source triangulation were conducted to establish trustworthiness. Results: Three higher-order themes emerged from the analysis. The initial theme, antecedents of work–family conflict, focused on the demands of the profession, flexibility of work schedules, and staffing patterns as contributing to work–life conflict for this group of ATs. The other 2 emergent higher-order themes, professional factors and personal factors, describe the components of a balanced lifestyle. The second-order theme of constructing the professional factors included both organizational policies and individual strategies, whereas the second-order theme of personal factors was separation of work and life and a supportive personal network. Conclusions: Long work hours, lack of control over work schedules, and unbalanced athlete-to-AT ratios can facilitate conflicts. However, as demonstrated by our results, several organizational and personal strategies can be helpful in creating a balanced lifestyle. PMID:21391805

Can we improve the performance and reporting of investigator-initiated clinical trials? Rheumatoid arthritis as an example.

PubMed

Landewé, Robert B M; Smolen, Josef S; Weinblatt, Michael E; Emery, Paul; Dougados, Maxime; Fleischmann, Roy; Aletaha, Daniel; Kavanaugh, Arthur; van der Heijde, Désirée

2014-10-01

Investigator-initiated trials, some of which have been referred to as comparative effectiveness trials, pragmatic trials, or strategy trials, are sometimes considered to be of greater clinical importance than industry-driven trials, because they address important but unresolved clinical questions that differ from the questions asked in industry-driven trials. Regulatory authorities have provided methodological guidance for industry-driven trials for the approval of new treatments, but such guidance is less clear for investigator-initiated trials. The European League Against Rheumatism (EULAR) task force for the update of the recommendations for the management of rheumatoid arthritis has critically looked at the methodological quality and conduct of many investigator-initiated trials, and has identified a number of concerns. In this Viewpoint paper, we highlight commonly encountered issues that are discussed using examples of well-known investigator-initiated trials. These issues cover three themes: (1) design choice (superiority vs non-inferiority designs); (2) statistical power and (3) convenience reporting. Since we acknowledge the importance of investigator-initiated research, we also propose a shortlist of points-to-consider when designing, performing and reporting investigator-initiated trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Discovery of functional interactions among actin regulators by analysis of image fluctuations in an unperturbed motile cell system.

PubMed

Isogai, Tadamoto; Danuser, Gaudenz

2018-05-26

Cell migration is driven by propulsive forces derived from polymerizing actin that pushes and extends the plasma membrane. The underlying actin network is constantly undergoing adaptation to new mechano-chemical environments and intracellular conditions. As such, mechanisms that regulate actin dynamics inherently contain multiple feedback loops and redundant pathways. Given the highly adaptable nature of such a system, studies that use only perturbation experiments (e.g. knockdowns, overexpression, pharmacological activation/inhibition, etc.) are challenged by the nonlinearity and redundancy of the pathway. In these pathway configurations, perturbation experiments at best describe the function(s) of a molecular component in an adapting (e.g. acutely drug-treated) or fully adapted (e.g. permanent gene silenced) cell system, where the targeted component now resides in a non-native equilibrium. Here, we propose how quantitative live-cell imaging and analysis of constitutive fluctuations of molecular activities can overcome these limitations. We highlight emerging actin filament barbed-end biology as a prime example of a complex, nonlinear molecular process that requires a fluctuation analytic approach, especially in an unperturbed cellular system, to decipher functional interactions of barbed-end regulators, actin polymerization and membrane protrusion.This article is part of the theme issue 'Self-organization in cell biology'. © 2018 The Author(s).
Need States Based on Eating Occasions Experienced by Midlife Women Section of the Journal for which the manuscript is intended: Research Brief

PubMed Central

Degeneffe, Dennis; Reicks, Marla

2008-01-01

Objective To identify a comprehensive set of distinct “need states” based on the eating occasions experienced by midlife women. Design Series of 7 focus group interviews. Setting Meeting room on a university campus. Participants A convenience sample of 34 multi-ethnic women (mean age = 46 years). Phenomenon of Interest Descriptions of eating occasions by “need states” - specific patterns of needs for the occasion. Analysis Interviews were audio taped, transcribed verbatim and analyzed for common themes using qualitative data analysis procedures. Findings Eight need states suggested a hypothetical framework reflecting a wide range in emotional gratification. Need states with a low level of emotional gratification were dominated by sets of functional needs such as coping with stress, balancing intake across occasions, meeting external demands of time and effort and maintaining a routine. Food was a means for reinforcing family identity, social expression and celebration in need states with high levels of emotional gratification. Occurrence of need states varied by day and meal/snack occasion, with food type/amount dependent on need state. Conclusions and Implications Eating occasions are driven by specific sets of needs ranging from physical/functional to more emotional/social needs. Addressing need states may improve weight intervention programs for midlife women. PMID:18984495
Melanoma risk: adolescent females' perspectives on skin protection pre/post-viewing a ultraviolet photoaged photograph of their own facial sun damage.

PubMed

Eastabrook, Suzette; Chang, Paul; Taylor, Myra F

2018-03-01

Suntanning increases skin cancer risk and prematurely ages skin. Photoageing photography is an effective means of increasing adult ultraviolet radiation (UVR) awareness and skin-protection practices. While adults' largely positive suntanning-deterrence responses to photoageing photography are well-documented, comparatively little is known about the deterrence effectiveness of photoageing photography with adolescents. To help fill this knowledge gap, in-depth interviews were collected from 10 adolescent females and were subsequently subjected to interpretive phenomenological analysis. The emergent central theme - Having a tan and looking good in the short-term is okay, however, in the longer-term you can end up looking far worse… but still a tan is worth it - and its component subthemes reveal that the adolescent female's desire for a suntan is largely appearance driven. While photoaged photography is effective in increasing their awareness of the skin damage that UVR exposure causes, it does not alter their suntanning intentions. The analysis also revealed that one of the major barriers to adolescent females' adoption of skin-protective behaviours is their belief in their own invincibility. Hence, skin-protection interventions that lessen the aura of invincibility around adolescent females' understanding of their risk for developing skin cancers are vital to reducing the incidence of malignant melanoma.
Qualitative Analysis of Dietary Behaviors in Picture Book Fiction for 4- to 8-Year-Olds.

PubMed

Matvienko, Oksana

2016-10-01

Picture books may facilitate parents' efforts to decrease pickiness and other undesirable food habits in children. This study conducted a content analysis of dietary behaviors and feeding strategies featured in fictional picture books compared with those discussed in the research literature. Several databases were searched for fictional picture books about dietary behavior, published between 2000 and 2016, accessible in the US, available in print format, and designated for 4- to 8-year-olds. Messages about dietary behavior in picture book fiction. Stories were systematically coded using holistic, data-driven, and evaluation coding methods. The final set of codes was examined for themes and patterns. Of the 104 books, 50% featured a specific eating behavior, 21% lifestyle/eating patterns, 20% food-related sensations and emotions, and 9% table manners. Books about dietary behaviors are abundant but the topic coverage is unbalanced. Problem behaviors portrayed in books overlap those discussed in the research literature. However, problem-solving strategies and actions do not align with those endorsed by nutrition professionals. Messages vary in their complexity (in terms of their plot and/or language), ranging from clear and direct to vague, sophisticated, unresolved, conflicting, or controversial. Recommendations for practitioners are discussed. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Transcriptional analysis of product-concentration driven changes in cellular programs of recombinant Clostridium acetobutylicumstrains.

PubMed

Tummala, Seshu B; Junne, Stefan G; Paredes, Carlos J; Papoutsakis, Eleftherios T

2003-12-30

Antisense RNA (asRNA) downregulation alters protein expression without changing the regulation of gene expression. Downregulation of primary metabolic enzymes possibly combined with overexpression of other metabolic enzymes may result in profound changes in product formation, and this may alter the large-scale transcriptional program of the cells. DNA-array based large-scale transcriptional analysis has the potential to elucidate factors that control cellular fluxes even in the absence of proteome data. These themes are explored in the study of large-scale transcriptional analysis programs and the in vivo primary-metabolism fluxes of several related recombinant C. acetobutylicum strains: C. acetobutylicum ATCC 824(pSOS95del) (plasmid control; produces high levels of butanol snd acetone), 824(pCTFB1AS) (expresses antisense RNA against CoA transferase (ctfb1-asRNA); produces very low levels of butanol and acetone), and 824(pAADB1) (expresses ctfb1-asRNA and the alcohol-aldehyde dahydrogenase gene (aad); produce high alcohol and low acetone levels). DNA-array based transcriptional analysis revealed that the large changes in product concentrations (snd notably butanol concentration) due to ctfb1-asRNA expression alone and in combination with aad overexpression resulted in dramatic changes of the cellular transcriptome. Cluster analysis and gene expression patterns of established and putative operons involved in stress response, motility, sporulation, and fatty-acid biosynthesis indicate that these simple genetic changes dramatically alter the cellular programs of C. acetobutylicum. Comparison of gene expression and flux analysis data may point to possible flux-controling steps and suggest unknown regulatory mechanisms. Copyright 2003; Wiley Periodicals, Inc.
Targeting the adaptive molecular landscape of castration-resistant prostate cancer

PubMed Central

Wyatt, Alexander W; Gleave, Martin E

2015-01-01

Castration and androgen receptor (AR) pathway inhibitors induce profound and sustained responses in advanced prostate cancer. However, the inevitable recurrence is associated with reactivation of the AR and progression to a more aggressive phenotype termed castration-resistant prostate cancer (CRPC). AR reactivation can occur directly through genomic modification of the AR gene, or indirectly via co-factor and co-chaperone deregulation. This mechanistic heterogeneity is further complicated by the stress-driven induction of a myriad of overlapping cellular survival pathways. In this review, we describe the heterogeneous and evolvable molecular landscape of CRPC and explore recent successes and failures of therapeutic strategies designed to target AR reactivation and adaptive survival pathways. We also discuss exciting areas of burgeoning anti-tumour research, and their potential to improve the survival and management of patients with CRPC. PMID:25896606
Climate Driven Life Histories: The Case of the Mediterranean Storm Petrel

PubMed Central

Soldatini, Cecilia; Albores-Barajas, Yuri Vladimir; Massa, Bruno; Gimenez, Olivier

2014-01-01

Seabirds are affected by changes in the marine ecosystem. The influence of climatic factors on marine food webs can be reflected in long-term seabird population changes. We modelled the survival and recruitment of the Mediterranean storm petrel (Hydrobates pelagicus melitensis) using a 21-year mark-recapture dataset involving almost 5000 birds. We demonstrated a strong influence of prebreeding climatic conditions on recruitment age and of rainfall and breeding period conditions on juvenile survival. The results suggest that the juvenile survival rate of the Mediterranean subspecies may not be negatively affected by the predicted features of climate change, i.e., warmer summers and lower rainfall. Based on considerations of winter conditions in different parts of the Mediterranean, we were able to draw inferences about the wintering areas of the species for the first time. PMID:24728099
Surviving an epidemic -- Australian GPs on caring for people with HIV and AIDS in the early years.

PubMed

Newman, Christy E; Reynolds, Robert; Gray, Rebecca; Canavan, Peter; De Wit, John; McMurchie, Marilyn; McCoy, Ronald; Kidd, Michael R

2013-10-01

Although general practitioners (GPs) play a central role in responding to human immunodeficiency virus (HIV) in Australia, the social history of their contribution in the early years has remained largely untold. In-depth interviews were conducted with 21 GPs who provided HIV care between 1982 and 1996. De-identified transcripts were broadly coded in NVivo, then analysed for themes regarding GP experiences during the early years. Participants recalled a time of death, fear and prejudice, with large numbers of patients diagnosed with and dying from a highly stigmatised disease. An enduring emotional legacy resulted, with GPs developing survival strategies such as better managing relationships with patients, seeking mental health support and reducing working hours. These GPs represent the first generation of GPs in Australia caring for people with HIV. Understanding their experiences can inform and inspire the next generation, who inherit a much brighter future for HIV care.
Succession and survival in psychotherapy organizations.

PubMed

Khaleelee, Olya

2008-11-01

This paper examines the world of psychotherapy by applying a systemic and psychodynamic understanding of the family business as a way of understanding the dilemmas and challenges of leadership succession. Oedipal factors are explored as an important theme within the succession process. This exploration is set within the context of what function psychotherapy has performed in society over the last thirty years. The hypothesis is that the first generation of leaders aimed to provide containment for the individual citizen at a time of failed dependency in society. The suggestion is that this gave way to the primary task for the second generation, which has been to focus on the therapist in training. The challenge for the third generation is to develop a meaningful role for psychotherapy today and to ensure survival at a time when other shorter therapies such as CBT are gaining ascendancy over longer term psychoanalytic psychotherapy.
Understanding and surviving the transition to value-based oncology.

PubMed

Cox, John V; Sprandio, John D; Barkley, Ronald

2013-01-01

This paper and the three presentations it supports are drawn from the theme of the 2012 Cancer Center Business Summit (CCBS): "Transitioning to Value-Based Oncology: Strategies to Survive and Thrive." The CCBS is a forum on oncology business innovation, and the principal question the organizers address each year is "What are the creative, innovative, and best business models and practices that are being conceived or piloted today that may provide a responsible and sustainable platform for the delivery of cancer care tomorrow?" At this moment in health care-when so much is in flux and new business models and solutions abound-the oncology sector has a solemn responsibility: to forge the business models and relationships that will help to define a new cancer care value proposition and a sustainable health care system of tomorrow for the benefit of the patients it serves to get it "right."
Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

PubMed Central

2011-01-01

Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%), and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55); concerns with chiropractic treatment (n = 54); areas where chiropractic is perceived as effective (n = 43); unethical behavior (n = 43); patient interaction (n = 36); the scientific basis of chiropractic (n = 26); personal experiences with chiropractic (n = 21); and chiropractic training (n = 18). Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare. PMID:21970333
Analysis of comments in a petition defending electronic cigarettes.

PubMed

Sumner, Holly Marie; McQueen, Amy; Scott, Michael John; Sumner, Walton

2014-11-01

A 2009 petition opposing a Food and Drug Administration (FDA) ban on electronic cigarettes (e-cigs) garnered international attention from e-cig users (vapers). Petitioners' comments described the perceived benefits of vaping. We conducted a qualitative and quantitative analysis of petitioners' comments. A sample of 200 petitioner names was sought in public records. Reviewers identified 13 major themes in a sample of comments, and themes related to current controversies were added. For each theme, software pattern-matching instructions (regular expressions) were developed and were used to scan comments. Agreement between reviewers and software was calculated; theme prevalence and clustering was ascertained. A total of 13,414 signatures and 8,285 comments from 50 states and 75 nations were collected in 6 months. Temporal patterns and name matches in public records suggest that most petitioners are authentic. Agreement between reviewers and software was moderate to high (κ = 0.4-0.8). Commonly cited themes were "e-cigs helped me quit" (34%), "a ban would be counterproductive" (15%), and "my health improved with e-cigs" (13%). Two clusters of themes emerged: the first combined comments about smoking cessation, health benefits, and smoking relapse that an e-cig ban would cause; the second combined themes that a "ban would be counterproductive," it would infringe on personal liberties, and it was motivated by government or industrial greed. People who cited mental health issues often mentioned avoiding withdrawal as a benefit of e-cigs. Early e-cig adopters were both frustrated and confused by discussion of a ban. They believed that e-cigs safely delivered nicotine and helped them quit smoking. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Race, Disadvantage and Faculty Experiences in Academic Medicine

PubMed Central

Cooper, Lisa A.; Carr, Phyllis

2010-01-01

ABSTRACT Background Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. Objective The study’s purpose was to document URM faculty perceptions and experience of the culture of academic medicine in the US and to raise awareness of obstacles to achieving the goal of having people of color in positions of leadership in academic medicine. Design The authors conducted a qualitative interview study in 2006–2007 of faculty in five US medical schools chosen for their diverse regional and organizational attributes. Participants Using purposeful sampling of medical faculty, 96 faculty were interviewed from four different career stages (early, plateaued, leaders and left academic medicine) and diverse specialties with an oversampling of URM faculty. Approach We identified patterns and themes emergent in the coded data. Analysis was inductive and data driven. Results Predominant themes underscored during analyses regarding the experience of URM faculty were: difficulty of cross-cultural relationships; isolation and feeling invisible; lack of mentoring, role models and social capital; disrespect, overt and covert bias/discrimination; different performance expectations related to race/ethnicity; devaluing of research on community health care and health disparities; the unfair burden of being identified with affirmative action and responsibility for diversity efforts; leadership’s role in diversity goals; and financial hardship. Conclusions Achieving an inclusive culture for diverse medical school faculty would help meet the mission of academic medicine to train a physician and research workforce that meets the disparate needs of our multicultural society. Medical school leaders need to value the inclusion of URM faculty. Failure to fully engage the skills and insights of URM faculty impairs our ability to provide the best science, education or medical care. PMID:20697960
Race, disadvantage and faculty experiences in academic medicine.

PubMed

Pololi, Linda; Cooper, Lisa A; Carr, Phyllis

2010-12-01

Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. The study's purpose was to document URM faculty perceptions and experience of the culture of academic medicine in the US and to raise awareness of obstacles to achieving the goal of having people of color in positions of leadership in academic medicine. The authors conducted a qualitative interview study in 2006-2007 of faculty in five US medical schools chosen for their diverse regional and organizational attributes. Using purposeful sampling of medical faculty, 96 faculty were interviewed from four different career stages (early, plateaued, leaders and left academic medicine) and diverse specialties with an oversampling of URM faculty. We identified patterns and themes emergent in the coded data. Analysis was inductive and data driven. Predominant themes underscored during analyses regarding the experience of URM faculty were: difficulty of cross-cultural relationships; isolation and feeling invisible; lack of mentoring, role models and social capital; disrespect, overt and covert bias/discrimination; different performance expectations related to race/ethnicity; devaluing of research on community health care and health disparities; the unfair burden of being identified with affirmative action and responsibility for diversity efforts; leadership's role in diversity goals; and financial hardship. Achieving an inclusive culture for diverse medical school faculty would help meet the mission of academic medicine to train a physician and research workforce that meets the disparate needs of our multicultural society. Medical school leaders need to value the inclusion of URM faculty. Failure to fully engage the skills and insights of URM faculty impairs our ability to provide the best science, education or medical care.
Using metaphorical techniques in focus groups to uncover mothers' feelings about family meals.

PubMed

Kling, Leslie; Cotugna, Nancy; Snider, Sue; Peterson, P Michael

2009-01-01

Traditional nutrition education has not been shown to consistently produce behavior change. While it has been suggested that using emotion-based messages may be a better way to influence nutrition behavior change, this has not been well tested. Producing emotion-based messages is a multi-step process that begins with exploring subconscious barriers to behavior change rather than the more obvious and typically reported barriers. The purpose of this research was to uncover the emotional reasons, sometimes referred to as emotional pulse points, for mothers' choosing or not choosing to have more family meals. This would then serve as the first step to developing emotion-based messages promoting the benefits of family meals. Five focus group interviews were conducted with 51 low-income Black (n=28) and white (n=23) mothers. Metaphorical techniques were used to determine underlying feelings toward family and family meals. Discussions were video-taped, transcribed, and manually analyzed using a content-driven, immersion/crystallization approach to qualitative data analysis. Four themes emerged around the definition of family: acceptance, sharing, chaos, and protective/loyal. Some mothers felt mealtime was merely obligatory, and described it as stressful. Some reported a preference for attending to their own needs instead of sitting down with their children, while others felt that mealtime should be used to interact with and educate children and felt guilty when they were not able to provide family meals. Three themes emerged around feelings towards having or not having family meals: unimportant, important, and guilty. When explored further, mothers indicated that using the feeling of guilt to encourage family meals might be effective. Data obtained are being used to develop innovative, emotion-based messages that will be tested for effectiveness in promoting family meals.
Adolescent, caregiver, and friend preferences for integrating social support and communication features into an asthma self-management app.

PubMed

Roberts, Courtney A; Geryk, Lorie L; Sage, Adam J; Sleath, Betsy L; Tate, Deborah F; Carpenter, Delesha M

2016-11-01

This study examines: 1) adolescent preferences for using asthma self-management mobile applications (apps) to interact with their friends, caregivers, medical providers, and other adolescents with asthma and 2) how caregivers and friends would use mobile apps to communicate with the adolescent and serve as sources of support for asthma management. We recruited 20 adolescents aged 12-16 years with persistent asthma, their caregivers (n = 20), and friends (n = 3) from two suburban pediatric practices in North Carolina. We gave participants iPods with two preloaded asthma apps and asked them to use the apps for 1 week. Adolescents and caregivers provided app feedback during a semi-structured interview at a regularly-scheduled clinic appointment and during a telephone interview one week later. Friends completed one telephone interview. Interviews were audio-recorded and transcribed verbatim. An inductive, theory-driven analysis was used to identify themes and preferences. Adolescents preferred to use apps for instrumental support from caregivers, informational support from friends, and belonging and informational support from others with asthma. The majority of adolescents believed apps could enhance communication with their caregivers and medical providers, and the theme of self-reliance emerged in which caregivers and adolescents believed apps could enable adolescents to better self-manage their asthma. Friends preferred to use apps to provide instrumental and informational support. Given preferences expressed in this study, apps may help adolescents obtain social support to better self-manage their asthma. Future app-based interventions should include features enabling adolescents with asthma to communicate and interact with their caregivers, medical providers, and friends.
The lived experiences of being physically active when morbidly obese: A qualitative systematic review

PubMed Central

Toft, Bente Skovsby; Uhrenfeldt, Lisbeth

2015-01-01

The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: “Identity” with the three subthemes: “considering weight,” “being able to,” and “belonging with others.” The theme and subthemes were merged into a meta-synthesis: “Homecoming: a change in identity.” The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of “homecoming” when active. PMID:26400462
The Meaning of Older Adults' Peer Teaching: A Phenomenological Study

ERIC Educational Resources Information Center

Choi, Ilseon

2009-01-01

This study investigated older adults' peer teaching experiences at a Lifelong Learning Institute through interviews with eight teachers and observations of their classes. Thematic analysis revealed themes of peer-to-peer teaching, volunteer teaching, and explorative teaching. Discussion of the themes examines the meaning of older adults' peer…
"Bionic Woman" (2007): Gender, Disability and Cyborgs

ERIC Educational Resources Information Center

Quinlan, Margaret M.; Bates, Benjamin R.

2009-01-01

This paper explores a representation of overlapping categories of gender, disability and cyborgs in "Bionic Woman" (2007). The television show "Bionic Woman" (2007) is a popular culture representation that uniquely brings together these categories. Three themes emerged from an analysis of blogger discourse surrounding the show. The themes reveal…

Themes and Interplay of Beliefs in Mathematical Reasoning

ERIC Educational Resources Information Center

Sumpter, Lovisa

2013-01-01

Upper secondary students' task solving reasoning was analysed with a focus on arguments for strategy choices and conclusions. Passages in their arguments for reasoning that indicated the students' beliefs were identified and, by using a thematic analysis, categorized. The results stress three themes of beliefs used as arguments for…
An Analysis of the Status of Curriculum Reform and Textbook Production in Indonesia.

ERIC Educational Resources Information Center

Theisen, Gary; And Others

Curriculum reform in Indonesia during the past 2 decades has been marked by several themes. These themes include an increased emphasis on educational outcomes, greater standardization in instructional practices, improved teacher quality, and increased locally relevant curricula. Some problems recognized include an overloading of instructional time…
Trends in Literacy Software Publication and Marketing: Multicultural Themes.

ERIC Educational Resources Information Center

Balajthy, Ernest

This article provides data and discussion of multicultural theme-related issues arising from analysis of a detailed database of commercial software products targeted to reading and literacy education. The database consisted of 1152 titles, representing the offerings of 104 publishers and distributors. Of the titles, 62 were identified as having…
The Changing Landscape of One Primary School's Mathematics Curriculum

ERIC Educational Resources Information Center

Dent, Wendy; McChesney, Jane

2016-01-01

This paper describes a period of substantial changes in the mathematics curriculum of one primary school in Christchurch. Using retrospective analysis, we identified two important conceptual themes: equity of mathematical learning and opportunities for all students to learn to be a mathematician. Access to research about these themes prompted two…
The University's Role in Advancing Race Relations: Reflections from the Community

ERIC Educational Resources Information Center

Edwards, Timothy; Montague, David R.

2014-01-01

This research paper involved thematic analysis of interview responses from local citizens regarding the university's role in improving race relations. The paper addressed these questions: (1) What themes emerged from participant responses regarding UALR's role in improving race relations? and (2) What themes emerged from participant responses…
A platform for high-throughput bioenergy production phenotype characterization in single cells

PubMed Central

Kelbauskas, Laimonas; Glenn, Honor; Anderson, Clifford; Messner, Jacob; Lee, Kristen B.; Song, Ganquan; Houkal, Jeff; Su, Fengyu; Zhang, Liqiang; Tian, Yanqing; Wang, Hong; Bussey, Kimberly; Johnson, Roger H.; Meldrum, Deirdre R.

2017-01-01

Driven by an increasing number of studies demonstrating its relevance to a broad variety of disease states, the bioenergy production phenotype has been widely characterized at the bulk sample level. Its cell-to-cell variability, a key player associated with cancer cell survival and recurrence, however, remains poorly understood due to ensemble averaging of the current approaches. We present a technology platform for performing oxygen consumption and extracellular acidification measurements of several hundreds to 1,000 individual cells per assay, while offering simultaneous analysis of cellular communication effects on the energy production phenotype. The platform comprises two major components: a tandem optical sensor for combined oxygen and pH detection, and a microwell device for isolation and analysis of single and few cells in hermetically sealed sub-nanoliter chambers. Our approach revealed subpopulations of cells with aberrant energy production profiles and enables determination of cellular response variability to electron transfer chain inhibitors and ion uncouplers. PMID:28349963
Molecular, Pathological, Radiological, and Immune Profiling of Non-brainstem Pediatric High-Grade Glioma from the HERBY Phase II Randomized Trial.

PubMed

Mackay, Alan; Burford, Anna; Molinari, Valeria; Jones, David T W; Izquierdo, Elisa; Brouwer-Visser, Jurriaan; Giangaspero, Felice; Haberler, Christine; Pietsch, Torsten; Jacques, Thomas S; Figarella-Branger, Dominique; Rodriguez, Daniel; Morgan, Paul S; Raman, Pichai; Waanders, Angela J; Resnick, Adam C; Massimino, Maura; Garrè, Maria Luisa; Smith, Helen; Capper, David; Pfister, Stefan M; Würdinger, Thomas; Tam, Rachel; Garcia, Josep; Thakur, Meghna Das; Vassal, Gilles; Grill, Jacques; Jaspan, Tim; Varlet, Pascale; Jones, Chris

2018-05-14

The HERBY trial was a phase II open-label, randomized, multicenter trial evaluating bevacizumab (BEV) in addition to temozolomide/radiotherapy in patients with newly diagnosed non-brainstem high-grade glioma (HGG) between the ages of 3 and 18 years. We carried out comprehensive molecular analysis integrated with pathology, radiology, and immune profiling. In post-hoc subgroup analysis, hypermutator tumors (mismatch repair deficiency and somatic POLE/POLD1 mutations) and those biologically resembling pleomorphic xanthoastrocytoma ([PXA]-like, driven by BRAF_V600E or NF1 mutation) had significantly more CD8 + tumor-infiltrating lymphocytes, and longer survival with the addition of BEV. Histone H3 subgroups (hemispheric G34R/V and midline K27M) had a worse outcome and were immune cold. Future clinical trials will need to take into account the diversity represented by the term "HGG" in the pediatric population. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.
A family survives genocide.

PubMed

Weine, S; Vojvoda, D; Hartman, S; Hyman, L

1997-01-01

This is a case study of a family that survived genocide and a discussion of families and massive psychic trauma. This family, like many others from Bosnia-Herzegovina, was driven from their home by Serb forces-"ethnically cleansed"-then eventually escaped to Croatia, and was later resettled in the United States. They were referred to us, a group of mental health professionals who established the Bosnian Refugee Trauma Program at the Yale Psychiatric Institute (YPI). We have done clinical, testimony, and research work with the refugee families from Bosnia who resettled in our region, described in part in prior reports (Weine, Becker et al. 1995a, 1995b; Weine and Laub 1995).
Credit availability: a possible barrier to growth for the Alaska forest products industry?

Treesearch

Geoffrey Donovan; Hayley Hesseln; John Garth

2005-01-01

Historically, the Alaska forest products industry has been driven by pulp production and the export of logs and cants primarily to Japan. Economic stagnation in Japan, the closure of Alaska's two pulp mills, harvest restrictions, and increased competition have severely impacted the industry. To survive, the industry must make significant investments in capital...
Strategic Planning in the Business Enterprise of Christian Colleges and Universities: A Multi-Case Study Approach

ERIC Educational Resources Information Center

Fletcher, Wayne Lewis

2013-01-01

Many tuition-driven private colleges and universities struggled for economic survival in the first decade of this millennium. The current study views higher education from a two-good framework that posits that every college and university provides teaching and service for the societal good while generating revenue from traditional business-like…
The effect of health-facility admission and skilled birth attendant coverage on maternal survival in India: a case-control analysis.

PubMed

Montgomery, Ann L; Fadel, Shaza; Kumar, Rajesh; Bondy, Sue; Moineddin, Rahim; Jha, Prabhat

2014-01-01

Research in areas of low skilled attendant coverage found that maternal mortality is paradoxically higher in women who seek obstetric care. We estimated the effect of health-facility admission on maternal survival, and how this effect varies with skilled attendant coverage across India. Using unmatched population-based case-control analysis of national datasets, we compared the effect of health-facility admission at any time (antenatal, intrapartum, postpartum) on maternal deaths (cases) to women reporting pregnancies (controls). Probability of maternal death decreased with increasing skilled attendant coverage, among both women who were and were not admitted to a health-facility, however, the risk of death among women who were admitted was higher (at 50% coverage, OR = 2.32, 95% confidence interval 1.85-2.92) than among those women who were not; while at higher levels of coverage, the effect of health-facility admission was attenuated. In a secondary analysis, the probability of maternal death decreased with increasing coverage among both women admitted for delivery or delivered at home but there was no effect of admission for delivery on mortality risk (50% coverage, OR = 1.0, 0.80-1.25), suggesting that poor quality of obstetric care may have attenuated the benefits of facility-based care. Subpopulation analysis of obstetric hemorrhage cases and report of 'excessive bleeding' in controls showed that the probability of maternal death decreased with increasing skilled attendant coverage; but the effect of health-facility admission was attenuated (at 50% coverage, OR = 1.47, 0.95-1.79), suggesting that some of the effect in the main model can be explained by women arriving at facility with complications underway. Finally, highest risk associated with health-facility admission was clustered in women with education ≤ 8 years. The effect of health-facility admission did vary by skilled attendant coverage, and this effect appears to be driven partially by reverse causality; however, inequitable access to and possibly poor quality of healthcare for primary and emergency services appears to play a role in maternal survival as well.
Stage 1 development of a patient-reported experience measure (PREM) for chronic obstructive pulmonary disease (COPD).

PubMed

Walker, Susan; Andrew, Sharon; Hodson, Matthew; Roberts, C Michael

2017-07-24

The study aimed to explore patients' experience of living with chronic obstructive pulmonary disease and their perspective of their community healthcare for chronic obstructive pulmonary disease to extract affective responses in order to develop potential items for a patient-reported experience measure for chronic obstructive pulmonary disease. Qualitative face-face interviews were conducted, in the community, with 64 patients with chronic obstructive pulmonary disease recruited from General Practices and Breathe-Easy community groups in the Outer North East, East and City areas of London and Essex, UK. A two phase analysis of the qualitative data was conducted to identify themes arising from patients' description of living with chronic obstructive pulmonary disease and their perceptions of their community healthcare and subsequently the affective responses underlying the themes raised by patients, which gave emotional colour to the themes, bringing the thematic analysis closer to the subjective patient experience. Five themes were identified from the interview data: 'Journey to diagnosis'; 'Smoking'; 'Usual care'; 'My everyday life'; and 'Exacerbations'. Twenty-one affective responses were identified and categorised as either 'negative', 'positive' or 'bivalent'. 'Frustration', a negative affective response was prevalent in four themes. 'Gratitude', 'hope' and 'happiness/enjoyment' were among the more positive responses more prevalent across several themes. By conducting a novel two-way analysis (thematic and affective) it was possible to identify themes and affective responses that were aligned to those themes. This enabled the development of 38 chronic obstructive pulmonary disease-specific experience items to take forward for further testing including item reduction and validity and reliability in the next stage of the patient-reported experience measure development. GIVING IMPORTANCE TO PATIENTS' EMOTIONS: An exploration of patient perceptions of living with chronic lung disease will help develop a new patient reported experience scale. Healthcare services are aiming to provide effective patient-centered care for those with chronic obstructive pulmonary disease (COPD). Such care strategies require structured, validated patient feedback scales to facilitate accurate communication between patients, carers and healthcare professionals. Susan Walker at Anglia Ruskin University in Chelmsford, UK, and co-workers analyzed qualitative data from interviews with 64 COPD patients in London and Essex regarding their emotions and perceptions of living with COPD, with the aim of creating a patient reported experience measure, or PREM. Initial results identified five themes-including 'journey to diagnosis' and 'everyday life'-and twenty-one affective responses, ranging from negative to positive. The team will take these results forward for further validation.
Using Two Different Approaches to Assess Dietary Patterns: Hypothesis-Driven and Data-Driven Analysis.

PubMed

Previdelli, Ágatha Nogueira; de Andrade, Samantha Caesar; Fisberg, Regina Mara; Marchioni, Dirce Maria

2016-09-23

The use of dietary patterns to assess dietary intake has become increasingly common in nutritional epidemiology studies due to the complexity and multidimensionality of the diet. Currently, two main approaches have been widely used to assess dietary patterns: data-driven and hypothesis-driven analysis. Since the methods explore different angles of dietary intake, using both approaches simultaneously might yield complementary and useful information; thus, we aimed to use both approaches to gain knowledge of adolescents' dietary patterns. Food intake from a cross-sectional survey with 295 adolescents was assessed by 24 h dietary recall (24HR). In hypothesis-driven analysis, based on the American National Cancer Institute method, the usual intake of Brazilian Healthy Eating Index Revised components were estimated. In the data-driven approach, the usual intake of foods/food groups was estimated by the Multiple Source Method. In the results, hypothesis-driven analysis showed low scores for Whole grains, Total vegetables, Total fruit and Whole fruits), while, in data-driven analysis, fruits and whole grains were not presented in any pattern. High intakes of sodium, fats and sugars were observed in hypothesis-driven analysis with low total scores for Sodium, Saturated fat and SoFAA (calories from solid fat, alcohol and added sugar) components in agreement, while the data-driven approach showed the intake of several foods/food groups rich in these nutrients, such as butter/margarine, cookies, chocolate powder, whole milk, cheese, processed meat/cold cuts and candies. In this study, using both approaches at the same time provided consistent and complementary information with regard to assessing the overall dietary habits that will be important in order to drive public health programs, and improve their efficiency to monitor and evaluate the dietary patterns of populations.
Assessing fitness-to-practice of overseas-trained health practitioners by Australian registration & accreditation bodies

PubMed Central

2012-01-01

Background Assessment of fitness-to-practice of health professionals trained overseas and who wish to practice in Australia is undertaken by a range of organisations. These organisations conduct assessments using a range of methods. However there is very little published about how these organisations conduct their assessments. The purpose of the current paper is to investigate the methods of assessment used by these organisations and the issues associated with conducting these assessments. Methods A series of semi-structured interviews was undertaken with a variety of organisations who undertake assessments of overseas-trained health professionals who wish to practice in Australia. Content analysis of the interviews was used to identify themes and patterns. Results Four themes were generated from the content analysis of the interviews: (1) assessing; (2) process; (3) examiners; and (4) cost-efficiency. The themes were interconnected and each theme also had a number of sub-themes. Conclusions The organisations who participated in the present study used a range of assessment methods to assess overseas trained health professionals. These organisations also highlighted a number of issues, particularly related to examiners and process issues, pre- and post-assessment. Organisations demonstrated an appreciation for ongoing review of their assessment processes and incorporating evidence from the literature to inform their processes and assessment development. PMID:23020885
Qualitative investigation of the reasons behind opposition to water fluoridation in regional NSW, Australia.

PubMed

Knox, Matthew C; Garner, Alexander; Dyason, Alan; Pearson, Thomas; Pit, Sabrina W

2017-02-15

To investigate reasons behind strong opposition to water fluoridation in regional New South Wales, Australia, and to make recommendations to improve community engagement. Few studies have used qualitative methodologies to understand the reasons for strong antifluoridation views. An understanding of these reasons could be useful when designing public campaigns to combat the strong antifluoridation message. The qualitative study used semistructured interviewing and thematic analysis. Ten participants were recruited using purposive and snowball sampling methods until data saturation was reached. Thematic analysis and graphical representation of themes assisted in analysing the data for logical connections and relationships. Six dominant themes and numerous subthemes were identified. Five of the major themes were reasons for opposition: scepticism, health effects, ethics, environmental impacts and economics. Each of these was inextricably linked to a sixth major theme: alternatives to fluoridation. All participants had strongly held antifluoridation views, and provided a unique insight into their perceptions and reasons for opposing water fluoridation. Concerns about 'fraudulent research' and the influence of industry on government bodies were novel themes. The concerns raised could be used to inform future population health campaigns, research, public education and resource-allocation decisions. Open community consultation may be able to address the issues raised in a nonjudgemental and collaborative manner.
International identification of research priorities for postgraduate theses in musculoskeletal physiotherapy using a modified Delphi technique.

PubMed

Rushton, Alison; Moore, Ann

2010-04-01

Research priorities are established to identify gaps and maximise opportunities in developing an evidence base. Numerous postgraduate research theses are undertaken each year within the specialist area of musculoskeletal physiotherapy, and although some are published, greater potential for influence exists. This paper identifies international research priorities for postgraduate theses developed using a consensual Delphi process. A purposive sample included course tutors and expert clinicians nominated by Member Organisations of the International Federation of Orthopaedic Manipulative Physical Therapists (N=91). Round 1 requested >10 priorities for theses, and content analysis identified research themes. Round 2 requested participants rank the importance of each theme on a 1-5 scale, and round 3 requested ranking the importance and feasibility of the research question areas within each agreed theme. Descriptive analysis and use of Kendall's coefficient of concordance enabled interpretation of consensus. The response rate of 68% was good, identifying 23 research themes in round 1. Round 2 identified 14 research themes as important. Participant rating of the importance and feasibility of research question areas in round 3 supported 43 agreed priorities demonstrating good measurement validity. Establishing priorities provides a vision of how postgraduate theses can contribute to the developing evidence base and offer a focus for international collaboration. Copyright 2009 Elsevier Ltd. All rights reserved.
Content Analysis of Trends in Print Magazine Tobacco Advertisements

PubMed Central

Banerjee, Smita; Shuk, Elyse; Greene, Kathryn; Ostroff, Jamie

2015-01-01

Objectives To provide a descriptive and comparative content analysis of tobacco print magazine ads, with a focus on rhetorical and persuasive themes. Methods Print tobacco ads for cigarettes, cigars, e-cigarettes, moist snuff, and snus (N = 171) were content analyzed for the physical composition/ad format (e.g., size of ad, image, setting, branding, warning label) and the content of the ad (e.g., rhetorical themes, persuasive themes). Results The theme of pathos (that elicits an emotional response) was most frequently utilized for cigarette (61%), cigar (50%), and moist snuff (50%) ads, and the theme of logos (use of logic or facts to support position) was most frequently used for e-cigarette (85%) ads. Additionally, comparative claims were most frequently used for snus (e.g., “spit-free,” “smoke-free”) and e-cigarette ads (e.g., “no tobacco smoke, only vapor,” “no odor, no ash”). Comparative claims were also used in cigarette ads, primarily to highlight availability in different flavors (e.g., “bold,” “menthol”). Conclusions This study has implications for tobacco product marketing regulation, particularly around limiting tobacco advertising in publications with a large youth readership and prohibiting false or misleading labels, labeling, and advertising for tobacco products, such as modified risk (unless approved by the FDA) or therapeutic claims. PMID:26236763
Wind driven saltation: a hitherto overlooked challenge for life on Mars

NASA Astrophysics Data System (ADS)

Bak, Ebbe; Goul, Michael; Rasmussen, Martin; Moeller, Ralf; Nørnberg, Per; Knak Jensen, Svend; Finster, Kai

2017-04-01

The Martian surface is a hostile environment characterized by low water availability, low atmospheric pressure and high UV and ionizing radiation. Furthermore, wind-driven saltation leads to abrasion of silicates with a production of reactive surface sites and, through triboelectric charging, a release of electrical discharges with a concomitant production of reactive oxygen species. While the effects of low water availability, low pressure and radiation have been extensively studied in relation to the habitability of the Martian surface and the preservation of organic biosignatures, the effects of wind-driven saltation have hitherto been ignored. In this study, we have investigated the effect of exposing bacteria to wind-abraded silicates and directly to wind-driven saltation on Mars in controlled laboratory simulation experiments. Wind-driven saltation was simulated by tumbling mineral samples in a Mars-like atmosphere in sealed quartz ampoules. The effects on bacterial survival and structure were evaluated by colony forming unit counts in combination with scanning electron microscopy, quantitative polymerase chain reaction and life/dead-staining with flow cytometry. The viability of vegetative cells of P. putida, B. subtilis and D. radiodurans in aqueous suspensions was reduced by more than 99% by exposure to abraded basalt, while the viability of B. subtilis endospores was unaffected. B. subtilis mutants lacking different spore components were likewise highly resistant to the exposure to abraded basalt, which indicates that the resistance of spores is not associated with any specific spore component. We found a significant but reduced effect of abraded quartz and we suggest that the stress effect of abraded silicates is induced by a production of reactive oxygen species and hydroxyl radicals produced by Fenton-like reactions in the presence of transition metals. Direct exposure to simulated saltation had a dramatic effect on both D. radiodurans cells and B. subtilis spore with a more than 99.9% decrease in survival after 17 days. The high susceptibility of the usually multi-resistant D. radiodurans cells and B. sublitis spores to the effects of wind-driven saltation indicates that wind abraded silicates as well as direct exposure to saltation represent a considerable stress for microorganisms at the Martian surface, which may have limited the chance of indigenous life, could limit the risk of forward contamination and may have degraded potential organic biosignatures.
Transforming User Needs into Functional Requirements for an Antibiotic Clinical Decision Support System

PubMed Central

Bright, T.J.

2013-01-01

Summary Background Many informatics studies use content analysis to generate functional requirements for system development. Explication of this translational process from qualitative data to functional requirements can strengthen the understanding and scientific rigor when applying content analysis in informatics studies. Objective To describe a user-centered approach transforming emergent themes derived from focus group data into functional requirements for informatics solutions and to illustrate these methods to the development of an antibiotic clinical decision support system (CDS). Methods The approach consisted of five steps: 1) identify unmet therapeutic planning information needs via Focus Group Study-I, 2) develop a coding framework of therapeutic planning themes to refine the domain scope to antibiotic therapeutic planning, 3) identify functional requirements of an antibiotic CDS system via Focus Group Study-II, 4) discover informatics solutions and functional requirements from coded data, and 5) determine the types of information needed to support the antibiotic CDS system and link with the identified informatics solutions and functional requirements. Results The coding framework for Focus Group Study-I revealed unmet therapeutic planning needs. Twelve subthemes emerged and were clustered into four themes; analysis indicated a need for an antibiotic CDS intervention. Focus Group Study-II included five types of information needs. Comments from the Barrier/Challenge to information access and Function/Feature themes produced three informatics solutions and 13 functional requirements of an antibiotic CDS system. Comments from the Patient, Institution, and Domain themes generated required data elements for each informatics solution. Conclusion This study presents one example explicating content analysis of focus group data and the analysis process to functional requirements from narrative data. Illustration of this 5-step method was used to develop an antibiotic CDS system, resolving unmet antibiotic prescribing needs. As a reusable approach, these techniques can be refined and applied to resolve unmet information needs with informatics interventions in additional domains. PMID:24454586
Emergency Department Patient Perspectives on the Risk of Addiction to Prescription Opioids.

PubMed

Conrardy, Michael; Lank, Patrick; Cameron, Kenzie A; McConnell, Ryan; Chevrier, Alison; Sears, Jill; Ahlstrom, Eric; Wolf, Michael S; Courtney, D Mark; McCarthy, Danielle M

2016-01-01

To characterize emergency department (ED) patients' knowledge and beliefs about the addictive potential of opioids. Mixed methods analysis of data from a randomized controlled trial. Urban academic ED (>88,000 visits). One hundred and seventy four discharged ED patients prescribed hydrocodone-acetaminophen for acute pain. The study analyzed data collected from a randomized controlled trial investigating patients' knowledge of opioids. ED patients discharged with hydrocodone-acetaminophen completed an audio-recorded phone interview 4–7 days later. This analysis focuses on responses about addiction. Responses were categorized using content analysis; thematic analysis identified broad themes common across different categories. Participants' mean age was 45.5 years (SD, 14.8), 58.6% female, 50.6% white, and the majority had an orthopedic diagnosis (24.1% back pain, 52.3% other injuries). Responses were categorized first based on whether the patient believed that opioids could be addictive (categorized as: yes, 58.7%; no, 19.5%; depends, 17.2%; or do not know, 4.6%), and second based on whether or not the patient discussed his/her own experience with the medication (categorized as: personalized, 35.6%; or not personalized, 64.4%). Cohen's Kappa was 0.84 for all categories. Three themes emerged in the thematic analysis: theme 1) patients expect to “feel” addicted if they are addicted, theme 2) patients fear addiction, and theme 3) side effects affected patient views of addiction. In this sample, patients had misconceptions about opioid addiction. Some patients did not know opioids could be addictive, others underestimated their personal risk of addiction, and others overtly feared addiction and, therefore, risked inadequate pain management. Despite limited data, we recommend providers discuss opioid addiction with their patients. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

Comprehension-Driven Program Analysis (CPA) for Malware Detection in Android Phones

DTIC Science & Technology

2015-07-01

COMPREHENSION-DRIVEN PROGRAM ANALYSIS (CPA) FOR MALWARE DETECTION IN ANDROID PHONES IOWA STATE UNIVERSITY JULY 2015 FINAL...DRIVEN PROGRAM ANALYSIS (CPA) FOR MALWARE DETECTION IN ANDROID PHONES Sb. GRANT NUMBER N/A Sc. PROGRAM ELEMENT NUMBER 6 1101E 6. AUTHOR(S) Sd...machine analysis system to detect novel, sophisticated Android malware. (c) An innovative library summarization technique and its incorporation in
Newspaper Articles Related to the Not Criminally Responsible on Account of Mental Disorder (NCRMD) Designation: A Comparative Analysis.

PubMed

Whitley, Rob; Wang, JiaWei; Carmichael, Victoria; Wellen, Ruth

2017-10-01

The not criminally responsible on account of mental disorder (NCRMD) designation remains widely misunderstood by the public. Such misunderstandings may also be reflected in the media. As such, the aim of this study is to conduct a preliminary examination of the tone and content of recent Canadian newspaper articles where NCRMD is a major theme, comparing these to generic articles about mental illness. Articles about mental illness were gathered from major Canadian newspapers. These were then divided into two categories: 1) articles where NCRMD was a major theme and 2) articles where NCRMD was not a major theme. Articles were then coded for the presence or absence of 1) a negative tone, 2) stigmatising tone/content, 3) recovery/rehabilitation as a theme, and 4) shortage of resources/poor quality of care as a theme. The retrieval strategy resulted in 940 articles. Fourteen percent ( n = 131) of all articles had NCRMD as a major theme. In comparison to generic articles about mental illness, articles with NCRMD as a major theme were significantly more likely to have a negative tone ( P < 0.001) and stigmatising tone/content ( P < 0.001) and significantly less likely to have recovery/rehabilitation ( P < 0.001) or shortage of resources/poor quality of care as a theme ( P < 0.001). Articles with NCRMD as a theme were overwhelmingly negative and almost never focused on recovery or rehabilitation, in stark comparison to generic articles about mental illness.
Newspaper Articles Related to the Not Criminally Responsible on Account of Mental Disorder (NCRMD) Designation: A Comparative Analysis

PubMed Central

Wang, JiaWei; Carmichael, Victoria; Wellen, Ruth

2017-01-01

Objective: The not criminally responsible on account of mental disorder (NCRMD) designation remains widely misunderstood by the public. Such misunderstandings may also be reflected in the media. As such, the aim of this study is to conduct a preliminary examination of the tone and content of recent Canadian newspaper articles where NCRMD is a major theme, comparing these to generic articles about mental illness. Methods: Articles about mental illness were gathered from major Canadian newspapers. These were then divided into two categories: 1) articles where NCRMD was a major theme and 2) articles where NCRMD was not a major theme. Articles were then coded for the presence or absence of 1) a negative tone, 2) stigmatising tone/content, 3) recovery/rehabilitation as a theme, and 4) shortage of resources/poor quality of care as a theme. Results: The retrieval strategy resulted in 940 articles. Fourteen percent (n = 131) of all articles had NCRMD as a major theme. In comparison to generic articles about mental illness, articles with NCRMD as a major theme were significantly more likely to have a negative tone (P < 0.001) and stigmatising tone/content (P < 0.001) and significantly less likely to have recovery/rehabilitation (P < 0.001) or shortage of resources/poor quality of care as a theme (P < 0.001). Conclusions: Articles with NCRMD as a theme were overwhelmingly negative and almost never focused on recovery or rehabilitation, in stark comparison to generic articles about mental illness. PMID:28697626
e-Infrastructures supporting research into depression, self-harm and suicide.

PubMed

McCafferty, S; Doherty, T; Sinnott, R O; Watt, J

2010-08-28

The Economic and Social Research Council (ESRC)-funded Data Management through e-Social Sciences (DAMES) project is investigating, as one of its four research themes, how research into depression, self-harm and suicide may be enhanced through the adoption of e-Science infrastructures and techniques. In this paper, we explore the challenges in supporting such research infrastructures and describe the distributed and heterogeneous datasets that need to be provisioned to support such research. We describe and demonstrate the application of an advanced user and security-driven infrastructure that has been developed specifically to meet these challenges in an on-going study into depression, self-harm and suicide.
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
Checklists, rules and creativity

NASA Astrophysics Data System (ADS)

Glasmacher, Thomas

2009-01-01

Universities have something that private industry wants - a unique culture of continuous learning, curiosity-driven research and international collaboration. According to an unending string of accounts in the business press, adopting this university culture is imperative for survival and success in the "technology-driven" 21st-century economy. The industry poster child for this idea is the IT giant Google. Its success undoubtedly buys the company increasing freedom to experiment with and nurture its own unique culture. But Google is routinely lauded for fostering academic-style debate in meetings, maintaining a fluid organization chart that allows employees to try other roles, and giving its engineers one day a week to pursue their own creative ideas for advancing the company's interests.
Indigenous migration dynamics in the Ecuadorian Amazon: a longitudinal and hierarchical analysis

PubMed Central

Davis, Jason; Sellers, Samuel; Gray, Clark; Bilsborrow, Richard

2017-01-01

Amazonian indigenous populations are approaching a critical stage in their history in which increasing education and market integration, rapid population growth and degradation of natural resources threaten the survival of their traditions and livelihoods. A topic that has hardly been touched upon in this context is migration and population mobility. We address this by analysing a unique longitudinal dataset from the Ecuadorian Amazon on the spatial mobility of five indigenous groups and mestizo co-residents. Analyses reveal traditional and new forms of population mobility and migrant selectivity, including gendered forms of marriage migration and rural-urban moves driven by education. These results illustrate a dynamic present and an uncertain future for indigenous populations in which rural, natural-resource-based lifeways may well be sustained but with increasing links to urban areas. PMID:29129939
Conflict prevention, conflict mitigation, and manifestations of conflict during emergency department consultations.

PubMed

Chan, Teresa; Bakewell, Francis; Orlich, Donika; Sherbino, Jonathan

2014-03-01

The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations. From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature. All participants recalled some manifestation of conflict. There were 12 negative conflict-producing themes and 10 protective conflict-mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model. Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations. © 2014 by the Society for Academic Emergency Medicine.
Forensic Learning Disability Nursing Role Analysis

ERIC Educational Resources Information Center

Mason, Tom; Phipps, Dianne; Melling, Kat

2011-01-01

This article reports on a study carried out on the role constructs of forensic and nonforensic Learning Disability Nursing in relation to six binary themes. The aims were to identify if there were differences in perceptions of forensic learning disability nurses and nonforensic learning disability nurses in relation to the six binary themes of the…
A Theoretical Framework for Media Law Courses (Approaches to Teaching Freedom of Expression).

ERIC Educational Resources Information Center

Helle, Steven

1991-01-01

Suggests that most students prefer teachers have a theme that provides coherence and cohesiveness to media law courses. Explains how libertarian and neoliberal themes can guide learning and enumerates some of the principles of the two theories. Identifies drawbacks of the case analysis approach to such courses. (SG)
Extended Editorial: Research and Education in Reliability, Maintenance, Quality Control, Risk and Safety.

ERIC Educational Resources Information Center

Ramalhoto, M. F.

1999-01-01

Introduces a special theme journal issue on research and education in quality control, maintenance, reliability, risk analysis, and safety. Discusses each of these theme concepts and their applications to naval architecture, marine engineering, and industrial engineering. Considers the effects of the rapid transfer of research results through…
Faculty Perceptions of Moving a Face-to-Face Course to Online Instruction

ERIC Educational Resources Information Center

Chiasson, Kari; Terras, Katherine; Smart, Kathy

2015-01-01

This qualitative study explores the experiences of 10 faculty members who developed and taught an online course that they had previously taught in a face-to-face classroom. The categories from the data analysis included planning, implementation, and reflection. Within the categories, eight themes emerged from the data. The themes addressed…
Exploration, Encounter, Exchange in History: National History Day Curriculum Book, 2004.

ERIC Educational Resources Information Center

Mazzenga, Maria, Comp.

The theme for 2004's National History Day is "Exploration, Encounter, Exchange in History." This is a broad theme, so topics should be carefully selected and developed in ways that best reflect student talents and abilities. Studies should include an investigation into available primary and secondary sources, analysis of the evidence,…
Academic Libraries and Quality: An Analysis and Evaluation Framework

ERIC Educational Resources Information Center

Atkinson, Jeremy

2017-01-01

The paper proposes and describes a framework for academic library quality to be used by new and more experienced library practitioners and by others involved in considering the quality of academic libraries' services and provision. The framework consists of eight themes and a number of questions to examine within each theme. The framework was…
Latino Parent and Adolescent Perceptions of Hoped-for and Feared Possible Selves for Adolescents

ERIC Educational Resources Information Center

Halfond, Raquel; Corona, Rosalie; Moon, Anya

2013-01-01

The authors examined Latino parent and adolescent reports of hoped-for and feared possible selves for adolescents. Twenty-nine Latino parents (18 mothers, 11 fathers) and their 18 adolescents participated in semistructured individual interviews. Interviews were digitally recorded, transcribed, and coded for themes via content analysis. Themes that…
Children's Violently Themed Play and Adult Imaginaries of Childhood: A Bakhtinian Analysis

ERIC Educational Resources Information Center

Rosen, Rachel

2015-01-01

Children's violently themed play has long been contentious within educational policy, parenting literature, and the academe, with conflicting views as to its immediate and long-term consequences. Yet, little attention has been given to the way in which the meanings and values attributed to childhood influence these debates. Drawing on an…
Information technology and hospice palliative care: social, cultural, ethical and technical implications in a rural setting.

PubMed

Kuziemsky, Craig; Jewers, Heather; Appleby, Brenda; Foshay, Neil; Maccaull, Wendy; Miller, Keith; Macdonald, Madonna

2012-01-01

There is a need to better understand the specific settings in which health information technology (HIT) is used and implemented. Factors that will determine the successful implementation of HIT are context-specific and often reside not at the technical level but rather at the process and people level. This paper provides the results of a needs assessment for HIT to support hospice palliative care (HPC) delivery in rural settings. Roundtable discussions using the nominal group technique were done to identify priority issues regarding HIT usage to support rural HPC delivery. Qualitative content analysis was then used to identify sociotechnical themes from the roundtable data. Twenty priority issues were identified at the roundtable session. Content analysis grouped the priority issues into one central theme and five supporting themes to form a sociotechnical framework for patient-centered care in rural settings. There are several sociotechnical themes and associated issues that need to be considered prior to implementing HIT in rural HPC settings. Proactive evaluation of these issues can enhance HIT implementation and also help to make ethical aspects of HIT design more explicit.
Children and parents' experiences of cognitive behavioral therapy for dental anxiety--a qualitative study.

PubMed

Shahnavaz, Shervin; Rutley, Sara; Larsson, Karin; Dahllöf, Göran

2015-09-01

There is a high prevalence of dental anxiety in children and adolescents. Cognitive behavioral therapy is emerging as a treatment option. The purpose of this study is to explore how children with dental anxiety and their parents experience cognitive behavioral therapy (CBT) in dentistry. We interviewed 12 children and one of their parents and conducted a thematic analysis of the transcribed interviews. Perspective shift emerged as overarching theme in our thematic analysis. This theme consisted of three main themes, which were mastery, safety, and reduced fear. Six subthemes were also identified according to our analyses. Mastery includes two subthemes, gradual exposure and autonomy and control. Subthemes and sources for safety feeling were therapeutic alliance and changed appraisal. The theme reduced fear also consisted of two subthemes; reduced anticipatory anxiety and coping. The results show that parents and children had positive experiences of CBT and its outcome and were able to benefit from this psychological treatment when dealing with dental anxiety. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Surviving the wait: defining support while awaiting breast cancer surgery.

PubMed

Dickerson, Suzanne S; Alqaissi, Nesreen; Underhill, Meghan; Lally, Robin M

2011-07-01

This paper is a report of a descriptive study of the common meanings, shared experiences and practices of social support of women within the days between breast cancer diagnosis and treatment initiation. Support needs, types of social support and support outcomes during and after breast cancer treatment have been explored worldwide. However, to promote women's psychological wellbeing it is essential to understand how women define support in the highly stressful period initially following diagnosis. Secondary analysis of narrative texts using interpretive phenomenology from 18 women in the Midwestern United States newly diagnosed with breast cancer who were interviewed in 2005 for a study of women's pretreatment thought processes. 'Surviving the wait for surgery by balancing support needs to maintain a hopeful outlook' was the overarching pattern linking six other related themes: (1) controlling access to information for self and to others, (2) knowing which supportive network members to access, (3) controlling anxiety through distraction to maintain hope while waiting, (4) being in good hands and comfortable with decision (provider support), (5) protecting others through concealment and being strong to maintain hope and (6) accepting care from others vs. maintaining a nurturing role. Implications for nurses working with women in the days following breast cancer diagnosis include assessing women's definitions and availability of support; respecting varied needs for informational support; providing a supportive clinical environment; educating clinicians, family and friends regarding unsupportive responses within the cultural context and validating women's control and balancing of support needs. © 2011 Blackwell Publishing Ltd.
Older fathers' children have lower evolutionary fitness across four centuries and in four populations

PubMed Central

Willführ, Kai P.; Frans, Emma M.; Verweij, Karin J. H.; Bürkner, Paul-Christian; Myrskylä, Mikko; Voland, Eckart; Zietsch, Brendan P.; Penke, Lars

2017-01-01

Higher paternal age at offspring conception increases de novo genetic mutations. Based on evolutionary genetic theory we predicted older fathers' children, all else equal, would be less likely to survive and reproduce, i.e. have lower fitness. In sibling control studies, we find support for negative paternal age effects on offspring survival and reproductive success across four large populations with an aggregate N > 1.4 million. Three populations were pre-industrial (1670–1850) Western populations and showed negative paternal age effects on infant survival and offspring reproductive success. In twentieth-century Sweden, we found minuscule paternal age effects on survival, but found negative effects on reproductive success. Effects survived tests for key competing explanations, including maternal age and parental loss, but effects varied widely over different plausible model specifications and some competing explanations such as diminishing paternal investment and epigenetic mutations could not be tested. We can use our findings to aid in predicting the effect increasingly older parents in today's society will have on their children's survival and reproductive success. To the extent that we succeeded in isolating a mutation-driven effect of paternal age, our results can be understood to show that de novo mutations reduce offspring fitness across populations and time periods. PMID:28904145

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